WO2020133607A1 - 肩关节假体 - Google Patents

肩关节假体 Download PDF

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Publication number
WO2020133607A1
WO2020133607A1 PCT/CN2019/072100 CN2019072100W WO2020133607A1 WO 2020133607 A1 WO2020133607 A1 WO 2020133607A1 CN 2019072100 W CN2019072100 W CN 2019072100W WO 2020133607 A1 WO2020133607 A1 WO 2020133607A1
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WO
WIPO (PCT)
Prior art keywords
limiting convex
outer cup
convex wall
shoulder joint
spherical
Prior art date
Application number
PCT/CN2019/072100
Other languages
English (en)
French (fr)
Inventor
王彩梅
Original Assignee
北京爱康宜诚医疗器材有限公司
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 北京爱康宜诚医疗器材有限公司 filed Critical 北京爱康宜诚医疗器材有限公司
Priority to US16/960,562 priority Critical patent/US20210361440A1/en
Priority to EP19863968.4A priority patent/EP3698760A4/en
Publication of WO2020133607A1 publication Critical patent/WO2020133607A1/zh

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    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4044—Connections of necks to shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4051—Connections of heads directly to shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4059—Humeral shafts
    • A61F2002/4062—Proximal or metaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A61F2002/4085—Glenoid components, e.g. cups having a convex shape, e.g. hemispherical heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Definitions

  • the present invention relates to the technical field of orthopedic medical devices, and in particular, to a shoulder joint prosthesis.
  • the shoulder joint consists of the glenoid of the scapula and the head of the humerus.
  • the size of the articular surface of the two connected bones differs greatly.
  • the joint socket can only accommodate 1/4 to 1/3 of the joint head.
  • the joint capsule is weak and slack, and it is attached between the circumference of the glenoid and the anatomical neck of the humerus.
  • the shoulder joint is the most flexible ball and socket joint in the whole body, which can be used for flexion, extension, contraction, expansion, rotation and rotation.
  • the structural difference between the joint head and the joint socket is large, and the joint capsule is thin and loose, which reflects the flexible movement function of the shoulder joint.
  • a large number of muscles pass around the shoulder joint. These muscles are important for maintaining the stability of the shoulder joint.
  • the anterior and inferior muscles of the shoulder joint are less, and the joint capsule is the most slack, so the shoulder joint is the weakest point of joint stability.
  • Total shoulder replacement is suitable for osteoarthritis.
  • Osteoarthritis includes primary and secondary, rheumatoid arthritis, traumatic arthritis, and rotator cuff injury arthropathy.
  • Total shoulder replacement surgery can also be applied to artificial shoulder joint revision, osteonecrosis, tumor, shoulder dysplasia, and old infections.
  • Artificial shoulder joint replacement refers to the use of metal, polymer polyethylene, ceramics and other materials to make artificial joint prostheses according to the shape, structure and function of human joints, which are implanted into the body through surgical techniques to replace the function of diseased joints. The purpose of alleviating joint pain and restoring shoulder joint function.
  • the artificial shoulder joint is an artificial organ that replaces the damaged shoulder joint.
  • artificial shoulder replacement surgery and artificial hip and knee replacement surgery have been applied at the same time in clinical practice, they are not comparable to artificial hip and knee replacement surgery in terms of number and long-term effect.
  • the main reason for artificial shoulder joint replacement is the wide range of shoulder joint movement and the high quality of life of patients.
  • the level of functional rehabilitation after joint reconstruction depends greatly on the conditions of the surrounding soft tissue.
  • artificial shoulders can be divided into: artificial half shoulder joints and artificial full shoulder joints.
  • Artificial humeral head is mainly used in cases of severe damage to normal rotator cuff and scapular glenoid articular surface, and comminuted fractures and necrosis of humeral rib head and proximal humeral bone. At present, the largest number of applications is artificial humeral head prosthesis.
  • the cylindrical and disc-shaped polyethylene prosthesis is used to replace the surface of the scapula, which is called artificial total shoulder arthroplasty.
  • the artificial full shoulder joint can be used for various joint diseases, such as osteoarthropathy, rheumatoid arthritis, bone tumors, etc. Bone tumors at the upper end of the humerus will severely damage the bone structure and are difficult to repair. If necessary, the proximal end of the humerus must be removed and the artificial shoulder replacement should be performed.
  • the present invention aims to provide a shoulder joint prosthesis to solve the problem of poor mobility and stability of the unrestricted artificial shoulder joint in the prior art.
  • a shoulder joint prosthesis includes an outer cup, an inner liner, a ball head, and a humeral stem.
  • the outer cup, the inner liner, and the ball head are nested in sequence.
  • the outer cup includes an outer cup body and A first limiting convex wall provided at the opening of the outer cup body, the outer cup body has a first spherical inner cavity, the first limiting convex wall protrudes from the center surface of the first spherical inner cavity, and the first spherical surface
  • the central surface of the cavity is a plane passing through the center of the first spherical inner cavity and perpendicular to the axis of the outer cup, the end surface of the outer cup body is lower than the central surface of the first spherical inner cavity;
  • the inner lining, the inner lining includes a hemispherical shell
  • the hemispherical shell body has a second spherical cavity for accommodating the ball head, a second limiting convex wall and a third limiting The convex wall restricts the ball head from escaping from the second spherical cavity.
  • the hemispherical shell body is provided with a groove for avoiding the humerus stem. The groove is lower than the central surface of the hemispherical shell body.
  • the lining is installed on the first spherical surface by screwing in. In the shape of the inner cavity, where the inner liner is provided in the outer cup, the first limiting convex wall is located outside the second limiting convex wall to restrict the inner liner from disengaging from the first spherical inner cavity.
  • the protrusion height of the second limiting convex wall is greater than the protrusion height of the third limiting convex wall.
  • the third limiting convex walls are two oppositely arranged, the second limiting convex walls are located between the two third limiting convex walls, there are multiple grooves, and the multiple grooves include two Two first grooves between the third limiting convex wall and the second limiting convex wall and a second groove disposed between the two third limiting convex walls.
  • the inner lining is an axisymmetric structure, and the second groove is opposite to the second limiting convex wall.
  • a first cut surface structure for avoiding the humeral stem is provided on the end surface of the outer cup body corresponding to the second groove.
  • end face of the main body of the outer cup is provided with a second cut surface structure to avoid the humeral stem at a position corresponding to one of the two first grooves.
  • the groove is an arc-shaped groove.
  • the cavity wall of the first spherical inner cavity is provided with an annular groove, and there are a plurality of annular grooves, and the plurality of annular grooves are spaced along the axis direction of the main body of the outer cup.
  • the cavity wall of the first spherical inner cavity is also provided with an outer cup clamping groove, and the clamping groove extends along the circumferential direction of the cavity wall of the first spherical inner cavity, and the outer wall surface of the lining is provided with a corresponding groove Of knots.
  • the shoulder joint prosthesis further includes a plurality of fixing members, and a plurality of connection holes are provided at the bottom of the outer cup body, and the connection holes are counterbored structures.
  • a plurality of included angles are formed between the axes of the plurality of connecting holes and the central axis of the outer cup body, and the angles of the plurality of included angles are different.
  • the shoulder joint prosthesis includes an outer cup, an inner lining, a ball head, and a humeral stem.
  • the outer cup, liner and ball head are nested in sequence.
  • the outer cup includes an outer cup body and a first limiting convex wall disposed at an opening of the outer cup body, the outer cup body has a first spherical cavity, and the first limiting convex wall protrudes from the first spherical surface
  • the central surface of the inner cavity of the shape, the central surface of the first spherical inner cavity is a plane passing through the center of the first spherical inner cavity and perpendicular to the axis of the outer cup, the end surface of the outer cup body is lower than the first spherical inner cavity Center plane.
  • the first limiting convex wall protrudes out of the central surface of the first spherical inner cavity to limit the components provided in the first spherical inner cavity.
  • the liner includes a hemispherical shell body and a second limiting convex wall and a third limiting convex wall disposed at the opening of the hemispherical shell body, the second limiting convex wall and the third limiting convex wall both protrude from the hemispherical shell body
  • the center surface of the hemispherical shell body is the plane passing through the center of the hemispherical shell body and perpendicular to the axis of the liner.
  • the hemispherical shell body has a second spherical cavity for accommodating the ball head, and the second limiting convex The wall and the third limiting convex wall restrict the ball head from escaping from the second spherical-shaped lumen.
  • the hemispherical shell body is provided with a groove for avoiding the humeral stem, and the groove is lower than the central surface of the hemispherical shell body.
  • Both the second limiting convex wall and the third limiting convex wall protrude from the central surface of the main body of the hemispherical shell, so that the ball head disposed in the second spherical inner cavity can be limited.
  • the shoulder joint prosthesis can be installed on the scapula of the patient.
  • the first limiting convex wall is located outside the second limiting convex wall to limit the lining from detaching from the first A spherical cavity.
  • the ball head is rotatably movable in the second spherical inner cavity, and the second limiting convex wall and the third limiting convex wall limit the ball head from being separated from the second spherical inner cavity.
  • the first spherical inner cavity can accommodate the inner liner, and the first spherical inner cavity prevents the inner liner from deforming, which can further ensure that the ball head does not come out of the second spherical inner cavity. Therefore, the ball head can rotate freely in the second spherical-shaped inner cavity without detaching from the lining, and thus can effectively prevent the ball head from being dislocated while ensuring the freedom of movement of the ball head.
  • the outer cup, the inner lining and the ball head of the shoulder joint prosthesis are nested in sequence, instead of pulling through the muscles and soft tissues of the human body in the prior art, thereby ensuring the stability of the movement of the shoulder joint prosthesis.
  • FIG. 1 shows a schematic diagram of a three-dimensional structure of an embodiment of a shoulder joint prosthesis according to the present invention
  • FIG. 2 shows a schematic perspective structural view of the shoulder joint prosthesis of FIG. 1 from another angle
  • FIG. 3 shows a schematic structural view of the humeral stem of the shoulder joint prosthesis of FIG. 1 at two first grooves;
  • FIG. 4 shows a schematic diagram of the three-dimensional structure of the shoulder joint prosthesis of FIG. 1 after removing the ball head and the humeral stem;
  • FIG. 5 shows a schematic front view of the outer cup and the fixing member of the shoulder joint prosthesis of FIG. 1;
  • FIG. 6 shows a schematic cross-sectional view taken along line A-A of the outer cup and the fixing member of FIG. 5;
  • FIG. 7 is a schematic left side view of the outer cup and the fixing member of FIG. 5;
  • FIG. 8 is a schematic perspective view of the outer cup of the shoulder joint prosthesis of FIG. 1;
  • FIG. 9 shows a schematic perspective structural view of the outer cup of FIG. 8 from another angle
  • FIG. 10 shows a schematic front view of the outer cup of FIG. 8;
  • FIG. 11 shows a schematic cross-sectional view taken along line B-B of the outer cup of FIG. 8;
  • FIG. 12 shows a schematic left side view of the outer cup of FIG. 8;
  • FIG. 13 shows a schematic front view of the lining of the shoulder joint prosthesis of FIG. 1;
  • FIG. 14 is a schematic cross-sectional view taken along line C-C of the liner of FIG. 13;
  • FIG. 15 shows a schematic plan view of the liner of the shoulder joint prosthesis of FIG. 1;
  • FIG. 16 shows a schematic left side view of the liner of FIG. 13.
  • FIG. 17 is a schematic perspective structural view of a clamping slot of the shoulder joint prosthesis of FIG. 1;
  • FIG. 18 shows a schematic cross-sectional view of the shoulder joint prosthesis of FIG. 1 when the clamping groove and the clamping bar are engaged;
  • FIG. 19 shows a schematic diagram of the assembly process of the outer cup and the inner liner of the shoulder joint prosthesis of FIG. 1.
  • Outer cup 11. Outer cup body; 111. First spherical inner cavity; 1111, annular groove; 1112, card slot; 112, first cut surface structure; 113, second cut surface structure; 114, connection hole ; 12.
  • the shoulder joint prosthesis of this embodiment includes an outer cup 10, an inner liner 30, a ball head 20, and a humerus stem 21.
  • the outer cup 10, the inner liner 30, and the ball head 20 are sequentially embedded set.
  • the outer cup 10 includes an outer cup body 11 and a first limiting convex wall 12 disposed at an opening of the outer cup body 11, the outer cup body 11 has a first spherical inner cavity 111, and the first limiting convex wall 12 protrudes At the center surface of the first spherical inner cavity 111, the center surface of the first spherical inner cavity 111 is a plane passing through the center of the first spherical inner cavity 111 and perpendicular to the axis of the outer cup 10.
  • the end surface is lower than the center surface of the first spherical cavity 111.
  • the inner liner 30 includes a hemispherical shell body 31 and a second limiting convex wall 32 and a third limiting convex wall 33 provided at the opening of the hemispherical shell body 31, the second limiting convex wall 32 and the third limiting The convex walls 33 all protrude from the central surface of the hemispherical shell body 31.
  • the central surface of the hemispherical shell body 31 is a plane passing through the center of the hemispherical shell body 31 and perpendicular to the axis of the liner 30.
  • the groove 35 of the humeral stem 21 is lower than the central surface of the hemispherical shell body 31, and the inner liner 30 is installed in the first spherical-shaped inner cavity 111 by screwing.
  • the first limiting convex wall 12 is located outside the second limiting convex wall 32, so as to limit the inner liner 30 from being separated from the first spherical inner cavity 111.
  • the shoulder joint prosthesis includes an outer cup 10, an inner liner 30, a ball head 20, and a humeral stem 21.
  • the outer cup 10, the inner liner 30 and the ball head 20 are nested in sequence.
  • the ball head 20 is first installed into the second spherical inner cavity 34 of the inner liner 30.
  • Both the second limiting convex wall 32 and the third limiting convex wall 33 protrude from the central surface of the hemispherical shell body 31, and can limit the ball head 20 disposed in the second spherical cavity 34.
  • the shoulder joint prosthesis may be installed on the scapula of the patient.
  • the first limiting convex wall 12 is located outside the second limiting convex wall 32 to limit The inner liner 30 is separated from the first spherical inner cavity 111.
  • the ball head is rotatably movable in the second spherical-shaped inner cavity 34, and the second limiting convex wall 32 and the third limiting convex wall 33 limit the ball head from the second spherical-shaped internal cavity 34.
  • the first spherical inner cavity 111 can accommodate the inner liner 30, and the first spherical inner cavity 111 prevents the inner liner 30 from being deformed, which can further ensure that the ball head 20 does not come out of the second spherical inner cavity 34. Therefore, the ball head 20 can rotate freely in the second spherical-shaped inner cavity 34 without detaching from the liner 30, thereby effectively preventing the ball head 20 from dislocating while ensuring the freedom of movement of the ball head 20.
  • the outer cup 10, the inner liner 30 and the ball head 20 of the shoulder joint prosthesis are sequentially connected in a nested manner instead of pulling through the muscles and soft tissues of the human body in the prior art, thereby ensuring the movement of the shoulder joint prosthesis Stability.
  • the axis of the outer cup 10 coincides with the axis of the inner liner 30.
  • the axis of the outer cup 10 also coincides with the axis of the shoulder joint prosthesis.
  • the humeral stem 21 includes a connecting post 211 connected to the ball head 20, and the groove 35 on the hemispherical shell body 31 is used to avoid the connecting post 211 of the humeral stem 21.
  • the groove 35 can effectively avoid the connecting post 211, so that the humeral stem 21 has a larger movement range and more flexible movement.
  • the protrusion height of the second limiting convex wall 32 is greater than the protrusion height of the third limiting convex wall 33.
  • the second limiting convex wall 32 cooperates with the first limiting convex wall 12 to prevent the inner liner 30 from falling out of the second spherical inner cavity 34.
  • the larger protrusion height of the second limiting convex wall 32 can better ensure the anti-off effect.
  • the degree of movement of the arm retracting forward is large, while the degree of movement extending backward is small.
  • the effect of the third limiting convex wall 33 on restricting the movement of the humeral stem 21 is weaker than that of the second limiting convex wall 32.
  • the protruding height of the second limiting convex wall 32 is greater than the protruding height of the third limiting convex wall 33 to achieve the effect that the arm of the human body is limited during movement.
  • the third limiting convex walls 33 are two oppositely disposed, and the second limiting convex walls 32 are located between the two third limiting convex walls 33, and are concave
  • the three grooves 35 include two first grooves 351 disposed between the two third limiting convex walls 33 and the second limiting convex walls 32 and two third limiting positions
  • the second groove 352 between the convex wall 33.
  • the second limiting convex wall 32 and the first limiting convex wall 12 need to be located on the posterior side of the humeral shank 21, so that the above three grooves 35 correspond to the anterior side, respectively , Superior and inferior regions, so that the humeral stem 21 can have a larger range of movement in the above regions.
  • the range of motion required on the posterior side of the humeral stem 21 is relatively small, so that the second limiting convex wall 32 and the first limiting convex wall 12 located on the posterior side can sufficiently provide a limiting effect.
  • the inner liner 30 has an axisymmetric structure, which is easier to process than the irregular shape of the non-axisymmetric structure.
  • the second groove 352 is disposed opposite to the second limiting convex wall 32, which facilitates the installation of the inner liner 30.
  • the humeral stem 21 further includes a humeral stem body and a curved neck connected to the connecting post 211, and the curved neck forms an angle with the humeral stem 21 body .
  • the first face structure 112 for avoiding the humerus shaft 21 is provided on the end surface of the outer cup body 11 corresponding to the second groove 352. In this way, during the rotation of the humeral stem 21 around the ball head 20, the first slice structure 112 can avoid bending the neck, so that the humeral stem 21 rotates smoothly.
  • the end face of the outer cup body 11 corresponds to one of the two first grooves 351, and a second cut surface structure 113 is provided to avoid the humeral stem 21.
  • the second cut surface structure 113 can avoid bending the neck, so that the humerus stem 21 rotates smoothly.
  • the groove 35 is Curved groove.
  • the structure of the arc-shaped groove also ensures that the humeral shank 21 has as much freedom as possible during rotation.
  • the cavity wall of the first spherical inner cavity 111 is provided with an annular groove 1111.
  • the annular groove 1111 is two, and the two annular grooves 1111 are along the axis of the outer cup body 11 Set the interval in the direction.
  • the inner liner 30 is installed into the outer cup body 11, and there is a gap between the outer wall surface of the inner liner 30 and the first spherical inner cavity 111. Therefore, it is necessary to add bone cement in the first spherical lumen 111 for auxiliary fixation.
  • the arrangement of the annular groove 1111 facilitates the addition of bone cement in the first spherical inner cavity 111, and the annular groove 1111 can effectively contain the bone cement. Adding bone cement into the annular groove 1111 enables bonding between the first spherical inner cavity 111 and the outer wall surface of the liner 30.
  • the number of annular grooves may be one, three or more.
  • the cavity wall of the first spherical inner cavity 111 is further provided with a clamping groove 1112.
  • the clamping groove 1112 extends along the circumferential direction of the cavity wall of the first spherical inner cavity 111.
  • a locking bar 36 corresponding to the locking groove 1112 is provided on the outer wall surface.
  • the rib 36 includes an inclined portion and a flat portion connected to the inclined portion.
  • the inclined portion is inclined relative to the axis of the inner liner 30, and the flat portion is perpendicular to the axis of the inner liner 30. This makes it easy for the locking ribs 36 to be smoothly inserted into the locking slot 1112 and has a better anti-off effect.
  • the inner liner 30 is squeezed, so that the locking rib 36 can enter the locking groove 1112, and the flat portion can be clamped in the locking groove Within 1112. In this way, the cooperation of the locking groove 1112 and the locking rib 36 makes it difficult for the inner liner 30 to escape from the first spherical inner cavity 111.
  • the shoulder joint prosthesis further includes three fixing members 40.
  • the bottom of the outer cup body 11 is provided with three connection holes 114.
  • the connection holes 114 have a counterbore structure.
  • the connecting hole 114 is a counterbore structure, which can prevent the fixing member 40 from protruding beyond the first spherical inner cavity 111 and prevent the fixing member 40 from interfering with the lining 30 after being inserted.
  • the three fixing members 40 fix the outer cup body 11 to the shoulder blade through the three connecting holes 114, so that the outer cup 10 can be fixed.
  • the fixing member 40 is preferably a screw.
  • the glenoid in the prior art requires osteotomy of the glenoid region of the scapula, which damages bone quality and at the same time destroys the cortex of the surface of the glenoid region, and cannot provide good fixing conditions for screw fixation.
  • the outer cup 10 is preferably a 3D printed titanium alloy, and the bottom of the outer cup 10 is in contact with the scapula
  • the shape of the surface is a matching shape, which is a shape formed by 3D printing technology according to the anatomical features of the broken scapula of the patient.
  • the anatomical features are processed by computer image technology. Therefore, the above method can realize individual customization without osteotomy, thereby providing good fixing conditions for subsequent screw fixation.
  • the inner liner 30 and the ball head 20 when the outer cup 10, the inner liner 30 and the ball head 20 are assembled, first install the ball head 20 into the second spherical inner cavity 34 of the inner liner 30, the inner liner 30 and the ball head 20 are assembled Then, it is installed in the first spherical inner cavity 111 by screwing.
  • the ball head 20 is not shown in FIG. 19.
  • the second limiting convex wall 32 is first aligned with the first cut surface structure 112 so that the second limiting convex wall 32 enters the first spherical cavity 111. The direction of the arrow in FIG.
  • the outer wall surface of the second limiting convex wall 32 can fit with the inner wall surface of the first limiting convex wall 12, and the second concave
  • the groove 352 is located at a position corresponding to the first cut surface structure 112, the outer wall surface of the hemispherical shell body 31 and the first spherical inner cavity 111 can be completely fitted together, at this time, the ball head 20 and the liner 30 are realized together Fitted in the first spherical inner cavity 111 of the outer cup 10.
  • the locking bar 36 will be locked into the locking groove 1112.
  • the shoulder joint prosthesis includes a glenoid prosthesis and a humerus prosthesis.
  • the glenoid prosthesis includes a structure in which an outer cup 10 and an inner liner 30 are connected together, wherein the outer cup 10 is made of metal and the inner liner 30 is over radius Spherical structure.
  • the ball head 20 is a humeral ball head, and the liner 30 receives the humeral ball head into the first spherical lumen 111.
  • orientation words such as “front, back, up, down, left, right", “horizontal, vertical, vertical, horizontal” and “top and bottom” indicate the orientation Or the positional relationship is usually based on the orientation or positional relationship shown in the drawings, just to facilitate the description of the present invention and simplify the description, in the case of no contrary description, these orientation words do not indicate and imply that the device or element It must have a specific orientation or be constructed and operated in a specific orientation, and therefore cannot be construed as limiting the scope of protection of the present invention; the orientation words “inside and outside” refer to inside and outside relative to the contour of each component itself.
  • spatially relative terms such as “above”, “above”, “above”, “above”, etc. can be used here to describe as shown in the figure The spatial relationship between a device or feature shown and other devices or features. It should be understood that spatially relative terms are intended to encompass different orientations in use or operation in addition to the orientation of the device described in the figures. For example, if the device in the drawings is turned upside down, a device described as “above another device or configuration” or “above another device or configuration” will then be positioned as “below other device or configuration” or “in Under other devices or structures”. Thus, the exemplary term “above” may include both “above” and “below” orientations. The device can also be positioned in other different ways (rotated 90 degrees or at other orientations), and the relative description of the space used here is explained accordingly.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

一种肩关节假体，包括外杯（10）、内衬（30）、球头（20）以及肱骨柄（21），外杯（10）、内衬（30）及球头（20）依次嵌套，其中，外杯（10）包括外杯主体（11）及设置在外杯主体（11）的开口处的第一限位凸壁（12），外杯主体（11）具有第一球面形内腔（111），第一限位凸壁（12）凸出于第一球面形内腔（111）的中心面，外杯主体（11）的端面低于第一球面形内腔（111）的中心面；内衬（30）包括半球壳主体（31）及设置在半球壳主体（31）的开口处的第二限位凸壁（32）和第三限位凸壁（33），半球壳主体（31）具有用于容纳球头（20）的第二球面形内腔（34），第二限位凸壁（32）和第三限位凸壁（33）限制球头（20）脱离第二球面形内腔（34），半球壳主体（31）上设置有用于避让肱骨柄（21）的凹槽（35）。有效解决了现有技术中由于肿瘤、严重创伤引起的骨结构以及肩袖缺失时非限制型人工肩关节活动稳定性差的问题。

Description

肩关节假体 技术领域
本发明涉及骨科医疗器械技术领域，具体而言，涉及一种肩关节假体。
背景技术
肩关节，由肩胛骨的关节盂和肱骨头组成。相连两骨关节面大小相差较大，具体地，关节窝仅能容纳关节头的1/4～1/3。关节窝周缘有关节唇加深关节盂。关节囊薄弱且松弛，附着在关节盂周缘和肱骨解剖颈之间，关节囊壁内还有由滑膜包裹的肱二头肌长头腱，通过此腱具有加固肩关节的作用。
肩关节为全身最灵活的球窝关节，可作屈、伸、收、展、旋转及环转运动。加以关节头与关节窝的面积差度大，关节囊薄而松弛等结构特征，反映了肩关节具有灵活性的运动机能。肩关节周围有大量肌肉通过，这些肌肉对维护肩关节的稳固性有重要意义。但肩关节的前下方肌肉较少，关节囊又最松弛，所以肩关节是关节稳固性最差的薄弱点。当上肢处于外展、外旋位向后跌倒时，手掌或肘部着地，易发生肩关节的前脱位。
全肩关节置换术适用于骨性关节炎病症。骨性关节炎包括原发及继发性、类风湿关节炎、创伤性关节炎、肩袖损伤性关节病。全肩关节置换术还可适用于人工肩关节翻修、骨坏死、肿瘤、肩关节发育不良、陈旧性感染等。
人工肩关节置换术是指采用金属、高分子聚乙烯、陶瓷等材料，根据人体关节的形态、构造及功能制成人工关节假体，通过外科技术植入人体内，代替患病关节功能，达到缓解关节疼痛，恢复肩关节功能的目的。
人工肩关节是替代受损肩关节的人工器官。尽管人工肩关节置换术与人工髋、膝关节置换术在临床上几乎同时开始应用，但无论在实施数量及长期效果方面均不能与人工髋、膝关节置换术相媲美。人工肩关节置换术其主要原因是肩关节活动范围大、患者对生活质量的要求高，而关节重建后的功能康复水平很大程度取决于周围软组织的条件。
人工肩关节的出现，是由于肱骨近端骨折的需要而产生的，有许多学者提出各种型式的人工肩，其中主要的有Neer在1953年开发出的NeerI型，后来根据临床的试验，发展成NeerII型、NeerIII型。
在此基础上，以后人工肩关节根据不同需要和不断的改进，新型的人工肩关节不断出现。一般讲人工肩可分为：人工半肩关节和人工全肩关节。
人工肱骨头主要应用于肩袖正常、肩胛盂关节面破坏较轻，而肱肋骨头、肱肪骨近端粉碎性骨折、坏死等严重病损的病例，进行人工半肩关节置换术。目前应用数量最大的是人工肱骨头假体。
对于肩胛盂关节面有破坏，在置换人工肱骨头时，使用圆筒形、碟盘形的聚乙烯假体置换肩胛盂的表面，即称为人工全肩关节置换术。人工全肩关节可用于各种的关节病，如骨关节病、风湿关节炎、骨肿瘤等。肱骨上端骨肿瘤会使骨结构遭严重破坏，难以修复，必要时需要切除肱骨近端，实施人工骨肩关节置换。
对于肩关节肿瘤，特别是肱骨上端骨肿瘤，肱骨近端肿瘤切除会使骨结构甚至于肩袖遭严重破坏，难以修复，常规的人工肩关节为非限制型关节，非限制型关节是通过人体自身的肌肉及软组织进行牵拉，无法提供人工肩关节活动的稳定性，严重时会导致脱位。
发明内容
本发明旨在提供一种肩关节假体，以解决现有技术中非限制型人工肩关节活动稳定性差的问题。
为了实现上述目的，根据本发明的一种肩关节假体，包括外杯、内衬、球头以及肱骨柄，外杯、内衬及球头依次嵌套，其中，外杯包括外杯主体及设置在外杯主体的开口处的第一限位凸壁，外杯主体具有第一球面形内腔，第一限位凸壁凸出于第一球面形内腔的中心面，第一球面形内腔的中心面为经过第一球面形内腔的球心且垂直于外杯的轴线的平面，外杯主体的端面低于第一球面形内腔的中心面；内衬，内衬包括半球壳主体及设置在半球壳主体的开口处的第二限位凸壁和第三限位凸壁，第二限位凸壁和第三限位凸壁均凸出于半球壳主体的中心面，半球壳主体的中心面为经过半球壳主体的球心且垂直于内衬的轴线的平面，半球壳主体具有用于容纳球头的第二球面形内腔，第二限位凸壁和第三限位凸壁限制球头脱离第二球面形内腔，半球壳主体上设置有用于避让肱骨柄的凹槽，凹槽低于半球壳主体的中心面，内衬通过旋入方式安装在第一球面形内腔内，其中，在内衬设置在外杯内的情况下，第一限位凸壁位于第二限位凸壁的外侧，以限制内衬脱离第一球面形内腔。
进一步地，第二限位凸壁的凸出高度大于第三限位凸壁的凸出高度。
进一步地，第三限位凸壁为相对设置的两个，第二限位凸壁位于两个第三限位凸壁之间，凹槽为多个，多个凹槽包括设置在两个第三限位凸壁与第二限位凸壁之间的两个第一凹槽以及设置在两个第三限位凸壁之间的第二凹槽。
进一步地，内衬为轴对称结构，第二凹槽与第二限位凸壁相对设置。
进一步地，外杯主体的端面上对应于第二凹槽的位置处设置有避让肱骨柄的第一切面结构。
进一步地，外杯主体的端面上对应于两个第一凹槽中的其中一个的位置处设置有避让肱骨柄的第二切面结构。
进一步地，凹槽为弧形槽。
进一步地，第一球面形内腔的腔壁设置有环形凹槽，环形凹槽为多个，多个环形凹槽沿着外杯主体轴线方向上间隔设置。
进一步地，第一球面形内腔的腔壁上还设置有外杯卡槽，卡槽沿第一球面形内腔的腔壁的周向延伸，内衬的外壁面上设置有与卡槽对应的卡筋。
进一步地，肩关节假体还包括多个固定件，外杯主体的底部设置有多个连接孔，连接孔为沉孔结构。
进一步地，多个连接孔的轴线与外杯主体的中心轴线之间形成多个夹角，多个夹角的角度均不同。
应用本发明的技术方案，肩关节假体包括外杯、内衬、球头以及肱骨柄。外杯、内衬及球头依次嵌套。在本申请中，外杯包括外杯主体及设置在外杯主体的开口处的第一限位凸壁，外杯主体具有第一球面形内腔，第一限位凸壁凸出于第一球面形内腔的中心面，第一球面形内腔的中心面为经过第一球面形内腔的球心且垂直于外杯的轴线的平面，外杯主体的端面低于第一球面形内腔的中心面。第一限位凸壁凸出于第一球面形内腔的中心面能够实现对设置在第一球面形内腔内的部件进行限位。内衬包括半球壳主体及设置在半球壳主体的开口处的第二限位凸壁和第三限位凸壁，第二限位凸壁和第三限位凸壁均凸出于半球壳主体的中心面，半球壳主体的中心面为经过半球壳主体的球心且垂直于内衬的轴线的平面，半球壳主体具有用于容纳球头的第二球面形内腔，第二限位凸壁和第三限位凸壁限制球头脱离第二球面形内腔，半球壳主体上设置有用于避让肱骨柄的凹槽，凹槽低于半球壳主体的中心面。在本申请中，外杯、内衬和球头进行装配时，先将球头装入至内衬的第二球面形内腔内。第二限位凸壁和第三限位凸壁均凸出于半球壳主体的中心面，能够实现对设置在第二球面形内腔内的球头进行限位。内衬和球头装配好后再通过旋入方式安装在第一球面形内腔内。在本申请中，肩关节假体可以安装在患者的肩胛骨上，在内衬设置在外杯内的情况下，第一限位凸壁位于第二限位凸壁的外侧，以限制内衬脱离第一球面形内腔。球头可转动地在第二球面形内腔内活动，第二限位凸壁和第三限位凸壁限制球头脱离第二球面形内腔。第一球面形内腔能够容纳内衬，并且第一球面形内腔使得内衬不会产生变形，这样能够进一步保证球头不会脱出第二球面形内腔。因此，球头能够在第二球面形内腔内自由转动，同时不会脱离内衬，进而在保证球头活动自由度的情况下还能有效防止球头发生脱位。本申请中肩关节假体的外杯、内衬及球头依次嵌套连接，而不是现有技术中通过人体自身的肌肉及软组织进行牵拉，进而保证了肩关节假体活动的稳定性。
附图说明
构成本申请的一部分的说明书附图用来提供对本发明的进一步理解，本发明的示意性实施例及其说明用于解释本发明，并不构成对本发明的不当限定。在附图中：
图1示出了根据本发明的肩关节假体的实施例的立体结构示意图；
图2示出了图1的肩关节假体的另一角度的立体结构示意图；
图3示出了图1的肩关节假体的肱骨柄处于两个第一凹槽处的结构示意图；
图4示出了图1的肩关节假体的除去球头和肱骨柄后的立体结构示意图；
图5示出了图1的肩关节假体的外杯和固定件的主视示意图；
图6示出了图5的外杯和固定件的A-A向剖视示意图；
图7示出了图5的外杯和固定件的左视示意图；
图8示出了图1的肩关节假体的外杯的立体结构示意图；
图9示出了图8的外杯的另一角度的立体结构示意图；
图10示出了图8的外杯的主视示意图；
图11示出了图8的外杯的B-B向剖视示意图；
图12示出了图8的外杯的左视示意图；
图13示出了图1的肩关节假体的内衬的主视示意图；
图14示出了图13的内衬的C-C向剖视示意图；
图15示出了图1的肩关节假体的内衬的俯视示意图；
图16示出了图13的内衬的左视示意图。
图17示出了图1的肩关节假体的卡槽的立体结构示意图；
图18示出了图1的肩关节假体的卡槽和卡筋配合时的剖视示意图；以及
图19示出了图1的肩关节假体的外杯和内衬的装配过程示意图。
其中，上述附图包括以下附图标记：
10、外杯；11、外杯主体；111、第一球面形内腔；1111、环形凹槽；1112、卡槽；112、第一切面结构；113、第二切面结构；114、连接孔；12、第一限位凸壁；20、球头；21、肱骨柄；211、连接柱；30、内衬；31、半球壳主体；32、第二限位凸壁；33、第三限位凸壁；34、第二球面形内腔；35、凹槽；351、第一凹槽；352、第二凹槽；36、卡筋；40、固定件。
具体实施方式
下面将结合本发明实施例中的附图，对本发明实施例中的技术方案进行清楚、完整地描述，显然，所描述的实施例仅仅是本发明一部分实施例，而不是全部的实施例。以下对至少一个示例性实施例的描述实际上仅仅是说明性的，决不作为对本发明及其应用或使用的任何限制。基于本发明中的实施例，本领域普通技术人员在没有作出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
需要注意的是，这里所使用的术语仅是为了描述具体实施方式，而非意图限制根据本申请的示例性实施方式。如在这里所使用的，除非上下文另外明确指出，否则单数形式也意图包括复数形式，此外，还应当理解的是，当在本说明书中使用术语“包含”和/或“包括”时，其指明存在特征、步骤、操作、器件、组件和/或它们的组合。
除非另外具体说明，否则在这些实施例中阐述的部件和步骤的相对布置、数字表达式和数值不限制本发明的范围。同时，应当明白，为了便于描述，附图中所示出的各个部分的尺寸并不是按照实际的比例关系绘制的。对于相关领域普通技术人员已知的技术、方法和设备可能不作详细讨论，但在适当情况下，所述技术、方法和设备应当被视为授权说明书的一部分。在这里示出和讨论的所有示例中，任何具体值应被解释为仅仅是示例性的，而不是作为限制。因此，示例性实施例的其它示例可以具有不同的值。应注意到：相似的标号和字母在下面的附图中表示类似项，因此，一旦某一项在一个附图中被定义，则在随后的附图中不需要对其进行进一步讨论。
如图1、图3和图6所示，本实施例的肩关节假体包括外杯10、内衬30、球头20以及肱骨柄21，外杯10、内衬30及球头20依次嵌套。其中，外杯10包括外杯主体11及设置在外杯主体11的开口处的第一限位凸壁12，外杯主体11具有第一球面形内腔111，第一限位凸壁12凸出于第一球面形内腔111的中心面，第一球面形内腔111的中心面为经过第一球面形内腔111的球心且垂直于外杯10的轴线的平面，外杯主体11的端面低于第一球面形内腔111的中心面。内衬30，内衬30包括半球壳主体31及设置在半球壳主体31的开口处的第二限位凸壁32和第三限位凸壁33，第二限位凸壁32和第三限位凸壁33均凸出于半球壳主体31的中心面，半球壳主体31的中心面为经过半球壳主体31的球心且垂直于内衬30的轴线的平面，半球壳主体31具有用于容纳球头20的第二球面形内腔34，第二限位凸壁32和第三限位凸壁33限制球头20脱离第二球面形内腔34，半球壳主体31上设置有用于避让肱骨柄21的凹槽35，凹槽35低于半球壳主体31的中心面，内衬30通过旋入方式安装在第一球面形内腔111内。其中，在内衬30设置在外杯10内的情况下，第一限位凸壁12位于第二限位凸壁32的外侧，以限制内衬30脱离第一球面形内腔111。
应用本实施例的技术方案，肩关节假体包括外杯10、内衬30、球头20以及肱骨柄21。外杯10、内衬30及球头20依次嵌套。在本实施例中，外杯10、内衬30和球头20进行装配时，先将球头20装入至内衬30的第二球面形内腔34内。第二限位凸壁32和第三限位凸壁33均凸出于半球壳主体31的中心面，能够实现对设置在第二球面形内腔34内的球头20进行限位。内衬30和球头20装配好后再通过旋入方式安装在第一球面形内腔111内。在实施例中，肩关节假体可以安装在患者的肩胛骨上，在内衬30设置在外杯10内的情况下，第一限位凸壁12位于第二限位凸壁32的外侧，以限制内衬30脱离第一球面形内腔111。球头可转动地在第二球面形内腔34内活动，第二限位凸壁32和第三限位凸壁33限制球头脱离第二球面形内腔34。第一球面形内腔111能够容纳内衬30，并且第一球面形内腔111使得内衬30不会产生变形，这样能够进一步保证球头20不会脱出第二球面形内腔34。因此，球头20能够在第二球面形内腔34内自由转动，同时不会脱离内衬30，进而在保证球头20活动自由度的情况下还能有效防止球头20发生脱位。本实施例中肩关节假体的外杯10、内衬30及球头20依次嵌套连接，而不是现有技术中通过人体自身的肌肉及软组织进行牵拉，进而保证了肩关节假体活动的稳定性。
需要说明的是：外杯10的轴线与内衬30的轴线重合。外杯10的轴线与肩关节假体的轴线也重合。
如图1至图4所示，在本实施例中，肱骨柄21包括与球头20连接的连接柱211，半球壳主体31上的凹槽35用于避让肱骨柄21的连接柱211。连接柱211随球头20转动的过程中，凹槽35能够有效避让连接柱211，使得肱骨柄21的活动范围更大、活动更加灵活。
如图1至图4所示，在本实施例中，第二限位凸壁32的凸出高度大于第三限位凸壁33的凸出高度。在内衬30设置在外杯10内的情况下，第二限位凸壁32与第一限位凸壁12相配合，以防止内衬30脱出第二球面形内腔34。第二限位凸壁32的凸出高度较大能够更好地保证防脱效果。此外，人体肩关节在活动中，由于手臂向前收的活动度大，而向后伸的活动度小。因此，当肩关节假体连接至患者体内时，第三限位凸壁33限制肱骨柄21活动的作用相对于第二限位凸壁32而言，限位的效果较弱。这样，通过第二限位凸壁32的凸出高度大于第三限位凸壁33的凸出高度来实现人体的手臂在活动中受到限位的效果。
如图1和图13所示，在本实施例中，第三限位凸壁33为相对设置的两个，第二限位凸壁32位于两个第三限位凸壁33之间，凹槽35为三个，三个凹槽35包括设置在两个第三限位凸壁33与第二限位凸壁32之间的两个第一凹槽351以及设置在两个第三限位凸壁33之间的第二凹槽352。连接柱211沿球头20的周向方向转动的过程中，两个第一凹槽351和第二凹槽352能够避让连接柱211转动，进而，使得肱骨柄21在转动的过程中，凹槽35能够提供足够的活动空间。对于肱骨柄21而言，一般需要在前侧、上侧、下侧区域内活动。当肩关节假体连接至患者体内时，需要使第二限位凸壁32与第一限位凸壁12位于肱骨柄21的后侧，这样，上述的三个凹槽35分别对应于前侧、上侧和下侧区域，这样使得肱骨柄21能够在上述区域有较大的活动范围。对于上述活动范围而言，肱骨柄21的后侧需要的活动范围较小，这样位于后侧的第二限位凸壁32与第一限位凸壁12能够充分地提供限制作用。
如图1至图13所示，在本实施例中，内衬30为轴对称结构，这样，相比于内衬为非轴对称结构的不规则的外形而言，便于加工。第二凹槽352与第二限位凸壁32相对设置，这样便于内衬30的安装。
如图1、图8和图16所示，在本实施例中，肱骨柄21还包括与连接柱211连接的肱骨柄主体和弯颈部，弯颈部与肱骨柄21主体之间成一定角度。外杯主体11的端面上对应于第二凹槽352的位置处设置有避让肱骨柄21的第一切面结构112。这样，在肱骨柄21绕球头20转动的过程中，第一切面结构112能够避让弯颈部，使得肱骨柄21转动顺畅。
如图1、图8和图16所示，外杯主体11的端面上对应于两个第一凹槽351中的其中一个的位置处设置有避让肱骨柄21的第二切面结构113。这样，在肱骨柄21绕球头20转动的过程中，第二切面结构113能够避让弯颈部，使得肱骨柄21转动顺畅。
如图1、图13至图16所示，在本实施例中，肱骨柄21绕球头20转动的过程中，为了使连接柱211在经过凹槽35时能够平稳的过渡，凹槽35为弧形槽。弧形槽的结构也保证了肱骨柄21在转动的过程中具有尽可能大的自由度。
如图4至图6和图11所示，第一球面形内腔111的腔壁设置有环形凹槽1111，环形凹槽1111为两个，两个环形凹槽1111沿着外杯主体11轴线方向上间隔设置。在本实施例中，内衬30装入至外杯主体11内，内衬30的外壁面与第一球面形内腔111之间会存在间隙。因此， 需要在第一球面形内腔111内添加骨水泥进行辅助固定。环形凹槽1111的设置便于在第一球面形内腔111内添加骨水泥，环形凹槽1111能够有效地容纳骨水泥。在环形凹槽1111内添加骨水泥使得第一球面形内腔111与内衬30的外壁面之间能够粘接。在其他图中未示出的实施例中，环形凹槽的数量可以为一个、三个及以上。
如图17和图18所示，第一球面形内腔111的腔壁上还设置有卡槽1112，卡槽1112沿第一球面形内腔111的腔壁的周向延伸，内衬30的外壁面上设置有与卡槽1112对应的卡筋36。卡筋36包括斜面部和与斜面部连接的平面部，斜面部相对于内衬30的轴线倾斜设置，平面部垂直于内衬30的轴线。这样使得卡筋36容易顺利卡入卡槽1112并且能够具有较好的防脱效果。在本实施例中，内衬30装入至第一球面形内腔111内的过程中，挤压内衬30，使得卡筋36能够进入到卡槽1112内，平面部能够卡紧在卡槽1112内。这样，卡槽1112与卡筋36的配合使得内衬30不易脱出第一球面形内腔111。
如图3、图6和图7所示，肩关节假体还包括三个固定件40，外杯主体11的底部设置有三个连接孔114，连接孔114为沉孔结构。在本实施例中，连接孔114为沉孔结构能够避免固定件40突出于第一球面形内腔111，防止固定件40与装入后的内衬30发生干涉。三个固定件40通过三个连接孔114将外杯主体11安装在肩胛骨处，能够实现外杯10的固定。
如图4至图7所示，三个连接孔114的轴线与外杯主体11的中心轴线之间形成三个夹角，三个夹角的角度均不同。上述的三个夹角使得固定件40固定外杯主体11更加的牢固，实现可靠的连接。固定件40优选为螺钉。
现有技术中的肩盂需要对肩胛骨的肩盂区域进行截骨，这样有损骨质，同时会破坏肩盂区域表层的皮质，不能给需要螺钉固定提供良好的固定条件。
本实施例的技术方案能够有效地避免上述的问题，具体地，如图10和图12所示，在本实施例中，外杯10优选为3D打印钛合金，外杯10的底部与肩胛骨接触的表面为相适配的形状，该形状是根据患者的肩胛骨破损处的解剖特征，通过计算机图像技术对解剖特征进行处理，并由3D打印技术形成的形状。因此，上述的方法能够实现个体定制化，无需截骨，进而给后续的螺钉固定提供良好的固定条件。
在本实施例中，外杯10、内衬30和球头20进行装配时，先将球头20装入至内衬30的第二球面形内腔34内，内衬30和球头20装配好后再通过旋入方式安装在第一球面形内腔111内。为了便于在图19中示出内衬30装入外杯10的过程，图19中未示出球头20。具体地，先将第二限位凸壁32对准第一切面结构112，使第二限位凸壁32进入到第一球面形内腔111内。图19中的箭头方向即为内衬30和球头20进入第一球面形内腔111内的方向。半球壳主体31的外壁面贴着第一球面形内腔111转动一定角度后，使得第二限位凸壁32的外壁面能够与第一限位凸壁12的内壁面相贴合，第二凹槽352位于与第一切面结构112对应的位置处，半球壳主体31的外壁面与第一球面形内腔111能够完全的贴合在一起，此时，实现球头20和内衬30一起装配在外杯10的第一球面形内腔111内。对于具有卡筋36和卡槽1112的实施例来说，当第二限位凸壁32与第一限位凸壁12的内壁面相对应时，卡筋36会卡到卡槽1112内。
具体地，肩关节假体包括肩盂假体和肱骨假体，肩盂假体包括外杯10和内衬30连接在一起的结构，其中，外杯10为金属材质，内衬30为过半径的球面结构。球头20为肱骨球头，内衬30将肱骨球头容纳入至第一球面形内腔111中。
在本发明的描述中，需要理解的是，方位词如“前、后、上、下、左、右”、“横向、竖向、垂直、水平”和“顶、底”等所指示的方位或位置关系通常是基于附图所示的方位或位置关系，仅是为了便于描述本发明和简化描述，在未作相反说明的情况下，这些方位词并不指示和暗示所指的装置或元件必须具有特定的方位或者以特定的方位构造和操作，因此不能理解为对本发明保护范围的限制；方位词“内、外”是指相对于各部件本身的轮廓的内外。
为了便于描述，在这里可以使用空间相对术语，如“在……之上”、“在……上方”、“在……上表面”、“上面的”等，用来描述如在图中所示的一个器件或特征与其他器件或特征的空间位置关系。应当理解的是，空间相对术语旨在包含除了器件在图中所描述的方位之外的在使用或操作中的不同方位。例如，如果附图中的器件被倒置，则描述为“在其他器件或构造上方”或“在其他器件或构造之上”的器件之后将被定位为“在其他器件或构造下方”或“在其他器件或构造之下”。因而，示例性术语“在……上方”可以包括“在……上方”和“在……下方”两种方位。该器件也可以其他不同方式定位(旋转90度或处于其他方位)，并且对这里所使用的空间相对描述作出相应解释。
此外，需要说明的是，使用“第一”、“第二”等词语来限定零部件，仅仅是为了便于对相应零部件进行区别，如没有另行声明，上述词语并没有特殊含义，因此不能理解为对本发明保护范围的限制。
以上所述仅为本发明的优选实施例而已，并不用于限制本发明，对于本领域的技术人员来说，本发明可以有各种更改和变化。凡在本发明的精神和原则之内，所作的任何修改、等同替换、改进等，均应包含在本发明的保护范围之内。

Claims (11)

  1. 一种肩关节假体，其特征在于，包括外杯(10)、内衬(30)、球头(20)以及肱骨柄(21)，所述外杯(10)、所述内衬(30)及所述球头(20)依次嵌套，其中，
    所述外杯(10)包括外杯主体(11)及设置在所述外杯主体(11)的开口处的第一限位凸壁(12)，所述外杯主体(11)具有第一球面形内腔(111)，所述第一限位凸壁(12)凸出于所述第一球面形内腔(111)的中心面，所述第一球面形内腔(111)的中心面为经过所述第一球面形内腔(111)的球心且垂直于所述外杯(10)的轴线的平面，所述外杯主体(11)的端面低于所述第一球面形内腔(111)的中心面；
    所述内衬(30)，所述内衬(30)包括半球壳主体(31)及设置在所述半球壳主体(31)的开口处的第二限位凸壁(32)和第三限位凸壁(33)，所述第二限位凸壁(32)和所述第三限位凸壁(33)均凸出于所述半球壳主体(31)的中心面，所述半球壳主体(31)的中心面为经过所述半球壳主体(31)的球心且垂直于所述内衬(30)的轴线的平面，所述半球壳主体(31)具有用于容纳所述球头(20)的第二球面形内腔(34)，所述第二限位凸壁(32)和所述第三限位凸壁(33)限制所述球头(20)脱离所述第二球面形内腔(34)，所述半球壳主体(31)上设置有用于避让所述肱骨柄(21)的凹槽(35)，所述凹槽(35)低于所述半球壳主体(31)的中心面，所述内衬(30)通过旋入方式安装在所述第一球面形内腔(111)内，
    其中，在所述内衬(30)设置在所述外杯(10)内的情况下，所述第一限位凸壁(12)位于所述第二限位凸壁(32)的外侧，以限制所述内衬(30)脱离所述第一球面形内腔(111)。
  2. 根据权利要求1所述的肩关节假体，其特征在于，所述第二限位凸壁(32)的凸出高度大于所述第三限位凸壁(33)的凸出高度。
  3. 根据权利要求1所述的肩关节假体，其特征在于，所述第三限位凸壁(33)为相对设置的两个，所述第二限位凸壁(32)位于两个所述第三限位凸壁(33)之间，所述凹槽(35)为多个，多个所述凹槽(35)包括设置在两个所述第三限位凸壁(33)与所述第二限位凸壁(32)之间的两个第一凹槽(351)以及设置在两个所述第三限位凸壁(33)之间的第二凹槽(352)。
  4. 根据权利要求3所述的肩关节假体，其特征在于，所述内衬(30)为轴对称结构，所述第二凹槽(352)与所述第二限位凸壁(32)相对设置。
  5. 根据权利要求3所述的肩关节假体，其特征在于，所述外杯主体(11)的端面上对应于所述第二凹槽(352)的位置处设置有避让所述肱骨柄(21)的第一切面结构(112)。
  6. 根据权利要求3所述的肩关节假体，其特征在于，所述外杯主体(11)的端面上对应于两个所述第一凹槽(351)中的其中一个的位置处设置有避让所述肱骨柄(21)的第二切面结构(113)。
  7. 根据权利要求1所述的肩关节假体，其特征在于，所述凹槽(35)为弧形槽。
  8. 根据权利要求1所述的肩关节假体，其特征在于，所述第一球面形内腔(111)的腔壁设置有环形凹槽(1111)，所述环形凹槽(1111)为多个，多个所述环形凹槽(1111)沿着所述外杯主体(11)轴线方向上间隔设置。
  9. 根据权利要求1所述的肩关节假体，其特征在于，所述第一球面形内腔(111)的腔壁上还设置有外杯卡槽(1112)，所述卡槽(1112)沿所述第一球面形内腔(111)的腔壁的周向延伸，所述内衬(30)的外壁面上设置有与所述卡槽(1112)对应的卡筋(36)。
  10. 根据权利要求1所述的肩关节假体，其特征在于，所述肩关节假体还包括多个固定件(40)，所述外杯主体(11)的底部设置有多个连接孔(114)，所述连接孔(114)为沉孔结构。
  11. 根据权利要求10所述的肩关节假体，其特征在于，多个所述连接孔(114)的轴线与所述外杯主体(11)的中心轴线之间形成多个夹角，多个所述夹角的角度均不同。
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US20210361440A1 (en) 2021-11-25

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