CN1169850A - 鞍形髋部假体 - Google Patents

鞍形髋部假体 Download PDF

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Publication number
CN1169850A
CN1169850A CN97113513A CN97113513A CN1169850A CN 1169850 A CN1169850 A CN 1169850A CN 97113513 A CN97113513 A CN 97113513A CN 97113513 A CN97113513 A CN 97113513A CN 1169850 A CN1169850 A CN 1169850A
Authority
CN
China
Prior art keywords
prosthese
clinocephaly
bearing
clinocepbalic
extends
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN97113513A
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English (en)
Other versions
CN1156254C (zh
Inventor
埃尔马·尼德尔
阿诺尔德·凯勒
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Waldemar Link GmbH and Co KG
Original Assignee
Waldemar Link GmbH and Co KG
GMT Gesellschaft fuer Medizinische Technik mbH
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Publication date
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Publication of CN1169850A publication Critical patent/CN1169850A/zh
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Publication of CN1156254C publication Critical patent/CN1156254C/zh
Anticipated expiration legal-status Critical
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Abstract

一种替代髋关节的鞍形假体包括:插入股骨中的胫骨组合件;带支座的鞍形头,用于形成与盆骨的一部分接合的支承面;和一个支架,用于使鞍形头与所述胫骨组合件耦接,以便能使鞍形头相对于所述胫骨组合件至少绕两个预定轴作枢轴转动,从而以两个以上的自由度转动,其中预定轴中的一个位于所述鞍形头的支承面的上方。

Description

鞍形髋部假体
一般地说，本发明与假体有关，更具体地说，本发明涉及一种用于整体更换髋关节的髋部假体，包括被固定在股骨之骨管中的胫骨和与胫骨相连并可相对于胫骨至少以两个自由度转动的呈鞍形的头，所述鞍形头具有为部分盆骨提供支承的支承座。
欧洲专利EP-A-0,300,131(A1)叙述了一种鞍形假体，它具有鞍形头，可相对于胫骨绕一横向轴转动，此轴基本是沿小腿的长度方向延伸的，并被相对于纵向胫骨轴平行地偏移定位。因而，该呈鞍形的头可以一个自由度相对于胫骨转动，以便使小腿能外转或内转。通过盆骨与鞍形头之间的运动，由这种鞍形假体实现小腿的附加转动运动或枢轴转动，即弯折和伸展或者外展和内收，于是所述鞍形头的支座是平坦的而且是开口的，以便能沿其纵向以及横向移动。因此，连同允许在假体内外转和内转的枢轴关节，由这种假体实现的小腿运动与由球关节实现的运动性能相类似，以致已经常常将这种鞍形假体用于替代髋关节。但实践表明，由于所述支座的相应开口外形，在外科手术后的最初几个月期间，这种鞍形假体有从它的骨骼支承座移位或从那里脱出的趋势。此后，由于在这种金属的呈鞍形的头部周围常常会形成坏死的组织囊，并且在很多情况下将会骨化，这种现象不再发生。另外，由于盆骨在所述鞍形头上的支座或支承表面较小，还可能引起该鞍形头在盆骨中轻微的向上移位，或者在该骨受到过大的压力时，甚至会使所述鞍形头上面的盆骨出现裂缝。
欧洲专利EP-A-0,300,131(A1)进而还揭示了一种具有一球关节的鞍形假体，所述球关节附设于鞍形头的正下方，在鞍形头与胫骨之间的位置处，并容许绕又一轴作有限自由度的运动，该轴相对于横向的鞍形头的轴倾斜，从而使鞍形头相对胫骨以三个自由度灵活转动。但两个关节的配合布置会导致鞍形头的不稳定，这可能引起摇动，所述二关节一是指球关节，另一是指开放的鞍形头与盆骨之间的关节。所以，这种鞍形假体实际上是不可取的。
于是，本发明的一个目的是要提供一种改进的、消除了上述缺点的鞍形假体。
具体地说，本发明的一个目的在于提供一种改进的鞍形假体，它消除了鞍形头的一切不稳定性或倾斜，而且还能阻碍盆骨从该鞍形头的位移或脱开和/或鞍形头在盆骨中的向上移位和/或其在所述鞍形头上方的断裂。
按照本发明，将以如下方式实现这些目的以及其它在下面将会变得愈加清晰的目的，即提供一接合在股骨中的胫骨组件；一带支承的鞍形头以形成一个支承面，用以支承部分盆骨；以及一个使鞍形头耦接于所述胫骨组件的连接组件，使鞍形头能相对于所述胫骨组件绕至少两个预定的转轴或枢轴转动，从而实现具有两个以上自由度的转动，其中至少一个预定的轴被定位于所述鞍形头的支承面上方，以便在大腿屈/伸和/或外展/内收过程中容许鞍形头相对手胫骨转动。
与现有技术中使鞍形头在其下方被可转动地支承相对照，本发明是基于使鞍形头在其支承面上方可转动地支承这样一个认识的。因而，盆骨承受重力的接触区被可回转地悬置在鞍形头中，使得自盆骨向鞍形头的重力的负荷传递发生在悬置体下方，由此当所述假体支承部分体重时，使鞍形头能不断地根据对重力产生影响的方向寻求最稳定的位置，从而消除倾斜的危险，而且不致有害地影响绕相应转轴或枢轴的转动运动或枢轴转动。鞍形头中的这种悬置为获得适当的转动和胫骨的枢轴转动提供条件，并形成可靠的力的传递。通过将鞍形头的断面尺寸选得尽可能的宽，以便容许在大面积范围内进行负荷传递，可阻止鞍形头的上移或盆骨的断裂。
本发明的另一特征是，给所述鞍形头提供两个鞍头，并且支座在其间伸展。与此相适应地，该鞍头应只略微扩张，以免所述鞍形头移位或变得自盆骨腔中脱出。
鞍形头的宽支承面和略为扩张的鞍头这两个措施将使欧洲专利EP-A-0,300,131(A1)所述的普通鞍形假体中骨骼与鞍形头之间的灵活性受到限制。为补偿这种限制而不放弃宽支承面和略为扩张的鞍头的结构，运动的所有三个自由度(此运动必须由鞍形假体传递，而且一般只通过采用球关节而实现)应该从骨骼和鞍形头之间的铰接转换成假体结构，而不致有害地影响其总体的稳定性。一般地说，响应于大腿的屈和伸或者外展和内收，只转换转轴或枢轴之一，最好是在相对的两鞍头之间伸展到所述假体中的一个枢轴，是可能的，与此同时使其它枢轴保持在鞍形支座的表面上，这些其它的枢轴最好在两鞍头之间延伸，并横跨所述支座。结果，可使用于使盆骨支承在所述鞍形头上的支承面明显地扩展，从而减少盆骨在鞍形头上面的上移和/或开裂的可能。还可以想到，减小所述鞍头的扩张，以实现更好地导引在鞍形头中的盆骨的边缘面，并由此减少手术后盆骨自所述鞍形座位移或脱出的可能。尽管由具有较宽承载面和较小扩张的鞍头的鞍形头限制了在它与骨骼之间的关节在二轴基本上垂直对准时的灵活性，但在屈/伸以及外展/内收或者这两种运动的组合的过程中，盆骨在所述鞍形头中的这种枢轴转动支承，以及所述鞍形头在胫骨上枢轴转动地悬置还能导致良好的小腿灵活性。也可以只将一个从一鞍头到另一鞍头横跨鞍形座面的枢轴移至所述假体内，并将在相对的两鞍头之间延伸的枢轴保持在鞍形支座的表面上。
按照本发明的一个优选实施例，将能实现组合的屈/伸和外展/内收所需的两个转轴或枢轴移至所述假体内，为的是实现承载支承面的进一步扩展和/或使两鞍头间的支座变窄，由此达到上述结果。最好利用鞍形头的万向悬架将鞍形头可摆动地安装在一环形体中，而所述环形体又独立于叉形装置中的鞍形头受到可转动地支承。此万向悬架一方面允许胫骨组件转动，因而允许大腿为具有两个自由度的结合在一起的屈/伸运动和外展/内收运动而转动，并且是在相对于所述鞍形头有较大的转角时转动；另一方面，允许在外科手术期间，所述鞍形头以如此配置方式与盆骨接合成最能适合于患者的骨骼结构，比如适于一个局部病患的盆骨。
按照本发明的另一特征，所述叉形装置可相对于胫骨组件绕一个转轴作附加的转动，所述转轴与小腿的纵轴基本上一致，为的是还允许大腿相对于盆骨外转/内转，以及为患者提供基本上与自然的髋关节的小腿灵活性相似的小腿的灵活性。
原则上说，盆骨可在假体内于鞍形头中略作转动，尽管是三自由度的转动，这样可选择地增大由所述假体的构造限制并预先确定的转角。盆骨在鞍形头中枢轴转动的可能性可以通过比如在盆骨与两鞍头相对的内表面之间提供一个较大的间隙和/或通过抛光它们的表面以免骨骼生长来实现。另一方面，现在还可以通过一相应的引导装置或将盆骨固定在鞍形头中，使其基本上或者完全固定，以便可靠地防止外科手术后盆骨自鞍形头移位或脱离。
所述引导装置可以适当地包括彼此相向的导引表面，它们靠压盆骨的相对的骨面，并由将所述盆骨支承在鞍形头中的支承面互连。这种引导装置最好呈槽形结构，并且被限定为呈大致为U形的横断面，并且面向形成导引面的鞍头的内侧。
还可以想到，以按解剖学修正的方式使鞍形头成形，可在制成一个天然盆骨模型的复制品之后(鞍形的内表面全支承在所述骨骼上)，然后再涂敷鞍形头的表面，以促进骨骼的生长。在后一种情况下，最好通过形成以不规则的表面压靠骨骼和/或支承面的鞍头的内侧，以容许骨骼物质生长，从而在骨骼与鞍形头之间形成一永久的连接而实现所述固定。另外，还可以想到，利用骨骼粘固粉，或者利用在鞍形头中的螺钉，使所述螺钉合适地容纳在延伸通过一个鞍头并终止于支座的相对侧的横向孔(呈一个带内螺纹的定位盲孔的形式)内，固定由支承面所支承并与引导装置接合的盆骨的边缘面。
为了在假体与盆骨间有相互作用的过程中提供较大的转动角，比较有利的是采用与鞍形头的相对鞍头之间的鞍形支承的纵轴平行配置的方式，通过万向悬架的两个转轴或枢轴中的一个，并且最好在一个将所述鞍形头分成两半的对称平面中，每一半提供一个鞍头，而另一转轴或枢轴最好垂直地相交于此，两鞍头横向于鞍形座的纵轴，并且该另一转轴或枢轴还在鞍形头的对称平面中适当地取向。为防止由于鞍形头的自重而绕一个轴或两个轴转动或枢轴转动，所述转轴或枢轴最好延伸通过鞍形头的重心，或者在该重心上方相交。
为产生所要求的三自由度运动，并非一定需要两个所述转轴或枢轴以及所述旋转轴彼此以直角相交。但是一种优选的实施例给出了这三个轴的直角坐标系定位，因为在这种情况下，在小腿的枢轴转动和/或转动过程中的运动非常类似于解剖学上的髋关节中的自然运动。
按照本发明的再一特征，通过保证鞍形头绕转轴或枢轴之一的枢轴转动，使所述假体在鞍形头及其支承范围内的总体尺寸保持很小，使所述环形体可替换地支承在沿鞍形头底面的互补的环形外导向槽中，而所述两个转轴或枢轴中的另一个由一转动支承限定，其中，所述环形体相对于所述支架的叉架可转动地支承。与此相适应地，一方面由所述导向槽，而另一方面由所述转动支座所限定的两个转轴或枢轴互相垂直地延伸。最好使所述导向槽相对于所述转轴或枢轴同心地凹入鞍形头的球形环绕的外表面中，所述转轴或枢轴沿鞍形支承的长度方向延伸，从而使所述导向槽在260-310°角，最好在270-300°角的范围内适当地延伸，而所述环形体最好在大约180°圆周角的范围延伸，以使环形体能相对于鞍形头从中心位置转过大约45-60°角而至每一侧。
本发明的鞍形假体最好包括几个可拆地连在一起的部件，即鞍形头、在所述鞍形头的导向槽中可移动的环形体、使环形体受到悬置支承的叉形支架，以及可绕旋转轴转动的转接器或中间片，所述转接器或中间片与所述支架的套管相连，以根据患者骨骼的不同和根据鞍形头装设位置的不同进行长度调整，还包括最好以固定连接的方式将所述转接器固定于其上的胫骨组件。
以下将参照附图详细描述本发明的上述以及其它目的、特征和优点，其中：
图1是本发明鞍形假体的一个实施例的正视图；
图2是图1所示鞍形假体的局部剖开的前视图，详细示出了它的支架；
图3是图2所示支架的顶视图；
图4是图1所示鞍形假体的侧视图，详细示出了支承在支架中的鞍形头；
图5是图4所示鞍形头的侧视图；以及
图6是沿图5中VI-VI线所取的鞍形头的剖面图。
各图中一般是以相同的参考标号表示相同的和相应的部件。
现在参见这些附图，特别是图1，它表示按照本发明的鞍形假体的一个实施例的正视图，该假体总的以参考标号2表示。假体2主要包括一个总的以参考标号4表示的胫骨组件和一个总的以参考标号6表示的通过一万向悬架安置在胫骨组件4上的鞍形头。鞍形头6的万向悬架一般包括一总的由参考标号8表示的支架，它包括一用于可转动地支承一个环形体12的叉架10，环形体12在位于鞍形头6底面上的导向槽14中被滑动地导引。假体2还包括一个总的由参考标号16表示的中间片或转接器，它被置于胫骨组件4上，用以绕转轴18可转动地支承支架8，所述转轴18与小腿的纵轴基本上一致，并形成万向悬架的第一预定转轴或枢轴。
胫骨组件4主要包括一细长的胫骨20，它具有一设有一颈圈22的上端，还包括一个成截锥形的固定销24，它从颈圈22向上延伸，与转接器16接合。胫骨20、颈圈22和固定销24都以单件结构为宜。
胫骨20可插入股骨(未示出)的髓状骨小管中，并用骨骼粘固粉，或以无粘固粉的方式通过压配合和适当的促进骨骼物质生长的表面结构固定于其中。颈圈22有一个平的支承端面26，它面对胫骨20并在安装假体2时布置在股骨的一个相应的被切除的上端上。胫骨20略呈弓形，并沿其远离颈圈的自由端的方向逐渐变细，以便沿侧向最好地配合髓管的曲率。
颈圈22设有一个侧眼28，以便于当在预备阶段为试验目的而把胫骨20插入股骨的髓管时抽出胫骨20。如图1所示，颈圈22朝远离胫骨20的方向向上逐渐变细，并且结束于一实际为圆柱形的中心部分30，所述；柱形中心部分的直径对应于截锥形固定销24的较宽的下端的直径。固定销24也沿远离颈圈22的方向向上逐渐变细，并限定一中心轴32，该轴在一侧平面上相对于转轴18倾斜大约35°角。由一个平的端面34限定固定销24的自由端，在那里形成一个偏心盲孔36，它与固定销24的中心轴32平行地延伸。
转接器16设有一个呈截锥形的凹槽42，以与固定销24的形状配合。圆柱形螺栓38的一端与凹槽42的底部40连成一体，所述柱螺栓可接合于盲孔36内。盲孔36与固定在盲孔36内不致窜动的柱螺栓38一起形成防止转动的机构，由此可防止转接器16相对于胫骨组件4的转动。
转接器16包括凸圆形的外表面，并呈现出一平的上端面44，此端面与转轴18垂直地延伸，用以支承支架8的互补的下端面。支架8包括一个套管50，它有一凹槽48，用于与圆柱形转动销钉46接合，转动销钉46自转接器16的上端面44伸出，并可绕转轴18转动。使转动销钉46接合于套管50的互补的凹槽48中，使之沿轴向不动。转动销钉46和凹槽48沿着它们相邻的周界设有对准的环形槽52、54，用以容纳定位环或者开口簧环56，它阻止转动销钉46从凹槽48中移出，同时允许支架8和转接器16不受阻碍地绕转轴18相对转动。
支架8还设置有一个一般呈叉状的叉架10，叉架10通常由两个互连的叉形部分58、60形成，这两个叉形部分与套管50一起形成一个单独的构件单元。如图3所示，叉形部分58、60被做成具有方形截面的四分之一圆环。不过，在本发明的范围内，必须使叉形部分58、60具有圆形的周缘或界面。
叉形部分58、60的自由端设有一枢轴承62、64，以支承环形体12，环形体12以与转轴18垂直布置的方式与叉架10共轴。使枢轴承62、64配置成限定相互对准的枢轴66，以形成万向悬架的第二预定转轴或枢轴。
如图2所示，每个枢轴承62、64包括一个在叉形部分58、60的自由端处形成的并且与环形体12中的一个相对的螺纹孔70对准的横向孔68。枢轴转动销钉72可成螺纹接合地以它的前螺纹74插入对准的孔68、70中，并以它的后圆柱形轴可摆动地支承于叉形部分58、60之一的横向孔68中。为了防止枢轴转动销钉72从它们的支承上脱出，在旋入枢轴转动销钉72的螺纹74之前，于螺纹孔70中加小量的可生物相容的粘性物质是适宜的。每个枢轴转动销钉72有一个直径较大的头部76，用以方便所述的啮合。头部76被容纳于横向孔68的埋头孔内，并压抵一个环形台肩78，以使环形体12和叉架10相互保持恒定的距离。
环形体12和叉架10都在一个180°的圆周角范围内伸展，并且环形体12的自由端略为互相平行地延伸，用以与枢轴承62、64相适应。转轴或枢轴66沿着半圆的基线径向地延伸，所述半圆是由叉架10和环形体12限定的。
再如图1所示，单一构件的鞍形头6包括两个相对的角形鞍头80、82和一个在两鞍头80，82之间延伸的呈深槽形的支座84，用于为盆骨(未示出)的周缘面提供一支承基面。支座84具有一一般呈U形的截面，鞍头80、82的平行地相向的内侧86，88形成导引表面，所述导引表面靠在装在支座84中的盆骨周缘面的相对的骨骼基面上。导引表面86、88由支座84的一个半圆形底面90彼此相互连接，形成一支承基面90，所述鞍形头6中的盆骨就支承在其上。根据究竟是使盆骨在鞍形头6中可动地受到导引还是不可动地固定于其中，而将导引表面86、88和/或支承基面90抛光，以防止骨骼的生长，或者呈现促进骨骼生长的不平坦的表面。
如图4和5所示，鞍形头6具有一般呈球状的外形，在支座84的相对端面处具有略被修平的端面92。通过适当地加工角形鞍头80、82的底面和相对的外部侧面，形成用于环形体12的环状导向槽14，它在大约270°圆周角的范围内横向于深槽形支座84的纵向延伸。在两个端面处，导向槽14与平的止挡面94的侧面相接，止挡面94相对于第三转轴或枢轴96实质上沿径向延伸，所述枢轴96在鞍头80、82之间伸展，并形成万向悬架的第三预定轴。导向槽14和环形体12具有互补的截面和平滑的表面，以使环形体12在导向槽14内在小摩擦的情况下滑动。环形体12或鞍形头6可涂覆以诸如聚乙烯之类的涂层(未示出)，为的是减小彼此滑动的表面间的摩擦。在涂层的厚度稍大，比如呈鞍形头6内的镶嵌层形式的情况下，所述涂层可同时用于将鞍形头6吸引在环形体12内。通过在略大于180°角的范围内延伸环形体的内圆周就可合适地实现这一点，这样为使鞍形头6与环形体12互相压紧，需使镶嵌层弹性变形，因而可将镶嵌层用作脱位防护机构，防止环形体12在受到拉伸负荷的情况下与鞍形头6分离。
鞍形头6的万向悬架的三个预定轴18、66、96中的两个，也就是鞍形头6与环形体12可绕其作枢轴转动，而且沿着支座84的纵向在鞍形头6的鞍头80、82之间延伸的预定轴96和通过鞍头80、82垂直于支座84的纵向延伸的预定轴66，被安排在半圆柱形支承面90的上面，使鞍形头6能不断地寻找它对于胫骨组件4的最稳定位置，而与自盆骨经鞍形假体2传向小腿方面的重力方向无关。因而，排除了倾转的危险。
预定转轴或枢轴66、96沿鞍形头6的两个对称平面延伸，这使鞍形头6在支座84的中心沿纵向并与之垂直地再细分为互为镜像的两等分。万向悬架的三个预定轴18、66、96还在鞍形头6的重心S处互相交叉，以致不管它们是否对准，也没有固有的角动量可以作用在鞍形头6上。
所述鞍形假体的各构件，即鞍形头6、环形体12、支架8、转接器16和胫骨组件4由可与人体相容的植入材料，如铬-钴-钼(CoCrMo)合金制成，并被可拆地连在一起，以便可以包含不同长度的构件的一套用具而存放，从而能使一套组合件最好地适合患者的骨骼结构。
本发明的鞍形假体2是以如下方式替代髋关节的：
除去被损坏的或患病的骨骼部分，并切除股骨的上端以形成一个平的支承表面，用以支承胫骨组件4之颈圈22的支承端26。接着，准备股骨的髓管，以嵌入胫骨20，并以这样的方式预备盆骨，即使在切除已损坏的或坏死的骨骼部分之后仍然保持的周缘面，或者使在盆骨中形成的空腔的部分周缘适于容纳角形鞍头80、82之一，以与由支座84形成的支承面配合。在嵌入假体2的过程中，预先从具有适宜长度的配套元件中选择一合适的转接器16，从而以最佳方式配合在所述胫骨组件4与连接鞍形头6和环形体12的支架8之间。  然后，用开口簧环56将所选的转接器16可靠地固定在支架8中，以防止沿轴向的移位，但使它仍能转动。在把胫骨20向下压入股骨，直至支承端26抵住股骨的支承面，并且将鞍形头6放置在所预备的盆骨的周缘面上之后，伸展小腿并且使截锥形固定销24嵌入转接器16的凹槽42中，这样柱螺栓38滑入盲孔36中。
虽然本发明已经以鞍形假体的方式被具体化地显示和描述，但并不意味着仅限于所示的说明，因为在不以任何方式脱离本发明的精髓的前提下可作出各种改型和结构变化。
拟由专利文件保护的发明内容在下面所附权利要求书中提出。

Claims (40)

1.一种用于替代髋关节的鞍形假体，包括：
一用于接合在股骨中的胫骨组件；
一带有一支座的鞍形头，用于形成一与盆骨的一部分接合的支承面；
连接装置，用于使鞍形头与所述胫骨组合件耦接，以便能使鞍形头相对于所述胫骨组合件至少绕两个预定轴作枢轴转动，从而以两个以上的自由度转动，其特征在于，所述预定轴中的一个被定位于所述鞍形头的支承面的上方。
2.一种如权利要求1所述的假体，其特征在于，所述鞍形头设有两个角形鞍头，在其间延伸有所述支座，所述的一个预定轴在所述相对的角形鞍头之间沿着支座的纵向延伸。
3.一种如权利要求1所述的假体，其特征在于，所述鞍形头有两个相对设置的角形鞍头，所述支座在其间延伸，所述的另一个预定轴沿支座的纵向在所述角形鞍头之间延伸。
4.一种如权利要求1所述的假体，其特征在于，所述预定轴至少在鞍形头的一个对称平面中延伸。
5.一种如权利要求1所述的假体，其特征在于，所述预定轴延伸通过鞍形头的重心。
6.一种如权利要求1所述的假体，其特征在于，所述预定轴有不同的取向，并在所述支承面上方的一个地方延伸。
7.一种如权利要求6所述的假体，其特征在于，绕两个预定轴的转动是彼此互相独立地进行的。
8.一种如权利要求6所述的假体，其特征在于，所述的两个预定轴彼此相交。
9.一种如权利要求6所述的假体，其特征在于，所述的两个预定轴在一个平面内以直角相交。
10.一种如权利要求1所述的假体，其特征在于，所述鞍形头相对于所述胫骨组合件绕所述的两个预定轴和一第三预定轴万向地枢轴转动。
11.一种如权利要求10所述的假体，其特征在于，由一条实质上沿纵向延伸的转轴限定所述第三预定轴，以允许小腿外转和内转。
12.一种如权利要求10所述的假体，其特征在于，三个预定轴互相相交成直角。
13.一种如权利要求10所述的假体，其特征在于，所述连接装置包括一个支架，所述鞍形头被悬置于支架上，以绕两个预定轴转动。
14.一种如权利要求13所述的假体，其特征在于，所述支架可相对于所述胫骨组合件绕第三预定轴转动。
15.一种如权利要求13所述的假体，其特征在于，所述支架包括一个可绕第三预定轴转动的套管和一个从该套管伸出的叉架。
16.一种如权利要求1所述的假体，其特征在于，在所述鞍形头中形成一个环形导向槽；鞍形头另外还包括一个环形体，它可摆动地支承于所述支架内，并可在鞍形头的导向槽中移动。
17.一种如权利要求16所述的假体，其特征在于，所述鞍形头设有两个角形鞍头，所述支座在其间延伸；当绕着另一个在角形鞍头之间延伸的预定轴作枢轴转动时，所述环形体在所述导向槽中受到引导，以在其中移动。
18.一种如权利要求16所述的假体，其特征在于，所述导向槽跨越所述鞍形头的底面延伸大约260-310°角。
19.一种如权利要求18所述的假体，其特征在于，所述导向槽跨越所述鞍形头的底面延伸大约270-300°角。
20.一种如权利要求16所述的假体，其特征在于，通过凹入所述鞍形头的一个球形围绕的外表面形成所述导向槽。
21.一种如权利要求16所述的假体，其特征在于，所述环形体可移动地固定在所述导向槽内。
22.一种如权利要求16所述的假体，其特征在于，所述环形体延伸大约150-190 °的圆周角。
23.一种如权利要求21所述的假体，其特征在于，所述环形体延伸大约150-180°的圆周角；所述带有导向槽的鞍形头被松弛地置于所述环形体上。
24.一种如权利要求16所述的假体，其特征在于，所述环形体延伸一比180°略大的圆周角，并可被锁紧在所述鞍形头的导向槽中。
25.一种如权利要求1所述的假体，其特征在于，所述鞍形头的支座形成一对盆骨的支承。
26.一种如权利要求25所述的假体，其特征在于，所述鞍形头设有相对设置的角形鞍头，所述支座在其间延伸，所述角形鞍头形成相对的内表面，以为盆骨的邻接骨骼面提供导引表面。
27.一种如权利要求1所述的假体，其特征在于，由所述支座的一个凹形底形成所述支承面。
28.一种如权利要求1所述的假体，其特征在于，所述支座具有一深槽形的构形，并且具有一大致为U形的截面。
29.一种如权利要求1所述的假体，其特征在于，所述支承面以局部为圆柱形的方式向外弯曲。
30.一种如权利要求26所述的假体，其特征在于，构成各导引面和支承面的一组元件中的至少一个被抛光。
31.一种如权利要求26所述的假体，其特征在于，构成各导引面和支承面的一组元件中的至少一个被形成促进骨骼物质生长的表面。
32.一种如权利要求16所述的假体，其特征在于，所述鞍形头、环形体、连接装置以及胫骨组合件至少是部分可拆地被连在一起的。
33.一种如权利要求32所述的假体，其特征在于，还包括一个脱位防护机构，它位于一方面是包括环形体及鞍形头的分组中的至少一个与另一方面是支架及胫骨组合件之间。
34.一种如权利要求1所述的假体，其特征在于，还包括一个转接器，它位于所述胫骨组合件与所述支架之间。
35.一种如权利要求34所述的假体，其特征在于，所述支架被连接到转接器上，以使之能够转动，并防止沿轴向位移。
36.一种如权利要求34所述的假体，其特征在于，所述转接器设有一个向上突起的转动销，用以接合在所述支架的一个凹槽中。
37.一种如权利要求36所述的假体，其特征在于，还包括一个定位环，它插入在所述凹槽和转动销中形成的相对的环形槽中。
38.一种如权利要求34所述的假体，其特征在于，所述转接器设有一截锥形槽，以容纳所述胫骨组合件的截锥形转动销。
39.一种如权利要求38所述的假体，其特征在于，还包括一防转动装置，用以防止转动销在所述凹槽内的转动。
40.一种如权利要求39所述的假体，其特征在于，所述防转动机构由一盲孔形成，所述盲孔与转动销的中心轴相距一定距离并以平行于该中心轴的布置方式延伸，所述防转动机构还包括一个；柱形螺栓，它以平行布置方式与所述凹槽的中心轴相距同样的距离，用以没有间隙地接合到所述盲孔中。
CNB971135134A 1996-05-25 1997-05-23 鞍形髋部假体 Expired - Lifetime CN1156254C (zh)

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