CN1774217B - 用于髋部假肢的髋臼植入物 - Google Patents

用于髋部假肢的髋臼植入物 Download PDF

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CN1774217B
CN1774217B CN2004800020334A CN200480002033A CN1774217B CN 1774217 B CN1774217 B CN 1774217B CN 2004800020334 A CN2004800020334 A CN 2004800020334A CN 200480002033 A CN200480002033 A CN 200480002033A CN 1774217 B CN1774217 B CN 1774217B
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insert
core body
femoral head
implant
inner chamber
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CN1774217A (zh
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让-伊夫·拉曾内克
克里斯蒂安·克吕谢-布歇
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Ceram Concept LLC
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Ceram Concept LLC
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Priority claimed from PCT/FR2004/000037 external-priority patent/WO2004069091A2/fr
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Abstract

本发明涉及一种用于髋部假肢的髋臼植入物，包括：第一种插入物(2)，其具有一个球形的内腔(2a)，用于装配一个半球形核心体(4)并使其可以活动，该核心体具有一个能与一股骨头铰接配合的内腔(4a)；第二种插入物，该插入物具有能与股骨头铰接配合的内腔；其特征在于，该股骨头的转动中心与上述第一种插入物(2)和/或上述第二种插入物的转动轴不同。

Description

用于髋部假肢的髋臼植入物
技术领域
本发明涉及一种用于髋关节的整形外科的植入物的技术领域。
背景技术
髋臼植入物主要包括一个通常为半球形的金属杯状体，在不同的装置或结构中，通过与接合剂结合或者不与接合剂结合，其用于嵌入髋骨的髋臼腔内。一般说来，该杯状体容纳一个由聚乙烯或陶瓷或金属制成的核心体，该核心体用于与一互补的股骨植入物的股骨头铰接配合(可动的连接)。该核心体可以装配在杯状体的内腔内，该装配或者用固定的方式或者具有可活动性或多方向的功能。
显然，根据核心体相对金属杯状体是可活动的或者固定的特征必然要求不同的组合。换句话来说，相同的金属杯状体不可能既用于可活动核心体的安装还用于固定的核心体的安装。
例如，根据专利FR 2.795.302描述，披露了一种包括杯状体的髋臼植入物，该杯状体能够容纳固定在一个可活动核心体上的一个固定插入物或一个可活动插入物，并且一个可活动插入物容纳一个固定核心体。在该专利中描述的技术方案只允许安装一个具有活动自由度的核心体或一个固定的核心体到一插入物上，该插入物安装于杯状体的半球形腔中并且可以活动。由此导致的结果是：在任何情况下，与股骨头配合的核心体都可被安装为相对于杯状体具有活动性。
基于该现有技术状态，本发明要解决的问题是：根据待处理的关节成形的类型，能够使用相同的金属杯状体，并且有可能获得双重活动性(可活动的核心体-可活动的头部)，或者单重活动性(固定插入物-可活动的头部)。需要重申的是，在任何情况下，股骨头相对于髋臼植入物的核心体总是被安装为铰接配合。
发明内容
为了解决上述问题，开发并制作了一种用于髋骨假肢的髋臼植入物，它包括：
第一种插入物，具有一个球形内腔，用于一个半球形核心体的安装并使其可以活动，该半球形核心体具有一个与股骨头铰接配合的内腔；
第二种插入物，具有一个能与股骨头铰接配合的内腔；
其特征在于，股骨头的转动中心与上述第一种插入物和/或上述第二种插入物的转动轴不同。
这样，第一种、第二种插入物和股骨头部的转动中心是排成直线的而不是重合的。
根据本发明，通过在该头部和髋臼之间设置一个双极杯状体，使得该头部可以在双极杯状体中转动，而双极杯状体可以在髋臼腔内转动解决了该技术问题。这种双重转动的可能性在很大程度上减少了脱臼和次脱臼。该系统也被称为双重可移动系统或三极系统。
根据以下描述和在附图中介绍的本发明的一种实施方式，根据本发明的植入物包括一个能够在髋骨的髋臼腔的底部固定的半球形金属杯状体。
上述杯状体优选限定一个具有不同结构或装置的内腔，用于以固定方式任意安装上述第一种或第二种插入物。
考虑这些结构或装置，由其导致的结果是：第一种插入物能获得双重活动性(核心体的活动性和股骨头的活动性)，而第二种插入物能获得单一的活动性(股骨头的活动性)。
在偏心的情况下，可以看到后者能使整个假肢偏向侧面。
同样可以预料到：可活动核心体的半球形的内腔还可以从对称轴偏心。
根据另一特征，第二种插入物和可活动核心体具有一些结构，用于环的装配，以确保夹持住股骨头。
该环是裂开的以使其可以弹性分开，从而被定位在插入物或核心体的开口所具有的互补的结构中。该环限定一个与股骨头的半球形外接触面相对的凹的内接触面。
为了解决确保每一种插入物在金属杯状体中固定的问题，腔的内层的结构与这两种插入物的外表面所具有的互补结构配合，这样特别地通过夹紧作用实现固定。
所述结构优选地由一系列圆锥台形的接触面构成。
基于该基本概念，第一种插入物是由陶瓷、聚乙烯或金属制成，第二种插入物是由陶瓷、聚乙烯或金属制成。至于核心体，是由陶瓷、聚乙烯或金属制成。
在一个优选实施方式中，插入物、核心体和股骨头都是由陶瓷制成。
第一种、第二种插入物和核心体由金属、或聚乙烯或陶瓷或这些材料的组合制成，股骨头由金属或陶瓷或这些材料的组合制成。
同样，除了股骨头，三种部件都可以用聚乙烯制成。这样，第一种、第二种插入物和核心体以及股骨头是由金属或聚乙烯或陶瓷或这些材料的组合制成。
附图说明
下面参照附图，更详细地对本发明进行说明：
图1是在髋臼植入物的部件装配前的纵剖面图，在该情况下其中的插入物属于第一种，用于可活动地装配一个用来容纳股骨头的核心体，并且这些不同的中心相对于杯状体的对称轴成直线。
图1bis与图1的视图类似，其中可活动核心体的半球形内腔从对称轴偏心。
图2是在髋臼植入物的基本部件装配前的纵剖面图，在该情况下第二种插入物用于直接容纳股骨头，并且这些不同的中心相对于杯状体的对称轴成直线。
图3是根据图1的实施例的髋臼植入物的整体的纵剖面图。
图4是对应图3的仰视图。
图5是根据图2的实施例的髋臼植入物的整体的纵剖面图。
图6是对应图5的仰视图。
图7是髋臼植入物的部件装配之前的纵剖面图，在该情况下插入物属于第一种，用于可活动地装配一个核心体，该核心体用来容纳股骨头部，并且在该情况下这些转动中心相对杯状体的对称轴偏移。
图8是在髋臼植入物的主要部件装配前的纵剖面图，在该情况下第二种插入物用于直接容纳股骨头，并且在该情况下这些中心相对杯状体的对称轴偏移。
图9是根据图7的实施例的髋臼植入物的整体的纵剖面图。
图10是对应图9的仰视图。
图11是图8说明的实施例的髋臼植入物的整体的纵剖面图。
图12是对应图11的仰视图。
图13是一个夹持环的放大的纵剖面图。
图14是对应图13的俯视图。
具体实施方式
根据本发明，髋臼植入物包括一个普通的形状为半球形的金属杯状体1。该杯状体1具有所有必要的装置以使其利用或不利用接合剂都可被固定在髋骨的髋臼腔内。该杯状体1限定一个带有一些结构的内腔1a，这样外科医生可以选择安装两种插入物2或3中的一种。
插入物类型2或3的选择取决于增加头部直径和/或获得双重活动性或者单一活动性的要求和必要性。
第一种插入物2具有一个球形内腔2a，用于装配一个具有移动自由度的半球形核心体4。该核心体自身具有一个半球形凹内腔4a，用于铰接安装对应的股骨植入物所具有的一个股骨头T。在图1至3和4所示的实施例中，通过位于插入物2的腔2a中的核心体4与位于该核心体4的内腔4a中的股骨头T能进行多方向性移动而获得双重活动性。
第二种插入物3具有一个内腔3a，该内腔能与股骨头T铰接配合。根据图2、5和6所示的实施例，活动性通过头部T在插入物3的腔3a中的多方向性移动来获得。
值得注意的是，第二种插入物3(也可能是插入物2)，和可活动核心体4可以具有结构3d和4b，用于装配环5以便夹持股骨头T。例如，分级的圆形接触面与腔3a和4a同心形成，所述圆形接触面的直径大于所述腔的直径。环5具有一个与图13所示的轮廓相符的外轮廓，并且在5a处有裂口，用于弹性分开，这样它可以放置于分级的圆形接触面3d和4b。孔5b中可以插入夹子的尖端。环5的内接触面5c是凹的，与股骨头的半球形外接触面相对。该环具有夹持作用，换言之，它使股骨头保持在插入物中，位于股骨头和可活动核心体4的腔的底部之间。
还可以看到，腔3a和4a的直径是相同的，以容纳具有确定直径的同一股骨头T。显然，腔3a和4a的直径是根据对应股骨头T的直径的尺寸范围而确定的。
杯状体1的内腔1a具有一些结构，用于以固定的方式装配插入物2或3中的一种。在此目的下，这些结构与插入物2和插入物3的外表面所具有的互补的结构相配合，尤其用于通过夹紧效应实现固定。在此目的下，在图示的实施例中，对插入物2来说，该结构由一系列圆锥台形的接触面2b和2c组成，对于插入物3来说，这些结构由一系列圆锥台形的接触面3b和3c组成。
当然，对此在不超出本发明范围的情况下，在杯状体1的内腔1a中固定插入物2或3可以通过其它组装的互补的形式和任何已知的合适的构造来进行。
优选地，第一种插入物2由陶瓷制成，第二种插入物3由陶瓷制成，核心体4也由陶瓷制成。同样，金属杯状体1可以具有外表面的涂层和/或对外表面进行处理。
基于这个基本概念，在一个优选实施例中，插入物、可活动核心体和股骨头均由陶瓷制成。
也可考虑髋臼植入物(可能是第一种或第二种插入物，核心体和股骨头部)完全为金属的实施例。
考虑到本发明的基本特征，第一种插入物2的中心01、核心体4的中心02和第二种插入物3的中心03沿杯状体1的对称轴(x-x’)彼此成直线(图1至6)。或者为了允许髋臼植入物的偏侧装配，第一种插入物2的中心01、核心体4的中心02和第二种插入物3的中心03成直线并且从杯状体的对称轴(x-x’)偏离(图7至12)。
正如图1bis所示，同样可以使内腔4a沿对称轴(x-x’)偏离可活动核心体4。
发明效果
本发明的基本目的在于减少现有技术体系的髋部假肢中脱臼的危险。另外，本发明也力求使用两种类型的插入物，从而获得具有一个中间核心体的双重活动性装配或者没有中间核心体的单一活动性装配的优点。
另外，该双重活动自由度减少脱臼的危险并且通过提供自动的重新中心定位而避免了冲突。
值得注意的是，在附图中的插入物相对金属杯状体是突起的。然而，应该理解这种实施类型不是绝对必要的，并且根据本发明的所述装置能同样良好地进行操作。

Claims (12)

1.一种用于髋部假肢的髋臼植入物，包括：
第一种插入物(2)，具有一个球形的内腔(2a)，用于装配一个活动的半球形核心体(4)，所述核心体具有一个能与一股骨头(T)铰接配合的内腔(4a)；或
第二种插入物(3)，具有一个能与股骨头(T)铰接配合的内腔(3a)；
其特征在于，所述第一种插入物(2)、所述第二种插入物(3)和所述股骨头(T)的转动中心是排成直线的而不是重合的。
2.根据权利要求1所述的植入物，其特征在于，它包括一个半球形的金属杯状体(1)，所述杯状体能被固定在髋骨的髋臼腔的底部。
3.根据权利要求2所述的植入物，其特征在于，所述杯状体(1)限定一个内腔(1a)，所述内腔具有用于以固定的方式任意地装配所述第一种插入物(2)和所述第二种插入物(3)的结构。
4.根据权利要求1所述的植入物，其特征在于，所述第二种插入物(3)和所述可活动的核心体(4)具有用于装配环(5)的结构，以确保夹持所述股骨头。
5.根据权利要求4所述的植入物，其特征在于，所述环(5)是裂开的以便弹性分开，用于定位在插入物或核心体的开口的互补形状的结构中，所述环限定一个与所述股骨头的半球形的外接触面相对应的凹的内接触面。
6.根据权利要求3所述的植入物，其特征在于，所述杯状体(1)的内腔(1a)的结构与所述第一种插入物(2)和所述第二种插入物(3)的外表面上的互补结构相配合，以确保通过夹紧作用固定。
7.根据权利要求6所述的植入物，其特征在于，所述第一种插入物(2)和所述第二种插入物(3)的外表面上的互补结构由一系列圆锥台形的接触面构成。
8.根据权利要求1-5中任一项所述的植入物，其特征在于，所述第一种插入物(2)和所述核心体(4)是由陶瓷、聚乙烯或金属制成，以及股骨头是由陶瓷或金属制成。
9.根据权利要求1-5中任一项所述的植入物，其特征在于，所述第二种插入物(3)是由陶瓷、金属或聚乙烯制成。
10.根据权利要求1-5中任一项所述的植入物，其特征在于，所述第一种插入物(2)、所述第二种插入物(3)、和所述核心体(4)是由金属、聚乙烯或陶瓷或这些材料的组合制成的，所述股骨头是由金属或陶瓷或这些材料的组合制成。
11.根据权利要求2所述的植入物，其特征在于，所述第二种插入物(3)和所述可活动的核心体(4)具有用于装配环(5)的结构，以确保夹持所述股骨头。
12.根据权利要求3所述的植入物，其特征在于，所述第二种插入物(3)和所述可活动的核心体(4)具有用于装配环(5)的结构，以确保夹持所述股骨头。
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EP1585469A2 (fr) 2005-10-19
JP5027853B2 (ja) 2012-09-19
CA2512274A1 (fr) 2004-08-19
US20060167556A1 (en) 2006-07-27
WO2003092557A2 (fr) 2003-11-13
US8529633B2 (en) 2013-09-10
AU2004210449A1 (en) 2004-08-19
CA2512274C (fr) 2011-06-28
JP2006516216A (ja) 2006-06-29
AU2004210449B2 (en) 2010-02-18
CN1774217A (zh) 2006-05-17
WO2003092557A3 (fr) 2004-04-08
FR2827154B1 (fr) 2004-04-30
JP2010012288A (ja) 2010-01-21
FR2827154A1 (fr) 2003-01-17
WO2003092557A8 (fr) 2004-07-22
JP4417373B2 (ja) 2010-02-17

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