CN1822801A - 关节内假体 - Google Patents

关节内假体 Download PDF

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CN1822801A
CN1822801A CNA038267772A CN03826777A CN1822801A CN 1822801 A CN1822801 A CN 1822801A CN A038267772 A CNA038267772 A CN A038267772A CN 03826777 A CN03826777 A CN 03826777A CN 1822801 A CN1822801 A CN 1822801A
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prosthese
intraarticular
joint
central axis
passage
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CN100566677C (zh
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B·莱西曼
R·比尔基
D·布尔卡德
R·弗里格
D·奥德马特
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AO Technology AG
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Synthes AG Chur
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Abstract

本发明涉及一种关节内假体，特别是椎间植入物(1)，包括一条中心轴线(2)、一个上件(10)、一个下件(20)和一个在中间设置的关节(5)，其中：A)关节(5)包括至少两个相互可滑动的关节面A和B；B)上件(10)具有一个与中心轴线(2)相交的上对合面(15)和侧面(11、12、13、14)；C)下件(20)具有一个与中心轴线(2)相交的下对合面(25)和侧面(21、22、23、24)；其中关节内假体包括至少一个适用于输送体液的通道(27、28)，所述通道通入到两个关节面A和B之一内并且将其与关节内假体的外部连通。

Description

关节内假体
技术领域
本发明涉及一种按照权利要求1的前序部分所述的关节内假体，特别涉及一种椎间植入物。
背景技术
大多数现在应用的椎间植入物或椎间盘假体包括一个关节，其关节面由金属、聚合物或陶瓷材料构成。关节面通常保持干燥的，因此可能降低植入物的使用寿命。并且由于相互可滑动支承的关节件的受限制的转动运动摩擦学特性是重要的。
由EP-B 0 193 538已知一种人造的髋臼，其配备一个液体室，以便改善关节面的摩擦学特性。在该植入物中不利的情况是，液体室是封闭的，从而不可能从外面吸收体液，而只能从室本身中吸收。此外通过细缝隙可能从外面进入液体室的体液可能积累于封闭的液体室内。由于缺少循环可能降低该积累的液体的pH值，因此植入物的各元件可能受到化学侵蚀。并且在封闭的液体中，其通过这些缝隙与植入物的外表面连通，各植入物元件的相对运动可能引起不符合要求的泵效应。
发明内容
在这里本发明将消除弊端。本发明的目的在于，提供一种关节假体，它包括一个或多个通入到植入物与骨之间的界面的通道，所述通道用于体液的输送，体液包含蛋白质和其他的具有良好润滑特性的物质，对相互可滑动支承的关节面是适宜的。
本发明利用具有权利要求1的特征的关节内假体达到提出的目的。
本发明的其他的有利的实施形式表明于诸从属权利要求中。
通过本发明达到的优点可看出基本上在于，由于按照本发明的关节内假体
-可向关节面输送体液；
-特别在其作为椎间植入物的实施形式中，各通道口可以设置在对合面的中心，从而可以类似于天然的椎间盘实现体液的输送；以及
-其他的体液可以通过由切口形成的洞流向关节面。
在一优选的实施形式中，将各下通道和上通道设置成使至少一个上通道通入上对合面和至少一个下通道通入下对合面，从而体液可以在两侧通向关节面。
在另一实施形式中，至少一个下通道和至少一个上通道从椎间植入物的侧面进入相应的关节件，从而也从由切口形成的洞向关节面输送体液。
优选，进入关节面A、B的通道口设置倒圆角。借此达到的优点是，不产生因锐边过渡引起的对关节面的损伤。
在又一实施形式中，椎间植入物包括多个上通道并且优选也包括多个下通道，将它们设置成使它们的纵轴线与椎间植入物的中心轴线之间形成一个0°与90°之间的角度。将这些角度选择成使得：
-保持椎间植入物的强度是足够的；
-各通道在要求的位置通入关节面；以及
-各通道口在外面在存在关节液体之处设置在椎间植入物上，
特别是在对合面的中心和在由切口形成的洞处。
在另一种实施形式中，每一通道具有一个横截面积，其大小在一个关节面A、B的0.01％与10％之间。对此在一个构成为椎间植入物的关节内假体的情况下适宜的尺寸确定如下：
-关节面A′在400mm2与500mm2之间；
-关节面A″在200mm2与300mm2之间；
-一个通道的最小横截面积为0.07mm2，
-一个通道的最大横截面积为12.6mm2；
-对合面积为969mm2。
优选各通道具有0.3mm与4.0mm之间的直径，其中最小直径匹配于粒子的尺寸，其具有润滑的特性，例如蛋白质。通道的最大直径选择成使其不显著削弱椎间植入物的强度。
在又一实施形式中，各通道对称分布通入关节面A、B。上对合面具有一个面积Fo，而上通道在一个具有面积To＜Fo的部分表面内通入上对合面。优选部分表面的面积To在上对合面的面积Fo的0.006％与1.0％之间。类似地，下对合面具有一个面积Fu，而下通道在一个具有面积Tu＜Fu的部分表面内通入下对合面，其中部分表面的面积Tu优选在下对合面的面积Fu的0.006％与1.0％之间。此外，这些部分表面优选同心于椎间植入物的中心轴线设置。
在不同的实施形式中关节包括两个或三个关节件。作为各关节件的材料副下列配对是特别适宜的：
-金属-聚合物
-金属-金属
-陶瓷-陶瓷
其中作为金属特别是包含钴、铬和钼的合金是适宜的。在一种金属一金属的金属副中，该合属还可以增碳。同样，一个由金属制成的关节件的表面借助于一种适宜的方法涂覆碳化钛、氮化钛或非晶碳。在聚合物中优选涉及高分子的聚乙烯(UHMWPE)，其中表面可以通过一种适宜的方法结网，以便改善耐磨性。
附图说明
以下借助多个实施例的部分的示意图还要更详细地说明本发明和本发明的进一步构成。其中：
图1a本发明的关节内假体的一个实施形式的中间侧视剖面图；
图1b图1a中所示的本发明的关节内假体的实施形式的下关节件的局部剖面，在关节面中具有倒圆的通道口；
图2本发明的关节内假体的另一实施形式的透视图；
图3图2中所示的实施形式平行于第一转动轴线的剖面图；
图4图2和3中所示的实施形式平行于第二转动轴线的剖面图；
图5图2至4中所示的实施形式的俯视图。
具体实施方式
图1中示出关节假体作为椎间植入物1的一个实施形式的中间侧视的剖面图。椎间植入物1包括相对其基本上平行于脊椎柱纵轴线的中心轴线2轴向相叠设置的上件10和下件20，它们包围一个关节5。上件10轴向外面具有一个与中心轴线2相交的、用以贴靠到上方邻接的椎骨体的底板上的上对合面15并且在内部具有一个下表面16，该下表面包括结合的上关节件6。类似于此，下件20轴向外面具有一个与中心轴线2相交的、用以贴靠到下方邻接的椎骨体的底板上的下对合面25并且在内部具有一个上表面26，该上表面包括结合的下关节件8。下关节件8在这里构成为球部分35，而上关节件6构成为互补于球部分35的关节壳36，从而两个件10、20可通过关节5相互相对多轴地转动。两个关节件6、8的每一个构成为单独的元件并且连接相应的元件10、22。
在上件10上设置各上通道27，它们通入上对合面15并且贯穿上件10和上关节件6直到关节壳36的关节面B。通过这些通道27将具有润滑特性的体液从上面输向关节5的关节面A、B。类似地，在下件20上设置各下通道28，它们通入下对合面25并且贯穿下件20以及下关节件8直到球部分35的关节面A，从而体液可从下面输向关节5的关节面A、B。通道27、28在两个件10、20中设置成使它们的开口40位于对合面15、25的中心。在图中所示的椎间植入物1的实施形式中上关节件6构成有三个上通道27a-c，其中中心的上通道27b的纵轴线42b在椎间植入物1的起始位置同轴于纵轴线2延伸并且两个侧面的上通道27a、27c的纵轴线42a、42c与中心轴线2之间形成一个角度，其中通道27a的纵轴线42a与中心轴线2之间形成一个-50°的角度而通道27c的纵轴线42c与中心轴线2之间形成一个+50°的角度。下关节件8包括两个下通道28a、28b，其纵轴线41a、41b同样与中心轴线2之间形成一个角度，其中通道28a的纵轴线41a与中心轴线2之间形成一个-15°的角度而通道28b的纵轴线41b与中心轴线2之间形成一个+15°的角度。
图1b中示出包括一个下通道28a的下关节件8的局部剖面。下通道28a贯穿球部分35直到关节面A，其中通道壁在过渡处设有倒圆角51，从而通道28a在关节面A中的通入口不构成锐边的而构成倒圆的。另一个通道28b和全部的上通道27a-c的通入口优选类似地构成。
图2至5中示出关节内假体构成为椎间植入物1的另一实施形式。椎间植入物1包括一上件10，其具有一个横向于中心轴线2设置的上对合面15，用以贴靠到一个邻接的椎骨体的底板上，还包括一个下件20，该下件具有一个横向于中心轴线2设置的下对合面25，用以贴靠到邻接的椎骨体的底板上，并且在中间包括一个关节5。通过该关节5，上件10和下件20可绕两条相互垂直的转动轴线3、4相互相对运动地连接。
关节5由三个关节件6、7、8实现，借助于它们，下关节件8和上关节件6分别构成一个与中间的关节件7协同操作的、可绕各一转动轴线3、4转动的转动关节38、39。下转动关节39包括一个在中间的关节件7上设置的同轴于第一转动轴线3的下凸面的关节面30作为关节面和一在下关节件8上设置的互补于关节面30的下凹面的关节面31。一转动关节38包括一个在上关节件6上设置的同轴于第二转动轴线4的上凸面的关节面32作为关节面和一个在中间的关节件7上设置的互补于关节面32的上凹面的关节面33。关节面30、31、32、33构成为具有轴向末端邻接的锥形外壳部分表面的圆柱外壳表面的部分表面。
此外，在上关节件6和中间的关节件7上在轴向末端安装有与转动轴线3、4同轴的凸榫17，这些凸榫可移动地容纳在下关节件8和中间的关节件7中的长导向孔18中。通过在长导向孔18中引导的凸榫18来限定关节件6、7、8绕转动轴线3、4的转动角。而且椎间植入物1通过容纳在长导向孔18中的凸榫18结合在一起。
如图3和4中所示，在上件10上设置四个上通道27a-d，它们通入上对合面15并且贯穿上件10包括上关节件6直到关节面A′。通过这些通道27将具有润滑特性的体液从上面输向上转动关节38的关节面A′、B′(图2)。在下件20上设置三个下通道28a-c，它们通入下对合面25并且贯穿下件20包括下关节件8直接关节面B″，从而可将体液从下面输向下转动关节39的关节面A″、B″(图2)。此外，在下关节件8上设置两个另外的下通道28d、28e(图4)，其纵轴线41d、41e垂直于中心轴线2并且它们在外面从前侧的和背侧的侧面21、22进入下关节件8并且贯穿下件20包括下关节件8直到关节面A″、B″。如由图3中所示的中间外侧的剖面显而易见的，四个上通道中只两个通道27b、27c通入上关节件6的关节面A′。其他两个上通道27a、27d通入上件10的下表面16并且具有平行于中心轴线2定向的纵轴线42a、42d。两个通道27b、27c的纵轴线42b、42c与中心轴线2形成一个角度，其中上通道27b的纵轴线42b与中心轴线2之间形成一个+25°的角度而通道27c的纵轴线42c与中心轴线2之间形成一个-25°的角度。此外由图4中所示的前后的剖面显而易见的是，两个下通道28d、28e具有横向于中心轴线2的纵轴线41d、41e，其中下通道28d的纵轴线41d与中心轴线2之间形成一个+90°的角度而下通道28e的纵轴线41e与中心轴线2之间形成一个-90°的角度。两条纵轴线41d、41e位于椎间植入物1的前后的中平面内。
图5示出通入上对合面15的上通道27a-d的开口40。各开口40位于一对合面15的部分表面37内，该表面垂直于中心轴线2并且与其同心。中心轴线2(图2)相交于第一与第二转动轴线3、4的交点并且从其中心向上件10的背侧的侧面12方向偏移。

Claims (21)

1.关节内假体，特别是椎间植入物(1)，包括一条中心轴线(2)、一个上件(10)、一个下件(20)和一个在其间设置的关节(5)，其中
A)关节(5)包括至少两个相互可滑动的关节面A和B；
B)上件(10)具有一个与中心轴线(2)相交的上对合面(15)和侧面(11、12、13、14)；
C)下件(20)具有一个与中心轴线(2)相交的下对合面(25)和侧面(21、22、23、24)；
其特征在于，关节内假体包括至少一个适用于输送体液的通道(27、28)，所述通道通入到两个关节面A和B之一内并且将其与关节内假体的外部连通。
2.按照权利要求1所述的关节内假体，其特征在于，至少一个上通道(27)通入到上对合面(15)内。
3.按照权利要求1或2所述的关节内假体，其特征在于，至少一个下通道(28)通入到下对合面(25)内。
4.按照权利要求1至3之一项所述的关节内假体，其特征在于，关节(5)包括至少两个关节件(6、8)并且至少一个通道(28)从其中一个关节件(6、8)的侧面(11、12、13、14，21、22、23、24)进入。
5.按照权利要求1至4之一项所述的关节内假体，其特征在于，通入到关节面A、B内的通道(27、28、29)的通入口设有倒圆角(51)。
6.按照权利要求2至5之一项所述的关节内假体，其特征在于，关节内假体包括多个上通道(27)。
7.按照权利要求3至6之一项所述的关节内假体，其特征在于，关节内假体包括多个下通道(28)。
8.按照权利要求1至7之一项所述的关节内假体，其特征在于，上通道和下通道(27、28)具有纵轴线(42、41)并且设置成使纵轴线(42、41)与中心轴线(2)之间形成一个0°与90°之间的角度。
9.按照权利要求1至8之一项所述的关节内假体，其特征在于，每一通道(27、28、29)具有一个横截面，该横截面占一个关节面A、B的0.01％到10％。
10.按照权利要求1至9之一项所述的关节内假体，其特征在于，通道(27、28、29)具有0.3mm与4.0mm之间的直径。
11.按照权利要求1至10之一项所述的关节内假体，其特征在于，通道(27、28、29)对称分布地通入到关节面A、B内。
12.按照权利要求1至11之一项所述的关节内假体，其特征在于，上对合面(15)具有一个面积Fo而上通道(27)在一个具有面积To＜Fo的部分表面(37)内通入到上对合面(15)内。
13.按照权利要求12所述的关节内假体，其特征在于，部分表面的面积To在上对合面(15)的面积Fo的0.006％与1.0％之间。
14.按照权利要求1至13之一项所述的关节内假体，其特征在于，下对合面(25)具有一个面积Fu而下通道(28)在一个具有面积Tu＜Fu的部分表面(37)内通入到下对合面(25)内。
15.按照权利要求14所述的关节内假体，其特征在于，部分表面的面积Tu在下对合面(25)的面积Fu的0.006％与1.0％之间。
16.按照权利要求12至15之一项所述的关节内假体，其特征在于，所述部分表面同心于中心轴线(2)设置。
17.按照权利要求2至16之一项所述的关节内假体，其特征在于，上通道(27)的纵轴线与中心轴线(2)之间形成一个0°与65°之间的角度。
18.按照权利要求3至17之一项所述的关节内假体，其特征在于，下通道(28)的纵轴线与中心轴线(2)之间形成一个0°与90°之间的角度。
19.按照权利要求1至18之一项所述的关节内假体，其特征在于，关节(5)包括至少一个上关节件和一个下关节件(6、8)。
20.按照权利要求1至19之一项所述的关节内假体，其特征在于，关节(5)包括一个上关节件、一个中间的关节件和一个下关节件(6、7、8)。
21.按照权利要求19或20所述的关节内假体，其特征在于，至少所述构成关节(5)的关节件(6、7、8)的关节面A、B由金属/聚合物、金属/金属或陶瓷/陶瓷材料副制成。
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JP2007504846A (ja) 2007-03-08
CA2533472A1 (en) 2005-01-27
CN100566677C (zh) 2009-12-09

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