CN112842451A - 一种用于修复和固定关节软骨的装置、试剂盒和方法 - Google Patents

一种用于修复和固定关节软骨的装置、试剂盒和方法 Download PDF

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CN112842451A
CN112842451A CN202110077845.0A CN202110077845A CN112842451A CN 112842451 A CN112842451 A CN 112842451A CN 202110077845 A CN202110077845 A CN 202110077845A CN 112842451 A CN112842451 A CN 112842451A
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cartilage
rod
sleeve
costal
costal cartilage
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杜大江
张长青
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Shanghai Sixth Peoples Hospital
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Abstract

本发明提供了一种用于修复和固定关节软骨的装置、试剂盒和方法，该装置包括肋软骨棒、外套筒、钻孔部件和辅助植入部件；钻孔部件包括钻套筒和与该钻套筒内径匹配的钻头；辅助植入部件包括软骨棒套筒和辅助推进件，肋软骨棒为由肋软骨经加工成直径为3‑8mm且小于软骨棒套筒内径的棒状结构，来源于自体、同种异体或异种肋软骨。该装置采用肋软骨加工成软骨棒，可与待固定关节软骨及骨床松质骨形成良好的生物结合界面，而且可采取的肋软骨充足，易于切削成型，可以大量生产；软骨棒表面可以通过切削与关节面塑形，并具有同关节软骨相似的生物力学特性。本发明提供的方法可操作性强，简单快速，为相关股软骨损伤的修复性治疗提供了新的策略。

Description

一种用于修复和固定关节软骨的装置、试剂盒和方法
技术领域
本发明涉及医疗技术领域，尤其一种用于修复和固定关节软骨的装置、试剂盒和方法。
背景技术
骨钉被用于人体骨折部位、脊柱部位等的体内固定，特别是用于将小骨碎片固定在一起。申请号为EP89305627.5的现有专利公开了一种骨针，为了解决移除钻头后，碎片容易错位的技术问题，将骨钉设计为以骨棒的形式***需固定部位，此外，其采用生物体内可吸收的聚合物材料。但是该专利提供的产品在实施过程中，其生物组织学及力学性质与关节软骨具有很大差异，无法有效修复和固定设计关节面的骨软骨。
肋软骨是透明软骨，本身细胞含量极少，且细胞包埋于软骨基质中，有免疫屏蔽的作用；主要成分硫酸软骨素和胶原蛋白均为安全成分，可作为植入材料，其他成分含量也很少。目前，肋软骨移植已常规被应用于外耳和气管重建，肋骨软骨结合部被用于指间关节、掌指关节、下颚关节、肘关节及腕关节软骨损伤的修复与重建。此外，申请号为201910330808.9和201310192619.2的发明专利公开了用肋软骨修复关节软骨缺损，其力学性质与关节软骨相近，几乎没有免疫排异反应，且肋软骨可与骨床形成稳定的生物结合。
综上所述，肋软骨适用于修复和固定关节软骨，如碎裂或剥脱关节面骨软骨骨块、自体移植修复骨软骨柱等，但目前未有将肋软骨削成软骨棒或软骨骨针用于碎裂或剥脱关节面骨软骨骨块、自体移植修复骨软骨柱等的相关报道。此外，辅助软骨骨棒固定的装置也有待改进。
发明内容
本发明针对现有技术的不足，提供了一种用于修复和固定关节软骨的装置、试剂盒和方法，软骨棒表面可以通过切削与关节面塑形，并具有同关节软骨相似的生物力学特性；软骨棒深部与骨床松质骨形成生物骨软骨界面，实现稳固的长期生物固定。该方法极大地提高了关节面软骨固定材料的生物学特性，并能够避免在操作过程中的骨软骨错位的现象。
为实现上述目的，本发明采用以下技术方案：
本发明的第一方面是提供了一种用于修复和固定关节软骨的装置，包括肋软骨棒、外套筒、钻孔部件和辅助植入部件；
上述钻孔部件包括钻套筒和与该钻套筒内径匹配的钻头；
上述辅助植入部件包括软骨棒套筒和辅助推进件。
进一步地，上述肋软骨棒为由肋软骨经加工成直径为3-8mm且小于软骨棒套筒内径的棒状结构。
进一步地，上述肋软骨来源于自体肋软骨、同种异体肋软骨或异种肋软骨。
进一步地，上述外套筒的底端设置有防止滑动的锯齿。
进一步地，钻套筒和软骨棒套筒的外径均与外套筒的内径大小相同。
进一步地，钻套筒和软骨棒套筒的上端均固定一限位部件。
进一步地，外套筒、钻套筒和软骨棒套筒为金属材质。
进一步地，上述辅助推进件为金属圆柱体，其直径小于或等于肋软骨棒的直径。
进一步地，上述金属圆柱体的顶端设置有把手；该把手为圆饼状或长方体。
本发明的第二方面是提供了一种用于修复和固定关节软骨的试剂盒，其包括第一方面提供的装置和固定卡合上述装置中各个组件的部件。
进一步地，上述试剂盒还包括梯度软骨棒；该梯度软骨棒由壳聚糖和HA混合制备而成。
本发明的第三方面是提供采用第二方面提供的试剂盒的修复和固定关节软骨的方法，包括如下步骤：
步骤一，施力将外套筒固定在待固定关节软骨，将钻头***钻套筒，然后将钻套筒嵌入外套筒内，按照所需深度进行钻孔；
步骤二，钻孔结束，将钻套筒取出，将套有软骨棒套筒的肋软骨棒***外套筒，采用辅助推进件将肋软骨棒植入钻的孔中；
步骤三，将装置撤去，切削肋软骨棒至其与关节面齐平。
进一步地，钻头进入的深度大于或等于肋软骨棒在待固定关节软骨内保留的长度。
进一步地，上述方法还包括在待固定关节软骨非承重区采用梯度软骨棒进行辅助固定。
本发明采用以上技术方案，与现有技术相比，具有如下技术效果：
本发明提供的装置采用肋软骨加工成软骨棒，可与待固定关节软骨及骨床形成良好的生物结合界面，而且可采取的肋软骨充足，易于切削成型，可以大量生产，此外，软骨棒表面可以通过切削与关节面塑形，并具有同关节软骨相似的生物力学特性；软骨棒深部与骨床松质骨形成生物骨软骨界面，实现稳固的长期生物固定。本发明提供的方法可操作性强，简单快速，为相关股软骨损伤的修复性治疗提供了新的策略。
附图说明
图1为本发明一实施例中用于修复和固定关节软骨的装置中的外套管的结构示意图；
图2为本发明一实施例中用于修复和固定关节软骨的装置中的钻孔部件的装配示意图；
图3为本发明一实施例中用于修复和固定关节软骨的装置中的辅助植入部件(未***和***肋软骨棒状态)的结构示意图；
图4为本发明一实施例中用于修复和固定关节软骨的装置中的辅助推进件的结构示意图；
图5为本发明一实施例中使用辅助推进件植入肋软骨棒时的装配示意图；
图6为本发明一实施例中修复和固定关节软骨的方法的流程图；
其中，1-外套管，11-锯齿，2-钻套筒，21-第一限位部件，3-钻头，4-软骨棒套筒，41-第二限位部件，5-肋软骨棒，6-辅助推进件。
具体实施方式
发明人的前期研究中的动物实验已经证实了肋软骨在移植后，可以与骨床形成稳定的生物结合，而可吸收材料最后留下空腔，而且基于肋软骨力学与组织学上相近、不易引起骨关节炎，具有免疫屏蔽型、不易引起免疫排斥反应，以及易于切削成型、来源广泛的特性，本发明提供了一种用于修复和固定关节软骨的装置。该装置包括肋软骨棒5、外套筒1、钻孔部件和辅助植入部件；
上述钻孔部件包括钻套筒2和与该钻套筒内径匹配的钻头3；
上述辅助植入部件包括软骨棒套筒4和辅助推进件6；
钻套筒2和软骨棒套筒4的外径均与外套筒1的内径大小相同。
在本发明一优选的实施方式中，肋软骨棒5为由肋软骨经加工成直径为3-8mm且小于软骨棒套筒4内径的棒状结构。
在本发明一优选的实施方式中，肋软骨来源于自体肋软骨、同种异体肋软骨或异种肋软骨中的一种。采用自体肋软骨时，所述肋软骨为5～7肋，优选右侧第6根肋软骨；采用同种异体或异种肋软骨时，所述软骨为任意水平肋软骨。
在本发明一优选的实施方式中，外套筒1的底端设置有防止滑动的均匀排列一周的锯齿11。
在本发明一优选的实施方式中，钻套筒2和软骨棒套筒4的上端均固定一限位部件，防止在操作过程中钻套筒2和软骨棒套筒4的过伸对骨关节造成不必要的承重和损伤，也方便仅有一名医护人员的情况下，施力和观察。
在本发明一优选的实施方式中，外套筒1、钻套2和软骨棒套筒4为金属材质。
在本发明一优选的实施方式中，上述辅助推进件6为金属圆柱体，其直径等于或略小于肋软骨棒5的直径。
本发明还提供了一种用于修复和固定关节软骨的试剂盒，其包括上述装置和固定卡合该装置中各个组件的部件。
在本发明一优选的实施方式中，试剂盒还包括梯度软骨棒；该梯度软骨棒由壳聚糖和HA混合制备而成。
此外，本发明还提供了采用上述装置或者试剂盒的修复和固定关节软骨的方法。
下面通过具体实施例和附图对本发明进行详细和具体的介绍，以使更好的理解本发明，但是下述实施例并不限制本发明范围。
实施例1
如图1-5所示，本实施例提供一种修复和固定关节软骨的装置，其包括肋软骨棒5、外套筒1、钻孔部件和辅助植入部件；
如图1所示，外套筒1的底端设置有防止滑动的均匀排列的锯齿11；外套管1为金属材质；
如图2所示，该钻孔部件包括长度略小于或等于外套筒1的钻套筒2和与该钻套筒内径匹配的钻头3；该钻套筒2的上端设置有第一限位部件21，该限位部件21为一凸起的套环结构，可与钻套筒2一体成型，均为金属材质；钻头3长度大于钻套管2的长度，且钻头3的直径等于钻套管2的内径；
如图3～5所示，辅助植入部件包括长度略小于或等于外套筒1的软骨棒套筒4和辅助推进件6；其中，该软骨棒套筒4的上端设置有第二限位部件41，该限位部件41为一凸起的套环结构，可与软骨棒套筒4一体成型，均为金属材质；肋软骨棒5的长度小于或等于软骨棒套筒4的长度，直径等于略小于软骨棒套筒4的内径且等于钻头3的直径，该肋软骨棒5由肋软骨(选自自体肋软骨、同种异体肋软骨和异种肋软骨的一种)经切削加工成直径为3-8mm的棒状结构，其直径、长短可根据实际需要加工；
此外，辅助推进件6为金属圆柱体，其直径略小于或等于肋软骨棒5的直径，其顶端设置有把手；该把手为圆饼状或长方体。
实施例2
参考图6，本实施例提供采用实施例1提供的装置对剥脱关节面骨软骨骨块固定的方法，包括如下步骤：
步骤一，施力将外套筒1固定在待固定关节软骨上，将钻头3***钻套筒2中，然后将钻套筒2嵌入外套筒1内，按照所需深度进行钻孔；
步骤二，钻孔结束，将钻套筒2取出，将套有软骨棒套筒4的肋软骨棒5***外套筒1中，采用辅助推进件6对准肋软骨棒5，施力将肋软骨棒5植入钻的孔中；
步骤三，将装置撤去，切削肋软骨棒5在关节面外侧的部分以使其与关节面齐平。
实施例3
本实施例提供一种用于修复和固定关节软骨的试剂盒，其包括实施例1提供的装置(如图1-5)，还包括固定卡合该装置中各个组件的部件和若干梯度软骨棒，该梯度软骨棒由壳聚糖和HA混合制备而成。
实施例4
本实施例采用实施例3提供的试剂盒对碎裂关节面骨软骨骨块固定的方法，包括如下步骤：
步骤一，施力将外套筒1固定在待固定关节软骨的承重部位，将钻头3***钻套筒2中，然后将钻套筒2嵌入外套筒1内，按照所需深度对待固定关节软骨进行钻孔；
步骤二，钻孔结束，将钻套筒2取出，将套有软骨棒套筒4的肋软骨棒5***外套筒1，将辅助推进件6对准肋软骨棒5，施力将肋软骨棒5植入钻的孔中；
步骤三，将装置撤去，切削肋软骨棒5在关节面外侧的部分以使其与关节面齐平；
步骤四，采用上述步骤一～步骤三的操作方法，将肋软骨棒5替换为梯度软骨棒，在非承重部位对关节软骨进行辅助加固。
以上对本发明的具体实施例进行了详细描述，但其只是作为范例，本发明并不限制于以上描述的具体实施例。对于本领域技术人员而言，任何对本发明进行的等同修改和替代也都在本发明的范畴之中。因此，在不脱离本发明的精神和范围下所作的均等变换和修改，都应涵盖在本发明的范围内。

Claims (13)

1.一种修复和固定关节软骨的装置，其特征在于，包括肋软骨棒(5)、外套筒(1)、钻孔部件和辅助植入部件；
所述钻孔部件包括钻套筒(2)和与所述钻套筒内径匹配的钻头(3)；
所述辅助进针部件包括软骨棒套筒(4)和辅助推进件(6)。
2.根据权利要求1所述的装置，其特征在于，所述肋软骨棒(5)为由肋软骨经加工成直径为3-8mm且小于所述软骨棒套筒(4)内径的棒状结构。
3.根据权利要求2所述的装置，其特征在于，所述肋软骨来源于自体肋软骨、同种异体肋软骨或异种肋软骨。
4.根据权利要求1所述的装置，其特征在于，所述外套筒(1)的底端设置有防止滑动的锯齿(11)。
5.根据权利要求1所述的装置，其特征在于，所述钻套筒(2)和软骨棒套筒(4)的外径均与所述外套筒(1)的内径大小相同。
6.根据权利要求1所述的装置，其特征在于，所述钻套筒(2)和软骨棒套筒(4)的上端均固定一限位部件。
7.根据权利要求1所述的装置，其特征在于，所述外套筒(1)、钻套筒(2)和骨针套筒(4)为金属材质。
8.根据权利要求1所述的装置，其特征在于，所述辅助推进件(6)为金属圆柱体，其直径小于或等于所述肋软骨棒(5)的直径。
9.一种用于修复和固定关节软骨的试剂盒，其特征在于，包括如权利要求1-8任一项所述的装置和固定卡合所述装置中各个组件的部件。
10.根据权利要求9所述的试剂盒，其特征在于，还包括梯度软骨棒；所述梯度软骨棒由壳聚糖和HA混合制备而成。
11.采用如权利要求9-10任一项所述试剂盒的修复和固定关节软骨的方法，其特征在于，包括如下步骤：
步骤一，施力将所述外套筒(1)固定在待固定关节软骨上，将所述钻头(3)***所述钻套筒(2)内，然后将所述钻套筒(2)嵌入所述外套筒(1)内，按照所需深度进行钻孔；
步骤二，钻孔结束，将所述钻套筒(2)取出，将套有所述软骨棒套筒(4)的肋软骨棒(5)***所述外套筒(1)，采用所述辅助推进件(6)将所述肋软骨棒(5)植入钻的孔中；
步骤三，将所述装置撤去，切削所述肋软骨棒(5)至其与关节面齐平。
12.根据权利要求11所述的方法，其特征在于，所述钻头(3)进入的深度与所述肋软骨棒(5)在待固定关节软骨内保留的长度相同。
13.根据权利要求11所述的方法，其特征在于，还包括在所述待固定关节软骨非承重区采用所述梯度软骨棒进行辅助固定。
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