CN102781372B - Hip joint device - Google Patents

Hip joint device Download PDF

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Publication number
CN102781372B
CN102781372B CN201080040398.1A CN201080040398A CN102781372B CN 102781372 B CN102781372 B CN 102781372B CN 201080040398 A CN201080040398 A CN 201080040398A CN 102781372 B CN102781372 B CN 102781372B
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China
Prior art keywords
hip
material component
component
hip prosthesis
prosthesises
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CN201080040398.1A
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Chinese (zh)
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CN102781372A (en
Inventor
彼得·福塞尔
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IMPLANTICA PATENTS CO., LTD.
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Milutinovic Alex Holdings Ltd
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Priority claimed from PCT/SE2010/050816 external-priority patent/WO2011005197A1/en
Publication of CN102781372A publication Critical patent/CN102781372A/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1637Hollow drills or saws producing a curved cut, e.g. cylindrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1662Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1664Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/34Acetabular cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3601Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • A61F2/3603Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices implanted without ablation of the whole natural femoral head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02Inorganic materials
    • A61L27/04Metals or alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14Macromolecular materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30014Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2002/3208Bipolar or multipolar joints, e.g. having a femoral head articulating within an intermediate acetabular shell whilst said shell articulates within the natural acetabular socket or within an artificial outer shell

Abstract

The invention provides a kind of hip prosthesis being suitable for implant patient hip joint.This hip prosthesis comprises first area and second area, and wherein said first area comprises and is suitable for resilient first material and described second area comprises and is suitable for resilient second material, and wherein said first material is suitable for more flexible than described second material.

Description

Hip joint device
Technical field
The present invention relates in general to hip prosthesis.
Background technology
Coxitis (HipjointOsteoarthritis) is a kind of syndrome, and in this syndrome, low grade inflammation causes pain in hip joint, is to be caused by the inordinate wear of the cartilage being used as mat in hip joint.The inordinate wear of this cartilage causes the joint lubrication liquid being referred to as synovial fluid to reduce equally.Coxitis have impact on the crowd's of over-65s 80% with severe form more or less according to estimates.
The treatment of current coxitis comprises NSAID medicament, the local injection of hyaluronic acid or glucocorticoid to help to lubricate hip joint, with by operation on hip joint prosthetic replacement part hip joint.
To this day, the aliquot replacement of hip joint is one of the most frequently used operation, and the whole world is implemented at hundreds of patient every year.The most frequently used method is included in implanted metal prosthese in femur and implants plastic bowl in acetabular bone.This operation also passes fascia lata and the pleural muscle enforcement of thigh by the side otch on the hip of upper leg portion.In order to touch joint, need to penetrate the support capsula articularis coxae be attached on femur and ilium.Then femur cervical region to be excised by bone saw and with or Cementless by Using prosthesis femur.Use Acetabular reamer that acetabular bone is expanded a little, and use screw or cement reaction plastic bowl.
The metal prostheses of implanted femur is generally hard than human skeletal, and this can be fixed to the position damage femur of femur in many cases at prosthese.Elasticly between femur from hip prosthesis differently also affect the fixing of prosthese.Prosthese loosening needs to reform the most general reason of operation on hip joint, and between prosthese and femur, the elastic fixed position that do not coexist produces tension force, and this has impelled loosening of prosthese.
Another problem using hard i.e. logy prosthese is that prosthese bears the load that natural bone brings completely, and this may make bone shrink and reduce the formation of its new bone tissue.Loosening of final this process conduction prosthese.Tension force on contact surface further from the vibrations of being conducted by health during normal walking or in accident situation, such as people falls down time larger tension force.Hard prosthese does not work in the mode of shock absorption, and therefore whole vibrations are transmitted to the contact surface that prosthese is fixed to femur.
Therefore, expect to obtain a kind of hip prosthesis, its position being fixed to bone at prosthese has the resilient property similar to bone, and/or obtains a kind of hip prosthesis, and it is with mode absorbing vibration that is similar to natural hip joint or that improve.
Summary of the invention
The invention provides a kind of hip prosthesis be suitable in implant patient hip joint.This hip prosthesis comprises first area and second area, and described first area comprises and is suitable for resilient first material or material component, and described second area comprises and is suitable for resilient second material or material component.First material or material component be suitable for than the second material or material component more flexible.
According to an embodiment, hip prosthesis comprises first end and the second end further, is arranged in the length axes of described hip prosthesis.First end comprises described first material or material component, and described second end comprises described second material or material component.As the implanted described patient of hip prosthesis, the near-end of described hip prosthesis can comprise described first end, and the far-end of described hip prosthesis can comprise described second end.
According to an embodiment, hip prosthesis is little by little more flexible to described first end from described second end.
According to another embodiment, hip prosthesis comprises the 3rd region, the 4th region and the 5th region further, 3rd region comprises the 3rd material or material component, and the 4th region comprises the 4th material or material component and the 5th region comprises the 5th material or material component.First, second, third, fourth and fifth material or material component can be interconnected by net attractive force.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component be suitable for than the 5th material or material component more flexible.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, second material or material component are suitable for more flexible than the 3rd material, 3rd material or material component are suitable for there is less elasticity than the 4th material or material component, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, as the implanted described patient of described hip prosthesis, first area is first, second, 3rd, the most proximal end region in the 4th and the 5th region, second area is described first, second, 3rd, the second most proximal end region in the 4th and the 5th region, 3rd region is described first, second, 3rd, the 3rd most proximal end region in the 4th and the 5th region, 4th region is described first, second, 3rd, the 4th most proximal end region in the 4th and the 5th region, 5th region is described first, second, 3rd, the 5th most proximal end region in the 4th and the 5th region.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component be suitable for than the 5th material or material component more flexible.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component are suitable for there is less elasticity than the 4th material or material component, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, first, second, third, fourth and fifth material or material component include the different materials of combination in any or the different piece of same material, and the different piece of wherein said material or described material all has different elasticity.
Hip joint comprises acetabular bone further, and it is the bowl-shaped portion of basin bone.Hip prosthesis may further include jointing, and described jointing comprises connecting surface.Connecting surface comprises the first surface material or material component with average elasticity, and wherein said surface is suitable for being connected with acetabular bone or its artificial substitute.Hip prosthesis may further include fixing section, and described fixing section comprises fixed surface.Fixed surface comprises the second surface material or material component with average elasticity, to be suitable for helping described hip prosthesis to be fixed to the femur of described patient.
According to an embodiment, the average elasticity of first surface material or material component is lower than the average elasticity of described second surface material or material component.
Material
According to an embodiment, hip prosthesis comprises metal, and described metal can be metal alloy, and described metal alloy can comprise steel and/or biocompatibility metal conversely.
According to an embodiment, the martensite percentage in described first surface material or material component is than the height in described second surface material or material component.
Can expect equally, described hip prosthesis comprises polymeric material.
Comprise at hip prosthesis in the embodiment of the first material or material component and the second material or material component, can expect, described first material or material component and described second material or material component include metal.Metal material or material component can be the metals being selected from a cohort, and this cohort is made up of steel, steel alloy, titanium, titanium alloy and biocompatibility metal.In the embodiment that hip prosthesis comprises first, second, third, fourth and fifth material or material component, can expect, all described first, second, third, fourth and fifth materials or material component are all metal material, this metal material can be the metal being selected from a cohort conversely, and this cohort is made up of steel, steel alloy, titanium, titanium alloy and biocompatibility metal.
Fixing section
According to an embodiment, hip prosthesis is suitable for being fixed to neck of femur.In this case, prosthese can be suitable for being fixed to neck of femur in neck of femur inside.In other embodiments, hip prosthesis is suitable for being fixed to femur, and in this case, it can be suitable for being fixed to femur inside.
Jointing
According to an embodiment, jointing comprises ceramic material or material component, and it can be titanium carbide.
By the material that net attractive force connects
According to an embodiment, hip prosthesis comprises by the interconnective first area of net attractive force and second area.First area comprises and is suitable for resilient first material or material component, and described second area comprises and is suitable for resilient second material or material component, and the first material or material component be suitable for than the second material or material component more flexible.
According to an embodiment, hip prosthesis comprises first end in the length axes being arranged on described hip prosthesis and the second end further.First end comprises the first material or material component, and the second end comprises the second material or material component.
According to an embodiment, as the implanted described patient of described hip prosthesis, the proximal part of hip prosthesis comprises described first end, and the far-end of described hip prosthesis comprises described second end.Can expect equally, hip prosthesis is little by little more flexible to described first end from described second end.
According to an embodiment, hip prosthesis comprises the 3rd region, the 4th region and the 5th region further.3rd region comprises the 3rd material or material component, and the 4th region comprises the 4th material or material component and the 5th region comprises the 5th material or material component.First, second, third, fourth and fifth material or material component are interconnected by net attractive force.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component be suitable for than the 5th material or material component more flexible.
According to another embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component are suitable for there is less elasticity than the 4th material or material component, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to another embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, as the implanted described patient of described hip prosthesis, first area is described first, second, 3rd, the most proximal end region in the 4th and the 5th region, second area is described first, second, 3rd, the second most proximal end region in the 4th and the 5th region, 3rd region is described first, second, 3rd, the 3rd most proximal end region in the 4th and the 5th region, 4th region is described first, second, 3rd, the 4th most proximal end region in the 4th and the 5th region, 5th region is described first, second, 3rd, the 5th most proximal end region in the 4th and the 5th region.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component be suitable for than the 5th material or material component more flexible.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component are suitable for there is less elasticity than the 4th material or material component, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
According to an embodiment, first material or material component be suitable for than the second material or material component more flexible, and the second material or material component be suitable for than the 3rd material or material component more flexible, 3rd material or material component be suitable for than the 4th material or material component more flexible, and the 4th material or material component are suitable for there is less elasticity than the 5th material or material component.
The hip joint of patient comprises acetabular bone, and described acetabular bone is the bowl-shaped portion of basin bone.Hip prosthesis may further include jointing according to any embodiment, and described jointing comprises connecting surface.Connecting surface comprises the first surface material or material component with average elasticity, and wherein said surface is suitable for being connected with acetabular bone or its artificial substitute.Prosthese comprises fixing section further, and described fixing section comprises fixed surface.Described fixed surface comprises the second surface material or material component with average elasticity, to be suitable for helping hip prosthesis to be fixed to the femur of described patient.
According to an embodiment, the average elasticity of described first surface material or material component is lower than the average elasticity of described second surface material or material component.
Material
According to an embodiment, hip prosthesis comprises metal, and described metal can be metal alloy, and described metal alloy can comprise steel, biocompatibility metal conversely.
According to an embodiment, the martensite percentage in described first surface material is than the height in described second surface material.
According to an embodiment, described hip prosthesis comprises polymeric material.
Comprise at hip prosthesis in the embodiment of the first material and the second material, can expect, described first material and described second material are metal material.Metal material can comprise the metal being selected from a cohort, and this cohort is made up of steel, steel alloy, titanium, titanium alloy and biocompatibility metal.
According to other embodiment, first, second, third, fourth and fifth material can be metal material, and this metal material can comprise the metal being selected from a cohort conversely, and this cohort is made up of steel, steel alloy, titanium, titanium alloy and biocompatibility metal.
Fixing section
According to an embodiment, hip prosthesis is suitable for being fixed to neck of femur, and described fixing can from neck of femur internal implementation.
According to another embodiment, hip prosthesis is suitable for being fixed to femur, and described fixing can from femur internal implementation.Also can expect with the combination of mentioned possibility.
Jointing
According to an embodiment, jointing comprises ceramic material such as titanium carbide.Can expect equally, the material of jointing is porous material.
Bend and distortion
The centre portion that hip prosthesis can comprise fixing section, jointing and be arranged between fixing section and jointing.According to any embodiment, by being suitable for the centre portion curving certain curvature when bearing active force, hip prosthesis can be suitable for elastic deformation when bearing active force, or by being suitable for the described centre portion of distortion when bearing active force, hip prosthesis is suitable for elastic deformation when bearing active force, or by being suitable for when bearing active force curving certain curvature and the described centre portion of distortion, described hip prosthesis can be suitable for elastic deformation when bearing active force.
According to an embodiment, centre portion is suitable for the curvature curving κ > 2, according to another embodiment, centre portion is suitable for the curvature curving κ > 4, and according to another one embodiment, centre portion is suitable for the curvature curving κ > 8, and above fixing section keeps being fixedly attached to femur simultaneously.
According to an embodiment, centre portion is suitable for distortion until torsion angle till, fix section simultaneously and keep being fixedly attached to femur, according to another embodiment, centre portion is suitable for distortion until torsion angle till, and according to another one embodiment, centre portion is suitable for distortion until torsion angle till, fix section simultaneously and keep being fixedly attached to femur.Can expect equally, centre portion is suitable for the curvature curving κ > 2, and distortion is until torsion angle till, fix section simultaneously and keep being fixedly attached to femur.
Method
The method used according to hip prosthesis Absorption power in patient's hip joint of any embodiment is provided further.The method comprises the step of described hip joint elastic deformation, the step of described hip joint elastic deformation comprises step: when bearing active force, the elastic properties of materials distortion of the described first area of described hip prosthesis, and when bearing active force, the material of the described second area of described hip prosthesis is out of shape more smallly than the material of the first area of hip prosthesis.
According to an embodiment, when bearing active force, the step of the elastic properties of materials distortion of the first area of hip prosthesis, comprise the step that described material is more flexiblely out of shape than the material of femur, and when bearing active force, the step that the material of the second area of hip prosthesis is out of shape more smallly than the described material of the described first area of described hip prosthesis, the step of the material comprising material and femur equally elastic deformation substantially.
According to another one embodiment, when bearing active force, the step of the elastic properties of materials distortion of the first area of hip prosthesis, comprise the step that described material is more flexiblely out of shape than the material of femur, and when bearing active force, the step that the material of the second area of hip prosthesis is out of shape more smallly than the material of the first area of hip prosthesis, comprise the step of material and bone cement equally elastic deformation substantially, described bone cement is used for hip prosthesis to be fixed to femur.
According to an embodiment, the centre portion that hip prosthesis comprises fixing section, jointing and is arranged between fixing section and jointing.When bearing active force, the step of hip prosthesis elastic deformation can comprise, when bearing active force, centre portion curves certain curvature, the maybe centre portion distortion when bearing active force, maybe when bearing active force, centre portion curves sweep and distortion, fix section to keep being fixedly attached to femur, and femur keeps complete step simultaneously.
According to an embodiment, centre portion curves the curvature of κ > 2, according to another embodiment, centre portion curves the curvature of κ > 4, and according to another one embodiment, centre portion curves the curvature of κ > 8, fixes section simultaneously and keeps being fixedly attached to femur.
According to an embodiment, centre portion distortion is until torsion angle till, fix section simultaneously and keep being fixedly attached to femur, according to another embodiment, centre portion distortion is until torsion angle till, and according to another one embodiment, centre portion distortion is until torsion angle till, fix section simultaneously and keep being fixedly attached to femur.Can expect equally, centre portion curves the curvature of κ > 2, and distortion is until torsion angle till, fix section simultaneously and keep being fixedly attached to femur.
According to an embodiment, when implanted, the proximal part of hip prosthesis comprises described first end, and the far-end of wherein said hip prosthesis comprises described second end, and the top of wherein said hip prosthesis on the surface of first end has the less layer of hard elasticity further.
According to an embodiment, under the layer that the hard elasticity at the top on first end surface is less/far-end, prosthese is more flexible substantially, and distally progressively has less elasticity further in a distal direction.
According to an embodiment, when implanted, in distal direction, distally have more small prosthetic component to stop in distally further gradually, first prosthese herein contacts femur.
According to an embodiment, when implanted, the prosthetic component be arranged in femur is distally progressively more flexible further in distal direction.
According to an embodiment, the prosthetic component of implanted femur has the elasticity close with bone elasticity.
Please note that any embodiment or embodiment part and any means or method part can combine in any way.
Accompanying drawing explanation
By the mode of example, embodiment is described referring now to accompanying drawing, wherein:
Fig. 1 shows when traditional operation is implemented, the patient in side view,
Fig. 2 shows when surgically method cuts out otch, the front view of patient,
Fig. 3 shows when otch cuts out with laparoscopy checking method, the front view of patient,
Fig. 4 shows the front view of the apparatus of patient and laparoscopy checking method,
Fig. 5 shows when laparoscopy checking method is implemented, the patient in section,
Fig. 6 shows the hip prosthesis according to an embodiment,
Fig. 7 shows the hip prosthesis according to an embodiment,
Fig. 8 illustrates in greater detail the hip prosthesis according to an embodiment,
Fig. 9 illustrates in greater detail the hip prosthesis according to an embodiment,
Figure 10 shows when being fixed in femur, according to the hip prosthesis of an embodiment,
Figure 11 shows when being fixed in neck of femur, according to the hip prosthesis of an embodiment,
Figure 12 shows the hip prosthesis according to an embodiment,
Figure 13 shows the hip prosthesis according to an embodiment,
Figure 14 shows hip prosthesis and its another part,
Figure 15 shows the hip prosthesis with sweep,
Figure 15 ' schematically shows the part how torsion affects hip prosthesis.
Detailed description of the invention
Elasticity should be understood to the ability that material is out of shape in a elastomeric manner.
Elastic deformation refers to material (such as applied external force) distortion under stress, but when stress relieved, recovers its original-shape.More resilient material should be understood to have the material compared with low elastic modulus.The elastic modelling quantity of object is defined as in regime of elastic deformation, the slope of load-deformation curve.Elastic modelling quantity is calculated as stress/strain, and wherein stress is the area that transmutative force is applied to divided by this power; And strain is the ratio of the change that stress causes.
Rigidity should be understood to the resistivity of elastic body to the distortion caused by active force.
Net attractive force should be understood to the interconnective material by the captivation on atom or molecular level.These net attractive force can be Van der Waals force, bipolarity power (bipolarforce) or covalent force.The material connected by net attractive force can be same material, through the same basic material of different disposal or the different materials that interfixed by certain bonding force.
The near-end of hip prosthesis should be understood to the part be positioned in patient body when implanted nearby.Therefore proximal part is the part comprising the jointing be connected with acetabular bone.Distal portions is that prosthese is positioned at part at a distance when implanted in patient body.Distal portions comprises the fixing section being suitable for prosthese being fixed to femur and/or neck of femur (collumfemur).
Material component should be understood to a part or the section of material, described part or section need not have identical attribute with the other parts of same material, a part for such as metal material and another part of metal material can differently be hardened, even if these two parts are parts of same foundation material, this is similar to polymer and ceramic material.
Biocompatible materials should be understood to have the immunoreactive material of low-level.Biocompatible materials is also sometimes referred to as biomaterial.Similar is biocompatibility metal, has low immunoreactive biocompatibility metal, such as titanium or tantalum.Biocompatibility metal also can be the biocompatible alloy comprising at least one biocompatibility metal.
Metal alloy should be understood to be in the mixture of two or more elements in solid solution, and in described solid solution, main component is metal.Therefore steel alloy is a kind of alloy, and wherein one of composition is steel, and described steel is the alloy of ferrum and carbon conversely.Therefore titanium alloy is a kind of alloy, and wherein one of composition is titanium.
Martensite is the adamantine form of one of steel crystal structure, but it is also any crystal structure formed by displacement conversion.It comprises the hard mineral that a class exists with lath-shaped or flat crystal granule.
According to an embodiment, hip prosthesis is steel alloy prosthese, such as rustless steel prosthese, and wherein one of the end of prosthese is suitable for being connected with acetabular bone, and described acetabular bone is the bowl-shape part of basin bone.Jointing has more small surface, and the other parts of described more small surface ratio prosthese are suitable for resisting wearing and tearing better.More small surface is formed by surface hardening, and described surface hardening is the process that described surface is rapidly heated and then cools fast.Quench by not making carbon atom diffuse out crystal structure and produce martensite on surface.Prosthese comprises the fixing section helping prosthese to be fixed to femur further.Fixing section can be only the prosthetic component with the surface be directly or indirectly connected with femur, and in this case, prosthese comprises further and is suitable for being arranged on the centre portion between described jointing and described fixing section.According to another embodiment, fixing section is the whole prostheses except jointing.Jointing can quench by cooling specific part fast, but also can expect, to whole prosthese quenching and to bearing the section tempering of any wearing and tearing to produce more resilient structure in the material.
According to an embodiment, jointing and fixing section are made a living thing biocompatible metallic material, and centre portion is biocompatible polymeric material, such as polyurethane elastomeric materials, polyamide elastane material, polyester elastic materials and silicone elastomer material.
According to an embodiment, hip prosthesis is titanium or titanium prosthesis, and wherein jointing comprises the ceramic layer of such as titanium carbide to produce more wear-resisting surface.Titanium or titanium prosthesis can by tempering to produce more resilient structure in the material.
According to any embodiment, medical apparatus and instruments can comprise the material that at least one is selected from the cohort be made up of politef (PTFE), excessively fluoroalkyl compound (PFA) and fluorinated ethylene propylene (FEP) (FEP).In addition can expect, this material comprises: metal alloy, such as cobalt-chromium-molybdenum or titanium or rustless steel; Or polyethylene, such as crosslinked polyethylene or gas depoisoning polyethylene.In contact surface or whole medical apparatus and instruments, the use of ceramic material also can be expected, such as zirconium or zirconia ceramic or aluminium oxide ceramics.The part contacted with skeleton for medical apparatus and instruments being fixed to skeleton of medical apparatus and instruments can comprise loose structure, described loose structure can be multi-pore micron or nanostructured, is suitable for promoting that the growth of skeleton in medical apparatus and instruments (growth-in) fixes medical apparatus and instruments.Loose structure can pass through coating hydroxyapatite (HA) coating, or coarse intercommunicating pore titanium coating realizes, and this can be produced by air plasma spraying, and the combination comprising coarse intercommunicating pore titanium coating and HA top layer also can be expected.Contact portion can be made up of self-lubricating material, such as ceraceous polymer, such as PTFE, PFA, FEP, PE and UHMWPE, or be made up of the powdered metallurgical material that can incorporate lubricant, described lubricant is preferably bio-compatible lubricant, such as derivatives of hyaluronic acids.Can expect equally, the material of contact portion or medical apparatus surface is suitable for being continued or lubricating off and on herein.According to some embodiments, the part of medical apparatus and instruments or parts can comprise the combination of metal material and/or carbon fiber and/or boron, the combination of metal and plastic material, the combination of metal and carbon-based material, the combination of carbon and plastic-based materials, flexibility and the combination of rigid material, the combination of resilient and few elastic material, Corian (Corian) or acrylate copolymer.
The detailed description of embodiment will be provided hereinafter.In the accompanying drawings, same reference number specifies same or corresponding element in whole a few width figure.It should be understood that these figure only do example with and limit its scope never in any form.Therefore, any direction mentioned, such as " on " or D score, only refer to the direction illustrated in the drawings.Equally, any size illustrated in the drawings etc. is all the object in order to example.
Fig. 1 shows the side view of traditional operation on hip joint, and wherein otch 112 cuts out in thigh 113, enables surgeon touch femur 7, and femoral head (caputfemur) 5 is positioned on femur 7.In traditional operation on hip joint, by capsula articularis coxae close to hip joint, this forces surgeon to penetrate lens capsule tissue.
Fig. 2 shows the front view of patient body, wherein implements the operation method installing hip prosthesis from the opposite side of acetabular bone.According to first embodiment, the method comes into effect from the otch 1 of patient's stomach wall.Otch 1 enters patients abdomen through rectus abdominis m. and peritoneum.In the second embodiment, under peritoneum, be cut out through the go forward side by side otch 2 in engagement bone district of rectus abdominis m..According to the 3rd embodiment, otch 3 is just cut out between ilium and surrounding tissue, and otch 3 can enable basin bone be cut open with little fascia and penetrating of muscular tissue.According to the 4th embodiment, otch 4 cuts out in groin.In all four embodiments, the tissue surrounding basin bone 9 in the region that acetabular bone is relative is removed or penetrates, and enables surgeon contact basin bone 9.
Fig. 3 shows the front view of patient body, wherein implements from the opposite side of acetabular bone the laparoscopic operation method installing hip prosthesis.According to the first embodiment, the method comes into effect from cutting out minimal incision * 14 patient's stomach wall.Minimal incision * enables surgeon that laparoscopic trocar is inserted patients abdomen.According to first embodiment, minimal incision * 14 enters the abdominal part of patient through stomach wall and peritoneum.According to second embodiment, through stomach wall, preferably pass through rectus abdominis m. and enter and be cut out at the minimal incision * 15 in subabdominoperitoneal basin bone region.According to the 3rd embodiment, minimal incision * 16 just cuts out between ilium and the tissue of encirclement, and otch 16 can enable basin bone be cut open with little fascia and penetrating of muscular tissue.According to the 4th embodiment, otch 17 cuts out in groin.In all four embodiments, the tissue surrounding basin bone 9 in the region of acetabular bone 8 opposite side is removed or penetrates, and enables surgeon contact basin bone 9.
Fig. 4 shows the front view of patient body, illustrates the laparoscopic operation method of performing the operation to hip joint from the opposite side of acetabular bone 8.Hip joint comprises acetabular bone 8 and femoral head 5.Minimal incision * 14 in patient's stomach wall allows laparoscopic trocar 33a, 33b, 33c to insert in patient body.One or more photographic head 34 subsequently, be suitable for the operating theater instruments 35 of pore-creating in basin bone, or for introducing, settling, connect, adhere to, create or the apparatus 36 of filling prosthesis or prosthetic component, can be inserted in described health by described laparoscopic trocar 33a, 33b, 33c.
Fig. 5 shows the side view of patient body, and wherein hip joint is shown specifically further in section.Hip joint comprises the femoral head 5 being positioned at neck of femur 6 top, and described neck of femur 6 is positioned at the top of femur 7.This femoral head is connected with the bowl-shaped portion acetabular bone 8 of basin bone 9.With one or more photographic head 34, be suitable for the operating theater instruments 35 of pore-creating in basin bone, or for introducing, settling, connect, adhere to, create or the apparatus 36 of filling prosthesis or prosthetic component, laparoscopic trocar 33a, 33b, 33c are used to arrive at hip joint 39.
Fig. 6 shows the hip prosthesis according to an embodiment, and wherein hip prosthesis is suitable for relying on fixing section A to be fixed to femur.Hip prosthesis is suitable for having the section being expressed as A, B, C and D, and described section is suitable for having different attributes.According to an embodiment, section A is suitable for there is less elasticity than section B, and described section B is suitable for there is less elasticity than section C conversely, and described section C is suitable for there is less elasticity than section D conversely.This enables the first section A be fixedly secured to femur, and hip prosthesis is by more resilient section simultaneously, can absorb the vibrations produced by the movement of patient and load.According to another embodiment, section A is suitable for there is less elasticity than section B, and described section B is suitable for there is less elasticity than section C conversely, but more flexible than section D.This enables the first section A be fixedly secured to femur, enables hip prosthesis absorbing vibration, and jointing D can resist and contact produced wearing and tearing with acetabular bone 8 or its artificial substitute simultaneously.But can expect equally, in any embodiment, artificial femur's head surface 45 comprises and is suitable for wear-resistant surfacing, and described surfacing can be have more small metal material, ceramic material, material with carbon element or polymeric material.
Fig. 7 shows the hip prosthesis according to an embodiment, and wherein hip prosthesis is suitable for relying on fixing section A to be fixed to neck of femur.Hip prosthesis comprises three are expressed as A, B and C section according to diagram.According to an embodiment, section A is suitable for there is less elasticity B than section B, and described section B has less elasticity than section C conversely.This enables the first section A be fixed firmly to neck of femur, and hip prosthesis is by more resilient section simultaneously, can absorb the vibrations produced by the movement of patient and load.According to an embodiment, section A is suitable for there is less elasticity B than section B, and described section B has less elasticity than section C conversely.This enables the first section A be fixedly secured to neck of femur, enables hip prosthesis absorbing vibration, and jointing C can resist and contact produced wearing and tearing with acetabular bone 8 or its artificial substitute simultaneously.But can expect equally, in any embodiment, artificial femur's head surface 45 comprises and is suitable for wear-resistant surfacing, and described surfacing can be have more small metal material, ceramic material, material with carbon element or polymeric material.
Fig. 8 shows hip prosthesis in one embodiment, and wherein hip prosthesis comprises multiple section being expressed as I-XI according to diagram.According to this embodiment, hip prosthesis is made up of metal material, and described metal material is hardened to make different section have different attributes.Hardening process can be implemented in one way, to obtain clear (clear) section with different attribute, but, can expect equally, described different attribute is propagated continuously in hip prosthesis, namely there is not boundary clearly, but attribute consecutive variations in whole hip prosthesis.But hip prosthesis comprises the section being applicable to different operation objects.Fixing section A preferably includes has less elastic section, because hip prosthesis greatly can not contribute to the ability that hip prosthesis is fixed firmly to femur by changes shape in section I-XI.Section B and C preferably includes the more resilient section in section I-XI, because this part of hip prosthesis can change its shape and can not produce any tremendous influence to the mechanical performance of hip prosthesis.The jointing D comprising artificial femur's head surface 45 preferably includes and is suitable for there is section that the is more small and metal material that abrasion resistance is larger, or surfacing, described surfacing is separated with the other parts of hip prosthesis and is suitable for resisting by the wearing and tearing connecting acetabular bone or its artificial substitute and produce.According to other embodiment, material is polymeric material, and described polymeric material is hardened or stretches and produces different attributes with the different sections at hip prosthesis.According to other embodiment, hip prosthesis is made up of pottery or powder sill, and in this case, hip prosthesis can be hardened or sinter to produce different attributes in the different sections extended along the length axes L of hip prosthesis.
Fig. 9 shows hip prosthesis in one embodiment, and wherein hip prosthesis comprises multiple section being expressed as I-VII according to diagram.According to this embodiment, hip prosthesis is made up of metal material, and described metal material is hardened to make different section have different attributes.Hardening process can be implemented in one way, to obtain the clear section with different attribute, but, can expect equally, described different attribute is propagated continuously in hip prosthesis, namely there is not boundary clearly, but attribute consecutive variations in whole hip prosthesis.But hip prosthesis comprises the section being applicable to different operation objects.Fixing section A preferably includes has more small section, because hip prosthesis greatly can not contribute to the ability that hip prosthesis is fixed firmly to neck of femur 6 by changes shape in section I-VII.Section B preferably includes the more resilient section in section I-VII, can not produce any great impact because this part of hip prosthesis can change its shape on the mechanical performance of hip prosthesis.The jointing C comprising artificial femur's head surface 45 preferably includes and is suitable for having the more small and metal material section that abrasion resistance is larger, or surfacing, described surfacing is separated with the other parts of hip prosthesis and is suitable for resisting by the wearing and tearing connecting acetabular bone or its artificial substitute and produce.According to other embodiment, material is polymeric material, and described polymeric material is hardened or stretches and produces different attributes with the different sections at hip prosthesis.According to other embodiment, hip prosthesis is made up of pottery or powder sill, and in this case, hip prosthesis can be hardened or sinter to produce different attributes at the different sections extended along the length axes L of hip prosthesis.
Figure 10 shows the hip prosthesis when being fixed to femur 7.According to this embodiment, hip prosthesis is suitable for being fixed to femur 7 and neck of femur 6.According to this embodiment, the fixing section A of hip prosthesis comprises the major part of hip prosthesis, and part B is substantially shorter as seen in Fig., and being suitable for has larger elasticity to absorb by the vibrations of the mobile generation of patient and vibration.
Figure 11 shows the hip prosthesis in the section of an embodiment, wherein consistent with embodiment above, and the hip prosthesis being suitable for being fixed to neck of femur is suitable for being arranged in hip joint by the hole 18 in basin bone 9.According to this embodiment, hip prosthesis comprises support component 612, and described support component 612 from the external support hip prosthesis of neck of femur 6, and to be connected by the surface of the section 614 with neck of femur 6 thus from the collateral support hip prosthesis of the acetabular bone of neck of femur 6.
Figure 12 shows the hip prosthesis according to an embodiment, and wherein hip prosthesis includes more small core texture 615 and more resilient surface texture 616.Hip prosthesis by being suitable for making in different step or from the metal material of outer and inner sclerosis, can obtain different attributes to make core texture 615 and surface texture.The thickness of surface segment can be changed further along the prolongation of hip prosthesis, with the relatively large part making the fixing section A being such as suitable for hip prosthesis to be fixed to femur 7 include more small core material 615, thus contribute to hip prosthesis and be fixed in femur.Similarly, section B and C preferably can be suitable for the vibrations and vibration that have larger elasticity to be produced by the movement of patient to enable these sections absorb.According to by the section clearly defined, hip prosthesis can be divided into more resilient surface segment 616 and have more small core section, but can expect equally, this division realizes in a continuous manner, namely between core section 615 and surface segment 616, there is not clearly boundary.
Figure 13 shows the hip prosthesis according to an embodiment, and wherein hip prosthesis includes more small core texture 615 and more resilient surface segment 616.Hip prosthesis by being suitable for making in different step or from the metal material of outer and inner sclerosis, can obtain different attributes to make core section 615 and surface texture.The thickness of surface segment can be changed further along the prolongation of hip prosthesis, with the relatively large part making the fixing section A being such as suitable for hip prosthesis to be fixed to neck of femur 6 include more small core material 615, this contributes to hip prosthesis and is fixed in femur.Similarly, section B and C preferably can be suitable for the vibrations and vibration that have larger elasticity to be produced by the movement of patient to enable these sections absorb.Rely on by the section clearly defined, hip prosthesis can be divided into more resilient surface segment 616 and have more small core section, but can expect equally, this division realizes in a continuous manner, namely between core section 615 and surface segment 616, there is not clearly boundary.
Figure 14 shows an embodiment of hip prosthesis, and wherein hip prosthesis comprises: fixing section A ', around the jointing C ' of the circumferential extension of artificial femur's head part 45 of hip prosthesis and the centre portion B ' that is arranged between described fixing section A ' and described jointing C '.Fixing section is suitable for being fixed to femur in femur inside.In order to mobile together with femur and and then reduce the risk of the cracked or prosthetic loosening of femur, fixing section A ' can make by having the material similar to femur and/or bone cement elasticity, and described bone cement is used for hip prosthesis to be fixed to femur.According to an embodiment, jointing C ' comprises the core material comparing jointing C ' more small surfacing, for resisting the wearing and tearing to acetabular bone or its artificial substitute better.Usually can expect, fixing section A ', jointing C ' and centre portion B ' can comprise the material or material component with dual extension-compression modulus.Can expect equally, hip prosthesis comprises different materials at a section, its prolongation and/or perpendicular to the part of prolongation in change, the core of such as hip prosthesis has a kind of elasticity and the surface of hip prosthesis has a kind of elasticity.
Figure 15 shows the hip prosthesis according to an embodiment, is wherein flexibly out of shape by hip prosthesis when bearing active force, and this hip prosthesis is suitable for absorbing the active force in hip joint.According to the embodiment shown in Fig. 5, the fixing section A of prosthese " comprise the material or material component that are suitable for elastic deformation when bearing active force, and the material that is more flexiblely out of shape of the material that the centre portion B of hip prosthesis " comprises and compares fixing section A " or material component.
By curving the centre portion of sweep, described sweep has curvature value κ=1/R, and wherein R is close radius of a circle sweep being put P, and the centre portion B of hip prosthesis " is suitable for Absorption power.According to an embodiment, hip prosthesis is suitable for controlling centre portion and curves curvature value κ > 2, fixes section A simultaneously " be still fixedly attached to femur, and femur keeps complete.According to another embodiment, hip prosthesis is suitable for controlling centre portion and curves curvature value κ > 4, fixes section A simultaneously " be still fixedly attached to femur, and femur keeps complete." be still fixedly attached to femur, and femur keeps complete and according to another one embodiment, hip prosthesis is suitable for controlling centre portion and curves curvature value κ > 8, fixes section A simultaneously.By centre portion B ", " comprise and be enough to absorb described active force and the elastomeric material that can not damage femur or the connection between prosthese and femur, all above-described embodiments are all feasible to described centre portion B.
The hip prosthesis of Figure 15, by can the centre portion B of elastic distortion ", be further adapted for the active force absorbed in hip joint.The ability that material absorbs torsion by distortion can be defined as material distortion certain angle and torsion angle when applying certain effect power ability.According to an embodiment, hip prosthesis is suitable for controlling centre portion B and " is twisted into torsion angle radian, fixes section A simultaneously " be still fixedly attached to femur, and femur keeps complete.According to another embodiment, hip prosthesis is suitable for controlling centre portion B and " is twisted into torsion angle radian, fixes section A simultaneously " be still fixedly attached to femur, and femur keeps complete, and according to another one embodiment, hip prosthesis is suitable for controlling centre portion B and " is twisted into torsion angle radian, fixes section A simultaneously " be still fixedly attached to femur, and femur keeps complete.Torsion angle is shown in Figure 15 '.By centre portion B ", " comprise elastic foot can not damage femur or the connection between prosthese and femur material to absorb described active force, all above-described embodiments are all feasible to described centre portion B.
According to any embodiment, hip prosthesis can be suitable for flexibly bending, or flexibly distortion, or flexibly bending also distortion.In addition can expect, according to any embodiment, hip prosthesis is suitable for the mode identical with femur flexibly distortion, and/or flexibly bends in the mode identical with femur and/or bone cement, and described bone cement is used for hip prosthesis to be fixed to femur.
For improving the growth of the osseous tissue of fixed fae body, according to any embodiment, fixing section can have porous or partially porous material to make.Porous material allows osseous tissue to extend into prosthese and forms stable fixing.
Please note that any embodiment or section Example and any means or Part Methods can combine in any way.Here all examples should be regarded as a part for general remark, and therefore briefly may combine in any way.

Claims (56)

1. a hip prosthesis, is suitable for, in implant patient hip joint, it is characterized in that, described hip prosthesis has the length axes (L) extended on its proximal-distal direction when implanted, and wherein hip prosthesis comprises:
-first area (C, D, II), it comprises the first material or the first material component,
-second area (A, I), it comprises the second material or the second material component,
-three region (III), it comprises the 3rd material or the 3rd material component,
-four region (IV), it comprises the 4th material or the 4th material component,
-five region (V), it comprises the 5th material or the 5th material component,
Wherein first, second, 3rd, 4th and the 5th material or first, second, 3rd, 4th and the 5th material component is interconnected by net attractive force, wherein said hip prosthesis has length axes (L) on distal-to-proximal direction, wherein said first, second, 3rd, 4th and the 5th region is settled continuously along described length axes (L), wherein said first, second, 3rd, 4th and the 5th material or first, second, 3rd, 4th and the 5th material component has different elasticity, thus make described first, second, 3rd, 4th and the 5th material or first, second, 3rd, the elastic Different Effects hip prosthesis of the 4th and the 5th material component is along the elasticity of its length axes (L).
2. hip prosthesis according to claim 1, it is characterized in that, the proximal part of described hip prosthesis comprises first end when implanted, and the far-end of wherein said hip prosthesis comprises the second end, and wherein said hip prosthesis is from described second end to described first end or little by little more flexible to described second end from described first end.
3. hip prosthesis according to claim 1, is characterized in that,
-described first material or the first material component than described second material or the second material component more flexible,
-described second material or the second material component than described 3rd material or the 3rd material component more flexible,
-described 3rd material or the 3rd material component than described 4th material or the 4th material component more flexible, and
-described 4th material or the 4th material component than described 5th material or the 5th material component more flexible.
4. hip prosthesis according to claim 1, is characterized in that:
-described first material or the first material component than described second material or the second material component more flexible,
-described second material or the second material component than described 3rd material or the 3rd material component more flexible,
-described 3rd material or the 3rd material component have less elasticity than described 4th material or the 4th material component, and
-described 4th material or the 4th material component have less elasticity than described 5th material or the 5th material component.
5. hip prosthesis according to claim 1, is characterized in that:
-described first material is more flexible than described second material,
-described second material is more flexible than described 3rd material,
-described 3rd material is more flexible than described 4th material, and
-described 4th material has less elasticity than described 5th material.
6. hip prosthesis according to claim 1, is characterized in that:
When described hip prosthesis is implanted in described patient,
-described first area is the most proximal end region in first, second, third, fourth and fifth region,
-described second area is the second most proximal end region in first, second, third, fourth and fifth region,
-described 3rd region is the 3rd most proximal end region in first, second, third, fourth and fifth region,
-described 4th region is the 4th most proximal end region in first, second, third, fourth and fifth region,
-described 5th region is the 5th most proximal end region in first, second, third, fourth and fifth region.
7. hip prosthesis according to claim 6, is characterized in that:
-described first material or the first material component than described second material or the second material component more flexible,
-described second material or the second material component than described 3rd material or the 3rd material component more flexible,
-described 3rd material or the 3rd material component than described 4th material or the 4th material component more flexible, and
-described 4th material or the 4th material component than described 5th material or the 5th material component more flexible.
8. hip prosthesis according to claim 6, is characterized in that:
-described first material or the first material component than described second material or the second material component more flexible,
-described second material or the second material component than described 3rd material or the 3rd material component more flexible,
-described 3rd material or the 3rd material component have less elasticity than described 4th material or the 4th material component, and
-described 4th material or the 4th material component have less elasticity than described 5th material or the 5th material component.
9. hip prosthesis according to claim 6, is characterized in that:
-described first material or the first material component than described second material or the second material component more flexible,
-described second material or the second material component than described 3rd material or the 3rd material component more flexible,
-described 3rd material or the 3rd material component than described 4th material or the 4th material component more flexible, and
-described 4th material or the 4th material component have less elasticity than described 5th material or the 5th material component.
10. the hip prosthesis according to any one of claim 1-9, is characterized in that, the described hip joint of patient comprises acetabular bone, and it is the bowl-shaped portion of basin bone, and described hip prosthesis comprises further:
-jointing, it comprises connecting surface, and described connecting surface comprises first surface material or first surface material component, and this first surface material or first surface material component have an average elasticity, and wherein said connecting surface is suitable for being connected with described acetabular bone or its artificial substitute, and
-fixing section, it comprises fixed surface, described fixed surface comprises second surface material or second surface material component, and this second surface material or second surface material component have an average elasticity, to be suitable for helping described hip prosthesis to be fixed to the femur of described patient.
11. hip prosthesises according to claim 10, is characterized in that, the average elasticity of described first surface material or described first surface material component is lower than the average elasticity of described second surface material or described second surface material component.
12. hip prosthesises according to claim 10, it is characterized in that, described hip prosthesis comprises further be connected to each other part between described first surface material and described second surface material, it comprises the 3rd material or the 3rd material component, and the average elasticity of wherein said 3rd material or described 3rd material component is higher than the average elasticity of described first material or described first material component, and higher than the average elasticity of described second material or described second material component.
13. hip prosthesises according to claim 10, is characterized in that, described hip prosthesis comprises metal.
14. hip prosthesises according to claim 13, is characterized in that, described hip prosthesis comprises metal alloy.
15. hip prosthesises according to claim 13, is characterized in that, described hip prosthesis comprises steel.
16. hip prosthesises according to claim 13, is characterized in that, described metal is biocompatibility metal.
17. hip prosthesises according to claim 15, is characterized in that, the martensite percentage in described first surface material or described first surface material component is than the height in described second surface material or described second surface material component.
18. hip prosthesises according to claim 13, is characterized in that, described metal comprises biocompatibility metal.
19. hip prosthesises according to claim 1, is characterized in that, described hip prosthesis comprises polymeric material or polymeric material part.
20. hip prosthesises according to claim 10, is characterized in that, described fixing section is suitable for being fixed to neck of femur.
21. hip prosthesises according to claim 20, is characterized in that, described fixing section is suitable for being fixed to neck of femur in neck of femur inside.
22. hip prosthesises according to claim 10, is characterized in that, described fixing section is suitable for being fixed to femur.
23. hip prosthesises according to claim 22, is characterized in that, described fixing section is suitable for being fixed to femur in femur inside.
24. hip prosthesises according to claim 10, is characterized in that, described jointing comprises ceramic material or ceramic material part.
25. hip prosthesises according to claim 24, is characterized in that, described ceramic material or described ceramic material part are titanium carbides.
26. hip prosthesises according to claim 1, is characterized in that, described first, second, third, fourth and fifth material or first, second, third, fourth and fifth material component are by the mutual material of net attractive force connects.
27. hip prosthesises according to claim 1, is characterized in that:
-described first material or described first material component than described second material or described second material component more flexible,
-described second material or described second material component than described 3rd material or described 3rd material component more flexible,
-described 3rd material or described 3rd material component than described 4th material or described 4th material component more flexible, and
-described 4th material or described 4th material component than described 5th material or described 5th material component more flexible.
28. hip prosthesises according to claim 1, is characterized in that:
-described first material or described first material component than described second material or described second material component more flexible,
-described second material or described second material component than described 3rd material or described 3rd material component more flexible,
-described 3rd material or described 3rd material component have less elasticity than described 4th material or described 4th material component, and
-described 4th material or described 4th material component have less elasticity than described 5th material or described 5th material component.
29. hip prosthesises according to claim 1, is characterized in that:
-described first material or described first material component than described second material or described second material component more flexible,
-described second material or described second material component than described 3rd material or described 3rd material component more flexible,
-described 3rd material or described 3rd material component than described 4th material or described 4th material component more flexible, and
-described 4th material or described 4th material component have less elasticity than described 5th material or described 5th material component.
30. hip prosthesises according to claim 1, is characterized in that:
As the implanted described patient of described hip prosthesis,
-described first area is the most proximal end region in first, second, third, fourth and fifth region,
-described second area is the second most proximal end region in first, second, third, fourth and fifth region,
-described 3rd region is the 3rd most proximal end region in first, second, third, fourth and fifth region,
-described 4th region is the 4th most proximal end region in first, second, third, fourth and fifth region,
-described 5th region is the 5th most proximal end region in first, second, third, fourth and fifth region.
31. hip prosthesises according to any one of claim 26-30, it is characterized in that, the described hip joint of patient comprises acetabular bone, and it is the bowl-shaped portion of basin bone, and described hip prosthesis comprises further:
-jointing, it comprises connecting surface, and described connecting surface comprises first surface material or first surface material component, and this first surface material or first surface material component have an average elasticity, and wherein said connecting surface is suitable for being connected with described acetabular bone or its artificial substitute, and
-fixing section, it comprises fixed surface, described fixed surface comprises second surface material or second surface material component, and this second surface material or second surface material component have an average elasticity, to be suitable for helping described hip prosthesis to be fixed to the femur of described patient.
32. hip prosthesises according to claim 31, is characterized in that, the average elasticity of described first surface material or described first surface material component is lower than the average elasticity of described second surface material or described second surface material component.
33. hip prosthesises according to claim 31, is characterized in that, described hip prosthesis comprises metal.
34. hip prosthesises according to claim 33, is characterized in that, described hip prosthesis comprises metal alloy.
35. hip prosthesises according to claim 33, is characterized in that, described hip prosthesis comprises steel.
36. hip prosthesises according to claim 33, is characterized in that, described metal is biocompatibility metal.
37. hip prosthesises according to claim 35, is characterized in that, the martensite percentage in described first surface material or described first surface material component is than the height in described second surface material or described second surface material component.
38. hip prosthesises according to claim 33, is characterized in that, described metal comprises biocompatibility metal.
39. hip prosthesises according to any one of claim 26-30, it is characterized in that, described hip prosthesis comprises polymeric material or polymeric material part.
40. hip prosthesises according to claim 31, is characterized in that, described fixing section is suitable for being fixed to neck of femur.
41. hip prosthesises according to claim 40, is characterized in that, described fixing section is suitable for being fixed to neck of femur in neck of femur inside.
42. hip prosthesises according to claim 31, is characterized in that, described fixing section is suitable for being fixed to femur.
43. hip prosthesises according to claim 42, is characterized in that, described fixing section is suitable for being fixed to femur in femur inside.
44. hip prosthesises according to claim 31, is characterized in that, described jointing comprises ceramic material or ceramic material part.
45. hip prosthesises according to claim 44, is characterized in that, described ceramic material or described ceramic material part are titanium carbides.
46. hip prosthesises according to claim 1, it is characterized in that, described hip prosthesis comprises fixing section, jointing and centre portion, described centre portion is arranged between described fixing section and described jointing, wherein by being suitable for the described centre portion curving certain curvature when bearing active force, described hip prosthesis is suitable for when bearing active force being flexibly out of shape.
47. hip prosthesises according to claim 1, it is characterized in that, described hip prosthesis comprises fixing section, jointing and centre portion, described centre portion is arranged between described fixing section and described jointing, wherein by being suitable for the described centre portion of distortion when bearing active force, described hip prosthesis is suitable for when bearing active force being flexibly out of shape.
48. hip prosthesises according to claim 1, it is characterized in that, described hip prosthesis comprises fixing section, jointing and centre portion, described centre portion is arranged between described fixing section and described jointing, wherein by being suitable for when bearing active force curving certain curvature and the described centre portion of distortion, described hip prosthesis is suitable for when bearing active force being flexibly out of shape.
49. hip prosthesises according to claim 47, is characterized in that, described centre portion is suitable for distortion until torsion angle till, described fixing section keeps being fixedly attached to femur simultaneously.
50. hip prosthesises according to claim 47, is characterized in that, described centre portion is suitable for distortion until torsion angle till, described fixing section keeps being fixedly attached to femur simultaneously.
51. hip prosthesises according to claim 47, is characterized in that, described centre portion is suitable for distortion until torsion angle till, described fixing section keeps being fixedly attached to femur simultaneously.
52. hip prosthesises according to claim 2, it is characterized in that, when implanted, the near-end of described hip prosthesis comprises described first end, and the far-end of wherein said hip prosthesis comprises described second end, and wherein said hip prosthesis has the less layer of hard elasticity further on the top on the surface of first end.
53. hip prosthesises according to claim 52, is characterized in that, under the layer that the hard elasticity at the top on first end surface is less/far-end, prosthese is more flexible roughly, and distally progressively has less elasticity further in distal direction.
54. hip prosthesises according to claim 53, is characterized in that, when implanted, in distal direction, distally progressively have more small prosthetic component to stop in distally further, first prosthese herein contacts femur.
55. hip prosthesises according to claim 54, is characterized in that, when implanted, the prosthetic component be arranged in femur is distad little by little more flexible further in a distal direction.
56. hip prosthesises according to claim 54, is characterized in that, the prosthetic component be arranged in femur has the elasticity close with the elasticity of bone.
CN201080040398.1A 2009-07-10 2010-07-12 Hip joint device Active CN102781372B (en)

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