Shoulder joint check block
Through 3D printing technology, the design and manufacture of personalized shoulder joint stops is solved, and the problems of structural damage, peripheral tissue damage and low bone healing rate of traditional coracoid dislocation are solved in the treatment of recurrent shoulder joint dislocation, achieving safer , more effective treatment effects.
Patent Information
- Application Number
- CN202420874871.5
- Authority / Receiving Office
- CN · China
- Patent Type
- Utility models(China)
- Current Assignee / Owner
- Filing Date
- 2024-04-25
- Publication Date
- 2025-02-07
- Estimated Expiration
- 2034-04-25
AI Technical Summary
Traditional coracoid dislocation surgery has problems such as structural damage, peripheral tissue damage, complications of nerve damage and low bone healing rate when treating recurrent prearthropathy of the shoulder.
3D printing additive manufacturing technology is used to design and manufacture personalized shoulder joint stops, and matched stops are designed according to the shape of the glenoid and the shape of the bone defect to increase the area of the glenoid and prevent the shoulder joint from being dislocated again.
It effectively avoids structural damage and peripheral tissue damage of coracoid dislocation, reduces complications of nerve damage, improves bone healing rate, and simplifies the surgical process and later revision.
Smart Images
Figure CN222426337U_ABST
Abstract
Description
Technical Field
[0001] The utility model relates to the technical field of medical instruments, in particular to a shoulder joint block. Background Art
[0002] Shoulder dislocation is a common sports injury, and recurrent shoulder dislocation is a special type. It usually occurs after the first trauma causing dislocation. When the shoulder joint is subjected to a small external force or in a specific position, it dislocates again. Unlike random dislocation, recurrent shoulder dislocation is usually accompanied by varying degrees of pain and dysfunction when it dislocates again, and it cannot be reset by itself. The pathological causes of recurrent shoulder dislocation mainly include loose or ruptured joint capsule, avulsion of the labrum, injury to the middle glenohumeral ligament, and destruction of the bone structure. These factors cause the joint's stabilizing device to be destroyed, making dislocation prone to recurrence. According to the direction of dislocation, recurrent shoulder dislocation can be divided into three types: anterior dislocation, anteroinferior dislocation, and posterior dislocation, among which anterior dislocation is the most common. In addition, according to the degree of dislocation, it can also be divided into complete dislocation and incomplete dislocation, also called subluxation. For recurrent anterior shoulder dislocation, open or arthroscopically assisted coracoid displacement is currently commonly used for clinical treatment. The so-called coracoid displacement is to remove the front half of the coracoid process on the scapula together with the joint tendon attached to the surface of the coracoid process (composed of the short head of the biceps brachii and the coracobrachialis muscle), and then transplant the coracoid process bone block to the front and lower part of the glenoid, relying on the coracoid process bone block to increase the glenoid area and provide bony blockage, thereby preventing the shoulder joint from dislocating again. However, the coracoid displacement still has the following shortcomings: 1. The separation of the coracoid process structure itself destroys the normal anatomical position and structure of the normal coracoid process and the tendons and ligaments attached to the surface of the coracoid process; 2. The use of an oscillating saw to separate the coracoid process is likely to cause additional damage to surrounding tissues (such as blood vessels and nerve structures); 3. Since the musculocutaneous nerve passes through the coracobrachialis muscle a few centimeters below the coracoid process, it is easy to cause musculocutaneous nerve damage when the coracoid process is cut off and the coracobrachialis muscle is turned down, leading to complications of nerve injury; 4. The cut coracoid process bone block does not match the glenoid bone surface morphology, making it difficult to fix the coracoid process, resulting in a lower bone healing rate and an increased risk of transplant failure.
[0003] The utility model provides a novel shoulder joint block, which avoids the traditional treatment of recurrent anterior shoulder dislocation by coracoid displacement. The shoulder joint block is individually designed and printed using the emerging 3D printing additive manufacturing technology, and can replace coracoid displacement. A matching block can be individually designed according to the shape of the glenoid or the shape of the bone defect to increase the glenoid area, thereby preventing the shoulder from dislocating again. Summary of the invention
[0004] The utility model aims to provide a shoulder joint block, and the technical problem to be solved at least includes how to avoid coracoid displacement or autologous / allogeneic bone transplantation, and reduce additional damage to other parts of the body to the greatest extent.
[0005] In order to achieve the above-mentioned purpose, the utility model provides a shoulder joint stopper, including a stopper body, a stopper wall, a porous structure and a screw channel; the screw channel is arranged in the middle of the base surface of the shoulder joint stopper, and is used to manufacture a channel with threads for screw fixation; the porous structure is arranged between the stopper wall and the screw channel.
[0006] Preferably, the shoulder joint stopper is a shoulder joint stopper designed to simulate the Bristow procedure, and a screw hole is provided in the middle of the base surface of the shoulder joint stopper for later tapping.
[0007] Preferably, shoulder joint blocks of different sizes have screw holes with different diameters.
[0008] Preferably, the screw holes of different diameters include a standard M3 mm screw hole and a standard M5 mm screw hole.
[0009] Preferably, the interior of the shoulder joint stopper is designed with cross-arranged lines.
[0010] Preferably, shoulder joint blocks of different sizes are provided with lines of different diameters to form a porous support structure, which can promote the growth of bone tissue, thereby improving the healing rate between the shoulder joint block and the glenoid bone surface.
[0011] Preferably, the lines of different diameters include lines with diameters of 0.5 mm, 0.6 mm, 0.7 mm and 0.8 mm.
[0012] Preferably, the shoulder joint stopper is a shoulder joint stopper designed to simulate the Latarjet procedure, the shoulder joint stopper is fitted with the bone surface of the anterior edge of the glenoid cavity, and the base surface of the shoulder joint stopper is provided with two screw holes for later tapping.
[0013] Preferably, the shoulder joint stopper is made of titanium alloy.
[0014] Preferably, the base surface of the shoulder joint stopper is coated with a hydroxyapatite coating to promote bone integration.
[0015] Compared with the prior art, the beneficial effects of the utility model are:
[0016] The shoulder joint block described in the utility model can design a block model according to the actual shape of the glenoid, effectively increase the glenoid area, and reduce the risk of humeral head dislocation; and the block base surface can be completely matched with the bone surface of the anterior edge of the glenoid, and there is no need for additional grinding and trimming of the bone surface of the anterior edge of the glenoid (the coracoid displacement surgery currently performed clinically, whether it is the Bristow procedure or the Latarjet procedure, requires grinding and trimming of the bone surface of the anterior edge of the glenoid and the coracoid process to increase the matching of the coracoid process and the bone surface of the anterior edge of the glenoid, but the bone surface trimming process is bound to cause additional bone loss, while the block designed by the utility model matches the shape of the bone surface of the anterior edge of the glenoid, and no bone surface trimming is required).
[0017] The shoulder joint block described in the utility model can avoid coracoid displacement or autologous / allogeneic bone transplantation, and does not need to be replaced by others, thereby minimizing additional damage to other parts of the body. For example, coracoid displacement is to replace the coracoid bone block together with the conjoint tendon attached to the coracoid (the conjoint tendon includes the short head of the biceps brachii tendon and the coracobrachialis muscle), which is bound to affect the basic functions of the conjoint tendon, such as contraction of the short head of the biceps brachii.
[0018] The shoulder joint block described in the utility model can significantly reduce the time cost. Traditional coracoid displacement or autologous / allogeneic bone transplantation requires obtaining the coracoid or bone block first, and then grinding and trimming the coracoid or bone block and the glenoid bone surface, which significantly prolongs the operation time. If the operation is performed openly, the whole process takes about 1 hour, and the operation time under arthroscopy is longer, about 2 hours. The shoulder joint block described in the utility model only needs to be transplanted and fixed in the designated position. Even if a minimally invasive operation is performed under arthroscopy, the operation can be completed within 40 minutes.
[0019] The shoulder joint block of the utility model makes the later surgical revision process simple and easy. For the traditional coracoid displacement surgery, if the transplantation fails after the operation, since there is only one coracoid process on one side of the scapula, additional bone blocks can only be obtained from other parts of the body for transplantation, such as the ilium, which causes additional damage. However, the utility model only needs to remove the transplanted block, redesign and print the block according to the needs, and then transplant it.
[0020] Traditional coracoid displacement or autologous / allogeneic bone transplantation may cause bone dissolution after surgery, resulting in transplantation failure. However, the titanium alloy block prepared by the utility model does not have this concern, and the utility model is coated with hydroxyapatite on the base surface of the block, and the interior is a porous scaffold structure, which can promote bone tissue growth, promote block bone integration, and increase block stability. Titanium alloy materials can be normally used for MRI and CT scanning, which is convenient for regular follow-up after surgery. BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The accompanying drawings are used to provide a further understanding of the technical solution of the utility model and constitute a part of the specification. Together with the specific implementation methods of the present application, they are used to explain the technical solution of the utility model and do not constitute a limitation on the technical solution of the utility model.
[0022] Figure 1 Schematic diagram of the bottom structure of the Bristow-type stopper described in the first embodiment.
[0023] Figure 2 It is a schematic diagram of the side structure of the Bristow type stopper described in the first embodiment.
[0024] Figure 3 It is a partially enlarged schematic diagram of the porous structure described in Example 1.
[0025] Figure 4 It is a schematic diagram of the first-person perspective after the Bristow-type block is transplanted onto the scapula.
[0026] Figure 5 It is a schematic diagram of a second perspective after the Bristow block is transplanted onto the scapula.
[0027] Figure 6 It is a schematic diagram of a third-person perspective after the Bristow-type block is transplanted onto the scapula.
[0028] Figure 7 It is a schematic diagram of the fourth perspective after the Bristow block is transplanted onto the scapula.
[0029] Figure 8 It is a schematic diagram of the bottom structure of the Latarjet type stopper.
[0030] Fig. 9 It is a structural schematic diagram of the bottom of the Latarjet type stopper from another perspective.
[0031] Fig.10 It is a schematic diagram of the top structure of the Latarjet type stopper.
[0032] Fig.11 It is a partially enlarged schematic diagram of the porous structure in the Latarjet block.
[0033] Fig.12 It is a schematic diagram of the first-person perspective after the Latarjet block is transplanted onto the scapula.
[0034] Fig.13 It is a schematic diagram of a second perspective after the Latarjet block is transplanted onto the scapula.
[0035] Fig.14 It is a schematic diagram of the third-person perspective after the Latarjet block is transplanted onto the shoulder blade.
[0036] Fig.15 It is a structural schematic diagram of the stopper described in the second embodiment.
[0037] Fig.16 It is a schematic structural diagram of the scapula defect portion described in the second embodiment.
[0038] Fig.17 It is a partially enlarged schematic diagram of the porous structure described in Example 2.
[0039] Fig.18 It is a schematic diagram of the first viewing angle after the block described in the second embodiment is transplanted.
[0040] Fig.19 It is a schematic diagram of a second viewing angle after the block described in the second embodiment is transplanted. DETAILED DESCRIPTION
[0041] The present invention is described in more detail hereinafter to facilitate understanding of the present invention.
[0042] Embodiment 1:
[0043] For patients with recurrent anterior shoulder dislocation whose glenoid bone tissue structure is intact, this embodiment treats recurrent anterior shoulder dislocation by using a personalized 3D printed titanium alloy metal block.
[0044] At present, there are mainly two types of coracoid displacement in clinical practice, namely, the Bristow procedure and the Latarjet procedure. For the Bristow procedure, during the fixation of the coracoid on the glenoid bone surface, the long axis of the coracoid is fixed perpendicular to the anterior glenoid bone surface, and the coracoid osteotomy surface is fixed in contact with the anterior glenoid bone surface; for the Latarjet procedure, during the fixation of the coracoid on the glenoid bone surface, the long axis of the coracoid is fixed parallel to the glenoid bone surface. The two fixation methods have their own advantages and disadvantages. In the Bristow procedure, the coracoid bone block is smaller, so the trauma is less when the coracoid bone block is cut, but because the coracoid bone block is smaller, the contact area between it and the glenoid bone surface is smaller, which is not conducive to bone healing. In the Latarjet procedure, the coracoid bone block is larger, so the trauma is greater when the coracoid bone block is cut, but because the coracoid bone block is larger, the contact area between it and the glenoid bone surface is increased, which is conducive to bone healing. The shoulder joint block provided by the utility model can be personalized before the operation. The block shape and size can be designed, so the block that meets the requirements can be designed according to the needs of clinicians or the actual situation of patients. This is also a major advantage of the utility model.
[0045] The shoulder joint block designed by the utility model simulating the Bristow procedure is named "Bristow block". Figure 1and 2 As shown, the Bristow-type stopper comprises a stopper body 1, a stopper wall 2, a porous structure 3 and a screw channel 4; the screw channel 4 is arranged in the middle of the base surface of the shoulder joint stopper, and is used to manufacture a channel with threads for screw fixation; the porous structure 3 is arranged between the stopper wall 2 and the screw channel 4.
[0046] A screw hole can be seen in the middle of the base surface of the shoulder joint block, which is used for later tapping to make a threaded hole for screw fixation. The utility model can design screw holes of different diameters according to the size of the shoulder joint block, for example, standard M3 / M5 mm screws. Secondly, the interior of the shoulder joint block is designed with cross-arranged lines, and lines of different diameters can be designed according to the size of the block, such as 0.5 / 0.6 / 0.7 / 0.8 mm, to form a porous scaffold structure, which can promote bone tissue growth, thereby improving the healing rate of the shoulder joint block and the glenoid bone surface.
[0047] The Bristow block is implanted on the scapula. Figures 4 to 7 After transplantation, the "Bristow-type stopper" matches the shape of the anterior edge of the glenoid fossa 6 (see Figure 4 ), closely fitting with the lateral glenoid bone bed (see Figure 5 ), which is in the same plane as the glenoid articular surface (see Figure 6 ), the porous structure inside the block connects with the bone surface, which can promote bone tissue growth (see Figure 7 ).
[0048] The utility model simulates the shoulder joint block designed by Latarjet operation, and is named as "Latarjet block". Figures 8 to 10 As shown, the Latarjet block comprises a block body 1, a block wall 2, a porous structure 3 and a screw channel 4. The shoulder joint block fits the bone surface of the anterior edge of the glenoid. Two screw channels can be seen on the basal surface of the shoulder joint block, which are used for later tapping. The present invention can design screw channels of different diameters according to the size of the shoulder joint block, for example, standard M3 / M5 mm screws. Secondly, the interior of the shoulder joint block is designed with cross-arranged lines. According to the size of the shoulder joint block, lines of different diameters can be designed, such as 0.5 / 0.6 / 0.7 / 0.8 mm, to form a porous scaffold structure, which can promote the growth of bone tissue, thereby improving the healing rate between the shoulder joint block and the glenoid bone surface.
[0049] The Latarjet block is implanted on the shoulder blade. Figure 12 to Figure 14 After transplantation, the "Latarjet block 7" matches the shape of the front edge of the glenoid cavity 6 (see Fig.12 ), closely fitting with the lateral glenoid bone bed (see Fig.13 ), which is in the same plane as the glenoid articular surface (see Fig.14 ).
[0050] The shoulder joint block is made of titanium alloy. The surface of the titanium alloy shoulder joint block is polished to ensure that the surface is smooth and has no edges and corners. According to the originally designed screw hole size, tapping is performed to prepare the thread. In order to improve the healing rate between the titanium alloy block and the glenoid bone surface, hydroxyapatite coating is performed on the basal surface of the shoulder joint block to promote bone integration and improve the stability of the shoulder joint block after transplantation. Subsequently, the treated titanium alloy shoulder joint block is transplanted to the anterior edge bone surface of the glenoid, and the shoulder joint block is fixed using rivets of corresponding specifications.
[0051] Embodiment 2:
[0052] For patients with recurrent anterior shoulder dislocation and glenoid bone tissue defects, this embodiment treats recurrent anterior shoulder dislocation by using a personalized 3D printed titanium alloy metal block.
[0053] Clinically, there are cases of glenoid bone tissue defects. Due to the bone defects, the glenoid area is reduced, resulting in recurrent anterior shoulder dislocation. Currently, autologous or allogeneic bone block transplantation is usually used to fill the glenoid bone defect, such as autologous iliac bone block transplantation, to restore the glenoid bone volume and glenoid area. However, autologous iliac bone block transplantation can cause additional damage to the donor site and postoperative complications of donor site pain. This application uses 3D printing to construct a titanium alloy block. By comparing the morphology of the normal shoulder joint on the other side, a personalized block is accurately constructed to fill the glenoid defect area and avoid the use of autologous or allogeneic bone tissue transplantation. Fig.15 and Fig.16 As shown, the designed block includes a block body 161, a screw hole 162 and a porous structure 163. Two screw holes can be seen on the base surface of the block for later tapping. The present application can design screw holes of different diameters according to the size of the block, for example, standard M3 / M5 mm screws. The block is designed with cross-arranged lines inside, and lines of different diameters can be designed according to the size of the block, for example, 0.5 / 0.6 / 0.7 / 0.8 mm, to form a porous scaffold structure, which can promote bone tissue growth, thereby improving the healing rate between the block and the glenoid bone surface. Fig.16 A scapula defect 164 is shown.
[0054] The surface of the titanium alloy shoulder joint block was polished to ensure a smooth surface without edges and corners. According to the originally designed screw hole size, the threads were tapped and prepared. In order to improve the healing rate between the titanium alloy block and the glenoid bone surface, hydroxyapatite coating was applied to the basal surface of the shoulder joint block to promote bone integration and improve the stability of the shoulder joint block after transplantation. Subsequently, the treated titanium alloy shoulder joint block was transplanted to the anterior edge of the glenoid bone surface, and the shoulder joint block was fixed with rivets of corresponding specifications.
[0055] The status of the block after transplantation is as follows Fig.18 and Fig.19 As shown, the transplanted stopper 160 matches the shape of the residual bone surface of the shoulder joint (see Fig.18 ), the transplanted block is in the same plane as the residual bone surface of the shoulder joint (see Fig.19 ).
[0056] The present application is a shoulder joint block designed for personalized shoulder blades, which is used to prevent shoulder dislocation. The shoulder joint block is preferably a titanium alloy block printed by metal 3D printing. The titanium alloy block is a block designed according to the patient's shoulder blade and condition. Currently, there is no related patent published and no clinical application, which is innovative.
[0057] The above describes the preferred embodiments of the present invention, but it is not intended to limit the present invention. Those skilled in the art may make improvements and changes to the embodiments disclosed herein without departing from the scope and spirit of the present invention.
Claims
1. A shoulder joint block, characterized in that: The shoulder joint block includes a block body, a block wall, a porous structure and a screw channel; the screw channel is arranged in the middle of the base surface of the shoulder joint block and is used to manufacture a channel with threads for screw fixation; the porous structure is arranged between the block wall and the screw channel.
2. The shoulder joint stopper according to claim 1, characterized in that: The shoulder joint block is a shoulder joint block designed to simulate the Bristow procedure, and a screw hole is arranged in the middle of the base surface of the shoulder joint block for later tapping.
3. The shoulder joint stopper according to claim 1, characterized in that: Shoulder blocks of different sizes have screw holes of different diameters.
4. The shoulder joint stopper according to claim 3, characterized in that: The screw holes of different diameters include a standard M3 mm screw hole and a standard M5 mm screw hole.
5. The shoulder joint stopper according to claim 1, characterized in that: The interior of the shoulder joint block is designed with cross-arranged lines.
6. The shoulder joint block according to claim 1, characterized in that: Shoulder joint blocks of different sizes are provided with lines of different diameters to form a porous scaffold structure, which can promote the growth of bone tissue, thereby improving the healing rate between the shoulder joint block and the glenoid bone surface.
7. The shoulder joint stopper according to claim 6, characterized in that: The lines with different diameters include lines with diameters of 0.5 mm, 0.6 mm, 0.7 mm and 0.8 mm.
8. The shoulder joint stopper according to claim 1, characterized in that: The shoulder joint block is designed to simulate the Latarjet procedure. The shoulder joint block fits the bone surface of the anterior edge of the glenoid cavity. The base surface of the shoulder joint block is provided with two screw holes for later tapping.
9. The shoulder joint stopper according to claim 1, characterized in that: The shoulder joint block is made of titanium alloy.
10. The shoulder joint stopper according to claim 1, characterized in that: The base surface of the shoulder joint block is coated with a hydroxyapatite coating to promote bone integration.