KR101848406B1 - 인공고관절용 스템 및 스템 설치 방법 - Google Patents

인공고관절용 스템 및 스템 설치 방법 Download PDF

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Publication number
KR101848406B1
KR101848406B1 KR1020160135826A KR20160135826A KR101848406B1 KR 101848406 B1 KR101848406 B1 KR 101848406B1 KR 1020160135826 A KR1020160135826 A KR 1020160135826A KR 20160135826 A KR20160135826 A KR 20160135826A KR 101848406 B1 KR101848406 B1 KR 101848406B1
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KR
South Korea
Prior art keywords
stem
fixing
head
hip joint
movable pin
Prior art date
Application number
KR1020160135826A
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English (en)
Inventor
김두만
김현덕
Original Assignee
주식회사 케이씨스
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Priority to KR1020160135826A priority Critical patent/KR101848406B1/ko
Application filed by 주식회사 케이씨스 filed Critical 주식회사 케이씨스
Priority to MX2019003973A priority patent/MX2019003973A/es
Priority to BR112019006901A priority patent/BR112019006901A2/pt
Priority to AU2017346076A priority patent/AU2017346076B2/en
Priority to CA3045166A priority patent/CA3045166C/en
Priority to US16/341,030 priority patent/US11141280B2/en
Priority to IL265878A priority patent/IL265878B2/en
Priority to CN201780061404.3A priority patent/CN110035715B/zh
Priority to EP17862527.3A priority patent/EP3530237B1/en
Priority to JP2019517356A priority patent/JP6881789B2/ja
Priority to RU2019110229A priority patent/RU2721295C1/ru
Priority to PCT/KR2017/000012 priority patent/WO2018074667A1/ko
Application granted granted Critical
Publication of KR101848406B1 publication Critical patent/KR101848406B1/ko

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  • Health & Medical Sciences (AREA)
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  • Surgery (AREA)
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  • Prostheses (AREA)

Abstract

본 발명에 인공고관절용 스템 및 스템 설치 방법에 관한 것으로, 그 구성은 대퇴골두 또는 비구가 손상되어 이를 대체하기 위해 사용되는 인공고관절용 스템에 있어서, 상기 인용고관절용 스템은, 상부에 헤드를 고정하는 헤드 고정부가 돌출되며, 상측을 수평 개구된 동작공간과, 상기 동작공간과 연결되도록 수직 관통된 머리삽입공이 구성된 스템몸체; 상기 머리삽입공에 삽입되어 회전하는 나사부; 상기 동작공간에 삽입되어 나사부와 연결된 상태로 나사부에 의해 수직 운동하는 동작변환부; 상기 동작공간 내에 삽입되어 상기 나사부가 깊이 변화없이 회전하도록 고정하는 고정브라켓; 상기 스템몸체의 지지면에 삽입되어 동작변환부의 동작에 의해 수평 방향 폭을 조절하게 하는 가변동작부; 및 상기 가변동작부를 동작변환부에 고정시키는 가동핀;을 포함한다.

Description

인공고관절용 스템 및 스템 설치 방법{A stem for artificial hip joint and stem install method}
본 발명은 인공고관절용 스템 및 스템 설치 방법에 관한 것으로, 더욱 상세하게는 인공고관절 중 대퇴골에 삽입되는 스템에 관한 것으로 스템이 분리 가능하고 축소 및 확장될 수 있는 구조를 갖게 함으로써 대퇴골에 삽입시 스템을 통해 대퇴골에 가해지는 충격을 최소로 발생할 수 있게 하고 제거시에도 쉽게 제거될 수 있게 하는 인공고관절용 스템 및 스템 설치 방법에 관한 것이다.
고관절은 골반과 대퇴골을 잇는 관절, 골반의 관골구와 대퇴골두 사이에 끼어 있는 관절로 상지의 견관절에 해당되며, 둥근 대퇴골두가 관골구에 끼여 있으므로 저구과절에 속한다.
이러한 고관절은 많은 사용에 따라 대퇴골두와 관골구 사이에 있는 연골이 손상되어 염증이 발생하는 것이 가는 빈번한 형태로 통상 고관절 골관절염이라고 한다.
현재의 고관절 골관절염의 치료에는 고관절의 윤활을 보조하고, 고관절 수술을 통해 고관절의 부분을 인공 기관으로 교체하는 것을 보조하기 위해 NSAID dir, 히알루론산 또는 당질코르티코이드의 국부적 주입이 포함된다.
또한 고관절의 골절이나 퇴화 등으로 인해 사용할 수 없게 되는 경우에는 관절 대체술(joint replacement surgery)을 이용해 치료하게 되는데, 해부학상으로 둔부는 구상관절이고, 여기서 "볼(ball)" 즉, 대퇴골 관절은 골반의 컵 형상의 소켓에 삽입 결합된다. 따라서 이러한 뼈들이 연화(ossifluece)되거나 부러지는 경우 고관절 임플란트가 외과적으로 삽입되어 고관절의 손상된 천연 뼈와 연골을 대체한다.
본질적으로 고관절 임플란트는 도 1에 도시된 바와 같이 구조적으로 4개의 다른 부분들을 구비한다.
천연 관골구(힙 소켓)를 대체하는 비구 "캡" 또는 "셀"로도 알려진 비구 삽입 임플란트, 컵의 내면을 덮고 일반적으로 폴리우레탄, 세라믹 또는 금속으로 제조된 라이너, 천연 대퇴골의 샤프트 속으로 삽입되어 대퇴골 경부를 대체하여 재건된 관절을 위한 안정성과 이동을 제공하는 금속 스템, 천연 대퇴골의 경부를 대체하는 금속 또는 세라믹 볼 등이다.
이러한 인공고관절은 기존의 대퇴골두 및 비구를 대체하기 위하여 스템은 대퇴골두를 일부 절단하여 그 절단된 대퇴골두에 구멍을 뚫어 스템을 삽입하여 고정하고, 쉘 또한 골반골의 비구를 일부 절단하여 대체하게 된다.
또한 종래의 경우 스템을 대퇴골에 삽입할 때에는 스템의 외경보다 대퇴골에 형성된 구멍의 직경을 작게 형성하여 대퇴골에 스템을 억지로 끼워 삽입하는 방식으로 결합하게 된다.
그러나 종래의 스템을 삽입하는 방식으로 대퇴골에 스템을 고정할 경우 억지 끼움에 의해 대퇴골에 강한 충격을 주어 노인 등과 같이 대퇴골의 골 밀도가 약한 경우 스템 삽입 과정에 대퇴골이 손상되는 등의 문제점이 있었다.
즉, 인공고관절이 초기 강한 고정력을 유지하기 위해서는 대퇴골과의 밀착력을 높여야 하기 때문에 스템의 직경 보다 대퇴골의 구멍을 작게 형성하므로 발생하는 문제점이다.
또한 대퇴골에 형성된 구멍을 스템 보다 작게 형성하여 억지 끼움으로 설치하여야 하나 실질적으로 구멍의 크기가 모두 작게 형성되지 않아 스템 보다 큰 구멍에 의해 수술이 실패하는 경우도 빈번히 발생하는 문제점이 있었다.
그리고 인공고관절은 그 사용 시기에 따라 향 후 재수술 등을 고려하지 않을 수 없기 때문에 설치된 인공고절관절 제거를 위한 방법이 모색되어야 하나 종래의 경우 이미 설치된 인공고관절을 제거하기 매우 어려운 문제점이 있었다.
이는 설치된 인공고관절은 시간이 경과 함에 따라 뼈의 성장에 의해 상호 고착화되거나 또는 골용해 문제로 인공고관절을 시술한 환자의 재수술이 필요한 경우 등에서 인공고관절을 분리하기 매우 어려워지게 되는 것이다.
이러한 인공고관절에 관한 종래 기술로서 공개특허 제10-2005-0100511호, 공개특허 제10-2005-0100512호 및 공개특허 제10-2008-0084930호 등이 개시되어 있으며, 수술 방법 등에 관한 기술로서 공개특허 제10-2012-0085239호, 공개특허 제10-2012-0062706호 및 공개특허 제10-2014-0128939호가 개시되어 있으며, 이러한 종래의 기술들은 앞선 문제점들을 내포하고 있다.
선행기술문헌 1 : 제10-2005-0100511호
선행기술문헌 2 : 제10-2005-0100512호
선행기술문헌 3 : 제10-2008-0084930호
선행기술문헌 4 : 제10-2012-0085239호
선행기술문헌 5 : 제10-2012-0062706호
선행기술문헌 6 : 제10-2014-0128939호
본 발명의 목적은 상기한 바와 같은 종래의 특성을 개선하기 위하여 제안된 것으로서, 인공고관절 중 대퇴골에 삽입되는 스템에 관한 것으로 스템이 분리 가능하고 축소 및 확장될 수 있는 구조를 갖게 함으로써 대퇴골에 삽입시 스템을 통해 대퇴골에 가해지는 충격을 최소로 발생할 수 있게 하고 제거시에도 쉽게 제거될 수 있게 하는 인공고관절용 스템 및 스템 설치 방법을 제공함에 있다.
또한 본 발명의 다른 목적은 삽입된 스템을 분리할 수 있게 함으로써 재수술시 분리되는 부분만을 제거하여 시술할 수 있거나 인공고관절을 완전히 제거하는데 용이하여 시술에 소요되는 시간과 더불어 시술에 따른 환자의 고통과 부작용을 감소할 수 있는 인공고관절용 스템 및 스템 설치 방법을 제공함에 있다.
본 발명은 앞서 본 목적을 달성하기 위하여 다음과 같은 구성을 가진다.
본 발명의 대퇴골두 또는 비구가 손상되어 이를 대체하기 위해 사용되는 인공고관절용 스템에 있어서, 상기 인공고관절용 스템은, 상부에 헤드를 고정하는 헤드 고정부가 돌출되며, 상측에 수평 개구된 동작공간과, 상기 동작공간과 연결되도록 수직 관통된 머리삽입공이 구성된 스템몸체; 상기 머리삽입공에 삽입되어 회전하는 나사부; 상기 동작공간에 삽입되어 나사부와 연결된 상태로 나사부에 의해 수직 운동하는 동작변환부; 상기 동작공간 내에 삽입되어 상기 나사부가 깊이 변화없이 회전하도록 고정하는 고정브라켓; 상기 스템몸체의 지지면에 삽입되어 동작변환부의 동작에 의해 수평 방향 폭을 조절하게 하는 가변동작부; 및 상기 가변동작부를 동작변환부에 고정시키는 가동핀;을 포함한다.
그리고 상기 가변동작부는 상단과 하단이 서로 다르게 확장되며, 상기 가변동작부는 상단이 하단보다 더 많이 확장된다.
또한 상기 동작변환부는 나사부에 의한 승하강시 안내공에 의해 가동핀을 곡선 운동시킨다.
그리고 상기 가동핀은 동작변환부에 경사지게 배치된다.
또한 상기 동작변환부의 안내공과 가동핀의 외주면은 길이 방향으로 곡선된 형태이다.
그리고 상기 안내공과 가동핀은 가변동작부의 확장 방향으로 반경을 형성하며 곡선된다.
또한 상기 곡선운동은 다음의 식에 의해 결정된다.
-다 음-
(1)
Figure 112016101478754-pat00001
(2)
Figure 112016101478754-pat00002
(3)
Figure 112016101478754-pat00003
(4)
Figure 112016101478754-pat00004
(5)
Figure 112016101478754-pat00005
(6)
Figure 112016101478754-pat00006
(7)
Figure 112016101478754-pat00007
(8)
Figure 112016101478754-pat00008
(9)
Figure 112016101478754-pat00009
(10)
Figure 112017128090316-pat00010

(11)
Figure 112017128090316-pat00075

(12)
Figure 112017128090316-pat00076

(13)
Figure 112017128090316-pat00077
(14)
Figure 112017128090316-pat00078
삭제
삭제
삭제
삭제
그리고 상기 스템몸체 상부에는 돌출된 칼라가 더 구비될 수 있어 칼라를 통해 절단된 대퇴골 상단 단면상에 걸쳐져 안착될 수 있게 하고 있다.
한편 본 발명은 인공고관절용 스템을 이용한 인공고관절용 스템 설치 방법으로써, 1) 스템몸체를 가공된 대퇴골두 상에 삽입하는 단계; 2) 삽입된 스템몸체의 나사부를 회전시켜 가변동작부를 스템몸체로부터 확장시키는 단계; 및 3) 외부 충격에 의해 나사부의 풀림이 방지되도록 고정하는 단계;를 포함한다.
그리고 상기 2)단계는 나사부의 회전 운동을 가동핀의 곡선운동으로 변환하여 가변동작부의 상단과 하단의 확장 폭이 다르게 한다.
또한 상기 2)단계는 가변동작부가 확장 방향으로 곡선을 형성하며 확장된다.
본 발명에 따르면, 인공고관절 중 대퇴골에 삽입되는 스템에 관한 것으로 스템이 분리 가능하고 축소 및 확장될 수 있는 구조를 갖게 함으로써 대퇴골에 삽입시 스템을 통해 대퇴골에 가해지는 충격을 최소로 발생할 수 있게 하고 제거시에도 쉽게 제거될 수 있게 하는 효과가 있다.
또한 본 발명에 따르면, 삽입된 스템을 축소 및 확장시킬 수 있도록 함으로써 재수술시 스템을 대퇴골로부터 쉽게 분리하는 것이 가능하므로 인공고관절을 완전히 제거하는데 용이하여 시술에 소요되는 시간과 더불어 시술에 따른 환자의 고통과 부작용을 감소시킬 수 있는 효과가 있다.
도 1은 종래의 일반적인 인공고관절을 나타내는 사진.
도 2는 본 발명에 따른 인공고관절용 스템을 나타내는 사시도.
도 3은 본 발명에 따른 인공고관절용 스템을 나태내는 분해 사시도.
도 4 및 도 5는 본 발명에 따른 인공고관절용 스템의 설치 상태를 나태내는 도면.
도 6은 본 발명의 인공고관절용 스템에 따른 동작 원리를 나태는 도면.
도 7은 본 발명의 인공고관절용 스템에 따른 곡선 운동을 위한 곡율 반경을 나타내는 그래프.
이하, 본 발명의 바람직한 실시 예들을 첨부된 도면을 참고하여 더욱 상세히 설명한다. 본 발명의 실시 예들은 여러 가지 형태로 변형될 수 있으며, 본 발명의 범위가 아래에서 설명하는 실시 예들에 한정되는 것으로 해석되어서는 안 된다. 본 실시 예들은 당해 발명이 속하는 기술 분야에서 통상의 지식을 가진 자에게 본 발명을 더욱 상세하게 설명하기 위해서 제공되는 것이다. 따라서 도면에 나타난 각 요소의 형상은 보다 분명한 설명을 강조하기 위하여 과장될 수 있다.
제1, 제2 등의 용어는 다양한 구성요소들을 설명하는데 사용될 수 있지만, 구성요소들은 용어들에 의해 한정되어서는 안 된다. 용어들은 하나의 구성요소를 다른 구성요소로부터 구별하는 목적으로만 사용된다.
본 출원에서 사용한 용어는 단지 특정한 실시 예를 설명하기 위해 사용된 것으로, 본 발명을 한정하려는 의도가 아니다. 단수의 표현은 문맥상 명백하게 다르게 뜻하지 않는 한, 복수의 표현을 포함한다. 본 출원에서, "포함하다" 또는 "가지다" 등의 용어는 명세서상에 기재된 특징, 숫자, 단계, 동작, 구성요소, 부품 또는 이들을 조합한 것이 존재함을 지정하려는 것이지, 하나 또는 그 이상의 다른 특징들이나 숫자, 단계, 동작, 구성요소, 부품 또는 이들을 조합한 것들의 존재 또는 부가 가능성을 미리 배제하지 않는 것으로 이해되어야 한다.
도 2 및 3에 도시된 바와 같은 본 발명의 인공고관절용 스템(100)은, 스템몸체(110), 나사부(120), 동작변환부(130), 고정브라켓(140), 가변동작부(150) 및 가동핀(160)으로 구성되어 있다.
상기 스템몸체(110)는 일정한 길이를 가지며, 하측으로 갈수록 점차 직경이 작아지는 형태를 하고 있고, 상단에서 일정한 경사각을 갖고 돌출되어 헤드(미도시)가 결속되는 헤드 고정부(111)가 구비되어 있다.
또한 상기 스템몸체(110)에는 상측 일부분이 절개되어 탈착되도록 하는 가변동작부(150)가 구비되며, 상기 가변동작부(150)가 결속되어 슬라이딩 이동될 수 있도록 상기 스템몸체(110) 측에는 상기 가변동작부(150)와 대응되는 형태의 지지면(112)이 형성되어 있고, 상기 지지면(112) 측을 일정한 길이를 갖고 수평 관통하도록 동작공간(113)이 형성되어 있으며, 상기 동작공간(113) 상측으로 연장된 형태의 삽입공간(114)이 형성되고, 상기 삽입공간(114) 측으로 연통되도록 상기 스템몸체(110) 상부로부터 수직하게 개통된 머리삽입공(115)이 형성되어 있다.
상기 스템몸체(110) 상단 일측에는 절단된 대퇴골두 상면 결착되어 지지되는 칼라(116)가 더 구비되어 있다.
그리고 상기 동작공간(113) 일측면에는 단차진 형태로 제1가이드면(113a)과 제2가이드면(113b)이 형성되어 있고, 상기 제1가이드면(113a)과 제2가이드면(113b)을 경사지게 연결하는 걸림면(113c)이 형성되어 있다.
상기 나사부(120)는 상기 스템몸체(110)의 머리삽입공(115)에 삽입되는 나사머리(121)와, 상기 나사머리(121)로부터 일정한 길이를 갖고 형성되는 수나사(122)와, 상기 나사머리(121)와 수나사(122) 사이에서 단차지게 형성되는 단턱(123a,123b)과 상기 단턱의 사이에 형성되는 삽입홈(124)으로 구성되어 있다.
상기 동작변환부(130)는 직사각형 형태를 하고 있으며, 외측 일측에는 단차진 슬라이딩면(131a,131b)이 형성되고, 상기 슬라이딩면(131a,131b)을 경사지게 연결하는 걸림면(132)이 형성되어 있으며, 내측에는 일측으로 경사지도록 일정한 길이를 갖고 수평 방향으로 개구된 안내공(133)이 형성되어 있고, 상기 안내공(133)과 연통되도록 상부로부터 개구된 암나사(134)가 형성되어 있다.
여기서 상기 안내공(133)은 경사진 방향으로 곡선진 형태를 하고 있다.
상기 고정브라켓(140)은 상기 삽입공간(114) 내에 위치되어 상기 나사부(120)의 삽입홈(124)에 삽입되어 나사부를 지지하도록 하는 것으로 한쌍의 돌기(141)와, 상기 돌기(141) 사이에 형성되는 홈(142)으로 구성되어 있다.
상기 가변동작부(150)는 상기 스템몸체(110)의 상측 일부분을 "ㄷ"자 형태로 절개하여 형성된 것으로 내측 삽입공간(151) 내에는 스템몸체(110)의 지지면(112)과 대응되는 안내면(152)이 형성되고, 수평방향으로 관통하는 한쌍의 고정공(153)이 형성되어 있다. 즉, 상기 가변동작부(150)는 스템몸체에 삽입되었을 때 스템몸체 외주면과 가변동작부 외주면이 일체화된 형태로 배치하게 된다.
여기서 상기 가변동작부의 상단과 하단은 곡선 형태를 하고 있다.
상기 가동핀(160)은 일정한 길이와 폭을 가지며 단면 형상이 타원 형태를 하고 있다. 또한 상기 가동핀은 상기 안내공(133)과 같이 곡선 형태를 하고 있어 상기 안내공(133) 내에서 슬라이딩 동작할 수 있게 하고 있다.
본 발명의 결합 상태를 보면, 먼저 동작변환부(130)의 슬라이딩면(131a,131b)가 상기 동작공간(113)의 제1가이드면(113a)과 제2가이드면(113b)에 각각 밀착되도록 삽입하여 걸림면(132)이 걸림면(113c)에 걸쳐지게 한다.
이 상태에서 머리삽입공(115) 측에 나사부(120)를 삽입하여 수나사(122)가 암나사(134)에 나사 결합되게 함과 동시에 고정브라켓(140)을 삽입공간(114)에 삽입하여 홈(142) 사이에 삽입홈(124)이 위치될 수 있게 하고 돌기(141)의 상단과 하단이 삽입홈(124)의 사이에서 단턱(123a,123b)을 지지할 수 있게 한다.
이때 상기 삽입공간(114)은 스템몸체(110)의 측면에서 일측은 개방되고 일측은 차단된 상태로 상기 동작공간(113)에서 연장 형성되어 고정브라켓(140)이 삽입되었을 때 차단된 측에 돌기가 밀착 고정될 수 있게 하고 있다.
다음으로 가변동작부(150)의 안내면(152)이 지지면(112)과 밀착되도록 스템몸체 측에 삽입하여 동작변환부(130)의 안내공(133)과 고정공(153)이 정렬되게 한 후 상기 고정공(153)과 안내공을 관통하여 가동핀(160)을 삽입 고정시킨다.
여기서 상기 안내공(133), 고정공(153) 및 가동핀(160)은 상기 가변동작부(150)의 폭 방향 확장 방향으로 곡선지고 경사진 형태이다.
상기 안내공, 고정공, 가동핀의 곡선 형태 및 가변동작부의 상단과 하단이 곡선인 것에 대하여는 아래에서 구체적으로 설명하도록 하겠다.
본 발명의 동작 상태를 설명하며 본 발명의 설치 방법을 같이 설명하도록 한다.
한편 본 발명은 인공고관절용 스템을 이용한 인공고관절용 스템 설치 방법으로써, 1) 스템몸체를 가공된 대퇴골두 상에 삽입하는 단계; 2) 삽입된 스템몸체의 나사부를 회전시켜 가변동작부를 스템몸체로부터 확장시키는 단계; 및 3) 외부 충격에 의해 나사부의 풀림이 방지되도록 고정하는 단계;를 포함하며, 상기 2)단계는 나사부의 회전 운동을 가동핀의 곡선운동으로 변환하여 가변동작부의 상단과 하단의 확장 폭이 다르게 할 수 있다.
또한 상기 2)단계는 가변동작부가 확장 방향으로 곡선을 형성하며 확장된다.
이하, 첨부된 도면을 참조하여 본 발명의 동작 상태를 설명한다.
도 4에 도시된 바와 같이 손상된 대퇴골두를 절단하고, 대퇴골두로부터 일정한 깊이를 갖도록 넙다리뼈에 구멍을 천공하여 스템을 삽입할 수 있게 한 후에 스템 삽입 도구를 이용하여 구멍에 스템을 삽입한다.
이때 삽입된 스템이 구멍과 밀착되도록 삽입될 경우에는 그대로 이용할 수 있으나, 스템의 형상이 곡선된 쐐기 형태를 하고 있어서 부분적 또는 전체적으로 구멍보다 작게 삽입될 경우가 빈번히 발생하게 된다.
즉, 의과적 시술시 스템의 형태와 동일한 또는 유사한 크기의 구멍을 천공하기가 매우 어렵고 고난도의 기술을 요하게 되므로 대체로 스템보다 구멍이 크게 형성되는 경우가 자주 발생하게 된다.
이렇게 구멍이 스템보다 크게 형성될 경우 그에 맞는 스템을 적용할 수 없는 문제가 있기 때문에, 도 5에 도시된 바와 같이 삽입된 스템 상부에 배치된 나사부(120)를 회전시켜 상기 나사부(120)의 회전 운동을 나사 결합된 동작변환부(130)로 하여금 수직 운동으로 변환하게 한 후 동작변환부(130)의 하강에 의해 안내공(133)에 삽입되고 가변동작부(150)에 고정된 상태의 가동핀(160)을 안내공 내에서 슬라이딩 이동시켜 가동핀에 연결된 가변동작부(150)를 폭 방향 외측으로 밀어 스템몸체(110) 외주면 보다 돌출되게 한다.
이때 돌출되는 가변동작부(150)는 상단과 하단이 각각 곡선 형태를 하고 있고, 가동핀 및 안내공 역시 곡선 형태여서 가동핀이 안내공의 곡선을 따라 이동하는 만큼 가변동작부 역시 곡선으로 움직이게 되어 상단의 돌출 폭(W1)이 하단의 돌출 폭(W2)보다 많이 돌출되어 확장하게 되므로 스템몸체(110) 외주면의 곡선 형태를 유지하며 구멍 크기에 맞게 확장되는 것이 가능해진다.
여기서 상기 스템몸체 상부 일측에는 절단된 대퇴골부 상면과 밀착되어 지지되는 칼라(116)가 더 구비될 수 있다.
즉, 나사부의 회전과 동시에 동작변환부가 동작공간(113) 내에서 수직 방향 슬라이딩하며 하강하면 하강하는 동작변환부의 이동 간격 만큼 가동핀이 안내공 내에서 슬라이딩하게 되는데, 가동핀과 안내공은 각각 곡선 형태를 하고 있어 곡선의 움직임 만큼 가동핀과 연결된 가변동작부가 곡선 운동에 의해 스템몸체 외측으로 확장하게 되는 것이다.
이와 같은 동작을 위해서는 가동핀과 안내공이 가변동작부의 확장 방향으로 반경으로 형성하며 곡선을 이루어야 하고, 이에 상응하도록 가변동작부의 상단과 하단이 곡선 형태를 이루어야 한다.
곡선의 움직임이 상호 간섭없이 이루어지게 하기 위해서는 다음과 같은 식을 만족하여야 한다.
다음 식의 설명을 위해 도 6을 참조하면, 도 6에서 "A"는 스템몸체이고, "B"는 가변동작부이며, "C"는 가동핀, 안내공 및 동작변환부이다. 설명의 편의를 위하여 "A", "B", "C"로 표현하여 설명한다.
도 6에서와 같이 특수 경사면은 좌표의 원점을 중심으로 회전 운동을 한다. "B"에서 접촉면의 하단부의 위치를 a, 상단부 위치를 b라 할 때, 각 위치의 좌표를 원통좌표계로 나타낼 경우
Figure 112016101478754-pat00015
,
Figure 112016101478754-pat00016
으로 각각 나타낼 수 있고, "C"의 수직 운동으로 "B"가 r만큼 회전되어 이동될 위치 a', b'의 좌표를 각각
Figure 112016101478754-pat00017
,
Figure 112016101478754-pat00018
으로 정의할 때, a, b와 a', b'는 다음의 관계를 가진다.
Figure 112016101478754-pat00019
또한 "B"가 팽창(확장)되지 않는 위치에서의 접촉면의 식은 다음식과 같이 원으로 나타낼 수 있다.
(1)
Figure 112016101478754-pat00021
"C"가 (-)y 방향으로
Figure 112016101478754-pat00022
만큼 이동할 때 접촉면은 이동된 접촉면의 식은 다음과 같이 나타낼 수 있다.
(2)
Figure 112016101478754-pat00023
팽창전의 "B"와 "C"가 서로 접촉하였을 때 두 점 a, b는 원의 방정식을 만족한다. 통좌표계로 정의 된 점 a, b를 직각 좌표계로 나타낼 경우 다음과 같이 나타낼 수 있다.
Figure 112016101478754-pat00024
Figure 112016101478754-pat00025
또한 팽창 후의 위치는 다음과 같이 나타낼 수 있다.
Figure 112016101478754-pat00026
Figure 112016101478754-pat00027
Figure 112016101478754-pat00028
,
Figure 112016101478754-pat00029
식 (1)의 방정식을 만족하며,
Figure 112016101478754-pat00030
,
Figure 112016101478754-pat00031
는 식 (2)를 만족해야 한다.
(3)
Figure 112016101478754-pat00032
(4)
Figure 112016101478754-pat00033
(5)
Figure 112016101478754-pat00034
(6)
Figure 112016101478754-pat00035

따라서 좌표 원점을 중심으로 r만큼 회전 팽창하는 구조의 인공고관절용 스템을 위해서는 식 (3) ~ (6)을 만족할 수 있도록 점 a, b, R을 결정해야 한다.
점 a, b에서
Figure 112016101478754-pat00036
,
Figure 112016101478754-pat00037
,
Figure 112016101478754-pat00038
는 가변동작부의 크기를 결정하는 변수로써 설계자의 의도에 의해 결정할 수 있는 변수이다.
Figure 112016101478754-pat00039
,
Figure 112016101478754-pat00040
,
Figure 112016101478754-pat00041
가 결정되었을 때 팽창 후 잘 접촉될 수 있도록
Figure 112016101478754-pat00042
, R을 결정해야 한다.
이 공학적 문제는 4개의 방정식을 동시에 만족시키는 변수
Figure 112016101478754-pat00043
, R를 찾는 문제라 할 수 있으나, 실질적으로 수학적으로 정답을 구하는 것은 불가능하기 때문에 인공고관절의 경우 금속간 결합되는 구조체로서 금속간 결합시 접촉되어 동작할 수 있게 하는 기계적 오차범위 보다 수학적 오류가 작다면 수학적 오류가 존재하더라도 충분히 기계적으로 동작할 수 있으므로 그에 준하는 값을 구하는 식이다. 여기서 조립을 위해 허용 가능한 오차를 "e"라고 할 때 이를 식(3) ~ (6)에 적용하면 다음식과 같이 나타낼 수 있다.
(7)
Figure 112016101478754-pat00044
(8)
Figure 112016101478754-pat00045
(9)
Figure 112016101478754-pat00046
(10)
Figure 112016101478754-pat00047
식 (7)에서
Figure 112017128090316-pat00048
이므로 e2을 무시할 경우 식 (7) ~ (10)은 식 (11) ~(14)와 같이 나타낼 수 있다.
(11)
Figure 112017128090316-pat00079

(12)
Figure 112017128090316-pat00080

(13)
Figure 112017128090316-pat00081
(14)
Figure 112017128090316-pat00082
삭제
삭제
삭제
삭제
식 (11) ~ (14)를 만족하는
Figure 112016101478754-pat00053
, R는 수치해법을 통해 계산될 수 있으며, 도 7에 도시된 바와 같이 그래프로 도출하여 "B"와 "C"의 접점 a, b를 이루는 R의 크기를 결정하여 결과적으로 가변동작부의 동작을 이끌어낼 수 있게 되는 것이다.
이와 같이 곡면을 가지며 곡면에 의해 움직임이 형성되는 안내공, 가동핀 및 가변동작부을 통해 스템 외주면을 확장될 수 있게 할 뿐만 아니라 하단과 상단의 확장 간격을 다르게 함으로써 삽입되는 스템이 구멍에 보다 정밀하고 견고히 고정될 수 있게 하는 것이 가능하다.
또한 삽입된 스템을 교체할 경우에도 확장된 상태의 가변동작부를 다시 축소시켜 밀착력을 제거할 경우 스템의 교체를 더욱 효율적으로 교체하는 것이 가능해진다.
이상, 본 발명을 바람직한 실시예를 통해 설명하였으나, 이는 본 발명의 기술적 내용에 대한 이해를 돕고자 하는 것일 뿐 발명의 기술적 범위를 이에 한정하고자 함이 아니다.
즉, 본 발명의 기술적 요지를 벗어나지 않고도 당해 발명이 속하는 기술 분야에서 통상의 지식을 가진 자라면 다양한 변형이나 개조가 가능함은 물론이고, 그와 같은 변경이나 개조는 청구범위의 해석상 본 발명의 기술적 범위 내에 있음은 말할 나위가 없다.
100 : 스템 110 : 스템몸체
120 : 나사부 130 : 동작변환부
140 : 고정브라켓 150 : 가변동작부
160 :가동핀

Claims (12)

  1. 대퇴골두 또는 비구가 손상되어 이를 대체하기 위해 사용되는 인공고관절용 스템에 있어서,
    상기 인공고관절용 스템은,
    상부에 헤드를 고정하는 헤드 고정부가 돌출되며, 상측을 수평 개구된 동작공간과, 상기 동작공간과 연결되도록 수직 관통된 머리삽입공이 구성된 스템몸체;
    상기 머리삽입공에 삽입되어 회전하는 나사부;
    상기 동작공간에 삽입되어 나사부와 연결된 상태로 나사부에 의해 수직 운동하는 동작변환부;
    상기 동작공간 내에 삽입되어 상기 나사부가 깊이 변화없이 회전하도록 고정하는 고정브라켓;
    상기 스템몸체의 지지면에 삽입되어 동작변환부의 동작에 의해 수평 방향 폭을 조절하게 하는 가변동작부; 및
    상기 가변동작부를 동작변환부에 고정시키는 가동핀;을 포함하는 것을 특징으로 하는 인공고관절용 스템.
  2. 제1항에 있어서,
    상기 가변동작부는 상단과 하단이 서로 다르게 확장되는 것을 특징으로 하는 인공고관절용 스템.
  3. 제2항에 있어서,
    상기 가변동작부는 상단이 하단보다 더 많이 확장되는 것을 특징으로 하는 인공고관절용 스템.
  4. 제1항에 있어서,
    상기 동작변환부는 나사부에 의해 승하강시 안내공에 의해 가동핀을 곡선 운동시키는 것을 특징으로 하는 인공고관절용 스템.
  5. 제4항에 있어서,
    상기 가동핀은 동작변환부에 경사지게 배치된 것을 특징으로 하는 인공고관절용 스템.
  6. 제4항에 있어서,
    상기 동작변환부의 안내공과 가동핀의 외주면은 길이 방향으로 곡선된 형태인 것을 특징으로 하는 인공고관절용 스템.
  7. 제6항에 있어서,
    상기 안내공과 가동핀은 가변동작부의 확장 방향으로 반경을 형성하며 곡선된 것을 특징으로 하는 인공고관절용 스템.
  8. 제4항에 있어서,
    상기 곡선운동은 다음의 식에 의해 결정되는 것을 특징으로 하는 인공고관절용 스템.
    -다 음-
    (1)
    Figure 112017128090316-pat00054

    (2)
    Figure 112017128090316-pat00055

    (3)
    Figure 112017128090316-pat00056

    (4)
    Figure 112017128090316-pat00057

    (5)
    Figure 112017128090316-pat00058

    (6)
    Figure 112017128090316-pat00059

    (7)
    Figure 112017128090316-pat00060

    (8)
    Figure 112017128090316-pat00061

    (9)
    Figure 112017128090316-pat00062

    (10)
    Figure 112017128090316-pat00063

    (11)
    Figure 112017128090316-pat00083

    (12)
    Figure 112017128090316-pat00084

    (13)
    Figure 112017128090316-pat00085

    (14)
    Figure 112017128090316-pat00086
  9. 제1항에 있어서,
    상기 스템몸체 상부에는 돌출된 칼라가 더 구비된 것을 특징으로 하는 인공고관절용 스템.
  10. 삭제
  11. 삭제
  12. 삭제
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BR112019006901A BR112019006901A2 (pt) 2016-10-19 2017-01-02 haste de articulação do quadril artificial, e método de fornecimento de etapa de articulação do quadril artificial
AU2017346076A AU2017346076B2 (en) 2016-10-19 2017-01-02 Artificial hip joint stem and stem providing method
CA3045166A CA3045166C (en) 2016-10-19 2017-01-02 Artificial hip joint stem and stem providing method
MX2019003973A MX2019003973A (es) 2016-10-19 2017-01-02 Vastago de articulacion de cadera artificial y metodo para proporcionar el vastago.
US16/341,030 US11141280B2 (en) 2016-10-19 2017-01-02 Artificial hip joint stem and stem providing method
IL265878A IL265878B2 (en) 2016-10-19 2017-01-02 Artificial hip joint stem and method of stem delivery
CN201780061404.3A CN110035715B (zh) 2016-10-19 2017-01-02 人工髋关节用杆及杆安装方法
EP17862527.3A EP3530237B1 (en) 2016-10-19 2017-01-02 Artificial hip joint stem
JP2019517356A JP6881789B2 (ja) 2016-10-19 2017-01-02 人工股関節用ステム及びステム設置方法
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