WO2019007290A1 - 人工膝关节 - Google Patents

人工膝关节 Download PDF

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Publication number
WO2019007290A1
WO2019007290A1 PCT/CN2018/093793 CN2018093793W WO2019007290A1 WO 2019007290 A1 WO2019007290 A1 WO 2019007290A1 CN 2018093793 W CN2018093793 W CN 2018093793W WO 2019007290 A1 WO2019007290 A1 WO 2019007290A1
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WO
WIPO (PCT)
Prior art keywords
prosthesis
tibial plateau
knee joint
tibial
artificial knee
Prior art date
Application number
PCT/CN2018/093793
Other languages
English (en)
French (fr)
Inventor
朱红文
黄国富
董荣华
朱天谋
Original Assignee
朱红文
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 朱红文 filed Critical 朱红文
Priority to US16/628,035 priority Critical patent/US11185416B2/en
Priority to JP2020522773A priority patent/JP7011058B2/ja
Priority to EP18827540.8A priority patent/EP3649988A4/en
Publication of WO2019007290A1 publication Critical patent/WO2019007290A1/zh

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Definitions

  • the invention relates to a medical artificial joint prosthesis, in particular to an artificial knee joint.
  • knee replacement surgery is the most fundamental treatment for knee lesions and injuries in the world.
  • joint prostheses also called artificial knee joints
  • further requirements for artificial knee joints and replacement surgery are getting higher and higher, people want to reduce pain, and hope to improve the service life, and hope that the postoperative recovery effect is better, and even hope to achieve normal health.
  • the two main leg bones of the human body are the femur and tibia, the femur is on the top, the tibia is on the lower side, the femur and the tibia intersect and interact with each other.
  • the knee joint is called the lower end of the femur in the knee joint.
  • the humerus is called the upper end of the humerus; the lower end of the femur and the upper end of the tibia become larger, providing a supporting foundation for the stability of the knee joint;
  • Two lower jaws are formed at the lower end of the femur.
  • the lower surface of the tendon is smooth and covered by articular cartilage.
  • the two isolated tendons are not symmetrical, the medial condyle is larger, and the lateral condyle is smaller to accommodate the medial aspect.
  • Different lateral forces; the upper end of the humerus includes a shallow, concave outer and medial platform covered by articular cartilage, the medial platform is larger than the lateral platform, and the entire tibial plateau is ridged or nodular between the lateral and medial platforms Separated
  • the humerus (knee bone) is buried in the quadriceps tendon.
  • the quadriceps tendon connects the anterior superior thigh muscle quadriceps muscle tissue to the tibia.
  • the patella ligament connects the humerus to the humerus directly below the knee joint;
  • the combination of the tendon, humerus and patella ligament is more like a pulley, transferring the force generated by the quadriceps muscle tissue to the tibia through the flexed knee joint, thereby straightening the leg or slowing the rate of flexion.
  • the tibia also has Other functions to protect the knee joint from impact damage;
  • the role of the cruciate ligament is to position the ankle generally over the humerus during flexion and extension.
  • the tension exerted by the anterior cruciate ligament restricts the posterior displacement of the ankle.
  • the posterior cruciate ligament is constrained. ⁇ forward displacement;
  • the knee meniscus plays a vital role in the normal function of the knee joint.
  • the meniscus is cushioned and differentiated as it passes through the knee joint, weakening the friction and impact between the femur and the tibia;
  • the natural tibial plateau is often directly removed, the artificial tibial plateau is replaced, and a similarly shaped femoral condyle prosthesis is mounted on the femoral surface, thereby making the new femoral condyle prosthesis and
  • the artificial tibial plateau interacts, which results in the absence of a cruciate ligament and meniscus in the knee joint after surgery, and some even have no tibia. Therefore, the current surgical methods and the corresponding characteristics of the artificial knee joint lead to such surgery. It is impossible to have the desired recovery effect. Such surgery destroys the original physiological structure and characteristics of the knee joint, causing permanent irreversible damage to the knee joint, and it is urgent to make adjustments. It is necessary to retain the cruciate ligament and the tibia. New artificial knee joint with meniscus cushioning.
  • an artificial knee joint including a femoral condyle prosthesis and a tibial plateau prosthesis, which are respectively disposed on the tibial plateau intercondylar ridge.
  • the artificial knee joint further comprising a positioning pin for fixing the tibial plateau prosthesis; and a prosthesis groove on the bottom surface of the tibial plateau prosthesis, A humeral groove is formed on the tibia below the tibial plateau prosthesis, and the prosthesis groove corresponds to the humeral groove, and together constitute a limiting hole for accommodating the positioning pin, the limiting hole penetrating the tibial plateau.
  • the ridge connects the tibial plateau inner prosthesis and the tibial plateau outer prosthesis, and the artificial knee joint further includes a positioning pin insertable into the limiting hole, and the positioning pin and the limiting hole can ensure the inner side of the tibial plateau
  • the relative position between the body and the tibial plateau prosthesis is stable and balanced, thereby completing the present invention.
  • an object of the present invention to provide an artificial knee joint comprising a femoral condyle prosthesis 1 and a tibial plateau prosthesis 2,
  • the tibial plateau prosthesis 2 includes a tibial plateau medial prosthesis 201 and a tibial plateau lateral prosthesis 202 that are independent of one another,
  • the tibial plateau medial prosthesis 201 and the tibial plateau lateral prosthesis 202 are respectively disposed on both sides of the tibial plateau intercondylar ridge 31 and are located below the femoral condyle prosthesis 1.
  • the tibial plateau prosthesis 2 is placed under the posterior aspect of the tibia.
  • the artificial knee joint further comprises a positioning pin 5, and the tibial plateau inner prosthesis 201 and the tibial plateau lateral prosthesis 202 are fixed to the tibia by the positioning pin 5.
  • the positioning pin 5 passes through the tibial platform intercondylar ridge 31, one end of which is mounted in the tibial plateau inner prosthesis 201, and the other end of which is mounted in the tibial plateau outer prosthesis 202.
  • a prosthesis groove 23 is formed in the bottom of the tibial plateau inner prosthesis 201 and the tibial plateau outer prosthesis 202;
  • a tibial recess 32 is formed on the top of the humerus below the tibial plateau prosthesis 2;
  • the prosthesis groove 23 forms a limiting hole 4 for mounting the positioning pin 5 together with the tibial recess 32, and the limiting hole penetrates the tibial platform intercondylar ridge 31.
  • the inner semi-temporal prosthesis 201 and the tibial plateau outer prosthesis 202 respectively include an upper spacer 21 and a lower spacer 22,
  • the lower spacer 22 is provided with an elastic member 6 through which the impact force transmitted from the femoral condyle prosthesis 1 to the spacer on the tibial plateau prosthesis 2 is buffered, so that the upper spacer 21 has a meniscus-like function. .
  • the elastic member 6 extends through the lower spacer 22 and is fixedly mounted on the lower spacer 22, and the upper end protrudes above the lower spacer 22 and is placed on the lower surface of the upper spacer.
  • the elastic member 6 comprises a sleeve 61 and a spring 62, the lower end of the spring 62 is embedded in the sleeve 61, and the upper end of the spring is placed on the lower surface of the upper gasket.
  • the sleeve 61 passes through the lower spacer 22, and the bottom end of the sleeve is mounted in the bore 7 on the tibia.
  • a bolt 63 for adjusting the tension of the spring 62 is provided at the bottom of the sleeve 61.
  • the invention also provides a method of using an artificial knee joint as described above, the method comprising the steps of:
  • Step 1 Mounting the femoral condyle prosthesis 1 on the femoral condyle;
  • Step 2 opening a space for installing the tibial plateau prosthesis 2 on the tibial plateau.
  • Step 3 excavating the humerus groove 32 on the tibia and extending the humerus groove 32 to the tibial plateau intercondylar ridge 31, forming an intercondylar ridge hole 33 on the tibial plate intercondylar ridge 31;
  • Step 4 excavating the cavity 7 on the tibia
  • Step 5 inserting the sleeve on the tibial plateau prosthesis 2 into the cavity 7, and adjusting the relative positions of the prosthesis groove 23, the humeral groove 32 and the intercondylar ridge hole 33, so that the prosthesis groove 23 and the tibia
  • the gap 32 and the intercondylar ridge hole 33 together form a limiting hole 4;
  • Step 6 the positioning pin 5 is installed into the limiting hole 4, after the positioning pin 5 is fixed, the tibial plateau prosthesis 2 is fixed by bone cement;
  • the tightening of the spring 62 is adjusted by the rotating bolt 63 before the step 5 is performed.
  • the artificial knee joint according to the present invention has two separate tibial plateau inner prosthesis and tibial plateau lateral prosthesis, which can be respectively placed on both sides of the tibial plateau intercondylar ridge, so that it is not necessary to remove or destroy the tibial plateau
  • the ridge ensures that the cruciate ligament on the intercondylar ridge of the tibial plateau can be preserved, which greatly enhances the use effect and patient experience;
  • the artificial knee joint provided by the present invention has two separate tibial plateau inner prosthesis and tibial plateau lateral prosthesis, and the prosthesis can be transplanted according to the condition, and the practical application is more flexible and convenient;
  • the tibial plateau prosthesis of the artificial knee joint according to the present invention is provided with an elastic member capable of simulating the function of the meniscus and providing a cushioning and shock absorbing effect, so that the artificial knee joint is more substantially similar to the natural knee joint;
  • the spring elastic/elastic force of the elastic member of the artificial knee joint tibial plateau prosthesis according to the present invention is adjustable, and can be adjusted according to different ages and physical conditions, thereby ensuring that the elastic/elastic force of the spring is in an optimal state;
  • the elastic member of the artificial knee joint tibial plateau prosthesis according to the present invention is disposed in a downwardly convex cylindrical structure which is embedded in a cavity in the tibia, thereby being capable of playing against the tibia
  • the tibial plateau prosthesis of the artificial knee joint according to the present invention is provided with a prosthesis groove, and a positioning pin connecting the tibial plateau inner prosthesis and the tibial plateau lateral prosthesis and passing through the intercondylar ridge of the tibial plateau is provided. Therefore, the relative position between the two tibial plateau prostheses is fixed in all directions, so that the artificial knee joint is balanced, the whole is stable, the service life is long, and the patient experience is good;
  • the artificial knee joint provided according to the present invention merely replaces a small portion of the femur and tibia, without any damage or damage to other physiological components near the femur and tibia, and does not affect its normal physiological function.
  • the relevant physiological structure in the knee joint such as the tibia and cruciate ligament is preserved after operation, so that it has a good postoperative recovery effect.
  • FIG. 1 shows an exploded view of an artificial knee joint assembly in accordance with a preferred embodiment of the present invention
  • Figure 2 is a schematic view showing the structure of a conventional integral femoral prosthesis in a prior art artificial knee joint
  • FIG. 3 is a schematic view showing the structure of an intra-femoral semi-tibial prosthesis or an external femoral semi-tibial prosthesis in an artificial knee joint according to a preferred embodiment of the present invention
  • FIG. 4 is a schematic cross-sectional view showing a shape of a limiting hole/positioning pin in an artificial knee joint according to a preferred embodiment of the present invention
  • FIG. 5 is a schematic cross-sectional view showing a shape of a limiting hole/positioning pin in an artificial knee joint according to a preferred embodiment of the present invention
  • FIG. 6 is a schematic cross-sectional view showing a shape of a limiting hole/positioning pin in an artificial knee joint according to a preferred embodiment of the present invention
  • FIG. 7 is a schematic view showing the structure of a tibial plateau inner prosthesis in an artificial knee joint according to a preferred embodiment of the present invention.
  • Figure 8 is a cross-sectional view showing an elastic member of a tibial plateau prosthesis in an artificial knee joint in accordance with a preferred embodiment of the present invention
  • FIG. 9 is a schematic view showing a tibial structure in which a tibial plateau prosthesis is placed in an artificial knee joint according to a preferred embodiment of the present invention.
  • FIG. 10 is a schematic view showing a tibial structure in which an intra-articular tibial prosthesis or a tibial plateau lateral prosthesis is placed in an artificial knee joint according to a preferred embodiment of the present invention
  • Figure 11 is a view showing an exploded view of a femoral condyle prosthesis and a femur assembly in an artificial knee joint according to a preferred embodiment of the present invention
  • Figure 12 is a schematic view showing the structure of the femoral condyle prosthesis and femur after assembly in an artificial knee joint according to a preferred embodiment of the present invention.
  • 1-femoral condyle prosthesis 101-femoral semi-sacral prosthesis; 102-femoral semi-sacral prosthesis; 11-front buckle; 12-fixed thorn; 13-rear cover; 14-fixed pin; Platform prosthesis; 201-tibia platform medial prosthesis; 202-tibia plateau lateral prosthesis; 21-upper gasket; 22-lower gasket; 23-prosthesis groove; 3-tibia; 31-tibia platform intercondylar ridge ; 32- ⁇ ⁇ ;; 33- ⁇ ⁇ ⁇ hole; 4-limit hole; 5--positioning pin; 6-elastic member; 61-sleeve; 62-spring; 63-bolt; 7-hole cavity; Femur
  • the artificial knee joint comprises a femoral condyle prosthesis 1 and a tibial plateau prosthesis 2, wherein the femoral condyle prosthesis 1 is placed at the lower end of the femur 8 and replaces the lower end of the femur A portion of the bone structure, the tibial plateau prosthesis 2 is disposed at the upper end of the humerus 3, and replaces a portion of the bone structure on the tibial plateau at the upper end of the tibia; the tibial plateau described in the present application is the surface of the tibia that is in contact with the lower end of the femur, and the center of the tibial plateau is
  • the tibial plateau intercondylar ridge 31, also referred to as a bulge or nodule, has a crisscross ligament attached thereto, and the tibial plateau is mainly composed of an inner platform and an outer platform on both sides
  • the tibial plateau prosthesis 2 includes a tibial plateau medial prosthesis 201 and a tibial plateau lateral prosthesis 202 that are independent of one another to replace the medial platform and the lateral platform, respectively.
  • the height of the unreplaced portion of the tibial plateau is consistent with the height of the tibial plateau prosthesis, ie, a portion of the humerus is replaced via the tibial plateau prosthesis After the structure, there was no change in the height and shape of the tibia.
  • the femoral condyle prosthesis may be two separate single iliacs or one integral iliac crest.
  • Figure 2 shows a sturdy femoral prosthesis connected in one piece, the volume of the femoral prosthesis And the weight is large, and the prosthesis will block the femoral trochle due to the change of the trochlear trajectory, and rubbing with the tibia often requires artificial humeral replacement to ensure its normal operation.
  • the present invention comprises two separate monouses, an intra-femoral semi-sacral prosthesis 101 and an external femoral semi-sacral prosthesis 102, namely a femoral semi-tibial prosthesis 101 and an external femoral semi-tenthanal prosthesis 102.
  • the semi-femoral semi-tibial prosthesis 101 is mounted on the inner semi-tibial femur and abuts on the top surface of the tibial plateau inner prosthesis 201
  • the femoral outer semi-temporal prosthesis 102 is mounted on the outer semi-tibial femur and abuts On the top surface of the tibial plateau outer prosthesis 202.
  • the femoral condyle prosthesis 101 and the femoral external semitendosis prosthesis 102 are similar in overall shape and configuration, and the two are approximately mirror-symmetric, due to the size and shape of the medial femoral condyle and the lateral femoral condyle. There is a slight difference, so the corresponding femoral semi-ankle prosthesis 101 and the femoral external semi-ankle prosthesis 102 are not completely symmetrical.
  • the femoral semi-ankle prosthesis 101 has been described as an example, which includes a front buckle cover 11, a fixed thorn 12, and a rear buckle. Cover 13 and fixing pin 14, as shown in Figures 1 and 3;
  • the shape of the femoral semi-ankle prosthesis 101 conforms to the shape of a portion of the femur that is replaced, and the outer portion thereof has a circular arc shape, and the semi-ankle prosthesis in the femur.
  • the front end of the femoral condyle 101 is fixed on the femur, and the top end of the posterior clasp 13 is inclined toward the front cover;
  • the concave prosthesis fixation area is first excavated on the femur. After the femoral condyle prosthesis is installed in the area, the area can be filled up, so that the femur is restored to the excavation site.
  • the previous state of the prosthetic fixation region; that is, the femoral semi-ankle prosthesis 101 is fixed to the femur by being embedded in the prosthetic fixation region.
  • a fixed thorn 12 and a fixing pin 14 are respectively disposed on the inner side of the femoral semi-ankle prosthesis 101 and the femoral external semi-tend prosthesis 102, and when the prosthetic fixed area is processed on the femur, the corresponding position is also in the cancellous bone.
  • the blind hole is dug out, and when the semi-tidal femoral prosthesis 101 or the femoral external hemorrhoid prosthesis 102 is fastened in the prosthesis fixing area, the fixing pin 14 is embedded in the blind hole;
  • a tapered groove/conical hole is formed near the anterior cortical bone, wherein the anterior cortical bone refers to the cortical bone in contact with the front buckle cover 11, the tapered groove/cone
  • the specific shape and number of the shaped holes correspond to the shape and number of the fixed thorns 12.
  • the diameter of the blind hole is slightly smaller than the outer diameter of the fixing pin 14.
  • the hole diameter of the blind hole is forced to expand, and the cancellous region of the bone is pressed. Forming a tight consolidation;
  • the fixing thorn 12 and the fixing pin 14 may be one or more.
  • two fixing thorns are provided, and one fixing pin is provided, and correspondingly, the blind hole and the tapered groove/taper The number of holes matches the number of fixing pins 14 and fixing thorns 12.
  • the area of the femur that is in contact with the front buckle cover 11 and the rear buckle cover 13 is a cortical area, which has high strength and toughness; further preferably, the front buckle cover 11 is adjacent to the fixed thorn 12, front The buckle cover 11 is buckled on the outside of the cortical bone, and the fixed thorn 12 is inserted into the cancellous bone, and is placed on the cortical bone from the inner side, thereby tightening the cortical bone, and forming a socket together with the posterior buckle cover 13 to be fastened and fixed on the femur; At the same time, the front buckle cover 11 and the fixed thorn 12 together form a V-shaped groove-like structure, and the bone cortex which is ground on the femur is topped at the bottom of the groove structure; The trough-like structure with V-shaped cross-section assists the fixation of the cortical bone by the front clasp 11 so that the front clasp 11 and the rear clasp 13 can be snapped on the femur; the femoral con
  • the femoral condyle prosthesis has a smaller surface area size, so the volume and weight are smaller.
  • the outer surface of the femoral condyle prosthesis 101 has an area of about half of the inner femur. 60% or less of the outer surface area of the iliac crest, preferably about 40% to 55%, and preferably about 50% in the present application.
  • the outer surface of the outer semi-femoral prosthesis 102 of the femur is about the outer side of the femur. 60% or less of the area, preferably about 40% to 55%, and preferably about 50% in the present application;
  • the femoral semitendial prosthesis 101 and the femoral external semitendinosus prosthesis 102 are respectively located on both sides of the femoral trochlear, and the replacement of the femoral semitendial prosthesis 101 and the femoral external semitendal prosthesis 102 does not affect the normal operation of the femoral trochlear. Therefore, replacement of the femoral condyle prosthesis 101 and the femoral external semitendosis prosthesis 102 has no effect on the normal operation and installation position of the tibia.
  • the tibial plateau prosthesis comprises a tibial plateau medial prosthesis 201 and a tibial plateau lateral prosthesis 202, and the tibial plateau medial prosthesis 201 and the tibial plateau lateral prosthesis 202 are respectively disposed on the tibial plateau intercondylar ridge.
  • the tibial plateau prosthesis 2 replaces the medial platform and the lateral platform in the tibial plateau and supports the femoral condyle prosthesis 1.
  • the modified tibial bone or the tibial plateau is shown in FIG.
  • the modified tibial or tibial plateau is as shown in FIG.
  • the superior surface of the tibial plateau prosthesis 2 has an inwardly and downwardly concave shape to facilitate engagement with the femur, similar to the medial platform and the lateral platform on the natural tibial plateau, as shown in FIG.
  • the cross-section of the tibial plateau prosthesis 2 is of a waist or a waist type, and its outer contour is consistent with the partially excavated tibial plateau.
  • the tibial plateau prosthesis 2 has a cross-sectional dimension that is about one-third the cross-sectional dimension of the tibial plateau.
  • the artificial knee joint further includes a positioning pin 5 for fixing the tibial plateau prosthesis 2, through which the tibial plateau inner prosthesis 201 and the tibial plateau are false.
  • the body 202 is fixed to the tibia.
  • the positioning pin 5 passes through the tibial plate intercondylar ridge 31, one end of which is mounted in the tibial plateau inner prosthesis 201, and the other end of which is mounted in the tibial plateau outer prosthesis 202;
  • a prosthesis groove 23 is opened at the bottom of the tibial plateau prosthesis 2,
  • a tibial recess 32 is formed on the top of the tibia below the tibial plateau prosthesis 2; that is, a tibial recess 32 is formed on the tibial/tibia platform below the tibial plateau prosthesis, and the tibial groove 32 passes through/
  • the intercondylar ridge 31 is inserted into the tibial plateau, that is, an intercondylar ridge hole 33 is formed in the intercondylar ridge of the tibial plate, and the intercondylar ridge hole 33 is a through hole; as shown in FIGS. 9 and 10.
  • the prosthesis groove 23 corresponds to the humeral groove 32, and together with the intercondylar ridge hole 33 constitutes a limiting hole 4 for mounting the positioning pin 5; as shown in FIG. 4, FIG. 5 and This is shown in Figure 6.
  • the limiting hole 4 and the positioning pin 5 penetrate the tibial plateau intercondylar ridge 31, and communicate with the tibial plateau inner prosthesis 201 and the tibial plateau outer prosthesis 202; that is, in the axial direction of the limiting hole 4.
  • the limiting hole is formed by three parts, wherein the two parts at both ends are surrounded by the upper prosthesis groove 23 and the lower tibial recess 32; the third part in the middle is completely
  • An intercondylar ridge hole 33 is provided on the intercondylar ridge 31 of the tibial plateau.
  • the length of the locating pin is greater than the length of the prosthesis 21 of the tibial plateau prosthesis 201 or the tibial plateau prosthesis 202.
  • the length of the locating pin is less than a prosthesis slot 23
  • the length value is the sum of the width value of the intercondylar ridge 31 of the tibial plateau.
  • the limit is The length of the hole 4 is naturally extended, and the positioning pin can be further moved deep into the extended limiting hole, and finally the positioning pin completely penetrates the tibial platform intercondylar ridge 31, and both ends of the positioning pin are embedded in the prosthesis groove 23 Inside, it plays a role in the limitation and fixation of the tibial plateau prosthesis 2. It is worth noting that due to the presence of the locating pin, it can be used on the medial prosthesis 201 and the tibial plateau of the tibial plateau located on both sides of the intercondylar ridge of the tibial plateau.
  • the prosthesis 202 is positioned in the vertical direction such that the physiological height of the replaced femoral femur is substantially consistent with the physiological height of the femur prior to replacement, and on the basis of this, the posterior aspect of the tibial plateau prosthesis 201 and the tibial plateau are performed.
  • the fixation of the body 202 allows the tibial prosthesis to be in a reasonable position to ensure a good patient experience after surgery.
  • the limiting hole extends into the tibial plateau intercondylar ridge 31 and does not penetrate the tibial plateau
  • the width value of the tibial plateau intercondylar ridge 31 is less than or equal to the length value of the prosthesis groove 23.
  • the sectional shape of the limiting hole 4 is identical to the sectional shape of the positioning pin 5; the sectional shape may be elliptical, square, trapezoidal. , diamonds, triangles, pentagons, pentagrams, hexagons, octagons, etc., in the shape of the pin of various cross-section shapes, triangles, squares, trapezoids and polygons are better.
  • the trapezoid is preferably selected in the present invention, and the trapezoidal superior is located in the prosthesis recess 23, the lower base is located in the sacral recess 32, and the upper base length is greater than the lower base length.
  • the cross-sectional dimension of the positioning pin corresponds to the cross-sectional dimension of the limiting hole, and the two are closely matched, preferably an interference fit; thus, the positioning pin is difficult to continue after being embedded in a certain depth. Extending in and being stuck, at this time the positioning pin just stays at the desired position, preferably, the position is a positive center position and does not deviate to both sides;
  • the cross-sectional dimension of the limiting hole corresponds to the cross-sectional dimension of the limiting hole
  • the positioning pin can be embedded in a corresponding depth position of the limiting hole, and the end surface of the positioning pin can be disposed with An expansion bolt, when the positioning pin is at a desired position, preferably in a positive center position, by screwing the expansion bolt, the positioning pin is locked and fixed in the limiting hole, thereby ensuring the position of the positioning pin is stable, not to the two Side offset
  • the cross-sectional dimension of the positioning pin is uniform, but the cross-sectional dimension of the limiting hole is varied, and an expansion bolt is disposed on the end surface of the positioning pin, and the positioning pin is disposed from the limiting hole.
  • the larger one side protrudes, and the positioning pin is difficult to continue to protrude after being embedded to a certain depth, so that the positioning pin can stay at a desired position, and the expansion bolt is screwed at this time, so that the positioning pin is locked and fixed. In the hole, the fixing of the positioning pin is more stable.
  • the positioning pin has one or more, each positioning pin is matched with a limiting hole.
  • each positioning pin is matched with a limiting hole.
  • there are a plurality of positioning pins there are also a plurality of limiting holes, the number of positioning pins and the limiting hole. The number is consistent.
  • the tibial plateau prosthesis 2 is placed at the anterior superior humeral end position, below the posterior tibial bone.
  • the tibial plateau prosthesis 2 is positioned at a predetermined distance from the lower tibia.
  • the distance between the natural tibial plateau and the tibia is equal to The predetermined distance value; replacement of the natural tibial plateau by the tibial plateau prosthesis 2 has no substantial influence on the tibia itself, nor does it affect the sliding of the tibia, thereby ensuring retention of the tibia after surgery.
  • the natural tibial plateau described in the present application refers to a tibial plateau that naturally grows in the human body, wherein naturally, it means that it exists naturally.
  • the inner semi-temporal prosthesis 201 and the tibial plateau lateral prosthesis 202 are substantially mirror symmetrical in a large configuration, but the dimensions of each component are slightly Differently, the imitation is completely in accordance with the physiological structure of the human body; the inner semi-temporal prosthesis 201 and the tibial plateau lateral prosthesis 202 both include an upper spacer 21 and a lower spacer 22, and the upper spacer 21 and the lower spacer 22 pass between The bolts, the pins, and the like are fixed so that the upper washer 21 and the lower washer 22 can have a relative displacement in the vertical direction and cannot move relative to each other in other directions.
  • An elastic member 6 is provided on the lower spacer 22.
  • the impact force transmitted from the femoral condyle prosthesis 1 to the spacer 21 on the tibial plateau prosthesis 2 is buffered by the elastic member 6, so that the upper spacer 21 has a meniscus-like function.
  • the meniscus is a cartilage tissue that acts as a cushioning effect in the human knee joint; specifically, when the femoral condyle prosthesis 1 transmits the impact force to the tibial plateau prosthesis 2, the impact force is first received by the upper spacer 21 And causing the upper spacer 21 to move downward, thereby pressing the elastic member 6, and as the reaction force of the elastic member 6 is gradually increased, the speed at which the upper spacer 21 moves downward becomes smaller and smaller, and the impact force thereon is also The smaller and smaller, finally the upper gasket is pressed against the lower gasket, and the force is transmitted to the tibia. Due to the buffering of the elastic member 6, the force corresponding to the tibia is negligible, thereby achieving a buffer similar to the meniscus. The role, which is known as having a meniscus-like function.
  • the elastic member 6 may include a spring, and may also include a flexible member capable of buffering and damping, such as an air bag or a cushioning pad, which is disposed under the upper spacer 21 and can cushion the upper pad.
  • a flexible member capable of buffering and damping such as an air bag or a cushioning pad, which is disposed under the upper spacer 21 and can cushion the upper pad.
  • the impact force transmitted from the sheet 21 can be selected, and a suitable specific placement position can be selected according to the specific structural features.
  • the elastic member 6 is penetrated and fixed to the lower spacer 22, and a part of the elastic member 6 located above the lower spacer 22 is placed on the lower surface of the upper spacer 21, and a part of the elastic member 6 located below the lower spacer 22 has a columnar shape.
  • the elastic member 6 includes a sleeve 61 and a spring 62,
  • the lower end of the spring 62 is embedded in the sleeve 61, and the upper end of the spring is placed on the lower surface of the upper gasket.
  • the prosthesis groove 23 described in the present invention is opened on the lower spacer 22.
  • the sleeve 61 is embedded in a bore 7 formed in the tibia 3.
  • the cross-sectional shape of the cavity is consistent with the cross-sectional shape of the sleeve 61, and the cross-sectional dimensions are also uniform, and the two can be closely fitted, so that the relative position between the tibia and the tibial plateau prosthesis is stable without relative displacement.
  • the cross-sectional shape of the sleeve 61 and the cavity 7 may be various shapes such as a polygon, a quadrangle, a triangular ellipse, a circle, etc., and the cross-sectional shape is preferably circular in the present invention.
  • the sleeve can not only protect the spring, but also limit and fix the tibial plateau prosthesis 2, so that the tibial plateau prosthesis 2 has a simple overall structure and simplifies the installation and fixation process of the tibial plateau prosthesis. .
  • the spring 62 is always in a non-stretched state.
  • a bolt 63 is provided at the bottom of the sleeve 61, and the bolt 63 is movable in a vertical direction with rotation, inside the sleeve 61.
  • the top of the bolt is placed at the bottom of the spring 62 so that the elastic size of the spring 62 can be adjusted by controlling the position of the bolt 63 in the vertical direction; the bolt 63 moves upward in the vertical direction, the spring 62 is pressed, and the spring 62
  • the elasticity is increased, the bolt 63 is moved downward in the vertical direction, the degree of compression of the spring 62 is reduced, and the elasticity of the spring 62 is reduced; thus, the appropriate spring elasticity can be adjusted according to the age and physical condition of the patient, or called a spring.
  • a scale line is drawn at the bottom of the sleeve 61 and/or near the bolt 63 such that the degree of screwing of the bolt 63 can be read directly by the scale line; thereby facilitating the placement of the resilient member 6 Adjusting the spring to tighten;
  • the spring 62 includes a top piece disposed at the top for contact with the upper shim 21.
  • the spring 62 may be made of a material such as metal or various high molecular polymers.
  • the invention provides a method for using an artificial knee joint
  • the artificial knee joint is the artificial knee joint described above, and the method comprises the following steps:
  • Step 1 Opening a space for placing the tibial plateau prosthesis 2 on the tibial plateau.
  • the space is located on one side of the intercondylar ridge 31 of the tibial plateau.
  • the tibial plateau is located respectively.
  • the humerus groove 32 is excavated from the tibia and the humerus groove 32 is extended to the tibial plateau intercondylar ridge 31, and the intercondylar ridge hole 33 is formed on the tibial plate intercondylar ridge 31; the cavity 7 is excavated on the tibia 7
  • the number of the sacral groove 32 and the cavity 7 is not fixed, and may be one, two or more, preferably one;
  • Step 3 inserting the sleeve on the tibial plateau prosthesis 2 into the cavity 7, and adjusting the relative positions of the prosthesis groove 23, the humeral groove 32 and the intercondylar ridge hole 33, so that the prosthesis groove 23 and the tibia
  • the gap 32 and the intercondylar ridge hole 33 together form a limiting hole 4;
  • Step 4 the positioning pin 5 is installed into the limiting hole 4;
  • step 5 the height position of the tibial plateau prosthesis 2 is fixed by the positioning pin 5, and the height of the tibial plateau prosthesis 2 is further fixed by adjusting the amount of bone cement injected.
  • the elasticity of the spring 62 is adjusted by the rotating bolt 63, wherein the elastic/detecting device is also used to detect the tension/strength of the spring to ensure the tension/strength of the springs in the plurality of elastic members 6 are uniform;
  • the method further comprises the following steps:
  • Step a assembling the upper spacer 21, the lower spacer 22 and the elastic member 6 into a complete tibial plateau prosthesis 2, preferably the tibial plateau prosthesis 2 comprises the tibial plateau medial prosthesis 201 and/or the lateral tibial plateau Prosthesis 202;
  • Step b installing a femoral condyle prosthesis 1, wherein the femoral condyle prosthesis is fixed on the femur and is located above the tibial plateau prosthesis in contact with the tibial plateau prosthesis; preferably, the prosthesis is first excavated on the femur The fixation area is embedded in the area, and because the femoral condyle has a special curvature and the front buckle cover 11 and the rear buckle cover 13, the femoral condyle prosthesis is fastened to the femur, and the femur is false.
  • the fixed thorn 12 on the body is inserted into the cancellous bone of the femur, and the fixation pin 14 on the femoral condyle prosthesis is inserted into the fixation pin 14 dug out of the femur, thereby achieving fixation between the femoral condyle prosthesis and the femur.
  • the invention provides an artificial knee joint replacement method
  • the artificial knee joint is the artificial knee joint described above, and the method comprises the following steps:
  • Step 1 Opening a space for placing the tibial plateau prosthesis 2 on the tibial plateau.
  • the space is located on one side of the intercondylar ridge 31 of the tibial plateau.
  • the tibial plateau is located respectively.
  • the humerus groove 32 is excavated from the tibia and the humerus groove 32 is extended to the tibial plateau intercondylar ridge 31, and the intercondylar ridge hole 33 is formed on the tibial plate intercondylar ridge 31; the cavity 7 is excavated on the tibia 7
  • the number of the sacral groove 32 and the cavity 7 is not fixed, and may be one, two or more, preferably one;
  • Step 3 inserting the sleeve on the tibial plateau prosthesis 2 into the cavity 7, and adjusting the relative positions of the prosthesis groove 23, the humeral groove 32 and the intercondylar ridge hole 33, so that the prosthesis groove 23 and the tibia
  • the gap 32 and the intercondylar ridge hole 33 together form a limiting hole 4;
  • Step 4 the positioning pin 5 is installed into the limiting hole 4;
  • step 5 the height position of the tibial plateau prosthesis 2 is fixed by the positioning pin 5, and the height of the tibial plateau prosthesis 2 is further fixed by adjusting the amount of bone cement injected.
  • the elasticity of the spring 62 is adjusted by the rotating bolt 63, wherein the elastic/detecting device is also used to detect the tension/strength of the spring to ensure the tension/strength of the springs in the plurality of elastic members 6 are uniform;
  • the method further comprises the following steps:
  • Step a assembling the upper spacer 21, the lower spacer 22 and the elastic member 6 into a complete tibial plateau prosthesis 2, preferably the tibial plateau prosthesis 2 comprises the tibial plateau medial prosthesis 201 and/or the lateral tibial plateau Prosthesis 202;
  • Step b installing a femoral condyle prosthesis 1, wherein the femoral condyle prosthesis is fixed on the femur and is located above the tibial plateau prosthesis in contact with the tibial plateau prosthesis; preferably, the prosthesis is first excavated on the femur The fixation area is embedded in the area, and because the femoral condyle has a special curvature and the front buckle cover 11 and the rear buckle cover 13, the femoral condyle prosthesis is fastened to the femur, and the femur is false.
  • the fixed thorn 12 on the body is inserted into the cancellous bone of the femur, and the fixation pin 14 on the femoral condyle prosthesis is inserted into the fixation pin 14 dug out of the femur, thereby achieving fixation between the femoral condyle prosthesis and the femur.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
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Abstract

一种人工膝关节，该膝关节包括股骨髁假体（1）和胫骨平台假体（2），胫骨平台假体（2）包括分别设置在胫骨平台髁间脊（31）两侧的胫骨平台内侧假体（201）和胫骨平台外侧假体（202），该人工膝关节还包括固定胫骨平台假体（2）的定位销（5）；在胫骨平台假体（2）的底面上开设有假体豁槽（23），在胫骨平台假体（2）下方的胫骨（3）上开设有胫骨豁槽（32），假体豁槽（23）与胫骨豁槽（32）相对应，一起构成容纳定位销（5）的限位孔洞（4），通过该定位销（5）与限位孔洞（4）的配合能够确保胫骨平台内侧假体（201）和胫骨平台外侧假体（202）之间相对位置稳定、平衡，胫骨平台假体（2）包括上垫片（21）和下垫片（22），在下垫片（22）上设置有弹性构件（6），既可以减震，又能够起到限位固定作用。

Description

人工膝关节 技术领域
本发明涉及一种医用人工关节假体，具体涉及一种人工膝关节。
背景技术
目前，膝关节替换手术是世界上针对膝关节病变和损伤的最根本性治疗方案，替换手术中将关节假体也称之为人工膝关节植入到人体内，用以替换人体天然的膝关节；随着科技的逐渐进步，对于人工膝关节和替换手术的进一步要求越来越高，人们既希望减少痛苦，还希望提高使用寿命，更希望术后恢复效果更佳，甚至希望能达到正常健康人的水平，为此，各种各样的人工膝关节逐步问世，各种构思设想纷纷提出，然而，目前主流的手术方法及人工膝关节还远远不能满足上述要求；
人体的两个主要腿骨是股骨和胫骨，股骨在上，胫骨在下，股骨和胫骨相交并且相互作用的位置即为膝关节；在膝关节中的一段股骨称之为股骨下端，在膝关节中的一段胫骨称之为胫骨上端；股骨下端和胫骨上端变大，为膝关节的稳定提供支撑基础；
股骨下端形成两个分离的髁，髁的下表面是平滑的圆形并且被关节软骨覆盖，所述两个分离的髁并不是对称的，内侧髁较大，外侧髁较小，以适应内侧和外侧不同的受力情况；胫骨上端包括浅的、凹形的、被关节软骨所覆盖的外侧和内侧平台，内侧平台大于外侧平台，整个胫骨平台被外侧平台和内侧平台之间的隆起或结节所分离；
髌骨(膝盖骨)埋在股四头肌肌腱中，股四头肌肌腱将前上大腿的股四头肌肌肉组织连接到髌骨，髌骨韧带将髌骨连接到位于膝关节正下方的胫骨；股四头肌肌腱、髌骨和髌骨韧带的组合更像一个滑轮，将由股四头肌肌肉组织产生的力经由屈曲的膝关节传递至胫骨，从而使得腿变直或者减慢屈曲的速度，显然，髌骨也具有保护膝关节免受撞击损伤的其他功能；
交叉韧带的作用是在屈曲和伸展期间使髁大致定位在胫骨上，在膝关节的屈曲期间，由前交叉韧带所施加的张力限制髁向后位移，在膝关节的伸展期间，后交叉韧带限制髁向前位移；
膝关节半月板对于膝关节发挥正常功能具有至关重要的作用，除了增加关节对称性外，半月板在使力经过膝关节时得到缓冲和分化，减弱股骨与胫骨之间的摩擦和冲击；
然而，目前流行的膝关节置换手术中，往往是直接切除自然的胫骨平台，换上人工的胫骨平台，并且在股骨表面安装有形状类似的股骨髁假体，从而 使得新的股骨髁假体与人工胫骨平台相互作用，这就导致术后的膝关节中没有了交叉韧带和半月板，有的甚至连髌骨也没有了，所以现行的手术方法及相应的人工膝关节本身特性导致了这样的手术后不可能具有期望的恢复效果，这样的手术破坏了膝关节原有的生理结构和特性，对膝关节造成了永久性的不可逆损坏，急需做出调整，需要一种能够保留交叉韧带、髌骨，并具有半月板缓冲功能的新的人工膝关节。
另外，经过多年临床研究获知，膝关节病变中，内侧髁和外侧髁，内侧平台和外侧平台的损伤程度并不相同，往往受到人的行为习惯、工作习惯等影响，位于内侧的髁或平台先行损坏，再导致另外一侧的髁或平台加速损坏，并且在此过程中病人承受巨大痛苦，如果此过程中进行手术，往往将没有损坏的一侧也一同切除，因为胫骨平台和新的股骨髁都是整体式的；而且，大多数膝关节病变都是由、半月板、股骨髁或者胫骨平台退变、磨损导致的，交叉韧带和髌骨损坏的极少；
为此，有人提出用半髁式膝关节替换已有的整体式膝关节，这种想法虽然值得提倡，但是在实际执行过程中却遇到了极大困难，最终无法实现，或者其真实效果还要低于原本的整体式膝关节；其主要问题在于，当更换了半髁式膝关节，更换部分与完好部分在功能、高度上不匹配，不能有效延缓完好部分的损坏速度，当原本完好的另一部分膝关节也损坏后，仍然需要手术更换人工膝关节，此时如果也使用半髁式膝关节，则两个半髁式膝关节在高度、尺寸、弹性等方面难以协调一致，使用效果不良，如果更换整体式膝关节，原来更换的半髁式膝关节又显得毫无意义，还涉及到胫骨与股骨的二次破损安装。
由于上述问题，本发明人对现有的人工膝关节做了深入研究，设计出一种能够解决上述问题的新的人工膝关节。
发明内容
为了克服上述问题，本发明人进行了锐意研究，设计出一种人工膝关节，该膝关节包括股骨髁假体和胫骨平台假体，所述胫骨平台假体包括分别设置在胫骨平台髁间脊两侧的胫骨平台内侧假体和胫骨平台外侧假体，该人工膝关节还包括固定胫骨平台假体的定位销；在所述胫骨平台假体的底面上开设有假体豁槽，在所述胫骨平台假体下方的胫骨上开设有胫骨豁槽，所述假体豁槽与所述胫骨豁槽相对应，一起构成容纳定位销的限位孔洞，所述限位孔洞穿透胫骨平台髁间脊，连通胫骨平台内侧假体和胫骨平台外侧假体，该人工膝关节还包括可嵌入到所述限位孔洞中的定位销，通过该定位销与限位孔洞的配合能够确保胫骨平台内侧假体和胫骨平台外侧假体之间相对位置稳 定、平衡，从而完成本发明。
具体来说，本发明的目的在于提供一种人工膝关节，该膝关节包括股骨髁假体1和胫骨平台假体2，
所述胫骨平台假体2包括彼此相互独立的胫骨平台内侧假体201和胫骨平台外侧假体202，
所述胫骨平台内侧假体201和胫骨平台外侧假体202分别设置在胫骨平台髁间脊31的两侧，并位于股骨髁假体1的下方。
其中，所述胫骨平台假体2置于髌骨后侧下方。
其中，该人工膝关节还包括定位销5，通过所述定位销5将胫骨平台内侧假体201和胫骨平台外侧假体202固定于胫骨上。
其中，所述定位销5穿过胫骨平台髁间脊31，其一端上部安装于胫骨平台内侧假体201中，其另一端上部安装于胫骨平台外侧假体202中。
其中，在所述胫骨平台内侧假体201和胫骨平台外侧假体202的底部开设有假体豁槽23；
在胫骨平台假体2之下的胫骨顶部开设有胫骨豁槽32；
所述假体豁槽23与所述胫骨豁槽32一起形成用于安装定位销5的限位孔洞4，且该限位孔洞穿透胫骨平台髁间脊31。
其中，所述内半髁假体201和胫骨平台外侧假体202都分别包括上垫片21和下垫片22，
其中，在下垫片22上设置有弹性构件6，通过该弹性构件6来缓冲由股骨髁假体1传递至胫骨平台假体2上垫片的冲击力，使得上垫片21具有类半月板功能。
其中，所述弹性构件6贯穿下垫片22，并固定安装于下垫片22上，上端伸出下垫片22上方，顶置于上垫片下表面。
其中，所述弹性构件6包括套筒61和弹簧62，弹簧62下端埋置于套筒61中，弹簧上端顶置于上垫片下表面，
套筒61穿过下垫片22，套筒底端安装于胫骨上的孔腔7中。
其中，在所述套筒61底部设有调节所述弹簧62松紧的螺栓63。
本发明还提供一种如上文所述的人工膝关节的使用方法，该方法包括如下步骤：
步骤1，将股骨髁假体1安装在股骨髁上；
步骤2，在胫骨平台上开设出安装胫骨平台假体2的空间，
步骤3，在胫骨上挖出胫骨豁槽32并延伸该胫骨豁槽32至胫骨平台髁间脊31，在胫骨平台髁间脊31上形成髁间脊孔洞33；
步骤4，在胫骨上挖出孔腔7；
步骤5，将胫骨平台假体2上的套筒嵌入到孔腔7中，同时调整假体豁槽23、胫骨豁槽32和髁间脊孔洞33的相对位置，使得假体豁槽23与胫骨豁槽32、以及髁间脊孔洞33一起构成限位孔洞4；
步骤6，将定位销5安装到限位孔洞4中，待定位销5固定后通过骨水泥固定胫骨平台假体2；
其中，优选地，在执行步骤5以前，通过旋转螺栓63调节弹簧62的松紧。
本发明所具有的有益效果包括：
(1)根据本发明提供的人工膝关节具有两个分离的胫骨平台内侧假体和胫骨平台外侧假体，能够分别放置在胫骨平台髁间脊两侧，从而使得不必切除、破坏胫骨平台髁间脊，确保胫骨平台髁间脊上的交叉韧带可以完好保留，从而使得使用效果和患者体验极大增强；
(2)根据本发明提供的人工膝关节具有两个分离的胫骨平台内侧假体和胫骨平台外侧假体，可以根据病情分阶段进行假体移植，实际应用更为灵活方便；
(3)根据本发明提供的人工膝关节的胫骨平台假体上设置有弹性构件，能够模拟半月板的功能，提供缓冲减震效果，使得人工膝关节与自然膝关节更加实质性相似；
(4)根据本发明提供的人工膝关节胫骨平台假体的弹性构件中弹簧弹性/弹力可调，可以根据不同年龄和身体状况进行调节，能够确保该弹簧弹性/弹力处于最佳的状态；
(5)根据本发明提供的人工膝关节胫骨平台假体的弹性构件设置在向下凸出的筒状结构中，该筒状结构嵌入到胫骨上的孔腔内，从而还能够起到对胫骨平台假体的限位固定作用；
(6)根据本发明提供的人工膝关节的胫骨平台假体上开设有假体豁槽，还设置有连通胫骨平台内侧假体和胫骨平台外侧假体并且穿过胫骨平台髁间脊的定位销，从而全方位地限制固定了两个胫骨平台假体之间的相对位置，使得人工膝关节受力均衡，整体稳定，使用寿命长，患者体验良好；
(7)根据本发明提供的人工膝关节仅仅替换了股骨和胫骨上的一小部分区域，对于股骨和胫骨附近的其他生理部件没有任何损伤和破坏，也不会影响其正常的生理功能，可以在术后保留髌骨、十字交叉韧带等膝关节中的相关生理结构，从而具有良好的术后恢复效果。
附图说明
图1示出根据本发明一种优选实施方式的人工膝关节装配爆炸图；
图2示出现有技术人工膝关节中一种常用的整体式股骨假体结构示意 图；
图3示出根据本发明一种优选实施方式的人工膝关节中一种股骨内半髁假体或者股骨外半髁假体结构示意图；
图4示出根据本发明一种优选实施方式的人工膝关节中限位孔洞/定位销截面形状图示意图；
图5示出根据本发明一种优选实施方式的人工膝关节中限位孔洞/定位销截面形状图示意图；
图6示出根据本发明一种优选实施方式的人工膝关节中限位孔洞/定位销截面形状图示意图；
图7示出根据本发明一种优选实施方式的人工膝关节中胫骨平台内侧假体结构示意图；
图8示出根据本发明一种优选实施方式的人工膝关节中胫骨平台假体上弹性构件剖视图；
图9示出根据本发明一种优选实施方式的人工膝关节中安放胫骨平台假体的胫骨结构示意图；
图10示出根据本发明一种优选实施方式的人工膝关节中安放一个胫骨平台内侧假体或者胫骨平台外侧假体的胫骨结构示意图；
图11示出根据本发明一种优选实施方式的人工膝关节中股骨髁假体与股骨装配爆炸图；
图12示出根据本发明一种优选实施方式的人工膝关节中股骨髁假体与股骨装配后的结构示意图。
附图标号说明：
1-股骨髁假体；101-股骨内半髁假体；102-股骨外半髁假体；11-前扣盖；12-固定刺；13-后扣盖；14-固定销；2-胫骨平台假体；201-胫骨平台内侧假体；202-胫骨平台外侧假体；21-上垫片；22-下垫片；23-假体豁槽；3-胫骨；31-胫骨平台髁间脊；32-胫骨豁槽；33-髁间脊孔洞；4-限位孔洞；5-定位销；6-弹性构件；61-套筒；62-弹簧；63-螺栓；7-孔腔；8-股骨；
具体实施方式
下面通过附图和实施例对本发明进一步详细说明。通过这些说明，本发明的特点和优点将变得更为清楚明确。
在这里专用的词“示例性”意为“用作例子、实施例或说明性”。这里作为“示例性”所说明的任何实施例不必解释为优于或好于其它实施例。尽管在附图中示出了实施例的各种方面，但是除非特别指出，不必按比例绘制 附图。
根据本发明提供的人工膝关节，如图1中所示，该人工膝关节包括股骨髁假体1和胫骨平台假体2，其中，股骨髁假体1设置在股骨8下端，并替换股骨下端的一部分骨结构，胫骨平台假体2设置在胫骨3上端，并替换胫骨上端胫骨平台上的一部分骨结构；本申请中所述胫骨平台为胫骨上与股骨下端接触的面，胫骨平台的中央有胫骨平台髁间脊31，也称之为隆起或结节，其上附着有十字交叉韧带，胫骨平台主要由所述胫骨平台髁间脊两侧的内侧平台和外侧平台构成。
所述胫骨平台假体2包括彼此相互独立的胫骨平台内侧假体201和胫骨平台外侧假体202，分别用以替换内侧平台和外侧平台。所述胫骨平台假体替换内侧平台和/或外侧平台后，胫骨平台上未被替换部分(包括胫骨平台髁间脊)高度与胫骨平台假体高度一致，即经由胫骨平台假体替换了一部分胫骨结构后，胫骨高度和外形都没有变化。
所述股骨髁假体可以是两个分离的单髁也可以是一个连接为一体的全髁，图2中示出的是一个连接为一体的全髁式股骨假体，该股骨假体的体积和重量较大，而且该假体会因滑车轨迹的改变而遮挡股骨滑车，与髌骨摩擦，往往需要人工髌骨置换才能保证其正常工作。
本发明中优选地，所述包括两个分离的单髁，分别为股骨内半髁假体101和股骨外半髁假体102，即股骨内半髁假体101和股骨外半髁假体102相互独立；股骨内半髁假体101安装在内半髁股骨上，并抵接在胫骨平台内侧假体201的顶面上，股骨外半髁假体102安装在外半髁股骨上，并抵接在胫骨平台外侧假体202的顶面上。
股骨髁假体的股骨内半髁假体101和股骨外半髁假体102在整体形状及构成上基本类似，二者近似镜像对称，由于股骨内侧半髁和股骨外侧半髁之间大小、形状都略有差别，所以与之相对应的股骨内半髁假体101和股骨外半髁假体102并不完全对称。由于股骨内半髁假体101和股骨外半髁假体102所具有的构件基本一致，现已股骨内半髁假体101为例进行说明，其包括前扣盖11、固定刺12、后扣盖13和固定销14，如图1和图3中所示；
具体来说，如图11和图12中所示，所述股骨内半髁假体101的外形与其替换的部分股骨外形一致，其外部呈圆弧面状，在所述股骨内半髁假体101的两端分别设置前扣盖11和后扣盖13，用以使得所述股骨内半髁假体101固定在股骨上，其中，所述后扣盖13顶端朝向前扣盖方向倾斜；
安装所述股骨髁假体时，首先在股骨上挖出内凹的假体固定区域，当股骨髁假体安装在该区域内以后，刚好可以将该区域填满，使得股骨恢复到挖出所述假体固定区域以前的状态；即股骨内半髁假体101通过嵌入到假体固 定区域来固定在股骨上。
在股骨内半髁假体101和股骨外半髁假体102的内侧都分别设置有固定刺12和固定销14，在股骨上加工假体固定区域时，还要在相应位置，在骨松质中挖出盲孔，当股骨内半髁假体101或股骨外半髁假体102扣合在假体固定区域时，固定销14嵌入到所述盲孔内；
同时，在骨松质上，靠近前骨皮质处开设出锥形槽/锥形孔，其中，所述前骨皮质是指与前扣盖11相接触的骨皮质，所述锥形槽/锥形孔的具体形状、数量都与固定刺12的形状、数量相对应，当股骨内半髁假体101或股骨外半髁假体102扣合在假体固定区域时，固定刺12上尖锐的插入到该锥形槽/锥形孔内；
优选地，所述盲孔的孔径尺寸略小于固定销14的外径尺寸，在固定销14嵌入到盲孔内的过程中，必然会迫使盲孔的孔径扩大，压迫该骨松质区域，从而形成紧密的固结；
优选地，所述固定刺12和固定销14都可以是一个或多个，本申请中优选地固定刺有两个，固定销有一个，相应地，所述盲孔和锥形槽/锥形孔的数量与固定销14和固定刺12的数量匹配。
股骨上与所述前扣盖11、后扣盖13相接触的区域为骨皮质区域，具有较高的强度和韧性；本发明进一步优选地，前扣盖11与所述固定刺12临近，前扣盖11扣在骨皮质外部，固定刺12插入到骨松质中，并且从内侧顶在骨皮质上，从而加紧骨皮质，与后扣盖13一同形成窝槽进而扣合固定在股骨上；同时，前扣盖11与所述固定刺12一起组成截面呈V型的槽状结构，股骨上经过磨削加工的骨皮质即顶在该槽状结构的底部；通过所述固定刺12和所述截面呈V型的槽状结构共同辅助前扣盖11对骨皮质的固定，从而使得前扣盖11和后扣盖13可以卡扣在股骨上；能够科学合理地使得股骨髁假体与股骨之间的固结牢固可靠，能够经受长时间的考验。
在一个优选的实施方式中，所述股骨髁假体的表面积尺寸较小，所以体积和重量都较小，具体来说，所述股骨内半髁假体101外表面的面积约占股骨内侧半髁外表面积的60％以下，优选地可达到40％～55％左右，本申请中优选为50％左右，同样，所述股骨外半髁假体102外表面的面积约占股骨外侧半髁外表面积的60％以下，优选地可达到40％～55％左右，本申请中优选为50％左右；
所述股骨内半髁假体101和股骨外半髁假体102分别位于股骨滑车的两侧，股骨内半髁假体101和股骨外半髁假体102的替换都不影响股骨滑车的正常工作，所以替换股骨内半髁假体101和股骨外半髁假体102对于髌骨的正常工作及安装位置无影响。
本发明中优选地，所述胫骨平台假体包括胫骨平台内侧假体201和胫骨平台外侧假体202，所述胫骨平台内侧假体201和胫骨平台外侧假体202分别设置在胫骨平台髁间脊31的两侧，并位于股骨髁假体1的下方，胫骨平台假体2替换胫骨平台中的内侧平台和外侧平台，并承托股骨髁假体1。为了放置固定所述两个胫骨平台假体，需要对胫骨或者胫骨平台作出一定结构上的改造，改造后的胫骨或者称之为胫骨平台，如图9中所示。当只更换所述胫骨平台假体的胫骨平台内侧假体201或者胫骨平台外侧假体202时，改造后的胫骨或者为胫骨平台如图10中所示。
所述胫骨平台假体2的上表面具有向内、向下凹陷，以便于与股骨进行配合，类似于天然胫骨平台上的内侧平台和外侧平台，如图1中所示。
所述胫骨平台假体2的截面呈腰型或者类腰型，其外轮廓与被挖掉的部分胫骨平台一致。
所述胫骨平台假体2的截面尺寸约为胫骨平台截面尺寸的三分之一。
在一个优选的实施方式中，如图1中所示，该人工膝关节还包括固定胫骨平台假体2的定位销5，通过所述定位销5将胫骨平台内侧假体201和胫骨平台外侧假体202固定于胫骨上。
优选地，所述定位销5穿过胫骨平台髁间脊31，其一端上部安装于胫骨平台内侧假体201中，其另一端上部安装于胫骨平台外侧假体202中；
在一个优选的实施方式中，如图7中所示，在所述胫骨平台假体2的底部开设有假体豁槽23，
在所述胫骨平台假体2的下方的胫骨顶部开设有胫骨豁槽32；即，在所述胫骨平台假体下方的胫骨/胫骨平台上开设有胫骨豁槽32，胫骨豁槽32穿过/穿入胫骨平台髁间脊31，即在所述胫骨平台髁间脊上开设有髁间脊孔洞33，髁间脊孔洞33为通孔；如图9和图10中所示。
所述假体豁槽23与所述胫骨豁槽32相对应，与髁间脊孔洞33一起构成限位孔洞4，该限位孔洞用于安装所述定位销5；如图4、图5和图6中所示。
优选地，所述限位孔洞4及定位销5穿透胫骨平台髁间脊31，连通胫骨平台内侧假体201和胫骨平台外侧假体202；即在所述限位孔洞4的轴向方向上，限位孔洞是由三部分拼接而成的，其中位于两端的两部分，都是由上方的假体豁槽23和下方的胫骨豁槽32围成的；位于中间的第三部分则完全是开设在胫骨平台髁间脊31上的髁间脊孔洞33。
在一个优选的实施方式中，定位销的长度值大于胫骨平台内侧假体201或者胫骨平台外侧假体202上假体豁槽23的长度值，该定位销的长度值小于一个假体豁槽23的长度值与胫骨平台髁间脊31宽度值之和。从而，当只安装胫骨平台内侧假体201或者胫骨平台外侧假体202时，该定位销能够满足定位 固定作用，当安装胫骨平台内侧假体201和胫骨平台外侧假体202时，所述限位孔洞4的长度自然随之延长，该定位销可以进一步向延长后的限位孔洞内深入移动，最终定位销完全贯穿胫骨平台髁间脊31，定位销的两端都嵌入到假体豁槽23内，起到对胫骨平台假体2的限位和固定作用，值得注意的是，由于定位销的存在，其能够对位于胫骨平台髁间脊两侧的胫骨平台内侧假体201和胫骨平台外侧假体202在竖直方向上定位，从而使得替换后的膝关节股骨的生理高度与替换前膝关节股骨生理高度基本一致，并在此基础上执行对胫骨平台内侧假体201和胫骨平台外侧假体202的固定，从而使得胫骨假体处于合理位置，确保术后患者体验良好。
当只安装所述胫骨平台假体2的胫骨平台内侧假体201或者胫外半髁假体202时，所述限位孔洞延伸至胫骨平台髁间脊31内，并不穿透所述胫骨平台髁间脊31，即此时的髁间脊孔洞33为盲孔。
优选地，胫骨平台髁间脊31的宽度值小于或等于假体豁槽23的长度值。
在一个优选的实施方式中，如图4、图5和图6中所示，所述限位孔洞4的截面形状与定位销5的截面形状一致；该截面形状可以为椭圆形、正方形、梯形、菱形、三角形、五边形、五角星形、六边形、八边形等等各种形状，在各种截面形状的定位销中，三角形、正方形、梯形和多边形的使用效果更好一些，本发明中优选地选择梯形，并且该梯形上底位于假体豁槽23中，下底位于胫骨豁槽32中，并且上底长度大于下底长度。
在一个优选的实施方式中，所述定位销的截面尺寸和限位孔洞的截面尺寸相对应，二者之间紧密配合，优选地为过盈配合；从而使得定位销嵌入到一定深度后难以继续伸入，并被卡死，此时定位销刚好停留在期望的位置，优选地，该位置为正中心位置，不会向两侧偏离；
在一个优选的实施方式中，所述限位孔洞的截面尺寸和限位孔洞的截面尺寸相对应，定位销可以嵌入到限位孔洞的相应深度位置，在所述定位销的端面上可设置有膨胀螺栓，当定位销位于期望的位置，优选为正中心位置时，通过旋拧所述膨胀螺栓，使得定位销卡死固定在限位孔洞中，从而确保定位销的位置稳固，不会向两侧偏移；
在一个优选的实施方式中，所述定位销的截面尺寸均一不变，但是限位孔洞的截面尺寸是变化的，在所述定位销的端面上设置有膨胀螺栓，定位销从限位孔洞上尺寸较大的一侧伸入，定位销嵌入到一定深度后难以继续伸入，从而使得定位销能够停留在期望的位置，并且此时旋拧所述膨胀螺栓，使得定位销卡死固定在限位孔洞中，使得定位销的固定更为稳固。
本发明中，所述定位销有一个或者多个，每个定位销都与一个限位孔洞相配合，当定位销有多个时，限位孔洞也有多个，定位销的数量与限位孔洞 的数量保持一致。
所述胫骨平台假体2置于胫骨前上端面位置，髌骨后侧下方，优选地，胫骨平台假体2的设置位置与髌骨下缘保持预定距离，自然胫骨平台与髌骨之间的距离值等于该预定距离值；通过胫骨平台假体2替换自然胫骨平台，对于髌骨本身没有实质影响，也不影响髌骨的滑动，可以确保术后保留髌骨。本申请中所述的自然胫骨平台是指人体内自然生长的胫骨平台，其中，自然即表示自然存在的。
在一个优选的实施方式中，如图7和图8中所示，所述内半髁假体201和胫骨平台外侧假体202在大的构造上基本镜像对称，但是每个部件的尺寸大小略有不同，完全按照人体生理结构进行仿制；所述内半髁假体201和胫骨平台外侧假体202都包括上垫片21和下垫片22，上垫片21和下垫片22之间通过螺栓、销轴等方式进行固定，使得上垫片21和下垫片22之间可以在竖直方向上有一定的相对位移，在其他方向上不能相对移动。
在下垫片22上设置有弹性构件6。通过该弹性构件6来缓冲由股骨髁假体1传递至胫骨平台假体2上垫片21的冲击力，使得上垫片21具有类半月板功能。所述半月板为人体膝关节中起到缓冲减震作用的软骨组织；具体来说，当股骨髁假体1传递给胫骨平台假体2冲击力时，首先由上垫片21受到该冲击力，并且致使上垫片21向下移动，从而压迫弹性构件6，并且随着弹性构件6的反作用力的逐渐增大，上垫片21向下移动的速度越来越小，其上的冲击力也越来越小，最终上垫片抵压在下垫片上，共同将作用力传递给胫骨，由于经过了弹性构件6的缓冲，该作用力对应胫骨的损耗可以忽略，从而达到类似半月板的缓冲作用，即称之为具有类半月板功能。
本申请中，所述弹性构件6可以包括弹簧，也可以包括气囊、缓冲垫片等能起到缓冲减震作用的具有一定弹性的构件，其设置在上垫片21的下方，能够缓冲上垫片21传递来的冲击力即可，可以根据具体结构特征选择适宜的具体安放位置。
下面以包括弹簧的弹性构件为例进行说明；
所述弹性构件6贯穿并固定在下垫片22上，位于下垫片22上方的部分弹性构件6顶在上垫片21的下表面，位于下垫片22下方的部分弹性构件6呈柱状。
优选地，具体来说，如图8中所示，所述弹性构件6包括套筒61和弹簧62，
其中，弹簧62下端埋置于套筒61中，弹簧上端顶置于上垫片下表面。从而使得由股骨髁假体传递给上垫片21的力经过弹簧62的缓冲后再作用到下垫片22上；
本发明中所述的假体豁槽23开设在所述下垫片22上。
在一个优选的实施方式中，所述套筒61嵌入到开设在胫骨3上的孔腔7中。优选地，孔腔的截面形状与套筒61的截面形状一致，截面尺寸也一致，二者可以紧密贴合，从而使得胫骨与胫骨平台假体之间相对位置稳定，没有相对位移。所述套筒61和孔腔7的截面形状可以为各种形状，如多边形、四边形、三角形椭圆形、圆形等等，本发明中优选地该截面形状为圆形。
所述套筒既能够起到保护安放弹簧的作用，也能够起到限位、固定胫骨平台假体2的作用，从而使得胫骨平台假体2整体结构简单，简化胫骨平台假体的安放固定过程。
本发明中优选地，所述弹簧62始终处于非拉伸状态，
在一个优选的实施方式中，如图8中所示，在所述套筒61的底部设置有螺栓63，该螺栓63可随着旋转而在竖直方向上移动，在所述套筒61内部，所述螺栓的顶部顶在弹簧62的底部，从而可以通过控制螺栓63在竖直方向上的位置来调节弹簧62的弹性大小；螺栓63在竖直方向向上移动，弹簧62被压迫，弹簧62的弹性增大，螺栓63在竖直方向向下移动，弹簧62的压迫程度减小，弹簧62的弹性减小；从而可以根据患者的年龄和身体状况调节适宜的弹簧弹性，或者称之为弹簧松紧，从而使得上垫片21和下垫片22之间的弹性与半月板的弹性一致，使得上垫片21和下垫片22的总高度/厚度与未更换人工膝关节一侧的高度一致，
还可以使得胫骨平台内侧假体201或者胫骨平台外侧假体202的上垫片21和下垫片22的总高度/厚度与在先更换的胫骨平台外侧假体202或者胫骨平台内侧假体201的高度一致，从而解决了分两次更换的胫骨平台内侧假体201和胫骨平台外侧假体202之间高度、弹性不一致的问题，使得分批次手术后的效果良好。
在一个优选的实施方式中，在所述套筒61的底部和/或螺栓63附近刻画刻度线，使得通过该刻度线能够直接读出螺栓63的旋拧程度；从而便于在安放弹性构件6时调节弹簧松紧；
优选地，所述弹簧62包括设置在顶部，用以与上垫片21接触的顶块。
本发明中，所述弹簧62可以由金属、各种高分子聚合物等材料制成。
本发明提供一种人工膝关节的使用方法，
该人工膝关节为上文中所述的人工膝关节，该方法包括如下步骤：
步骤1，在胫骨平台上开设出安放胫骨平台假体2的空间，优选地，该空间只有一个时，位于胫骨平台髁间脊31的一侧，该空间有两个时，分别位于胫骨平台髁间脊31的两侧，并且在开设该空间的过程中，对于胫骨平台髁间脊31及其上的十字韧带没有破坏，进一步优选地，还不会对髌骨及其所在的股四头肌肌腱造成损伤；
步骤2，在胫骨上挖出胫骨豁槽32并延伸该胫骨豁槽32至胫骨平台髁间脊31，在胫骨平台髁间脊31上形成髁间脊孔洞33；在胫骨上挖出孔腔7；优选地，胫骨豁槽32和孔腔7的数量不固定，可以是一个、两个或者多个，优选地都选择一个；
步骤3，将胫骨平台假体2上的套筒嵌入到孔腔7中，同时调整假体豁槽23、胫骨豁槽32和髁间脊孔洞33的相对位置，使得假体豁槽23与胫骨豁槽32、以及髁间脊孔洞33一起构成限位孔洞4；
步骤4，将定位销5安装到限位孔洞4中；
步骤5，通过定位销5固定胫骨平台假体2的高度位置，通过调节骨水泥的注入量进一步固定胫骨平台假体2的高度。
优选地，在执行步骤3以前，通过旋转螺栓63调节弹簧62的松紧，其中，还使用弹性检测设备检测弹簧的松紧/强度，以保证多个弹性构件6中弹簧的松紧/强度一致；
优选地，还包括任选的如下步骤：
步骤a，将上垫片21、下垫片22和弹性构件6组装为完整的胫骨平台假体2，优选地，所述胫骨平台假体2包括胫骨平台内侧假体201和/或胫骨平台外侧假体202；
步骤b，安装股骨髁假体1，其中，股骨髁假体固定在股骨上，并且位于胫骨平台假体上方，与胫骨平台假体相接触；优选地，首先在所述股骨上挖出假体固定区域，再将股骨髁假体嵌入到该区域内，并且由于股骨髁假体具有特殊的弧度及前扣盖11和后扣盖13，股骨髁假体扣合在股骨上，同时股骨髁假体上的固定刺12插入到股骨的骨松质中，股骨髁假体上的固定销14嵌入到股骨上挖出的固定销14内，从而实现股骨髁假体与股骨之间的固定。
本发明提供一种人工膝关节置换方法，
该人工膝关节为上文中所述的人工膝关节，该方法包括如下步骤：
步骤1，在胫骨平台上开设出安放胫骨平台假体2的空间，优选地，该空间只有一个时，位于胫骨平台髁间脊31的一侧，该空间有两个时，分别位于胫骨平台髁间脊31的两侧，并且在开设该空间的过程中，对于胫骨平台髁间脊31及其上的十字韧带没有破坏，进一步优选地，还不会对髌骨及其所在的股四头肌肌腱造成损伤；
步骤2，在胫骨上挖出胫骨豁槽32并延伸该胫骨豁槽32至胫骨平台髁间脊31，在胫骨平台髁间脊31上形成髁间脊孔洞33；在胫骨上挖出孔腔7；优选地，胫骨豁槽32和孔腔7的数量不固定，可以是一个、两个或者多个，优选地都选择一个；
步骤3，将胫骨平台假体2上的套筒嵌入到孔腔7中，同时调整假体豁槽 23、胫骨豁槽32和髁间脊孔洞33的相对位置，使得假体豁槽23与胫骨豁槽32、以及髁间脊孔洞33一起构成限位孔洞4；
步骤4，将定位销5安装到限位孔洞4中；
步骤5，通过定位销5固定胫骨平台假体2的高度位置，通过调节骨水泥的注入量进一步固定胫骨平台假体2的高度。
优选地，在执行步骤3以前，通过旋转螺栓63调节弹簧62的松紧，其中，还使用弹性检测设备检测弹簧的松紧/强度，以保证多个弹性构件6中弹簧的松紧/强度一致；
优选地，还包括任选的如下步骤：
步骤a，将上垫片21、下垫片22和弹性构件6组装为完整的胫骨平台假体2，优选地，所述胫骨平台假体2包括胫骨平台内侧假体201和/或胫骨平台外侧假体202；
步骤b，安装股骨髁假体1，其中，股骨髁假体固定在股骨上，并且位于胫骨平台假体上方，与胫骨平台假体相接触；优选地，首先在所述股骨上挖出假体固定区域，再将股骨髁假体嵌入到该区域内，并且由于股骨髁假体具有特殊的弧度及前扣盖11和后扣盖13，股骨髁假体扣合在股骨上，同时股骨髁假体上的固定刺12插入到股骨的骨松质中，股骨髁假体上的固定销14嵌入到股骨上挖出的固定销14内，从而实现股骨髁假体与股骨之间的固定。
以上结合了优选的实施方式对本发明进行了说明，不过这些实施方式仅是范例性的，仅起到说明性的作用。在此基础上，可以对本发明进行多种替换和改进，这些均落入本发明的保护范围内。

Claims (10)

  1. 一种人工膝关节，其特征在于，该膝关节包括股骨髁假体(1)和胫骨平台假体(2)，
    所述胫骨平台假体(2)包括彼此相互独立的胫骨平台内侧假体(201)和胫骨平台外侧假体(202)，
    所述胫骨平台内侧假体(201)和胫骨平台外侧假体(202)分别设置在胫骨平台髁间脊(31)的两侧，并位于股骨髁假体(1)的下方。
  2. 根据权利要求1所述的人工膝关节，其特征在于，
    所述胫骨平台假体(2)置于髌骨后侧下方。
  3. 根据权利要求1所述的人工膝关节，其特征在于，
    该人工膝关节还包括定位销(5)，通过所述定位销(5)将胫骨平台内侧假体(201)和胫骨平台外侧假体(202)固定于胫骨上端。
  4. 根据权利要求3所述的人工膝关节，其特征在于，
    所述定位销(5)穿过胫骨平台髁间脊(31)，其一端上部安装于胫骨平台内侧假体(201)中，其另一端上部安装于胫骨平台外侧假体(202)中。
  5. 根据权利要求3所述的人工膝关节，其特征在于，
    在所述胫骨平台内侧假体(201)和胫骨平台外侧假体(202)的底部开设有假体豁槽(23)；
    在胫骨平台假体(2)之下的胫骨顶部开设有胫骨豁槽(32)；
    所述假体豁槽(23)与所述胫骨豁槽(32)一起形成用于安装定位销(5)的限位孔洞(4)，且该限位孔洞穿透胫骨平台髁间脊(31)。
  6. 根据权利要求1所述的人工膝关节，其特征在于，
    所述胫骨平台内侧假体(201)和胫骨平台外侧假体(202)都分别包括上垫片(21)和下垫片(22)，
    其中，在下垫片(22)上设置有弹性构件(6)，通过该弹性构件(6)来缓冲由股骨髁假体(1)传递至胫骨平台假体(2)上垫片的冲击力，使得上垫片(21)具有类半月板功能。
  7. 根据权利要求6所述的人工膝关节，其特征在于，
    所述弹性构件(6)贯穿下垫片(22)，并固定安装于下垫片(22)上，上端伸出下垫片(22)上方，顶置于上垫片下表面。
  8. 根据权利要求6所述的人工膝关节，其特征在于，
    所述弹性构件(6)包括套筒(61)和弹簧(62)，弹簧(62)下端埋置于套筒(61)中，弹簧上端顶置于上垫片下表面，
    套筒(61)穿过下垫片(22)，套筒底端安装于胫骨上的孔腔(7)中。
  9. 根据权利要求8所述的人工膝关节，其特征在于，
    在所述套筒(61)底部设有调节所述弹簧(62)松紧的螺栓(63)。
  10. 一种如权利要求1-9所述的人工膝关节的使用方法，其特征在于，该方法包括如下步骤：
    步骤1，将股骨髁假体(1)安装在股骨髁上；
    步骤2，在胫骨平台上开设出安装胫骨平台假体(2)的空间，
    步骤3，在胫骨上挖出胫骨豁槽(32)并延伸该胫骨豁槽(32)至胫骨平台髁间脊(31)，在胫骨平台髁间脊(31)上形成髁间脊孔洞(33)；
    步骤4，在胫骨上挖出孔腔(7)；
    步骤5，将胫骨平台假体(2)上的套筒嵌入到孔腔(7)中，同时调整假体豁槽(23)、胫骨豁槽(32)和髁间脊孔洞(33)的相对位置，使得假体豁槽(23)与胫骨豁槽(32)、以及髁间脊孔洞(33)一起构成限位孔洞(4)；
    步骤6，将定位销(5)安装到限位孔洞(4)中，待定位销(5)固定后通过骨水泥固定胫骨平台假体(2)；
    其中，优选地，在执行步骤5以前，通过旋转螺栓(63)调节弹簧(62)的松紧。
PCT/CN2018/093793 2017-07-03 2018-06-29 人工膝关节 WO2019007290A1 (zh)

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