CN112022448B - 一种高活动度人工肩关节假体 - Google Patents

一种高活动度人工肩关节假体 Download PDF

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CN112022448B
CN112022448B CN202011054698.7A CN202011054698A CN112022448B CN 112022448 B CN112022448 B CN 112022448B CN 202011054698 A CN202011054698 A CN 202011054698A CN 112022448 B CN112022448 B CN 112022448B
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humerus
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shoulder
cup
ball head
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CN112022448A (zh
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史春宝
周海斌
许奎雪
焦树豪
张朝锋
赵自强
王振国
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Beijing Chunlizhengda Medical Instruments Co Ltd
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Abstract

本发明涉及一种高活动度人工肩关节假体，包括肩盂杯、肩盂内衬、肱骨头、肱骨上端内衬和肱骨上端，肩盂内衬通过肩盂杯开口***并卡在肩盂杯内腔中；肱骨头包括第一球头、第二球头和连接在第一球头和第二球头之间的中间连接杆，第一球头通过肩盂内衬开口***并卡在肩盂内衬内腔中；肱骨上端的顶部设置有肱骨上端开口，该肱骨上端开口与设置在肱骨上端内部的肱骨上端内腔连通；肱骨上端内衬通过该肱骨上端开口***并卡在肱骨上端内腔中；肱骨上端内衬的顶部设置有肱骨上端内衬开口，该肱骨上端内衬开口与设置在肱骨上端内衬内部的肱骨上端内衬内腔连通；第二球头通过该肱骨上端内衬开口***并卡在肱骨上端内衬内腔中。

Description

一种高活动度人工肩关节假体
技术领域
本发明涉及医疗卫生技术领域，具体涉及一种高活动度人工肩关节假体。
背景技术
肩关节由肩胛骨的关节盂和肱骨头构成,属球窝关节。因为肱骨头较大,呈球形，关节盂浅而小，仅包绕肱骨头的1/3,关节囊薄而松弛,所以肩关节是人体运动范围最大而又最灵活的关节,它可做前屈、后伸、内收、外展、内旋、外旋以及环转等运动。但肩关节的这个结构上的特点虽然保证了它的灵活性,但它的牢固稳定性都较其他关节为差,是全身大关节中结构最不稳固的关节。最常见的是向肩关节的前下脱位,因为肩关节的上方有肩峰、喙突及连于其间的喙肩韧带,可以防止肱骨头向上脱位。肩关节的前、后、上部都有肌肉、肌腱与关节囊纤维层愈合,增强了其牢固性。而只有关节囊的前下部没有肌肉、肌腱的增强,这是肩关节的一个薄弱区。因此当上肢外展时,在外力作用下或跌倒时,如上肢外展外旋后伸着地,肱骨头可冲破关节囊前下方的薄弱区,移出到肩胛骨的前方,造成肩关节前脱位持续疼痛。而人工肩关节假体由于肩关节的特殊结构,为保证肩关节的固定稳固,同时保证肩关节的活动角度,常会出现假体组件相互碰撞的情况。
如图1所示，中国专利文献CN107773330A公开了组配式肩关节假体组件,包括肱骨柄假体1，依次设于肱骨假体近端的肱骨适配盘2、肱骨适配盘垫3、肩盂球头4、肩盂固定盘5及骨笼6，所述肱骨假体包括肱骨假体头部及肱骨假体柄部，所述肱骨假体柄部设有光滑表面，所述肱骨假体头部体近端设有承接端面，承接端面中部设有肱骨柄假体凹槽，所述肱骨适配盘一侧设有肱骨适配盘凸耳，所述肱骨适配盘凸耳与肱骨柄假体凹槽锥度配合，肱骨适配盘另一侧与肱骨适配盘垫卡扣连接，所述肱骨适配盘垫包括设于下部的卡扣连接座及设于连接座上的肩盂假体，所述肩盂假体与肩盂球头球窝配合，肩盂球头球面对侧设有肩盂球头凹槽，肩盂固定盘嵌入肩盂球头凹槽并与肩盂球头凹槽锥度配合，肩盂固定盘的设有连接通孔，所述骨笼***并与肩盂固定盘固定。
现有技术中肩关节假体的缺陷包括以下几个方面：
(1)现有技术中的肩关节假体活动范围小于180°，达不到人体所需。
(2)现有技术中的肩关节假体初期稳定性以及长期稳定性差。
(3)现有技术中的肩关节假体为机加工制作假体，误差大，肩盂杯不能很好贴合关节面。
(4)现有技术中的肩盂球头和肱骨适配盘垫适配，活动过大时容易出现脱位现象。
发明内容
本发明旨在提供一种高活动度人工肩关节假体，所要解决的技术问题包括如何加大肩关节假体在人体中的活动角度，增大患者肩关节部位的活动范围，提升肩关节假体初期稳定性以及长期稳定性，防止假体出现脱位现象。
本发明的目的是解决现有技术的不足，提供一种高活动度人工肩关节假体，包括肩盂杯、肩盂内衬、肱骨头、肱骨上端内衬和肱骨上端，所述肩盂杯的下表面设置有肩盂杯开口，该肩盂杯开口与设置在所述肩盂杯内部的肩盂杯内腔连通；所述的肩盂内衬通过该肩盂杯开口***并卡在所述的肩盂杯内腔中；所述肩盂内衬的顶部设置有肩盂内衬开口，该肩盂内衬开口与设置在所述肩盂内衬内部的肩盂内衬内腔连通；所述肱骨头包括第一球头、第二球头和连接在第一球头和第二球头之间的中间连接杆，所述第一球头通过该肩盂内衬开口***并卡在所述的肩盂内衬内腔中；所述肱骨上端的顶部设置有肱骨上端开口，该肱骨上端开口与设置在所述肱骨上端内部的肱骨上端内腔连通；所述肱骨上端内衬通过该肱骨上端开口***并卡在所述的肱骨上端内腔中；所述肱骨上端内衬的顶部设置有肱骨上端内衬开口，该肱骨上端内衬开口与设置在所述肱骨上端内衬内部的肱骨上端内衬内腔连通；所述第二球头通过该肱骨上端内衬开口***并卡在所述的肱骨上端内衬内腔中。
所述的肩盂杯为3D打印的钛合金肩盂杯。
所述肩盂杯的上表面上由3D打印一体成型有一层骨小梁结构，该骨小梁结构上设置有第一网格孔，该第一网格孔的孔隙率设置为50％～80％，该第一网格孔的孔径设置为100～300μm，该骨小梁结构的厚度为2-3mm。
所述肩盂杯的上表面上还打印有骨小梁柱，该骨小梁柱的直径为5-6mm，该骨小梁柱上设置有第二网格孔，该第二网格孔的孔隙率设置为50％～80％，孔径设置为200～400μm。
所述肩盂杯上还设置有连接孔，该连接孔与自攻螺钉配合将所述肩盂杯固定到肩盂上。
所述肩盂内衬的材料为超高分子聚乙烯，通过机加工成型，该肩盂内衬为超半径结构，肩盂内衬的半径超出所述肩盂杯内腔的半径4-6mm。
所述第一球头、第二球头和连接在第一球头和第二球头之间的中间连接杆通过机加工一体成型，所述第一球头的直径范围为22-42mm，所述第二球头的直径范围为12-22mm，所述中间连接杆的长度范围为15-30mm。
所述肱骨头的材料为钴铬钼。
所述肱骨上端内衬的材料为超高分子聚乙烯，通过机加工成型，该肱骨上端内衬为超半径结构，肱骨上端内衬半径超出所述肱骨上端内腔的半径4-6mm。
所述肱骨上端的材料为钛合金，由3D打印技术一体成型。
有益效果
与现有技术相比，本发明的有益效果是：
(1)现有结构采用单球内衬，活动范围受限，不能满足假体在人体的活动范围，本发明中肩盂杯侧和肱骨上端一侧同时采用双球头内衬，为双侧双动结构，加大了肩关节假体在人体中的活动角度，可以增大患者肩关节部位的活动范围，满足患者的日常需求。
(2)现有结构采用与肩盂连接部分为传统结构，不利于肩关节假体初期稳定性以及长期稳定性，本发明中假体与肩盂贴合的部分采用3D打印骨小梁结构能有效提升骨长入效果，3D打印骨小梁柱打入肩盂内也能提升骨长入效果，提升肩关节假体初期稳定性以及长期稳定性。
(3)现有结构与肩盂贴合部分为及加工处理，误差过大，不能与肩盂完美贴合，本发明中假体肩盂杯采用3D打印，采用病人原始数据，一体成型，能很好的贴合关节面，有利于病人术后的恢复。
(4)本发明中肩盂杯与肩盂内衬、肱骨上端与肱骨上端内衬采用超半径锁合，防止假体出现脱位现象。
附图说明
附图用来提供对本发明技术方案的进一步理解，并且构成说明书的一部分，与本申请的具体实施方式一起用于解释本发明的技术方案，并不构成对本发明技术方案的限制。
图1是现有技术中组配式肩关节假体组件的结构示意图。
图2是本发明所述肩盂杯的结构示意图。
图3是本发明所述肩盂内衬的结构示意图。
图4是本发明所述肱骨头的结构示意图。
图5是本发明所述肱骨上端内衬的结构示意图。
图6是本发明所述肱骨上端的结构示意图。
图7是本发明所述肩关节外举上展的结构示意图。
图8是本发明所述肩关节水平位前屈后伸的结构示意图。
图9是本发明所述高活动度人工肩关节假体的整体结构示意图。
具体实施方式
在下文中更详细地描述了本发明以有助于对本发明的理解。
如图2至图9所示，本发明所述的高活动度人工肩关节假体包括肩盂杯1、肩盂内衬2、肱骨头3、肱骨上端内衬4和肱骨上端5，所述肩盂杯的下表面设置有肩盂杯开口14，该肩盂杯开口与设置在所述肩盂杯内部的肩盂杯内腔连通；所述的肩盂内衬2通过该肩盂杯开口***并卡在所述的肩盂杯内腔中；所述肩盂内衬2的顶部设置有肩盂内衬开口21，该肩盂内衬开口与设置在所述肩盂内衬内部的肩盂内衬内腔连通；所述肱骨头包括第一球头31、第二球头32和连接在第一球头和第二球头之间的中间连接杆33，所述第一球头31通过该肩盂内衬开口21***并卡在所述的肩盂内衬内腔中；所述肱骨上端的顶部设置有肱骨上端开口51，该肱骨上端开口与设置在所述肱骨上端内部的肱骨上端内腔连通；所述肱骨上端内衬4通过该肱骨上端开口***并卡在所述的肱骨上端内腔中；所述肱骨上端内衬4的顶部设置有肱骨上端内衬开口41，该肱骨上端内衬开口与设置在所述肱骨上端内衬内部的肱骨上端内衬内腔连通；所述第二球头32通过该肱骨上端内衬开口***并卡在所述的肱骨上端内衬内腔中。
所述的肩盂杯为3D打印的钛合金肩盂杯。
所述肩盂杯的上表面上由3D打印一体成型有一层骨小梁结构11，该骨小梁结构上设置有第一网格孔，该第一网格孔的孔隙率设置为50％～80％，该第一网格孔的孔径设置为100～300μm，该骨小梁结构的厚度为2-3mm。
所述肩盂杯的上表面上还打印有骨小梁柱12，该骨小梁柱的直径为5-6mm，该骨小梁柱上设置有第二网格孔，该第二网格孔的孔隙率设置为50％～80％，孔径设置为200～400μm。
所述肩盂杯上还设置有连接孔，该连接孔与自攻螺钉13配合将所述肩盂杯固定到肩盂上。所述自攻螺钉的大径为3-5mm，螺距为1-2mm，螺杆长度为30-60mm。
所述肩盂内衬的材料为超高分子聚乙烯，通过机加工成型，该肩盂内衬为超半径结构，肩盂内衬的半径超出所述肩盂杯内腔的半径4-6mm。
所述第一球头31、第二球头32和连接在第一球头和第二球头之间的中间连接杆33通过机加工一体成型，所述第一球头的直径范围为22-42mm，所述第二球头的直径范围为12-22mm，所述中间连接杆的长度范围为15-30mm。
所述肱骨头的材料为钴铬钼。
所述肱骨上端内衬的材料为超高分子聚乙烯，通过机加工成型，该肱骨上端内衬为超半径结构，肱骨上端内衬半径超出所述肱骨上端内腔的半径4-6mm。
所述肱骨上端的材料为钛合金，由3D打印技术一体成型。
如图7和图8所示，肩关节的主要运动为肩关节外举上展和肩关节的水平位前屈后伸。图7示出了该肩关节假体外举上展的活动范围，所述肱骨上端的活动范围为162°，外加人体肩胛骨的活动范围60°，所以该肩关节假体外举上展的活动范围为222°，超过人体所需的活动范围180°，增大了关节的灵活性。
图8示出了该肩关节假体水平位前屈后伸的活动范围，所述肱骨上端水平前屈的角度为135°，水平后伸的角度为55°，人体所需肩关节水平后伸的角度为45-50°，此肩关节假体水平后伸的角度为55°，同样超过人体肩关节假体所需活动范围，同样增加了关节的灵活性。
本发明所述的高活动度人工肩关节假体中的“高活动度”可以理解为人工肩关节假体的外举上展的活动范围超过人体所需的活动范围180°，水平位前屈后伸的活动范围超过人体肩关节假体所需活动范围。
如图9所示，肩盂内衬2与第一球头31共同构成双球头内衬，安装入肩盂杯1内，形成双动结构。肱骨上端内衬4与第二球头32共同构成双球头内衬，安装入肱骨上端5内，形成双动结构。
以上描述了本发明优选实施方式，然其并非用以限定本发明。本领域技术人员对在此公开的实施方案可进行并不偏离本发明范畴和精神的改进和变化。

Claims (1)

1.一种高活动度人工肩关节假体，其特征在于，所述的高活动度人工肩关节假体包括肩盂杯、肩盂内衬、肱骨头、肱骨上端内衬和肱骨上端，所述肩盂杯的下表面设置有肩盂杯开口，该肩盂杯开口与设置在所述肩盂杯内部的肩盂杯内腔连通；所述的肩盂内衬通过该肩盂杯开口***并卡在所述的肩盂杯内腔中；所述肩盂内衬的顶部设置有肩盂内衬开口，该肩盂内衬开口与设置在所述肩盂内衬内部的肩盂内衬内腔连通；所述肱骨头包括第一球头、第二球头和连接在第一球头和第二球头之间的中间连接杆，所述第一球头通过该肩盂内衬开口***并卡在所述的肩盂内衬内腔中；所述肱骨上端的顶部设置有肱骨上端开口，该肱骨上端开口与设置在所述肱骨上端内部的肱骨上端内腔连通；所述肱骨上端内衬通过该肱骨上端开口***并卡在所述的肱骨上端内腔中；所述肱骨上端内衬的顶部设置有肱骨上端内衬开口，该肱骨上端内衬开口与设置在所述肱骨上端内衬内部的肱骨上端内衬内腔连通；所述第二球头通过该肱骨上端内衬开口***并卡在所述的肱骨上端内衬内腔中；
所述肩盂内衬的材料为超高分子聚乙烯，通过机加工成型，该肩盂内衬为超半径结构，肩盂内衬的半径超出所述肩盂杯内腔的半径4-6mm；
所述肩盂杯的上表面上由3D打印一体成型有一层骨小梁结构，该骨小梁结构上设置有第一网格孔，该第一网格孔的孔隙率设置为50％～80％，该第一网格孔的孔径设置为100～300μm，该骨小梁结构的厚度为2-3mm；
所述肩盂杯的上表面上还打印有骨小梁柱，该骨小梁柱的直径为5-6mm，该骨小梁柱上设置有第二网格孔，该第二网格孔的孔隙率设置为50％～80％，孔径设置为200～400μm；
所述的骨小梁柱设置有至少两个，并且沿着垂直于所述骨小梁结构的方向延伸；所述的骨小梁柱打入肩盂内能提升骨长入效果，提升肩关节假体初期稳定性以及长期稳定性；所述的肩盂杯为3D打印的钛合金肩盂杯；
所述肩盂杯上还设置有连接孔，该连接孔与自攻螺钉配合将所述肩盂杯固定到肩盂上；
所述第一球头、第二球头和连接在第一球头和第二球头之间的中间连接杆通过机加工一体成型，所述第一球头的直径范围为22-42mm，所述第二球头的直径范围为12-22mm，所述中间连接杆的长度范围为15-30mm；所述肱骨头的材料为钴铬钼；
所述肱骨上端内衬的材料为超高分子聚乙烯，通过机加工成型，该肱骨上端内衬为超半径结构，肱骨上端内衬半径超出所述肱骨上端内腔的半径4-6mm；
所述肱骨上端的材料为钛合金，由3D打印技术一体成型；
所述的高活动度是指人工肩关节假体的外举上展的活动范围超过人体所需的活动范围180°，水平位前屈后伸的活动范围超过人体肩关节假体所需活动范围；
所述的肩盂内衬与第一球头共同构成双球头内衬，安装入肩盂杯内，形成双动结构；肱骨上端内衬与第二球头共同构成双球头内衬，安装入肱骨上端内，形成双动结构；
所述的肩盂杯采用3D打印，采用病人原始数据，一体成型；
所述的肩盂杯与肩盂内衬、肱骨上端与肱骨上端内衬采用超半径锁合，防止假体出现脱位现象；
所述肩关节假体外举上展的活动范围包括所述肱骨上端的活动范围为162°，外加人体肩胛骨的活动范围60°，所以该肩关节假体外举上展的活动范围为222°，超过人体所需的活动范围180°；
所述肩关节假体水平位前屈后伸的活动范围包括所述肱骨上端水平前屈的角度为135°，水平后伸的角度为55°，人体所需肩关节水平后伸的角度为45-50°，该肩关节假体水平后伸的角度为55°，同样超过人体肩关节假体所需活动范围。
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