CN113017855B

CN113017855B - Preparation method of perineal column for hip arthroscopy operation

Info

Publication number: CN113017855B
Application number: CN202110581183.0A
Authority: CN
Inventors: 黄洪杰; 张辛; 王健全; 薛士麟; 王成; 鞠晓东; 徐雁; 印钰
Original assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Current assignee: Peking University Third Hospital Peking University Third Clinical Medical College
Priority date: 2021-05-27
Filing date: 2021-05-27
Publication date: 2022-02-01
Anticipated expiration: 2041-05-27
Also published as: CN113017855A

Abstract

The invention provides a perineal column for hip arthroscopy operation, which comprises: the perineum column is of a hollow cylinder structure in a honeycomb hole shape as a whole, the hollow cylinder structure is sequentially provided with a central pore channel, a supporting layer and a contact layer which are coaxial from inside to outside, and the hardness of the supporting layer is greater than that of the contact layer. The advantages are that: the fiber structure in the supporting layer is thick, the mechanical strength is hard, and the huge stress during traction in the operation can be maintained; the fiber structure in the contact layer is fine, the mechanical strength is soft, the contact layer is directly contacted with a patient, and the elastic softness of the contact layer can protect the patient in the whole traction process.

Description

Preparation method of perineal column for hip arthroscopy operation

Technical Field

The invention relates to the technical field of orthopedic medical treatment, in particular to a preparation method of a perineum column for hip arthroscopy operation.

Background

Hip arthroscopy surgery is the mainstream minimally invasive surgical form of hip surgery in recent years. Compared with open surgery, hip arthroscopy surgery has the characteristics of less bleeding, short postoperative recovery time and less postoperative complications, and has smaller damage to femoral head and reduced risk of ischemic necrosis. With the development of hip arthroscopy, indications for this time have covered the assessment of primary pathological changes in the hip joint and peritrochanteric gap disease, trauma, hip fracture, childhood hip joint disease, and post-total joint replacement pain. As such, hip arthroscopy technology is gaining increasing importance in the field of orthopedics, particularly hip surgery.

Before the hip arthroscopy operation, the affected limb of a patient needs to be axially pulled by a traction frame, so that the hip joint clearance is increased, and a sufficient working space is provided for introducing the arthroscopy and instruments. The traction force required by 27 cases of hip arthroscopic surgery was measured by Maarten et al and the results showed that the average traction force before surgery 714N could cause the hip joint gap to widen by about 8.8mm, e.g. the traction force was significantly reduced by 200N after the vacuum seal was released by puncturing the hip joint. The traction force is obviously reduced by 250N after the joint capsule is cut open in the operation. Dominic et al propose maximum traction threshold, average traction threshold, traction duration threshold and traction impulse threshold at traction of 120 lb, 82 lb, 61 min and 7109 lb · min, respectively, below which patients experience little traction-related sensory or motor dysfunction.

However, in the case of prolonged surgery or excessive traction, such traction can lead to traction injuries to the femoral and sciatic nerves, the most common complication of hip arthroscopy, with an incidence of up to 7%. These injuries are usually temporary neurological disabilities due to traction, but the presence of long-term sequelae has not been reported. The manifestations of the injury are mainly numbness in the groin, inner/outer thigh, instep and other areas, and there is a significant influence on the numbness location by traction time and traction force.

To reduce such injuries, current hip arthroscopic surgery typically uses the perineal column in addition to the use of muscle relaxants. The basic requirements for the perineal column are: the outer layer is provided with a good liner; a diameter of at least 9 cm; ensuring that pressure is applied through the inner thigh, not through the groin or genitals. The current common perineum column usually adopts a sponge liner, the deformation is large when the perineum column is pressed, the air permeability of an outer layer material is poor, and soft tissue injury easily occurs after long-time operation, including scrotum or lip edema, hematoma formation and even pressure necrosis.

Disclosure of Invention

The invention provides a preparation method of a perineum column with elasticity and good tear resistance for hip arthroscopy operation, which aims to overcome the defect that nerve injury and the like often occur due to the fact that reverse supporting force is applied to the perineum in the hip arthroscopy operation.

In order to achieve the above purpose, the invention provides the following technical scheme:

in one aspect, the present invention provides a perineal column for hip arthroscopy surgery, comprising: the perineum column is of a hollow cylinder structure in a honeycomb hole shape as a whole, the hollow cylinder structure is sequentially provided with a central pore channel, a supporting layer and a contact layer which are coaxial from inside to outside, and the hardness of the supporting layer is greater than that of the contact layer.

Preferably, the outer diameter of the support layer is 8.4-8.8 cm; the outer diameter of the contact layer is 17.8-18.1 cm.

Further, the perineum column is made of EM +21 engineering resin materials, and the density of the supporting layer is larger than that of the contact layer.

The invention also provides a preparation method of the perineum column for hip arthroscopy operation, which comprises the steps of specifically modeling through computer modeling software to prepare a three-dimensional model of the needed perineum column, then printing and molding through a 3D printer by using EM +21 engineering resin as a raw material, finally cleaning and removing a support structure, and carrying out thermosetting treatment to obtain the perineum column.

Preferably, the baking temperature is 115-125 ℃ and the time is 7.6-8.2h in the thermal curing treatment process.

Preferably, the perineum column is of a hollow cylinder structure in a honeycomb hole shape, the hollow cylinder structure is sequentially provided with a central pore channel, a supporting layer and a contact layer which are coaxial from inside to outside, and the hardness of the supporting layer is greater than that of the contact layer.

Further, the diameter of the central pore canal is set according to the specification of the traction bed, and the outer diameter of the supporting layer is constant.

Further, the hardness of the supporting layer is 58-63A, and the hardness of the contact layer is 35-42A.

Further, a vertical distance from an outer edge of the support layer to an outer edge of the central cell is less than a vertical distance from an outer edge of the contact layer to an outer edge of the support layer.

The perineum column for hip arthroscopy operation and the preparation method thereof have the advantages that:

1. according to the design of the perineum column structure, the fiber structure in the supporting layer is thick, the mechanical strength is hard, and therefore huge stress during traction in the operation can be maintained; the fiber structure in the contact layer is fine, the mechanical strength is soft, the contact layer is directly contacted with a patient, and the elastic softness can protect the patient in the whole traction process;

2. the perineum column is of a hollow cylinder structure in a honeycomb hole shape, so that the perineum column has good air permeability and elasticity in gradient distribution during use while effectively reducing weight, further protects a patient and provides better comfort for the patient;

3. according to the invention, the perineum column is integrally printed by a Lux 3L-type 3D printer and EM +21 engineering resin, compared with a transmission processing mode, the method has the advantages of rapidness, low cost and convenience, and no assembly is needed, and a more complex internal structure can be designed according to needs to meet higher practical requirements;

4. the perineum column prepared by the method ensures the core strength, ensures the outer side to have higher compressibility, ensures that a patient feels more comfortable when the perineum column is used, and reduces the compression injury to the perineum of the patient.

Drawings

The accompanying drawings are included to provide a further understanding of the invention, and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description serve to explain the principles of the invention. In the drawings:

FIG. 1 is a schematic perspective view of a perineal column for hip arthroscopy operation according to the present invention;

FIG. 2 is a schematic top view of a perineal column for hip arthroscopy operation;

wherein:

central pore 1, support layer 2, contact layer 3.

Detailed Description

The preferred embodiments of the present invention will be described in conjunction with the accompanying drawings, and it will be understood that they are described herein for the purpose of illustration and explanation and not limitation.

The perineum column on the market is manufactured by adopting a traditional technical mode, the material is single, the cost is low, the perineum column is manufactured by adopting a 3D printing technology and EM +21 engineering resin to solve the problems that nerve injury and the like often occur due to the fact that reverse supporting force is applied to the perineum in hip arthroscopic surgery, meanwhile, the method is simple, the cost is low, and structures with different gap shapes can be designed according to requirements, so that the purpose of reducing perineum injury is met through improvement of the material and stress, and the experience of a patient in the surgery and after the surgery is improved.

As shown in fig. 1 and 2, the perineal column for hip arthroscopy surgery of the invention has a hollow cylindrical structure with honeycomb holes as a whole, so that the perineal column has the advantages of light weight, improved air permeability, increased compressibility and more comfort compared with the traditional perineal column;

in order to ensure that the perineum column has enough supporting strength in the using process and simultaneously does not affect the comfort level of the perineum column in the operation and after the operation, the hollow cylinder structure sequentially comprises a central pore canal 1, a supporting layer 2 and a contact layer 3 from inside to outside, wherein the density of the supporting layer 2 is greater than that of the contact layer 3, so that the hardness of the supporting layer 2 is greater than that of the contact layer 3, the core strength of the perineum column is improved, and the supporting force of the perineum column is enhanced; the overall shapes of the central pore canal 1, the support layer 2 and the contact layer 3 are all cylinders, wherein the support layer 2 and the contact layer 3 are cylinders formed by honeycomb holes; more specifically, the support layer 2 is a cylindrical structure concentric with the central pore passage 1, and the contact layer 3 is located outside the support layer 2 and is a cylindrical structure concentric with the central pore passage 1 and the support layer 2.

In a specific use process, in order to further improve the comfort level of the perineum column, the outer diameter of the support layer 2 is 8.4-8.8 cm; the outer diameter of the contact layer 3 is 17.8-18.1 cm. Preferably the outer diameter of the support layer 2 is 8.5cm and the outer diameter of the contact layer 3 is 18 cm; the diameter of the central bore 1 is 4.5 cm.

Further, the height of the perineal column is preferably 20 cm. When the size is used, the supporting force and the softness of the size contacting with the human body can reach the appropriate state, and the compression injury to the perineum of a patient is reduced.

In the specific technical scheme, the perineum column is prepared from an EM +21 engineering resin material.

In the specific embodiment:

a preparation method of perineal column for hip arthroscopy operation comprises the following specific steps:

firstly, determining an internal gap structure of a perineum column as required, modeling through computer modeling software to prepare a three-dimensional model of the required perineum column, then, filling the three-dimensional model into a Lux 3L type 3D printer by using liquid EM +21 engineering resin as a raw material, inputting a model file printed by the perineum column, printing the model file, finally, cleaning to remove a support structure, and baking for 8 hours at 120 ℃ to perform thermocuring treatment to obtain the perineum column;

in the preparation process, the whole prepared perineum column needs to be in a honeycomb hole-shaped hollow cylinder structure so as to reduce weight, improve air permeability and enhance compressibility; the hollow cylinder structure is sequentially provided with a central pore passage 1, a supporting layer 2 and a contact layer 3 which are coaxial from inside to outside, the hardness of the supporting layer 2 is greater than that of the contact layer 3, and the integral shapes of the central pore passage 1, the supporting layer 2 and the contact layer 3 are all cylinders, wherein the integral shapes of the supporting layer 2 and the contact layer 3 are cylinders formed by honeycomb pores; more specifically, the support layer 2 is a cylindrical structure concentric with the central pore passage 1, and the contact layer 3 is located outside the support layer 2 and is a cylindrical structure concentric with the central pore passage 1 and the support layer 2. The structure is fast, cheap and convenient to prepare, and does not need to be assembled; as shown in fig. 2, the vertical distance from the outer edge (e.g. point a) of the support layer 2 to the outer edge (e.g. point b) of the central tunnel 1 is smaller than the vertical distance from the outer edge (e.g. point c) of the contact layer 3 to the outer edge (e.g. point a) of the support layer 2, so that the perineal column has enough support strength during use without affecting the comfort of the perineal column during and after operation.

For the use comfort level of furthest guarantee perineum post to improve the flexibility of using, embody the convenience that 3D printed, in the actual preparation process, can change the diameter of comfortable central pore 1 according to the traction table specification of different brands in order to adapt to the installation demand, but need remain throughout the external diameter of supporting layer 2 is invariable.

Specifically, the diameter of the central pore canal 1 is 4.5cm, the outer diameter of the support layer 2 is 8.5cm, and the outer diameter of the contact layer 3 is 18cm, that is, the thickness of the support layer 2 and the thickness of the contact layer 3 are 2cm and 4.75cm, respectively. The height of the perineum column is 20cm, and the Shore hardness of the EM +21 engineering resin used in the method is 67A; the hardness of the perineal column with the size is detected, and the hardness of the supporting layer 2 is 60A, and the hardness of the contact layer 3 is 40A; the hardness of the common sponge is between 40 and 50A, and the high-resilience sponge used for sofas, mattresses and the like can reach 50A or more; the perineum column prepared by the method has the advantages that the hardness of the supporting layer 2 is higher than that of the sponge, the strength of the perineum column core and the supporting effect on the perineum and the hip joint are guaranteed, and the hardness of the contact layer 3 is lower than that of the sponge, so that the use comfort is improved.

Two groups of experiments are designed, five perineal columns with the sizes (namely the diameter of the central pore canal is 4.5cm, the outer diameter of the supporting layer is 8.5cm, and the outer diameter of the contact layer is 18 cm) are designed in each group, and the group A is the product prepared by the method; group B is a control group, perineal columns (conventional sponge pads) of this size were prepared using prior art methods, and two groups of experimental products were measured for weight as shown in table 1 below:

TABLE 1

The averages of group A and group B in Table 1 were 2.23. + -. 0.16 and 6.35. + -. 0.99, respectively, where 0.16 and 0.99 are standard deviations. The comparison shows that the weight of the perineum column obtained by the method is far less than that of the perineum column prepared by the traditional method, so that the burden on a patient after the operation is reduced.

Structures or method steps, operation processes and the like which are not described in detail in the invention can be obtained by conventional methods, and are not described herein again.

It will be apparent to those skilled in the art that various changes and modifications may be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include such modifications and variations.

Claims

1. A preparation method of perineal column for hip arthroscopy operation is characterized by comprising the following steps: modeling through computer modeling software to prepare a three-dimensional model of the needed perineum column, then integrally printing and molding by using EM +21 engineering resin as a raw material through a 3D printer, finally cleaning to remove a support structure, and performing thermosetting treatment to obtain the perineum column;

in the heat curing process, the baking temperature is 115-125 ℃, and the time is 7.6-8.2 h;

the perineum column is of a honeycomb-hole-shaped hollow cylindrical structure integrally, the hollow cylindrical structure is sequentially provided with a central pore passage (1), a supporting layer (2) and a contact layer (3) which are coaxial from inside to outside, the hardness of the supporting layer (2) is greater than that of the contact layer (3), and the density of the supporting layer (2) is greater than that of the contact layer (3); the outer diameter of the supporting layer (2) is 8.4-8.8 cm; the outer diameter of the contact layer (3) is 17.8-18.1 cm.

2. The method for preparing the perineal column for hip arthroscopy operation according to claim 1, wherein the method comprises the following steps: the diameter of the central pore canal (1) is set according to the specification of the traction bed, and the outer diameter of the supporting layer (2) is constant.

3. The method for preparing the perineal column for hip arthroscopy operation according to claim 1, wherein the method comprises the following steps: the hardness of the support layer (2) is 58-63A, and the hardness of the contact layer (3) is 35-42A.

4. The method for preparing perineal column for hip arthroscopy operation according to claim 2 or 3, wherein the method comprises the following steps: the vertical distance from the outer edge of the supporting layer (2) to the outer edge of the central pore canal (1) is smaller than the vertical distance from the outer edge of the contact layer (3) to the outer edge of the supporting layer (2).