KR20220076543A - Hip joint device and method - Google Patents

Abstract

A hip joint prosthesis according to the present invention, which can be implanted in a patient's hip joint, is provided. The hip prosthesis comprises a first region and a second region, the first region comprising a first material that may be elastic, the second region comprising a second material that may be elastic, wherein the first The material may be more elastic than the second material.

Description

HIP JOINT DEVICE AND METHOD

FIELD OF THE INVENTION The present invention relates generally to hip joint prosthesis.

Hip osteoarthritis is a syndrome in which low-grade inflammation causes pain in the hip joint caused by abnormal wear of cartilage that acts as a cushion in the hip joint. This abnormal wear of cartilage also reduces joint synovial fluid called synovial fluid. Hip osteoarthritis is estimated to affect 80% of people over the age of 65 in some severe form.

Current treatment of hip osteoarthritis includes topical administration of NSAID drugs, hyaluronic acid, or glucocorticoids to aid in lubrication of the hip joint and to assist in replacing a part of the hip joint with an artificial organ through hip joint surgery. injection is included.

Hip replacement is one of the most common surgeries performed on thousands of patients worldwide to date. The most common method involves placing a metal prosthesis in the femur and placing a plastic bowl in the acetabulum. This operation is performed through a lateral incision in the hip and upper thigh, and is performed through the fascia lata and lateral muscle of the thigh. To access the joint, it is necessary to penetrate the supporting hip capsule attached to the femur and ilium. The femur is then cut at the neck with a bone saw, and an artificial organ is placed in the femur with or without bone cement. The acetabulum is slightly dilated using an acetabular reamer, and a plastic bowl is placed using a screw or bone cement.

Metal prostheses placed within the femur are typically harder than human bone, in many cases damaging the femoral bone at the point where the prosthesis is anchored to the femur bone. The difference in elasticity between the femoral bone and the hip prosthesis also affects the fixation of the prosthesis. Loosening the prosthesis is the most common reason for the need for reoperation of the hip joint, and the difference in elasticity between the prosthesis and the femur bone creates tension at the fixation point, which promotes loosening of the prosthesis.

A further problem with having prostheses that are not rigid or elastic enough is that the prosthesis fully takes on the load bearing from the natural bone, causing the bone to contract and reducing the formation of new bone tissue. Ultimately, this process propagates prosthetic loosening. Deformation in the contact surface additionally results from an impact that typically propagates through the body when walking, or from a wider range of deformations in accident situations, such as when a person falls. The rigid prosthesis does not act in a shock-absorbing manner, so the entire shock is transmitted to the contact surface where the prosthesis is anchored to the femoral bone.

Accordingly, it is an object of the present invention to provide a hip joint prosthesis having elastic properties similar to bone at the point of fixing the prosthesis to the bone, and/or to absorb shock in a manner similar or improved to the natural hip joint. is to provide

A hip prosthesis is provided that can be implanted within a patient's hip joint. The hip prosthesis comprises a first region and a second region, wherein the first region comprises a first material or portion of material that may be elastic, and wherein the second region comprises a second material or portion of material that may be elastic. a portion, wherein the first material or portion of the material may be more resilient than the second material or portion of the material.

According to an embodiment, the hip prosthesis further comprises a first end and a second end positioned along a longitudinal axis of the hip prosthesis. The first end includes the first material or portion of material and the second end includes the second material or portion of the material. When the hip prosthesis is implanted in a patient, the proximal portion of the hip prosthesis may include the first end and the distal end of the hip prosthesis may include the second end.

According to an embodiment, the elasticity of the hip joint prosthesis is gradually increased from the first end to the end.

According to another embodiment, the hip prosthesis further comprises a third region, a fourth region, and a fifth region, wherein the third region comprises a third material or portion of material, wherein the fourth region comprises a third region 4 materials or portions of materials, wherein the fifth region includes a fifth material or portions of materials, and wherein the first, second, third, fourth and fifth materials or portions of materials are net attractive ( They are connected to each other through net attractive forces.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material This could be bigger.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be less elastic than the fourth material or portion of material, and wherein the fourth material or portion of material is more elastic than the fifth material or portion of material This could be smaller.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material This could be smaller.

According to an embodiment, when the hip joint artificial organ is implanted in a patient, the first region is the most proximal region among the first, second, third, fourth, and fifth regions, and the second region is the a second nearest region among the first, second, third, fourth, and fifth regions, wherein the third region is a third nearest region among the first, second, third, fourth, and fifth regions and the fourth region is a fourth most proximal region among the first, second, third, fourth, and fifth regions, and the fifth region is the first, second, third, fourth and fifth regions. It is the 5th most recent region out of 5 regions.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material This could be bigger.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be less elastic than the fourth material or portion of material, and wherein the fourth material or portion of material is more elastic than the fifth material or portion of material This could be smaller.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material This could be smaller.

According to one embodiment, the first, second, third, fourth and fifth materials or portions of materials all include other materials or other portions of the same material in any combination, and all materials or portions of the materials All other parts have different elasticity.

The hip joint contains the acetabulum, a bowl shaped portion of the pelvic bone. The hip prosthesis may further include a connecting section comprising a connecting surface. The connecting surface comprises a first surface material or portion of material having an average elasticity, the surface being capable of connecting with the acetabulum or artificial replacement of the acetabulum. The hip prosthesis further includes a fixation section comprising a fixation surface. The anchoring surface includes a second surface material or portion of material having an average elasticity that can assist in anchoring the hip prosthesis to the femoral bone of a patient.

According to an embodiment, the average elasticity of the first surface material or part of the material is less than the average elasticity of the second surface material or part of the material.

(ingredient)

According to an embodiment, the hip joint prosthesis may include a metal, the metal may be a metal alloy, and the alloy may include steel and/or a biocompatible metal.

According to one embodiment, the percentage of martensite is higher in the first surface material or portion of material than in the second surface material or portion of material.

It is also conceivable that the hip prosthesis comprises a polymer material.

In embodiments in which the hip prosthesis comprises a first and a second material or portion of material, it is conceivable that the first and second material or portion of the material comprise a metal. The metallic material or portion of the material may be a metal selected from the group consisting of steel, steel alloys, titanium, titanium alloys, and biocompatible metals. In embodiments wherein the hip prosthesis comprises first, second, third, fourth and fifth materials or portions of materials, said first, second, third, fourth and fifth materials or portions of materials Silver is an all-metal material, and the metal material may be a metal selected from the group consisting of steel, an alloy including steel, titanium, a titanium alloy, and a biocompatible metal.

(fixed section)

According to one embodiment, the hip joint prosthesis may be fixed to the neck femur. In such a case, the prosthesis may be secured to the neck femur within the neck femur. In another embodiment, the hip prosthesis may be secured to the femoral bone, in which case the hip prosthesis may be secured within the femoral bone.

(connection section)

According to one embodiment, the connecting section comprises a ceramic material or part of the material which may be titanium carbide.

(Materials connected through milling force)

According to an embodiment, the hip joint prosthesis includes a first region and a second region connected to each other through a net attraction. The first region comprises a first material or portion of material that may be elastic, the second region comprises a second material or portion of the material that may be elastic, and wherein the first material or portion of the material comprises the first material or portion of the material 2 May be more elastic than a material or part of a material.

According to one embodiment, the hip joint prosthesis further comprises a first end and a second end positioned on the longitudinal axis of the hip joint prosthesis. The first end includes the first material or portion of material and the second end includes the second material or portion of the material.

According to one embodiment, when the hip prosthesis is implanted in a patient, the proximal portion of the hip prosthesis comprises the first end and the distal end of the hip prosthesis comprises the second end. In addition, it is conceivable that the elasticity of the hip joint prosthesis gradually increases from the second end to the first end.

According to an embodiment, the hip joint prosthesis further includes a third region, a fourth region, and a fifth region. The third region includes a third material or portion of material, the fourth region includes a fourth material or portion of material, and the fifth region includes a fifth material or portion of material. The first, second, third, fourth and fifth materials or portions of materials are connected to each other via net attraction.

According to an embodiment, the first material or portion of material may be more resilient than the second material or portion of material, wherein the second material or portion of material is more resilient than the third material or portion of material may be greater, wherein the third material or portion of material may be more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material This could be bigger.

According to another embodiment, the first material or portion of material is more resilient than the second material or portion of material, and the second material or portion of material is more resilient than the third material or portion of material. large, wherein the third material or portion of material is less elastic than the fourth material or portion of material, and the fourth material or portion of material is less elastic than the fifth material or portion of material.

According to another embodiment, said first material or portion of material is more elastic than said second material or portion of material, and said second material or portion of material is more elastic than said third material or portion of material. larger, wherein the third material or portion of material is more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is less resilient than the fifth material or portion of material. .

According to an embodiment, when the hip joint prosthesis is implanted in a patient, the first region is the most proximal region among the first, second, third, fourth, and fifth regions, and the second region is the a second nearest region among the first, second, third, fourth, and fifth regions, wherein the third region is a third nearest region among the first, second, third, fourth, and fifth regions and the fourth region is a fourth most proximal region among the first, second, third, fourth, and fifth regions, and the fifth region is the first, second, third, fourth and fifth regions. It is the 5th most recent region out of 5 regions.

According to an embodiment, the first material or portion of material is more resilient than the second material or portion of material, and the second material or portion of material is more resilient than the third material or portion of material and wherein the third material or portion of material is more resilient than the fourth material or portion of material, and wherein the fourth material or portion of material is more resilient than the fifth material or portion of material.

According to an embodiment, the first material or portion of material is more resilient than the second material or portion of material, and the second material or portion of material is more resilient than the third material or portion of material large, wherein the third material or portion of material is less elastic than the fourth material or portion of material, and the fourth material or portion of material is less elastic than the fifth material or portion of material.

According to an embodiment, the first material or portion of material is more resilient than the second material or portion of material, and the second material or portion of material is more resilient than the third material or portion of material and wherein the third material or portion of material is more resilient than the fourth material or portion of material, and the fourth material or portion of material is less resilient than the fifth material or portion of material.

The hip joint includes the acetabulum which is the bowl-like portion of the pelvic bone. The hip joint prosthesis according to any one of the above embodiments may further include a connection section comprising a connection surface. The connecting surface comprises a first surface material or portion of material having an average elasticity, the surface being capable of connecting with the acetabulum or artificial replacement of the acetabulum. The prosthesis further includes a fixation section comprising a fixation surface. The anchoring surface includes a second surface material or portion of material having an average elasticity that can assist in anchoring the hip prosthesis to the femoral bone of a patient.

According to an embodiment, the average elasticity of the first surface material or part of the material is less than the average elasticity of the second surface material or part of the material.

(ingredient)

According to an embodiment, the hip joint prosthesis may include a metal such as a metal alloy, and the alloy may include steel and/or a biocompatible metal.

According to one embodiment, the percentage of martensite is higher in the first surface material or portion of material than in the second surface material or portion of material.

According to one embodiment, the hip prosthesis comprises a polymeric material.

In embodiments wherein the hip prosthesis comprises a first and a second material or portion of material, it is conceivable that the first and second material or portion of the material are metal. The metallic material may include a metal selected from the group consisting of steel, steel alloys, titanium, titanium alloys, and biocompatible metals.

According to another embodiment, the first, second, third, fourth and fifth material or part of the material may be a metallic material, the metallic material being steel, an alloy comprising steel, titanium, a titanium alloy and and a metal selected from the group consisting of biocompatible metals.

(fixed section)

According to an embodiment, the hip joint prosthesis may be fixed to the neck femur, and the fixation may be performed from the inside of the neck femur.

According to another embodiment, the hip joint prosthesis may be fixed to the femur bone, and the fixation may be performed from within the femoral bone. Combinations of the above embodiments are also conceivable.

(connection section)

According to one embodiment, the connecting section comprises a ceramic material such as titanium carbide. It is also conceivable that the material of the connecting section is a porous material.

(bending and twisting)

The hip prosthesis may include a fixation section, a connecting section, and an intermediate section positioned between the fixation section and the connecting section. The hip prosthesis according to any one of the above embodiments includes an intermediate section that can be elastically deformed through an intermediate section that can be bent into a curve when exposed to a force, or that can be twisted when exposed to a force. may be elastically deformed through, or the hip prosthesis may be elastically deformed through the intermediate section, which may be bent and twisted in a curve when exposed to force.

While the fixation section remains fixedly attached to the femoral bone, the intermediate section may, according to one embodiment, bend into a curve where κ>2, and in another embodiment, into a curve with κ>4. It can be bent, and according to another embodiment, it can be bent into a curve where κ>8.

While the fixation section remains fixedly attached to the femoral bone, the intermediate section may be twisted, according to one embodiment, to an angle of twisting of (φ)>0.005π, according to another embodiment. , may be twisted up to an angle of twisting of (φ)>0.01π, and according to another embodiment, twisting may be twisted up to an angle of twisting of (φ)>0.02π. It is also contemplated that the intermediate section can be bent into a curve where κ>2 and twisted to an angle of twist of (φ)>0.005π while the fixation section remains fixedly attached to the femoral bone. can

(Way)

There is further provided a method of absorbing a force in a patient's hip joint using the hip joint prosthesis according to any one of the above embodiments. The method includes elastically deforming the hip prosthesis, wherein the elastically deforming the hip prosthesis comprises: the material of the first region of the hip prosthesis when exposed to a force elastically deforming, and deforming the material of the second region of the hip prosthesis less elastically than the material of the first region of the hip prosthesis when exposed to a force.

According to one embodiment, said step of elastically deforming said material of said first region of said hip prosthesis when exposed to said force comprises: deforming said material more elastically than material of said femoral bone. wherein the material of the second region of the hip prosthesis deforms less elastically than the material of the first region of the hip prosthesis when exposed to the force, wherein the material is formed from the femoral bone. and being elastically deformed substantially the same as the material of

According to another embodiment, said step of elastically deforming said material of said first region of said hip prosthesis when exposed to said force comprises: deforming said material more elastically than material of said femoral bone. wherein the material of the second region of the hip prosthesis deforms less elastically than the material of the first region of the hip prosthesis when exposed to the force, wherein the material comprises: and elastically deforming substantially the same as bone cement used to fix the hip prosthesis to the femoral bone.

According to one embodiment, the hip prosthesis comprises a fixation section, a connecting section, and an intermediate section positioned between the fixation section and the connecting section. wherein said step of elastically deforming said hip prosthesis when exposed to said force includes said step of elastically deforming said hip prosthesis when exposed to force, while said fixation section remains fixedly attached to the femoral bone and the femoral bone remains intact. bending the intermediate section into a curve, or twisting the intermediate section when exposed to a force, or bending and twisting the intermediate section when exposed to a force.

While the fixation section remains fixedly attached to the femoral bone, the intermediate section is bent in a curve where, according to one embodiment, κ>2, and in another embodiment, in a curve where κ>4; , bent into a curve with κ>8, according to another embodiment.

While the fixation section remains fixedly attached to the femoral bone, the intermediate section is twisted, according to one embodiment, to an angle of twisting of (φ)>0.005π, or, according to another embodiment, ( Twisted to an angle of twisting of φ)>0.01π, or according to another embodiment to an angle of twisting of (φ)>0.02π.

It is also conceivable that, while the fixation section remains fixedly attached to the femoral bone, the middle section is bent into a curve with κ>2 and twisted to an angle of twist of (φ)>0.005π. It is also conceivable that, while the fixation section remains fixedly attached to the femoral bone, the middle section is bent into a curve with κ>2 and twisted to an angle of twist of (φ)>0.005π.

According to one embodiment, when implanted, the proximal portion of the hip prosthesis comprises the first end, the distal end of the hip prosthesis comprises the second end, and wherein the hip prosthesis comprises the It further has a hard, less elastic layer on the surface of the first end.

According to one embodiment, at the surface of the first end below/at the end of the upper rigid less elastic layer, the prosthesis is substantially resilient and more distally progressively less resilient in the distal direction.

According to an embodiment, the portion of the prosthesis whose elasticity gradually decreases from the distal direction toward the distal end ends at the distal end at which the prosthesis comes into contact with the femoral bone when implanted.

According to an embodiment, the portion of the prosthesis positioned within the femoral bone becomes more elastic gradually from the distal direction when implanted to the more distal end.

According to one embodiment, the portion of the prosthesis positioned within the femoral bone has an elasticity close to that of the bone.

It should be noted that any embodiment or part of an embodiment and any method or part of a method may be combined in any manner.

1 is a side view of a patient when a conventional hip joint surgery is performed.
2 is a front view of a patient when an incision is made by a surgical method.
3 is a front view of a patient when an incision is made in a laparoscopic method;
4 is a front view of a patient and tool in a laparoscopic method.
5 is a cross-sectional view of a patient when a laparoscopic method is performed.
6 is a view of a hip joint prosthesis according to an embodiment.
7 is a view of a hip joint prosthesis according to an embodiment.
8 is a detailed view of a hip joint prosthesis according to an embodiment.
9 is another detailed view of a hip joint prosthesis according to an embodiment.
10 is a detailed view of the hip joint prosthesis according to an embodiment when it is fixed to the femur bone.
11 is a detailed view of a hip joint prosthesis according to an embodiment when it is fixed to a neck femur.
12 is a view of a hip joint prosthesis according to an embodiment.
13 is a view of a hip joint prosthesis according to an embodiment.
14 is a view of a hip joint prosthesis and another part of the hip joint prosthesis.
15 is a diagram of a hip joint prosthesis with curvature.
15A is a diagram schematically illustrating how torsion affects a portion of a hip prosthesis.

An embodiment of the present invention will now be described by way of example with reference to the accompanying drawings.

Elasticity should be understood as the ability of a material to deform in an elastic manner.

Elastic deformation occurs when a material deforms under stress (eg) but returns to its original shape when the stress is removed. A more elastic material should be understood as a material with a low modulus of elasticity. The modulus of elasticity of an object is defined as the slope of the stress-strain curve of the object in the elastic deformation region. The modulus of elasticity is calculated as stress/strain, where stress is the force causing the strain divided by the area to which the force is applied, and strain is the ratio of the change occurring in the stress.

Stiffness is to be understood as the resistance of an elastic body to deformation by an applied force.

Net attraction should be understood as the attractive force that allows materials to connect to each other at the atomic or molecular level. These net attractive forces may be van der Waals forces, bipolar forces, or covalent forces. The materials to be joined through net attraction may be the same material, the same base material by different treatments, or different materials fixed to each other through some kind of bonding force.

The proximal part of the hip prosthesis is to be understood as the part that is positioned proximally in the patient when implanted. Accordingly, the proximal portion is a portion including a connection portion connected to the acetabulum. The distal part is to be understood as the part of the prosthesis that is positioned distally in the patient when implanted. The distal portion includes an anchoring portion capable of anchoring the prosthesis to the femur bone and/or to the neck femur.

A part of a material is to be understood as a part of a material that does not necessarily have the same properties as another part of the same material, for example, a part of a metallic material is a different part of a metallic material even if the two parts are part of the same base material. can be cured differently, and this is similar for polymer and ceramic materials.

A biocompatible material should be understood as a material with a low level of immune response. Biocompatible materials are often also referred to as biomaterials. Biocompatible metals with low immune response, such as titanium or tantalum, are similar. The biocompatible metal may also be a biocompatible alloy comprising one or more biocompatible metals.

A metal alloy is to be understood as a mixture of two or more elements in a solid solution in which the main component is a metal. Therefore, a steel alloy is an alloy in which steel, which is an alloy of iron and carbon, is one of the components. Accordingly, the titanium alloy is an alloy in which one of the components is titanium.

Martensite is a very hard form of steel crystal structure, but is also any crystal structure formed by displacement transformation. It contains a kind of hard mineral that occurs as lath or plate-like crystal grains.

According to an embodiment, the hip joint prosthesis is a steel alloy prosthesis, such as a stainless steel prosthesis, and one of the ends of the prosthesis may be connected to an acetabulum, which is a bowl-shaped part of a pelvic bone. The joint has a less resilient surface that can better withstand wear than the rest of the prosthesis. Less elastic surfaces are formed through quenching of the surface, a process in which the surface is rapidly heated and cooled rapidly. Quenching creates martensite on the surface by preventing carbon atoms from diffusing through the crystal structure. The prosthesis includes a fixture that assists in securing the prosthesis to the femoral bone. The fixture may only be a part of the prosthesis having a surface in direct or indirect connection with the femoral bone, in which case the prosthesis further comprises an intermediate portion which may be positioned between the connector and the fixture. According to another embodiment, the fixing part is the entire prosthesis except for the connecting part. The joint can be quenched by rapidly cooling that particular part, but it is also conceivable that the entire prosthesis is quenched, and the part not exposed to any wear is tempered to create a more resilient structure in the material.

According to one embodiment, the connecting portion and the fixing portion are a biocompatible metallic material, and the intermediate portion is a biocompatible polymeric material such as a polyurethane elastomer material, a polyamide elastomer material, a polyester elastomer material, and a silicone material.

According to one embodiment, the hip prosthesis is a titanium or titanium alloy prosthesis wherein the joint comprises a ceramic layer such as titanium carbide to create a more wear resistant surface. A titanium or titanium alloy prosthesis may be tempered to create a more resilient structure in the material.

A medical device according to any one of the embodiments may comprise one or more materials selected from the group consisting of polytetrafluoroethylene (PTFE), perfluoroalkoxy (PFA), and fluorinated ethylenepropylene (FEP). can It is also conceivable for the material to include cobalt-chromium-molybdenum or a metal alloy such as titanium or stainless steel, or polyethylene such as cross-linked polyethylene or gas-sterilized polyethylene. The use of ceramic materials such as zirconium or zirconium dioxide ceramics or alumina ceramics is also conceivable for the contact surface or for the entire medical device. The portion of the medical device that contacts the human bone for securing the medical device to the human bone is porous capable of promoting growth-in of the human bone within the medical device for securing the medical device. It may include poorhouse structures, which may be micro or nano structures. The porous structure is achieved by applying a combination comprising a hydroxy-apatite (HA) coating, or a rough open-pored titanium coating, which can be generated by air plasma spraying, an open pore titanium coating. can be, and the HA upper layer is also conceivable. The contact part is made of a self-lubricating material such as a waxy polymer such as PTFE, PFA, FEP and UHMWPE, or a powder metallurgical material that can be injected with a lubricant, which is preferably a biocompatible lubricant such as hyaluronic acid derivate. can be done It is also conceivable here that the material of the contact part or surface of the medical device may be lubricated continuously or intermittently. According to some embodiments, the part of the medical device comprises a metal material and/or a combination of carbon fiber and/or boron, a combination of a metal and a plastic material, a combination of a metal and a carbon base material, a combination of a carbon and a plastic base material, It may include a combination of flexible and rigid materials, elastic and less elastic materials, Corian or acrylic polymers.

In the following, a detailed description of the embodiments will be given. In the drawings, like reference numbers refer to the same or corresponding elements throughout the several drawings. It will be understood that these drawings are for illustrative purposes only and are in no way intended to limit the scope. Accordingly, directions such as “upward” or “downward” refer only to directions shown in the drawings. Also, any size shown in the drawings is for illustrative purposes.

1 is a lateral view of a conventional hip surgery in which an incision 112 is made in a tight 113 to allow the surgeon to reach the femur bone 7 in which the supracapillary femur 5 is located. to be. In conventional hip surgery, the hip joint is accessed through the hip capsule, which forces the surgeon to pierce the tissue of the capsule.

2 is a front view of a patient's body in which a surgical method of providing a hip joint prosthesis from the opposite side to the acetabulum is performed; The method, according to a first embodiment, is performed starting from an incision 1 in the patient's abdominal wall. The incision 1 enters the abdomen through the patient's rectus abdominis and peritoneum. In a second embodiment, the incision 2 is led through the rectus abdominis into the pelvic region below the peritoneum. According to a third embodiment, an incision 3 is made directly between the iliac bone and the surrounding tissue, and the incision 3 allows the pelvic bone to be dissected with very little penetration of the fascia and muscle tissue. . According to a fourth embodiment, the incision 4 is made in the inguinal channel. In all four embodiments, tissue surrounding the pelvic bone 9 in the area opposite to the acetabulum is removed or pierced, allowing the surgeon to reach the pelvic bone.

3 is a front view of a patient's body in which a laparoscopic method of providing a hip prosthesis from the opposite side to the acetabulum is performed; The method is performed, according to a first embodiment, starting with making a small incision 14 in the patient's abdominal wall. The small incision allows the surgeon to insert laparoscopic trocars into the patient's abdomen. According to a first embodiment, the incision 14 enters the abdomen through the abdominal wall and peritoneum of the patient. According to a second embodiment, a small incision 15 is led through the abdominal wall, preferably through the rectus abdominis muscle, into the pelvic region below the peritoneum. According to a third embodiment, a small incision 16 is made directly between the iliac bone and the surrounding tissue, and the incision 16 allows the pelvic bone to be dissected with very little penetration of the fascia and muscle tissue. According to a fourth embodiment, the incision 4 is made in the inguinal canal. In all four embodiments, tissue surrounding the pelvic bone 9 in the area opposite to the acetabulum 8 is removed or pierced, allowing the surgeon to reach the pelvic bone.

4 is a front view of the patient's body showing the laparoscopic method of operating the hip joint from the opposite side to the acetabulum 8 . The hip joint includes the acetabulum (8) and the scapular femur (5). A small incision 14 in the patient's abdominal wall allows insertion of the laparoscopic trocar 33a, 33b, 33c into the patient's body. Thereafter, one or more cameras 34 , surgical instruments capable of forming a hole in pelvic bone 35 , or instruments 36 for introducing, positioning, connecting, attaching, forming, or filling an artificial organ or portion of an artificial organ. ) may be inserted into the body through the laparoscopic trocar 33a, 33b, 33c.

Fig. 5 is a lateral detail view of the patient's body with the hip joint shown in cross section; The hip joint includes the cephalosternal femur 5 located just above the neck femur 6 , which is the upper portion of the femur bone 7 . The head of the femur is connected to the acetabulum, which is a bowl-shaped portion of the pelvic bone (9). Laparoscopic trocars 33a , 33b , 33c may be used to introduce, place, connect, attach, or attach one or more cameras 34 , surgical instruments capable of forming holes in pelvic bones 35 , or prostheses or parts of prostheses. , used in conjunction with an instrument 36 for forming or filling.

6 shows a hip joint prosthesis according to an embodiment, wherein the hip joint prosthesis may be fixed to the femoral bone by means of a fixing section (A). The hip prosthesis may have sections schematically indicated by A, B, C, and D, and the sections may have different properties. According to one embodiment, section (A) is less elastic than section (B), section (B) is less elastic than section (C), and section (C) is less elastic than section (D). This allows the hip joint prosthesis to absorb the shock generated by the patient's movement and load while allowing the first section (A) to be firmly fixed to the femoral bone. According to another embodiment, section (A) is less elastic than section (B), section (B) is less elastic than section (C) but more elastic than section (D). This allows the connection section (D) to withstand the wear caused by contact with the acetabulum 8 or its artificial replacement, while at the same time allowing the first section (A) to be rigidly fixed to the femoral bone, and the hip joint It allows the prosthesis to absorb the shock. However, also in any of the embodiments, the suprahead femoral surface 45 comprises a surface material that may be a less resilient metallic material, a ceramic material, a carbon material, or a polymer material that can withstand abrasion.

7 illustrates a hip prosthesis according to one embodiment, in which the hip prosthesis may be fixed to the neck femur by means of an anchoring section (A). The hip prosthesis includes three sections, schematically denoted A, B, and C. According to one embodiment, section (A) is less elastic than section (B), and section (B) is less elastic than section (C). This allows the hip prosthesis, through the more elastic section, to absorb the shock generated by the patient's movement and load, while at the same time allowing the first section (A) to be securely fixed to the neck femur. According to one embodiment, section (A) is less elastic than section (B), and section (B) is larger than section (C). This allows the connection section (C) to withstand the wear caused by contact with the acetabulum 8 or its artificial replacement, while at the same time allowing the first section (A) to be rigidly fixed to the neck femur and the hip joint prosthesis. It allows the organ to absorb the shock. However, also in any of the embodiments, the suprahead femoral surface 45 comprises a surface material that may be a less resilient metallic material, a ceramic material, a carbon material, or a polymer material that can withstand abrasion.

8 illustrates a hip prosthesis in one embodiment, wherein the hip prosthesis comprises several sections, schematically indicated by I-XI. According to this embodiment, the hip prosthesis is made of a metal material that is hardened such that the different sections have different properties. The hardening process can be carried out in such a way that there are individual sections with different properties, but also the continuous propagation of different properties into the hip prosthesis, i.e. the continuously changing properties through the hip prosthesis without individual boundaries. You can also think of this. However, hip prostheses include sections that are adapted for several surgical purposes. The fixation section (A) preferably comprises a less elastic section (I-XI), since the ability to securely fix the hip prosthesis to the femoral bone is assisted by the hip prosthesis, which does not change dramatically in shape. . Sections (B, C) are preferably more elastic sections (I-XI), since this part of the hip prosthesis can change its shape without having any dramatic effect on the mechanical function of the hip prosthesis. includes The connecting section (D) comprising the prosthetic femoral surface (45) is preferably a section of metal material that is less resilient and more resistant to wear, or is separated from the rest of the hip prosthesis and is separated from the acetabulum or prosthetic replacement of the acetabulum. It contains a surface material that can withstand the abrasion caused by the connection of According to another embodiment, the material is a polymeric material that is hardened or stretched to produce different properties in different sections of the hip prosthesis. According to another embodiment, the hip prosthesis is made of a ceramic or powder base material, in which case the hip prosthesis has different properties in the different sections extending along the longitudinal axis (L) of the hip prosthesis. can be cured or sintered to produce

9 illustrates the hip prosthesis in one embodiment, wherein the hip prosthesis includes several sections, schematically indicated by I-VII. According to this embodiment, the hip prosthesis is made of a metal material that is hardened such that the different sections have different properties. The hardening process can be carried out in such a way that there are individual sections with different properties, but also the continuous propagation of different properties into the hip prosthesis, i.e. the continuously changing properties through the hip prosthesis without individual boundaries. You can also think of this. However, hip prostheses include sections that are adapted for several surgical purposes. The fixation section (A) is preferably a less elastic section (I-VII), since the ability to securely fix the hip prosthesis to the neck femur 6 is assisted by the hip prosthesis whose shape does not change dramatically. includes Section (B) preferably includes sections (I-VII) that are more resilient, since this part of the hip prosthesis can change its shape without having any dramatic effect on the mechanical function of the hip prosthesis do. The connecting section (C) comprising the prosthetic femoral surface (45) is preferably a section of metal material that is less elastic and more resistant to wear, or is separated from the remainder of the hip prosthesis and is separated from the acetabulum or prosthetic replacement of the acetabulum. It contains a surface material that can withstand the abrasion caused by the connection of According to another embodiment, the material is a polymeric material that is hardened or stretched to produce different properties in different sections of the hip prosthesis. According to another embodiment, the hip prosthesis is made of a ceramic or powder base material, in which case the hip prosthesis has different properties in the different sections extending along the longitudinal axis (L) of the hip prosthesis. can be cured or sintered to produce

10 shows the hip joint prosthesis when fixed to the femur bone 7 . According to this embodiment, the hip prosthesis may be fixed to the femur bone 7 and the neck femur 6 . According to this embodiment, the fixed section (A) of the hip prosthesis includes most of the hip prosthesis, and the section (B), which may be more elastic to absorb the shock and vibration generated by the movement of the patient, is shown in the figure. As shown, it is quite short.

11 is a cross-sectional view of the hip joint in one embodiment, in which a hip prosthesis, which may be secured to the neck femur, may be positioned in the hip joint through a hole 18 in the pelvic bone 9 according to one embodiment. According to this embodiment, the hip prosthesis is from the outside of the neck femur 6 , and also from the acetabulum side of the neck femur 6 through connection with the surface of the section 614 of the neck femur 6 . It includes a support member 612 for supporting the.

12 illustrates a hip prosthesis according to one embodiment, wherein the hip prosthesis includes a less resilient core structure 615 and a more resilient surface structure 616 . The hip joint prosthesis may be made of a metal material that can be externally hardened in several steps so that the surface structure of the core section 615 has different properties. Also, a relatively large portion of the less resilient core material 615 that aids in securing the hip prosthesis within the femoral bone is provided, for example, by a fixation section (A) capable of securing the hip prosthesis to the femoral bone 7 . to include varying thickness of the surface section along the extension of the hip prosthesis. In the same way, sections B, C can preferably be more resilient to be able to absorb the shocks and vibrations generated by the movement of the patient. The hip prosthesis can be separated into a more elastic surface section 616 and a less elastic core section by means of individually defined sections, but also this separation is in a continuous manner, i.e. the core section 615 and the surface It is also conceivable that there are no individual boundaries between sections 616 .

13 illustrates a hip prosthesis according to one embodiment, wherein the hip prosthesis includes a less resilient core structure 615 and a more resilient surface structure 616 . The hip joint prosthesis may be made of a metal material that can be externally hardened in several steps so that the surface structure of the core section 615 has different properties. Also, a relatively large portion of the less resilient core material 615 that aids in securing the hip prosthesis within the femoral bone is provided, for example, by a fixation section (A) capable of securing the hip prosthesis to the neck femur 6 , for example. to include varying thickness of the surface section along the extension of the hip prosthesis. In the same way, sections B, C can preferably be more resilient to be able to absorb the shocks and vibrations generated by the movement of the patient. The hip prosthesis can be separated into a more elastic surface section 616 and a less elastic core section by means of individually defined sections, but also this separation is in a continuous manner, i.e. the core section 615 and the surface It is also conceivable that there are no individual boundaries between sections 616 .

14 shows one embodiment of a hip prosthesis, comprising a fixed section (A'), a connecting section (C') extending around the circumference of the supracapsular femoral portion 45 of the hip prosthesis. ), and an intermediate section (B') positioned between the fixing section (A') and the connecting section (C'). The fixation section may be secured to the femoral bone within the femoral bone. In order to connect and move together with the femoral bone, thereby reducing the risk of fracture of the femur bone or loosening of the prosthesis, the fixation section (A') is used to fix the femur bone and/or the hip prosthesis to the femur bone. It may be made of a material having elasticity similar to bone cement. According to one embodiment, the connecting section C' comprises a surface material less resilient than the core material of the connecting section C' in order to better resist wear to the acetabulum or artificial replacement of the acetabulum. In general, it is conceivable that the fixed section A', the connecting section C' and the intermediate section B' may comprise materials or parts of materials with different modulus of elasticity. Further, the hip prosthesis changes along the extension of one section, and/or is perpendicular to the extension, for example as the core of the hip prosthesis has one elasticity and the surface of the hip prosthesis has one elasticity. It is also conceivable to include other materials that vary with .

15 illustrates a hip joint prosthesis according to an embodiment, and when the hip joint prosthesis is exposed to force, it can absorb force in the hip joint through elastic deformation. According to the embodiment shown in FIG. 15 , the anchoring section (A″) of the prosthesis comprises a material or portion of material that can be elastically deformed when exposed to a force, and includes an intermediate section (B) of the hip prosthesis. ") comprises a material or portion of material that deforms more elastically than the material of the fixed section A".

The midsection (B") of the hip prosthesis can absorb the force through the midsection bent into a curve with a value of curvature κ=1/R, where R is an osculating circle within a point P on the curve. According to one embodiment, the hip prosthesis is such that the middle section is flexed with a curvature value κ>2, while the fixation section A″ is still fixedly attached to the femur bone, and the femoral bone is in a complete state. , can be managed. According to another embodiment, the hip prosthesis can be managed such that the middle section is flexed with a curvature value κ>4 and the femoral bone is intact while the fixation section A" is still fixedly attached to the femur bone, and , according to another embodiment, the hip prosthesis is to be managed such that the middle section is bent with a curvature value κ>8 while the fixation section A" is still fixedly attached to the femur bone, and the femur bone is in a complete state. can All of the above embodiments are made possible through an intermediate section (B") comprising a material that is sufficiently resilient to absorb the force without damaging the femoral bone or the connection between the femoral bone and the hip prosthesis.

The hip prosthesis of Figure 15 may also absorb forces within the hip joint through an elastically twistable middle section (B"). can be defined as the ability of the material to twist at an angle when applied, ie the angle of twisting = φ. According to one embodiment, the hip prosthesis is configured such that the fixation section A″ is still fixed to the femoral bone. During attachment, the middle section (B") is twisted with an angle of twisting φ>0.005π radians, and the femoral bone can be managed to be intact. According to another embodiment, the hip prosthesis comprises a fixed section The middle section (B") is twisted with an angle of twisting φ>0.01π radians while (A") is still fixedly attached to the femur bone, and the femoral bone can be managed to be intact, another practice According to an example, the hip prosthesis is such that the middle section (B") is twisted with an angle of twisting φ>0.02π radians while the fixation section (A") is still fixedly attached to the femur bone, and the femur bone is intact The angle of twisting is shown in Fig. 15A. All of the above embodiments are sufficient to absorb the force without damaging the femur bone or the connection between the femur bone and the hip prosthesis. This is made possible through an intermediate section (B") comprising a resilient material.

The hip joint prosthesis according to any one of the embodiments may be elastically bent, elastically twisted, or elastically bent and twisted. Further, the hip prosthesis according to any one of the embodiments is elastically twisted in the same manner as the femoral bone, and/or identical to the bone cement used to secure the femur bone and/or the hip prosthesis to the femoral bone. It is conceivable that it can be elastically bent in this way.

To enhance the growth of bone tissue to anchor the prosthesis, the fixation section according to any one of the embodiments may be made of a porous or partially porous material. The porous material allows the bone tissue to extend into the prosthesis and result in a stable fixation.

It should be noted that any embodiment or part of an embodiment and any method or part of a method may be combined in any manner. All examples in this specification are to be understood as part of the general description, and thus may be combined in any manner in a general sense.

Claims (1)

A device as described in the detailed description or as shown in the drawings.

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