A double-acting total shoulder joint prosthesis

Abstract

The present invention relates to a double-acting total shoulder prosthesis, comprising: a glenoid prosthesis for fixedly connecting with an autologous glenoid, on which a first ball socket is formed; a humeral-side prosthesis for fixedly connecting with an autologous humerus, and on which a second ball socket is formed; a glenoid-side ball head installed in the first ball socket of the glenoid element and forming a semi-constrained glenoid-side ball socket joint therewith, and having an inner tapered hole formed thereon; a humeral-side ball head including a ball head portion and an outer tapered portion integrally formed on the outside of the ball head portion, the ball head portion of the humeral-side ball head being installed in the second ball socket of the humeral-side prosthesis and forming a semi-constrained humeral-side ball socket joint therewith, and the outer tapered portion of the humeral-side ball head being taper-connected in the inner tapered hole of the glenoid-side ball head and forming a rotating pair. Due to the double-acting joint design of the present invention, the stress concentration during shoulder joint movement is released, the occurrence of artificial shoulder joint dislocation can be effectively reduced, a good shoulder contour can be maintained, and the range of motion of the shoulder joint can be restored to the greatest extent possible.

Description

Technical Field

[0001] The present invention relates to an artificial prosthesis, and particularly to a bipolar total shoulder joint artificial prosthesis, belonging to the technical field of medical devices. Background Art

[0002] The proximal humerus in adults is one of the most common sites for highly malignant bone tumors. Approximately 90% of malignant tumors of the proximal humerus can be treated with limb salvage surgery. Reconstructing the bone defect of the proximal humerus with an artificial prosthesis is the most commonly used reconstruction method, which has the advantages of simple operation and maintaining a good shoulder appearance. Currently, the most commonly used proximal humerus prosthesis is a hemi-shoulder prosthesis, followed by a reverse total shoulder prosthesis. However, compared with artificial prostheses in other parts, the function after replacement of the proximal humerus artificial prosthesis is the worst, and the main reasons include:

[0003] ① Poor stability: For hemi-shoulder prosthesis replacement, since a large amount of muscle, ligament and joint capsule are removed during the tumor resection, the remaining joint capsule cannot well wrap and fix the metal humeral head, resulting in a high rate of prosthesis subluxation and dislocation; for reverse total shoulder prosthesis replacement, due to its design concept for surface replacement of shoulder arthritis and shoulder joint injuries, it will also cause joint instability and a high dislocation rate for large bone and soft tissue defects.

[0004] ② Poor mobility: Whether it is hemi-shoulder or reverse total shoulder prosthesis replacement, postoperative joint stability depends on long-term immobilization and scar adhesion. However, subsequent functional exercises will be greatly reduced due to scar adhesion; at the same time, intraoperative injury to the deltoid muscle or axillary nerve, as well as insufficient muscle tension after reconstruction, also lead to poor shoulder joint mobility.

[0005] ③ Mechanical complications are common: The glenoid component of the reverse total shoulder prosthesis often vertically cuts the scapula, resulting in prosthesis failure.

[0006] In addition, for hemi-shoulder replacement or reverse total shoulder replacement for severe shoulder arthritis, comminuted fracture of the humeral head, and severe rotator cuff injury, the above problems also exist postoperatively.

[0007] The ideal state of an artificial shoulder joint should be able to maintain shoulder joint stability without dislocation and obtain the maximum range of shoulder joint mobility. Currently, there is no positive total shoulder prosthesis design and product applied to tumor patients or requiring shoulder joint surface replacement in the world, mainly having the following three problems: ① The problem of bone integration between the artificial glenoid and the autologous glenoid has not been well solved; ② The range of motion of the artificial shoulder joint is small; ③ The dislocation rate of the artificial shoulder joint is relatively high. Summary of the Invention

[0008] In view of the above problems, the object of the present invention is to provide a double-acting total shoulder prosthesis, which can effectively reduce the occurrence of shoulder prosthesis dislocation, maintain a good shoulder appearance, and restore the range of motion of the shoulder joint as much as possible.

[0009] To achieve the above object, the present invention adopts the following technical solutions: A double-acting total shoulder prosthesis, comprising: a glenoid prosthesis for fixedly connecting with the autologous glenoid, a first ball socket is formed on the glenoid prosthesis; a humeral-side prosthesis for fixedly connecting with the autologous humerus, and a second ball socket is formed on the humeral-side prosthesis; a glenoid-side ball head, installed in the first ball socket of the glenoid prosthesis and forming a semi-restricted glenoid-side ball socket joint therewith, and an inner tapered hole is formed on the glenoid-side ball head; a humeral-side ball head, including a ball head portion and an outer tapered portion integrally formed on the outside of the ball head portion, the ball head portion of the humeral-side ball head is installed in the second ball socket of the humeral-side prosthesis and forms a semi-restricted humeral-side ball socket joint therewith, and the outer tapered portion of the humeral-side ball head is tapered and connected in the inner tapered hole of the glenoid-side ball head and forms a rotating pair.

[0010] In the double-acting total shoulder prosthesis, preferably, a glenoid-side ball socket liner for accommodating the glenoid-side ball head is provided in the first ball socket of the glenoid prosthesis.

[0011] In the double-acting total shoulder prosthesis, preferably, an anti-dislocation ring is further included, the diameter of the anti-dislocation ring is slightly larger than the diameter of the outer tapered portion of the humeral-side ball head and slightly smaller than the diameter of the glenoid-side ball socket liner, and the glenoid-side ball head is firmly fitted inside the glenoid-side ball socket liner through the anti-dislocation ring.

[0012] In the double-acting total shoulder prosthesis, preferably, a humeral-side ball socket liner for accommodating the humeral-side ball head is provided in the second ball socket of the humeral-side prosthesis.

[0013] In the double-acting total shoulder prosthesis, preferably, the double-acting total shoulder prosthesis includes a tumor type suitable for bone defect reconstruction after resection of proximal humeral tumors, and a common type suitable for cases of severe arthritis, comminuted humeral head fractures, and severe rotator cuff injuries.

[0014] In the double-acting total shoulder prosthesis, preferably, when the double-acting total shoulder prosthesis is of the tumor type, the humeral-side prosthesis includes a proximal humeral basic segment, an adjustable defect segment, and a intramedullary stem, and the three are assembled by Morse taper connection.

[0015] For the double-acting total shoulder prosthesis described above, preferably, when the double-acting total shoulder prosthesis is of the ordinary type, the humeral prosthesis includes a proximal humerus basic segment and an intramedullary stem. The intramedullary stem is connected to the proximal humerus basic segment by taper connection, and two screw holes are provided at the taper connection to prevent the taper connection from slipping out.

[0016] For the double-acting total shoulder prosthesis described above, preferably, the articular surface sides of the glenoid prosthesis and the humeral prosthesis are both provided with a 45° inclined plane structure.

[0017] For the double-acting total shoulder prosthesis described above, preferably, the glenoid prosthesis is produced from Ti6Al4V alloy powder by electron beam melting 3D printing technology. Three radially arranged nail holes are left in the glenoid prosthesis for fixed connection with the autologous glenoid. A porous metal trabecular structure with a pore size of 200 - 800 μm and completely connected pores is prepared on the outer surface of the glenoid prosthesis, and the porosity is 50% - 80%.

[0018] For the double-acting total shoulder prosthesis described above, preferably, both the glenoid side ball head and the humeral side ball head are made of metal materials, and the glenoid side socket liner, the anti-dislocation ring, and the humeral side socket liner are all made of polyethylene materials.

[0019] Due to the above technical solutions adopted by the present invention, it has the following advantages: Through the research and development and use of the double-acting total shoulder prosthesis, the present invention can achieve:

[0020] (1) Due to the adoption of the double-acting joint design, the stress concentration during shoulder joint movement is released. At the same time, an anti-dislocation device is adopted, effectively reducing the occurrence of artificial shoulder joint dislocation and maintaining a good shoulder shape;

[0021] (2) The combined double-headed shaft, the glenoid prosthesis, and the humeral prosthesis form a double-acting total shoulder joint, allowing early shoulder joint functional exercise. The movement of the humeral side joint forms a linkage with the movement of the scapular side, relieving the stress concentration and restoring the shoulder joint range of motion as much as possible;

[0022] (3) Achieving bone integration between the glenoid prosthesis and the autologous scapula, reducing mechanical complications;

[0023] (4) Keeping the shoulder muscles in tension, which is beneficial to improving the abduction muscle strength and providing sufficient power for shoulder joint movement. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Figure 1 It is an exploded view of the tumor-type double-acting total shoulder prosthesis provided by an embodiment of the present invention;

[0025] Figure 2The figure shows the usage state of the tumor-type double-moving total shoulder joint prosthesis provided by this embodiment of the present invention;

[0026] Figure 3 The figure is an exploded view of the common-type double-moving total shoulder joint prosthesis provided by another embodiment of the present invention;

[0027] Figure 4 The figure shows the usage state of the common-type double-moving total shoulder joint prosthesis provided by this embodiment of the present invention. Detailed implementation manners

[0028] To make the objectives, technical solutions and advantages of the present invention clearer, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are some, but not all, of the embodiments of the present invention. All other embodiments obtained by those of ordinary skill in the art based on the embodiments of the present invention without creative efforts shall fall within the protection scope of the present invention.

[0029] In the description of the present invention, it should be noted that the orientation or positional relationship indicated by the terms "upper", "lower", "inner", "outer", etc. is based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the system or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be construed as a limitation to the present invention. In addition, the use of terms such as "first" and "second" to define components is only for the convenience of distinguishing the above components. Without further statement, the above terms have no special meanings and should not be construed as indicating or implying relative importance.

[0030] In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, the terms "installed", "set", "connected" shall be understood in a broad sense. For example, it may be a fixed connection, a detachable connection, or an integral connection; it may be a mechanical connection or an electrical connection; it may be directly connected or indirectly connected through an intermediate medium, and it may be the internal communication of two components. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0031] The double-acting total shoulder joint prosthesis provided by the present invention includes: a glenoid prosthesis for fixedly connecting with the autologous glenoid, and a first ball socket is formed on the glenoid prosthesis; a humeral-side prosthesis for fixedly connecting with the autologous humerus, and a second ball socket is formed on the humeral-side prosthesis; a glenoid-side ball head installed in the first ball socket of the glenoid prosthesis and forming a semi-constrained glenoid-side ball socket joint therewith, and an inner tapered hole is formed on the glenoid-side ball head; a humeral-side ball head including a ball head portion and an outer tapered portion integrally formed on the outer side of the ball head portion, the ball head portion of the humeral-side ball head is installed in the second ball socket of the humeral-side prosthesis and forms a semi-constrained humeral-side ball socket joint therewith, and the outer tapered portion of the humeral-side ball head is taper-connected in the inner tapered hole of the glenoid-side ball head and forms a rotating pair. Due to the double-acting joint design of the present invention, the stress concentration during the movement of the shoulder joint is released, the occurrence of artificial shoulder joint dislocation can be effectively reduced, a good shoulder shape can be maintained, and the range of motion of the shoulder joint can be restored to the greatest extent possible.

[0032] Next, the double-acting total shoulder joint prosthesis provided by the embodiments of the present invention will be described in detail with reference to the accompanying drawings.

[0033] Figure 1 and Figure 2 There is shown a tumor-type double-acting total shoulder joint prosthesis, which is mainly applicable to the bone defect reconstruction after the resection of the proximal humerus tumor. The double-acting total shoulder joint prosthesis includes: a glenoid prosthesis 1 for fixedly connecting with the autologous glenoid 10, and a first ball socket is formed on the glenoid prosthesis 1; a humeral-side prosthesis 6 for fixedly connecting with the autologous humerus 20, and a second ball socket is formed on the humeral-side prosthesis 6; a glenoid-side ball head 4 installed in the first ball socket of the glenoid prosthesis 1 and forming a semi-constrained glenoid-side ball socket joint therewith, and an inner tapered hole is formed on the glenoid-side ball head 4; a humeral-side ball head 5 including a ball head portion and an outer tapered portion integrally formed on the outer side of the ball head portion, the ball head portion of the humeral-side ball head 5 is installed in the second ball socket of the humeral-side prosthesis 6 and forms a semi-constrained humeral-side ball socket joint therewith, and the outer tapered portion of the humeral-side ball head 5 is taper-connected in the inner tapered hole of the glenoid-side ball head 4 and forms a rotating pair. Thus, the glenoid-side ball head 4 and the humeral-side ball head 5 form a double-headed shaft structure through taper connection, and the double-acting effect is achieved as a whole. This double-acting joint mechanism can not only increase the mobility of the total shoulder joint prosthesis (when the humeral-side ball socket joint moves to the limit, the range of motion of the shoulder joint can be further increased through the movement of the glenoid-side socket joint), but also relieve the stress concentration generated during the movement of the shoulder joint, reducing the dislocation rate and the occurrence of mechanical complications.

[0034] In the above embodiment, preferably, a glenoid-side ball socket liner 2 for accommodating the glenoid-side ball head 4 is provided in the first ball socket of the glenoid prosthesis 1, thereby avoiding friction between the glenoid-side ball head 4 and the glenoid prosthesis 1.

[0035] In the above embodiments, preferably, it further includes an anti - dislocation ring 3. The diameter of the anti - dislocation ring 3 is slightly larger than the outer conical part diameter of the humeral - side ball head 5 and slightly smaller than the diameter of the glenoid - side socket liner 2. The glenoid - side ball head 4 is firmly fitted inside the glenoid - side socket liner 2 through the anti - dislocation ring 3, thereby preventing the glenoid - side ball head 4 from dislocating from the glenoid - side socket liner 2.

[0036] In the above embodiments, preferably, a humeral - side socket liner (not shown in the figure) for accommodating the humeral - side ball head 5 is provided in the second socket of the humeral - side prosthesis 6, thereby avoiding friction between the humeral - side ball head 5 and the humeral - side prosthesis 6.

[0037] In the above embodiments, preferably, the humeral - side prosthesis 6 includes a proximal humerus basic segment 61, an adjustable defect segment 62, and an intramedullary stem 63, and the three are assembled by Morse taper connection. Thus, according to the different defect lengths of the upper humerus of the patient, an adjustable defect segment 62 with different lengths can be selected to meet the shoulder joint reconstruction requirements for different upper humerus defect lengths.

[0038] In the above embodiments, preferably, the joint surface sides of the glenoid prosthesis 1 and the humeral - side prosthesis 6 are both provided with a 45° inclined plane structure, which is beneficial to increasing the abduction range of motion of the shoulder joint.

[0039] In the above embodiments, preferably, the glenoid prosthesis 1 is produced from Ti6Al4V alloy powder by electron beam melting (EBM) 3D printing technology. There are 3 radially - arranged nail holes in the glenoid prosthesis 1 for fixed connection with the autologous glenoid 10. The outer surface of the glenoid prosthesis 1 is prepared with a porous metal trabecular structure with a pore size of 200 - 800 μm and completely connected pores, and the porosity is 50% - 80%, thereby providing a growth space for new bone tissue, enabling the new bone tissue to grow into the pore structure by creeping, and solving the bone integration problem between the glenoid prosthesis 1 and the autologous glenoid 10.

[0040] In the above embodiments, preferably, both the glenoid - side ball head 4 and the humeral - side ball head 5 are made of metal materials, and the glenoid - side socket liner 2, the anti - dislocation ring 3, and the humeral - side socket liner are all made of polyethylene materials.

[0041] When the double - acting total shoulder joint prosthesis provided in the above embodiments of the present invention is in use, the implementation process is specifically as follows:

[0042] Step 1: Fix the glenoid prosthesis 1 to the autologous glenoid 10 with 3 screws, and then place the glenoid - side socket liner 2 in the first socket of the glenoid prosthesis 1;

[0043] Step 2: Assemble the glenoid ball head 4 and the humeral ball head 5 in vitro to form a double-headed shaft structure, place the glenoid ball head 4 in the first ball socket of the glenoid prosthesis 1, and install the anti-dislocation ring 3 so that the glenoid ball head 4 can be restricted in the glenoid prosthesis 1;

[0044] Step 3: Assemble the humeral prosthesis 6 and fix the intramedullary stem 63 in the medullary cavity of the autologous humerus 20 to maintain the normal force line;

[0045] Step 4: Press and reposition the glenoid lateral ball head 4 and the humeral lateral ball head 5 to complete the installation of the tumor-type double-motion total shoulder joint artificial prosthesis.

[0046] Figure 3 and Figure 4 The present invention shows a common double-motion total shoulder prosthesis, which is mainly suitable for cases of severe arthritis, comminuted humeral head fracture and severe rotator cuff injury. Its structure is basically the same as the above-mentioned tumor-type double-motion total shoulder prosthesis, with the difference that the humeral side prosthesis 6 of the common double-motion total shoulder prosthesis only includes the proximal humeral basic segment 61 and the intramedullary stem 63, and the intramedullary stem 63 is connected to the proximal humeral basic segment 61 by a taper connection, and two screw holes are provided at the taper connection to prevent the taper connection from coming out.

[0047] In the above embodiment, preferably, the intramedullary stem 63 of the conventional dual-motion total shoulder joint prosthesis is divided into two types: a cement stem and a biological stem, each having different thicknesses. The type of stem is selected according to the patient's bone condition and the type is selected according to the intraoperative medullary expansion condition.

[0048] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention, rather than to limit it. Although the present invention has been described in detail with reference to the aforementioned embodiments, those skilled in the art should understand that they can still modify the technical solutions described in the aforementioned embodiments, or make equivalent replacements for some of the technical features therein. However, these modifications or replacements do not deviate the essence of the corresponding technical solutions from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A double-acting total shoulder joint prosthesis, characterized in that, Comprising: A glenoid prosthesis (1) for fixedly connecting with the autologous glenoid (10), and a first ball-and-socket is formed on the glenoid prosthesis (1); A humeral-side prosthesis (6) for fixedly connecting with the autologous humerus (20), and a second ball-and-socket is formed on the humeral-side prosthesis (6); A glenoid-side ball head (4) installed in the first ball-and-socket of the glenoid prosthesis (1) and forming a semi-constrained glenoid-side ball-and-socket joint therewith, and an inner tapered hole is formed on the glenoid-side ball head (4); A humeral-side ball head (5) includes a ball head portion and an outer tapered portion integrally formed on the outside of the ball head portion. The ball head portion of the humeral-side ball head (5) is installed in the second ball-and-socket of the humeral-side prosthesis (6) and forms a semi-constrained humeral-side ball-and-socket joint therewith. The outer tapered portion of the humeral-side ball head (5) is tapered and connected in the inner tapered hole of the glenoid-side ball head (4) to form a rotating pair; A glenoid-side ball-and-socket liner (2) for accommodating the glenoid-side ball head (4) is arranged in the first ball-and-socket of the glenoid prosthesis (1); It further includes an anti-dislocation ring (3). The diameter of the anti-dislocation ring (3) is slightly larger than the diameter of the outer tapered portion of the humeral-side ball head (5) and slightly smaller than the diameter of the glenoid-side ball-and-socket liner (2). The glenoid-side ball head (4) is firmly fitted inside the glenoid-side ball-and-socket liner (2) through the anti-dislocation ring (3); The joint surface sides of the glenoid prosthesis (1) and the humeral-side prosthesis (6) are both provided with a 45° inclined plane structure.

2. The double-acting total shoulder joint prosthesis according to claim 1, characterized in that A humeral-side ball-and-socket liner for accommodating the humeral-side ball head (5) is arranged in the second ball-and-socket of the humeral-side prosthesis (6).

3. The double-acting total shoulder joint prosthesis according to claim 1, characterized in that, The double-motion total shoulder joint prosthesis includes a tumor type applicable to bone defect reconstruction after resection of proximal humeral tumors, and a common type applicable to cases of severe arthritis, comminuted humeral head fractures, and severe rotator cuff injuries.

4. The double-acting total shoulder joint prosthesis according to claim 3, characterized in that, When the double-motion total shoulder joint prosthesis is of the tumor type, the humeral-side prosthesis (6) includes a proximal humeral basic segment (61), an adjustable defect segment (62), and an intramedullary stem (63), and the three are assembled by Morse taper connection.

5. The double-acting total shoulder joint prosthesis according to claim 1, characterized in that, When the double-motion total shoulder joint prosthesis is of the common type, the humeral-side prosthesis (6) includes a proximal humeral basic segment (61) and an intramedullary stem (63). The intramedullary stem (63) is connected to the proximal humeral basic segment (61) by taper connection, and two screw holes are provided at the taper connection to prevent the taper connection from coming out.

6. The double-acting total shoulder joint prosthesis according to any one of claims 1 to 5, characterized in that, The glenoid prosthesis (1) is produced by electron beam melting 3D printing technology with Ti6Al4V alloy powder. Three radial nail holes are left in the glenoid prosthesis (1) for fixedly connecting with the autologous glenoid (10). The outer surface of the glenoid prosthesis (1) is prepared with a porous metal trabecular structure with a pore size of 200 - 800 μm and completely connected, and the porosity is 50% - 80%.

7. The double-acting total shoulder joint prosthesis according to claim 2, characterized in that, Both the glenoid-side ball head (4) and the humeral-side ball head (5) are made of metal materials, and the glenoid-side ball-and-socket liner (2), the anti-dislocation ring (3), and the humeral-side ball-and-socket liner are all made of polyethylene materials.

Images