CN114786623A - 植入物部件组件 - Google Patents
植入物部件组件 Download PDFInfo
- Publication number
- CN114786623A CN114786623A CN202080086792.2A CN202080086792A CN114786623A CN 114786623 A CN114786623 A CN 114786623A CN 202080086792 A CN202080086792 A CN 202080086792A CN 114786623 A CN114786623 A CN 114786623A
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- CN
- China
- Prior art keywords
- screw
- assembly
- implant component
- implant
- interface
- Prior art date
- 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.)
- Pending
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Classifications
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- 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
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- A61F2/30—Joints
- A61F2/30721—Accessories
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- 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
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Landscapes
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Abstract
本公开提供了一种用于关节置换物的植入物部件组件(1)。该组件包括植入物部件(10),该植入物部件包括用于附接另一植入物部件(50)的接口部分(20)和组装通道(11)。该组件进一步包括用于将另一植入物部件固定到该植入物部件的组装螺钉(30),组装螺钉具有纵向轴线(L)、螺钉头(31)以及螺钉杆(32)并且能够***到组装通道中。该组件的螺钉保持单元(40)被配置成用于将组装螺钉保持在组装通道内并且允许组装螺钉围绕纵向轴线旋转。
Description
技术领域
本公开涉及一种植入物部件组件,该植入物部件组件采用组装螺钉和螺钉保持单元,该螺钉保持单元用于将组装螺钉在组装到另一植入物组件之前保持可移动地附接到植入物部件组件的植入物部件。本公开还涉及一种用于预组装植入物部件组件的方法。
背景技术
模块化关节置换物是用于置换患者的原生关节的现有技术。这些植入物的模块化允许它们的形状和尺寸适配于患者的个体解剖情况。这种模块化是可用于治疗恶化关节的关节置换物的持久和成功的原因之一。
虽然通常持续十多年,同时经常为患者提供手术前的生活和活动,但是出于若干原因,关节置换物可能不得不被置换。这些原因之一是关节置换物随时间推移的磨损。在此,目的是通过将植入物部件的置换限制于已经磨损到它们需要更换的程度的部件来利用模块化。
可能需要修整关节置换物的另一原因是植入物周围的组织的感染。如果感染程度允许关节置换物的部分更换,则植入物的模块化在这种情况下也可以有利地使用,以便防止对整个植入物部件的修整的需要。
在用于主要由软组织(即韧带和肌肉组织)稳定的滑膜关节的关节置换物的情况下,单个植入物部件的置换而不是整个关节置换也是有利的。对于这些关节,单个植入物部件的更换防止了关节在手术后的脱位,因为外科手术需要比在至少关节置换物的受影响侧的修整的情况下更小的入口。结果是,改善了周围软组织的保留。这种关节的示例是膝关节、肩关节、踝关节和腕关节。
然而,模块化关节置换物的单个部件的拆卸通常证明是冗长的,因为它必须通过在外科手术过程中创建的小可触及开口执行以便保留软组织结构。此外,植入物部件之间的连接要持久,以免成为修整的原因。因此,通常难以拆卸已经长时间保持植入的植入物部件。
特别地,渐缩的连接是用于关节置换物中的持久连接的优选类型,因为关节部件通常承受压缩力。这些压缩力以有利的方式作用在该连接类型及其自锁特性上。更具体地,在日常使用期间施加的负载引起植入物部件之间的更紧密的互锁。
尽管如此,这种类型的连接的优点在植入物部件的更换期间可能变成缺点,同时保持剩余的植入物部件未被改变。不仅难以分离该自锁连接,而且仅存在可用于施加分离植入物部件所需的力的有限空间。
发明内容
因此,以下公开的目的是提供一种允许容易拆卸的植入物部件组件或模块式关节置换物。特别地,本发明的目的是提供一种机构,该机构便于植入物部件在有限空间的环境中拆卸,以施加使这些植入物部件的连接脱离接合所需的力。
在独立权利要求中限定了这个目的的解决方案,其中,从属权利要求指明了优选实施例。
通过提供用于关节置换物的植入物部件组件已经解决了上述目的。该组件包括植入物部件,该植入物部件包括用于附接另一植入物部件的接口部分和组装通道。该组件进一步包括组装螺钉,组装螺钉用于将另一植入物部件固定到植入物部件,其中组装螺钉具有纵向轴线、螺钉头以及螺钉杆,并且能够***组装通道中。它还包括螺钉保持单元,螺钉保持单元被配置成用于将组装螺钉保持在组装通道内并且允许组装螺钉围绕纵向轴线旋转。
当组装螺钉被紧固时将植入物部件彼此固定。由于螺钉保持单元将组装螺钉保持在组装通道内,同时允许组装螺钉绕纵向轴线旋转,因此组装螺钉不必单独地***,而是与植入物部件一起***。这有助于组装到另一个植入物部件,特别是如果另一植入物部件已经被放置在患者体内的话。
此外,螺钉保持单元还在拆卸期间(即在螺钉松动的过程中)将组装螺钉保持在组装通道内。换言之,组装螺钉的螺钉杆从与另一植入物部件的螺纹接合中移出。然而,由于组装螺钉沿着组装通道的移动性受到螺钉保持单元的限制,由于组装螺钉接合在植入物部件的组装通道中,组装螺钉还将植入物部件移动远离另一植入物部件。
换言之,植入物部件的螺钉保持单元将组装螺钉保持或系留在组装通道(即在沿组装通道的两个方向上)内。因此,保持单元防止组装螺钉在操纵植入物部件时从组装通道掉出。优选地,保持单元为螺钉提供形状配合,该形状配合系留螺钉但允许螺钉在其旋转方向上自由移动以及沿着其纵向轴线的有限移动。
由于组装螺钉被布置成用于将植入物部件固定到另一植入物部件,所以组装螺钉被布置成从植入物部件的组装通道突出并且优选地被布置成在植入物部件的接口部分处突出。
为了紧固或使用组装螺钉,组装螺钉在螺钉头的一侧是可触及的。这种可触及性是由组装通道提供的。特别地,组装通道被配置成容纳用于接合螺钉头的工具,以便在任一方向上旋转螺钉。因此,组装通道优选地从接口部分延伸到植入物部件的与接口部分相对的一侧。组装通道具有纵向轴线并且优选地是直的。尽管如此,组装通道还可以是至少部分弯曲的。
此外,组装螺钉可被制造成使得其与螺钉保持单元接合,例如通过增材制造或将组装螺钉安装在组装通道内部。
优选地,螺钉保持单元包括用于支撑螺钉头的螺钉座,螺钉座包括用于容纳螺钉杆的通孔。
螺钉座是简单的结构特征以限制组装螺钉相对于植入物部件并且更具体地在至少一个方向上相对于组装通道的移动。当植入物部件被组装到另一植入物部件时,螺钉座至少支撑螺钉头。因此,螺钉座支撑螺钉头,其中组装螺钉被紧固。
此外,螺钉座还可以在两个方向上起作用,即沿着组装通道的两个方向限制组装螺钉的能力。特别地,螺钉座与螺钉杆接合,并且优选地与螺钉杆的螺纹部分相比具有减小的直径的螺钉杆的一部分接合。因此,具有减小直径的这个部分位于螺钉杆的螺纹部分与螺钉头之间。
优选地,组装通道包括容纳部分,并且螺钉座能够***到容纳部分中。
在这种情况下,该螺钉座是可***的,即,该螺钉座是单独的部分或部件而不是与植入物部件一体形成的部件。因此,在将螺钉座***并固定至植入物部件之前,可以通过将组装螺钉的螺钉头放置在组装通道内来组装螺钉保持单元。优选地,螺钉座形成为安装在组装通道的容纳部分中的螺钉***件。为此,螺钉座可包括工具接合接口,以操纵螺钉座和/或将螺钉座固定至植入物部件。
因此,特征的这种组合提供了组装螺钉保持单元的容易的方式。这有助于螺钉保持单元的制造和质量,因为植入物部件组件的部分在被组装之前分开生产,而不是必须诸如通过增材制造等同时生产。换言之,螺钉座不与植入物部件一体形成。
此外,螺钉座优选地通过形状配合、摩擦配合和/或焊接固定在容纳部分内。
作为用于固定螺钉座的形状配合,可以采用卡扣配合布置。可替代地,优选地通过引起螺钉座与螺纹通道的容纳部分之间的压力配合,可以使用摩擦配合。尽管如此,优选地,经由螺纹接合将螺钉座组装并固定至植入物部件,即它经由摩擦配合固定到植入物部件。这种布置允许螺钉座的组装和拆卸。独立于螺钉的固定,螺钉座可以用作螺钉相对于植入物部件在沿着组装通道(螺钉或组装通道的纵向轴线)的任一方向或两个方向上的运动的限制。
在螺钉座在植入物部件的安装状态下支撑组装螺钉的螺钉头的情况下,整个螺钉轴被配置为穿过螺钉座的通孔。在螺钉座限制组装螺钉在两个方向上移动的自由度的情况下,在螺钉轴和组装螺钉的组装状态下,仅允许螺钉轴的一部分通过,使得在纵向移动范围中的一个端部处,螺钉头由螺钉座支撑,并且在纵向移动范围的另一端部处,螺钉轴的远端部分在螺钉座的与支撑螺钉头的一侧相对的一侧上具有更大的直径。对于后者,组装螺钉优选地通过形状配合或摩擦配合保持在螺钉座中。
特别优选的是,螺钉保持单元进一步包括螺钉止挡件,该螺钉止挡件优选地被形成为组装通道的台阶。
在这种情况下,当与螺钉杆的一侧相对的一侧上的组装螺钉的螺钉头在组装通道内部沿此方向移动时抵靠在螺钉止挡件处。换言之,螺钉止挡件限制组装螺钉进一步移动到组装通道中,即在螺钉松动期间,限制组装螺钉移动的方向。在植入物部件组件的组装状态下,组装螺钉的头部的端面面向螺钉止挡件。相反,螺钉头的杆突出的端面面向螺钉座。
该配置使得组装螺钉将植入物部件推离另一植入物部件。因此,植入物部件的拆卸更容易操纵,并且在顶部上以非常受控的方式进行,而不使用承受组织损坏风险的任何突然的力。
螺钉止挡件优选地形成为组装通道中的台阶,即沿背离接口部分的方向减小组装通道的直径。因此,台阶的接口侧上的组装通道的直径足够大以容纳组装螺钉的螺钉头,而相对侧上的直径较小,使得螺钉头不能通过。尽管如此,组装通道的较小直径被定尺寸成允许紧固工具穿过并且接合组装螺钉以用于紧固或松动。
因此,组装通道的直径可以小于螺钉头的直径,使得组装螺钉不能通过组装通道的与接口部分所在一侧相对的一侧的端部离开。
台阶优选地与组装通道成一体,但也可以作为单独的部分***并固定。在这方面,应当注意的是,螺钉座以及螺钉止挡件中的任一个或两者优选地形成为经由表面接触而不是线或点接触提供与组装螺钉的接触。
在使用螺钉止挡件的配置中,组装螺钉在另一方向上的移动优选地由如上所述的螺钉座、优选地可***的螺钉座限制。螺钉座和螺钉止动件一起形成系留部分(captureportion),该系留部分用于限制螺钉头沿着假设的纵向轴线的移动能力,并且因此限制组装螺钉的移动。
因此,系留部分被定尺寸成使得螺钉座与螺钉止挡件之间的空间在纵向方向上的延伸大于螺纹头在纵向方向上的延伸。
技术人员将理解,测量系留部分在组装通道的纵向方向上的延伸和螺钉头在螺钉的纵向方向上的延伸,从而使得它们彼此相关(例如,在它们的最大延伸处)。
优选地,该植入物部件的接口部分包括用于安装另一植入物部件的渐缩的接口表面,该渐缩的接口表面优选地限定凹部。
特别地,当被配置为渐缩的连接时,组装螺钉一方面允许使用预定的力来锁定渐缩的连接,另一方面允许在植入物部件的拆卸期间脱离接合渐缩的连接。
换言之,接口部分被配置为渐缩的连接。它还可以可替代地或另外地形成为与圆柱形接口表面的连接。优选地,具有渐缩的连接的配置被配置为锥形连接。如果形成为凹部,该接口表面形成了径向地面向内的周向壁。同样地,如果形成为突出部,接口表面形成径向面向外的周向壁。
独立于渐缩的或圆柱形的,组装螺钉的纵向轴线在组装状态下优选地基本上平行于接口部分的纵向轴线,即基本上限定用于使植入物部件彼此接触的向量的纵向轴线。应当注意的是,接口部分的纵向轴线可以相对于植入物部件的纵向轴线平行或倾斜。
此外,如果形成为凹部,则组装通道的口部(接口的出口开口)位于凹部的底部,而如果形成为突出部,则组装通道的口部位于突出部的尖端。
此外,形成为凹部产生包括组装通道的植入物部件的更紧凑的构造。
优选地,组装螺钉的螺钉杆具有螺纹部分和无螺纹部分,无螺纹部分位于螺纹部分与螺钉头之间。
组装螺钉的这种配置可以与螺钉座结合使用,以限制组装螺钉在组装通道的两个方向上的移动。在包括螺钉座和螺钉止动件两者的情况下,组装螺钉的这种设计具有可靠地防止组装螺钉与螺钉座的通孔的任何接触的优点以及因此防止在连接至另一重要部件时对接口部分和另一重要部件的接口部分的任何影响的优点。此外,无螺纹部分优选地是圆柱形的。
还优选的是,植入物部件进一步包括用于附接关节构件的另一接口部分,另一接口部分形成为凹部,优选为渐缩的凹部,并且甚至更优选地包括关节组装通道,关节组装通道被定尺寸成容纳用于固定关节构件的关节固定螺钉。
如果组装通道具有比组装螺钉的螺钉头更小的直径,则这有助于使植入物部件具有多个接口,诸如用于附接关节构件的接口部分等。自然地,该关节组装通道还可以被配置成像根据以上描述的组装通道。
优选地,植入物部件进一步包括用于将软组织固定到植入物部件的至少一个缝合线孔和/或至少一个缝合线凹槽。
在此,使用以上指出的结构特征促进了软组织结构的附接。由于组装通道的尺寸较小,因为必须仅将用于将植入物部件组装至另一植入物部件的紧固工具穿过该通道,所以可以为植入物部件提供更多的形成为孔或凹部的结构特征,而不影响植入物部件的强度,该强度是承受在植入之后作用在植入物部件组件上的力所必需的。
此外,所述植入物部件可以包括用于接合操纵工具的操纵工具接合凹部,以在外科手术期间操纵植入物部件。
出于与上述原因相同的原因,可提供操纵工具接合凹部。此外,这样的凹部或与这个凹部接合的操纵工具可以通过在向植入物部件施加扭矩的过程中支撑植入物部件来帮助紧固或松动组装螺钉。优选地,操纵工具接合凹部设置在植入物部件的近侧处以用于触及。
优选地,组装螺钉包括工具接口凹部,工具接口凹部形成用于紧固工具在围绕组装螺钉的纵向轴线的旋转方向上的接合。
本公开进一步提供了用于预组装如上所述的关节置换物的植入物部件组件的方法。该方法包括以下步骤:提供包括组装通道和接口部分的植入物部件,其中组装通道形成为通孔并且从植入物部件的近侧延伸至接口部分;提供螺钉座,其中螺钉座包括通孔;提供具有纵向轴线、螺钉头和螺钉杆的组装螺钉;将组装螺钉的螺钉杆***螺钉座的通孔中;将组装好的螺钉座和具有螺钉头的组装螺钉从接口部分一侧先***组装通道的容纳部分;将螺钉座固定在组装通道的容纳部分内。
优选地,该方法进一步包括以下步骤:提供另一植入物部件,特别是植入物柄,另一植入物部件包括与植入物部件的接口部分相对应的接口部分以及用于与组装螺钉接合的螺纹孔;经由植入物部件的接口部分连接植入物部件;以及经由紧固组装螺钉将植入物部件彼此固定。
附图说明
以下附图示出了本发明的优选实施例。这些实施例不应被解释为限制性的,而仅仅是为了在以下描述的情况下增强对本发明的理解。在这些图中,贯穿附图,相同的附图标记指代具有相同或等效功能和/或结构的特征。这特别适用于在后两个数位中相同的附图标记,其中前面的数位表示实施例。应注意,出于描述简明的原因,通常省略这些部件的重复描述。
图1示出了关节置换物的植入物部件组件的实施例的侧视图;
图2从不同的视角示出了图1中所示的植入物部件组件的三维视图;
图3是植入物部件的三维视图,其示出了该部件的接口部分;
图4是图3中所示的植入物部件的横截面视图;
图5示出了关节置换物的植入物部件组件的另一实施例的侧视图;以及
图6是图5中所示的植入物部件组件的三维视图。
具体实施方式
技术人员将了解,包括植入物部件组件的关节置换物部件可以仅布置在滑膜关节的一侧,即它可以置换滑膜关节的仅一侧。在这种情况下,关节置换物部件仅表示关节的部分置换物,即所谓的半关节成形术。尽管如此,通常关节置换物涉及关节两侧上的关节表面的置换物。此外,关节置换物的任一侧或两侧可以包括若干植入物部件的组件,诸如关节部件和锚定部件等。
图1和图2图示了关节置换物部件1的示例性实施例。关节置换物部件1包括第一植入物部件10和关节构件60。如图1所示,关节构件60可以包括关节部分61和中间部分62。关节部分61和中间部分62通过上述任何方式彼此附接。关节部件60安装至第一植入物部件10,即在本实施例中,包括关节表面的关节部分61经由中间部分62安装至植入物部件10。中间部分62可以作为适配器以优化包括关节表面的关节部分61的位置和取向。这样的中间部分可以经由紧固螺钉固定到第一植入物部件10,如下文将进一步更详细地解释的。这允许第一植入物部件10和中间部分62之间特别可靠的连接。具有中间部分62的布置还防止了到关节部分61的渐缩的连接的松动,因为关节表面被布置成靠近该渐缩的连接,从而本质上不存在可能导致这种松动的杠杆臂。因此,在关节表面中不存在在其他方面经由螺钉固定关节部分61所必需的孔。适配器还可以包括缝合线孔(未示出)。
尽管如此,关节构件60也可以直接附接至第一植入物部件10。
第一植入物部件10具有近端部和远端部。第一植入物部件10的近端部是更靠近关节置换物的关节或关节表面的位置的端部,而远端部在与关节所处的一侧相对的一侧上。
如以下将进一步更详细描述的,第一植入物部件10优选地被配置成用于附接软组织,而第二植入物部件50被配置成用于将植入物锚定在骨组织中。这种配置在肩关节置换物的情况下特别有利。
为了连接关节构件62,第一植入物部件10包括在其近端部处的第二接口部分25。在图3中更详细地示出了没有关节构件60的第二接口部分25。如该图所示,第二接口部分25可以包括由接口表面26限定的安装孔。在示例性实施例中,接口表面26形成渐缩的凹部(参见图4)。因此,关节构件60包括渐缩的突出部(未示出)。一旦组装,渐缩的凹部和渐缩的突出部一起在关节构件60与第一植入物部件10之间建立渐缩的连接。虽然第二接口部分25和关节构件60的对应接口部分也可以由圆柱形接口表面限定,但是渐缩的接口表面是优选的,特别是锥形接口表面。已经证明这种渐缩的连接是容易组装的并且在植入物的使用过程中是可靠的。自然地,还可以切换接口部分的凹部和突出部,使得凹部形成在关节构件60处并且突出部形成在第一植入物部件10处。
如在图3的示例性实施例中所展示的,第二接口部分可以进一步包括凹形接口表面27。在图1和图4的侧视图中更清楚地示出,关节构件60包括凸形接口表面63,凸形接口表面63形成为对应于第二接口部分25的凹形接口表面27。由于图1至图4所示的示例性实施例(以及还优选图5至图6中所示的实施例)在关节构件60与第一植入物部件10之间采用渐缩的连接,关节构件60的凸形接口表面63以一定距离(即这些表面不接触)面向第一植入物部件的凹形接口表面27,使得不损害渐缩的连接的功能。
此外,图3所示的第二接口部分25包括分度孔28的阵列。这些分度孔28布置在圆上。该圆的中心沿着由接口表面26限定的纵向轴线定位,该纵向轴线即这个示例性实施例的渐缩的锥形的旋转轴线。这些分度孔28可以为关节构件60围绕这个旋转轴线的取向提供锁定机构。因为关节构件60的关节表面相对于渐缩的连接的纵向轴线旋转对称,所以关节构件60可以包括相应的分度销(未示出)以防止关节构件60围绕渐缩的连接的纵向轴线的任何旋转。这种分度防止了这两个植入物部件10和60之间的无意识的相对旋转,并且因此有助于防止这些植入物部件的连接的无意识的松动。
在另一实施例中,关节构件60可以是偏心关节构件,即这种关节构件的中心偏离这两个植入物部件之间的连接的中心。在该实施例中,分度允许相对于第一植入物部件10在预定位置和取向上调节和固定关节构件60。
此外,第一植入物部件10包括组装通道11,组装通道11从第一植入物部件10的近端部(参见图3)朝向远端部延伸直到第一接口部分(参见图4)。如图1所示,紧固工具70可以被***到组装通道11中以使用组装螺钉30(参见图4)将第二植入物部件50紧固到第一植入物部件10,如以下将进一步更详细描述的。
如图3所示,第一植入物部件10可以进一步包括操纵工具接合凹部16,操纵工具接合凹部16设置在第一植入物部件10的近端部,以便在手术之前或期间操纵该部件。换言之,操纵工具接合凹部16和/或组装通道11的入口优选地位于关节置换物部件的近侧。这有助于通过外科手术的可触及伤口定位这些结构特征。
在附图中示出的示例性实施例的第一植入物部件10还包括一个或多于一个、特别是两个缝合线凹槽15。此外,第一植入物部件10可以包括缝合线孔14。这些缝合线孔14和缝合线凹槽15被布置在第一植入物部件10的周向处,优选地在总体上周向方向或平行于周向的切线的方向上延伸。缝合线特征能够保持用于固定软组织结构的缝合线。优选地,缝合线孔14和/或缝合线凹槽15(总体上均匀地)围绕第一植入物部件10的周向分布,即围绕纵向轴线L的方向上的轴线(参见图4)分布。
所示实施例的至少一个缝合线凹槽15进一步优选地形成为第一植入物部件10的与包括锚定结构17的该部件的外表面径向相对地定位的一侧中的纵向凹部。锚定结构17至少阻碍与该结构接触的组织和第一植入物部件10之间的相对运动。它可以是第一植入物部件本体的集成结构、涂层或优选地借助于增材制造添加的结构。
第一植入物部件10包括位于例如该部件的远端部的第一接口部分20(参见附图)。应当指出的是,第二接口部分25(即,在所示实施例中,经由接口表面26到关节构件60的连接)可以基于将在下文中关于第一接口部分20描述的相同原理。尽管如此,在所示的示例中,第一植入物部件与关节构件之间的连接是使用渐缩的连接来建立的,该渐缩的连接经由***关节组装通道13中的紧固螺钉(未示出)而被紧固并且锁定。关节组装通道13沿着这个凹部的纵向轴线从由接口表面26限定的渐缩的凹部延伸到与渐缩的凹部所在的一侧相对的一侧。优选地,关节组装通道13包括用于与前述紧固螺钉接合的螺纹。
如上所述,第一植入物部件10可以具有形成为凹部或腔的许多结构特征。为了在一个植入物部件中提供这些结构特征,特别是接口部分20、25提供给其他植入物部件(通常需要最大空间),这些结构特征优选地被设计为需要较少空间。
这将在下文中特别地关于提供紧密且牢固的连接以及紧凑构造的组装通道11和第一接口部分20进行描述。这在图4中示出的部分组装的关节置换物部件1(即植入物部件组件)的横截面中最佳可见。在这个图中,第一接口部分20采用组装螺钉34,该组装螺钉34将第二植入物部件50附接到第一植入物部件10。该示例性实施例的第二植入物部件50是待锚定在患者长骨(在本实施方式中为肱骨)的准备腔内的植入物柄。
如图4所示,第一接口部分20的接口表面21优选地限定了用于到第二植入物部件50的渐缩的连接的渐缩的接口表面。已经证明这种渐缩的连接形成与另一植入物部件的可靠连接。然而,为了防止植入物部件连接的任何问题,诸如松动或侵蚀等,本实施例包括组装螺钉30。该组装螺钉30允许紧固由第一接口部分20提供的到另一植入物部件(诸如第二植入物部件50等)的连接。特别是在渐缩的连接的情况下,组装螺钉30提供确保渐缩的连接的永久自锁定的压缩的连接力。这是通过用预定扭矩紧固组装螺钉30抵靠在形成螺钉保持单元40的一部分的螺钉座41上来实现的。这种预定的紧固通常不能通过使用锤击来组装渐缩的连接的常用技术来实现。
为了紧固,第二植入物部件50包括具有接口表面53的接口部分51。接口表面优选地形成对应于第一接口部分20的渐缩部,特别是锥形渐缩部。接口部分51还包括螺纹孔52,优选地为盲孔(未示出),该螺纹孔52在近端-远端方向上延伸并且与延伸穿过螺钉座41的通孔42的纵向轴线L对准。螺纹孔52被形成用于接合组装螺钉30的螺纹部分33。在紧固和锁定第一植入物部件10和第二植入物部件50之间的连接期间,第二植入物部件50的第二接口部分51被拉入到第一植入物部件10的第一接口部分20内。将第一接口部分20和第二接口部分朝向彼此拉动允许接口的比锤击更有引导的且更稳定的组装。应注意,凸形接口部分和凹形接口部分51和20可以被配置成反过来也这样的。
螺钉座41优选地形成为用于安装到第一植入物部件10的单独的部分。在图4所示的实施例中,螺钉座41被容纳在容纳部分12中,容纳部分12是邻近于并且优选地直接邻近于第一接口部分20的接口表面21形成的。换言之,当从第一接口部分20观察时,容纳部分12位于比接口表面21更靠近第一植入物部件10的内部。容纳部分12形成为从由渐缩的接口表面21形成的凹部延伸到第一植入物部件10的近端的组装通道11的一部分。尽管优选地,接口部分20和组装通道是对齐的,但是它们也可以具有平行偏移。尽管如此,在这两种情况下,它们应当被对齐以便允许将接口部分并且因此将植入物部件朝向彼此拉动。
如前所述,螺钉座41可以通过形状配合和/或摩擦配合安装到第一植入物部件10。在图4的示例性实施例中,螺钉座41被***到容纳部分12中并且通过容纳部分12的内周向表面与螺钉座41的外周向表面之间的螺纹接合而被紧固抵靠组装通道11中的座邻接台阶46或肩部。为了紧固螺钉座41,螺钉座41优选地在面向接口部分20或第二植入物部件50的一侧上包括工具接合接口(未示出)。
螺钉座41的背离接口部分20的一侧形成用于组装螺钉30的螺钉头31的支撑表面。螺钉座41的该侧也是邻接抵靠组装通道11的前述座邻接台阶46的一侧。在组装通道11的该位置处,组装通道11的直径从容纳部分12的直径减小到用于容纳螺钉头31的直径。该直径允许螺钉头31围绕上述纵向轴线L旋转以便紧固和松动与第二植入物部件50的螺纹孔52的螺纹接合。
如前所述,螺钉保持单元40的螺钉座41可以可替代地与第一植入物部件10一体形成。在这种情况下,通孔41可以具有螺纹(未示出),该螺纹相对于组装螺钉的螺纹部分33的螺纹在相反方向上起作用。如上所述,螺纹部分33用于与第二植入物部件50的螺纹孔51接合。例如,螺纹部分33可以具有右旋螺纹,而螺钉座的通孔42的螺纹具有左旋螺纹。为了接合后者,组装螺钉30的螺钉头31还设置有左旋螺纹。
在组装期间,通过将螺钉头31的左旋螺纹拧入螺钉座41的左旋螺纹通孔中来将组装螺钉30从第一接口部分20的一侧***。螺钉头31的拧入继续,直到螺钉头31的左旋螺纹已经完全穿过和脱离连接左旋螺纹通孔。在这种状态下,组装螺钉的螺钉杆33的无螺纹部分34面向左旋螺纹而没有任何接合。这使得组装螺钉31被系留在螺钉座41的通孔42中,螺钉座41在螺钉头31的左旋螺纹与螺钉杆的螺纹部分33的右旋螺纹之间。此外,当植入物部件40和50彼此紧固时,左旋螺纹将不接合。相反,螺钉头31的左旋螺纹将由螺钉座41的左旋螺纹支撑。如本领域技术人员将理解的,来自上方的左旋螺纹可以可替代地被提供为右旋螺纹,反之亦然。
如图4所示,组装通道11进一步包括螺钉止挡件43,该螺钉止挡件43被形成为组装通道11内的台阶。螺钉止挡件43引起组装通道的直径的减小,这防止了组装螺钉30的螺钉头31穿过通道的邻近部分,即在图4的实施例中,该通道的近端部分。螺钉止挡件43和螺钉座41在组装通道11内形成用于系留螺钉头31的系留部分44。因此,螺钉保持单元40防止了组装螺钉30在任一方向上穿过组装通道11。
更具体地,组装螺钉30以其背向接口部分20的端部邻接在螺钉止挡件43处。在该端部,组装螺钉30包括工具接合接口45,对于紧固工具70,该工具接合接口45可以从与朝向接口部分20打开的组装通道11的一侧相对的组装通道11的一侧触及。如上所述,在系留部分44的另一端部处,螺钉头31由螺钉座41的背离接口部分20的表面支撑。
系留部分44沿着纵向轴线L的延伸具有这样的长度,该长度允许组装螺钉30围绕纵向轴线L旋转并且确保在组装好的状态下,螺钉杆32穿过螺钉座41的通孔42。具体地,组装通道11的系留部分44的长度被配置成使得当螺钉31邻接抵靠螺钉止挡件31时,螺钉杆32的螺纹部分33至少部分地从螺钉座41在面向第二植入物部件50的一侧上延伸。
如上所述,第一植入物部件10优选在沿着纵向轴线L从接口表面21到用于紧固工具70的组装通道11的入口的方向上包括以下顺序的上述特征:由第一接口部分20的接口表面21限定的渐缩的凹部,用于螺钉座41的容纳部分12、用于组装螺钉30的螺钉头31的系留部分44以及直到前述组装通道11的入口的组装通道11的剩余部分(在本实施例中位于第一植入物部件10的近端部处)。应注意,在接口部分20形成为凸形接口部分的情况下,螺钉座41可与该接口部分一体形成。
在相同的方向上,接口部分20和组装通道11相对于彼此具有以下内径。在接口表面21限定凹部的情况下,该凹部的内径大于或基本上等于容纳部分12的内径。在接口表面21形成突出部的情况下,螺钉座41可与该突出部一体形成。此外,容纳部分12的直径大于系留部分44的直径。系留部分44的直径进而至少部分地大于直到这个通道的紧固工具入口的组装通道11的剩余部分的直径。
接口部分20、螺钉座41、组装螺钉30和组装通道11的这种布置改善了第二植入物部件50的组装和拆卸。更具体地,组装螺钉30确保如上所述的第一植入物部件10和第二植入物部件50之间的紧密连接。通过提供牢固且可靠的连接,该连接相当紧密,这使得难以拆卸植入物部件10和50,特别是如果接口表面21、53或接口部分20、51形成渐缩的连接。在此,将组装螺钉30并且特别是螺钉头31系留在系留部分44中引起在松动组装螺钉30时将第二植入物部件50推离第一植入物部件10。这是由螺钉头31移动脱离与螺钉座41的接触并邻接抵靠螺钉止挡件43引起的。邻接螺钉止挡件43时,进一步松动组装螺钉30,通过与螺纹孔52的接合而将第二植入物部件50推得更远。因此,组装螺钉30的系留配置有利地帮助第一植入物部件10和第二植入物部件50的组装和拆卸。
此外,这种布置具有以下优点:组装通道11可以被配置成在延伸穿过第一植入物部件10的同时具有较小的直径,因为仅紧固工具必须穿过这个通道用于接合工具接口凹部而不是螺钉头31。这使得用于该部件的设计更加自由。在本实施例的情况下,可在第一植入物部件10的本体中形成多个凹部和孔以为该部件提供用于关节置换物的所需功能。
例如,在附图中示出的第一植入物部件10的实施例被配置成至少部分地从骨组织突出并且用作围绕我们经过第一植入物部件10的软组织结构的附接结构。可替代地,第一植入物部件10还可以被配置为被植入骨组织中而无需用于软组织的任何附接结构。如本领域技术人员将理解的,对于第一植入物部件10的这样的实施例,该部件的外表面然后可以适配于骨向内生长或经由骨结合剂锚定植入物部件。
此外,示例性实施例的关节置换物构件1是用于附接到患者的肱骨的肩关节置换物构件。然而,技术人员将了解,以上和以下描述还可以应用于患者的其他滑膜关节(例如上面列出的滑膜关节)的关节置换物。
至少所系留的组装螺钉30优选地在第一植入物部件10的植入之前被预组装。对于该预组装,组装螺钉30的螺钉杆32***到螺钉座41的通孔42中。然后,将组装螺钉30和螺钉座41***到由接口表面21(或者如果接口表面21限定突出部,则优选地与接口表面21一起)限定的凹部中,以用于接合容纳部分12。如上所述,在示出的示例性实施方式中,螺钉座41与接合部分12之间的接合是螺纹接合。然而,任何其他形式的接合(诸如压配合或卡扣配合等)也是可能的。优选地,螺钉座41邻接组装通道11内的座邻接台阶以限制螺钉座41的***程度。然而,用于限制***到组装通道11中的任何其他装置可以用于实现这个目的(例如,有限的螺纹、粘合剂、销、保持环等)。一旦螺钉座41被固定到第一植入物部件10,组装螺钉30被系留在由组装通道11形成的系留部分44和螺钉座41内。
预组件还可以包括到第二植入物部件50的组件。为了组装到第二植入物部件50,使第二植入物部件50的接口部分51与第一植入物部件10的第一接合部分20接合。在这种接合过程中,使组装螺钉30与第二植入物部件50的螺纹通孔52接合并且优选地使用紧固工具70以预定的扭矩紧固以便在第一植入物部件10与第二植入物部件50之间提供牢固的连接。如前所述,接口部分20、51优选地形成有渐缩的接口表面21、53,其中这些渐缩的接口表面中的一个径向地面向外,而这些渐缩的接口表面中的另一个径向地面向内。
此外,将第一植入物部件10从第二植入物组件50拆卸可能是必要的或至少有利的。如果在解剖学配置(诸如软组织结构的缩短或延长等)中存在变化或由于软组织的过度填充或撞击,则这种拆卸可能变得必要。该植入物部件组件相对于第一植入物部件10的优点以及通过这种组件能够实现到另一植入物部件50的连接是不必移除关节置换物部件1的一部分(诸如植入物柄等)但可以保持锚定在患者的组织内。这具有保留组织的优点,因此对患者更温和。
为了拆卸第一植入物部件10和第二植入物部件50,紧固工具70像在紧固组装螺钉30过程中一样通过前述的入口进入到组装通道11中,但是这次紧固工具70用于将组装螺钉30从第二植入物部件50松动和拧下。如上所述,这使得组装螺钉30将第一植入物部件10推离第二植入物部件50。这种推离动作仅在两个植入物部件之间发生,而不使用患者的任何周围组织结构作为支撑。这使得在植入物部件(诸如关节构件60和/或第一植入物部件10等)修整的情况下对患者的应力和组织损害减小。
图5和图6示出了利用第一植入物部件10的关节置换物部件101的另一实施例。该第一植入物部件10优选如上述实施例中的任一个配置。与先前附图中并且特别是图1和图2中所示的实施例不同,关节构件160具有与图1和图2中所示的关节构件60不同的配置。更具体地,关节构件160包括形成为倾斜镶嵌件的中间部分162,以用于接收包括凹形关节表面164的关节部分161。关节置换物部件的这种配置表示反向肩关节的肱骨部件,并且优选地使用与解剖的关节置换物相同的接口配置。
附图标记以下是在说明书和附图中使用的附图标记的最后两位数的列表。如以上提到的和在整个附图中,这些附图标记是指具有相同或等效功能和/或结构的特征。
1关节置换物部件
10第一植入物部件
11组装通道
12容纳部分
13关节组装通道
14缝合线孔
15缝合线凹槽
16工具接合凹部
17锚定结构
20第一接口部分
21渐缩的接口表面
25第二接口部分
26接口表面
27凹形接口表面
28分度孔
30组装螺钉
31螺钉头
32螺钉杆
33螺纹部分
34无螺纹部分
35工具接口凹部
40螺钉保持单元
41螺钉座
42通孔
43螺钉止挡件
44系留部分
45工具接合接口
46座邻接台阶
50第二植入物部件
51接口部分
52螺纹孔
53接口表面
60关节构件
61关节部分
62中间部分
63凸形接口表面
65关节固定螺钉
70紧固工具
L纵向轴线
d1组装通道的直径
d2螺钉头的直径
Claims (15)
1.一种用于关节置换物的植入物部件组件(1),所述组件包括:
植入物部件(10),所述植入物部件包括用于附接另一植入物部件(50)的接口部分(20)和组装通道(11),
组装螺钉(30),所述组装螺钉(30)用于将所述另一植入物部件固定到所述植入物部件,所述组装螺钉具有纵向轴线(L)、螺钉头(31)以及螺钉杆(32)并且所述组装螺钉能够***到所述组装通道中,
螺钉保持单元(40),所述螺钉保持单元(40)被配置成用于将所述组装螺钉保持在所述组装通道内并且允许所述组装螺钉围绕所述纵向轴线旋转。
2.根据权利要求1所述的植入物部件组件(1),其中,所述螺钉保持单元(40)包括用于支撑所述螺钉头(31)的螺钉座(41),所述螺钉座包括用于容纳所述螺钉杆(32)的通孔(42)。
3.根据权利要求2所述的植入物部件组件(1),其中,所述组装通道(11)包括容纳部分(12),并且所述螺钉座(41)能够***到所述容纳部分中。
4.根据权利要求3所述的植入物部件组件(1),其中,所述螺钉座(41)通过形状配合、摩擦配合和/或焊接固定在所述容纳部分(12)内。
5.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述螺钉保持单元(40)包括螺钉止挡件(43),所述螺钉止挡件优选地形成为所述组装通道(11)的台阶。
6.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述组装通道(11)的直径(d1)小于所述螺钉头的直径(d2)。
7.根据从属于权利要求2至4中任一项所述的权利要求5或6所述的植入物部件组件(1),其中,在所述螺钉座(41)与所述螺钉止挡件(43)之间的空间在所述纵向方向(L)上的延伸大于所述螺纹头(31)在所述纵向方向(L)上的延伸。
8.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述植入物部件(10)的所述接口部分(20)包括用于安装所述另一植入物部件(50)的渐缩的接口表面(21),所述渐缩的接口表面优选地限定凹部。
9.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述组装螺钉(30)的所述螺钉杆(32)具有螺纹部分(33)和无螺纹部分(34),所述无螺纹部分位于所述螺纹部分与所述螺钉头(31)之间。
10.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述植入物部件(10)进一步包括用于附接关节构件(60)的另一接口部分(25),所述另一接口部分被形成为凹部,优选渐缩的凹部,并且甚至更优选地包括关节组装通道(13),所述关节组装通道(13)被定尺寸成用于容纳用于固定所述关节构件的关节固定螺钉(65)。
11.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述植入物部件(10)进一步包括用于将软组织固定至所述植入物部件的至少一个缝合线孔(14)和/或至少一个缝合线凹槽(15)。
12.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述植入物部件(10)还包括用于接合操纵工具以在外科手术期间操纵所述植入物部件的操纵工具接合凹部(16)。
13.根据前述权利要求中任一项所述的植入物部件组件(1),其中,所述组装螺钉(30)包括工具接口凹部(35),所述工具接口凹部(35)形成为用于紧固工具(70)在围绕所述组装螺钉的所述纵向轴线(L)的旋转方向上的接合。
14.一种用于预组装根据前述权利要求中任一项所述的关节置换物的植入物部件组件(1)的方法,所述方法包括以下步骤:
提供包括组装通道(11)和接口部分(20)的植入物部件(10),其中,所述组装通道被形成为通孔并且从所述植入物部件的近侧延伸至所述接口部分;
提供螺钉座(41),所述螺钉座包括通孔(42);
提供具有纵向轴线(L)、螺钉头(31)和螺钉杆(32)的组装螺钉(30);
将所述组装螺钉的螺钉杆***所述螺钉座的通孔中;
将组装好的所述螺钉座和具有所述螺钉头的组装螺钉从所述接口部分的一侧首先***到所述组装通道的容纳部分(12)中;以及
将所述螺钉座固定在所述组装通道的容纳部分内。
15.根据权利要求14所述的预组装方法,进一步包括以下步骤:
提供另一植入物部件(50),特别是植入物柄,所述另一植入物部件包括与所述植入物部件(10)的所述接口部分(20)对应的接口部分(51)和用于与所述组装螺钉(30)接合的螺纹孔(52);
经由它们的接口部分连接所述植入物部件;以及
经由紧固所述组装螺钉将所述植入物部件彼此固定。
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EP19216469.7A EP3838225A1 (en) | 2019-12-16 | 2019-12-16 | Implant component assembly |
EP19216469.7 | 2019-12-16 | ||
PCT/EP2020/086181 WO2021122568A1 (en) | 2019-12-16 | 2020-12-15 | Implant component assembly |
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EP (1) | EP3838225A1 (zh) |
JP (1) | JP2023505340A (zh) |
KR (1) | KR20220129558A (zh) |
CN (1) | CN114786623A (zh) |
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FR2802799B1 (fr) * | 1999-12-23 | 2002-08-16 | Depuy France | Ensemble de prothese d'epaule |
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KR20220129558A (ko) | 2022-09-23 |
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