JPH05200058A - Spacer used in operation for joint section - Google Patents

Abstract

PURPOSE:To smooth the sub-dislocation state or the like of a joint section using an organism affinitive material, and obviate an operation to take out a wire from a body by forming a spacer body to be inserted in a gap at the joint section and a pin to fix the spacer body to an ilium, respectively with the organism affinitive material. CONSTITUTION:The section of a pelvis 1 in a human body comprises a hipbone joint section 3, a thighbone condyle 5, a thighbone 7 and the like. In this case, a joint section 3A is preliminarily cut and separated from a bone, and a bone gap 21 is formed in smoothing the sub-location state of a hip joint and the improper formation of a joint. Then, the insertion section 2701 of a spacer body 27 in a spacer 23 used for an operation to form a proper joint section is first inserted in the gap 21, and the flange 2703 of the body 27 is kept in contact with the outside 1A-1 of an iliac wall 1A. Then, a hole 31 of small diameter leading from the hole 2705 of the flange 2703 to the outside 1A-1 of the wall 1A is drilled, and a pin 29 is driven in the holes 2705 and 31, thereby fixing the spacer body 27. Subsequently, the deep area of the gap 21 is filled with a small natural own bone piece 25, thereby completing a joint smoothing operation.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a spacer used for correcting subluxation and acetabular malformation of a hip joint in a human body.

[0002]

2. Description of the Related Art In hip subluxation, for example, as shown in FIG. 6, the shape of the acetabular cover 3 formed on the pelvis 1 is incomplete, and the femoral head 5 is placed in the acetabular cover 3. When it occurs in an unacceptable state in good condition and subluxation occurs, the articular cartilage between the acetabulum 3 and the epiphysis 5 becomes worn, causing pain and limitation of movement, and finally becoming unable to walk. As a surgical method for compensating for the dislocation due to the imperfect shape of the acetabular lid 3, as shown in FIGS. 6 and 7, a spacer 9 shaped into an optimum shape is prepared in advance, and a dotted line 11 (FIG. 6, FIG. 6). As shown in FIG. 7), the acetabular portion 3A is cut and the head 5 is moved inward and downward, and the acetabular portion 3A is moved outward and forward so as to cover the head 5 sufficiently. The spacer 9 is interposed in the bone gap 13 generated by the movement of 3A, the crushed bone 15 is filled in the inner portion of the remaining bone gap 13, and the acetabular portion 3A is fixed at an appropriate position to wait for bone union. Is being carried out.

Conventionally, iliac bones, fibula, etc. have been used as the spacer 9. However, the surgical invasion is increased by collecting the transplanted bone, and the acetabular portion 3A may not be held at an appropriate position due to crushing due to bone resorption or the like. In most cases, autologous bone is taken from the iliac crest when the spacer 9 is manufactured,
Since the iliac crest is the origin of the gluteus medius muscle, the muscular strength of the gluteus medius muscle is weakened by bone collection, resulting in a loss of muscle balance in the lower limbs, leading to Trendenburg lameness based on Powell's theory. There is also a problem that it is easy.

Therefore, the spacer 9 is made of a ceramic made of a biocompatible material such as alumina or apatite, and the bone gap 1 generated by the movement of the acetabular portion 3A is prepared.
An operation method of inserting the spacer 9 into 3 has also been proposed.

[0005]

According to this method, although the above problems can be solved, the spacer 9 is fixed so that the spacer 9 does not separate from the bone gap 13 until the spacer 9 is fused with the bone. It is necessary to keep it. Therefore, when performing this operation, the iliac wall 1A, the acetabular portion 3A,
Holes are provided in the spacer 9 in a direction substantially orthogonal to the insertion direction of the spacer 9, and the spacer 9 is fixed by the wire 17 penetrating these holes.

Therefore, according to this technique, the wire 17
Is extended in a direction substantially orthogonal to the insertion direction of the spacer 9, and the wire 17 is difficult to be made of a biocompatible material. After the spacer 17 is fused with bone and fixed, the wire 17 is re-operated. There was a problem that I had to take out my body. The present invention has been devised in view of the above circumstances, and an object of the present invention is to use a biocompatible material to compensate for subluxation, and further, a mortar that does not require surgery for taking the wire out of the body. To provide a lid-forming spacer.

[0007]

In order to achieve the above object, the present invention has a predetermined thickness and length which are formed of a biocompatible material and which are inserted into a bone gap in which the acetabular portion is cut and separated. Formed of a biocompatible material, and a spacer main body made of a flange connected to the end of the insertion portion and abutting against the outer side of the iliac wall in a state where the insertion portion is inserted into the gap, It is characterized by comprising a pin which penetrates the flange and is implanted in the iliac wall in a state of being in contact with the outside of the iliac wall.

[0008]

Embodiments of the present invention will be described below with reference to the accompanying drawings. FIG. 1 is an enlarged view of a pelvis portion corrected by a spacer for acetabular surgery according to an embodiment. 1 is a pelvis, 3 is an acetabular acetabulum, 5 is a femoral head, 7 is a femur, and the acetabular acetabular portion 3A is rotated and pulled down to form a bone gap 21. A plastic surgery spacer 23 is attached, and at the back of the bone gap 21, a piece 25 of autologous bone is attached.
Is filled. The spacer 23 is the bone gap 21.
Spacer body 27 to be inserted into the spacer body 2 and the spacer body 2
And a pin 29 for fixing 7 to the pelvis 1.

The spacer body 27 is made of a material having excellent biocompatibility, such as ceramics such as alumina, apatite and calcium phosphate, and metals such as titanium and zirconium. In the embodiment, the spacer body 27 is formed of an apatite porous body. The spacer body 27 has a predetermined thickness corresponding to the bone gap 21, as shown in a sectional side view of FIG. 2, a view of arrow A of FIG. 2 in FIG. 3, and a view of arrow B of FIG. 2 in FIG. It is composed of an insertion portion 2701 and a flange 2703 extending a predetermined length. As shown in FIG. 2, the insertion portion 2701 has a spherical surface 2701A of which _one surface in the thickness direction has a radius R ₁ centered on O _1.
Is formed in a concave shape. Further, as shown in FIG. 2, the other surface in the thickness direction is centered on O _{2 and} has the radius R ₁
A circular arc having a larger radius R ₂ and, as shown in FIG. 4, its cross section is formed by a curved surface 2701B having a radius R ₃ smaller than the radius R ₁ centered on O ₃ .

The flange 2703 is bulged from the end of the insertion portion 2701, and a hole 2705 is formed at the center of the flange 2703 so as to extend substantially parallel to the extending direction of the insertion portion 2701. As shown in FIG. 4, the end surface of the flange 2703 has a radius R ₃ of the same dimension as that of the curved surface 2701B and is O.
It is formed by a cylindrical surface 2703B centered on ₄ .

Similar to the spacer body 27, the pin 29 is made of a material having excellent biocompatibility, and is made of a dense apatite body in the embodiment. As shown in the side view of FIG. 5, the pin 29 is composed of a cylindrical portion 2901A having an outer diameter corresponding to the hole 2705 and a conical taper portion 2901B having a cross-sectional area that decreases toward the tip. .

To correct the subluxation, the acetabular portion 3A is cut into bones and separated from each other, and the insertion portion 2701 is inserted into the bone gap 21 formed by the separation of the acetabular portion 3A to form the flange 27.
03 is brought into contact with the outer side 1A-1 of the iliac wall 1A, and the flange 2
After making a small-diameter hole 31 from the hole 2705 of 703 to the outer side 1A-1 of the iliac wall 1A, the pin 29 is inserted into these holes 2705.
The spacer main body 27 is fixed by driving it into 31, and then, the inner part of the bone gap 21 is filled with the strip 25 of the autologous bone to complete the correction operation.

As described above, according to the present embodiment, the patient can be relieved of the burden of autologous bone collection when compensating for a high dislocation, and damage to the gluteus medius muscle due to cutting of the iliac crest can be avoided. Further, the spacer body 27 and the pins 29 are made of apatite so as not to be absorbed into the bone, and a large number of dislocation adjusting spacers 23 having an arbitrary size can be prepared in advance. Moreover, compared with the method using a wire, unnecessary holes formed in the pelvis 1 can be shortened as much as possible,
Since the spacer body 27 and the pin 29 are fused with bone and may remain in the body, it is possible to omit a surgery to be taken out of the body later.

In the embodiment, the case where one flange 2703 is formed has been described, but the number and shape of the flanges 2703 are arbitrary.

[0015]

As is clear from the above description, the use of the acetabular spacer according to the present invention relieves the patient from the burden of autologous bone harvesting and damage of the gluteus medius muscle due to cutting of the iliac crest. It is also possible to avoid the bone resorption and prevent bone resorption, and it is also possible to omit the operation for taking the wire out of the body after the subluxation is completely cured.

[Brief description of drawings]

FIG. 1 is an enlarged view of a pelvis portion corrected by a spacer according to an embodiment.

FIG. 2 is a side view of a spacer body.

FIG. 3 is a view on arrow A in FIG.

FIG. 4 is a view on arrow B of FIG.

FIG. 5 is a side view of the pin.

FIG. 6 is an explanatory diagram of a subluxation state.

FIG. 7 is a diagram showing a state of dislocation compensation according to a conventional technique.

[Explanation of symbols]

 1 Pelvis 3 Acetabulum 5 Femoral head 7 Femur 21 Space 23 Spacer 27 Spacer body 29 Pin 2701 Insertion part 2703 Flange

Claims (1)

[Claims] 1. An insertion part, which is made of a biocompatible material, has a predetermined thickness and length and is inserted into a bone gap in which an acetabular portion is cut into bones and is separated, and is connected to an end portion of the insertion part. And a spacer body formed of a biocompatible material, the spacer main body being in contact with the outside of the iliac wall when the insertion portion is inserted into the gap, and the flange being in contact with the outside of the iliac wall. A acetablasty spacer comprising: a pin that penetrates the flange and is implanted in the iliac wall.