A porous metal spacer for reconstruction of severe acetabular bone defects with extension fixation

Abstract

The application relates to the technical field of medical prostheses, and discloses a porous metal pad block for extension fixation and used for acetabular severe bone defect reconstruction, which is used in cooperation with an acetabular cup and comprises a supporting plate, the bottom surface of the supporting plate is used for receiving the acetabular cup; a supporting wing, one end of the supporting wing is fixed to one end of the supporting plate, the supporting wing is arranged at an included angle between the supporting plate, the side of the supporting wing away from the supporting plate is used for being attached to the remaining host bone of the acetabulum, and a fixing part for arranging a fixing piece is arranged on the supporting wing, wherein the fixing piece is used for being fixed with the remaining host bone of the acetabulum; and a tooth structure, the tooth structure is arranged at the bottom of the side of the supporting wing away from the supporting plate and comprises at least two strip-shaped teeth arranged in a comb shape, one end of each strip-shaped tooth is fixed to the side of the supporting wing away from the supporting plate, and the other end is suspended. The application has the effects of reconstructing excellent acetabular stability, restoring the original physiological function of a patient, reducing the economic burden of the patient, and reducing the waiting period of the patient.

Description

Technical Field

[0001] This application relates to the technical field of medical prostheses, and in particular to a porous metal pad for extended fixation in the reconstruction of severe bone defects in the acetabulum. Background Technology

[0002] Bone defects on the acetabular side of the hip joint are relatively common in revision surgery. For severe defects in the host bone on the acetabular side caused by tumor lesions, one existing revision method is to use multiple filler blocks to complement each other to fill the bone defect. However, this brings the problem that the bone graft block-acetabulum-remaining host bone cannot form a firm whole. The consequences of unreliable fixation are that screw breakage, filler block displacement, and acetabular cup tilting are likely to occur after surgery.

[0003] Another existing revision method is to make custom-made prostheses. Based on the patient's defect, a personalized prosthesis is made for the patient. This personalized prosthesis can fit the patient's defect well. However, it is relatively expensive in clinical practice and the waiting period for patients is long, making it difficult to promote on a large scale.

[0004] Therefore, there is an urgent need for an acetabular reconstruction pad that can restore excellent acetabular stability, restore the patient's original physiological function, reduce the patient's economic burden, and shorten the patient's waiting period. Summary of the Invention

[0005] To address the difficulties in revision surgery for severe acetabular bone defects and the poor stability after revision reconstruction, this application provides a porous metal pad for extended fixation in the reconstruction of severe acetabular bone defects.

[0006] This application provides a porous metal pad for extended fixation in reconstruction of severe acetabular bone defects, employing the following technical solution:

[0007] A porous metal pad for extended fixation in reconstruction of severe acetabular bone defects, used in conjunction with an acetabular cup, comprising:

[0008] A support plate, the bottom surface of which supports the acetabular cup;

[0009] The support wing has one end fixed to one end of the support plate. The support wing and the support plate are arranged at an angle. The side of the support wing away from the support plate is used to attach to the remaining host bone of the acetabulum. The support wing is provided with a fixing part for setting a fixation member, wherein the fixation member is used to fix to the remaining host bone of the acetabulum.

[0010] The tooth structure is arranged at the bottom of the side of the supporting wing away from the supporting plate, and comprises at least two strip-shaped teeth arranged in a comb shape, each of the strip-shaped teeth is fixed at one end of the side of the supporting wing away from the supporting plate and is suspended at the other end;

[0011] The suspended end of the strip-shaped teeth is immersed in the remaining host bone of the acetabulum, the bottom of the side of the supporting wing on which the strip-shaped teeth are arranged is matched with the section of the remaining host bone of the acetabulum, and the bottom surface of the supporting plate, the bottom surface of the supporting wing close to the supporting plate and the remaining host bone of the acetabulum form an acetabular cavity for fixing the acetabular cup.

[0012] By adopting the technical scheme, after the lesion site is treated in the operation, the acetabulum is exposed, the size is determined by using the instrument of the same size as the pad block product of the application, after the pad block prosthesis is determined, the pad block is pre-fixed by using the fixing part, at this time, the suspended end of the strip-shaped teeth is in contact with the host bone, the supporting plate is hit by using the corresponding instrument, the tooth structure is completely immersed in the remaining host bone of the acetabulum, and whether it is firm is checked, then the pad block is fixed by using the fixing part, finally, whether the pad block is firm is checked, and the corresponding acetabular cup can be installed. The bottom surface of the supporting plate, the bottom surface of the supporting wing close to the supporting plate and the remaining host bone of the acetabulum can reconstruct the acetabulum, the fixation between the pad block and the remaining acetabulum after half or more than half of the acetabulum is removed due to bone tumor lesion is also improved, the connection strength between the pad block and the human body tissue after installation is improved, and a stable environment is provided for the installation of the acetabular cup.

[0013] Optionally, the strip-shaped teeth are arc-shaped, and the arc-shaped opening of the strip-shaped teeth faces the side of the supporting plate receiving the acetabular cup.

[0014] By adopting the technical scheme, the arc-shaped strip-shaped teeth help the pad block to be hit into the remaining host bone of the acetabulum, and the fixation effect is better, on the other hand, compared with the linear strip-shaped teeth, the arc-shaped strip-shaped teeth have a shallower depth when being hit into the human body, and the possibility of bone splitting can be effectively reduced.

[0015] Optionally, the area of the cross section of the strip-shaped teeth in the vertical direction gradually decreases away from the supporting wing.

[0016] By adopting the technical scheme, the end of the strip-shaped teeth away from the supporting wing is relatively sharp, and it is more convenient to hit into the human body.

[0017] Optionally, tooth peaks are formed on the side of the strip-shaped teeth away from the arc-shaped opening.

[0018] By adopting the technical scheme, the tooth peaks can increase the sharpness of the strip-shaped teeth, so that the strip-shaped teeth are more convenient to hit into the human body.

[0019] Optionally, the heights of adjacent two tooth peaks are inconsistent, and the high and low tooth peaks are arranged in a staggered manner.

[0020] By adopting the technical scheme, when the tooth peaks of different heights contact the bone, the tooth peaks of different heights contact the bone of different heights due to the different heights, so that the strip-shaped tooth is not easily punched in due to excessive force.

[0021] Optionally, the tooth peak is sprayed with a hydroxyapatite coating layer for inducing and promoting bone growth.

[0022] By adopting the technical scheme, the hydroxyapatite coating layer can induce the bone to grow on the strip-shaped tooth, so as to provide a good bone integration interface and facilitate fixation in the later period.

[0023] Optionally, at least one communication hole is formed in the sidewall of each strip-shaped tooth, and the bone grows from the communication hole of one strip-shaped tooth into the communication hole of another strip-shaped tooth to radially position the spacer.

[0024] By adopting the technical scheme, in the process of bone growth, the bone grows from the communication hole of one strip-shaped tooth into the communication hole of another strip-shaped tooth to radially position the spacer and enhance the stability of the spacer.

[0025] Optionally, a sliding hole is formed in the supporting wing, and a straight line in the length direction of the sliding hole is parallel to a straight line in the length direction of the supporting wing.

[0026] A pre-fixing member is arranged in the sliding hole, and the pre-fixing member can move in the direction of the sliding hole.

[0027] By adopting the technical scheme, after the position of the spacer is determined, the spacer is pre-fixed on the remaining host bone of the acetabulum by using the pre-fixing member. Since the pre-fixing member can move in the vertical direction within a small range of the sliding hole, after the pre-fixing member is fixed on the remaining host bone of the acetabulum, the bottom of the spacer is hit by using a corresponding instrument, the spacer will move in the direction of the sliding hole, and after the hitting is completed, the tooth structure will be completely embedded in the remaining host bone of the acetabulum.

[0028] Optionally, the supporting wing, the supporting plate, and the tooth structure are in an integrated structure.

[0029] By adopting the technical scheme, the integrated structure can effectively improve the bearing capacity of the spacer, thereby effectively improving the stability of the spacer and ensuring the stability between the spacer and the acetabular cup.

[0030] Optionally, the width of the supporting wing gradually decreases in the direction away from the supporting plate.

[0031] By adopting the technical scheme, the width of the support wing near one end of the support plate is greater than the width of the support wing away from the other end of the support plate, the narrower top part facilitates the implantation of the pad into the narrow space of the acetabulum, and the wider bottom part can increase the contact area between the pad and the remaining host fixation of the acetabulum, thereby improving the bearing capacity of the pad and reconstructing excellent acetabular stability.

[0032] In summary, the present application has at least one of the following beneficial technical effects:

[0033] 1. By arranging the support plate, the support wing, and the tooth structure, the bottom surface of the support plate, the bottom surface of the support wing near the support plate, and the remaining host bone of the acetabulum can reconstruct the acetabulum, the fixation between the pad and the remaining acetabulum after half-side or multi-side acetabulum resection due to bone tumor lesions is also improved, the connection strength between the pad and the human body tissue after installation is improved, and a stable environment is provided for the installation of the acetabular cup;

[0034] 2. By arranging the arc-shaped strip-shaped teeth, compared with the linear strip-shaped teeth, the arc-shaped strip-shaped teeth have a shallower depth when punched into the human body, which can effectively reduce the possibility of bone splitting;

[0035] 3. By arranging the area of the cross section of the strip-shaped teeth in the vertical direction gradually decreases away from the support wing, the end of the strip-shaped teeth away from the support wing is relatively sharp, and it is more convenient to punch into the human body. BRIEF DESCRIPTION OF DRAWINGS

[0036] Figure 1 is a structure diagram of the pad cooperating with the acetabular cup.

[0037] Figure 2 is an exploded structure diagram of the pad and the acetabular cup.

[0038] Figure 3 is a structure diagram of a three-tooth pad.

[0039] Figure 4 is a structure diagram of a two-tooth pad.

[0040] BRIEF DESCRIPTION OF DRAWINGS: 1, support plate; 11, positioning cavity; 2, support wing; 21, fixing hole; 22, sliding hole; 3, tooth structure; 31, strip-shaped tooth; 311, tooth peak; 312, communication hole; 4, screw; 5, acetabular cup. DETAILED DESCRIPTION

[0041] In the description of the present application, it should be noted that the terms "horizontal", "vertical", "close", "away", "up", "down", "internal" and the like are based on the relative relationship shown in the drawings, and are only for the convenience of describing the present application and simplifying the description, and do not indicate or imply that the processes or modules referred to must have a specific orientation, state and operation, therefore cannot be understood as a limitation on the present application. The following will be described in conjunction with theFigures 1-3 The application is described in further detail.

[0042] The application discloses a porous metal pad for reconstruction of severe acetabular bone defect.

[0043] With reference to Figure 1 and Figure 2 The porous metal pad for reconstruction of severe acetabular bone defect is used in cooperation with an acetabular cup 5, and comprises a supporting plate 1, a supporting wing 2 in the form of a plate and fixed to the supporting plate 1, a tooth structure 3 arranged on the side of the supporting wing 2 away from the supporting plate 1, and a screw 4 fixed to the supporting wing 2.

[0044] One end of the supporting wing 2 is fixed to one end of the supporting plate 1, and the supporting wing 2 and the supporting plate 1 are arranged at an angle, and in the embodiment, the angle between the supporting wing 2 and the supporting plate 1 is a right angle, that is, the supporting wing 2 and the supporting plate 1 are arranged in an L shape, and the supporting plate 1, the supporting wing 2 and the tooth structure 3 are in an integrated structure.

[0045] With reference to Figure 1 and Figure 2 The side surface of the supporting plate 1 away from the supporting wing 2 is a bottom surface, and a positioning cavity 11 is arranged on the bottom surface of the supporting plate 1 and is matched with the acetabular cup 5. During the operation, a small amount of bone cement can be used to fix the supporting plate 1 and the acetabular cup 5.

[0046] With reference to Figure 1 and Figure 2 During the operation, after the lesion site is treated, the acetabulum is exposed, a trial is performed on the instrument of the same specification as the pad product to determine the specification, the pad prosthesis is determined, and then the pad is pre-fixed by using the screw 4. At this time, the tooth structure 3 is in contact with the host bone, the corresponding instrument is used to hit the supporting plate 1, so that the tooth structure 3 is completely immersed in the remaining host bone of the acetabulum, and whether it is firm is checked, then the pad is fixed by using the screw 4, and finally whether the pad is firm is checked, and then the corresponding acetabular cup 5 can be installed.

[0047] With reference to Figure 1 and Figure 2 The bottom of the side of the supporting wing 2 away from the supporting plate 1 can be attached to the section of the remaining host bone of the acetabulum, the bottom surface of the supporting plate 1, the bottom surface of the supporting wing 2 close to the bottom surface of the supporting plate 1 and the remaining host bone of the acetabulum can form an acetabular fossa for fixing the acetabular cup 5. The pad can be stably fixed on the remaining host bone of the acetabulum under the double action of the tooth structure 3 and the screw 4, and excellent acetabular stability can be reconstructed.

[0048] Compared with the customized prosthesis, the pad has a wider application range, different specifications of the pad can be selected according to different patients and different lesion sites, and various needs can be met. In addition, the patient does not need to wait for a long time, and the economic burden of the patient can be reduced.

[0049] With reference toFigure 1 and Figure 2 The tooth structure 3 includes at least two strip teeth 31 arranged in a comb-like pattern, and multiple strip teeth 31 are equally spaced, with the number of strip teeth 31 being 2-4. (See Appendix to this application.) Figure 1 Taking a three-toothed 31 implant as an example. When the patient is relatively young and has good bone quality, a implant with two teeth 31 can be used. When the patient is older and has osteoporosis, a implant with three or four teeth 31 can be selected depending on the patient's condition. During the operation, the implant with an appropriate number of teeth 31 should be selected according to the patient's condition to avoid implanting too many teeth 31, which could cause bone fracture.

[0050] Reference Figure 2 and Figure 3 One end of the strip tooth 31 is fixed to the bottom of the side of the support wing 2 facing away from the support plate 1, and the other end is suspended. There is a gap of 1mm between the strip tooth 31 and the bottom of the support plate 1. This gap can effectively prevent interference between the strip tooth 31 and the support plate 1 during the fixing of the pad, thus preventing the fixing effect from being affected.

[0051] The strip tooth 31 is arc-shaped, with its arc-shaped opening facing the bottom surface of the support plate 1. The arc of the strip tooth 31 is consistent with the arc of the acetabular cup 5. The plane containing the tooth surface of the strip tooth 31 is perpendicular to the side of the support wing 2 away from the support plate 1. The cross-sectional area of ​​the strip tooth 31 along the vertical direction gradually decreases along the direction of the support wing 2.

[0052] In reference Figure 1 and Figure 2 On the side of the strip tooth 31 away from the arc-shaped opening, tooth peaks 311 are also formed. The heights of two adjacent tooth peaks 311 are not the same, and the high and low tooth peaks 311 are arranged in a staggered manner. A hydroxyapatite coating is also sprayed on the tooth peaks 311 to induce and promote bone ingrowth.

[0053] Reference Figure 1 and Figure 2 Two connecting holes 312 are provided on the strip tooth 31 for bone to grow into. The connecting holes 312 are spaced apart along the length of the strip tooth 31.

[0054] During the fixation of the pad, the arc-shaped strip teeth 31 are easier to penetrate into the remaining host bone of the acetabulum. Compared with the straight strip teeth 31, the arc-shaped strip teeth 31 penetrate to a shallower depth in the human body, which can effectively reduce the possibility of bone splitting. The design of being wider at the front and narrower at the back makes the end of the strip teeth 31 away from the support wing 2 sharper than the conventional strip teeth, which is more conducive to the penetration of the tooth structure 3.

[0055] Reference Figure 1 and Figure 2The tooth peak 311 can increase the sharpness of the strip tooth 31, so that the strip tooth 31 is more convenient to punch into the human body, and the tooth peaks 311 with different heights can contact the bones with different heights when contacting the bones, so that the strip tooth 31 is not easily punched in due to excessive force.

[0056] When the pad block is fixed, the hydroxyapatite coating can induce and promote bone growth on the strip tooth 31, thereby providing a good bone integration interface, facilitating fixation in the later period, and the grown bone can grow from the communication hole 312 of one strip tooth 31 into the communication hole 312 of another strip tooth 31, thereby realizing radial positioning of the pad block.

[0057] Referring to Figure 1 , in some embodiments of the present application, the included angle between the tooth surface of the strip tooth 31 and the side of the support wing 2 away from the support plate 1 is an acute angle, that is, the strip tooth 31 is inclined to be arranged. Figure 2 In the present application, two strip teeth 31 are taken as an example, the two strip teeth 31 are symmetrical and arranged in a spread-eagle type, and the inclined strip tooth 31 can realize radial fixation and axial fixation of the pad block at the same time.

[0058] Referring to Figure 4 and Figure 4 , the width of the support wing 2 gradually decreases along the direction away from the support plate 1, so that the width of the support wing 2 near the end of the support plate 1 is greater than the width of the support wing 2 away from the end of the support plate 1, the narrower top facilitates the pad block to be implanted into the narrow space of the acetabulum, and the wider bottom can increase the contact area between the pad block and the remaining host bone of the acetabulum, thereby improving the bearing capacity of the pad block and reconstructing excellent acetabular stability.

[0059] Referring to Figure 1 and Figure 2 , the side of the support wing 2 away from the support plate 1 is designed with a porous grid structure, which can provide a good bone growth interface and help to increase the bone growth effect, and the long-term stability of the implanted pad block prosthesis is good.

[0060] Referring to Figure 1 and Figure 2 , four fixing holes 21 are arranged on the support wing 2 in a spaced manner, the center lines of the four fixing holes 21 form a square, a screw 4 can be inserted into each fixing hole 21, and a countersunk hole is formed at the end of each fixing hole 21 near the support plate 1 to hide the cap part of the screw 4, thereby reducing the occupied space of the screw 4 in the human body.

[0061] When the patient is relatively young and the bone quality is good, only two symmetrical screws 4 can be fixed, and when the patient is relatively old and the bone is osteoporotic, all four screws 4 need to be fixed. During the operation, the number of screws 4 should be selected according to the condition of the patient, so as to prevent the bone from being split due to too many screws 4.

[0062] Referring to Figure 2 and Figure 3 Figure 2 Figure 3 Two sliding holes 22 are also provided on the supporting wing 2 and are spaced apart laterally, and each of the two sliding holes 22 is located below the fixing hole 21. The sliding hole 22 is a strip-shaped hole, and a straight line in which the length direction of the sliding hole 22 is located is parallel to a straight line in which the length direction of the supporting wing 2 is located. The screw 4 can be inserted into each of the sliding holes 22.

[0063] After the position of the pad block is determined, the screw 4 in the sliding hole 22 is used to pre-fix the pad block on the remaining host bone of the acetabulum. Since the sliding hole 22 is a strip-shaped hole, after the bottom of the pad block is struck by the corresponding instrument, the pad block will move along the direction of the sliding hole 22. After the striking is completed, the tooth structure 3 will be completely embedded in the remaining host bone of the acetabulum.

[0064] The implementation principle of the extended fixed porous metal pad block for acetabular severe bone defect reconstruction in the embodiment of the application is as follows: after the lesion site is treated in the operation, the acetabulum is exposed, the instrument of the same specification as the pad block product of the application is used to determine the specification, the pad block prosthesis is determined, the screw 4 is inserted into the sliding hole 22, and the pad block is pre-fixed by using the screw 4. At this time, the suspended end of the strip-shaped tooth 31 is in contact with the host bone. The supporting plate 1 is struck by the corresponding instrument, so that the strip-shaped tooth 31 is completely embedded in the remaining host bone of the acetabulum, and it is checked whether it is firm. The screw 4 is inserted into the fixing hole 21 and fixed with the remaining host bone of the acetabulum. After the pad block is fixed, it is finally checked whether the pad block is firm, and the corresponding acetabular cup 5 can be installed. The bottom surface of the supporting plate 1, the bottom surface of the supporting wing 2 close to the supporting plate 1, and the remaining host bone of the acetabulum can reconstruct the acetabulum. The fixation between the pad block and the remaining acetabulum after the half-side and multi-side acetabulum is removed due to bone tumor lesions is also improved, the connection strength between the pad block and the human tissue after the pad block is installed is improved, and a stable environment is provided for the installation of the subsequent acetabular cup 5.

[0065] The specific embodiment is only an explanation of the application, and is not a limitation of the application. Those skilled in the art can make modifications to the embodiment without creative contribution after reading the specification, but as long as the modifications are within the scope of the claims of the application, they are protected by the patent law.

Claims

1. A porous metal pad for reconstruction of severe acetabular bone defects, used in conjunction with an acetabular cup (5), characterized in that: include: Support plate (1), the bottom surface of which supports the acetabular cup (5); Support wing (2), one end of the support wing (2) is fixed to one end of the support plate (1), the support wing (2) and the support plate (1) are arranged at an angle, the side of the support wing (2) away from the support plate (1) is used to attach to the remaining host bone of the acetabulum, and the support wing (2) is provided with a fixing part for setting a fixation member, wherein the fixation member is used to fix to the remaining host bone of the acetabulum; The tooth structure (3) is located at the bottom of the side of the support wing (2) away from the support plate (1), and includes at least two strip teeth (31) arranged in a comb-like pattern. One end of each strip tooth (31) is fixed to the side of the support wing (2) away from the support plate (1), and the other end is suspended. The suspended end of the strip tooth (31) is inserted into the remaining host bone of the acetabulum. The bottom of the wing (2) on one side of the strip tooth (31) is in contact with the cross section of the remaining host bone of the acetabulum. The bottom surface of the plate (1), the bottom surface of the wing (2) near the plate (1), and the remaining host bone of the acetabulum form an acetabular fossa for fixing the acetabular cup (5). The strip tooth (31) is arc-shaped, and the arc-shaped opening of the strip tooth (31) faces the side of the support plate (1) that supports the acetabular cup (5); the area of ​​the cross section of the strip tooth (31) in the vertical direction gradually decreases in the direction away from the support wing (2); At least one connecting hole (312) is provided on the side wall of each of the strip teeth (31), and the bone grows from the connecting hole (312) of one strip tooth (31) to the connecting hole (312) of another strip tooth (31) to radially position the pad; a sliding hole (22) is provided on the support wing (2), and the straight line in the length direction of the sliding hole (22) is parallel to the straight line in the length direction of the support wing (2); a pre-fixing member is provided in the sliding hole (22), and the pre-fixing member can move along the direction of the sliding hole (22).

2. The porous metal pad for reconstruction of severe acetabular bone defects with extended fixation according to claim 1, characterized in that: Tooth peaks (311) are machined on the side of the strip tooth (31) away from the arc-shaped opening.

3. The porous metal pad for reconstruction of severe acetabular bone defects with extended fixation according to claim 2, characterized in that: The heights of two adjacent tooth peaks (311) are not consistent, and the high and low tooth peaks (311) are arranged in a staggered manner.

4. A porous metal pad for reconstruction of severe acetabular bone defects with extended fixation according to claim 3, characterized in that: A hydroxyapatite coating that induces and promotes bone ingrowth is sprayed onto the tooth peak (311).

5. The porous metal pad for reconstruction of severe acetabular bone defects with extended fixation according to claim 1, characterized in that: The support wing (2), the support plate (1), and the tooth structure (3) are an integral structure.

6. The porous metal pad for reconstruction of severe acetabular bone defects with extended fixation according to claim 1, characterized in that: The width of the support wing (2) gradually decreases in the direction away from the support plate (1).

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