JP5571580B2 - 低剛性の整形外科部品 - Google Patents
低剛性の整形外科部品 Download PDFInfo
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- JP5571580B2 JP5571580B2 JP2010545156A JP2010545156A JP5571580B2 JP 5571580 B2 JP5571580 B2 JP 5571580B2 JP 2010545156 A JP2010545156 A JP 2010545156A JP 2010545156 A JP2010545156 A JP 2010545156A JP 5571580 B2 JP5571580 B2 JP 5571580B2
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- A61F2310/00005—The prosthesis being constructed from a particular material
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Description
本願は、2008年11月13日に出願された名称「ORTHOPEDIC COMPONENT OF LOW STIFFNESS」の米国仮出願第61/104,870号、2008年3月20日に出願された名称「ORTHOPEDIC COMPONENT OF LOW STIFFNESS」の米国仮出願第61/038,281号、2008年1月30日に出願された名称「ACETABULAR COMPONENT」の米国仮出願第61/024,737号、及び2008年1月30日に出願された名称「ACETABULAR COMPONENT」の米国仮出願第61/024,778号(これらの全開示内容は、参照により明確に本明細書に援用される。)の米国特許法119(e)に基づく利益を請求する。
本発明は、整形外科用品、及び特に整形外科用インプラントに関する。
完全股関節形成術などの整形外科手術中に、整形外科用人工装具が、患者の身体中に埋め込まれる。例えば、大腿骨ステムは、患者の大腿の骨髄内管中に埋め込まれることができる。ステムが好ましい深さ及び方向で骨髄内管中に挿入された後に、大腿骨頭は、ステムの近位端に取り付けられることができる。大腿骨頭は、寛骨臼人工装具の実質的に半球形のソケットに適合して、大腿骨頭と寛骨臼人工装具の咬合のために面を提供する。
本発明、典型的な一実施形態では、整形外科部品がインプラントされる骨の弾性により厳密に近づけるために、既知の整形外科部品の弾性よりも実質的に低い全体的な弾性を提供するために選択される多層を有する整形外科部品を提供する。典型的な一実施形態では、整形外科部品は、寛骨臼シェルである。例えば、寛骨臼シェルは、患者の元の臼蓋窩へ固定するために構成された外層、及び寛骨臼ライナーを受け入れるように構成された内層を含んでよい。元の股関節の機能を再現するために、大腿骨人工装具の頭部は、寛骨臼ライナーと関節接合する。また、寛骨臼シェルの内層は、大腿骨人工装具の頭部が関節接合する一体の寛骨臼ライナーとして機能してよい。
図1に示すように、整形外科部品は、寛骨臼シェル10として表される。寛骨臼シェルに対する特定の符号によって本明細書では説明及び描写されているが、本発明の整形外科部品は、肩人工装具系に使用されるための関節部品などの任意の整形外科部品でよい。寛骨臼シェル10は、実質的に半球形を有し、かつ第一の外側の骨に接触する層12、並びに対応する大腿骨整形外科部品及び/又は元の大腿骨頭が接合する第二の内層14を含む。典型的な一実施形態では、第二の内層14は、追加の寛骨臼ライナー(図3)が位置してよい面を提供する。さらに、寛骨臼人工装具10は、当技術分野で知られているような任意の適切な形状(例えば、半球形など)を有してよく、かつ一般に、前述の通り、本発明の譲受人に譲渡された名称「FEMORAL HEAD ASSEMBLY WITH VARIABLE OFFSET」の米国特許第7,306,629号明細書(その全開示内容が参照により全体で本明細書に明確に援用される)に開示されている大腿骨頭集成体などの大腿骨頭集成体と結合するように構成されている。同様に、人工装具10は、本発明の譲受人に譲渡された名称「ACETABULAR CUP」の米国特許第5,879,398号明細書(その全開示内容が参照により全体で本明細書に明確に援用される)に開示されているものと類似する形状を有してよい。
PEEK層/多孔質層構造物の有効剛性
分析モデルを使用して、多孔質金属の層と隣接して配置されたPEEK層の有効剛性を研究した。
PEEK層/多孔質層剛性における寛骨臼カップ形状の影響
有限要素(FE)モデルを使用して、多孔質金属の層と相互咬合しているPEEK層を有する理想的な寛骨臼の尻カップモデルの有効剛性を研究した。
多孔質金属/UHMWPE整形外科部品における層厚の影響
2D確率的微細構造FEモデルを開発して、多孔質金属層と相互咬合しているUHMWPE層を有する理想的な寛骨臼の尻カップを示した。内形状は、FORTRANのカスタムプログラムによって発生した2Dランダムボロノイ構造を基準とした。また、このプログラムは、異なる設計を作るために、3個の層、すなわちUHMWPE層、相互咬合層、及び多孔質金属層の厚さをパラメータ的に変えることを可能にする。タンタル微細構造(例えば、Trabecular METAL(商標)技術を用いて形成された材料中に形成されたものなど)は、図2aに示したように、結ばれていない先端を有し、かつ多孔質金属層の周辺を規定している靭帯16の部分である。図7に示したように、これらのタンタル微細構造を双線形弾性材料としてモデル化し、一方で、図8に示したように、多重線形弾性材料としてUHMWPEをモデル化した。さらに、本明細書で説明するように、モデルに使用されたUHMWPEの様々な特性は、酸化防止安定化された架橋UHMWPEの特性と一致する。FEモデルに使用された要素は、二次変位挙動を有する8個のノードの二次要素であり、かつ2Dの不規則メッシュをモデル化するのに最適であるPLANE183であった。したがって、一般に、生成したFEモデルは、50,000個以上の要素を含んでいた。モデルを調製して直ぐに、図9に示したように、非拘束圧縮負荷条件を用いて一軸圧縮をシミュレートした。非拘束圧縮は、荷重が掛けられているものと反対の方向への自由な寸法変化を許可する。図9には、x軸と平行な横寸法の次元δ1の変化を示す。このオブジェクトは、y軸と平行な縦寸法に変形するのは自由である。
層の厚さにおける酸化防止剤安定化の影響
上記実施例3で開発された先のFEモデルを用いて、多孔質金属及び従来のUHMWPE(すなわち、酸化防止安定化されていないUHMWPE)を用いるUHMWPEの設計を、酸化防止安定化UHMWPE(すなわち、ビタミンEなどの酸化防止剤を組み込んでいるUHMWPE)を用いる多孔質金属及びUHMWPE設計と比較した。多孔質金属の多孔度を82%であると仮定した。多線形材料(図5に示したように、酸化防止安定化UHMWPEが、従来のUHMWPEより低い弾性率を有するが、高い降伏応力を有することを示す)として、従来のUHMWPE及び酸化防止安定化UHMWPEの両方をモデル化した。全モデルを一軸圧縮下としてシミュレートしたところ、全モデルの形状は同一であった。さらに、モデルでは、従来のUHMWPE及び酸化防止安定化UHMWPE層の両方の厚さが3.5mmであり、そして多孔質金属層の厚さは3.0mmであった。
α−トコフェロールアセテートの実行可能性研究
下記で説明される様々な実施例5〜13を通して、照射されたUHMWPE混合物(すなわち、酸化防止安定化された架橋UHMWPE)を使用したが、それらは、3つの異なる照射法の1つに従って照射された。下記実施例で使用されたように、用語「UHMWPE混合物」とは、酸化防止安定化UHMWPEをいうか、又は架橋照射を受けさせた後の酸化防止安定化UHMWPEをいうものとして使用されるならば、酸化防止安定化された架橋UHMWPEをいう。上記で説明したように、照射条件と技術の差は、UHMWPE混合物の得られた材料特性に影響するであろう。したがって、実施例及び対応する表で説明される結果を適切に分析して比べるために、関連する場合には、下記表8で説明される方法の1つによって照射されているように、下記実施例で使用される照射されたUHMWPE混合物のそれぞれを示した。さらに、低い照射線量で線量測定を実行して、次に、より高い線量を達成するのに必要な電子ビーム源の活性化をパラメータ的に決定することにより、電子ビーム源を調整する。結果として、より高い照射線量で、実際の線量とパラメータ的に決定された線量の間に差が存在し、それは、照射されたUHMWPE混合物の材料特性における差をもたらすであろう。
トコフェロールを有するUHMWPE混合物の化学特性
バー状に成形され、かつ電子ビームを照射されたUHMWPE粉末と機械的に混合されたd/l−α−トコフェロールの化学特性を調査した。この調査を実行するために、ミネソタ州ミネアポリスのスタット・イーズ(Stat−Ease)社製Design Expert6.0.10ソフトウェアを利用して、実験の改良された一部実施要因計画(DOE)を立てた。DOEでは、5つの異なる値:UHMWPE樹脂種、d/l−α−トコフェロールの質量%、予熱温度、線量率、及び照射線量を評価した。
d/l−α−トコフェロールと混合されたUHMWPEの機械特性
バー状に成形され、かつ電子ビームを照射されたUHMWPE粉末と機械的に混合されたd/l−α−トコフェロールの機械特性を調査した。この調査を実行するために、ミネソタ州ミネアポリスのスタット・イーズ社製Design Expert6.0.10ソフトウェアを利用して、実験の改良された一部実施要因計画(DOE)を立てた。DOEでは、5つの異なる値:UHMWPE樹脂種、d/l−α−トコフェロールの質量%、予熱温度、線量率、及び照射線量を評価した。
d,l−α−トコフェロールと混合されたUHMWPEの磨耗性状
d/l−α−トコフェロールと機械的に混合され、かつ電子ビームを照射されたUHMWPEの磨耗性状を調査した。この調査を実行するために、ミネソタ州ミネアポリスのスタット・イーズ(Stat−Ease)社製Design Expert6.0.10ソフトウェアを利用して、実験の改良された一部実施要因計画(DOE)を立てた。DOEでは、5つの異なる値:予熱温度、線量率、全照射線量、d,l−α−トコフェロール濃度、及び冷却期間、すなわち、予熱の終了から照射に対する初期曝露までの経過時間を評価した。
UHMWPE混合物/基板接合部分での温度変化
ケンタッキー州フローレンスに北米本社を有するティコナ社からGUR1050医療グレードのUHMWPE粉末を得た。DSMニュートリショナル・プロダクツ社(オランダ、ヘレーン)からd/l−α−トコフェロールを得た。イリノイ州ガーニーのアイリッヒ・マシーンズ社製高強度ミキサーを用いて、GUR1050をd/l−α−トコフェロールと機械的に混合した。GUR1050樹脂をd/l−α−トコフェロールと混合して、0.2質量%のd/l−α−トコフェロールを有するUHMWPE混合物を形成した。
UHMWPE混合物における基板方向の影響
ケンタッキー州フローレンスに北米本社を有するティコナ社からGUR1050医療グレードのUHMWPE粉末を得た。DSMニュートリショナル・プロダクツ社(オランダ、ヘレーン)からd/l−α−トコフェロールを得た。イリノイ州ガーニーのアイリッヒ・マシーンズ社製高強度ミキサーを用いて、GUR1050をd/l−α−トコフェロールと機械的に混合した。GUR1050樹脂をd/l−α−トコフェロールと混合して、0.5質量%のd/l−α−トコフェロールを有するUHMWPE混合物を形成した。
UHMWPE混合物における照射線量の影響
ミネソタ州ミネアポリスのスタット・イーズ社製Design Expert6.0.10ソフトウェアを利用して、実験の中心複合反応面計画(DOE)をセットアップした。DOEによって、4つの異なる値:d,l−α−トコフェロール濃度、予熱温度、与えられた全照射線量、及び1パス当たりの照射線量を評価した。
膨潤比、架橋密度、及び架橋間の分子量
GUR1050医療グレードのUHMWPE粉末をケンタッキー州フローレンスに北米本社を有するティコナ社から得た。DSMニュートリショナル・プロダクツ社(オランダ、ヘレーン)からd/l−α−トコフェロールを得た。イリノイ州ガーニーのアイリッヒ・マシーンズ社製高強度ミキサーを用いて、GUR1050をd/l−α−トコフェロールと機械的に混合した。GUR1050樹脂をd/l−α−トコフェロールと混合して、0.2、0.5、又は1.0質量%のd/l−α−トコフェロールを有するUHMWPE混合物を形成した。次に、UHMWPE混合物を圧縮成形してパックを形成し、次にパックを機械加工して、5mm辺を有する立方体を形成した。次に、4O℃、100℃、及び11O℃から選択した予熱温度にUHMWPE立方体を加熱した。選択した予熱温度に加熱したら直ぐに、上記表8で説明する方法Cを用いて、全照射線量を受けるまで、UHMWPE混合物に照射した。90kGy、120kGy、150kGy、及び200kGyから全照射線量を選択した。
d/l−α−トコフェロールと混合されたUHMWPE中のフリーラジカル濃度
電子ビーム照射されたUHMWPE混合物成形パックのフリーラジカル濃度におけるd/l−α−トコフェロールをUHMWPE粉末と機械的に混合する影響を調査した。この調査を行なうために、ミネソタ州ミネアポリスのスタット・イーズ社製Design Expert6.0.10ソフトウェアを利用して、実験の改良された中心複合計画(DOE)をセットアップした。DOEによって、5つの要因:予熱温度、線量率、照射線量、d/l−α−トコフェロール濃度、及び所定の保持時間、すなわち、オーブンからのUHMWPE混合物の取り出しから電子ビーム照射の開始までに経過した時間を評価した。
金属裏張寛骨臼カップの疲労挙動におけるUHMWPEの厚さの影響
金属裏張寛骨臼カップ設計において酸化防止安定化UHMWPE層の厚さを減らす影響を調査した。
Claims (9)
- 股関節置換術に使用するために構成された寛骨臼部品であって、寛骨臼部品が:
寛骨臼部品がインプラントされるときに骨組織と接触して接合するように構成された多孔質層;
酸化防止安定化架橋超高分子量ポリエチレンから形成され、6mm未満の厚さを有し、かつ大腿骨部品を受け入れるように構成された内層;及び
前記内層の前記酸化防止安定化架橋超高分子量ポリエチレンが前記多孔質層の細孔に浸透する距離によって規定された相互咬合層
を含み、かつ0.1GPa〜15GPaの有効剛性を有し、
前記酸化防止安定化架橋超高分子量ポリエチレンは、以下の工程:
超高分子量ポリエチレンと酸化防止剤とを合わせて、混合物を形成する工程;
前記混合物を固化処理して、融点を有する固化混合物を形成する工程;
前記固化混合物を、前記固化混合物の前記融点より低い予熱温度へ予熱する工程;及び
予熱された固化混合物を前記固化混合物の前記融点より低い温度に維持しながら、前記予熱された固化混合物に光を照射する工程;
を含む方法により製造され、かつ
前記酸化防止剤は、前記酸化防止安定化架橋超高分子量ポリエチレンの全体に亘って均質に分布している、
寛骨臼部品。 - 前記内層が2mmと実質的に等しい厚さを有する、請求項1に記載の寛骨臼部品。
- 前記多孔質層が少なくとも55%の多孔度を有する、請求項1に記載の寛骨臼部品。
- 前記多孔質層が15GPa未満の弾性率を有する多孔質金属により規定されている、請求項1に記載の寛骨臼部品。
- 0.1GPa〜10GPaの有効剛性をさらに含む、請求項1に記載の寛骨臼部品。
- 0.3GPa〜1.5GPaの有効剛性をさらに含む、請求項1に記載の寛骨臼部品。
- 骨中へのインプラントのための整形外科部品の製造方法であって、整形外科用インプラントが骨接触層、相互咬合層、及び内層を有し、該製造方法が:
骨の弾性率を決定する工程;
骨の弾性率に基づいて、骨接触層、相互咬合層、及び内層の少なくとも1つの厚さを選択する工程;並びに
内層を骨接触層に合わせて、選択した厚さを有する骨接触層、相互咬合層、及び内層の少なくとも1つを形成する工程
を含み、該整形外科部品は、0.1GPa〜15GPaの有効剛性を有し、
該内層は、酸化防止安定化架橋超高分子量ポリエチレンから形成され、該酸化防止安定化架橋超高分子量ポリエチレンは、以下の工程:
超高分子量ポリエチレンと酸化防止剤とを合わせて、混合物を形成する工程;
前記混合物を固化処理して、融点を有する固化混合物を形成する工程;
前記固化混合物を、前記固化混合物の前記融点より低い予熱温度へ予熱する工程;及び
予熱された固化混合物を前記固化混合物の前記融点より低い温度に維持しながら、前記予熱された固化混合物に光を照射する工程;
を含む方法により製造され、かつ
前記酸化防止剤は、前記酸化防止安定化架橋超高分子量ポリエチレンの全体に亘って均質に分布している、製造方法。 - 厚さを選択する工程の後に、骨の弾性率に基づいて、骨接触層、相互咬合層、及び内層の少なくとも1つとは別の層の厚さを選択する工程をさらに含む、請求項7に記載の方法。
- 骨接触層が多孔質金属を含む、請求項7に記載の方法。
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