KR20180018864A - Hip joint device and method - Google Patents

Abstract

The present invention provides a medical device for treating hip arthritis by providing a joint surface. The medical device includes two or more artificial hip surface portions and two or more artificial hip surface portions are configured to be connected to each other to form an artificial hip surface during surgery. The present invention also provides a method for treating a hip of a patient by providing the medical device. The method includes: cutting the skin of a patient; dissecting a region of the pelvic bone on the opposite side of the ankle; dissecting the dissected region through the pelvic bone and into the patient ' And providing the medical device to the hip joint through a hole in the patient's pelvic bone.

Description

[0001] HIP JOINT DEVICE AND METHOD [0002]

The present invention relates generally to a medical device for implantation in a hip joint and a method of providing such a medical device.

Hip joint osteoarthritis is a syndrome in which less severe inflammation causes pain in the hip joint caused by abnormal wear of the cartilage acting as a cushion inside the hip joint. Such abnormal wear of the cartilage also results in a reduction in the amount of articular lubricant referred to as synovial fluid. Hip arthritis is estimated to affect 80% of all people over 65 years of age with a more severe or less severe condition.

Current treatments for hip arthritis include NSAID drugs, topical infusion of hyaluronic acid or glucocorticoid to help lubricate the hip joint, and replacement of a portion of the hip joint with hip prosthesis by prosthesis .

* Replacing a portion of the hip joint is one of the most common surgical procedures performed to hundreds of thousands of patients worldwide every year. The most common method involves placing a metal prosthesis in the femur and placing a plastic bowl in the acetabulum. This surgery is usually done through the lateral incision of the buttocks and upper thigh and also through the lateral muscles of the fascia lata and hips. To access the hip, it is necessary to penetrate the supporting hip joint capsule attached to the ilium of the femur and pelvis, making it difficult for the joint to function fully after surgery. The femur is then cut at the neck with a fracture tongue, and the prosthesis is placed in the femur without bone cement or bone cement. The acetabular reamer is somewhat expanded using an acetabular reamer, and the plastic bowl is placed using screws or bone cement.

Surgery usually requires one week of hospitalization due to an increased risk of infection. The recovery process takes an average of about six weeks, but after this period, the patient should not do any physical activity that puts great pressure on the joints.

A medical device for implantation in a hip joint to provide a hip surface is provided. The medical device includes an artificial caput femur surface configured to function as a bearing surface of the hip when in its functional position and an artificial femur surface configured to secure the artificial femur head surface to the femoral bone Wherein the medical device comprises two or more portions configured to be connected to one another in situ to form the medical device. ≪ RTI ID = 0.0 > [0002] < / RTI >

According to one embodiment, the two or more artificial hip surface portions are configured to be mounted in place to form a mounted medical device.

According to another embodiment, the two or more first portions include a hip joint contact surface, and the second portion of the two or more portions comprise a hip joint contact surface. The first portion and the second portion are connected in the interconnect area of the medical device, and the interconnect area is a portion of the contact surface of the mounted medical device.

The medical device further includes a locking member configured to lock the first portion and the second portion together after the first and second portions of the two or more portions are connected into the mounted medical device.

At least one of the two or more portions includes a hip joint contact surface configured to contact an articular alternate of the ankle or ankle, and a femur contact surface configured to contact the patient's femoral bone.

The medical device according to any of the embodiments of the present invention may be frustum spherical.

According to one embodiment, the artificial femur head surface comprises a first bearing surface for supporting the weight in the hip joint, the two or more sections being configured to be fixed with respect to each other such that a first connection And the first connection line is located at least partially within the first support surface.

According to an optional embodiment, the two or more artificial hip joint surface portions are configured to be introduced into the pelvic bone through a hole having a cross-sectional area less than 530 mm 2, less than 380 mm 2, less than 250 mm 2, less than 180 mm 2, or less than 110 mm 2 .

According to one embodiment, the locking member may be a locking band configured to surround a portion of the thigh bone.

According to one embodiment, the two or more parts have a distribution that is part of a circle.

According to another embodiment, the mounted medical device exhibits a hollow partial sphere shape and can be configured to be secured to the femoral bone of a patient by at least partially surrounding a portion of the femoral bone.

According to yet another embodiment, the locking member may be a locking band configured to surround the mounted medical device to further secure the mounted medical device to a portion of the femur bone.

According to an optional embodiment of the invention, the two or more artificial femoral head surface portions are configured to be inserted through an opening in the pelvic bone from the opposite side of the acetabulum, Has a smaller diameter than the maximum diameter of the medical device.

According to yet another embodiment, the two or more artificial femoral head surface portions are configured to be inserted through a bore of a supporting hip joint capsule, the bore being configured such that when the medical device is in a functional position in the hip, And a diameter smaller than a maximum diameter of the medical device.

Wherein the two or more artificial femur head surface portions are configured to be inserted through a hole in a femoral bone and the hole has a diameter smaller than a maximum diameter of the medical device at a functional position in the hip joint.

One or more of the two or more portions may be a portion configured to act as a base portion to which one or more additional portions may be connected.

The medical device includes a plurality of ring shaped objects, wherein the plurality of ring shaped objects are configured to be connected to one another in situ after being inserted into the hip joint to form an artificial rib surface.

According to yet another embodiment, the medical device may further comprise a second artificial hip joint surface for replacing the second bearing surface which supports the weight in the hip joint. The third and fourth portions of the two or more portions may be configured to contact a first bearing surface and an artificial alternate of the first bearing surface during a functional hip movement. The third portion and the fourth portion being configured to be fixed to each other to form a second connection line therebetween, the second connection line being located at least partially within the bearing surface of the articulating rib surface.

The two or more portions are configured to be mounted together to form a substantially even surface.

The portion forming the substantially even surface along the connection line has a height difference of up to 10 [mu] m.

The portion forming the substantially even surface along the connection line has a height difference of up to 100 [mu] m or up to 1 mm.

According to another embodiment, the part includes a form fitted structure having a locking position to be mechanically secured to one another.

The medical device includes a shape fitting structure including a self-locking structure configured to lock in a locked position.

Wherein the two or more portions include structures that are configured to slide relative to each other relative to one another, wherein the two or more portions are substantially parallel to each other at least in the sliding direction and / Locked.

The shape fitting structure is configured such that, when the parts are mounted together, a portion of at least one of the portions is configured to be introduced to the other portion, and is configured to be introduced in at least two successive different directions, And a portion of the structure configured to be substantially locked in all directions except for the introduction direction and / or the reverse direction.

The two or more portions are configured to be displaceable with respect to each other until the portions are positioned at a functional location within the hip joint at a predefined location such that the medical device can function as a hip joint surface.

The two or more portions are configured to be rotatably connected to each other in situ, and configured to function as a hip joint surface when the two or more portions are connected in place.

Wherein at least one of the at least two portions comprises an elastic member and the medical device is configured to be secured to the femoral head or pelvic bone by the resilient member exerting a squeezing force on the femoral bone or pelvic bone.

There is also provided a medical device for treating hip arthritis by providing a hip surface. The medical device includes two or more artificial hip surface portions and two or more artificial hip surface portions are configured to be connected to each other to form an artificial hip surface during surgery to treat hip arthritis.

According to one embodiment, the medical device may be configured to provide an artificial femur head surface, and in accordance with another embodiment, the medical device may be configured to provide a femoral head surface. In addition, the medical device can be configured to provide both the artificial femoral head surface and the artificial skeletal surface.

APPEARANCE

Two or more portions of the medical device may have a circular distribution, or two or more portions may have a distribution that is part of a circle to correspond to the ankle and / or femoral head. Portions according to embodiments herein can be constructed of the same material and can be configured to be mounted inside the hip joint during surgery.

According to one embodiment, the medical device includes one or more artificial femoral head surfaces and / or artificial skeletal surface surfaces, and shows a hollow sphere shape, through which the femoral head is deflected beyond the maximum diameter of the femoral head At least partially enclosing the artificial femoral head surface mechanically to secure the artificial femoral head surface to the femoral head or its artificial alternate.

According to one embodiment, two or more of the two artificial femoral head surface portions are configured to be inserted through the hole of the pelvic bone from the opposite side of the patient's ankle. The hole may have a smaller diameter than the maximum diameter of the medical device at the functional location of the hip joint to enable less invasive insertion of the medical device.

According to one embodiment, at least one of the two or more portions is a portion configured to act as a base portion to which at least one additional portion can be connected. The base portion may be centrally located relative to at least one further portion.

According to another embodiment, the medical device comprises a plurality of ring-shaped objects configured to be connected to one another after insertion into the hip joint to form an articulating rib surface.

According to one embodiment, the medical device is defined as a spherical or more spherical shape.

The implantable medical device includes a first bearing surface for supporting the weight in the hip joint, the portions being configured to be fixed to each other to form a first connection line therebetween, . However, it is also conceivable that the line does not include the first supporting surface.

According to another embodiment, the implantable medical device further comprises a second artificial hip joint surface for replacing the second bearing surface to support the weight in the hip joint. The second support surface is configured to contact the first support surface or the artificial replacement portion during functional gluteal movement and the second portion is configured to be fixed to each other to form a second connection line therebetween, 2 contact surface at least partially. However, it is also conceivable that the line does not include the first supporting surface.

The portion along the connection line that includes the support surface may be configured to be mounted together to create a substantially even surface that may have a height difference of up to 10 [mu] m, according to one embodiment, Have a height difference of up to 100 [mu] m, or according to another embodiment have a height difference of up to 1 mm.

According to one embodiment, portions of the implantable medical device include a shape-fitting structure having a locking position to be mechanically secured to one another. The shape fitting structure may further include a self-locking structure configured to lock into the locked position.

According to one embodiment, the medical device comprises a shape fitting structure, which is configured to have a portion that slides relative to each other when mounted together, and also at least in the sliding direction and / To substantially lock in all directions except for the < / RTI >

According to one embodiment, a medical device includes a shape-fitting structure, wherein at least a portion of at least one portion of the portion is configured to be introduced inwardly with respect to one another when mounted together, And is configured to substantially lock in all directions except for the introduction direction and / or the reverse direction.

According to one embodiment, a medical device includes a shape-fitting structure, wherein at least a portion of at least one portion of the portion is configured to be introduced inwardly with respect to one another when mounted together, And is structured to be introduced in a different direction, and is configured to be substantially locked at least in all directions except the final introduction direction and / or the reverse direction at the locking position.

The implantable medical device may further comprise a locking member configured to lock the structure into the locked position. The locking member may be configured to lock the portion into the locked position to keep the portion mounted relative to each other.

According to another embodiment, the locking member is configured to lock the portion to the locking position by keeping the portion mounted on the human bone. The locking member according to any embodiment may include a splint and / or a screw.

The locking member may be configured to be rotated, angled, introduced, or bent to lock the portion in relation to the portion into the locked position.

The implantable medical device may further include a self-locking member configured to lock into the self-locking position, the self-locking member being further configured to further lock into the self-locking position with further assistance by the locking member.

According to one embodiment, an implantable medical device includes a locking member, wherein the portion of the shape fitting structure is configured to be introduced into the other portion when the locking member is mounted together into the locking position within the hip joint, And at least a portion of at least one portion of the portions configured to be locked.

The portions of the shape fitting structure are each configured to be mounted towards each other when mounted together in a locked position in the hip joint, according to one of the above embodiments, and configured to be substantially locked by the locking member, . ≪ / RTI >

According to one embodiment, the first contact surface in the hip joint comprises three or more portions configured to be mechanically secured to each other when implanted in the hip joint after being introduced into the hip joint within the hip joint capsule.

According to another embodiment of the medical device, a second artificial surface for replacing the second contact surface in the hip joint is configured to be mechanically fixed to each other when implanted in the hip joint after being introduced into the hip joint, ≪ / RTI >

The first artificial surface may comprise two or more layers mounted together, one of which may comprise a flexible layer adapted to be mounted on the at least one support layer. The support layer may include two or more portions mounted on the soft layer.

According to another embodiment of the medical device, the second artificial surface comprises two or more layers mounted together. One layer may comprise a soft layer configured to mount one or more support layers thereon. The support layer may include two or more portions mounted on the soft layer.

The second artificial surface may be configured to be introduced into the hip joint in a bent or rolled state and a portion of the support layer may be configured to be unbented or unrolled after being introduced into the hip joint within the hip joint capsule And the portion of the support layer may be in a first position relative to each other to create a support surface to replace at least the portion of the second contact surface that carries the weight in the hip joint during functional movement of the hip joint As shown in FIG.

The support layer according to any embodiment may comprise three or more portions mounted on the soft layer, and the portion of the support layer may be formed in the shape of a < RTI ID = 0.0 > Can be configured to be customized. Portions of the support layer may be adhered to each other to maintain an even surface.

CONNECTION / FIXATION

The two artificial hip joint surface portions are configured such that, according to one of the above embodiments, one or more screws, one or more splints, at least a portion of at least one portion of the portion is introduced into the other portion, A ball mounted in a cup which is part of the above-mentioned part, the shape fitting, the welding, the adhesive, the sprint, the wire, the one mounted in the female part of the other part, With a member selected from the group consisting of a male part of a portion of the portion of the first portion of the first portion, a key, a key, and / or other mechanical connecting member introduced into the lock that is part of the portion And may be configured to be mechanically connected.

According to yet another embodiment, the two or more portions may be configured to be mechanically connected to each other using a self-locking element that may be supported by adhesive or bone cement.

The medical device may include one or more elastic members for changing the shape of the medical device.

The two portions may be configured to be connected to each other and to be displaceable relative to each other, at least partially, in connection, according to one of the embodiments described above.

According to another embodiment of the medical device, the two or more displaceable portions may be configured to be displaceable relative to each other until the portions are located at a functional position within the hip including a predetermined position, The two or more portions are fixed so that the medical device can function as a hip joint surface.

The two or more portions may be rotatably connected to each other so that the medical device has a first state for insertion into the hip joint through the hole and a second state that allows the artificial hip joint surface to function as a hip joint surface, The medical device may be configured to change between the first state and the second state via the rotatable connection.

According to one embodiment, a medical device is provided that includes at least one screw, at least one pin, at least a portion of at least one of the portions being adapted to be introduced into another portion, A ball mounted in a bowl that is part of at least a portion of the portion of the body, such as shape fitting, weld, glue, pin, wire, part of the portion, To be fixed to the femoral head or the pelvic bone using an element selected from the group consisting of a key, a band, and other mechanical connecting members introduced into the lock, which is part of the femoral head. It is also possible that the medical device is configured to be fixed to the femoral head or pelvis bone without penetrating the femoral head, the femoral bone, or the cortex of the pelvic bone through an elastic member that exerts a pressing force on the femur head or the pelvic bone . However, the medical device may also be configured to be fixed to the femoral head or pelvic bone by penetration of the femoral head, femoral bone, or pelvic bone envelope.

The medical device may be configured to be inserted through a hole in the pelvic bone, a hole in the femoral bone, or a hole in the capsule.

It is also possible that the medical device is configured to provide one or more hinge surfaces when the hinge is in a normal functional or dislocated position.

In an embodiment in which the medical device includes an elastic member, the elastic member is configured to change the maximum diameter or maximum cross-sectional distance of the medical device for insertion through a hole having a diameter less than a maximum diameter or maximum cross- Thereby permitting insertion of less invasive medical devices.

According to one embodiment, the two or more hinge surface portions are configured to be inserted through a hole in the pelvic bone from the opposite side of the patient's oropharyngeal bone, the hole having a diameter smaller than the maximum diameter of the medical device.

The medical device according to one of the embodiments is characterized in that the medical device is introduced through a hole having a cross-sectional area of less than 530 mm 2, a cross-sectional area of less than 380 mm 2, a cross-sectional area of less than 250 mm 2, a cross-sectional area of less than 180 mm 2, The maximum radius, or the maximum cross-sectional distance, which can be varied.

MATERIAL

A medical device according to one of the embodiments may be made of a material selected from the group consisting of PIEE, corian, polyethylene based materials, titanium, stainless steel, wolfram, other metal materials, combinations of metal materials, carbon fibers, boron, A combination of a metal and a carbon-based material, a combination of a carbon and a plastic-based material, a multi-material in which one material includes a soft material, a composite material in which one material comprises an elastic material, A composite material in which one material comprises more than one part of another material, PE and an acrylic polymer.

The medical device may also be configured to be lubricated in a non-invasive manner after being inserted into the hip, for example via an implantable lubrication system, or the medical device may comprise a self-lubricating material.

INSTRUMENT

According to another embodiment, the medical device can be configured to be introduced into the hip joint using a manual operation or a surgical instrument configured for it. The surgical instrument may comprise a band comprising one or more elements selected from the group consisting of fixed angles, adjustable angles, and sections or sections arranged in parallel.

Surgical / Laparoscopic Surgical / Laparoscopic Method

There is provided a method of treating a hip of a patient by providing a medical device according to one of the above embodiments. The method includes the steps of cutting the patient's skin, dissecting the area of the pelvic bone on the opposite side of the ankle, forming a hole in the dissected area through the pelvic bone into the patient's hip, And providing the medical device to the hip joint through the hole.

There is provided a method of treating a hip of a patient by providing a medical device according to one of the above embodiments. The method includes the steps of inserting a device, such as a needle or tube, into the patient's body to expand the cavity in the body by filling the patient's body with a gas using a device such as a needle or tube, Placing the at least two laparoscopic trocar in the cavity, inserting the camera in the cavity through one laparoscopic trocar, inserting one or more dissection tools through one of the two or more laparoscopic trocarers, Dissecting the area of the opposite pelvic bone, forming a hole through the pelvic bone into the patient ' s hip joint in the dissected area, and providing the medical device to the hip joint through the hole in the patient's pelvic bone .

According to one embodiment, the method includes cutting a patient's skin, dissecting the area of the hip, forming a hole in the dissected area that leads into the patient's hip, and removing the medical device from the hip joint .

There is also provided a method for treating a hip of a patient by providing a medical device according to one of the above embodiments. The method includes the steps of inserting a device such as a needle or tube into a patient's body and inflating a cavity in the body by filling the patient's body with a gas using a device such as a needle or a tube, Placing the at least two laparoscopic trocar in the cavity, inserting the camera in the cavity through one laparoscopic trocar, inserting one or more dissection tools through one of the two or more laparoscopic trocarers, Dissecting the area, forming a hole in the dissected area that leads into the patient ' s hip, and providing the medical device to the hip joint through the hole.

According to one embodiment, the method further comprises one or more of the following steps: dissecting the area of the hip joint comprising dissecting the pelvic bone on the opposite side of the ankle, advancing into the patient ' s hip through the pelvic bone Forming a hole in the dissected area that includes forming a hole and providing the medical device to the hip joint through a hole in the patient's pelvic bone.

FURTHER STEPS OF THE OPERATION

The method according to one of the embodiments may further comprise reaming the ankle and / or femoral head, and fixing the surface of the hip joint to the femoral head and / or the ankle. The fixation can be carried out through mechanical fastening means, bone cement or adhesive.

According to yet another embodiment, the method further comprises filling the hole through a bone cement, a bone plug, or a prosthetic portion.

According to yet another embodiment, the method further comprises the steps of positioning a mold within the hip, injecting fluid into the mold located inside the patient's hip, or applying one or more sealing Placing the member, creating a sealed region between the rib and the femoral head, and injecting fluid into the sealed region.

After the method is completed, it is desirable to perform a step of withdrawing the device and filling the patient's skin with a suture or staple.

INCISION AND DISSECTION

According to one embodiment, cutting the patient's skin is performed in the abdominal wall, inguinal area, and / or pelvic region of the patient.

Depending on the embodiment in which the cavity is formed, the cavity may be located in the abdomen, inguinal and / or pelvic region of the patient.

The step of dissecting the region of the pelvic bone described in the present method comprises the steps of: locating the region of the abdominal cavity, the region between the peritoneum and the pelvic bone, the region between the pelvic bone and the surrounding tissue, And / or dissecting the area of the inguinal region.

In addition, a surgical operation method for transplanting a medical device according to one of the embodiments is provided. The method comprises the steps of cutting the patient's skin, dissecting the area of the hip, dissecting and preparing the area of the first support surface, introducing the part through the hip joint into the hip joint, Replacing the first bearing surface with a first artificial hip surface, and mounting the jointed portion to the functional hip joint.

There is also provided a surgical method of transplanting a medical device according to one of the embodiments, comprising the steps of cutting the skin of the patient, dissecting the area of the hip joint, dissecting the area of the second bearing surface Introducing the second portion into the hip joint via the high capsule, mechanically connecting the second portion to each other, replacing the second bearing surface with a second artificial surface, Into the functional hip joint.

An arthroscopic surgical method for implanting a medical device into a hip joint according to one of the embodiments includes the steps of inserting a device such as one or more needles or a tube into a patient's hip joint using a tool such as a needle or a tube, , Placing two or more arthroscopic trocar in the hip joint, inserting the camera into the hip joint through one arthroscope and attaching one or more dissection tools through one of the two or more arthroscope trousers Inserting a portion of the first support surface into the hip, introducing the portion into the hip joint through the hip joint, mechanically connecting the portions together, replacing the first support surface with the artificial hip joint surface , And attaching the portions together to the functional hip joint.

Using a device such as a needle or tube to fill the hips with fluid may include circulating fluid to one inlet and one outlet from the hips.

Further, there is provided an arthroscopic surgical method for transplanting a medical device according to one of the embodiments into a hip joint. The method includes the steps of inserting a device, such as one or more needles or tubes, into a patient's hip, filling the hip with fluid using a tool such as the needle or tube, applying two or more arthroscopic trocar to the hip Inserting one or more anatomical tools through one of the two or more arthroscopic cannulas, incisionally preparing an area of the second support surface, , Introducing the second portion into the hip joint via the high capsule, mechanically connecting the second portion to each other, replacing the second bearing surface with the artificial hip surface, mounting the second portions together on the functional hip joint .

According to one embodiment, the method may further comprise circulating fluid to one inlet and one outlet from the hip joint.

Any of the embodiments, portions of embodiments, features, methods, related systems, and portions of systems described herein may be combined in any manner.

Fig. 1 is a view showing a hip joint in a sectional view.
2 is a side view of a conventional hip surgery.
3 is a diagram illustrating a medical device according to one embodiment used in conventional surgical operations.
4 is a view showing a medical device according to an embodiment used in conventional surgery.
FIG. 5 is a view showing a medical device according to an embodiment used in conventional surgery.
6 is a view showing a medical device according to an embodiment used in conventional surgery.
7 is a view showing a medical device according to an embodiment used for conventional surgery.
8 is a view showing a medical device according to an embodiment used in conventional surgery.
9 is a view showing a medical device according to an embodiment used in conventional surgery.
10 is a view showing a side view of the femoral region of the patient when the incision is closed using the suture;
11 is a view showing a caput femur surface larger than an equator frustum spherical.
12A is a view showing an artificial femur head surface according to an embodiment.
12B is a view showing the surface of the artificial femur head according to one embodiment when it is fixed to the femoral head.
13 is a cross-sectional view of the hip joint.
14 is a view showing an artificial femur head surface according to an embodiment.
15A is a view showing a surface of an artificial femur head according to a larger equal-circle dual-specific embodiment.
15B is a view showing the surface of the artificial femur head according to still another embodiment.
16A to 16E are views showing the surfaces of the artificial femur head according to still another embodiment.
17A is a view showing a surface of an artificial femur head according to still another embodiment.
Fig. 17B is a view showing the surface of the artificial femur head according to Fig. 17A in a folded state. Fig.
18A is a view showing a surface of an artificial femur head according to still another embodiment.
Fig. 18B is a view showing the surface of the artificial femur head according to Fig. 18A during assembly. Fig.
18C is a view showing the surface of the artificial femur head according to Figs. 18A and 18B in an enlarged state of the connecting member. Fig.
19A is a view showing a surface of an artificial femur head according to still another embodiment.
Fig. 19B is a view showing in detail the surface of the artificial femur head according to Fig. 19A. Fig.
Fig. 19C is a view showing the surface of the artificial femur head according to Fig. 19A during assembly. Fig.
20A is a diagram showing a conceptual view of the function of the expandable femoral head surface.
20B is a view showing an adjustable locking member to be mounted on the surface of the artificial rib;
20C to 20F are views showing another embodiment of the locking member and the engaging member.
20G is a view showing a medical device and a locking member according to still another embodiment.
20H is a view showing a medical device and a locking member according to another embodiment.
Figure 20i is a view of a medical device having an integrated locking member in accordance with one embodiment.
20J is a view of a medical device having an integrated locking member according to yet another embodiment.
20K is a view showing an embodiment of a medical device and a mechanical fixing member.
FIG. 20L is a view showing a first kit including three artificial femoral head surfaces and one locking member. FIG.
20m is a view showing a second kit including one artificial femoral head surface and three locking members.
20n is a view showing a third kit including three artificial femoral head surfaces and three locking members.
21 is a conceptual diagram of the function of the expandable femoral head surface.
FIG. 22A is a conceptual diagram of the function of the surface of the extensible orchid bone.
Fig. 22B is a view showing the hip joint in a sectional view when the artificial rib surface is provided. Fig.
23 is a diagram illustrating an assembly of a medical device.
24 is a diagram illustrating an assembly of a medical device.
25 is a diagram illustrating an assembly of a medical device.
26 is a diagram illustrating an assembly of a medical device.
27A, 27B, and 27C are views showing an assembly of a medical device.
28A, 28B and 28C are diagrams showing an assembly of a medical device.
29A, 29B, and 29C are diagrams showing an assembly of a medical device.
30A, 30B, and 30C are views showing an assembly of a medical device.
FIG. 31A is a view showing providing a first flexible layer on the femoral head. FIG.
31B is a view showing the femoral head when the soft layer is provided.
32A is a diagram illustrating a medical device including a plurality of portions.
32B is a diagram showing in more detail a medical device including a plurality of portions.
33 is a view showing positioning of the second stiff layer in the first soft layer.
34 is a view showing a hip joint when the second rigid layer is placed on the first soft layer.
Fig. 35 is a view showing the insertion of a portion of the artificial hip joint surface by a surgical operation. Fig.
36 is a view showing in detail the steps of a laparoscopic method / arthroscopic method.
37 is a view showing different positions of the incisions made on the human body by the surgical operation.
38 is a view showing different positions where a small incision can be made in the human body by the laparoscopic / arthroscopic surgery method.
39A is a view showing a laparoscopic operation method / arthroscope operation for operating a patient's hip joint.
39B is a side view of a section of the laparoscopic / arthroscopic method.
40 is a view showing a sectional view of the hip joint when a hole is formed in the pelvic bone.
41 is a view showing a sectional view of the hip joint when a small hole is formed in the pelvic bone.
42 is a view showing an apparatus for creating a hole in the pelvic bone according to the first embodiment.
43 is a view showing in more detail the equipment for generating a hole in the pelvic bone according to the first embodiment.
44 is a view showing an apparatus for creating a hole in the pelvic bone according to the second embodiment.
45 is a view showing an apparatus for generating a hole in the pelvic bone according to the third embodiment.
46 is a view showing a bone contacting organ according to the first embodiment.
47 is a view showing a bone contact organ according to the second embodiment.
48A is a view showing a step of providing an artificial femur head surface.
48B is a view showing a section of the hip joint after providing the surface of the artificial femur head;
Figure 49 is a view showing an expandable widening.
50 is a view showing the expandable reamer in a folded state.
Figure 51 is a view of the expandable reamer from below.
Figure 52 is a view showing an expandable reamer used in surgical or laparoscopic surgery / arthroscopy.
53A is a view showing the expandable artificial femur head surface according to the second embodiment as it moves through the hole of the pelvic bone.
53B is a view showing the expandable artificial femur head surface according to the second embodiment when it is placed on the femoral head.
53C is a view showing the expandable artificial femur head surface according to the second embodiment when it is placed on the femoral head.
Fig. 54A shows insertion of the surface portion of the artificial femur into the hip joint.
FIG. 54B is a view showing two portions of the artificial femur after the inside of the hip joint is connected to form the surface of the artificial femur.
FIG. 54C is a view showing how the shape of the surface portion of the artificial femoral head enables connection of the artificial femoral head surfaces to form the artificial femoral head surface. FIG.
54D is a view showing a camera inserted in the hip joint.
55A is a view showing a hip joint when a medical device including a plurality of portions is provided.
55B is a plan view of the hip joint when a medical device including a plurality of portions is provided;
56 is a cross-sectional view of a patient when a medical device suitable for creating a hole in the pelvic bone is provided.
57 is a sectional view showing a hip joint when a hole is formed in the pelvic bone.
Fig. 58 is a sectional view of the hip joint when a surgical instrument for removing the femoral head is provided. Fig.
Fig. 59 is a view showing, in cross-section, a hip joint when a surgical instrument for removing the femoral head is placed inside the femoral head and the femur.
60 is a view showing the removal of the femoral head through the hole of the femoral bone.
61 is a view showing removal of a part of bone fragments from the femoral head.
62 is a view showing a piece of bone placed on a medical device.
63 is a view of a medical device in which a piece of bone is inserted through a hole in the pelvic bone.
Fig. 64 is a view showing, in cross-section, a hip joint when a medical device is provided. Fig.
65 is a view showing the step of reaming the femoral neck from the hole of the pelvic bone.
66 is a view showing the step of applying an adhesive to the region of the femoral neck.
67 is a view showing the step of positioning the artificial hip joint surface at the femoral neck.
68 is a diagram illustrating portions of a medical device according to another embodiment.
69 is a view showing a hip joint in a sectional view when the medical device is provided;
Fig. 70 is a view showing arranging the prosthetic part in the hole of the pelvic bone.
71 is a view showing a section of the hip joint when the medical device is fixed;
72 is a diagram showing a pre-installation example of the medical device.
FIG. 73 is a view showing an assembled state of a pre-installed embodiment of the medical device in an assembled state; FIG.
74 is a diagram showing a pre-mounting embodiment of the medical device.
75 is a view showing an assembled state of a pre-installed embodiment of the medical device in an assembled state;
76 is a diagram showing an example of pre-installation of the medical device when the femur is mounted on the femur.
77 is a diagram showing a pre-mounting embodiment of the medical device mounted on the femoral neck;
78 is a view showing the surface of the artificial rib when inserted into the hip joint;
79 is a view showing the surface of the artificial fork in accordance with the first embodiment.
80A is a view showing a surface of an artificial forklift according to the second embodiment.
80B is a view showing the surface of the artificial rib in accordance with the second embodiment in more detail.
80C is a view showing the surface of the artificial ribs at the time of assembly.
FIG. 81A is a view showing a surface of a prosthesis according to the third embodiment. FIG.
FIG. 81B is a view showing a surface of the artificial row of ribs according to the third embodiment at the time of assembly.
FIG. 81C is a view showing the connecting function of the surface of the artificial rib of the art according to the third embodiment. FIG.
FIG. 82A is a view showing the surface of the artificial forklift according to the fourth embodiment. FIG.
82B is a view showing the function of the surface of the artificial rib or groove according to the fourth embodiment.
FIG. 82C is a view showing the artificial glenoid surface according to the fourth embodiment in a folded state. FIG.
FIG. 82D is a view showing the connecting function of the surface of the artificial rib of the fourth embodiment. FIG.
FIG. 83A is a view showing the surface of the artificial rib of the fifth embodiment. FIG.
FIG. 83B is a view showing the artificial glenoid surface according to the fifth embodiment in a folded state. FIG.
84A is a view showing a mechanism for inserting a part into a hip joint according to the first embodiment.
84B is a view showing a mechanism for inserting a part into a hip joint according to the second embodiment.
84C is a view showing a mechanism for inserting a part into a hip joint according to the third embodiment.
85 is a view showing in cross-section the hip joint after the surface of the artificial femur and the surface of the artificial rib surface are provided.
86 is a cross-sectional view of the hip joint in the first state when the medical device is provided.
87 is a view showing, in cross-section, a hip joint in a second state when the medical device is provided;
88 is a view showing, in cross-section, a hip joint in a first state when the medical device is provided;
89 is a cross-sectional view of the hip joint in the second state when the medical device is provided.
90 is a view showing the medical device in a sectional view;
91 is a diagram showing another embodiment of the medical device shown in Fig. 88 in the first state; Fig.
92 is a diagram showing another embodiment of the medical device shown in Fig. 88 in the second state; Fig.
93 is a view showing, in cross-section, a hip joint in a first state when a medical device according to another embodiment is provided.
94 is a cross-sectional view of a hip joint in a second state when a medical device according to another embodiment is provided.
95A is a cross-sectional view of a hip joint in a first state when a medical device is provided that includes an elastic band or rupture band.
95B is a view showing the medical device of Fig. 95A in a first state in a sectional view.
Figure 96a is a cross-sectional view of a hip joint in a second state when a medical device is provided that includes an elastic band or rupture band.
FIG. 96B is a view showing the medical device of FIG. 96A in the second state in a sectional view. FIG.
97 is a cross-sectional view of a hip joint in a first state when a medical device according to another embodiment is provided.
98 is a view in cross-section of a hip joint in a second state when a medical device according to another embodiment is provided.
99 is a view in cross-section of a hip joint in a first state when a medical device according to another embodiment is provided.
100 is a view showing in cross-section a hip joint in a second state when a medical device according to another embodiment is provided.
101 is a view showing, in cross-section, a hip joint in a first state when the medical device according to the embodiment is provided with an artificial rib surface including an elastic element;
102 is a view in cross-sectional view of a hip joint in a second state when the medical device according to the embodiment is provided with an artificial rib surface including an elastic element;
103 is a diagram showing another embodiment of the medical device shown in Fig.
104 is a view showing an embodiment in which the surface of the artificial rib is fixed to the pelvic bone and the surface of the artificial femur is fixed to the femoral head.
FIG. 105 is a sectional view of a hip joint when a mold is inserted. FIG.
106A is a diagram showing generation of life span of the femoral bone.
106B is a view showing a mechanism for introducing an object into the hip joint through the femoral bone.
106c is a view showing the positioning of the mold inside the hip joint using a mechanism operating through the thigh bone.
FIG. 106D is a cross-sectional view of the hip joint after the mold is placed in the hip joint using a mechanism that operates through the thigh bone.
107 is a view showing insertion of the first sealing member into the hip joint.
108 is a view showing the insertion of the second sealing member.
FIG. 109A is a view showing creating a hole in the femoral bone. FIG.
109B is a view showing a mechanism for introducing an object to the hip joint through the femoral bone.
109c is a view showing the positioning of the sealing member inside the hip joint using a mechanism that operates through the thigh bone.
110A is a view showing a mechanism for inserting a mold or a sealing member into a hip joint.
110B is a sectional view showing a mechanism for inserting a mold or a sealing member into a hip joint.
110C is a sectional view showing a mechanism for inserting a mold or a sealing member into the hip joint according to the second embodiment.
111 is a view showing filling of the sealed region inside the hip using a mechanism operating through the pelvic bone.
112 is a view showing the filling of the mold inside the hip using a mechanism that operates through the thigh bone.
113 is a view showing filling of the sealed region inside the hip using a mechanism that operates through the thigh bone.
114 is a cross-sectional view of a hip joint after filling a sealed region of the hip joint with fluid;
115 is a view showing the insertion of fluid into the region of the hip joint;
116 is a view showing the filling of the hole of the hip joint using a bone plug;
117 is a view showing fixing of a bone plug to a pelvic bone.
118 is a view showing a portion for filling a hole of a pelvic bone having a displaceable support member;
119A is a view showing a prosthetic portion used to fill a hole of a pelvic bone.
119B is a view showing a method of using a section of the prosthetic portion as a support against the edge of the hole of the pelvic bone.
119c is a view showing insertion of the prosthetic part into the hole of the pelvic bone.
120 is a view showing a method of fixing a bone plug or prosthesis to a hole of a patient's pelvic bone using a screw;
121 is a view showing a cross-sectional view of the pelvic bone.
122A is a view showing a method of fixing a bone plug or prosthesis to a hole of a patient's pelvic bone using a support plate.
122B is a view showing two bone plugs or prostheses fixed using a support plate.
122c is a view showing a cross section of the hip joint after filling two holes of the pelvic bone with fluid.
123A is a view showing an injection member configured to inject fluid into a region of the hip joint;
123B is a view showing an injection member configured to inject fluid into a region of the hip joint when injecting the fluid.
124 is a view showing the injection member in more detail;
125A is a view showing a step of sealing or stamping in a surgical operation method.
125B is a view showing a step of sealing or stamping in the laparoscopic / arthroscopic method.
126 is a diagram showing a front view of the patient when the lubrication system is provided;
127 is a view showing the hip joint and lubrication system in more detail.
128 is a diagram showing a circulating lubrication system.
129 is a diagram showing a circulating lubrication system having a filter.

Hereinafter, embodiments of the present invention will be described as an example with reference to the accompanying drawings.

Biocompatible materials can be understood as materials having a low level of immune response. Biocompatible materials are often also referred to as biomaterials. Similarly, a biocompatible metal is a metal with a low immune response, such as titanium or tantalum. Such biocompatible metals may also be biocompatible alloys comprising at least one biocompatible metal.

The shape fitting can be understood as a member having a portion or section configured to mechanically connect the member to at least one other member using the member or section. The shape fitting structure is a structure of a member capable of shape fitting.

The elasticity can be understood as the ability of the material to be deformed in an elastic manner.

Elastic deformation refers to the material being deformed under stress (e.g., external force) but returning to its original shape when the stress is removed. A more elastic material can be understood as a material having a lower elastic modulus. The elastic modulus of an object is defined as the slope of the stress-strain curve in the region of elastic strain. The elastic modulus is calculated as the stress / strain, where the stress is the force that causes the strain divided by the area applied by this force; Deformation is the rate of deformation caused by stress.

The stiffness can be understood as the resistance of the elastic body to deformation by the applied force.

Functional buttock movement can be understood as the movement of the buttocks at least partially corresponding to the natural movement of the buttocks. In some cases, the natural movement of the hip joint may be somewhat limited or changed after hip surgery, and the functional hip motion of the hip with an artificial surface will be somewhat different from the functional hip motion of the hip.

The functional location of the implantable medical device or prosthesis is where the hip can perform functional gluteal motion.

A functional hip is a hip joint capable of performing a functional hip motion in the absence of an implanted medical device or prosthesis or in the absence of an implanted medical device or prosthesis.

In certain embodiments of the invention, the contact surface may comprise a ceramic material such as a zirconium dioxide ceramic material.

A detailed description of the embodiments will be provided below. In the drawings, like reference numerals designate like or corresponding elements throughout the several views. It will be appreciated that these figures are for illustrative purposes only and are not intended to limit the scope of the invention. Thus, any reference to a direction such as "up" or "below " is merely to refer to the orientation shown in the figures. In addition, any of the dimensions and the like shown in the drawings are for the purpose of illustration.

Figure 1 shows a patient ' s hip joint in cross-section. The hip includes the femoral head (5) located at the top of the femur (6; collum femur), which is the top of the femur bone (7). The femoral head is connected to the rib 8, which is a bowl-shaped portion of the pelvic bone 9. The surface 10 of the femoral head and the surface of the iliac crest 11 are covered with articular cartilage 13, which acts as a cushion in the hip joint. In patients with hip arthritis, these articular cartilages 13 are also abnormally worn out by mild inflammation. The hip joint is surrounded by a capsule (12) that provides support for the joint and prevents dislocation. After conventional hip arthroplasty through the capsular bag, the capsular capsule (12) is dramatically weakened due to the limited healing ability of the ligament tissue. By performing hip arthroplasty without damage to the capsular bag (12), the patient can fully recover and apply the same amount of pressure on the artificial joint as possible to the natural joint.

Functional buttock movement can be understood as the movement of the buttocks at least partially corresponding to the natural movement of the buttocks. In some cases, the natural movement of the hip may be somewhat limited or altered after hip surgery, and the functional hip motion of the hip with an artificial surface will be somewhat different from the functional hip movement of the hip.

The functional position or normal functional position of the implantable medical device or prosthesis is the position at which the hip joint can perform functional gluteal motion. The final position can be understood as a functional location where the medical device does not require further position changes.

2 shows a side view of a conventional hip surgery in which the incision 112 is made in the femur 113 so that the surgeon can reach the femur bone 7 where the femur head 5 is located.

Figure 3 shows placement of the artificial femoral head surface 45 on the femoral head 5 in a conventional surgical procedure when the femur is removed from its position in the hip joint.

Fig. 4 shows placement of the artificial femoral head surface 45 on the femoral head in a conventional surgery. The artificial femoral head according to the present embodiment is configured such that the structure of the surface of the artificial femur is formed by a slit 49 and an arm 50 which softly clasp the femur head 5 and allow the femur head 5 to become soft beyond the maximum diameter of the femoral head 5 ). Also, the artificial femoral head surface 45 can be inserted into the hip joint through a hole that is smaller than the total functional size of the artificial femoral head surface 45, enabling less invasive surgical procedures.

Figure 5 illustrates placement of the artificial femoral head surface 45 on the femoral head in a conventional surgery. The artificial femoral head according to the present embodiment has a structure in which the structure of the artificial femoral head has a larger slit 49 and a smaller arm 49 which allow the femoral head 5 to be gripped and softened to exceed the maximum diameter of the femoral head 5 50). Also, the artificial femoral head surface 45 can be inserted into the hip joint through a hole smaller than the entire functional size of the artificial femoral head surface 45, thereby enabling less invasive procedures.

Figure 6 shows placement of the artificial femoral head surface 45 on the femoral head in a conventional surgery. The artificial femoral head surface 45 includes a plurality of ring-shaped artificial femoral head surface portions 63. The plurality of ring-shaped artificial femoral head surface portions 63 are connected to each other to form an artificial femoral head surface 45.

Figure 7 shows placement of the artificial femoral head surface 45 on the femoral head in a conventional surgical procedure. The artificial femoral head surface 45 includes a plurality of portions 46 that are connected to each other and configured to form an artificial femur head surface 45.

Figure 8 shows the placement of the artificial femoral head surface 45 in a conventional surgical procedure and the femur bone 7 is cut at the neck or femoral neck and the neck is replaced by the prosthesis stem 1201, The stem 1201 also secures the medical device to the femur bone 7 by being fixed to the femur bone 7 using bone cement or without bone cement. The artificial rib surface 65 is pre-mounted on the artificial femoral head 45. The artificial rib surface 65 has ductility because the artificial rib surface 65 includes a slit 66. The artificial rib surface 65 is further secured by a band, cord or wire 59 disposed beyond the maximum diameter of the femoral head to secure the artificial rib surface 65 to the artificial femoral head 45.

9 shows the artificial rib surface 65 that is disposed in the patient ' s zebra and is secured to the pelvic bone 9. As shown in FIG. A less invasive procedure that includes a slit 66 that allows the artificial orbital surface 65 to exceed the maximum diameter of the femoral head 5 and / or passes through a hole that is smaller than the maximum functional size of the artificial ankle surface 65 The artificial rib surface 65 is structurally flexible.

Fig. 10 shows a side view of the thigh of a patient when the incision made to reach the hip joint is sealed by the suture line 110. Fig.

Figure 11 shows in cross-section the artificial femoral head surface 45 having a maximum cross-sectional distance 52 that is configured to exceed the maximum diameter of the femoral head 5. The maximum diameter of the femoral head 5 is located at the corresponding maximum cross-sectional distance 61 of the surface of the artificial femur. The second distance 62 is the distance that the artificial femur head surface 45 exceeds the maximum diameter of the femoral head 5. This distance 62 is an excess of the surface of the artificial femur head and is the portion of the femoral head 5 that mechanically fixes the artificial femur head surface 45.

12A shows the surface of the artificial femur head according to the first embodiment, and the artificial femur head surface 45 is configured to exceed the maximum diameter of the femoral head 5. This enables mechanical fixation using the shape of the artificial femoral head surface 45. In this embodiment, the artificial femur head surface 45 includes at least one slit 49 that makes the artificial femur head surface 45 flexible so that it exceeds the maximum diameter of the femoral head 5. The structure may be further ducted such that the size of the artificial femoral head surface 45 is changed smaller so as to be inserted through the hole 18 in the pelvic bone 9 smaller than the overall functional size of the artificial femoral head surface 45 . It is also conceivable that the artificial femoral head surface 45 comprises two or more artificial femoral head surface arms 50 having a cross-sectional distance 52 from each other. According to one embodiment, such a cross-sectional distance 52 is shorter than the maximum diameter of the femoral head 5, so that the artificial femur head surface arm 50 enables mechanical fastening of the artificial femoral head surface 45. For additional fixation, a band, cord or wire 59 may be placed around the artificial femur head surface 45 beyond the maximum diameter of the femoral head 5. A band, a cord or a wire 59 may be mechanically connected using the self-locking member 50 to form a ring-shaped member that helps secure the artificial femur head surface 45 to the femoral head 5 .

12B shows the artificial femoral head surface 45 when fixed to the femoral head using a support band, cord or wire disposed around the artificial femoral head surface 45 beyond the maximum diameter of the femoral head 5 . The arm may also be configured to enter the bone of the femoral head 5 and lock the artificial femoral head surface 45.

13 shows a partial view of the hip joint and the hip joint includes a femoral neck 6 having a first axis distribution leading to the femoral head 5 and a central axis L1 of the femoral head 5 is a center axis And the femoral head has a substantially ball-shaped structure having an outer maximum diameter 1203 substantially perpendicular to the central axis Ll of the femoral head when viewed in an AA cross-section. The femoral head 5 is normally located in a bowl-shaped glenoidal opening 8 having an opening and the bowl-shaped glenoidal opening 8 extends from the center of the lower portion of the ankle-bone bowl 8 along the center of the bowl, And has a second axis distribution having a central axis L2 of the typhus cortex facing the femoral head 5 toward the second axis. The bony elbow ball 8 has an inner maximum diameter 1202 which is substantially perpendicular to the center of the oropharyngeal bone L2 when viewed in cross section BB and the center axis L2 of the femur 2 has a femoral head 5, Aligned with the center of the chin bone 8 in the hip joint as shown in Fig. The femoral head 5 and the ankle 8 each have a single hip surface disposed facing and in contact with each other, and the hip surface can withstand the weight of the hip joint.

Fig. 14 shows the artificial femur head surface 45 according to the second embodiment. A shaft or a screw located in the center of the artificial femoral head surface 45 serves as a mechanical attachment 44 that passes through the cortex of the femur head 5 and fixes the artificial femoral head surface 45 to the femoral head 5 . However, such a shaft or screw may be assisted or replaced with screws, welds, sprints, bands, adhesives or any other mechanical connecting member.

FIG. 15 illustrates the artificial hip surface according to one embodiment, wherein the artificial hip surface includes an inner surface 906, and an outer surface 907. The inner surface has a first point 908a, a second point 909a, a third point 908b, a fourth point 909b, a fifth point 908c and a sixth point 909c, A first straight line 910a extending from the first point 908a to the second point 909a is disposed at a third point 908b on the inner surface 906, And then this second straight line 910b is parallel to the third straight line 910c from the fifth point 908c to the sixth point 909c, The first and third straight lines 910a and 910c have the same length and the second straight line 910b is longer than the first straight line 910a and the third straight line 910c, (910a) and the third straight line (910c). As a result, the surface of the artificial hip exceeds the maximum diameter of the artificial hip surface, which allows the artificial hip surface to grip members such as the femoral head (5), artificial femoral head surface, or an artificial replacement of the femoral head. The artificial hip surface is curved in two or more directions and is the same as shown with reference to L1 and L2, which are curved lines in the vertical direction.

Figure 15B shows an artificial femur head surface 45 according to a third embodiment wherein the artificial femur head surface 45 comprises at least one slit 49, So that the maximum diameter 51 of the artificial femur 45 can be inserted through the hole in the pelvic bone 9 smaller than the total functional size of the artificial femur head surface 45, Can be changed. According to this embodiment, the artificial femur head surface 45 further comprises an artificial femoral head surface arm 50 positioned on the side of the at least one slit 49. The femoral head surface arm 50 may be made of a flexible material so that the hole 18 in the pelvic bone 9 smaller than the maximum diameter 51 of the artificial femur head surface 45 when in its full functional size Or the like.

According to one embodiment, the artificial femoral head surface 45 of the third embodiment can be configured to exceed the maximum diameter of the femoral head 5. This enables mechanical fixation using the shape of the artificial femoral head surface 45. In an embodiment in which the artificial femoral head surface 45 exceeds the maximum diameter of the femoral head 5, the artificial femur head surface 45 is formed with an artificial femur head surface 45 to be inserted through the hole 18 in the pelvic bone smaller than the total functional size of the artificial femoral head surface 45, The structure can be flexible so that the size of the artificial femur 45 is changed to be smaller than the size of the artificial femur 45 and can have an aperture adapter beyond the femoral head 5, So that the artificial femur head surface 45 can at least partially cover an area exceeding the maximum diameter of the femoral head 5 from the direction of the ankle 8. According to a second embodiment, the artificial femur head surface 45 comprises two or more artificial femoral head surface arms 50 having a cross-sectional distance 52 from each other. According to one embodiment, this cross-sectional distance 52 is shorter than the maximum diameter of the femoral head 5, thereby enabling mechanical fixation of the artificial femoral head surface 45 by the artificial femur head arm 50.

Figs. 16A, 16B, 16C, 16D and 16E illustrate an artificial femur head surface 45 according to a fourth embodiment, wherein the artificial femur head surface 45 is formed as shown in Fig. 1 section 53a and a second section 53b. The first and second sections are displaceable with respect to each other. According to the first embodiment, the first section 53a can be rotated with respect to the second section 53b so that the second section 53b, as shown in Fig. 16c, is moved below the first section 53a The displaced artificial femoral head surface 54 can be inserted into the patient's hip through the oval hole 18 or at least can be inserted into the patient's hip joint, Sectional area of the artificial femoral head surface 45 when it is at the total functional size 45 as shown in FIG. According to the present embodiment, these two sections are connected to each other when the artificial femoral head surface 45 is returned to the full functional size using the mechanical shape fitting 55 as shown in Fig. 16E. However, it is anticipated that such connections may also be assisted or replaced by screws, welds, sprints, bands, adhesives or any other mechanical connecting member.

17A and 17B show an artificial femur head surface 45 according to a fifth embodiment, wherein the artificial femur head surface 45 includes four slits. The artificial femoral head surface 45 is structurally flexible so that the four artificial femoral head arms 50 can be folded toward the central axis of the artificial femoral head surface 45 so that the artificial femoral head surface 45 And can be inserted into the hip joint through a hole smaller than the entire functional size of the artificial femoral head surface 45. According to the present embodiment, the artificial femoral head surface 45 may be configured to exceed the maximum diameter of the femoral head 5, and in this case, the structure with the slit 49 may be such that the artificial femur head surface 45 has a full functional size Allowing both the smaller size and larger size to be varied.

17B shows the artificial femur head surface 45 when the artificial femur head arm 50 is folded so as to be inserted through the hole 18 having an area smaller than the maximum area of the artificial femoral head surface 45 in the entire functional size ). ≪ / RTI >

18A shows an artificial femur head surface 45 according to a sixth embodiment, wherein the artificial femur head surface 45 includes a plurality of ring-shaped artificial femoral head surface portions 63. Fig. The plurality of ring-shaped artificial femoral head surface portions 63 are configured to be connected to each other to form an artificial femoral head surface 45 as shown in Fig. 18B. According to one embodiment, the artificial femoral head surface portions 63 are configured to be connected to each other by using mechanical connecting members 64a, 64b. In Fig. 18C, 64a shows a manner in which each ring-shaped artificial femoral head surface portion 63 is connected by itself in order to form a continuous ring shape. 64b illustrate how each ring-shaped artificial femoral head surface portion 63 is connected to the other ring-shaped artificial femoral head surface portion 63 to form the artificial femoral head surface 45. [ According to the present embodiment, the artificial femur head surface 45 can be further configured to exceed the maximum diameter of the femoral head 5.

Figs. 19A, 19B and 19C show an artificial femur head surface 45 according to a sixth embodiment, wherein the artificial femur head surface 45 includes a plurality of artificial femoral head surface portions 46. Fig. The plurality of artificial femoral head surface portions 46 may be inserted into the hip joint and then connected to the interconnecting artificial femoral head surface portion 56. The interconnected artificial femoral head surface portion serving as the base portion 56 includes a self-locking connecting member 57 as shown in Fig. 19B, which includes a corresponding self-locking member 58 of the artificial femur head surface portion 46, . The artificial femoral head surface has a substantially even surface, which according to one embodiment has a height difference 1204 of up to 10 mu m, according to another embodiment a height difference 1204 of up to 100 mu m, According to another embodiment, it has a height difference 1204 of at most 1 mm. The artificial femoral head surface 45 may be further configured to exceed the maximum diameter of the femoral head 5.

After at least two artificial femoral head surfaces are mounted in place on the femoral head, according to some embodiments, these portions need to be further anchored to the femoral head using a locking member. An embodiment of the locking member combined with the surface portion or portion of the artificial femur bone is further disclosed below with reference to Figures 20a to 20n.

20A shows an artificial femur head surface 45 in accordance with one embodiment wherein the artificial femur head surface is connected to the interconnect 56 by an operable joint 1205 disposed along one side of the moveable portion 1224, And a plurality of movable portions 1224 connected to the movable member. After the movable portions 1224 are disposed at their functional positions to grip the femur head 5, the surface of the artificial femur head is moved in the same manner as the band, cord or wire 59, which is disposed beyond the maximum diameter of the femoral head 5 And further fixed to the femoral head by a lock member 59. [ The A-A section shows the movable portion 1224 when not in the functional state. The movable portion is connected to the interconnecting portion 56 through a movable member in the form of a hinge 1205 so that the movable portion can move and grip the femoral head 5 and / The maximum diameter of the artificial femur head surface is changed so as to pass through the smaller hole, in which case the movable member is moved in the direction toward the center of the artificial femoral head surface (not shown).

Fig. 20B discloses an adjustable locking member 59 to be mounted on the artificial femur head surface 45. Fig. The locking member 59 is a loop-shaped member having two ends 59a and 59b which are mechanically connected using the engaging member 60 and are configured to form a closed loop having a specific circumference. The locking member 59 may be made of an elastic material that is deformed under stress (e.g., external force) but returns to its original shape when the stress is removed.

The artificial femoral head surface 45 includes two or more artificial femoral head surface arms 50 that form a maximum diameter 52. In order to lock the artificial femoral head 2 in the femoral head 5, the locking member 59 is moved in the open state until the surface of the locking member 59 reaches a distance D that exceeds the maximum diameter of the femoral head 5, (45). The locking member 59 can also be pulled until it reaches the surface arm 50 and lies thereon. When in the final position, the locking member ends 59a and 59b are mechanically connected by the engagement member 60 and the artificial femoral head is held in place.

20C shows another embodiment of the locking member 59 and the engaging member 60. Fig.

A first embodiment of the locking member 59 and the engaging member 60 is shown in Fig. Engagement member 60 includes first and second portions 60a, 60b arranged at first and second locking member ends 59a, 59b, respectively. The first and second engagement member portions 60a, 60b have the shape of protrusions extending axially upward and downward from the first and second locking member ends, respectively. Thus, a horizontally arranged gripping claw is formed. The first engagement member portion 60a has an incision on the lower surface and the second engagement member portion 60b has an incision on the upper surface. These cut-outs are arranged to form upper and lower hooks which are mechanically self-connected by utilizing the elasticity of the material and are configured to form loops having specific circumferences suitable for the diameter of the femoral head 5.

In the second embodiment of the locking member 59 shown in Figure 20d, the engagement member 60 'is arranged at one of the first and second ends 59a and 59b of the locking member. At the first locking member end 59a, one first engaging member portion 60a 'in the form of a protrusion extending radially toward the center of the loop is arranged. The first engaging member portion 60a is configured to engage one of the corresponding second engaging member portions 60b and the second engaging member portion 60b is configured to engage with the rest of the locking member extending radially from the center of the loop. And is a protrusion arranged at the second end 59b. The protrusions form an engaging member in the form of a vertically arranged gripping claw 60 '. The circumference of the locking member can be adjusted by using two or more second engaging member portions 60b and arranging them at different distances from the second end 59b of the locking member. 20d, two or more, preferably three to six, gripping claws 60b 'are arranged on the second end 59b of the locking member 59. In the second embodiment of Fig. The diameter of the locking member 59 can be adjusted in this way.

A third embodiment of the locking member 59 is shown in Fig. 20e. A first engaging member portion 60a "in the form of a protrusion at one first end 59a of the locking member 59 is provided at the other second end 59b of the locking member 59, Into the second engaging member portion 60b " It is also possible to have two or more holes so that the circumference of the locking member 59 is adjustable.

A fourth embodiment of the locking member 59 is disclosed in Fig. 20f. Wherein the first and second ends 59a and 59b of the locking member 59 have two pivotable first locking portions 60a1 '' 'and 60a2' '' and one second locking portion 60b '' ' Quot;) < / RTI > The first locking portion 60a1 '' 'is pivotally attached to the first end portion 59a of the locking member 59 and the second locking portion 60a2' ''. The second locking portion 60a2 '' 'is preferably formed at an engagement point arranged between the outer ends of the first locking portion 60a1' '', preferably substantially at the center of the first locking portion 60a1 ' Is attached to the first locking portion 60a1 '" The second locking portion 60a2 '' 'is also configured to engage with a projection 60b' '' arranged at the second end 59b of the locking member 59. When the second locking portion 60a2 '' 'is engaged with the projection 60b' '', the first and second ends of the locking members 59a and 59b are locked together to form a closed loop having a first circumference . The first and second locking member ends 59a and 59b may be pulled together to form a closed loop having a second circumference that firmly surrounds the artificial femoral head and locks it against the femoral head 5. [ The first and second locking member ends 59a and 59b are pulled together to pivot by pivoting the first locking portion about the engagement point at the first end 59a of the locking member. The first and second locking member ends 59a and 59b may overlap each other or may be arranged end to end when locked together to form a loop having a second circumference.

Figure 20g shows another embodiment of a locking member wherein the locking member does not completely surround the femoral head surface 45 and thus leaves the point 2101 free of locking members. According to the embodiment shown in Fig. 20G, the locking member 59 clamps the surface of the artificial femur bone by making the locking member made of an elastic material such as stainless steel. The structure with the locking member allows the surface of the artificial femur to be made of a more resilient material, thereby allowing the surface of the artificial femur to extend beyond a larger portion of the femoral head. One advantage of the embodiment shown in Fig. 20g is that the locking member 59 need not be as elastic as the locking member completely surrounding the femoral head to be held in place by the surgeon.

Figure 20h shows a locking member according to an embodiment similar to the previously described embodiment with reference to Figure 20g. 20h, however, the locking member 59 includes a hinge 2105 located at the center of the locking member 59 in which the two portions 2106a, 2106b of the locking member are connected do. A locking device connected to the hinge is arranged to include a male part 2108 configured to be connected to the female part 2109, thereby forming a locking position. The locking member in the locked position grasps the artificial femoral head surface 45 and thus further secures the artificial femoral head surface 45 to the femoral head. The embodiment of Figure 20h with hinges is similar to the embodiment described with reference to Figure 20g in that a locking member is made of a less elastic material than is necessary in the case of an embodiment in which an entire locking piece is made of a single piece of material I will. This embodiment can further reduce the force required to lock the locking member 59 in place onto the artificial femur head surface 45.

20I shows a locking member 59 according to yet another embodiment wherein the locking member 59 includes first and second units (not shown) disposed on two sides of the slit 49 of the artificial femur head surface 45 2102a, 2102b. The first unit 2102a includes a male part 2103 that can be inserted into the female part 2104 of the second unit 2102b and the male part 2103 is locked in the female part 2104, The slit 49 is placed in a more closed state to fix the femoral head surface 45. [

20J illustrates a medical device according to one embodiment wherein the locking member 59 is disposed at the top center of the embodiment of the artificial femur head surface 45 and the artificial femoral head surface is divided into two halves . The locking member includes first and second units 2102a and 2102b according to the embodiment shown with reference to Figure 20i, and the first unit is a male part that is configured to be locked to the inside of the female part housed in the second unit (2103).

20k illustrates an embodiment of a locking member 59 wherein the locking member 59 is configured to extend from the first point of the artificial femoral head surface 45 through the bones of the femoral head and / To the second point of the second line. This embodiment allows the locking member to engage the artificial femoral head surface 45 by gripping the femoral head with a squeezing force and / or allowing the locking member 59 within the bone to actually create a mechanical lock It can be fixed to the femoral head. According to the embodiment shown in FIG. 20K, the locking member 59 advances through the bones of the femoral head / femoral head from one point on the artificial femur head surface 45 to another point on the artificial femur head surface 45. However, in another embodiment (not shown), the locking member proceeds from one point on the surface of the artificial femur to the bone of the femoral head / femoral neck, and in this embodiment the locking member may be a mechanical fixing member such as an orthopedic screw.

Fig. 20L shows a kit according to the first embodiment, which comprises three different sized artificial femoral head surfaces 45a, b, c, which can be selected on the basis of the patient, To fit, the locking member 59 has some condition that can be tightened around the different artificial femoral head surfaces 45a, b, c.

20m shows a kit according to the second embodiment, which includes one artificial femur head surface 45 and three different sized locking members 59a, b, c, and three different sized The locking members 59a, b, c may be disposed to surround the artificial femur head surface 45 and may be selected for a particular femur of a patient.

20n shows a kit according to the second embodiment, which comprises three different sized artificial femoral head surfaces 45a, b, c and three different sized locking members 59a, b, c, and three different sized locking members 59a, b, c may be disposed to surround the artificial femur head surface 45 and selected for a particular femur of a patient.

The kit solution allows an orthopedic surgeon to select a suitable medical device when the femoral head is exposed, since it is very difficult to determine the exact size and shape of the femoral head with only a simple image formed from the outside of the body.

21 is a conceptual diagram in which a diameter or cross-sectional distance dl sufficiently small to allow the artificial femoral head surface 45 according to any of the embodiments herein to move through the hole 18 in the pelvic bone 9 . After the artificial femoral head surface 45 has moved through the hole 18 in the pelvic bone 9, the artificial femur head surface 45 is expanded so that the diameter or cross-sectional distance d2 exceeds the femoral head 5 It becomes long enough. Finally, the artificial femoral head surface 45 is located on the femoral head 5, and in this state, the diameter d3 or the cross-sectional distance is smaller than the maximum diameter of the femoral head 5, The two surfaces 45 are mechanically attached. d3 is the steady-state cross-sectional distance of the medical device, i.e., the cross-sectional distance that the medical device has when the medical device is in the functional position. The figure may also show an artificial ganglion surface mounted on the femoral head or an artificial alternate thereof having the same locking principle as an alternative embodiment.

22A is a conceptual view, wherein the artificial rib surface 65 has a diameter or cross-sectional distance d1 that is small enough to allow movement through the hole 18 in the pelvic bone 9. [ After the artificial ganglion surface 65 has moved through the hole 18 in the pelvic bone 9, the artificial ganglion surface is pulled out of the hole 18 in the pelvic bone 9, The diameter or the cross-sectional distance d2 is enlarged sufficiently large so as not to be able to pass through.

23 illustrates a medical device according to one embodiment wherein the medical device includes an artificial femoral head surface 45, a fixation member 608 and a stabilization member 612 and the stabilization member 612 includes a femoral head The femoral head 6 is positioned so as to come into contact with the cut surface portion 610 on the femoral head 6 so as to be substantially perpendicular to the longitudinal extension line of the femur 6 from the outside of the femur 6 and from the longitudinal direction of the femur 6 And is configured to stabilize the medical device substantially in side by side with the extension line. The stabilizing member 612 and the fixing member 608 can be fixed to the femoral neck 6 by the adhesive 614 or the bone cement. The stabilizing member 612 is made of a biocompatible polymer (e.g., titanium or tantalum), or a biocompatible polymer or ceramic material. The medical device includes two portions configured to form interconnected, interconnected medical devices. The first portion of the medical device includes a first portion 608 'of the anchoring member and a first portion 45' of the femoral head surface. The second portion of the medical device includes a second portion 608 "of the anchoring member and a second portion 45" of the femoral head surface. These parts are configured to be connected to each other by a sliding dovetail joint. The first portion of the medical device includes a dovetail groove 1207 that fits into the dovetail section 1206 of the second portion of the medical device. These two portions may be interconnected to form a medical device prior to or during the surgical procedure, preferably during surgery, such that the portions are joined together by a hole that is smaller than the hole through which the interconnected medical device can pass Because these parts can be introduced into the hip joint. The A-A cross section shows the anchoring femoral head 45 and the anchoring portion when interconnected by the sliding dovetail 1206, 1207.

Fig. 24 shows a medical device including an artificial femoral head 45 and a prosthetic stem 1201. Fig. The medical device includes two portions, each including portions 1201 ', 1201 " of the prosthesis stem and artificial femoral head surfaces 45', 45 ". The medical device is configured to be interconnected by a plurality of sliding dovetail joints 1206 and 1207 and the dovetail groove of the second portion of the medical device fits into the dovetail section 1206 of the first portion of the medical device. The A-A cross-section shows the prosthetic stem of the first portion 1201 'with the dovetail section 1206 and the prosthesis stem of the second portion with the dovetail groove 1207.

Figure 25 illustrates a medical device according to one embodiment wherein the medical device includes an artificial femoral head 45, a fastening member 608 and a stabilizing member 612, 6 so as to be substantially perpendicular to the longitudinal extension of the femoral neck 6 from the outside of the femur 6 and from the side of the longitudinal axis of the femoral neck 6 RTI ID = 0.0 > substantially < / RTI > The medical device includes two portions configured to form interconnected, interconnected medical devices. The first portion of the medical device includes a first portion 608 'of the anchoring member and a first portion 45' of the femoral head surface. The second portion of the medical device includes a second portion 608 "of the anchoring member and a second portion 45" of the femoral head surface. These portions are configured to be connected to each other by a structure having fins 1208 and grooves 1209 that fit together. The first portion of the medical device includes a groove 1209 that fits into the pin 1208 of the second portion of the medical device. These two portions may be interconnected to form a medical device prior to or during the surgical procedure, preferably during surgery, such that the portions are joined together by a hole that is smaller than the hole through which the interconnected medical device can pass Because these parts can be introduced into the hip joint. The pin 1208 and the groove 1209 are secured by an elongate member 1212, which may be flexible like a wire, or rigid like a pin. The elongated member 1212 is configured to be inserted into the hole 1211 of the first portion of the medical device and the hole 1210 of the pin 1208 to secure the pin within the groove 1211. The AA section shows the fixed portion 608'608 '' of the medical device where the elongated member 1212 is located in the hole 1210 in the pin 1208 and in the hole 1211 in the medical device. And an end portion 1213 having a flat upper surface configured to form a portion of the surface 45.

Fig. 26 shows a medical device including an artificial femoral head 45 and a prosthetic stem 1201. Fig. The medical device includes two portions, each including portions 1201 ', 1201 " of the prosthesis stem and artificial femoral head surfaces 45', 45 ". These portions are configured to be connected to each other by a structure having fins 1208 and grooves 1209 that fit together. The first portion of the medical device includes a groove 1209 that fits into the pin 1208 of the second portion of the medical device. These two portions may be interconnected to form a medical device prior to or during the surgical procedure, preferably during surgery, such that the portions are joined together by a hole that is smaller than the hole through which the interconnected medical device can pass Because these parts can be introduced into the hip joint. The pin 1208 and the groove 1209 are secured by an elongate member 1212, which may be flexible like a wire, or rigid like a pin. The elongated member 1212 is configured to be inserted into the hole 1211 of the first portion of the medical device and the hole 1210 of the pin 1208 to secure the pin within the groove 1211. The AA cross-section shows the prosthetic stem 1201 ', 1201 "of the medical device where the elongated member 1212 is located in the hole 1210 in the pin 1208 and in the hole 1211 in the medical device. And an end portion 1213 having a flat upper surface configured to form a portion of the femoral head surface 45.

27A shows a medical device including an artificial femoral head 45 and a prosthetic stem 1201. Fig. The medical device includes two portions, each including portions 1201 ', 1201 " of the prosthesis stem and artificial femoral head surfaces 45', 45 ". These portions are configured to be connected to each other by a structure having fins 1214 and grooves 1215 that fit together. The first portion of the medical device includes a hole 1215 that is configured to receive the pin 1214 in a first direction and then lock the pin in the hole in a second direction. These two portions may be interconnected to form a medical device prior to or during the surgical procedure, preferably during surgery, such that the portions are joined together by a hole that is smaller than the hole through which the interconnected medical device can pass Because these parts can be introduced into the hip joint. A-A cross-section in Figure 27C shows the pin 1214 in the hole 1215 after the pin 1214 is first introduced in one direction and then pressed to the side to lock the pin 1214 in the hole.

28A shows a medical device according to one embodiment wherein the medical device includes an artificial femoral head 45, a fastening member 608 and a stabilizing member 612, 6 so as to be substantially perpendicular to the longitudinal extension of the femoral neck 6 from the outside of the femur 6 and from the side of the longitudinal axis of the femoral neck 6 RTI ID = 0.0 > substantially < / RTI > The medical device includes two parts configured to form a interconnected and interconnected medical device as shown in Figure 28B. The first portion of the medical device includes a first portion 608 'of the anchoring member and a first portion 45' of the femoral head surface. The second portion of the medical device includes a second portion 608 "of the anchoring member and a second portion 45" of the femoral head surface. These portions are configured to be connected to each other by a structure having a pin 1216 and a hole 1217 that fit together. The first portion of the medical device includes a hole 1217 that is configured to receive the pin 1216 in a first direction and then lock the pin in the hole 1217 in a second direction. These two portions may be interconnected to form a medical device prior to or during the surgical procedure, preferably during surgery, such that the portions are joined together by a hole that is smaller than the hole through which the interconnected medical device can pass Because these parts can be introduced into the hip joint. A-A cross-section in Figure 28C shows the pin 1216 in the hole 1217 after the pin 1216 is first introduced in one direction and then pressed to the side to lock the pin 1216 in the hole 1217. [

29A shows a medical device including an artificial femoral head 45 and a prosthetic stem 1201. Fig. The medical device includes two portions, each including portions 1201 ', 1201 " of the prosthesis stem and artificial femoral head surfaces 45', 45 ". These portions are configured to be connected to each other by a structure having fins 1218 and grooves 1219 that fit together. The first portion of the medical device includes a hole 1219 which receives the pin 1218 in a first direction and then rotates the first and second portions about the other to receive the pin 1218 in a second direction And is configured to lock the pin within the hole. These two portions may be interconnected to form a medical device prior to or during the surgical procedure as shown in Figure 29b, preferably during surgical procedures, such that the interconnected medical device can be passed This is because these parts can be introduced into the hip joint through a hole that is smaller than the hole. 29C shows the pin 1218 in the hole 1219 after the pin 1218 is first introduced in one direction and then rotated to lock the pin 1218 in the hole 1219. FIG.

30A shows a medical device in accordance with one embodiment wherein the medical device includes an artificial femoral head 45, a fastening member 608 and a stabilizing member 612 and the stabilizing member 612 includes a femoral head 6 so as to be substantially perpendicular to the longitudinal extension of the femoral neck 6 from the outside of the femur 6 and from the side of the longitudinal axis of the femoral neck 6 RTI ID = 0.0 > substantially < / RTI > The medical device includes two parts configured to form a interconnected interconnected medical device as shown in Figure 30B. The first portion of the medical device includes a first portion 608 'of the anchoring member and a first portion 45' of the femoral head surface. The second portion of the medical device includes a second portion 608 "of the anchoring member and a second portion 45" of the femoral head surface. The first portion of the medical device includes a hole 1221 that receives the pin 1220 in a first direction and then rotates the first and second portions about the other to receive the pin 1220 in a second direction, To lock the pin 1220 in the pinion 1221. These two portions may be interconnected to form a medical device prior to or during the surgical procedure as shown in FIG. 30B, preferably during surgical procedures, such that the interconnected medical device can pass This is because these parts can be introduced into the hip joint through a hole that is smaller than the hole. A-A cross-section in Figure 30C shows the pin 1220 in the hole 1221 after the pin 1220 is first introduced in the first direction and then rotated to lock the pin 1220 in the hole 1221. [

Portions of a medical device according to any embodiment may have a maximum diameter that allows a medical device to be introduced through a hole having a cross-sectional area of 530 mm 2 or less, or 380 mm 2 or less, or 250 mm 2 or less, or 180 mm 2 or less, The radius or the maximum cross-sectional distance.

FIG. 31A shows an embodiment in which the first soft layer 1222 is applied on the femoral head 5. The first flexible layer 1222 is configured to serve as a layer for securing the second rigid layer and serves as the artificial rib surface 45. The first soft layer 1222 may be secured to the femoral head 5 using, for example, an adhesive.

Fig. 31B shows the hip joint with the femoral head 5 when the first soft layer 1222 is applied thereon. The first soft layer 1222 may be further configured to exceed the maximum diameter of the femoral head 5.

Fig. 32A shows an example of a rigid artificial femoral head surface 45 including a plurality of artificial femoral head surface portions 46. Fig. The plurality of artificial femoral head surface portions 46 are configured to be inserted into the hip joint and then connected to the interconnecting artificial femoral head surface portion 56. The interconnected artificial femur head surface portion 56 serving as the base portion 56 includes a self-locking connecting member 57 as shown in Fig. 32B, which has a self-locking connection member 57 of the artificial femur head surface portion 46, Fit into the member 58. The artificial femoral head surface portion 46 forms the artificial femoral head surface 45 when connected to each other. The self-locking members 57, 58 may be supplemented or replaced with screws, welds, sprints, bands, adhesives or any other mechanical connecting member. The artificial femur head surface 45 according to the present embodiment can be further configured to exceed the maximum diameter of the femoral head 5. [

Fig. 33 shows that the surface portion is applied to the femoral head 5 on which the first soft artificial layer 1222 is placed. The first flexible layer 1222 may be configured to even out the surface of the femoral head 5 to achieve better fixation of the second stiffness layer and may function as an artificial femur head surface 45, And functions as an elastic member when the hip joint is in the functional position to absorb the impact.

34 shows the femoral head 5 when the surface 45 of the rigid artificial femur bone is completed and fixed on top of the first flexible layer 1222. Fig. The rigid layer is preferably made of a rigid material, or an artificial substitute thereof, to resist the abrasion caused by the connection with the ribs 8. The second stiff layer 45 may be secured to the first flexible layer 1222 using an adhesive, a shape fit, or a mechanical securing member. The second stiffness layer 45 according to the present embodiment may be further configured to exceed the maximum diameter of the femoral head 5. [

According to Fig. 35, the artificial hip surface portion 48 according to any embodiment is inserted through an incision according to a surgical method. According to a first embodiment, the artificial hip surface portion 48 is an artificial femoral head surface portion 46 configured to be connected to each other after insertion to form an artificial femur head surface 45.

36, an artificial hip joint surface portion 48 according to an embodiment is inserted through a laparoscopic / arthroscopic surgical procedure / arthroscope through a small incision through the laparoscopic / arthroscopic trocar cap 33a, b, c. According to a first embodiment, the artificial hip surface portion 48 is an artificial femoral head surface portion 46 configured to be connected to each other after insertion to form an artificial femur head surface 45.

Surgical laparoscopic / arthroscopic procedures are also provided to treat hip arthritis by providing a hip surface through the patient's pelvic bone from the opposite side of the ankle. Such a method will now be described in further detail.

Figure 37 shows a front view of the patient's body. According to the first embodiment, a surgical method of operating the hip joint from the opposite side of the ankle 8 is performed starting with the incision 1 of the abdominal wall of the patient. This incision (1) passes through the abdominal wall and into the abdomen, including the patient's peritoneum. In a second preferred embodiment, an incision 2 is made into the abdominal wall and into the pelvic region, below the peritoneal cavity. According to a third embodiment, an incision 3 is made between the bone of the pelvic bone and the surrounding tissue, and this incision 3 allows the pelvic bone 9 to be incised without passing through the fascia and muscle tissue . According to the fourth embodiment, the incision 4 is made in the inguinal region. In all four embodiments, the tissue surrounding the pelvic bone 9 in the region opposite the ankle 8 is removed, pierced, or divided or transferred to allow the surgeon to reach the pelvic bone 9. It is evident that the described methods can be combined or modified to achieve the same purpose for dissecting the pelvic bone 9 on the opposite side of the ankle 8.

38 shows a front view of the patient's body. The laparoscopic surgery / arthroscopic surgery for the hip joint procedure begins with a small incision 14 in the abdominal wall of the patient from the opposite side of the ankle 8 according to the first embodiment. This small incision allows the surgeon to insert the laparoscopic / arthroscopic trocar into the abdomen of the patient. According to the first embodiment, the incision 14 passes into the abdomen through the abdominal wall and peritoneum of the patient. According to a second preferred embodiment, a small incision 15 is made through the rectus abdominis muscle or on the side of the rectus abdominis muscle and below the peritoneum into the pelvic region. According to a third embodiment, a small incision 16 is made between the bone of the pelvic bone and the surrounding tissue, which makes it possible for the pelvic bone to be dissected without substantially penetrating the fascia and muscle tissue. According to the fourth embodiment, the incision 17 is made in the inguinal region. In all four embodiments, the tissue surrounding the pelvic bone 9 in the region opposite the ankle 8 is removed, pierced, or divided or transferred to allow the surgeon to reach the pelvic bone 9.

FIG. 39A shows a front view of the patient's body, and shows a laparoscopic / arthroscopic method of operating the hip joint from the opposite side of the ankle 8. FIG. The hip joint includes a rib (8) and a femoral head (5). The small incision 14 of the patient's abdominal wall allows the laparoscopic / arthroscopic trocar needle 33a, b, c to be inserted into the patient's body. A device 36 for dissecting, introducing, placing, connecting, attaching, shaping or shaping a surgical instrument or prosthetic or prosthetic component configured to create a hole in one or more cameras 34, pelvic bones 35, May be inserted into the body through the arthroscopic trocar cap (33a, b, c).

Figure 39b shows a side cross-sectional view of the patient's body, and the hip joint is shown in greater detail in part. The hip joint includes a femoral head (5) located at the top of the femoral neck (6), which is the uppermost part of the femur bone (7). The femoral head 5 is connected to the cheek bone 8, which is the bowl-shaped portion of the pelvic bone 9. With the instrument 36 for dissecting, introducing, placing, connecting, attaching, shaping, or smoothing the prosthesis or prosthesis, one or more cameras 34, a surgical instrument configured to puncture the pelvic bone 35, The arthroscopic trocar cap 33a, b, c is used to reach the hip joint 39. [

As shown in Fig. 19, after dissection of the pelvic bone 9, a hole 18 is formed in the pelvic bone 9. The hole 18 passes from the opposite side of the ankle 8 through the pelvic bone 9 into the hip joint 19.

Figure 40 shows a hole 18 in the pelvic bone 9 according to the first embodiment and such a hole 18 is large enough to allow the prosthesis to pass through the hole 18 in its full functional size. According to the second embodiment, the hole 20 formed in the surgical or laparoscopic surgery / arthroscopic surgery is much smaller as shown in FIG. 41, allowing the surgical instrument forming the hole to be made smaller, And the incision and dissection performed on the skin becomes smaller.

Figure 41 shows a surgical instrument for forming the holes 18,20 in the pelvic bone 9a according to the first embodiment. Such a surgical instrument includes driving members 21a, b. The driving members 21a, b may be a shaft, a rod, a belt, a chain, or any other member suitable for transmitting force or torque. The surgical instrument also includes a bone contacting organ 22 configured to form holes 18, 20 in the pelvic bone 9. [ The bone contact organ 22 may have a sawing, drilling or milling effect using a sharp object; The bone contact organ 22 forms a hole using water, a polishing fluid, a laser, or radiation. The surgical instrument also includes an actuating device 23a configured to actuate the driving members 21a, b. The actuation device may comprise an electrical, mechanical, pneumatic or magnetic motor and may be configured to generate rotation, oscillation, vibration or repetitive motion. The actuating device may comprise a source of ultrasound, radiation, laser or water.

Fig. 42 shows a surgical instrument further comprising a parallel displacement portion or a parallel displacement portion 26. Fig. The parallel displacements or parallel displacement portions 26 improve the reach of the medical device to allow the creation of holes 18 in the pelvic bone 9 from the opposite side of the ankle 8. 42, the parallel displacement portion or parallel displacement portion 26 has a telescopic function by being divided into first and second portions 27a, b, wherein the second portion 27b, Can slide in and out of the first portion 27a.

Figure 43 shows an embodiment in which the actuating device 23b is positioned to be directly connected to the bone contact organs 22, in which case the actuating device 23b also serves as a driving member. In such an arrangement, the handle portion 24 can be attached to the surgical instrument, making it easier for the surgeon to handle the surgical instrument. To improve the reach of the surgical instrument, the handle portion 24 may be attached perpendicular to the hole forming direction 25 of the surgical instrument, and the handle portion 24 may include a parallel displacement portion or a parallel displacement portion, It is anticipated that it can be wheeled by an angle, an adjustable angle or a soft part.

44 shows a surgical instrument according to a second embodiment, wherein the surgical instrument comprises a drive member 28a, b, c having two angular adjustment members 29a, b. Each adjustment member 29a, b can be adjusted to vary the angle of the drive member 28a, b, c, or fixed at an angle suitable to form a hole in the pelvic bone 9 from the opposite side of the ankle 8 . The portion of the drive member 28c that is connected to the bone contact organ 22 in another embodiment (not shown) can be very short, so that when the hole 18 is formed in the pelvic bone 9, Lt; RTI ID = 0.0 > 9 < / RTI >

Figure 45 shows a surgical instrument according to a third embodiment wherein the drive member 30 is so flexible that it can be adjusted very precisely so that the drive member 30 forms a hole 18 in the pelvic bone 9 of the patient. . The stiffness of the drive member 30 may range from full ductility to full stiffness to suit a particular operating environment.

46 shows a bone contact organ according to the first embodiment, wherein the bone contact organ 22a is configured to generate a bone plug 31. Fig. The bone plug 31 may be configured to replace the hole 18 after the surgical or laparoscopic / arthroscopic step performed on the hip joint is completed.

47 shows a bone contact organ according to a second embodiment wherein the bone contact organ 22b is configured to form a small piece of bone 32 when forming the hole 18 in the pelvic bone 9 . Small pieces of bone can be transferred out of the body from the area using a vacuum powered or hydraulic delivery system.

48A partially shows the hip joint with the femoral head 5 located at the top of the femoral neck 6, which is the uppermost part of the femur bone 7. Fig. The femoral head is connected to the cheek bone 8, which is the bowl-shaped portion of the pelvic bone 9. [ The hole 18 formed in the pelvic bone 9 from the opposite side of the ankle 8 is larger than the artificial femoral head surface 45 which allows the artificial femoral head surface 45 Enabling insertion. This insertion of the artificial femoral head surface 45 can be performed as a step in the laparoscopic surgery / arthroscope as well as a surgical method step. After insertion, the artificial femoral head surface 45 is attached to the femoral head 5, and this attachment is effected by a mechanical attachment 44 comprising a shaft or thread passing through the cortex. It is contemplated, however, that the mechanical attachment 44 may be assisted or replaced by bone cement or adhesive positioned between the femoral head 5 and the artificial femoral head surface 45 or connected to the shaft or screw 44 . An alternative method of attaching the artificial femoral head surface 45 includes: at least one screw, at least one pin, at least one portion of the portions configured to be introduced into the other portion, Introduced into a lock which is part of at least a part of the part of the part, shape fitting, welding, adhesion, pin, wire, ball mounted in a bowl that is part of the parts, Keyed portion, band, or other mechanical connecting member.

48B partially shows the hip joint having the artificial femoral head surface 45 attached to the femoral head 5. [

The described surgical laparoscopic surgery / arthroscope procedure further includes reaming the ankle 8 or the femoral head 5. According to the first embodiment, the widening of the ankle 8 or the femoral head is performed using the expandable reamer shown in Figs. 49 to 51. The expandable reamer comprises at least one baffle blade (40) comprising a baffle surface (41a, b). The expandable widening can be configured to widen the ankle (8), femoral head (5), or both. In an embodiment in which the expandable reamer is configured to expand the ankle 8, the expandable reamer is positioned on the femoral head (40) while the expandable reamer is located on the outside of the at least one expandable blade 5, the piercing surface 41a is positioned on the interior of the at least one baffle blade 40. In the embodiment shown in Fig. According to a second embodiment, the expandable reamer is configured to expand both the ankle and femoral head, and in this case the reamer has a bushing surface 41a, 41b on the outside and inside of the at least one breeze blade 40, b.

Figure 50 shows an expandable widening according to some embodiments and the widening blade 40 can be folded toward the center of the hemisphere that is created with the widenable widening as shown in Figure 49. [ When the expandable blade 40 is folded, the expandable reamer can be used to introduce expandable reamer through the hole smaller than the expandable region into the hip joint.

51 shows the interior of the expandable reamer with the bladed blade 40. Fig. In embodiments in which the expandable reamer is configured to expand the femoral head, the inside of the at least one expandable blade (40) includes a widening surface (41b).

Figure 52 shows the expandable widening of the wrist when the wrist 8 and / or the femoral head 5 is deployed according to an optional embodiment. The reamer may be configured to operate manually or to operate by a rotating, oscillating, or oscillating actuator.

According to one embodiment, the bone contact organ 22 of a surgical instrument for forming an aperture in the pelvic bone may be replaced by the expandable reamer shown in Figures 49 to 51, Can be powered by using the actuators 23a, b used in the surgical instrument.

Following the preparation of the hip surface, a method step of inserting or forming a new surface is performed.

53A illustrates how an expandable artificial femoral head surface 45 is inserted through the aperture 18 of the pelvic bone 9 using a tool for insertion of the medical device 1240. Fig.

53B shows how the arm 50 on the surface of the artificial femur 2 softens the surface of the artificial femur so that the expandable artificial femoral head surface 45 passes through the hole 18 of the pelvic bone 9 and is guided by the femoral head 5, ≪ / RTI >

53C shows the expandable artificial femoral head surface 45 after being placed on the femoral head 5. In this embodiment, the artificial femoral head surface arm 50 grips the femoral head 5.

54A partially illustrates the hip joint according to the second embodiment, wherein the hole 18 in the pelvic bone 9 is smaller than the artificial femoral head surface 45 in overall functional size. According to the present embodiment, the artificial femoral head surface 45 is introduced into the hip joint through the hole 18 of the pelvic bone 9 from the opposite side of the ankle 8. The artificial femoral head surface portion 46 is inserted into the hip joint and connected to each other to form the artificial femoral head surface 45.

54B partially shows the hip joint when the artificial femur head surface portion 46 is connected to each other using the shape fitting 47. However, such shape fitting can be assisted by or replaced with an adhesive agent or bone cement Is expected. After the artificial femoral head surface portion 46 is introduced and connected to the hip joint, the artificial femoral head surface portion is mechanically fixed to the femoral head 5, and this mechanical fixation can be accomplished by: at least one screw, at least one At least a portion of at least one portion of the portions configured to slide into the other portion as portions adapted to be introduced into the other portion of the pin, a ball mounted into the bowl that is part of the shape, fit, weld, A key portion, a band, or other mechanical connecting member introduced into the lock which is a part of the part mounted in the female part of the part, a part of the parts.

54C shows an artificial femur head surface portion 46 having portions that provide a shape fit 47 to connect the parts to one another.

Figure 54d partially illustrates the hip joint where the second hole 18b of the pelvic bone 9 allows the surgeon to position the camera 34 preferably in the laparoscopic surgery / arthroscopy procedure into the hip joint do.

Fig. 55A shows the femoral bone 7 in which a plurality of positioning shafts 900a, b, c are located in the femoral head 5. Fig. The position setting shafts 900a, b and c are provided for guiding, positioning and centering the artificial hip joint surface portions 913a and 913b on the femoral head 5 or placing the artificial hip joint surface portions 913a and 913b Positioning, and centering to be positioned. Each of the artificial hip joint surface portions 913a and 9b has positioning holes 910a and 9b configured to surround positioning shafts 900a, b and c positioned in the femoral head 5. The artificial hip surface portions 913a, b are configured to be connected to each other after being inserted into the hip using the mechanical connecting members 914a, b, wherein the mechanical connecting member is located on the first hip joint surface portion 913b, And the corresponding second portion 914b is located at the second hip joint surface 913a. The first portion 914a is configured to fit into the second portion 914b of the first hip joint 914a. Thereby, the plurality of positioning shafts 900a, b assist the plurality of artificial hip joint surface portions 913a, b to be connected to each other. However, the mechanical connecting members 914a, b may be supplemented or replaced by an adhesive.

B shows the positioning of the artificial hip joint surface portions 913a and 913b and the positioning holes 910a and 913b of the artificial hip joint surface portions 913a and 913b are positioned on the positioning shafts 900a and 900b, Whereby the positioning shafts 900a, b, and c guide, position, and center the artificial hip joint surface portions 913a, b on the hip joint.

56 shows a side view of the patient, wherein a surgical instrument 35 configured to puncture the pelvic bone from the abdominal side of the pelvic bone 9 is inserted through the incision in the abdominal wall. The surgical instrument may include a securable portion or section 300 to allow the surgical instrument to be precisely adjusted to reach the pelvic bone or to reach the hip joint from the abdominal side of the pelvic bone. The strength of the flexible section or section 300 may range from complete ductility to complete stiffness to suit a particular operating environment. The surgical instrument 35 may be powered through an actuating device, which may comprise an electrical, mechanical, pneumatic or magnetic engine and may be configured to generate rotation, oscillation, vibration or repetitive motion .

According to another embodiment (not shown), the surgical instrument 35 is powered from an operating device located outside the human body in the femoral region. The force generated by the actuating device is then transmitted through the force transmitting member located in the femoral neck and femur. This allows the surgeon to provide power to the hips and the environment through the incisions in the thighs.

Fig. 57 is a sectional view of the hip joint, in which the surgical instrument 35 for making the hole 18 in the pelvic bone 9 is made to form the bone plug 31. Fig. The bone plug 31 may be relocated into the hole 18 after the surgical or laparoscopic examination step performed at the hip joint is completed.

58 is a cross-sectional view of the hip joint, in which a surgical instrument 604 for removing the femoral head 5 is provided through a hole 18 in the pelvic bone 9. The surgical instrument passes along the longitudinal extension of the femoral neck 6 to make a hole in the femoral head 5. The surgical instrument further includes a top member 605a, b for separating the femoral head from the femoral neck. In the first state 605a, the top member 605a is retracted into the interior of the surgical instrument 604. When the surgical instrument is positioned inside the femoral neck at the desired location, the top member is folded into a second state 605b which separates the femoral head 5 from the femoral neck 6 to create a cut in the femoral neck .

FIG. 59 is a sectional view of the hip joint when the surgical instrument 604 and the top member 605b are located inside the femoral neck. After the femoral head 5 is removed, the stabilizing portion of the femoral neck 6 is maintained. The stabilizing portion of the femoral head (6) can be defined as the proximal half of the femoral neck (6), the proximal 2/3 of the femoral neck, the proximal third of the femur neck, the proximal 90% of the femoral neck or the entire femoral route. The proximal part of the femoral neck is the closest part to the human body in the femoral neck.

60-64 illustrate a medical device according to one embodiment and a method of deploying the same.

60 shows removal of the femoral head 5 after the surgical instrument has made the surface of the cut 610 substantially perpendicular to the longitudinal extension of the femur 6. The separated femoral head 5 is then removed through a hole 18 in the pelvic bone 9. [

61 shows removal of the bone fragments 609 from the femoral head 5. Removing the bone fragments 609 is preferably performed outside the human body. 13 shows the removal of the upper part of the femoral head 5, but the bone fragments can likewise be removed from the other side of the femoral head.

 62 shows a medical device 600 according to one embodiment. The medical device includes a fixation member 608 and an articulated femoral bone surface 607. The artificial femoral head surface 607 is brought into contact with the orbital surface 11 or an artificial substitute thereof. The fixation member 608 is at least partially stabilized by the cortical bone 601 of the stabilizing portion of the femoral neck 6. The stabilization may be performed substantially internally perpendicular to the longitudinal extension of the femoral neck 6 and substantially aligned with the longitudinal extension on the side of the rib. The stabilization is carried out in such a way that it is substantially aligned with the longitudinal extension of the femoral neck 6 on the side of the ankle and substantially perpendicular to the longitudinal extension of the femoral neck 6 on the outside, Substantially perpendicular to the longitudinal extent of the femoral neck (6) substantially perpendicular to the longitudinal extent of the femoral neck (6), or substantially perpendicular to the longitudinal extent of the femoral neck (6) May further be carried out substantially perpendicular to the longitudinal extension of the base portion (6). The medical device 600 may be at least partly stabilized directly by the cortical bone 601 of the stabilizing portion of the femoral neck 6 or may be stabilized indirectly by the cortical bone 601 of the stabilizing portion of the femoral neck 6. [ . (Not shown) between the cortical bone 601 and the anchoring member 608 of the medical device 600 when the medical device 600 is indirectly stabilized by the cortical bone 601 of the femur 6 Any material can be placed. The material may be bone cement, at least partially elastic material, glue, adhesive, antibiotic, biocompatible plastic material, biocompatible ceramic and / or biocompatible metal such as titanium or tantalum.

The hole 609 in the bone piece 606 obtained in the femoral head 5 is preferably a hole made by the surgical instrument 604 during the process of removing the femur head, It may be necessary to modify or adapt the hole 609 to fit the fastening member 608 disposed within the hole 609 in the housing 606. [

63 shows the hip joint when the medical device 600 including the artificial femoral head surface 607, the fixation member 608 and the stabilization member 606 is inserted through the hole 18 in the pelvic bone 9 Sectional view. According to this embodiment, the stabilizing member is a bone fragment 606 that is disposed on the exterior of the fixation member 608. The stabilizing member 606 may be secured to the fixing member 608 using a mechanical connection means such as an adhesive or a screw, cord, band or pop rivet. According to this embodiment, since the stabilizing member is disposed in contact with the surface of the cutout 610 of the femur 6, the medical device can prevent the femur 6 from being deformed by the cortical bone 601 of the femur 6 from the inside. Is substantially stabilized to be substantially aligned with the longitudinally extending portion and also with the longitudinally extending portion of the femoral neck 6 on the side of the rib. The stabilizing member and the fixing member can be fixed to the femoral neck 6 with an adhesive or bone cement.

Figure 64 is a cross-sectional view of the hip joint when the medical device 600 according to the first embodiment is placed in the femoral neck 6 and stabilized with a direct or indirect connection with the cortical bone of the femoral neck 6, will be.

65 shows the femoral head 5 after the proximal portion has been removed along the cut created by the medical device to make the hole. When the proximal portion of the femoral head 5 is removed, the surface of the cut portion 102 is formed in the cortical bone of the femoral head 5. A reamer 40 for attaching the force transmitting member 21 to the femoral head 5 through the connecting portion 101 is attached. According to this embodiment, the force transmitting member 21 is the same as the force transmitting member used for making the hole in the pelvic bone 9, but the force transmitting member 21 is provided so that the femoral head 5 can be extended It may be specially designed. Expansions of the femoral head and a portion of the femoral neck (6) are performed primarily in the spongiform bone, but some expansions may need to be performed on the cortical bone of the femoral head (5) and / or the femoral neck (6).

66 shows the step of applying the adhesive 106 to the concave surface made of the reamer 40. Fig. This adhesive 106 is applied to the injection member 104 including the injection nozzle 105. The adhesive 106 is preferably a biocompatible adhesive such as bone cement. In this embodiment, the injection member 104 is bent and introduced through the hole 18 in the pelvic bone 9.

67 shows the step of providing a medical device 109 comprising a concave hip joint surface 110. Fig. The concave artificial hip surface 110 is fixed to the concave surface 103 formed on the femoral head 5 and the femoral neck 6. [ The medical device 109 includes a fixed support 111 for connecting the concave artificial hip surface 110 to at least one of the femoral head 5 and the femoral neck 6. The medical device 109 is introduced into the hip joint through the hole 18 in the pelvic bone 9 using the insertion member 107. [ According to this embodiment, the insertion member is flexed to operate through the hole 18 in the pelvic bone 9. [ The insertion member 107 includes a connecting member 108 which is connected to the medical device 109. According to one embodiment, the medical device 109 comprises a self-lubricating material such as PTFE, but the medical device includes titanium, stainless steel, Corian, PE or other acrylic polymer, Can be operated after being inserted into the hip joint.

68 shows a medical device including a convex artificial hip surface 112; This convex artificial hip surface 112 is fixed to the pelvic bone 9 and is inserted through the hole 18 in the pelvic bone 9. The medical device includes a nut (120) that includes a screw for securely securing the medical device to the pelvic bone (9). The medical device further includes a prosthesis part (118) which occupies the hole (18) formed in the pelvic bone (9) after the medical device is implanted in the patient. The prosthetic portion 118 includes a support member 119 that is brought into contact with the pelvic bone 9 to aid in supporting the load exerted on the medical device from the patient's weight during normal use. Normal use is defined as the use of natural hips by humans. The medical device also includes a locking element 116 that includes a surface 117 that is adapted to contact the convex artificial hip surface 112. The locking element 116 further includes a locking member 115 that aids in securing the locking member 116 to the femoral head 5 or the femoral neck 6, Thereby fixing the hip surface 112. The convex artificial hip surface 112 is fixed to an attaching rod 113 including a screw 114 whose thread corresponds to the screw of the nut 120 when connected to the prosthesis 118. [ 68, the portion including the convex artificial hip surface 112, the attachment rod 113, and the screw 114 is formed in two parts, the first portion 1241 'being formed of a convex artificial hip joint surface Includes a first portion of the convex hinge surface 112, a first portion of the attachment rod 113 and a first portion of the screw 114, and a second portion 1241 " , A second portion of the attachment rod 113 and a second portion of the screw 114 '. The first and second portions are connected to each other by, for example, interconnecting functional portions as described with reference to Figures 23 to 30 Thereby forming a connected portion.

69 is a sectional view of the hip joint when the convex artificial hip joint surface is fixed to the medical device 109 including the concave hip joint surface 110. Fig. The convex hinge surface 112 is secured by a locking element 116 that is secured to the femoral head using a screw 121. The surface of the locking element 117 and the concave hinge surface 117 are disposed in connection with the convex hinge surface and can be made of a friction reducing material such as PTFE or a self-lubricating powder material. However, the implantable lubrication system, which is adapted to lubricate the medical device after the medical device has been implanted in the patient, may be used to actuate the connection surface.

70 shows placement of the prosthetic portion 118 occupying the hole 18 formed in the pelvic bone 9. As shown in Fig. The prosthetic portion 118 includes a support member 119 that is brought into contact with the pelvic bone 9 to aid in supporting the load exerted on the medical device from the patient's body weight. 12, the support member 119 is positioned on the abdomen side of the pelvic bone 9, but the support member 119 may be located on the side of the rib 9 of the pelvic bone 9, The support member is preferably displaceable so that the prosthetic portion 118 can be inserted through the hole 18 in the pelvic bone 9. [ It is also shown in Fig. 12 that the nut 120 is fixed to the attachment rod 113. Fig. According to the embodiment shown in Figure 12, the hole 18 in the pelvic bone 9 is larger than the medical device so that the medical device can be inserted into its full functional size. According to another embodiment, the hole 18 is made smaller, in which case the medical device comprises several parts that are connected after being inserted into the hip joint as shown in Figure 68, or the medical device has its full functional size And may be expandable to be inserted through a smaller hole. Such an expandable medical device may be enabled through elements of a medical device including an elastic material.

71 is a cross-sectional view of the hip joint when all elements of the medical device are secured in or around the region of the hip. The prosthesis 113 which occupies the hole 18 in the pelvic bone 9 is fixed here by a screw 121 but this screw 121 is formed on the surface S between the prosthesis and the pelvic bone 9 ) Or may be replaced with this adhesive.

In the above-described embodiment, the medical device 600 has been described in connection with the operation proceeding from the abdominal side of the pelvic bone, but the medical condition may be inserted through a hole in the femur or a hole in the high capsule, . ≪ / RTI > As shown in FIGS. 2 to 10, a conceptual diagram of an embodiment in which the medical device 600 is inserted through the hip joint capsule is usually described as conventional hip surgery.

Following the step of providing the surface of the artificial femur, the surgical and laparoscopic surgery / arthroscope procedure further comprises providing a prosthesis surface.

72 shows an embodiment in which the artificial rib surface 65 is pre-installed on the artificial femoral head surface 45. Fig. The medical device including the artificial femoral head surface 45 further includes a fixation member 608 and a stabilization member 612 which is disposed in contact with the surface of the cut portion of the femoral neck 6 , Substantially perpendicular to the longitudinal extension of the femoral neck (6) outside the femoral neck (6), and substantially longitudinally to the longitudinal extension of the femoral neck (6) . 72, the artificial rib surface 65 is of a flexible structure having a plurality of slits 66 which allow the artificial rib surface 65 to be positioned on the artificial femoral head surface 45, So that the artificial femoral head surface 45 can be gripped. The artificial rib surface is fixed by a band, cord or wire 1223 disposed around the artificial rib surface 65.

73 is a schematic view of an embodiment of a medical treatment device provided with a pre-installed prosthesis 65 surface and being secured by a band, cord or wire 1223 surrounding the artificial rib surface 65 beyond the maximum diameter of the artificial femur head surface 45. [ Device.

74 shows an embodiment in which the artificial rib surface 65 is pre-installed on the artificial femur head surface 45. A medical device comprising an artificial femur head surface 45 includes a prosthetic stem for securing the medical device to the femur . 74, the artificial rib surface 65 is of a soft structure having a plurality of slits 66, because of these slits, the artificial rib surface 65 is located on the artificial femoral head surface 45, It is possible to grasp the artificial femoral head surface 45 beyond the maximum diameter of the artificial femoral head 45. The artificial rib surface is fixed by a band, cord or wire 1223 disposed around the artificial rib surface 65.

Figure 75 is a schematic view of an embodiment of a medical device that is provided with a pre-installed artificial gingiva surface 65 and which is secured by a band, cord or wire 1223 that surrounds the artificial gingival wall surface 65 beyond the maximum diameter of the artificial femoral head surface 45. [ Device.

76 shows the femur in the step in which the surface of the cut portion 610 in the femoral neck 6 is prepared. An adhesive is applied to the femoral head 6 to fix the medical device including the artificial rib surface 65 previously provided on the surface of the artificial femur 65 to the femoral neck 6 using the fixing member 608 and the stabilizing member 612. [ To the surface of the cut portion (610).

77 shows the femur after the step of introducing and fixing the medical device to the femur 6. The stabilizing member 612 is disposed in contact with the outer surface of the femoral neck 6 and the surface of the cutout 610 of the femur 6 to define the length of the femur 6 from outside the femur 6 And substantially stabilize the medical device 600 to be substantially aligned with the longitudinal extension of the femoral neck 6 on the tibial sulcus side. The stabilizing member 612 is fixed to the outer surface of the femoral neck 6 and / or the surface of the cut portion 610 in the femoral neck 6 by an adhesive 614. [ However, this adhesive 614 may be replaced with or assisted by bone cement or mechanical fastening elements.

According to one embodiment, the artificial rib surface 65 is provided through the hole 18 of the pelvic bone 9 on the opposite side of the ankle 8

78 shows the artificial rib surface of a full functional size while the artificial rib surface 65 is inserted through the hole 18 of the pelvic bone 9. [

Figure 79 shows a prosthesis 65 surface according to a second embodiment which includes at least one slit 66 which causes the artificial forearm surface 65 to be artificial Can be sized to be inserted through the hole (18) of the pelvic bone (9), which is smaller than the overall functional size of the femoral head surface (45). The slits are disposed between one or more prosthetic knee surface arms 67, which can be deflected by a material or by a joint that affects the prosthetic knee surface arm 67.

80A, 80B and 80C illustrate an articulating orbital surface 65 according to the second embodiment, which includes a plurality of artificial orbicularis surface portions 68. As shown in FIG. The plurality of artificial rib surface portions 68 are adapted to be connected to the interconnecting artificial rib surface portion 69 after being inserted into the hip joint. The interconnecting artificial femoral head surface portion 69 includes a self-locking connecting member 70a as shown in FIG. 80b, which engages with the corresponding self-locking member 70b of the artificial rib surface portion 68, Respectively. The artificial glenohumeral surface portion 68 forms the artificial glenoid surface 65 when connected to each other as shown in FIG. 80C. The self-locking members 70a and 70b are formed by at least one screw, at least one pin, at least a portion of at least one of the portions (which slides into another portion) A ball mounted in a bowl that is part of the part, a part of the male part of the other part of the female part, a key part of the lock part that is part of the part, a band or other mechanical connecting member Or they can be helped.

Figures 81a, 81b and 81c illustrate an articulating orbital surface 65 according to the third embodiment, which includes a plurality of ring-shaped artificial orbicular surface portions 71. The plurality of ring shaped artificial fork ligament surface portions 71 are inserted into the hip joint and then connected to each other to form the artificial rib surface 65. According to one embodiment, the artificial side wall surface portions 71 are connected to each other by using mechanical connecting members 72a, b. FIG. 81C shows how the individual ring-shaped artificial forearm finger surface portion 71 is connected to itself and forms a continuous ring shape by using the mechanical connecting member 72a. 81C shows how the individual ring shaped articulated orbicular surface portion 71 is connected to the other ring shaped artificial orbicular surface portion 71 using the mechanical connecting member 72b to form the artificial forearm surface 65 .

82a, 82b, 82c and 82d show the artificial rib surface 65 according to the fourth embodiment, the artificial rib surface 65 having a first portion 73a and a second portion 73b, Portion 73b. The first and second portions are displaceable relative to each other. According to the first embodiment, the first portion 73a can rotate with respect to the second portion 73b so that the second portion 73b moves under the first portion 73a, Through a hole having an area that is elliptical or at least smaller than the cross-sectional area of the artificial rib surface 65 at the time of the full functional size 65, the displaced artificial rib surface 74 is formed It can be inserted into the patient ' s hips. According to this embodiment, using the mechanical feature fitting 75 as shown in Figure 82d, the two portions 73a and 73b are connected to each other when the artificial rib surface is returned to its full functional size . However, the connection may also include at least one portion of at least one of at least one screw, at least one pin, portions that are intended to fit into another portion (slidably into another portion), shape fitting, welding, A wire, a ball mounted in a bowl that is part of the part, a part of the male part of the female part of the other part, a key part of the lock part which is part of the part, a band or other mechanical connecting member, Can help.

Figure 83a shows a prosthetic forearm surface 65 according to a fifth embodiment, which includes four slits 66. The artificial rib surface 65 has a flexible structure so that the four artificial rib members 67 can be folded toward the center axis of the artificial rib surface 65 so that the artificial rib surface 65 is smaller than its full functional size It can be inserted into the hip through the hole.

83B shows a state in which the artificial rib surface 65 according to the fifth embodiment is folded. Any artificial rib surface 65 of any embodiment can be fixed to the femoral head or an artificial alternate for that femoral head 5 by grasping the femoral head 5 beyond the maximum diameter of the femoral head 5.

84A shows a surgical instrument according to the first embodiment, which is adapted to insert a prosthesis, a prosthesis, or a part necessary for forming or providing a hip surface. The surgical instrument includes a grip portion 76 and a handling portion 77. According to the embodiment shown in FIGS. 84A, 84B and 84C, the surgical instrument further comprises a rotating element 78 which allows the gripping portion 76 to be rotated relative to the handling portion 77, It is likewise possible that the surgical instrument does not have this rotating element 78.

84B shows a surgical instrument according to the second embodiment, which is adapted to insert a prosthesis, a prosthesis, or a part necessary for forming or providing a hip surface. According to this embodiment, the surgical instrument further comprises a parallel displacement portion 79 which, due to this parallel displacement, increases the reach of the surgical instrument and also reaches the hip joint through the hole in the pelvic bone on the opposite side of the ankle It becomes easy.

84C shows a surgical instrument according to the third embodiment, which is adapted to insert the parts required to form or provide the prosthesis, the abutment or the hip surface. According to this embodiment, the surgical instrument further comprises two angulation members 84a, b. The angle regulating member can be adjusted to change the angle of the grip portion 77 with respect to the handling portion 77 or can be adjusted at an angle suitable for working in the hip joint through the hole of the pelvic bone on the opposite side of the ankle 8 Can be fixed.

85 is a cross-sectional view of the hip joint after the artificial femoral head surface 45 and the artificial rib surface 65 are provided through the hole of the pelvic bone.

86 shows a bowl-shaped artificial fork groove cup 65 disposed in the pelvic bone 9. As shown in Fig. Bowl-shaped artificial trough cup 65 includes a release member 801 which is in the first state a femoral head 5 (a ball-shaped portion attached to femoral neck 6) Shaped artificial fork cup 65 disposed in the cup 9, as shown in Fig. In the second state, the releasing member 801 releases the femoral head 5 or an artificial substitute for the femoral head 5 from the bowl-shaped artificial fork socket 65 disposed in the pelvic bone 9. [ The releasing member 801 is switched from the first state to the second state when a predetermined strain is applied to the releasing member 801. [ The strain is caused, for example, by abnormal movement of the hip joint caused by the patient falling. According to the embodiment shown in Fig. 9, the release member 801 includes an elastic portion including an elastic material, and in the illustrated embodiment, the elastic portion is an entire release member 801. Fig. When the predetermined strain is applied to the releasing member 801, the releasing member can be non-invasively switched from the first state to the second state and from the second state to the first state.

87 is a sectional view of the hip joint when the releasing member 801 is in the second state. In this case, the releasing member 801 is moved from the bowl-shaped artificial fork groove cup 65 disposed in the pelvic bone 9 Releasing the femoral head (5) or an artificial substitute for it. The releasing member 801 is in a state in which the predetermined strain is applied to the releasing member 801 and thus is switched from the first state to the second state.

88 is a perspective view of an embodiment including a releasable member 801 including a holding member 802a, 802b in which a bowl-shaped artificial rib surface 65 is brought into sliding contact with the femoral head 5 or an artificial surrogate therefor Medical device. In the first state, the holding member is inserted into the bowl-shaped artificial fork socket cup 65 disposed in the pelvic bone 9, in the femoral head 5 or an artificial substitute (a ball-shaped portion attached to the femoral neck 6) It is held in position for the hip joint. In the second state, the releasing member 801 releases the femoral head 5 or an artificial replacement for the femoral head 5 from the bowl-shaped artificial fork socket 65 in the pelvic bone 9. [ The holding members 802a and 802b are subjected to a spring load through the springs 803a and 803b disposed between the correction members (correction screws 804a and 804b) and the holding members 802a and 802b. The force applied from the springs 803a and 803b to the holding members 802a and 802b causes the femoral head 5 or an artificial substitute for the femoral head 5 to be held in the artificial fork 65 during normal functioning of the hip joint, When the predetermined strain generated by the abnormal movement of the hip joint caused by the fall of the patient is applied to the releasing member, the femoral head 5 or the artificial substitute for the femoral head 5 is released from the artificial fork 65. Through the correction screws 804a and 804b, it can be determined whether the strain causes the holding members 802a and 802b to be switched from the first state to the second state.

89 shows a release member in a second state when a predetermined strain is exceeded due to abnormal movement of the hip joint due to, for example, the patient's fall. The holding members 802a and 802b retract into the sleeve 806 of the artificial rib surface 65 to compress the springs 803a and 803b. When the holding members 802a and 802b are withdrawn, the femoral head 5 or an artificial surrogate thereof deviates / dislocates from its position at the artificial rib surface 65 because the large strain is caused by the predetermined strain of the hip joint and the femur 7 When applied to the holding members 802a and 802b, the risk of the patient's femur 7 or pelvic bone 9 being ruptured is reduced. When a predetermined strain is applied to the holding members 802a and 802b, the holding members 802a and 802b are non-invasively switched from the first state to the second state and from the second state to the first state.

Figure 90 shows an artificial fork 65 having a holding member 802 that is evenly distributed along the cross section of the artificial fork 65. These holding members hold the femoral head 5 or an artificial alternate thereof at the artificial fork 65 )

91 shows an alternative embodiment of the principle shown in Figures 88-90 wherein the holding members 802a and 802b include ball members 805a, b in contact with the femoral head 5 or its artificial surrogate And these ball-like members are rolled in the femoral head 5 or an artificial alternate thereof and the holding members 802a and 802b are brought into contact with the springs 803a and 803b supported by the correcting screws 804a and 804b And places the femoral head 5 or an artificial substitute thereof in the artificial rib 65 by applying a force to the femoral head 5 or an artificial substitute thereof.

92 shows a releasing member in a second state when, for example, a predetermined strain due to a fall of the patient is exceeded, preferably due to abnormal movement of the hip joint. The holding members 802a and 802b including the ball shaped members 805a and 805b are retracted into the sleeve 806 of the artificial rib surface 65 to compress the springs 803a and 803b. When the holding members 802a and 802b are retracted, the femoral head 5 or its artificial substitute is displaced / dislocated at its position at the artificial rib surface 65, which is when the large strain is applied to the hip joint and femur 7, The risk of rupture of the patient's femur 7 or pelvic bone 9 is reduced. When a predetermined strain is applied to the holding members 802a and 802b, the holding members 802a and 802b can be non-invasively switched from the first state to the second state and from the second state to the first state, The femoral head 5 or its artificial substitute can be relocated to the artificial fork 65 without any procedure.

93 shows a medical device of an embodiment in which the releasing member 801 includes a breaking device 807, 808, 809 which is broken at a predetermined strain. According to this embodiment, the breaking device is broken pins 807, 808 and 809. The broken pins have base portions 809a and 809b and weakened portions 808a and 808b fixed to the artificial fork 65, And 807b attached to the base portions 809a and 809b via the femoral head 580 or 808b and when a predetermined strain is applied to the fracture device in contact with the femoral head 5 or its artificial substitute, (807a, 807b) are separated from the base portions (809a, 809b).

94 shows a medical device according to the embodiment of Fig. 93 when a predetermined strain on the breaking device has been exceeded so that the breaking device has failed; According to one embodiment (not shown), the breakable portions 807a and 807b can be formed by holding the breakable portions 807a and 807b in the vicinity of the base portions 809a and 809b even after the breakage device has failed, 807a, 807b are connected to the base portion.

95A shows a medical device according to an embodiment in which the artificial rib 65 includes a circular sleeve 806 in which an elastic band or rupture band 810 is provided. The elastic band or judging band 810 at least partially surrounds the ball-shaped femoral head 5 or its artificial substitute. When a predetermined strain is applied to the elastic or fracture band 810, the circular opening surrounding the femoral head 5 or its artificial alternator is expanded and the femoral head 5 or its artificial alternate is released from the artificial fork 65 And the femoral head or artificial surrogate is held by the elastic band 610 in the artificial rib. In an embodiment in which the medical device includes a rupture band 810 that holds the femoral head 5 or an artificial surrogate thereof at the artificial rib 65, the weakened portion 811 of the band 810 is disabled, The circular opening surrounding the two (5) or its artificial surge is expanded so that the femoral head (5) or its artificial replacement is loosened at the artificial fork 63. In embodiments where the band 810 is an elastic band 810, the band 810 may comprise an elastic portion, or the entire band 810 may be made of an elastic material.

95 is a cross-sectional view of the medical device when elastic bands or fracture bands 810 holding the femoral head 5 or an artificial surrogate thereof are disposed in the circular sleeve 806 in the artificial rib 65. Fig. The openings or weakened portions 811 are provided perpendicular to the periphery of the band 810.

96A shows a medical device in a second state in which the femoral head or an artificial surrogate thereof is disconnected from the ankle joint after a predetermined strain is applied to the elastic or fracture band 810. Fig. As shown in FIG. 96B, the crevices or weakened portions are enlarged so that the head posterior femur or an artificial alternate thereof can pass through an opening defined by an elastic or rupturable band 810. The medical device can be non-invasively switched from the first state to the second state and from the second state to the first state when a predetermined strain is applied to the band 810, ) Or an artificial surrogate thereof may be relocated to the artificial rib 65.

97 shows a medical device according to an embodiment in which the release member 801 comprises an elastic wing of the artificial fork 65. This elastic wing is attached to the femoral head 5 at a point having a maximum cross- Beyond the femoral head 5 or the artificial alternate of the femoral head 5 in the artificial forearm 65 to assist the elastic or fracture band 810 surrounding the medical device. The resilient or rupturable band 810 is positioned in the groove along the periphery of the artificial fork 65 to be held in position relative to the artificial fork 65. However, the grooves can be replaced with adhesives or mechanical fastening elements or can be assisted by them.

98 shows the medical device in the second state, in which the release member 801 releases the femoral head 5 or artificial surrogate thereof from the artificial fork 65. Fig. In embodiments where the band 810 is an elastic band 810, the elastic band is expanded such that the hole through which the femoral head or its artificial alternate can pass is increased. In the embodiment where the band 810 is a rupture band, the band 810 is disabled so that the femoral head 5 or its artificial substitute is only held by the release member 801, which releases the predetermined strain Upon release, the femoral head (5) or its artificial surrogate is released. The medical device can be non-invasively switched from the first state to the second state and from the second state to the first state when a predetermined strain is applied to the band 810 and / or the release member 801, So that the femoral head 5 or its artificial substitute can be relocated to the artificial fork 65 without any procedure.

99 shows a prosthetic portion 818 according to one embodiment which is fixed to the femur 7 and includes a femoral head 812 including a cavity 816, And a releasing member 801 according to the embodiment shown in Figs. 9 and 10, and due to the cavity, the hip joint is fixed to the fixing portion 814 of the artificial femoral head 812 The elastic band 817 can be used to perform a functional hip motion in the first state held in the artificial rib. The combination of the releasing member 801 and the elastic band 817 holds the prosthesis 818 in the artificial rib 65 in the first state and releases the prosthesis 818 from the artificial rib 65 in the second state do. According to another embodiment (not shown), the prosthesis is held in the artificial fork 65 using only the elastic band 817 while being supported by the remaining articular caps and affected muscles.

Fig. 100 shows an embodiment of the medical device according to Fig. 99 in the second state, in which the elastic band 817 is stretched so that the prosthetic portion 818 is loosened from the artificial ribs 65. Fig. The elastic band 817 may be formed of at least one screw, at least one pin, a shape fit, a weld, an adhesive, a pin, a wire, a ball installed in a bowl, (814) of the artificial femoral head (812) and / or the fixed portion (815) of the artificial fork (65) using a key, a part of the lock, . For example, as the patient falls, the fracture band 813 is lost due to abnormal movement of the hip joint. Preferably, the elastic band 817 comprises an elastic portion, which may be an entire elastic band 818, which is elastic (e.g., flexible), such as an elastomeric material, such as a copolymer material such as polystyrene, poly (ethylene-butylene) It is made of material. The material may also be a polyurethane elastomeric material, a polyamide elastomeric material, and a polyester elastomeric material of an ethylene and at least one vinyl monomer (e.g., vinyl acetate, an unsaturated aliphatic monocarboxylic acid and an ester of such a monocarboxylic acid) It may be an elastic copolymer. The elastic bands 813 may include a barrier coating, which can not penetrate human cells. Preferably, the barrier coating comprises a parylene coating or a biocompatible metal coating such as gold, silver or titanium. According to another embodiment, the elastic band comprises a spring-like member, a combination of metal and plastic material, a combination of metal and carbon-based material, or a combination of carbon and plastic-based material.

101 is a sectional view of the hip joint in an embodiment including a prosthetic portion 819 to which the medical device is fixed to the femur 7. [ The prosthesis includes an artificial femoral head including an elastic band 820 which functions as a releasing member for holding the artificial femoral head 65 inside the artificial fork 65 fixed to the pelvic bone do. The elastic element 820 of the artificial femoral head is preferably made of an elastic material, which may be, for example, an elastomeric polymer material or an elastic metal material. The resilient material may include an outer layer that is connected to the artificial ankle 65, which is resistant to wear due to contact with the artificial rib surface (which may be a ceramic material). When a predetermined strain is applied to the hip joint and elastic element 820, the elastic element is compressed. When the elastic element 820 is compressed, the artificial femoral head is released from the artificial rib 65.

Figure 102 shows that the medical device according to the embodiment shown in Figure 101 is in the second state in which the elastic element 820 is compressed when a predetermined strain is applied to the medical device. Thus, the medical device is in a second state, in which the artificial femoral head is released from the artificial arch.

Figure 103 illustrates one embodiment of a medical device in which the resilient element 820 is further assisted by a spring 821 connected to the two resilient elements 820 and a predetermined strain is applied to the prosthesis 819, the spring 821 is compressed along the elastic member 820.

Figure 104 shows a scalable artificial rib surface 65 that is secured to the pelvic bone 9. This artificial rib surface 65 is beyond the maximum diameter of the femoral head 5 and catches the femoral head 5. The artificial femoral head surface 45 is provided on the femoral head 5 and the artificial femoral head is caught by the femoral head 5 beyond the maximum diameter of the femoral head 5. With the configuration in which the surface exceeds the maximum diameter of the femoral head 5, the hip surface can be stably fixed and the risk of dislocation is reduced.

Another approach to the step of providing an artificial hip surface will now be described. The method includes forming an artificial hip surface on the inside of the hip joint. These steps can be performed with a mold. Such molds use body parts such as femoral heads and / or ribs or any artificial hip surfaces.

105 shows the step of placing the mold 81 inside the patient's hip through the hole 18 in the pelvic bone 9. [ The step of disposing the mold 81 may be performed by an operation method, a laparoscopic method, or an arthroscopic method.

Figs. 106A, 106B, 106C and 106D show alternative arrangements for placing the mold 81 in the patient's hip joint. This alternative approach involves making a hole 82 in the femur 7 along the longitudinal axis of the femur 6 which starts from the side of the thigh and passes through the cortex of the femur 7 , Reaching the cortex of the femoral head (5) from the inside and entering the hip joint. After making the hole 82 in the femur 7, the mold 81 is inserted through the hole 82 into the hip joint using a surgical instrument 83 (shown in FIG. 106B) adapted for it.

Figure 106 (c) shows that the mold 82 is inserted into the hip using the surgical instrument 83 adapted for it.

106d shows the mold 82 after being inserted into the hip joint, wherein the surgical instrument used to place the mold 82 in the hip joint is retracted after insertion is complete.

It is also possible to provide a hip surface by providing a hip surface within the hip without using a mold.

107 is a cross-sectional view of the hip joint when the first sealing member 84 is inserted through the hole 18 of the pelvic bone 9 using the instrument 85 adapted for it. The step of disposing the first sealing ring member 84 may be performed by a surgical method or a laparoscopic / arthroscopic method.

108 is a sectional view of the hip joint when the second sealing member 86 is inserted through a surgical method or a laparoscopic / arthroscopic method. The first sealing member 84 and the second sealing member 86 form a sealed space 87 between the rib 8 and the femoral head 5 or one or two artificial alternatives therefor, And is used as a mold for providing the ankle 65 and / or the femoral head surface 45.

FIGS. 109A, 109B and 109C show alternative arrangements for disposing the first sealing member 84 in the patient ' s hip joint. This alternative approach includes the step of making a hole 82 in the femur 7 along the longitudinal axis of the femur 6 as shown in Figure 46a starting from the side of the femur 7, ) To reach the cortex of the femoral head 5 from the inside and into the hip joint. After making the hole 82 in the femur 7, the first sealing member 84 is inserted through the hole 82 into the hip joint using the surgical instrument 83 adapted for it, as shown in Figure 109c .

Figures 110a, 110b and 110c illustrate the use of the mold 81 and / or the first and second sealing members 84, 86 (not shown) through the hole 82 in the hole 18 or the femur 9 in the pelvic bone 9. [ ) Into the patient's hip.

Figure 110b shows a portion of a surgical instrument 83,85, 88 comprising a tubular element for receiving a mold 81 and / or first and second sealing members 84,86. A piston 89 is also shown which is used to insert the mold 81 and / or the first and second sealing members 84, 86 into the patient's hip.

FIG. 110C shows a surgical instrument 83, 85, 88 for inserting the mold 81 and / or the first and second sealing members 84, 86 into the patient's hip, And a flexible or curved portion 91 for improving the strength of the cable.

After the step of providing the mold 81 or the sealed space 87 the fluid is forced through the hole 18 in the pelvic bone 9 or the hole 82 in the femur 7, (87).

Figure 111 is a sectional view of the hip joint in the case where the injection member 92 injects the fluid 93 into the sealed region 87 in the hip joint through the hole 18 of the pelvic bone 9 on the opposite side of the rib 8. [ . The sealed region 87 is sealed with a first sealing member 84 and a second sealing member 86. The injection member 92 includes a piston 94 for pushing the fluid 93 into the sealed region 87.

112 is a sectional view of the hip joint in which the injection member 92 injects the fluid 93 into the mold 81 in the hip joint through the hole 82 of the femur 7. The injection member 92 includes a piston 94 for pushing the fluid 93 into the mold 81.

Figure 113 is a cross-sectional view of the hip joint in which the injection member 92 injects the fluid 93 into the sealed region 87 in the hip joint through the hole 82 in the femur 7. The sealed region (87) is sealed with at least the first sealing member (84). The injection member 92 includes a piston 94 for pushing the fluid 93 into the sealed region 87.

Figure 114 shows a sealed region 87 sealed with the first sealing member 84 and the second sealing member 86 together with the femoral head 5 and the pelvic bone 9. A fluid 93 to be hardened is injected into the sealed region, and after hardening of the fluid, at least one hip surface is provided.

115 shows a side view of the human body in which the injection member 92 injects the fluid 92 into the mold 81 in the hip joint through the hole 18 of the pelvic bone 9 on the opposite side of the ankle 8 .

The injection member 92 is withdrawn from the region after the fluid 93 has been injected into the mold 81 or the sealed region 87.

The mold 81 and the first and second sealing members 84 and 86 according to any of the above embodiments may be reabsorbed to the human body or may be dissolved after they perform the purpose.

After at least one hip surface is provided through the hole 18 of the pelvic bone 9 according to any of the above embodiments, the hole 18 needs to be closed.

Any of the above-described embodiments of a mold, or molding or injection, injection through a space formed in a human tissue, or a device related to the method, may be used by inserting a portion through a high-joint capsule. Both the first sealing member and the second sealing member can be inserted in that way.

116 is a cross-sectional view of the hip joint when the bone plug 31 is disposed in the hole 18 to close the hole 18 in the pelvic bone 9. [ According to the first embodiment, the artificial rib surface 65 includes a support member 94 for supporting a load applied to the rib 8 from the body weight of the patient through contact with the femoral head 5. This support member may be a displaceable support member 97. The bone plug 31 includes at least one portion of at least one of bone cement, adhesive, at least one screw, at least one pin, portions (which slide into another portion) A portion of the lock that is part of the part, a part of the lock, a part of the lock, a part of the lock, a part of the lock, And / or the pelvic bone 9 by means of other mechanical connecting members.

117 shows at least one portion of at least one of the bone cement, adhesive, at least one screw, at least one pin, portions that are intended to be received in another portion (sliding into another portion), shape fitting, welding, , A pin, a wire, a ball mounted in a bowl that is part of the part, a part of the male part in the female part of the other part, a key part in the lock part which is part of the part, A bone plug 31 disposed in the hole 18 of the pelvic bone 9 is supported by a support member (not shown) disposed between the bone plug 31 and the pelvic bone 9 on the opposite side of the ankle bone 8 96), which is a cross-sectional view of the patient's hip.

118 shows a bone plug 31 or a prosthetic portion 98 including a plurality of displaceable support members that bear the load applied to the ribs 8 from the body weight of the patient through contact with the femoral head 5 . The displaceable portions 97 are displaced into corresponding portions at the perforations 18 or at the edges of the pelvic bone 9.

According to the second embodiment, the hole 18 of the pelvic bone is closed by the prosthesis 98. [

119A shows that the prosthetic portion 98 is inserted into the hole 18 of the pelvic bone 9 on the opposite side of the ankle 8. According to one embodiment, the prosthetic portion 98 includes a support member 99 adapted to correspond to a portion 100 of the hole 18 in the pelvic bone 9. After the prosthetic portion 98 is inserted into the hole 18 of the pelvic bone 9, the support member 99 is brought into contact with the pelvic bone 9 and also contacts the femoral head 5, And is rotated so as to support the load applied to the ribs 8 from the body weight. The prosthetic portion 98 may also serve as the artificial rib surface 65 according to any of the embodiments described above.

119B shows the prosthetic portion 98 when it is rotated so as to bear the load applied to the rib 8 from the body weight of the patient through contact with the femoral head 5.

This support member may be constructed in many other ways and should be considered illustrative.

119C shows a state in which the prosthetic portion 98 closes the hole 18 of the pelvic bone 9 and the load applied to the rib 8 from the patient's body weight through contact with the femoral head 5 It is a sectional view of the patient's hip when supporting. The prosthetic portion 98 may include at least one portion of at least one of bone cement, an adhesive, at least one screw, at least one pin, portions that are intended to fit into another portion (slides into another portion), shape fitting, Welding, adhesives, pins, wires, balls mounted in a bowl that is part of the abovementioned part, a part of the male part in the female part of the other part, a key part in the lock part which is part of the part, And can be further fixed to the pelvic bone 9 by a connecting member.

120 is a sectional view of a patient's hip when the bone plug 31 or the prosthetic portion 98 is attached to the pelvic bone 9 by a screw 101 disposed on the opposite side of the rib 8. [ The screws 101 may be arranged at different angles depending on the reach or the need for support. This configuration can be implemented in many other ways.

121 is a schematic cross-sectional view of the pelvic bone. The pelvic bone includes an internal cortex 201 that is disposed on the abdomen side (AB) of the pelvic bone and an external cortex (201b) that is disposed on the side of the pelvic bone (AC). The inner and outer cortices 201a, b contain cortical bone, which is a more dense curable bone. The pelvic bone further includes a spongiform bone 202, which is located in the bone marrow between the internal cortex 201a and the external cortex 201b. The support member of the medical device according to any of the above embodiments may contact the outside of the inner cortex 201a as a support member 203 or may be disposed inside the inner cortex 201a as a support member 204 So that the support member can support the load in the abdomen direction AB and the ankle joint direction AC. In addition, the support member may be disposed as a support member 205 between the inner cortex 201a and the outer cortex 201b in the cavernous bone, in which case the support member may be located inside the inner cortex 201a, And can contact the outer cortex on the inner side of the outer cortex 201b so that the support member can bear the load in the abdomen direction AB and in the direction of the ankle joint AC. The support member may also be in contact with the outside of the outer cortex 201b as a support member 207 or may be disposed within the outer cortex 201b as a support member 206, (AB) and in the direction of the ankle (AC).

Figure 122a shows a side view of the patient when attached to the pelvic bone 9 by the plate plug 102 at least partially covering the bone plug 31 or prosthetic portion 98 with the bone plug 31 or the prosthetic portion 98. [ The hips are shown in cross-section. According to a first embodiment, the plate 102 is attached to the pelvic bone 9 by means of a screw 103 arranged on the opposite side of the ankle 8. However, the screw 103 may be replaced or assisted by bone cement, adhesive, shape fitting, welding, sprint, band or some other mechanical connecting member.

Fig. 122B shows a case where two bone plugs 31 or prosthetic portions 98 are attached to the pelvic bone 9 by a plate 102 at least partially covering the bone plug 31 or the prosthetic portion 98 Sectional view of the patient's hip. According to a first embodiment, the plate 102 is attached to the pelvic bone 9 by means of a screw 103 arranged on the opposite side of the ankle 8. However, the screw 103 may be replaced or assisted by bone cement, adhesive, shape fitting, welding, sprint, band or some other mechanical connecting member. Figure 122b also shows the provided artificial rib surface 65.

122c is a cross-sectional view of a patient's hip when two pores 18 in the pelvic bone are covered with fluid injected into the hole 18 through a sealing member 104, Cured. Also provided is a full rate 102 that at least partially covers the aperture 18. According to the first embodiment, the plate 102 is attached to the pelvic bone 9 by a screw 103 disposed on the opposite side of the ankle 8. However, the screw 103 may be replaced or assisted by bone cement, adhesive, shape fitting, welding, sprint, band or some other mechanical connecting member. Figure 122C also shows the provided artificial rib surface 65 and the provided artificial femur head surface 45. [

Figure 123a shows an injection member 105 for injecting fluid to be hardened 93, preferably bone cement or adhesive, which is used as a support when closing the hole 18 of the pelvic bone 9. [ The injection member 105 includes a piston 94 for pushing the fluid 93 into the area where it is needed.

Figure 123b illustrates an injection member 105 that is inserted through a patient's skin 106 by a surgical procedure or by a laparoscopic / arthroscopic procedure, which is inserted through the hole 18 in the pelvic bone 9, Respectively. The injection member 105 injects the fluid 93 to be cured.

124 shows a connection area between the mold 81, the sealed region 87 or between the pelvic bone 9 and the prosthesis, between the pelvic bone 9 and the bone plug 31 or between the femur head 5 and the prosthesis, Lt; RTI ID = 0.0 > 105 < / RTI > according to any of the embodiments described above. The injection member 105 includes a container 107 for containing a fluid for injection. According to the first embodiment, the vessel 107 comprises two compartments 108a, 108b for containing two different fluids, which are cured upon mixing. In embodiments where the container 107 is intended to contain two types of fluids, the injection member 105 may further comprise a mixing member 109, in which case the two fluids are mixed prior to injection. According to the second embodiment (not shown), the container keeps the fluid aseptic. According to the third embodiment (not shown), the container keeps the fluid at a low temperature, and according to the fourth embodiment (not shown), the container keeps the fluid in a dark environment. Also, a combination of the above embodiments is possible.

After the step of closing the hole in the patient's pelvic bone is terminated, all instruments are removed and the final step of the surgical procedure or laparoscopic / arthroscopic procedure is performed. This final step involves suturing or stapling the affected tissue and ultimately sealing or stapling the patient's skin.

Figure 125a shows the step of stitching (110) or stapling (111) the patient's skin 106 in a surgical manner and Figure 125b shows the step of stitching the patient's skin 106 in a laparoscopic / arthroscopic procedure (110) or stapling (111). Laparoscopic / arthroscopic surgery may not require suturing.

Figure 126 shows a front view of a patient with an implantable lubrication system 120 implanted therein. The implantable lubrication system 120 is adapted to inject the lubricating fluid continuously, intermittently or as needed into the hip joint. According to the embodiment shown in Figure 126, the implantable lubrication system includes two units 121, 122 connected together. Two units connected to each other are disposed in the abdominal region of the patient and connected to the hip joint through the fluid transmitting member 129.

Figure 127 shows the implantable lubrication system 120 in more detail. According to the embodiment shown, the implantable lubrication system comprises a first unit 121 comprising a dispensing member 123 which is adapted to dispense lubricating fluid from the reservoir 127 to the area of the hip joint . The first unit 121 further includes an injection port 125 for filling the reservoir 127 outside the body without the need to perform the procedure. The injection port 125 includes a needle-piercing self-cleaning membrane attached to the syringe. The first unit 121 further includes a wireless energy receiver 124 preferably including a coil. This wireless energy receiver is used to charge the battery 126. According to this embodiment, the implantable lubrication system 120 further includes a second unit 122, which includes a battery 126 and a fluid reservoir 127. The lubricating fluid 128 is discharged from the reservoir by the dispensing device and passes through the first unit 121 and the fluid transmitting member 129 to go into the hip joint region to help lubricate the hip joint surface. The lubricating fluid is preferably a biocompatible lubricating fluid such as hyaluronic acid.

128 illustrates an implantable lubrication system in accordance with one embodiment wherein the implantable lubrication system is a circulatory lubrication system that includes one inlet 130 and one outlet 131 for entering the joint to be lubricated. Preferably, the system is a continuous lubrication system in which delivery member 123 continuously circulates lubricating fluid 128 within the hip joint.

129 shows an implantable lubrication system for circulating lubrication, which further comprises a filtration member 132 for filtering the lubricating fluid. The filter is self-purifying and the filtered and filtered material is processed into the abdomen of the patient through the treatment channel 133 or into the vessel attached to the treatment channel 133. Through filtration of the lubricating fluid 128, the circulating lubrication system can operate for a long period of time without the need for surgical procedures.

The medical device according to any of the above embodiments may comprise at least one material selected from the group consisting of polytetrafluoroethylene (PTFE), perfluoroalkoxy (PFA) and fluorinated ethylene propylene (FEP). In addition, the material may include cobalt-chromium-molybdenum or metal alloys such as titanium or stainless steel, or polyethylene such as cross-linked polyethylene or gaseous sterilized polyethylene. Ceramic materials such as zirconium or zirconium dioxide ceramics or alumina ceramics may be used on the contact surface or throughout the entire medical device. The portion of the human bone in contact with the human bone for securing the medical device to the human bone in the medical device may be a porous micro or nano structure that is adapted to facilitate the growth of human bone in the medical device for securing the medical device . The porous structure can be obtained by forming a hydroxy-epatite (HA) coating, or a coarse open-pored titanium coating, and these coatings can be made by air plasma spraying. Combinations of coarse open-pored titanium coatings and HA top layers are also possible. The contacts may be made of a powder metallurgical material into which a self-lubricating material such as a waxy polymer such as PIFE, PFA, FEP, PE and UHMWPE, or a lubricating oil (preferably a biocompatible lubricant such as a hyaluronic acid derivative) . In addition, the material of the contact or surface of the medical device may always or intermittently lubricate. According to some embodiments, a portion of the medical device comprises a combination of a metallic material and / or a combination of carbon fibers and / or boron, a combination of a metal and a plastic material, a combination of a metal and a carbonaceous material, Combinations, combinations of flexible and rigid materials, combinations of elastic and less elastic materials, Corian or acrylic polymers.

Any of the above-described embodiments, portions thereof and any method and portions thereof may be combined in any manner. All embodiments herein are to be regarded as a part of the general description and, thus, may in general be combined in any manner.

Claims (15)

A medical device for treating a hip joint arthritis in a human patient by providing at least one artificial hip surface, the hip joint comprising a gingival 11, which is part of the pelvic bone 9, and a portion of the femur bone 7, A femoral head (5) having a partially spherical shape, the medical device comprising:
A prosthetic portion 98 or a bone plug 31 configured to be disposed in the hole 18 in the pelvic bone so that the concave inner surface of the prosthetic portion or the bone plug faces in the direction toward the femur head,
And a support member (95; 99) connected to the prosthetic portion or the bone plug,
Wherein the support member is connected to the pelvic bone when implanted to transmit a load from the prosthetic portion or bone plug to the pelvic bone,
Characterized in that the medical device comprises an artificial femur head surface (45), the maximum cross-sectional distance of the surface of the artificial femur being smaller than the hole, such that the surface of the artificial femur head can penetrate through the hole, and
The medical device comprises a prosthesis 65 surface, the maximum cross-sectional distance of the surface of the prosthesis being smaller than the hole, such that the surface of the prosthesis can penetrate the hole
≪ / RTI > The method according to claim 1,
Wherein the medical device has a maximum diameter and is configured to change the maximum diameter during surgery to treat a human patient's hip arthritis by providing at least one artificial hip surface. 3. The method according to claim 1 or 2,
The medical device comprising:
A slit 66 allowing a change in the maximum diameter, and
An elastic member or elastic member allowing a change in the maximum diameter
≪ / RTI > 4. The method according to any one of claims 1 to 3,
Wherein the medical device comprises at least two portions (46; 68; 69), the at least two portions being configured to form a functional artificial hip joint surface after being inserted into a human patient's hip joint. 5. The method according to any one of claims 1 to 4,
The medical device comprising:
The artificial femoral head with the largest diameter,
Artificial glenoid surface having a maximum diameter, and
Artificial femoral head surface and artificial arch surface
≪ / RTI > 6. The method of claim 5,
Wherein the surface of the artificial row of ribs comprises at least one support member,
Wherein the at least one support member is configured to be connected to the pelvic bone after being inserted into a hole in the pelvic bone,
Wherein the at least one support member is further configured to support a load applied to the femoral head from the weight of the human patient by being connected to the pelvic bone after being inserted through a hole in the pelvic bone. 7. The method according to any one of claims 1 to 6,
Wherein the support member comprises:
The screws (101),
glue,
At least one plate 95,
Bone cement, and
The section of the articular <
And at least one element selected from the group consisting of: 8. The method according to any one of claims 1 to 7,
Said at least one support member comprising:
a. The abdomen side of the pelvic bone for directly or indirectly supporting the load, and
b. The side of the pelvic bones to support the load directly or indirectly
Of the medical device. 9. The method according to any one of claims 1 to 8,
Wherein the at least one support member is connected to a bone surrounding the hole, the bone directly or indirectly supporting the load. 10. The method according to any one of claims 1 to 9,
Said at least one support member comprising:
Fixed to the cortex of the pelvic bone to support the load, and
Fixed to the surface of the pelvic bone to support the load
Wherein the medical device is configured to include at least one of: 11. The method according to any one of claims 1 to 10,
Wherein the medical device comprises first and second portions, and wherein the second portion (95; 97) comprises the support member. 12. The method of claim 11,
Said second portion comprising:
Wherein the first portion is displaceable relative to the first portion,
And is configured to support the load by being connected to the pelvic bone,
And supports said load when displaced. 13. The method according to any one of claims 1 to 12,
Said at least one support member comprising:
The bone being connected to a bone surrounding the hole, the bone directly or indirectly supporting the load,
Configured to be secured to the cortex of the pelvic bone to support the load, and
Being configured to be secured to the surface of the pelvic bone to support the load
≪ / RTI > 14. The method according to any one of claims 1 to 13,
Wherein the support member includes a first position that allows the medical device to pierce through an aperture in the pelvic bone and a second position in which the support member connects the medical device to the pelvic bone such that the medical device, The second position being allowed to transmit a load to the bone. 15. The method of claim 14,
Wherein the support member is configured to be rotated to change from the first position to the second position.

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