CN101879100A - 胫骨部件和包括所述胫骨部件的膝关节假体 - Google Patents
胫骨部件和包括所述胫骨部件的膝关节假体 Download PDFInfo
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- CN101879100A CN101879100A CN201010236612.2A CN201010236612A CN101879100A CN 101879100 A CN101879100 A CN 101879100A CN 201010236612 A CN201010236612 A CN 201010236612A CN 101879100 A CN101879100 A CN 101879100A
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- Prior art keywords
- tibial component
- projection
- pin
- tibial
- lug
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- Legal status (The legal status 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 status listed.)
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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Abstract
用于固定关节假体的销包括用于与假体(2)相关的连接部分(4)和位于在骨骼上形成的孔中的接合部分(5)。接合部分(5)可沿径向并以弹性方式至少部分地变形,以便允许销(1)立刻锁定在孔内,并且将假体(2)基本固定到骨骼上,以便通过利用压力将连接部分简单地引入形成于骨骼本身上的孔中而基本上容易地固定假体。
Description
本分案申请的母案为申请号200680032422.0和申请日2006年9月4日的发明申请。
技术领域
本发明涉及关节假体固定销以及具有这种销的关节假体。
本发明还涉及胫骨部件和包括这种胫骨部件的膝关节假体。
本发明属于矫形外科领域,并且涉及用于不同关节隔室的微型假体的固定***,所述微型假体例如由钛、铬钴合金或其它金属合金或者陶瓷材料制成。
背景技术
人们发现本发明在膝关节假体,特别是为膝关节设计的单隔室微型假体(固定到股骨髁上,固定到胫骨板上,固定到膝盖骨上)方面具有有利应用。
与任何其它关节隔室一样,膝关节由透明软骨膜包覆,所述透明软骨膜由于磨损而容易受到病变(关节)影响,如果不使用胶接剂进行固定的话,所述病变在最严重的情况下会影响相邻骨骼。
当安装完成时,股骨髁部件靠在胫骨部件上并滑动,为此,具有与股骨髁部件的联接表面,其中所述股骨髁部件由具有低摩擦阻力的材料,例如极高密度的聚乙烯制成。
为了保证最主要的稳定性能,已知利用螺钉锁定在相应孔中的销,所述螺钉穿过骨头并横向接合在销本身中。这种结构不允许快速、简单地锁定假体,还需要在骨头上制造附加孔以容纳螺钉。
可选地,销通过合适的骨头胶接剂粘接在孔中(在这种情况下,稳定性不是骨性结合型)。
而且,已知类型的销和棒为固体,缺少能够容纳用于合成来自于骨髓的骨基质(成骨细胞)的亲本细胞和用于骨头改型(破骨细胞)的细胞的支座。而且,人工骨骼置换物适合于股骨和/或胫骨和/或膝盖骨软骨下骨的病理形式。在这样的病理学条件下,关节表面附近可能引起疼痛、僵硬、关节功能丧失。
通常,关节软骨在其最早期的病理形式需要进行外科手术,其目的在于,如果影响被限制在单个软骨隔室内,则通过参考膝关节,在关节假体之间对具有单隔室假体的膝关节进行定位来修复受损关节面,以便恢复股骨关节部分在胫骨关节部分上的正常滑动。
因此,假体包括股骨髁部件和胫骨部件,胫骨部件有时定义为术语胫骨板,这是因为一旦安装,它就在功能上代替骨质胫骨板。
众所周知,每个髁骨部件和胫骨部件由具有一个或多个固定销或棒的板组成,所述固定销设计为在通过切割股骨和胫骨获得的相应支座中接合。销必须立即锁定在相应的孔中,以便确保假体最主要的稳定问题,并且由于不具有可用空间,其次应当允许在困难情况下促进骨性结合。因此,在已知类型的销中,必须工作且促进最佳的骨性结合的元件只是外表面,该外表面在必要时可以通过喷射处理或化学侵蚀改变,以便获得特定的粗糙度,从而允许对进行新骨骼合成的细胞进行固定。
而且,在必要时还给与骨头保持接触的胫骨部件的板表面赋予预定粗糙度,以便获得上文所称的作用。
发明内容
在这种情况下,作为本发明基础的技术任务在于设计关节假体的固定销,使其能够大体上消除上述限制。
主要地,本发明的目标在于设计关节假体的固定销,其能够确保可靠、准确的基本固定。
特别地,本发明的目的在于提供一种销,其可以方便、快速地引入形成于骨头上的孔内并锁定于其中。
在所述技术任务的范围内,本发明的重要目的在于设计关节假体的固定销,其确保假体的精确定位以及假体的稳定性。
而且,本发明的目的在于销的发明,其通过促进骨细胞移动和骨瘤生长而确保完全的骨性结合。
本发明的另一目的在于设计关节假体,使其可以容易、稳定地固定在骨头上。
在这种情况下,作为本发明基础的技术任务还在于设计胫骨部件,其能够大体上消除上述限制。
主要地,本发明的目标在于设计胫骨部件,其能够确保可靠、准确的基本固定。
特别地,本发明的目的在于提供一种胫骨部件,其可以方便、快速地引入形成于胫骨板的骨头上的支座内并锁定于其中。
在所述技术任务的范围内,本发明的重要目的在于设计胫骨部件,其确保假体的精确定位以及假体的稳定性。
而且,本发明的目的在于胫骨部件的发明,所述胫骨部件通过促进骨细胞移动和新骨头生长而确保完全的骨性结合。
最后,本发明的目的在于设计膝关节假体,其包括这种能够容易、稳定地固定在骨头上的胫骨部件。
通过具有如权利要求1-11中一项或多项所述特征的关节假体销和根据权利要求12-20中一项或多项的关节假体,可以大体上实现上述技术任务和特定目的。
通过具有如权利要求21-55中一项或多项所述特征的胫骨部件和根据权利要求56和57的膝关节假体,进一步大体上实现了上述技术任务和特定目的。
附图说明
现在将以非限制实例的方式,对附图所示的根据本发明的关节假体销的两个优选但非专有的实施例,以及根据本发明的胫骨部件的优选但非专有的实施例进行说明,其中:
图1显示了根据第一实施例且处于第一工作配置的根据本发明的关节假体销的透视图;
图2显示了处于第二工作配置的图1所示销的侧面正视图;
图3显示了沿图2中直线III-III剖开的销的剖视图;
图4显示了处于第一工作配置的图1所示销的第二实施例的透视图;
图5显示了处于第二工作配置的图4所示销的侧面正视图;
图6显示了图4所示销的顶视图;和
图7图解显示了配备有图1-6所示销的关节假体;
图8显示了根据本发明的胫骨部件的分解透视图;
图8a是图8所示胫骨部件的元件之一的一部分的放大图;
图9显示了图8所示胫骨部件的局部剖开的分解侧面正视图;
图10显示了图8和9所示胫骨部件的元件沿图9所示箭头″A″观察的平面图;
图10a是图10所示元件的一部分的放大图;和
图11显示了图8和9所示胫骨部件的元件沿图9所示箭头″B″观察的平面图;
图12显示了图8所示胫骨部件的元件的执行变型的透视图;
图13显示了图12所示元件的侧面正视图;
图14是图13所示侧面正视图的剖视图;和
图15显示了图12所示元件沿图13所示箭头″C″观察的平面图;
图16显示了图8所示胫骨部件的其它元件的透视图;
图17是图16所示其它元件的侧视图;
图18是图16所示其它元件沿图17所示直线XI-XI剖开的纵剖面图。
具体实施方式
参考上述附图,根据本发明的关节假体销通常以数字1显示,并且根据本发明的用于膝关节假体的胫骨部件通常以数字30显示。
在图7所示的非限制实例中,销1与膝关节假体2相关,所述膝关节假体由半月形板3界定并设计为与股骨髁相关。但是,销1可以属于胫骨部件30(有时定义为术语胫骨板)或者属于为任何关节隔室设计的其它类型的假体。
销1沿其自身的线性纵向轴线″X″延伸并且包括设计为与假体2相关的连接部分4和适于引入在骨骼上形成的孔中的接合部分5。
在优选的所示实施例中,销1的连接部分4和接合部分5显示为圆形横截面,并且连接部分4具有外螺纹6,该外螺纹可以与在板3中形成、但未显示的螺纹孔相接合。
根据未显示但落入本发明范围之内的其它实施例,接合部分5具有不同形状,例如多边形截面,而连接部分4利用不同的方法,例如通过焊接连接到板3上。
而且,如果销1由与板3相同的材料,例如钛制成,整个假体2可以整体方式,例如通过模制或从单个金属毛坯上去除材料获得。
有利地,销1的接合部分5可沿径向并以弹性方式至少部分地变形,以便允许销1立刻锁定在孔内,并且将假体2基本固定到骨骼上。接合部分5优选地包括多个远离自身外侧表面8的弹性元件7,所述弹性元件在压缩情况下可沿与销1的轴线″X″相关的径向移动于静止配置和工作配置之间。
在静止配置中,弹性元件7的自由端9与销1的侧面8隔开一段距离。当销1引入孔中时,同一孔的内壁使弹性元件7朝向销1的轴线″X″发生变形。当接合部分5***后,所述元件7的弹性推动该元件的自由端9靠住孔的内壁,从而将销1保持在骨骼中。
更特别地,根据附图所示,接合部分5的弹性元件7由多个从外表面8伸出的弹性翼7界定。
优选地,每个翼7上与自由端9相对的约束端10连接到接合部分5,并且主要沿与销1的纵向轴线″X″平行的方向延伸。
而且有利地,接合部分5至少部分地中空且具有开口11a、11b,以便允许容纳例如羟磷灰石的骨诱导性和骨引导性材料,并且允许为围绕销1和在其内部形成新骨骼材料而设计的体液及骨髓血流过。
在图1、2和3所示的第一实施例中,接合部分5由具有圆形截面的圆筒形壁12界定,所述圆筒形壁具有多个凹口13。每一凹口13界定翼7,并界定相应的主开口11a。所示销1的总长度为14mm,而连接部分5的轴向长度为11.5mm。连接部分5的内径为5.8mm,外径为6mm。
每个主开口11a为矩形,其与销1的纵向轴线″X″平行的长边长度为4mm。因此,每个翼大体上为矩形,主要沿与纵向轴线″X″平行的方向延伸,并且具有连接到圆筒形壁8上的下侧14。每个翼7的自由端9面向连接部分4并且具有尖端,以便确保与形成于骨骼上的内壁形成更有效的干涉。
每个翼7进一步为弯曲的,并且具有面向销1外部的凹状。特别地,根据图1、2和3所示,翼7包括连接到圆筒形壁12上的第一部分和结束于尖形自由端9并通过弯曲部17与所述第一部分隔开的第二部分16。
在图1所示的静止配置中,第一部分15大体上位于壁12上,并且第二部分16由于弯曲部17的原因而远离壁17延伸并面向连接部分4。
在图2和3所示的工作配置中,第二部分16的自由端9被推向壁12,并且尤其是与弯曲部17相对应,翼7部分地返回到接合部分5内。第一部分15弹性弯曲到所述接合部分5内,并且确保翼7径向压靠在容纳所述销1的孔的壁部上。
图1、2和3所示的销1具有翼7的第一系列18,其位于彼此的侧面并围绕纵向轴线″X″周向布置。特别地,第一系列的翼7为九个,并且彼此角向隔开40°。在每个翼7及下一个翼之间还具有副开口11b,所述副开口为矩形,并且尺寸大体上等于与翼7相关的主开口11a的尺寸。所示副开口11b为九个,并且彼此角向隔开40°,与相邻翼7角向隔开20°。
销1还具有与各副开口11b相关的翼7的第二系列19,其与所述第一系列18轴向隔开大约1mm。翼7的第二系列19还与第一系列18以一定角度错开,使得第一系列18中的每个翼7与第二系列19中的副开口11b沿接合部分5的母线对齐。
最后,在图3所示的横截面中,每个主开口11a和副开口11b界定了一圆弧并且对着大约10°的弧。
在图4、5和6所示的第二实施例中,每个翼7具有含有边20和自由顶点21的三角形状,所述边20位于圆筒形部分12的周向准线上并连接到圆筒形壁12上,所述自由顶点21面向连接部分4。如图所示,三角形为等腰三角形,其中连接边20优选地为1.85mm,其余边为大约2mm。每个翼7通过一对直线形凹口13形成,所述凹口相交于交点22并界定了三角形主开口11a。与连接到壁12上的边20相对应,还形成了附加开口23,其用于减少翼7与壁12之间的连接强度。优选地,这种开口为圆形,并且直径为0.8mm。
第二实施例显示了翼7的三个系列,每个系列与相邻系列轴向并以一定角度地错开,并且包括以等角度隔开的四个翼7和相同数量的圆形副开口11b,所述圆形副开口的直径优选地为2mm。
在所示两个实施例中,接合部分5的与连接部分4相对的端部24敞口,从而允许在由壁12界定的圆筒形凹部25内容纳所述骨诱导性矿物材料的小圆柱,所述骨诱导性矿物材料有助于使担负骨性结合作用的细胞进行移动。
根据本发明制造的销1获得了重要的好处。
事实上,弹性翼的存在,更一般地,销的径向弹性变形性质允许通过将连接部分简单地压配合到形成于骨骼上的孔内,而将假体基本上容易地固定在骨骼上。这种好处由于无需在骨骼腔室内对代表传统固定***的例如螺钉的多个元件进行定位,从而使外科手术程序明显简化。
而且,使用一个或多个根据本发明的销可以在安放之后立即防止处于常用配置情况下的假体结构发生任何纵向和轴向运动。
连接部分的空心结构以及在圆筒形壁中具有开口允许在固定销的圆筒形空心结构内实现细胞成分的移动、自体骨骼生长以及富有生长因子的营养流体流动。所有这些生物成分是骨骼新生过程的决定因素。
最后,将以具有高孔隙度的羟磷灰石为基础的仿生性骨骼置换物的小圆柱仅通过″压配合″安放而装满固定销的空间是有助于骨骼新生过程的因素,并且事实上有助于在形成于软骨下骨中的支座内进行骨性结合。支架将被细胞群体占据,这些细胞群体将由于同样的仿生性质而在成骨细胞感觉(sense)上产生差异,造成骨基质合成,并由于骨基质的多微孔网络而促进新的血管生成。
在图8-18所示的非限制实例中,胫骨部件30包括固定板31和***件32,所述固定板约束到患者的骨质胫骨板上,所述***件由具有低摩擦系数和高耐压缩性的材料,优选地极高密度的聚乙烯制成。
可选地,***件可以由其它耐磨聚合物或陶瓷材料制成。
固定板31具有其中容纳有***件32的支座33,所述固定板的作用在于替换骨质胫骨板的受损关节软骨。
详细地讲,固定板31包括底壁34,该底壁具有主要沿预定方向″W″平面延伸的平面卵形形状或,更确切地说,″豆形″形状(图10)。底壁34还具有第一表面35和第二表面36,它们彼此相对且优选地为平坦的。
侧壁37沿底壁34的周边展开并且垂直于所述底壁34、远离第二表面36延伸,以便与第二表面一起界定用于***件31的所述支座33。
优选地,侧壁37的高度,或者沿与板34的表面35、36垂直的轴向″Z″的侧壁延伸长度为板34的较大平面尺寸的0.1到0.2倍。
***件32显示为与固定板31类似的平面形状,并且包括第一部分38,所述第一部分具有为接触股骨髁部件而设计的工作面39。在所示实施例中,该表面39为平坦的,但是在未显示的其它实施例中,根据需要可以采取不同的构造。
***件32还显示了第二部分40,其相对于第一部分38具有减小的平面尺寸,从而允许导入固定板31的支座33中。
在第一部分38和第二部分40之间具有界定了环形肩部表面41(图9)的台阶,其位于第一部分38上,与工作面39相对且围绕所述第二部分40。
当***件32安装在支座33中时,第二部分40容纳在该支座33中,并且环形肩部表面41抵靠固定板31的侧壁37的终边42。第二部分40的表面43抵靠第二表面36。
有利地,***件32搭扣安装在支座33中。为此,***件32包括至少一对可弹性变形的齿44,并且所述齿可以搭扣安放在形成于支座33中的相应腔室45内。
在优选的所示实施例中,***件32具有与所述***件32的相对端部46相对应的两个齿44,所述相对端部主要沿预定方向″Y″布置(图11)。
每个齿44远离***件32的第一部分38延伸,与第二部分40平齐放置并且与所述第二部分40充分隔开,以允许齿44本身弯曲。为此,齿44布置在形成于第二部分40中的凹部47内(图11)。
每个齿44包括一部件,该部件具有连接到第一部分38上且位于靠近发生弯曲的位置处的缩颈48,和逐渐变厚以具有与相应腔室45互补形状的远端49(图9)。
在支座33内,与沿所述预定方向″W″向下延伸的板31的相对端部51相对应,在侧壁37的内表面50上制造的凹部形成、界定了两个腔室45。每个齿44的远端49具有弯曲的平面形状,该形状与凹部45的平面形状相同。
固定板31还包括布置在其外周侧面上的多个突起52,所述外周侧面与侧壁37的外表面相一致并且面向与支座33相对的部分。
突起52允许胫骨部件30立刻锁定在形成于患者的骨质胫骨板上的腔室内并且将该胫骨部件30基本上固定到该胫骨板上。突起52还具有这种结构以允许容易地引入骨骼并且同时确保立刻锁定。
为此,优选地,每个突起52具有相对于外周侧面53倾斜的倾斜面54,所述倾斜面54从与***件32的安装支座33相对的胫骨部件30的区域开始朝向所述支座33远离外周侧面53延伸。
换句话说,倾斜面54从其靠近底壁34的近端开始朝向其更靠近侧壁37的终边42的远端远离侧壁37的外表面53延伸(图9)。因此,突起52在接近终边42时通常分开,并且在安放胫骨部件30时,朝***件32的工作面39分开。而且,有利地,每个突起52具有锋利边缘55,该锋利边缘优选地处于每个突起52的远端,以便与骨骼有效干涉(图8a和10a)。
在所示实施例中,每个突起52由所述倾斜面54和上表面56界定,所述上表面与外周侧面53垂直并且大体上与底壁34的第一和第二表面35、36平行。倾斜面54和上表面56相交于公共边缘,该边缘界定了突起52远端的锋利边缘55。
而且,每个突起52由一对凹形侧面57界定,所述侧面按照沿曲线延伸的相应边缘58将倾斜面54与上表面56相连。
优选地,突起52沿外周侧面53的外周延展部分或在侧壁的外表面上连续定位,从而界定凹凸边界。如图所示,两个相邻突起52的凹形侧面57连续连接。
在优选的所示实施例中,同样沿外周侧面53的外周延展部分连续布置的所述突起52的第二系列60位于沿外周侧面53外周延展部分连续布置的突起52第一系列59的侧面。第二系列60沿与外周表面53的母线平行的轴向″Z″位于第一系列59的侧面,以便界定两个凹凸边界(图8和9)。
而且有利地,第一系列59的突起52和第二系列60的突起52相互错开。
更特别地,相对于与外周表面53第二系列母线平行且穿过突起52本身的所述轴向″Z″,第一系列59的每个突起52与第二系列60的每个突起52不对齐。
换句话说,与外周表面53的母线平行且穿过第一系列59的突起52的尖端的轴向″Z″不穿过与第二系列60的突起52对应的尖端。
特别地,在所示实施例中,第一系列59的突起52的远端的每个锋利边缘55面向第二系列60的两个相邻突起52的凹形侧面57。
根据未显示但落入本发明范围内的其它实施例,可以具有突起52的其它系列,它们根据如上所述的内容,优选地彼此错开。
胫骨部件30还包括凸耳61,其从固定板31的与支座33相对的底壁34的第一表面35伸出并且至少具有凹部62。
凸耳61由辅助壁63界定,所述辅助壁从第一表面35垂直伸出并且界定了所述凹部62。
如图所示,辅助壁63显示为具有圆形截面的管状形状,所述管形形状保持敞口以与连接底壁34的部分的相对端连通(图10)。
有利地,辅助壁63还具有与凹部62连通的多个通孔64。这种通孔64由周向分布在辅助壁63上的多个孔界定。
有利地,凸耳61至少部分地中空且具有孔64,以便允许容纳适合于促进担负骨性结合作用的细胞移动的例如羟磷灰石的骨引导性材料,以及允许为围绕胫骨部件30和在其内部形成新骨骼材料而设计的体液及骨髓血流过。
凸耳61还可以象销1那样执行如上文参照图1-7描述和显示的骨骼假体的固定。
而且有利地,固定板31的与支座33相对的第一表面35还具有面向支座33本身的多个通孔65。换句话说,对底壁34进行穿孔,以便允许新骨骼材料也形成在固定板31内。孔65的一部分在凸耳61的凹部62内敞口(图9和10)。
突起52,优选地还有凸耳61以与固定板31成整体的方式,例如通过模制和/或从单块金属毛坯去除材料的方法获得。
根据图12-15所示实施例,固定板31的凸耳61相对于底壁34的第一表面35偏心,优选地具有纵向延伸的自身轴线″K″,该轴线相对于所述第一表面35界定了除90°以外的角度″α″。优选地,角度″α″小于90°,优选地为45到70°。更优选地,角度″α″为60°。
可选地,角度″α″为45°到90°且小于90°,优选地,角度″α″为70°到90°且小于90°。
同样,第二实施例的凸耳61由辅助壁63界定,该辅助壁从第一表面35倾斜延伸并界定了凹部62。
如图所示,辅助壁63为具有圆形截面的管形形状,具有敞口的相对端部66、67。如图14清楚显示的,凸耳61没有穿孔,而是敞口的,既与连接底壁34的近端66连通,又与连接底壁34的部分相对的终端67连通。
而且,凸耳61的终端67的边缘的第一弯曲部分68与纵向延伸的所述轴线″K″垂直,而同一边缘的第二弯曲部分69与第一表面35平行。第一部分68和第二部分69相交于两个凸边70,所述凸边优选地沿与固定板31的主要延伸方向″W″垂直的方向延伸(图15)。
凸耳61还包括布置在其外侧表面72上的突起71,其突起71优选地具有锋利边缘73。
在所示实施例中,所述突起71和相应边缘73中的每一个具有弯曲形状,并且至少部分地围绕纵向延伸轴线″K″延伸。
锋利边缘73大体上与底壁34的第一表面35平行。
同样地,布置在侧壁37上的突起52,以及凸耳61的突起71允许胫骨部件30立刻锁定在形成于骨质胫骨板中的腔室内,并且将该胫骨部件30基本上固定到胫骨板上。
突起71还具有这种结构以允许容易地引入骨骼并且同时确保立刻锁定。
为此,优选地,每个突起71具有表面74以与布置在侧壁37上的突起52倾斜面54的倾角相等的方式倾斜。
换句话说,倾斜面74从其靠近凸耳61的终端67的近端开始朝向其更靠近凸耳61的近端66的远端远离凸耳61的外侧表面72延伸。
在所示实施例变型中,通过在辅助壁63上例如通过模制和/或材料去除制造一些凹部来形成突起71。
而且优选地,如图14所示,在凸耳61上形成的凹部62沿凸耳61的纵向延展部分不具有恒定截面,而是朝向终端67略微成锥形。
优选地,如图12-15所示的实施例进一步具有销75(图16、17和18所示),其***凸耳61的凹部62中并且伸出超过凸耳61的终端67。
销75优选地与如上文参照图1-7描述和显示的用于固定骨骼假体的销1类似。
更特别地,销75沿其直线形纵向轴线″L″延伸,并且包括设计为***并锁定在凸耳61的凹部62内的近侧部76和适合于***形成于骨骼中的孔内的远侧部77。
当销75安装在固定板31上时,远侧部77伸出超过凸耳61的终端67,并且销75的纵轴″L″与凸耳61的纵向延伸的轴线″K″一致。
在优选的所示实施例中,销75的近侧部76和远侧端77都具有圆形截面。
近侧部76为截锥形,并且优选地由凹部62中的插口容纳和锁定。
近侧部76的终边78成形为当销75安装在固定板31上时不从底壁34的第一表面35伸出。
为此,上述终边78具有第一弯曲部分79和第二弯曲部分80,它们相交于两条凸边缘81,与图6、7和8所示的凸耳61的终端67的形状类似。边缘81界定了大约120°的角度。有利地,销75的远侧部77可沿径向并以弹性方式至少部分地变形,以便允许销75立刻锁定在形成于骨骼上的孔内,并且将胫骨部件30基本固定到骨骼本身上。
远侧部77优选地包括多个远离自身外侧表面83延伸的弹性元件82,所述弹性元件在压缩情况下可沿与销75的轴线″L″相关的径向在静止配置和工作配置之间移动。
在静止配置中,弹性元件82的自由端与销75的侧面83间隔开。当销75引入孔中时,同一孔的内壁使弹性元件82朝向销75的轴线″L″发生变形。当远侧部77***后,所述元件82的弹性推动该元件的自由端靠住孔的内壁,从而将销75保持在骨骼中。
更特别地,根据附图所示,远侧部77的弹性元件82由多个从外表面83伸出的弹性翼限定。
优选地,每个翼82通过与其自由端相对的约束端连接到远侧部77上,并且主要沿与销75的纵向轴线″L″平行的方向延伸。
而且有利地,远侧部77至少部分地中空且具有开口84,以便允许容纳例如羟磷灰石的骨诱导性材料,以及允许为围绕销75和在其内部形成新骨骼材料而设计的体液及骨髓血流过。
在图16、17和18所示的优选实施例中,每个翼82显示为具有边85和自由顶点的三角形状,所述边位于圆筒形侧面83的周向准线上并连接该表面83,所述自由顶点面向近侧部76。
每个翼82通过一对直线形凹口形成,所述凹口相交于交点并界定了三角形主开口86。
所示实施例的销75显示了翼82的三个系列,每个系列与相邻系列轴向且以一定角度地错开,并且包括以等角度隔开的三个翼82和相同数量的圆形副开口84。
销75为中空的并且远侧部77的端部87敞口,以便允许容纳所述骨诱导性矿物材料的小圆柱,所述骨诱导性矿物材料适合于促进担负骨性结合作用的细胞进行移动。
在使用中,当在患者胫骨板上已经形成适当的腔室时,固定板31压入该腔室中,使得侧壁37的终边42与骨骼表面大体上保持齐平,并且突起52、73与上述腔室的内壁形成接触和干涉。
必要时,凸耳61和销75***在上述腔室底部上形成的适当孔中。
***件32保持在腔室的外面,并且工作面39面向并接触股骨髁部件的板3,例如图7中图解说明的那样。
根据本发明的胫骨部件30获得了重要的好处。事实上,突起的存在允许通过将固定板简单地压配合到胫骨板中,而将假体基本上容易地固定在骨骼上。
突起的构造允许胫骨部件引入,而且在已经执行完安装时还可靠地防止胫骨部件产生任何运动。
这种好处由于无需在骨骼腔室内对代表传统固定***的例如螺钉的多个元件进行定位,也不使用用于临时锁定的胶接剂,从而使外科手术程序明显简化。
而且,***件在植入患者骨骼内之前通过搭扣联接容易地连接到固定板上,从而使这种手术相当快速、安全。
凸耳和销的空心结构以及在底壁和销中具有开口允许在凸耳的圆筒形空心结构内实现细胞成分移动、自体骨骼生长以及富有生长因子的营养流体流动。所有这些生物成分是骨骼新生过程的决定因素。
最后,将以具有高孔隙度的羟磷灰石为基础的仿生性骨骼置换物的小圆柱仅通过″压配合″简单地放入或者可注射糊状形式的骨骼置换物装满固定板的凸耳或销的空间是有助于骨骼新生过程的因素,并且事实上促进了在形成于胫骨上的支座内进行骨性结合。支架将被细胞群体占据,这些细胞群体将由于同样的仿生性质而在成骨细胞感觉上产生差异,造成骨基质合成,并由于骨基质的多微孔网络而促进新的血管生成。
通常由股骨髁部件2(图7中举例说明)和胫骨部件30(图8中举例说明)构成的膝关节假体包括与如上所述和/或如权利要求1-11中一项或多项所述的股骨髁部件2的板3相关的销1。而且或可选地,对于如上所述和/或如权利要求1-11中一项或多项所述的销1而言,上述假体通常具有如上所述和/或如权利要求21-55中一项或多项所述的胫骨部件30的特征。换句话说,膝关节假体通常可以具有根据本发明的用于固定股骨髁部件2和传统的胫骨部件的销1,或者用于固定股骨髁部件2和根据本发明的胫骨部件30的传统销,或者根据本发明的销1和根据本发明的胫骨部件30。
Claims (36)
1.胫骨部件,包括可以连接到骨质胫骨板上的固定板(31)和可以安装在形成于固定板(31)上的支座(33)中的***件(32);
其特征在于,固定板(31)包括布置在其外周侧面(53)上的多个突起(52),以便允许将胫骨部件(30)立刻锁定在形成于骨质胫骨板上的腔室中,并且将所述胫骨部件(30)基本固定到所述胫骨板上。
2.如权利要求1所述的胫骨部件,其特征在于,每个所述突起(52)具有关于外周侧面(53)倾斜的倾斜面(54)。
3.如权利要求2所述的胫骨部件,其特征在于,每个所述突起(52)的倾斜面(54)从胫骨部件(30)的与***件(32)的安装支座(33)相对的区域开始朝向***件(32)的所述安装支座(33)远离外周侧面(53)延伸。
4.如权利要求1所述的胫骨部件,其特征在于,每个所述突起(52)具有锋利边缘(55)。
5.如权利要求1所述的胫骨部件,其特征在于,所述胫骨部件至少包括沿外周侧面(53)的外周延展部分连续布置的第一系列(59)的所述突起(52)。
6.如权利要求5所述的胫骨部件,其特征在于,所述胫骨部件至少包括沿外周侧面(53)的外周延展部分连续布置的第二系列(60)的所述突起(52);所述第二系列(60)的突起(52)沿与外周表面(53)的母线平行的轴向(Z)位于所述第一系列(59)的突起(52)的侧面。
7.如权利要求6所述的胫骨部件,其特征在于,第一系列(59)的突起(52)和第二系列(60)的突起(52)相互错开。
8.如权利要求6所述的胫骨部件,其特征在于,相对于与外周表面(53)的母线平行且穿过第一系列(59)的突起(52)的相应轴向(Z)而言,第一系列(59)的每个突起(52)与第二系列(60)的突起(52)不对齐。
9.如权利要求2或3所述的胫骨部件,其特征在于,每个突起(52)由倾斜面(54)和与外周侧面(53)垂直的上表面(56)界定,所述倾斜面(54)和上表面(56)相交于限定了突起(52)的远端的公共边缘(55)。
10.如权利要求9所述的胫骨部件,其特征在于,每个突起(52)还由一对凹形侧面(57)界定,所述凹形侧面使所述倾斜面(54)与所述上表面(56)连接。
11.如权利要求1所述的胫骨部件,其特征在于,所述胫骨部件还包括凸耳(61),所述凸耳从固定板(31)的与支座(33)相对的第一表面(35)伸出并具有至少一个凹部(62)。
12.如权利要求11所述的胫骨部件,其特征在于,凸耳(61)由辅助壁(63)限定,所述辅助壁与第一表面(35)垂直、从所述第一表面(35)伸出并界定所述至少一个凹部(62)。
13.如权利要求12所述的胫骨部件,其特征在于,辅助壁(63)具有与所述至少一个凹部(62)连通的多个通孔(64)。
14.如权利要求1所述的胫骨部件,其特征在于,固定板(31)的与支座(33)相对的第一表面(35)具有面向所述支座(33)的多个通孔(65)。
15.如权利要求1所述的胫骨部件,其特征在于,***件(32)能够搭扣安装在支座(33)中。
16.如权利要求1所述的胫骨部件,其特征在于,***件(32)包括至少一对齿(44),所述齿可弹性变形并且能够搭扣安放在形成于支座(33)上的相应腔室(45)中,以便将所述***件(32)安装在所述支座(33)中。
17.如在先权利要求中至少一项所述的胫骨部件,其特征在于,固定板(31)包括底壁(34)和侧壁(37),所述侧壁沿底壁(34)的边缘并与所述底壁(34)垂直地延伸;底壁(34)和侧壁(37)界定了用于***件(32)的支座(33);侧壁(37)具有与所述支座(33)相对的外周侧面(53)。
18.如权利要求1所述的胫骨部件,其特征在于,突起(52)与固定板(31)整体地形成。
19.如权利要求11所述的胫骨部件,其特征在于,凸耳(61)相对于第一表面(35)偏心。
20.如权利要求11所述的胫骨部件,其特征在于,凸耳(61)具有纵向延伸的轴线(K),该轴线相对于第一表面(35)界定了除90°以外的角度(α)。
21.如权利要求20所述的胫骨部件,其特征在于,所述角度(α)为45°到70°。
22.如权利要求11所述的胫骨部件,其特征在于,凸耳(61)具有布置在其外侧表面(72)上的突起(71)。
23.如权利要求22所述的胫骨部件,其特征在于,凸耳(61)的突起(71)具有锋利边缘(73)。
24.如权利要求11所述的胫骨部件,其特征在于,凸耳(61)为具有敞口的相对端部(66,67)的管形形状。
25.如权利要求11所述的胫骨部件,其特征在于,所述胫骨部件还包括销(75),所述销能够***凸耳(61)的凹部(62)中并且伸出超过所述凸耳(61)的终端(67)。
26.如权利要求25所述的胫骨部件,其特征在于,销(75)具有截锥形近侧部(76),该截锥形近侧部能够容纳并锁定在凹部(62)中。
27.如权利要求26所述的胫骨部件,其特征在于,截锥形近侧部(76)通过插口锁定在凹部(62)中。
28.如权利要求25所述的胫骨部件,其特征在于,销(75)具有远侧部(77),所述远侧部可沿径向并以弹性方式至少部分地变形,以便允许销(75)立刻锁定在形成于骨骼上的孔内,并且将所述胫骨部件(30)基本固定到骨骼上。
29.如权利要求28所述的胫骨部件,其特征在于,远侧部(77)具有多个弹性翼(82),所述弹性翼远离所述远侧部(77)的外表面(83)延伸并且用于与形成于骨骼上的孔的内壁形成干涉。
30.如权利要求28所述的胫骨部件,其特征在于,远侧部(77)为至少部分地中空并且具有开口(84,86),以便允许容纳具有骨诱导性和/或骨引导性的作为骨置换物的材料,并且允许骨髓流体流过。
31.如权利要求28所述的胫骨部件,其特征在于,远侧部(77)具有界定翼(82)并限定所述开口(86)的多个凹口。
32.如权利要求29所述的胫骨部件,其特征在于,每个所述翼(82)具有面向近侧部(76)的自由端。
33.如权利要求32所述的胫骨部件,其特征在于,翼(82)的自由端为尖形。
34.如权利要求29所述的胫骨部件,其特征在于,每个翼(82)表示为具有边(85)和自由顶点的三角形状,所述边连接到外表面(83)上,所述自由顶点面向近侧部(76)。
35.如权利要求25所述的胫骨部件,其特征在于,销(75)为中空的,以便允许容纳材料的小圆柱或者糊状形式的所述材料,所述材料作为具有骨诱导性和/或骨引导性的骨置换物。
36.膝关节假体,其特征在于,所述膝关节假体包括根据权利要求1-35中至少一项的胫骨部件(30)。
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ITMI20061633 ITMI20061633A1 (it) | 2006-08-22 | 2006-08-22 | Componente tibiale e protesi articolare per il ginocchio comprendente tale componente tibiale |
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CN103260553A (zh) * | 2010-12-07 | 2013-08-21 | 捷迈有限公司 | 假体膝盖骨 |
CN103260553B (zh) * | 2010-12-07 | 2015-11-25 | 捷迈有限公司 | 假体膝盖骨 |
CN108236516A (zh) * | 2016-12-23 | 2018-07-03 | 重庆润泽医药有限公司 | 多孔钽钽棒设备 |
CN108236515A (zh) * | 2016-12-23 | 2018-07-03 | 重庆润泽医药有限公司 | 一种多孔钽钽棒设备 |
CN109464220A (zh) * | 2017-09-08 | 2019-03-15 | 重庆润泽医药有限公司 | 一种用于医学手术的钽棒 |
CN109481091A (zh) * | 2017-09-13 | 2019-03-19 | 重庆润泽医药有限公司 | 钽棒 |
CN109481090A (zh) * | 2017-09-13 | 2019-03-19 | 重庆润泽医药有限公司 | 多孔钽钽棒 |
Also Published As
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WO2007029276A3 (en) | 2007-12-13 |
US20080200957A1 (en) | 2008-08-21 |
WO2007029276A2 (en) | 2007-03-15 |
EP1922022A2 (en) | 2008-05-21 |
AU2006288672A1 (en) | 2007-03-15 |
JP2009506826A (ja) | 2009-02-19 |
CA2619896A1 (en) | 2007-03-15 |
BRPI0615262A2 (pt) | 2011-05-17 |
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