WO2020155377A1 - 半月板替代物及具有其的膝关节假体 - Google Patents
半月板替代物及具有其的膝关节假体 Download PDFInfo
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- WO2020155377A1 WO2020155377A1 PCT/CN2019/081496 CN2019081496W WO2020155377A1 WO 2020155377 A1 WO2020155377 A1 WO 2020155377A1 CN 2019081496 W CN2019081496 W CN 2019081496W WO 2020155377 A1 WO2020155377 A1 WO 2020155377A1
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- meniscus
- soft tissue
- layer
- suture
- integration
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- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
- A61F2002/30899—Protrusions pierced with apertures
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2002/3093—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth for promoting ingrowth of bone tissue
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30968—Sintering
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30971—Laminates, i.e. layered products
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2002/3895—Joints for elbows or knees unicompartimental
Definitions
- the present invention relates to the field of medical prostheses, in particular to a meniscus substitute and a knee joint prosthesis having the same.
- the knee joint is the largest and most complex joint in the human body.
- the main structure of the knee joint includes the lower end of the femur (femoral condyle), the upper end of the tibia (tibial plateau), and the articular surface between the patella.
- the reason why the knee joint can move freely without dislocation is mainly due to the anterior and posterior cruciate ligaments, The medial collateral ligament, the lateral collateral ligament, the joint capsule and the tendons attached to the joints provide stability of the joint.
- the meniscus is composed of fibrocartilage and is located in the joint space of the knee joint.
- the structure of the meniscus is semi-circular, with a thick outer periphery and a thin and sharp inner edge; the upper surface is concave, which is compatible with the femoral condyle; the lower surface is flat, which is compatible with the tibial plateau.
- the meniscus is mainly attached to the tibia, but it can move with the femur in a certain range. Its shape fills up the gap between the tibial condyle and femoral condyle, increases the stability of the joint, and prevents the surrounding soft tissue from being squeezed into the joint .
- Meniscus replacements currently used by researchers include autologous tissue transplantation to regenerate meniscus, allogeneic meniscus transplantation, xenograft replacement, and artificial synthetic material transplantation replacement.
- autologous tissue transplantation to replace the total meniscus is not yet satisfactory.
- the curative effect of allogeneic meniscus transplantation is far from proven.
- the meniscus lacks blood supply and can shield most of the immune system problems, the lack of blood supply also leads to extremely low repair capabilities, and there is a shortage of sources and transportation. A series of questions such as preservation. Xenogeneic tissue transplantation is facing more research and challenges, and there is still a long way to go before entering the clinic.
- the present invention aims to provide a meniscus replacement and a knee joint prosthesis having the same, so as to solve the unsatisfactory treatment effect caused by the instability of the meniscus replacement and the instability of the bone combination in the prior art. problem.
- a meniscus substitute including: a base body, which is arranged on the tibial plateau or tibial plateau prosthesis of the tibia; and a polymer joint body, which is arranged on the base body Upper; bone screw, inserted in the tibia and connected with the base body.
- the base body includes an integration layer, an isolation layer and a fusion layer.
- the fusion layer can contact and fuse with the polymer joint body.
- the human tissue around the meniscus replacement can grow into the integration layer.
- the isolation layer is set in the fusion layer and the integration layer. between.
- the isolation layer includes a bottom wall and a side wall arranged at an angle, the bottom wall corresponds to the tibia, and the side wall corresponds to the soft tissue around the meniscus replacement.
- the integrated layer includes a bone tissue integration part and a soft tissue integration part. The part is arranged on the bottom wall, and the soft tissue integration part is arranged on the side wall.
- the base body further includes a soft tissue fixing part, the soft tissue fixing part is arranged on the sidewall of the isolation layer and passing through the soft tissue integration part, the soft tissue fixing part includes a suture groove and a suture column arranged in the suture groove, a suture groove and a suture The post forms a passage for the suture thread to pass through, so that the soft tissue can be tied and fixed on the suture post.
- the base body includes a base body and an integrated layer.
- the surface of the base body facing the polymer joint body is provided with a clamping groove
- the polymer joint body is provided with a clamping protrusion that matches the clamping groove
- the base body faces away from the
- the surface of the polymer joint body is provided with an integration layer
- the part of the integration layer facing the tibial bone bed is the bone tissue integration part
- the part of the integration layer facing the surrounding soft tissue is the soft tissue integration part.
- the base body further includes a soft tissue fixing part, the soft tissue fixing part is arranged on the base body, the soft tissue fixing part includes a suture groove and a suture column arranged in the suture groove, the suture groove and the suture column form a passage for the suture thread to pass through, So that the soft tissue can be tied and fixed on the suture post.
- the integration layer and/or the fusion layer have a porous structure.
- the pore size of the porous structure of the bone tissue integration part is between 150 ⁇ m and 1200 ⁇ m, and the pore size of the porous structure of the soft tissue integration part is between 400 ⁇ m and 2000 ⁇ m.
- the integration layer and/or the fusion layer are made by 3D printing technology.
- the integration layer and/or the fusion layer are made by metal particle sintering technology.
- the side of the base body facing the tibial bed is provided with a positioning convex portion
- the positioning convex portion is provided with a first threaded hole adapted to the bone screw
- the tibial plateau or the tibial plateau prosthesis is provided with a positioning convex
- the second threaded hole for assembling the bone screw is arranged in the positioning concave part that is matched with the part of the tibia.
- both ends of the bone screw are respectively provided with a first thread and a second thread
- the first thread is used to fit with the first threaded hole of the positioning protrusion
- the second thread is used to fit with the second threaded hole on the tibia.
- the nominal diameter of the second thread is not less than the nominal diameter of the first thread.
- bone screws are made of medical metal, and bone screws of appropriate length can be selected according to the needs during the operation.
- the bone screw is made of absorbable medical polymer materials, such as polyglycolide-lactide (PLGA), polylactic acid (PLA), polycaprolactone (PCL) and the like.
- PLGA polyglycolide-lactide
- PLA polylactic acid
- PCL polycaprolactone
- a knee joint prosthesis including a meniscus substitute, and the meniscus substitute is the above-mentioned meniscus substitute.
- the bone screw is inserted into the tibial structure and the polymer joint body is arranged on the base body and matched with the femoral structure.
- the bone screw and the base body enable the meniscus replacement to be effectively fixed on the tibial structure, preventing it from exceeding the expected displacement and deformation on the tibial structure.
- the surface of the polymer joint body facing the femoral structure is similar to the native meniscus and can deform to a certain extent with the rotation and compression of the femoral structure, thereby ensuring the area of contact with the femur and avoiding aggregation Local overwork and injury of the joint body of the animal will affect the overall use effect and service life of the meniscus replacement.
- Figure 1 shows a schematic diagram of the first embodiment of the meniscus substitute according to the present invention on the tibia
- Figure 2 shows a schematic diagram of the structure of the meniscus replacement of Figure 1 separated from the tibia
- Fig. 3 shows an enlarged schematic diagram of a partial structure of the meniscus substitute of Fig. 2;
- Fig. 4 shows a schematic diagram of the B-direction structure of the meniscus replacement of Fig. 3;
- Fig. 5 shows a schematic structural diagram of the meniscus replacement of Fig. 2 from another perspective
- Fig. 6 shows a schematic diagram of the A-A sectional structure of the meniscus replacement of Fig. 2;
- Fig. 7 shows a schematic diagram of the front view of the meniscus substitute of Fig. 1 between the femur and the tibia;
- Fig. 8 shows a schematic side view of the structure of the meniscus replacement of Fig. 7 from another perspective
- Fig. 9 shows a schematic top view of the structure of the meniscus replacement of Fig. 7;
- Figure 10 shows a schematic structural view of the second embodiment of the meniscus replacement according to the present invention.
- FIG. 11 shows a schematic structural diagram of Embodiment 3 of the meniscus replacement according to the present invention.
- Fig. 12 shows a schematic structural diagram of the meniscus replacement of Fig. 11 from another perspective
- Fig. 13 shows a schematic sectional view of the meniscus substitute of Fig. 12 between the femur and the tibia;
- Figure 14 shows several bone screws suitable for the meniscus replacement of the present invention.
- FIGS 15-18 show schematic diagrams of the installation process of the first embodiment of the meniscus replacement of the present invention.
- Base body 11. Integration layer; 111. Bone tissue integration part; 112. Soft tissue integration part; 12. Fusion layer; 13. Isolation layer; 14. Soft tissue fixation part; 141. Suture groove; 142. Suture column; 15. Base body; 16. Clamping groove; 17, positioning protrusion; 18, first threaded hole; 20, polymer joint body; 30, bone screw; 41, punching template; 42, first positioning backing plate; 43 , The second positioning backing plate; 44, positioning hole; 45, punch; 46, drilling template; 47, positioning pin; 48, guide hole; 50, suture line; 60, ligament; 70, femoral structure; 80, half moon Plate; 90, tibial structure; 91, positioning recess; 92, second threaded hole; 93, cortical bone; 94, cancellous bone.
- the meniscus replacement of the first embodiment includes a base body 10, a polymer joint body 20 and a bone screw 30.
- the base body 10 is arranged on the tibial plateau or tibial plateau prosthesis of the tibia
- the polymer joint body 20 is arranged on the base body 10
- the bone screw 30 is inserted in the tibia and is connected with the base body 10 and the tibial bone. Connected.
- the polymer joint body 20 is arranged on the base body 10 and matched with the femoral structure, the bone screw 30 is inserted into the tibia and is threadedly connected with the base body 10 and the tibia, respectively, and the bone screw 30 And the base body 10 enables the meniscus replacement to be effectively fixed on the tibial structure 90, preventing it from displacement and deformation beyond expectations on the tibial structure 90.
- the surface of the polymer joint body 20 facing the femoral structure is similar to the native meniscus and can be deformed with the rotation of the femoral structure, thereby ensuring a fit area with the femur and avoiding polymer joints Part of the body 20 is overworked and damaged, which affects the overall use effect and service life of the meniscus replacement.
- the bone screw 30 can be selected from several types of screws shown in FIG. 14. As shown in FIGS. 1 to 9, both ends of the bone screw are provided with a first thread 31 and a second thread respectively.
- the first thread 32 is used for fitting with the first threaded hole 18 of the positioning protrusion 17 of the base body 10, and the second thread 32 is used for fitting with the second threaded hole 92 on the tibia.
- the first thread 31 is preferably a conventional cylindrical thread, and the thread pitch is preferably between 0.15 mm and 3 mm;
- the second thread 32 can be a conventional cylindrical thread or a taper thread, and the thread direction and pitch of the thread are the same as those at one end of the positioning protrusion 17
- the thread direction and pitch are the same, and the second thread 32 butted with the cortical bone 93 is provided with a self-tapping cutting edge.
- the end of the bone screw 30 corresponding to the cortical bone 93 can also be provided with a screw cap to provide greater restraining force when the strength of the local cortical bone of the patient is insufficient.
- the base body 10 is made of medical metal and/or medical ceramics that can be implanted into the human body, such as titanium-based, cobalt-based, nickel-based, magnesium-based, tantalum, and other alloy materials, austenitic Body stainless steel, etc.
- the polymer joint body 20 is made of medical polymers (such as but not limited to polyethylene, polytetrafluoroethylene, polyurethane, carbon fiber polymer, etc.) that can be implanted into the human body through molding and machining methods.
- a joint body locking structure corresponding to the base body 10 is provided to ensure the connection and fixation between the polymer joint body 20 and the base body 10.
- the bone screw 30 is made of medical metal and/or absorbable medical polymer material that can be implanted into the human body. The bone screw 30 connects and fixes the base body 10 and the tibia bone by thread positioning.
- the base body 10 of this embodiment includes an integrated layer 11, an isolation layer 13 and a fusion layer 12.
- the integration layer 11 and the fusion layer 12 are porous structures made by 3D printing technology or metal and ceramic sintering technology.
- the pore size range of the fusion layer 12 is preferably between 500 ⁇ m and 3000 ⁇ m. This pore size range is convenient for manufacturing the polymer joint body 20.
- a compression molding method is used to pressurize the polymer material into the pores of the porous structure, and the polymer joint body 20 and the base body 10 are finally fused into a whole through the thermoplastic or thermosetting molding process to strengthen the polymer joint body 20 and base body 10 connection strength.
- the thickness of the partition wall or the connecting wire diameter between the holes of the fusion layer 12 is preferably Between 0.5mm and 3mm.
- the isolation layer 13 is a layer of solid metal or ceramic and is arranged between the fusion layer 12 and the integration layer 11. Its thickness is preferably between 0.2 mm and 2 mm, and is used to prevent unexpected infiltration and occupation of polymer materials during the molding process The pore space between the integration layer 11 and the fusion layer 12 of the base body 10.
- the tissue surrounding the meniscus replacement can also grow into the integration layer 11.
- the isolation layer 13 includes an angled bottom wall and side walls, the bottom wall corresponds to the tibial structure 90, and the side walls correspond to the soft tissue around the meniscus substitute.
- the integration layer 11 includes a bone tissue integration part 111 and a soft tissue integration part 112.
- the bone tissue integration part 111 is provided on the bottom wall.
- the bone tissue integration part 111 can interact with the patient's tibia.
- the bone surface of the bone is attached so that the tibia bone can grow into the pores of the bone tissue integration part 111.
- the soft tissue integration part 112 is arranged on the side wall, which is also conducive to soft tissue growth.
- the pore size of the porous structure of the bone tissue integration part 111 of this embodiment is between 150 ⁇ m and 1200 ⁇ m, and this pore size range is favorable for inducing bone cells to grow in to form confluent bone tissue integration.
- the pore size of the porous structure of the soft tissue integration portion 112 is between 400 ⁇ m and 2000 ⁇ m, and this pore size range is conducive to inducing soft tissue cells to grow in to form confluent soft tissue integration.
- the integration layer and the fusion layer can also be obtained by other technical means, such as plasma spraying, metal particle sintering, laser drilling, high-energy beam cladding, etc. Structure or other structures that facilitate the growth of bone tissue and soft tissue.
- the base body 10 of this embodiment further includes a soft tissue fixing part 14, which is arranged on the side wall of the isolation layer 13. Go up and out of the soft tissue integration part 112.
- the soft tissue fixing part 14 includes a suture groove 141 and a suture post 142 arranged in the suture groove 141.
- the suture groove 141 and the suture post 142 form a passage for the suture needle and suture thread to pass in and out, so that the soft tissue can be tied and fixed on the suture post. 142 on.
- the suture post 142 provides a mechanical fulcrum for binding and fixing the suture, so that soft tissues such as ligaments can be closely attached to the porous structure of the soft tissue integration portion 112. During postoperative healing, the soft tissues such as ligaments can grow into the voids of the porous structure.
- the base body 10 of this embodiment is provided with a positioning protrusion 17 on the side facing the tibia.
- the positioning protrusion 17 is provided with a first threaded hole 18, and the first threaded hole 18 It is matched with the first thread 31 of the bone screw 30.
- the tibial structure 90 is provided with a positioning concave portion 91 that is adapted to the positioning convex portion 17, and the tibial structure 90 is provided with a second threaded hole 92 for assembling the bone screw 30, and the bone screw 30 penetrates into the tibial structure from the second threaded hole 92 90 and the first threaded hole 18 and the second thread 32 at the tail end of the bone screw 30 is matched with the second threaded hole 92 in the tibial structure 90.
- the tibial structure 90 is the patient's tibia. In other embodiments not shown in the figure, the tibial structure may also be a tibial prosthesis set on the patient's tibia.
- the meniscus replacement of this embodiment has a "C" shape as a whole, and can completely replace the patient's inner and outer meniscus.
- each meniscus substitute is provided with two positioning protrusions 17, and the two positioning protrusions 17 are respectively provided on the front and rear corners of the meniscus substitute, so that the meniscus The substitute is closer to the mechanical form of the original meniscus.
- the bone screw 30 obliquely penetrates into the cancellous bone 94 of the tibial structure 90, one end of the bone screw 30 is connected and fixed with the base body 10, and the other end is connected and fixed with the cortical bone 93 of the tibial structure 90.
- the polymer joint body 20 is arranged on the base body 10 and is in contact with the femoral structure 70. Under the action of the patient's own weight load G, the femoral structure 70 and the tibial structure 90 approach each other, and squeeze the polymer joint body 20 to generate a forward bulging force f1 and a forward bulging force f2 of the meniscus substitute. At this time, the two positioning protrusions 17 will transmit the above-mentioned bulging force to the cortical bone 93 of the tibial structure 90 through the respective bone screws 30 and generate a restraining force F1' and a restraining force F2', and the bulging force and the restraining force are offset to make The meniscus replacement is stable.
- the positioning protrusions on the meniscus substitute may also be provided with one or more according to the size of the meniscus substitute.
- the meniscus replacement of the second embodiment has changed the structural form of the base body 10 and the connection mode with the polymer joint body 20.
- the base body 10 of the second embodiment includes a base 15 and an integrated layer 11.
- the integrated layer 11 is arranged on the side of the base 15 facing the tibia, so that the soft tissue around the meniscus substitute can contact and fuse with the integrated layer 11. .
- the surface of the base 15 facing the polymer joint body 20 is provided with a clamping groove 16, and the polymer joint body 20 is provided with a clamping protrusion 26 that matches the clamping groove 16.
- the connection and fixation between the base support body 10 and the polymer joint body 20 is achieved by the engagement of the engagement protrusion 26 and the engagement groove 16.
- the soft tissue fixing portion 14 in this embodiment is on the base 15, and the suture groove 141 and suture post 142 of the soft tissue fixing portion 14 have the same structure and function as the first embodiment.
- the suture groove 141 and the suture post 142 form a suture thread.
- the meniscus substitute of the third embodiment has changed its alternative manner.
- the meniscus substitute of the third embodiment only replaces a part of the patient’s original meniscus 80, and its overall structure It is basically the same as the meniscus replacement of the first embodiment.
- one end of the bone screw 30 penetrates the cancellous bone 94 and is connected with the positioning protrusion, and the other end is fixed on the cortical bone 93.
- the ligament 60 is tied to the suture post 142 by the suture 50.
- the femoral structure 70 relative to the meniscus substitute may generate a horizontal movement force Fh, and the inner side of the meniscus substitute with P as the fulcrum may generate a vertical upward force f3.
- the above-mentioned force can be transmitted to the cortical bone 93 through the bone screw 30 and generate a vertical downward reaction force f3' and a horizontal leftward reaction force Fh' to stabilize the meniscus substitute.
- Figures 15 to 18 show the operation process of the meniscus substitute in the first embodiment of the present invention.
- the punching template 41 is stabilized by the first positioning backing plate 42 and the second positioning backing plate 43
- the punch 45 passes through the positioning hole 44 on the punching template 41 to determine the position of the positioning convex portion on the tibial structure 90, and drill the positioning concave portion at the position.
- the shape of the drilling template 46 is basically the same as that of the punching template 41.
- the guide hole 48 is positioned by extending the positioning pin 47 into the positioning hole 44 and the channel for the bone screw to pass through is drilled.
- the positioning convex part of the prefabricated meniscus substitute is extended into the positioning concave part and the bone screw is installed to complete the implantation of the meniscus substitute.
- the present application also provides a knee joint prosthesis.
- the knee joint prosthesis (not shown in the figure) according to this embodiment includes a meniscus substitute, and the meniscus substitute is a meniscus substitute containing all or part of the above technical structure Things.
- the bone screw is inserted in the tibial structure and connected and fixed with the base body, and the polymer joint body is arranged on the base body and matched with the femoral structure.
- the bone screw and the base body enable the meniscus replacement to be effectively fixed on the tibial structure, preventing it from exceeding the expected displacement and deformation on the tibial structure.
- the surface of the polymer joint body facing the femoral structure is similar to the native meniscus and can deform with the rotation of the femoral structure, thereby ensuring the joint area with the femur and avoiding local polymer joint body. Overwork damage affects the overall use effect and service life of the meniscus replacement.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Physical Education & Sports Medicine (AREA)
- Manufacturing & Machinery (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
一种半月板替代物及具有其的膝关节假体。半月板替代物包括:基托体(10),设置在胫骨的胫骨平台或胫骨平台假体上;聚合物关节体(20),设置在基托体(10)上;骨螺钉(30),穿设在胫骨中并与基托体(10)相连。该半月板替代物有效地解决了现有技术中半月板替代物不能提供有效的约束、与骨质结合的不稳定导致的治疗效果不理想的问题。
Description
本发明涉及医疗假体领域,具体而言,涉及一种半月板替代物及具有其的膝关节假体。
膝关节是人体最大且最复杂的关节。膝关节的主要结构包含股骨下端(股骨髁)、胫骨上端(胫骨平台)、及髌骨之间的关节面,膝关节之所以能活动自如又不会发生脱位,主要是因为前、后交叉韧带、内侧副韧带、外侧副韧带、关节囊及附着于关节附近的肌腱提供了关节的稳定性。此外,胫骨关节内外侧各有一块半月板,半月板由纤维软骨组成,位于膝关节的关节间隙。半月板的结构呈半环形,外周较厚,内缘薄锐;上面凹陷,与股骨髁相适应;下面平坦,与胫骨平台相适应。半月板主要附着于胫骨,但可随股骨作一定范围的移动,其形态填充补偿了胫骨髁面与股骨髁面配合之间的空缺,增加关节的稳定性,并可避免周围软组织被挤入关节。
当前研究者所使用的半月板替代物包括自体组织移植再生半月板、同种异体半月板移植、异种异体组织移植替代、人工合成材料移植替代物。但就目前的研究来看,自体组织移植替代全切半月板效果尚不理想。同种异体半月板移植其疗效远未得到证实,虽然半月板由于缺少血供而可以屏蔽大部分免疫***的问题,但缺少血供也导致其自身的修复能力极低,且存在来源短缺和运输保存等一系列的问题。异种异体组织移植则面临着更多的研究和挑战,距离进入临床还有着极漫长的路要走。在人工合成材料替代半月板的研究领域,人们做了大量的工作,包括可吸收的聚乳酸、聚乙酸;不可吸收的材料聚乙烯、聚四氟乙烯、聚氨酯、碳纤维聚合物等等。在模拟人体生理半月板的结构、力学特性和功能性方面还存在着相当多的问题,包括半月板假体不能与胫骨平台的骨质形成良好的稳定结合,在负重情况下移位,超出预期的变形膨出,不能对股骨髁向前、后、侧方的活动度提供有效的约束等等。
发明内容
本发明旨在提供一种半月板替代物及具有其的膝关节假体,以解决现有技术中半月板替代物不能提供有效的约束、与骨质结合的不稳定导致的治疗效果不理想的问题。
为了实现上述目的,根据本发明的一个方面,提供了一种半月板替代物,包括:基托体,设置在胫骨的胫骨平台或胫骨平台假体上;聚合物关节体,设置在基托体上;骨螺钉,穿设在胫骨中并与基托体相连。
进一步地,基托体包括整合层、隔离层和融合层,融合层能够与聚合物关节体接触融合,半月板替代物周围的人体组织能够长入整合层,隔离层设置在融合层和整合层之间。
进一步地,隔离层包括呈角度设置的底壁和侧壁,底壁与胫骨相对应,侧壁与半月板替 代物周围的软组织对应,整合层包括骨组织整合部和软组织整合部,骨组织整合部设置在底壁上,软组织整合部设置在侧壁上。
进一步地,基托体还包括软组织固定部,软组织固定部设置在隔离层的侧壁上并穿出软组织整合部,软组织固定部包括缝合槽和设置在缝合槽中的缝合柱,缝合槽和缝合柱形成供缝合线穿过的通道,以使软组织能够捆扎固定在缝合柱上。
进一步地,基托体包括基体和整合层,基体朝向聚合物关节体的表面上设置有卡接槽,聚合物关节体上设置有与卡接槽相适配的卡接凸起,基体背向聚合物关节体的表面设置有整合层,整合层朝向胫骨骨床一侧的部分为骨组织整合部,整合层朝向周围软组织的部分为软组织整合部。
进一步地,基托体还包括软组织固定部,软组织固定部设置在基体上,软组织固定部包括缝合槽和设置在缝合槽中的缝合柱,缝合槽和缝合柱形成供缝合线穿过的通道,以使软组织能够捆扎固定在缝合柱上。
进一步地,整合层和/或融合层为多孔结构。
进一步地,骨组织整合部的多孔结构的孔径在150μm至1200μm之间,软组织整合部的多孔结构的孔径在400μm至2000μm之间。
进一步地,整合层和/或融合层通过3D打印技术制成。
进一步地,整合层和/或融合层通过金属颗粒烧结技术制成。
进一步地,基托体朝向胫骨骨床的一侧设置有定位凸部,定位凸部上设置有与骨螺钉相适配的第一螺纹孔,胫骨平台或胫骨平台假体上设置有与定位凸部相适配的定位凹部,胫骨中设置有用于装配骨螺钉的第二螺纹孔。
进一步地,骨螺钉的两端分别设有第一螺纹和第二螺纹,第一螺纹用于与定位凸部的第一螺纹孔适配,第二螺纹用于与胫骨上的第二螺纹孔适配。第二螺纹的公称直径不小于第一螺纹的公称直径。
进一步地,骨螺钉由医用金属制成,在术中可根据需要选用适当长度的骨螺钉。
进一步地,骨螺钉由可吸收的医用高分子材料制成,例如聚乙交酯-丙交酯(PLGA)、聚乳酸(PLA)、聚己内酯(PCL)等。
根据本发明的另一方面,提供了一种膝关节假体,包括半月板替代物,半月板替代物为上述半月板替代物。
应用本发明的技术方案,骨螺钉穿设在胫骨结构中聚合物关节体设置在基托体上并与股骨结构配合。骨螺钉和基托体使半月板替代物能够有效地固定在胫骨结构上,防止其在胫骨结构上发生超出预期的位移和变形。在股骨结构相对胫骨结构活动时,聚合物关节体朝向股骨结构的表面与原生半月板相近并能够随股骨结构的转动压缩而产生一定程度形变,从而保证与股骨之间的贴合面积,避免聚合物关节体局部过劳损伤,影响半月板替代物整体的使用 效果和使用寿命。
构成本申请的一部分的说明书附图用来提供对本发明的进一步理解,本发明的示意性实施例及其说明用于解释本发明,并不构成对本发明的不当限定。在附图中:
图1示出了根据本发明的半月板替代物的实施例一在胫骨上的结构示意图;
图2示出了图1的半月板替代物与胫骨分离的结构示意图;
图3示出了图2的半月板替代物的局部结构放大示意图;
图4示出了图3的半月板替代物的B向结构示意图;
图5示出了图2的半月板替代物在另一视角下的结构示意图;
图6示出了图2的半月板替代物的A-A向剖视结构示意图;
图7示出了图1的半月板替代物在股骨和胫骨之间的主视结构示意图;
图8示出了图7的半月板替代物在另一视角下的侧视结构示意图;
图9示出了图7的半月板替代物的俯视结构示意图;
图10示出了根据本发明的半月板替代物的实施例二的结构示意图;
图11示出了根据本发明的半月板替代物的实施例三的结构示意图;
图12示出了图11的半月板替代物在另一视角下的结构示意图;
图13示出了图12的半月板替代物在股骨和胫骨之间的剖视结构示意图;
图14示出了几种适用于本发明的半月板替代物的骨螺钉;以及
图15-图18示出了本发明的半月板替代物的实施例一的安装过程示意图。
其中,上述附图包括以下附图标记:
10、基托体;11、整合层;111、骨组织整合部;112、软组织整合部;12、融合层;13、隔离层;14、软组织固定部;141、缝合槽;142、缝合柱;15、基体;16、卡接槽;17、定位凸部;18、第一螺纹孔;20、聚合物关节体;30、骨螺钉;41、冲孔模板;42、第一定位靠板;43、第二定位靠板;44、定位孔;45、冲头;46、钻孔模板;47、定位销;48、导向孔;50、缝合线;60、韧带;70、股骨结构;80、半月板;90、胫骨结构;91、定位凹部;92、第二螺纹孔;93、皮质骨;94、松质骨。
需要说明的是,在不冲突的情况下,本申请中的实施例及实施例中的特征可以相互组合。 下面将参考附图并结合实施例来详细说明本发明。
如图1和图2所示,实施例一的半月板替代物包括基托体10、聚合物关节体20和骨螺钉30。其中,基托体10设置在胫骨的胫骨平台或胫骨平台假体上,聚合物关节体20设置在基托体10上,骨螺钉30穿设在胫骨中并与基托体10以及胫骨骨质相连。
应用本实施例的技术方案,聚合物关节体20设置在基托体10上并与股骨结构配合,骨螺钉30穿设于胫骨中并分别与基托体10和胫骨以螺纹连接,骨螺钉30和基托体10使半月板替代物能够有效地固定在胫骨结构90上,防止其在胫骨结构90上发生超出预期的位移和变形。在股骨结构相对胫骨结构90活动时,聚合物关节体20朝向股骨结构的表面与原生半月板相近并能够随股骨结构的转动而形变,从而保证与股骨之间的贴合面积,避免聚合物关节体20局部过劳损伤,影响半月板替代物整体的使用效果和使用寿命。
在本实施例的半月板替代物中,骨螺钉30可选用图14中示出的几种螺钉,如图1至图9所示,骨螺钉的两端分别设有第一螺纹31和第二螺纹32,第一螺纹31用于与基托体10的定位凸部17的第一螺纹孔18适配,第二螺纹32用于与胫骨上的第二螺纹孔92适配。其中,第一螺纹31优选为常规圆柱螺纹,螺纹距优选在0.15mm~3mm之间;第二螺纹32可选用常规圆柱螺纹或者锥度螺纹,该螺纹的旋向和螺距与定位凸部17一端的螺纹旋向和螺距相同,与皮质骨93对接的第二螺纹32设有自攻刃口。骨螺钉30对应皮质骨93的一端也可以设置螺钉帽以便在患者局部骨皮质强度不足时提供更大的约束力。
可供选择地,基托体10由可用于植入人体的医用金属和/或医用陶瓷制作而成,例如:钛基、钴基、镍基、镁基、钽金属等等合金材料,奥氏体不锈钢等。聚合物关节体20由可用于植入人体的医用聚合物(例如但不限于聚乙烯、聚四氟乙烯、聚氨酯、碳纤维聚合物等)通过模压及机加工方法制成,聚合物关节体20上设有与基托体10对应的关节体卡锁结构,以保证聚合物关节体20与基托体10之间的连接固定。骨螺钉30由可用于植入人体的医用金属和/或可吸收的医用高分子材料制作而成,骨螺钉30将基托体10与胫骨骨质通过螺纹定位进行连接固定。
如图3和图4所示,本实施例的基托体10包括整合层11、隔离层13和融合层12。整合层11和融合层12为通过3D打印技术或金属、陶瓷烧结技术制成的多孔结构,融合层12的孔径范围优选在500μm至3000μm之间,这一孔径范围便于在制造聚合物关节体20的过程中采用模压成型方法将聚合物材料加压渗入到多孔结构的孔隙内并通过热塑或热固成型过程最终使得聚合物关节体20与基托体10融合成为一体,加强聚合物关节体20与基托体10的连接强度。为避免多孔层的孔与孔之间的间隔壁或连接丝由于尺寸过小而对聚合物材料产生较强的切割效应,融合层12的孔与孔之间的间隔壁厚度或连接丝直径优选在0.5mm~3mm之间。
隔离层13是一层实体金属或陶瓷并设置在融合层12和整合层11之间,其厚度优选在0.2mm~2mm之间,并用以在模压过程中防止聚合物材料非预期的渗入并占据基托体10的整合层11与融合层12的孔隙空间。
与融合层12相似地,半月板替代物周围的组织例如胫骨结构90的皮质骨和松质骨以及 韧带等软组织也能够长入整合层11。如图4和图5所示,隔离层13包括呈角度设置的底壁和侧壁,底壁与胫骨结构90相对应,侧壁与半月板替代物周围的软组织对应。相应地,整合层11包括骨组织整合部111和软组织整合部112,骨组织整合部111设置在底壁上,在半月板替代物植入患者膝关节中时骨组织整合部111能够与患者胫骨的骨面贴合,使胫骨骨质能够长入骨组织整合部111的孔隙中。软组织整合部112设置在侧壁上,同样也有利于软组织长入。
优选地,本实施例的骨组织整合部111的多孔结构的孔径在150μm至1200μm之间,这一孔径范围有利于诱导骨细胞的长入以形成融合性的骨组织整合。软组织整合部112的多孔结构的孔径在400μm至2000μm之间,这一孔径范围有利于诱导软组织细胞的长入以形成融合性的软组织整合。
当然,可以理解地,在图中未示出的其他实施例中,整合层和融合层也可以通过其他技术手段,如等离子喷涂、金属颗粒烧结、激光打孔、高能束熔覆等,得到多孔结构或者有利于骨组织、软组织长入的其他结构。
为进一步促进软组织与软组织整合部112之间的整合,如图3至图6所示,本实施例的基托体10还包括软组织固定部14,软组织固定部14设置在隔离层13的侧壁上并穿出软组织整合部112。软组织固定部14包括缝合槽141和设置在缝合槽141中的缝合柱142,缝合槽141和缝合柱142形成供缝合针、缝合线穿入穿出的通道,以使软组织能够捆扎固定在缝合柱142上。缝合柱142为缝合线提供了捆扎固定的力学支点,使韧带等软组织能够与软组织整合部112的多孔结构紧密贴合,在术后愈合过程中,韧带等软组织能够长入多孔结构的空隙中。
如图2、图5和图6所示,本实施例的基托体10朝向胫骨的一侧设置有定位凸部17,定位凸部17上设置有第一螺纹孔18,第一螺纹孔18与骨螺钉30的第一螺纹31相适配。胫骨结构90上设置有与定位凸部17相适配的定位凹部91,胫骨结构90中设置有用于装配骨螺钉30的第二螺纹孔92,骨螺钉30从第二螺纹孔92穿入胫骨结构90并与第一螺纹孔18配合而骨螺钉30尾端的第二螺纹32则与胫骨结构90中的第二螺纹孔92相配合。在本实施例中,胫骨结构90是患者的胫骨,在图中未示出的其他实施例中,胫骨结构也可以是设置在患者胫骨上的胫骨假体。
本实施例的半月板替代物整体呈“C”状,并能够完整的替换患者的内外侧半月板。如图7至图9所示,每个半月板替代物上设置两个定位凸部17,并且两个定位凸部17分别设置在半月板替代物的前角和后角上,以使半月板替代物更贴近原生半月板的力学形态。骨螺钉30斜穿入胫骨结构90的松质骨94中,骨螺钉30的一端与基托体10连接固定,另一端与胫骨结构90的皮质骨93连接固定。聚合物关节体20设置在基托体10上并与股骨结构70接触配合。在患者自身负重载荷G的作用下,股骨结构70和胫骨结构90相互靠近,并挤压聚合物关节体20使半月板替代物产生向前的膨出力f1和向前的膨出力f2。此时两个定位凸部17将通过各自的骨螺钉30将上述膨出力传递至胫骨结构90的皮质骨93中并产生约束力F1’和约束力F2’,膨出力和约束力相抵消以使半月板替代物稳定。
当然,可以理解的是,在其他实施例中,半月板替代物上的定位凸部也可以根据半月板替代物的大小设置一个或更多个。
实施例二的半月板替代物相比于实施例一改变了基托体10的结构形式以及与聚合物关节体20之间的连接方式。如图10所示,实施例二的基托体10包括基体15和整合层11,整合层11设置在基体15朝向胫骨的一侧,使半月板替代物周围的软组织能够与整合层11接触融合。基体15朝向聚合物关节体20的表面上设置有卡接槽16,聚合物关节体20上设置有与卡接槽16相适配的卡接凸起26。通过卡接凸起26与卡接槽16的卡接配合实现基托体10与聚合物关节体20之间的连接固定。这种结构为手术过程中不同规格的选择以及后期关节体损坏时更换提供了机会和可能。
相应的,本实施例中的软组织固定部14在基体15上,软组织固定部14的缝合槽141和缝合柱142的结构和功能与实施例一相同,缝合槽141和缝合柱142形成供缝合线穿过的通道,以使软组织能够捆扎固定在缝合柱142上。
实施例三的半月板替代物相比于实施例一改变了替代方式,如图11至图13所示,实施例三的半月板替代物仅替换患者原生半月板80中的一部分,其整体结构与实施例一的半月板替代物基本相同。如图13所示,骨螺钉30的一端穿入松质骨94并与定位凸部相连,另一端固定在皮质骨93上。韧带60通过缝合线50捆扎在缝合柱142上。
术后患者活动时股骨结构70相对半月板替代物可能会产生水平方向的移动力Fh,并以P为支点半月板替代物的内侧可能产生竖直向上的力f3。此时通过骨螺钉30能够将上述力传递至皮质骨93上并产生竖直向下的反力f3’和水平向左的反力Fh’以使半月板替代物稳定。
图15至图18示出了本发明实施例一的半月板替代物的施术过程,如图15和16所示,冲孔模板41通过第一定位靠板42和第二定位靠板43稳定在胫骨结构90上,冲头45穿过冲孔模板41上的定位孔44在胫骨结构90上确定定位凸部的位置,并在该位置钻出定位凹部。如图17和图18所示,钻孔模板46的形状与冲孔模板41基本相同,通过将定位销47伸入定位孔44将导向孔48定位并钻取供骨螺钉穿过的通道。最后将预制好的半月板替代物的定位凸部伸入定位凹部并装入骨螺钉即可完成半月板替代物的植入。
本申请还提供了一种膝关节假体,根据本实施例的膝关节假体(图中未示出)包括半月板替代物,半月板替代物为包含上述全部或部分技术结构的半月板替代物。
从以上的描述中,可以看出,本发明上述的实施例实现了如下技术效果:
骨螺钉穿设在胫骨结构中并与基托体连接固定,聚合物关节体设置在基托体上并与股骨结构配合。骨螺钉和基托体使半月板替代物能够有效地固定在胫骨结构上,防止其在胫骨结构上发生超出预期的位移和变形。在股骨结构相对胫骨结构活动时,聚合物关节体朝向股骨结构的表面与原生半月板相近并能够随股骨结构的转动而形变,从而保证与股骨之间的贴合面积,避免聚合物关节体局部过劳损伤,影响半月板替代物整体的使用效果和使用寿命。
以上所述仅为本发明的优选实施例而已,并不用于限制本发明,对于本领域的技术人员来说,本发明可以有各种更改和变化。凡在本发明的精神和原则之内,所作的任何修改、等同替换、改进等,均应包含在本发明的保护范围之内。
Claims (13)
- 一种半月板替代物,其特征在于,包括:基托体(10),设置在胫骨的胫骨平台或胫骨平台假体上;聚合物关节体(20),设置在所述基托体(10)上;骨螺钉(30),穿设在所述胫骨中并与所述基托体(10)相连。
- 根据权利要求1所述的半月板替代物,其特征在于,所述基托体(10)包括整合层(11)、隔离层(13)和融合层(12),所述融合层(12)能够与所述聚合物关节体(20)接触融合,所述半月板替代物周围的人体组织能够长入所述整合层(11),所述隔离层(13)设置在所述融合层(12)和所述整合层(11)之间。
- 根据权利要求2所述的半月板替代物,其特征在于,所述隔离层(13)包括呈角度设置的底壁和侧壁,所述底壁与所述胫骨相对应,所述侧壁与所述半月板替代物周围的软组织对应,所述整合层(11)包括骨组织整合部(111)和软组织整合部(112),所述骨组织整合部(111)设置在所述底壁上,所述软组织整合部(112)设置在所述侧壁上。
- 根据权利要求3所述的半月板替代物,其特征在于,所述基托体(10)还包括软组织固定部(14),所述软组织固定部(14)设置在所述隔离层(13)的所述侧壁上并穿出所述软组织整合部(112),所述软组织固定部(14)包括缝合槽(141)和设置在所述缝合槽(141)中的缝合柱(142),所述缝合槽(141)和所述缝合柱(142)形成供缝合线穿过的通道,以使软组织能够捆扎固定在所述缝合柱(142)上。
- 根据权利要求3所述的半月板替代物,其特征在于,所述整合层(11)和/或所述融合层(12)为多孔结构。
- 根据权利要求5所述的半月板替代物,其特征在于,所述骨组织整合部(111)的多孔结构的孔径在150μm至1200μm之间,所述软组织整合部(112)的多孔结构的孔径在400μm至2000μm之间。
- 根据权利要求2所述的半月板替代物,其特征在于,所述整合层(11)和/或所述融合层(12)通过3D打印技术制成。
- 根据权利要求2所述的半月板替代物,其特征在于,所述整合层(11)和/或所述融合层(12)通过金属颗粒烧结技术制成。
- 根据权利要求1所述的半月板替代物,其特征在于,所述基托体(10)包括基体(15)和整合层(11),所述基体(15)朝向所述聚合物关节体(20)的表面上设置有卡接槽(16),所述聚合物关节体(20)上设置有与所述卡接槽(16)相适配的卡接凸起(26),所述整合层(11)设置在所述基体(15)朝向所述胫骨的一侧,所述半月板替代物周围的软组织能够与所述整合层(11)接触融合。
- 根据权利要求9所述的半月板替代物,其特征在于,所述基托体(10)还包括软组织固 定部(14),所述软组织固定部(14)设置在所述基体(15)上,所述软组织固定部(14)包括缝合槽(141)和设置在所述缝合槽(141)中的缝合柱(142),所述缝合槽(141)和所述缝合柱(142)形成供缝合线穿过的通道,以使软组织能够捆扎固定在所述缝合柱(142)上。
- 根据权利要求1所述的半月板替代物,其特征在于,所述基托体(10)朝向所述胫骨的一侧设置有定位凸部(17),所述定位凸部(17)上设置有与所述骨螺钉(30)相适配的第一螺纹孔(18),所述胫骨平台或所述胫骨平台假体上设置有与所述定位凸部(17)相适配的定位凹部(91),所述胫骨中设置有用于装配所述骨螺钉(30)的第二螺纹孔(92)。
- 根据权利要求11所述的半月板替代物,其特征在于,所述骨螺钉(30)至少设有两段螺纹,在骨螺钉(30)的两端分别设有第一螺纹(31)和第二螺纹(32),所述第一螺纹(31)用于与所述定位凸部(17)的第一螺纹孔(18)适配,所述第二螺纹(32)用于与胫骨上的所述第二螺纹孔(92)适配,所述第二螺纹(32)的公称直径不小于所述第一螺纹(31)的公称直径。
- 一种膝关节假体,包括半月板替代物,其特征在于,所述半月板替代物为权利要求1至12中任一项所述的半月板替代物。
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US20230138980A1 (en) * | 2021-11-03 | 2023-05-04 | Actuos, LLC | Unicompartmental knee arthroplasty systems and methods |
CN117653424B (zh) * | 2024-01-10 | 2024-05-28 | 北京爱康宜诚医疗器材有限公司 | 膝关节假体 |
CN117653266B (zh) * | 2024-01-31 | 2024-04-23 | 鑫君特(苏州)医疗科技有限公司 | 髁间窝截骨规划装置、髁间窝自动截骨装置和相关设备 |
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