|Publication number||CN100479788 C|
|Application number||CN 200480002277|
|Publication date||22 Apr 2009|
|Filing date||14 Jan 2004|
|Priority date||17 Jan 2003|
|Also published as||CA2498387A1, CA2498387C, CN1738581A, DE502004008404D1, EP1438932A1, EP1587459A1, EP1587459B1, US7914585, US20060004464, WO2004064689A1|
|Publication number||200480002277.2, CN 100479788 C, CN 100479788C, CN 200480002277, CN-C-100479788, CN100479788 C, CN100479788C, CN200480002277, CN200480002277.2, PCT/2004/225, PCT/EP/2004/000225, PCT/EP/2004/00225, PCT/EP/4/000225, PCT/EP/4/00225, PCT/EP2004/000225, PCT/EP2004/00225, PCT/EP2004000225, PCT/EP200400225, PCT/EP4/000225, PCT/EP4/00225, PCT/EP4000225, PCT/EP400225|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (6), Classifications (28), Legal Events (3)|
|External Links: SIPO, Espacenet|
带有插入股骨中的轴的髋部假肢 Hip prostheses with the insertion of the femoral shaft
本发明涉及一种带有插入股骨中的轴的髋部假肢，所述轴的在上股骨干骺区中插入的近体部分在前侧和后侧分别具有一个凸出的肋条， 肋条的内侧侧面偏离所述轴纵轴线、向上向股骨颈部方向倾斜。 The present invention relates to the inner side of a hip prosthesis with a shaft inserted into the femur, the said shaft portion of the femur near the metaphyseal region of the front and rear insert respectively have a convex rib, the ribs side is offset from the longitudinal axis, the neck portion is inclined upward direction.
对于在股骨中锚定假肢轴，骨骺区的情况与骨干区不同。 For anchor prosthetic femoral shaft, the situation with the backbone area epiphyseal region is different. 在骨骺区， 也就是基本在股骨小转子上方区域，疏松的骨头填充了多孔骨质，在骨质内必须做出人工接收管道以接收假肢轴。 In the epiphyseal region, which is essential in the area above the lesser trochanter of the femur, loose bones filled porous bone, the bone must be made in order to receive a prosthetic artificial receive pipeline axis. 因多孔骨质松软，所以限制了在该区域传力的可能性。 Due to the porous bone and soft, so limiting the possibility of transmission power in the region. 在股骨小转子下方，强壮的骨外壳限定了较窄的骨髓腔，该骨外壳为传力提供了好得多的前提条件。 Below the lesser trochanter of the femur, strong housing defining a narrow bone marrow, the bone dowel shell provides better preconditions. 为此， To this end,
发展的假肢轴特别适合锚定或楔入在骨的该股骨干区（Schneider: Die Totalprothese der Huef te,第214页及以后几页）。 Particularly suitable for the development of prosthetic shaft anchored or wedged in the bone stock backbone area (Schneider: Die Totalprothese der Huef te, page 214, and after a few pages). 其可靠地锚定在在骨的骨干导至骨的骨骺区不受力。 Securely anchored in its backbone lead to bone epiphyseal bone area without power. 如果骨质不受力，它将逐渐萎缩。 If the bone is not power, it will gradually shrink. 这是不希望发生的。 This is undesirable.
在最初锚定在骨的干骺区假肢情况下，已知的是（EP-B-761183; EP-A-780106 ; EP-A-1070490 ; EP-B-159462 ; EP-B-821923 ; EP-B-112435; DE-C-4428099 )通过从假肢基体腹侧或背侧凸出的肋条和边缘改善在干骺区的锚定。 Initially anchored in the metaphyseal region of the bone prosthetic situation, it is known (EP-B-761183; EP-A-780106; EP-A-1070490; EP-B-159462; EP-B-821923; EP -B-112435; DE-C-4428099) through the ventral prosthesis substrate or from the back side and edges projecting ribs improvement in the metaphyseal region of the anchor. 如果规定用于锚定在骨粘合剂或形状相同的铣出的腔内，则这些肋条允许在内外侧方向上有相当大的延伸范围（EP-A-780106; EP-A-1070490; DE-C-4428099 )。 The provisions for anchoring in a bone adhesive or the same shape as the milled cavity, these ribs allow the inner considerably extending the range of (EP-A-780106 lateral direction; EP-A-1070490; DE -C-4428099). 当4吏用了肋条， When the four officials with the ribs,
该肋条在无粘合剂植入情况下切入骨质并将其压缩，则在无粘合剂植入情况下，术后假肢非常牢固地配合在骨中（EP-B-761183 )。 The ribs are cut into the bone in the absence of a binder and compressed implant cases, the implantation in the absence of a binder, postoperative prosthesis is firmly fitted in the bone (EP-B-761183). 因此在 Therefore,
将假肢轴插入骨中之前准备的腔的大小限定为轴基体的体积。 The size of the prosthetic shaft inserted into the bone before the prepared cavity defining the volume of the substrate axis. 为在压入轴时肋条不将骨胀破，将肋条设计为狭长形并带有倾斜向下的内侧和外侧侧面（EP-B-159462; EP-B-821923; EP-B-761183 )。 Is pressed into the shaft ribs when the bone does not burst, the elongated ribs designed with a downwardly inclined inner and outer side surfaces (EP-B-159462; EP-B-821923; EP-B-761183). 这限制了 This limits
其传力能力。 Its power transmission capacity. 发明内容 SUMMARY
本发明涉及这种假肢类型，其中特别要实现在骨的骨干区进行锚定。 The present invention relates to this type of prostheses, including in particular to achieve key areas in the bone anchor. 本发明的任务是克服负荷减轻造成的干骺区萎缩。 The task of the present invention is to overcome the load reduction caused by shrinking the metaphyseal region. 根据本发明的解决方案在于，一种带有插入上股骨内的轴的髋部假肢，所述轴的在上股骨干骺区中插入的近体部分在前侧和后侧分别具有一个凸出的肋条，肋条的内侧側面偏离所述轴纵轴线、向上向股骨颈部方向倾斜。 The solution according to the present invention is a hip prosthesis femoral shaft inserted inside with the said shaft on the body portion of the femur near the metaphyseal region inserted in the front and rear sides, respectively, having a convex ribs, the inner side of the rib deviates from the longitudinal axis, the neck portion is inclined upward direction. 根据本发明在干骺区使用了由肋条构成的附加传力装置。 According to the present invention is used in the metaphyseal region of the additional force transmission means constituted by the ribs. 这些肋条具有带指向内侧的陡侧面的特别形状。 These ribs have a special shape with a point inside the steep side. 由此与带有倾斜向下的内外和外侧侧面的已知狭长肋条相比，肋条向前或向后指向的表面相应地更宽了。 Thus, compared with the downward inclination of the inner and outer side surfaces and an outer rib having a known narrow, forwardly or rearwardly directed ribs correspondingly wider the surface. 为使得在将轴压入骨中时仍然不会产生可能将骨胀破的力，还规定，肋条从限定内侧侧面的棱边向外侧减少高度。 Is such that when the axial compression into the bone may still not produce bone bursting force, also provides that the ribs reduce the height defined from the inside to the outside of the side edges. 传统的转向外侧的肋条侧面因此消失或减少到比较低的高度，该高度最高等于内侧侧面高度的一半。 Conventional steering outer side of the rib thus removed or reduced to a relatively low height, the maximum height is equal to half the height of the inner side. 这是容许的，因为由肋条向外侧传递的力比向内柳j方向的力小。 This is acceptable, since the ribs outward by the force transmitted is smaller than the inward force Liu j direction.
内侧侧面陵的特征表明，其与内外侧轴平面几乎构成直角。 The medial side of the mausoleum of the characteristics indicate that the inner and outer shaft is almost at right angles to the plane. 与该角 And the angle
度的偏差最好不要大于25° ，更好的是不要大于15。 Preferably not more than the degree of deviation 25 °, preferably not more than 15. 。 .
内侧侧面至少在其长度的一部分偏离轴的纵向、向上向股骨颈部方向倾斜。 At least a portion of the inner side of the off-axis longitudinal length thereof, the neck portion upwardly inclined direction. 这种形状的优点是，当推入假肢时，如果推入方向与假肢的纵向相符，肋条的内侧侧面象楔子一样压缩在推入方向上位于其前方的多孔骨质，使得骨质能够具有更强的传力能力。 The advantage of this shape is that when pushed into the prosthesis, if pushed into the longitudinal direction of the prosthesis in line, the inner side of the rib as the compression wedge in the thrust direction as located in front of a porous bone such that the bone can have a more strong force transmission capacity. 特別当该内侧侧面与轴纵向包围的角度在5和15°之间，优选的是约IO。 Especially when the inner side surface and the longitudinal axis of the angle enclosed between 5 and 15 °, preferably about IO. 时，就会产生这种作用。 When will produce this effect.
根据本发明，相应地压缩肋条的前面和后面由此实现，即各个轴基体表面上方的肋条高度从下向上增加。 According to the present invention, the front and rear respectively thereby achieving compression ribs, rib height increases from bottom to top of each axis that is above the surface of the substrate. 因此肋条是双向楔形，即首先是向内侧侧面方向，其次是向前侧或后侧方向。 Thus the wedge rib is bidirectional, i.e., the first side surface is inward direction, followed by the front side or rear direction. 在外侧方向上，即在背离内侧側面的侧面上，肋条高度可逐渐降低。 In the lateral direction, i.e., on the side away from the inner side, rib height can be gradually reduced.
通过肋条压缩多孔骨质的先决条件是，在植入后肋条所位于的位置上事先存在骨质。 Prerequisites by ribs compressed porous bone, the presence of bone in advance rib is located after implantation position. 如果在将假肢插入骨的干骺区之前，人工构成假肢轴的接收管道，那么接收管道库该只对应假肢轴基体的横截面并且因此还不构成以后接收肋条的凸面。 If you receive the pipe inserted into the bone before the metaphyseal region prosthetics, artificial prostheses constitute the shaft, then the receiver pipe cross-section of the library the only prosthetic axis corresponds to the matrix and thus do not constitute a convex after receiving ribs. 如果使用粗锉刀形成该接收管道， 那么粗锉刀的形状也应该只对应轴基体，不带有去除肋条区域物质的装置。 If you use a coarse rasp form the receive pipeline, then the shape of the coarse rasp should also be only the corresponding axis matrix, the removal of the rib area of a device without substance. 作为另外一种选择，还存在粗锉刀备有肋条的方案，该肋条与假肢轴的肋条对应并且设计为压缩骨质而不去除物质。 Alternatively, there are provided ribs program rasps, the ribs and the ribs of the prosthetic shaft and are designed to correspond to the compression without removing bone material. 因此上述在肋条传力区域压缩骨质就已经可通过粗锉刀实现或部分地由其准备。 Therefore, the compression force transmission rib bone in the region has been to achieve or part of its preparation by rasps.
附图说明下面参考示出有利实施例的附图更详细地解释本发明。 BRIEF DESCRIPTION advantageous embodiment illustrated with reference to accompanying drawings to explain the present invention in more detail. 其中； Among them;
图1为从前方看到的视图； Figure 1 is a view seen from the front;
图2为从内侧看到的视图； Figure 2 is a view seen from the inside;
图3为从上面看到的视图； Figure 3 is a view as seen from above;
图4至6为在轴的相应高度穿过轴的截面。 Figures 4 to 6 for the corresponding height of a section through the shaft axis.
具体实施方式 DETAILED DESCRIPTION
假肢由轴l，颈部2，用于套装铰链头部4的锥体3组成，其中铰链头部的周边用虚线表示。 Prosthesis by the shaft l, neck portion 2, a hinge for Set 3 consisting of a head cone 4, wherein the head portion of the periphery of the hinge shown in phantom. 轴由远体部分6和近体部分7装配而成。 Shaft assembly by far the body part 6 and part 7 from near the body. 在内外侧方向上，远体部分横截面为细长的，如图4和5所示。 The inner outward direction, away portion an elongated cross section, as shown in Figures 4 and 5. 该部分备有一对肋条8以向上股骨骨骺区域中包围轴的多孔骨质传力。 This section is provided with a pair of ribs 8 femoral epiphysis up area surrounded by porous bone shaft power transmission. 可明显看出轴1是直轴。 As is apparent shaft 1 is a straight shaft. 这意味着轴直线构成，并因而必须在其纵向上和在上股骨的骨干纵向上推入骨干。 This means that the axis of straight lines, and therefore must be in its longitudinal direction and in the longitudinal direction on the upper femur backbone push backbone.
轴近体部分和远体部分之间的过渡位置9这样设置，即在植入的状态其约位于小转子附近，优选的是稍稍位于其下方，并且远体的轴部分7因而位于骨髓管道区域，在该区域轴部分7被强壮的骨外壳限定。 Transition position portion and distal portion of the shaft near the body between 9 arranged such that in the implanted state thereof is located in approximately the lesser trochanter, preferably located slightly below it, and the shaft body portion 7 thus far marrow ducting region located , in the area of the shaft portion 7 is defined by strong bone shell. 不需要在假肢上特別标明过渡位置。 No special transition marked locations on the prosthesis. 它是这样确定的，即其位于小转子或者优选的是小转子下边缘在植入状态所处位置。 It is determined so that it is located in the small rotor or preferably is an edge location in the implanted state small rotor. 按轴方向上的箭头10测量，其通常位于比铰链头部4的中心5低7至9厘米的位置。 10 measured by the arrow axis direction, which is typically located 7-9 cm lower than the head portion 4 of the hinge 5 of the center position.
远体的轴部分这样设计，即其适合锚定在上股骨的骨干区。 Far body shaft portion designed such that it is anchored in the femur for the backbone area. 为配合得牢固，其轴芯稍稍为圆锥形并具有纵向肋条。 To get a firm with its slightly conical shaft and having a longitudinal rib. 由此位于轴芯15表面 Thus the surface of the shaft 15 is located in the core
和皮层骨髓腔边界之间的间隙内的骨质被压缩，其中这些骨质被肋条固定。 Cortical bone marrow cavity and the gap between the inner boundary is compressed, wherein the ribs are fixed to bone. 远体的部分还可按其它方式这样设计，即其适合将轴初步锚定在骨的骨干中。 Far body portion may also be designed in other ways, i.e., it is adapted to the shaft initially anchored in the bone of the backbone.
肋条8从轴基体22的前后表面21凸起。 8 ribs protruding from the front surface of the shaft 22 of the base 21. 其具有指向内侧的侧面23和前侧或后侧的表面部分24，其中后者由外侧侧面25限定。 Having a side surface 23 and the surface toward the inside of the front or rear side portion 24, the latter of which is defined by the outer side surface 25. 如图3 和4所示，陴着与内側侧面23距离的增加，表面24向表面21方向倾斜，使得肋条具有约三角形或梯形的横截面形状。 3 and 4, with the inner side parapet increase the distance 23, the surface 24 is inclined to the direction of the surface 21, such that the rib having an approximately triangular cross-sectional shape or trapezoidal. 其在基体"表面n 上方的高度在内侧侧面23上至少为在外側边缘上的两倍。肋条8起始于轴近体部分和远体部分之间的过渡区域9，高度为零并且宽度较窄。 肋条向上均匀地增加到其在上端26达到的其最大高度和宽度。内侧侧面23与轴的纵轴线27包围角oc，在实施例中该角约为8° 。内侧侧面23的高度在轴上端26在2和4厘米之间，最好约为3厘米。侧面25的高度在零和内侧侧面23高度的一半之间。在侧视图中，外侧侧面25 与纵轴线27重合或者平行或者与纵轴线成非常小的角度。 Its matrix "in height above the surface of the n inner side surface 23 is at least twice on the outside edge. 8 starting a transition region between the rib portion and distal portion of the shaft near the body 9, the height and width than zero narrower ribs evenly upward to its inboard side 23 and the longitudinal axis of the shaft 27 surrounds the angle oc in the upper end 26 reaches its maximum height and width, in the embodiment, the angle is about 8 °. height 23 in the inner side of shaft end 26 between 2 and 4 cm, preferably about 3 cm. height 25 of the side surface 23 between zero and half the height of the inner side in the side view, the outer side surface 25 and the longitudinal axis 27 parallel to or coincident or with the longitudinal axis of a very small angle.
肋条横截面从下向上成楔形双向增加，即向内侧侧面23方向和前或后侧面24方向增加。 A wedge-shaped cross-section of the ribs to increase two-way from the bottom up, namely the medial side of the 23 directions and the direction of the front or rear side 24 increases. 如果为将假肢轴接收在上股骨的干骺、多孔区而形成的腔在横截面上与轴的基体22相等，则在推入轴时肋条8挤出并压缩存在的多孔物质。 If the cavity for receiving the prosthesis shaft on the femur metaphyseal, the porous region is formed in the base cross section of the shaft 22 are equal, when the shaft is pushed into the rib 8 extruded and compressed porous material existence. 由此使其更适合传力。 Thus making it more suitable for power transmission. 肋条从内侧边缘向外侧边缘倾斜具有额外的优点，即在骨的干骺端中可用的空间可更好地用于体积大的轴设计。 The ribs from the inside to the outside edge of the inclined edge has the additional advantage that the available space in the bone of the metaphysis be better used for large volumes of shaft design.
实施例示出了肋条8的直线走向。 Embodiment shows a straight line toward the ribs 8. 但其楔形形状也可具有非直线的走向。 But it may also have a wedge-shape non-linear direction.
虽然规定假肢初步锚定在骨干中，但和假肢轴其它的指向内侧的表面28 —样，内侧侧面23同样有助于在干骺区传力。 Although the provisions of the prosthesis anchored in the backbone of the preliminary, but the surface of the prosthesis and the other pointing to the inside of the shaft 28 - like the inner side of the metaphyseal region 23 also helps in force transmission. 由此骨的干骺也参与了传力。 Metaphyseal bone thus also involved in power transmission. 由此避免了其萎缩的危险。 Thereby avoiding the risk of their shrinking. 可更好地将假肢长期可靠地 The prostheses can be better long-term reliable
固定在骨内。 Fixed in the bone.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|CN1245675A||3 Jun 1999||1 Mar 2000||苏舍奥索帕迪有限公司||Artificial limb|
|EP0466638A1||12 Jun 1991||15 Jan 1992||Gebrüder Sulzer Aktiengesellschaft||Femoral head prosthesis|
|FR2602672A1||Title not available|
|FR2668059A1||Title not available|
|FR2676359A1||Title not available|
|US5507833||28 Sep 1994||16 Apr 1996||Kim-Med, Inc.||Hip replacement system and method for implanting the same|
|International Classification||A61F2/00, A61F, A61F2/36, A61F2/30, A61F2/32|
|Cooperative Classification||A61F2250/0026, A61F2002/30891, A61F2/3676, A61F2002/3625, A61F2/30771, A61F2002/30322, A61F2002/30879, A61F2/3662, A61F2230/0026, A61F2230/0008, A61F2/367, A61F2002/3611, A61F2002/30113, A61F2002/30156, A61F2002/30797, A61F2230/0006, A61F2230/0023, A61F2002/3664, A61F2002/365, A61F2002/30125, A61F2002/30158|
|European Classification||A61F2/30L2, A61F2/36D|
|22 Feb 2006||C06||Publication|
|19 Apr 2006||C10||Request of examination as to substance|
|22 Apr 2009||C14||Granted|