Biological trochlear groove replacement assembly and method for using same

Abstract

Provided are a biological trochlear groove replacement assembly and a method for using same. The biological trochlear groove replacement assembly comprises a prosthesis (10), a test model (20), and a cushion block (30). The test model (20) has an upper surface generally fitting with the prosthesis (10) and a height identical to the prosthesis (10), and is configured for simulating the mounting posture of the prosthesis (10). An adjustment hole (22) provided on the test model (20) can facilitate the adjustment of the posture of the test model (20) while the test model (20) is preliminarily positioned. A positioning hole (21), a first positioning hole (31), and a second positioning hole (32) provided on the test model (20) and the cushion block (30) are configured for drilling mounting holes with a drill rod, such that the mounting of the cushion block (30) and the prosthesis (10) can be accurately directed, and the matching extent between the positions of the first mounting hole and the second mounting hole provided on the femoral section and a prosthesis mounting column is ensured, thereby ensuring that the prosthesis (10) can be mounted at the posture where the test model (20) is positioned, and effectively improving the success rate of the prosthesis implantation surgery.

Description

Biological trochlear groove replacement assembly and method of using same TECHNICAL FIELD

[0001] The present application belongs to the technical field of medical devices, and particularly relates to a biological trochlear groove replacement assembly and a method of using same. BACKGROUND

[0002] When pet dogs and cats are dislocated due to trochlea injury or developmental deformity, etc., a patellar trochlea replacement surgery can be performed for treatment, and a replacement prosthesis needs to be implanted after the damaged trochlear groove part of the femur is removed. The widely used trochlear groove replacement prosthesis currently includes a base plate and a trochlea prosthesis that are in plug-in cooperation with each other. When the patellar trochlea replacement surgery is performed, after the installation position of the trochlea prosthesis is determined, the base plate is first fixed to the distal end of the femur by penetrating the base plate with a screw, and then the trochlea prosthesis is pressed and fixed to the base plate, so that the effective connection between the prosthesis assembly and the femur can be achieved while maintaining the smoothness and continuity of the trochlea surface. However, in actual application, the connection between the trochlea prosthesis and the base plate may be loose, the trochlea prosthesis may be separated from the base plate and even fall off, which shortens the service life of the prosthesis and requires reoperation for repair.

[0003] Chinese Patent CN217723822U discloses a trochlea replacement system to overcome the defects of the existing trochlear groove replacement prosthesis assembly, which includes a trochlea prosthesis, at least one first fixing member installed on the distal end of the trochlea prosthesis, and at least one second fixing member installed on the distal end of the trochlea prosthesis. The first fixing member is vertically arranged relative to the distal end surface of the trochlea prosthesis, and the second fixing member is obliquely arranged relative to the distal end surface of the trochlea prosthesis. The proximal ends of the first fixing member and the second fixing member are connected to the distal end of the trochlea prosthesis, and the distal ends of the first fixing member and the second fixing member are used for inserting into the bone to be replaced. Specifically, as shown in the accompanying drawing 3 of the specification of this patent, two second installation holes penetrate from the side surface of the trochlea prosthesis to the distal end surface of the trochlea prosthesis, and the overall arrangement is in the shape of an eight-character, so that the two second fixing members arranged oppositely are inserted into the femur along the guide of the second installation hole in an oblique direction, which can limit the outward displacement of the trochlea prosthesis along the axial direction of the first fixing member. Although this scheme can enhance the pull-out resistance of the trochlea replacement system, due to the size limitation of the trochlea prosthesis, the hole end distance between the two second installation holes located on the same end surface of the trochlea prosthesis is small, so that the parts of the two second fixing members inserted into the femur will be arranged in close proximity or even interfere with each other, which makes the second fixing members unable to be reliably connected to the femur, or causes the femoral tissue between the two second fixing members to be difficult to heal or even necrotic and fall off, thereby affecting the service life of the trochlea replacement system.

[0004] SUMMARY

[0005] The present application aims to provide a biological trochlear groove replacement assembly and a method of using same, which can stably and reliably implant a trochlea prosthesis.

[0006] To achieve the above object, the technical scheme adopted by the present application is:

[0007] A biological trochlear groove replacement assembly, comprising a prosthesis, a test model, a spacer,

[0008] The upper surface of the prosthesis is a continuous curved surface constituting the trochlear groove, the lower surface of the prosthesis is flat as a whole, the lower surface of the prosthesis is provided with a first mounting column arranged centrally and a second mounting column arranged adjacent to the peripheral edge of the prosthesis, the column body of the first mounting column and the second mounting column extends away from the side where the upper surface of the prosthesis is located from the lower surface of the prosthesis;

[0009] The upper surface of the test model is entirely consistent with the contour of the upper surface of the prosthesis, the lower surface of the test model is flat as a whole, the maximum height difference between the upper surface of the test model and the lower surface of the test model is consistent with the maximum height difference between the upper surface of the prosthesis and the lower surface of the prosthesis, the test model is provided with a positioning hole penetrating through the upper surface and the lower surface of the test model and an adjusting hole penetrating through the side wall surface and the lower surface of the test model, the pose of the hole core of the positioning hole on the lower surface of the test model is consistent with the pose of the column core of the second mounting column on the lower surface of the prosthesis;

[0010] The spacer is in the form of a plate as a whole, the spacer is provided with a first positioning hole and a second positioning hole penetrating through the upper surface and the lower surface of the spacer, the pose of the hole core of the first positioning hole on the lower surface of the spacer is consistent with the pose of the column core of the first mounting column on the lower surface of the prosthesis, and the pose of the hole core of the second positioning hole on the lower surface of the spacer is consistent with the pose of the column core of the second mounting column on the lower surface of the prosthesis.

[0011] A method for using a biological trochlear groove replacement assembly, comprising the following steps:

[0012] A. Maintain the fitting state of the lower surface of the test model and the femoral section, apply the needle rod to penetrate through the adjusting hole and insert into the femoral section to achieve the preliminary positioning of the test model;

[0013] B. Determine whether the trochlear groove length direction and the inclination angle of the upper surface of the test model are consistent with the designed displacement path of the patella, if they are consistent, go to step C, if they are not consistent, remove the needle rod and adjust the pose of the test model, and return to step A;

[0014] C. Apply the second drill rod to penetrate through the positioning hole on the test model and drill the second mounting hole on the femoral section;

[0015] D. Maintain the connection state of each second drill rod and the femoral section, remove the needle rod, and lead the test model out along the rod body of the second drill rod after separating the test model from the femoral section;

[0016] E. Lead each second drill rod into the second positioning hole of the spacer, then guide and fit the spacer with the femoral section along the rod body of the second drill rod, and apply the first drill rod to penetrate through the first positioning hole on the spacer and drill the first mounting hole on the femoral section;

[0017] F, the gasket is separated from the femoral section and is guided outwards along the shafts of the first drill rod and the second drill rod, and the first drill rod and the second drill rod are removed;

[0018] G, the first mounting column of the prosthesis abuts the orifice of the first mounting hole, and the second mounting column abuts the orifice of the second mounting hole, the prosthesis is tightly fixed on the femoral section, and the lower surface of the prosthesis is attached to the femoral section, and the implantation of the prosthesis is completed.

[0019] Compared with the prior art, the technical effects of the present application are as follows: in the biological-type trochlear groove replacement assembly, the test model with a matching upper surface and a consistent height with the prosthesis can be used to simulate the installation position of the prosthesis, the adjusting holes arranged on the test model can be used to adjust the position of the test model while preliminarily positioning the test model; the positioning holes, the first positioning holes and the second positioning holes arranged on the test model and the pad can be used to drill the mounting holes by the drill rods, so that the installation of the pad and the prosthesis can be accurately positioned, the matching degree of the first mounting hole and the second mounting hole drilled on the femoral section and the mounting column of the prosthesis is ensured, and then the prosthesis can be installed at the position positioned by the test model, thereby effectively improving the success rate of the prosthesis implantation surgery. BRIEF DESCRIPTION OF DRAWINGS

[0020] The content expressed by each figure of the present specification and the marks in the figures are briefly described as follows:

[0021] Fig. 1 and Fig. 2 are perspective views of the prosthesis in embodiment one;

[0022] Fig. 3 is a bottom view of the prosthesis in embodiment one;

[0023] Fig. 4 is a cross-sectional view of A-A in Fig. 3;

[0024] Fig. 5 is an enlarged view of E in Fig. 4;

[0025] Fig. 6 is a cross-sectional view of B-B in Fig. 3;

[0026] Fig. 7 is a perspective view of the prosthesis in embodiment two;

[0027] Fig. 8 is a bottom view of the prosthesis in embodiment two;

[0028] Fig. 9 is a cross-sectional view of C-C in Fig. 8;

[0029] Fig. 10 is an enlarged view of F in Fig. 9;

[0030] Fig. 11 is a cross-sectional view of D-D in Fig. 8;

[0031] Fig. 12 and Fig. 13 are perspective views of the test model in embodiment one;

[0032] Fig. 14 is a semi-cross-sectional perspective view of the test model in embodiment one;

[0033] Fig. 15 is a perspective view of the mold core of the first embodiment in a section along the plane of the adjustment hole;

[0034] Fig. 16 is a top view of the mold of the second embodiment;

[0035] Fig. 17 is a G-G sectional view of Fig. 16;

[0036] Fig. 18 is a perspective view of the mold of the second embodiment;

[0037] Fig. 19 is a perspective view of the spacer of the first embodiment. DETAILED DESCRIPTION

[0038] The specific embodiments of the present application will be further described in detail with reference to the accompanying drawings.

[0039] A biological trochlear groove replacement assembly includes a prosthesis 10, a mold 20, and a spacer 30.

[0040] The prosthesis 10 includes a prosthesis upper surface 101, which is in a groove shape with the middle low and the two sides high in the width direction of the prosthesis 10 and in a hill shape with the middle high and the two sides low in the length direction of the prosthesis. The prosthesis upper surface 101 is a smooth continuous curved surface, and the inner concave area in the middle part constitutes a trochlear groove for cooperating with the patella. The patella can slide in the trochlear groove constituted by the prosthesis upper surface 101, and the ridge parts on the two sides of the prosthesis 10 can prevent the patella from escaping from the two sides of the prosthesis 10, thereby achieving effective guidance and limiting of the displacement of the patella. The two sides of the prosthesis upper surface 101 extend downward through a prosthesis side wall surface 103, the bottom of the prosthesis side wall surface 103 is connected with a prosthesis lower surface 102, and the prosthesis lower surface 102 is flat as a whole. The bottom of the prosthesis 10 is provided with a first mounting column 11 arranged in the middle and a second mounting column 12 arranged adjacent to the outer peripheral edge of the prosthesis 10. The first mounting column 11 and the second mounting column 12 are used for inserting into the femur to realize the connection between the prosthesis 10 and the femur.

[0041] The mold 20 includes a mold upper surface 201 which is in overall conformity with the prosthesis upper surface 101, and the two sides of the mold upper surface 201 extend downward through a mold side wall surface 203, the bottom of the mold side wall surface 203 is connected with a mold lower surface 202, and the mold lower surface 202 is flat as a whole. The maximum height difference between the mold upper surface 201 and the mold lower surface 202 is consistent with the maximum height difference between the prosthesis upper surface 101 and the prosthesis lower surface 102, that is, the height of the mold 20 is consistent with the main body height of the prosthesis 10. The main body height of the prosthesis 10 refers to the height of the remaining part of the prosthesis 10 after removing the first mounting column 11 and the second mounting column 12, that is, the outer contour of the mold 20 is in overall conformity with the outer contour of the prosthesis 10 after removing the first mounting column 11 and the second mounting column 12.

[0042] The upper surface 201 of the test mold 20 comprises a curved surface part which is consistent with the upper surface 101 of the prosthesis. The test mold 20 is provided with a positioning hole 21 which penetrates the upper surface 201 and the lower surface 202 of the test mold 20. The position of the hole core of the positioning hole 21 on the lower surface 202 of the test mold 20 is consistent with the position of the column core of the second mounting column 12 on the lower surface 102 of the prosthesis. Here, the consistent position means that the hole drilled by the drill rod penetrating the positioning hole 21 can be inserted into the second mounting column 12 and reliably connected thereto. Obviously, the upper hole end of the positioning hole 21 which penetrates the upper surface 201 and the lower surface 202 of the test mold 20 will form a recess on the upper surface 201 of the test mold 20, so that the upper surface of the test mold 20 at the upper hole end of the positioning hole 21 is different from the upper surface of the prosthesis 10 at the same position. Therefore, the upper surface 201 of the test mold 20 is only consistent with the upper surface 101 of the prosthesis as a whole, but not completely consistent. The height of the test mold 20 is consistent with the height of the main body of the prosthesis 10, which aims to make the position of the upper surface 201 of the test mold 20 consistent with the position of the upper surface 101 of the prosthesis 10 when the lower surface 102 of the prosthesis 10 is attached to the femoral section in the installed state. The side part of the test mold 20 is provided with an adjusting hole 22 which penetrates the side wall 203 and the lower surface 202 of the test mold 20. The adjusting hole 22 is used for the needle rod to penetrate, so as to achieve the preliminary positioning of the test mold 20 on the femoral section.

[0043] The cushion block 30 is in the form of a plate and is provided with a first positioning hole 31 and a second positioning hole 32. The first positioning hole 31 and the second positioning hole 32 penetrate the upper surface 301 and the lower surface 302 of the cushion block 30, respectively. The position of the hole core of the first positioning hole 31 on the lower surface 302 of the cushion block is consistent with the position of the column core of the first mounting column 11 on the lower surface 102 of the prosthesis. The position of the hole core of the second positioning hole 32 on the lower surface 302 of the cushion block is consistent with the position of the column core of the second mounting column 12 on the lower surface 102 of the prosthesis. Here, the consistent position means that the hole drilled by the drill rod penetrating the first positioning hole 31 can be inserted into the first mounting column 11 and connected thereto, and the hole drilled by the drill rod penetrating the second positioning hole 32 can be inserted into the second mounting column 12 and connected thereto.

[0044] The method for using the aforementioned biological-type trochlear groove replacement assembly specifically comprises the following steps:

[0045] A. The lower surface 202 of the test mold is maintained in the attached state of the femoral section, the needle rod is inserted into the femoral section through the adjusting hole 22, and the preliminary positioning of the test mold 20 is achieved. As shown in FIG. 15, the hole cavity of the adjusting hole 22 is inclined, so that the needle rod can be obliquely inserted into the cancellous bone located in the middle of the femoral section. The surgeon can operate by hand, and the installation and disassembly of the test mold 20 can be conveniently achieved by inserting and removing the needle rod. The operation of adjusting the position of the test mold 20 on the femoral section is very convenient.

[0046] B, determine whether the length direction of the trochlear groove and the tilt angle of the patella design displacement path on the surface 201 of the test model are consistent, if they are consistent, go to step C, if they are not consistent, remove the needle rod and adjust the position of the test model 20, return to step A. The patella or patella prosthesis can be used in cooperation with the preliminary positioning test model 20 to visually determine whether the position of the test model 20 is in the design position. Since the overall contour of the test model 20 is consistent with the contour of the prosthesis 10, the position of the test model 20 is determined, and the installation position of the prosthesis 10 is determined.

[0047] C, use the second drill rod to pass through the positioning hole 21 on the test model 20 and drill a second installation hole on the femoral section. This step needs to maintain the insertion state of the needle rod to ensure that the test model 20 is in the design position, and the second drill rod remains connected to the femur after drilling the hole to form a guide column for subsequent surgical operations. After completing this step, the second installation hole corresponding to the second installation column 12 on the prosthesis 10 is formed on the femoral section.

[0048] D, maintain the connection state of each second drill rod and the femoral section, remove the needle rod, and separate the test model 20 from the femoral section and guide it outward along the shaft of the second drill rod. The second drill rod cooperates with the positioning hole 21 on the test model 20 to position the test model 20 and the pad 30, so the needle rod can be removed to avoid affecting the surgical operation field of view and action. After this step is completed, the test model 20 completes its function of simulating the adjustment of the installation position of the prosthesis 10 and positioning the second installation hole drilling position.

[0049] E, pass each second drill rod through the second positioning hole 32 of the pad 30, then guide the pad 30 downward along the shaft of the second drill rod and make it fit the femoral section, and use the first drill rod to pass through the first positioning hole 31 on the pad 30 and drill a first installation hole on the femoral section. That is, insert the shaft of the second drill rod into the second positioning hole 32 of the pad 30, then displace the pad 30 downward along the guide of the shaft of the second drill rod to the fit position of the femoral section, maintain the fit position of the pad 20 and the femoral section, and drill the first positioning hole 31 using the first drill rod. After completing this step, the first installation hole corresponding to the first installation column 11 on the prosthesis 10 is formed on the femoral section.

[0050] F, separate the pad 30 from the femoral section and guide it outward along the shaft of the first drill rod and the second drill rod, and remove the first drill rod and the second drill rod. In step E, the drilling of the first installation hole and the second installation hole has been completed, that is, the installation holes for installing the bottom installation column of the prosthesis 10 on the femoral section have been drilled, so the pad and the drill rods can be removed for the implantation and installation of the prosthesis 10.

[0051] G, the first mounting column 11 of the prosthesis 10 abuts the hole of the first mounting hole on the femoral section, the second mounting column 12 abuts the hole of the second mounting hole on the femoral section, the prosthesis 10 is pressed and fixed on the femoral section, and the lower surface 102 of the prosthesis is attached to the femoral section, and the implantation of the prosthesis 10 is completed.

[0052] Therefore, the test mold 20 is used to simulate the installation position of the prosthesis 10 and the drilling position of the second mounting hole, and the pad 30 is used to position the drilling position of the first mounting hole. After the drilling operation of the first mounting hole and the second mounting hole on the femoral section is completed, the installation of the prosthesis 10 can be implemented. Since the first mounting column 11 is located at the central position of the bottom of the prosthesis 10, if a positioning hole is opened at the same position of the first mounting column on the test mold 20, a recess will be formed at the central position of the upper surface 201 of the test mold, which will affect the judgment of the key surgical indicator of the matching degree of the test mold upper surface 201 simulated sliding surface and the patella. Therefore, the positioning hole 21 on the test mold 20 is only used to realize the drilling positioning of the second mounting hole, and the pad 30 is additionally provided. After the drilling of the second mounting hole is completed, the drill rod for drilling the second mounting hole is used as a positioning rod to realize the drilling positioning of the first mounting hole.

[0053] In order to ensure the consistency of the corresponding column, hole position of the prosthesis 10, the test mold 20 and the pad 30, the outer periphery contour of the lower surface 102 of the prosthesis, the lower surface 202 of the test mold and the lower surface 302 of the pad is consistent in the preferred solution of embodiment one. In this way, the assembly product can be produced and processed in the same station to reduce the product size deviation caused by production error.

[0054] Further, in order to improve the reliability and stability of the connection between the prosthesis 10 and the femoral section, the prosthesis 10 is arranged in axial symmetry, and the symmetry axis is parallel to the length direction of the lower surface 102 of the prosthesis and located at the center in the width direction of the lower surface 102 of the prosthesis. When the lower surface outer periphery contour of the prosthesis 10, the test mold 20 and the pad 30 is consistent, the test mold 20 and the pad 30 are also arranged in axial symmetry respectively, and the symmetry axes of the test mold 20 and the pad 30 are also parallel to the length direction of the lower surface of the component and located at the center in the width direction of the lower surface of the component.

[0055] In the embodiment, the middle part of the femoral section formed after the trochlear surface osteotomy is cancellous bone with loose texture, and the peripheral part is cortical bone with hard texture. The second mounting column 12 is arranged adjacent to the peripheral edge of the prosthesis 10, which makes the second mounting column 12 connected to the cortical bone adjacent to the peripheral edge of the femoral section, so that the second mounting column 12 with a small cross-sectional size can also ensure the reliable connection of the second mounting column 12 and the femur. In order to ensure the stable connection of the middle part of the prosthesis 10 and the femur, the first mounting column 11 needs to have a large cross-sectional size, so that the column body of the first mounting column 11 is adjacent to the hard cortical bone of the femoral section, thereby improving the reliability of the connection between the first mounting column 11 and the femur. That is, the cross-sectional area of the first mounting column 11 is larger than the cross-sectional area of the second mounting column 12, and the outer peripheral contour of the first mounting column 11 is larger than the outer peripheral contour of the second mounting column 12. In order to facilitate processing, reduce irritation to bone tissue, and reduce inflammatory response, in the embodiment, the first mounting column 11 and the second mounting column 12 are in the shape of a cylinder as a whole, and the outer diameter of the first mounting column 21 is larger than the outer diameter of the second mounting column 22. In other embodiments, the first mounting column 11 and the second mounting column 12 can also be non-cylindrical, such as polygonal column or elliptical column, etc., so as to be inserted into the femoral section.

[0056] In the embodiment shown in FIG. 3, the size of the first mounting column 11 in the width direction of the prosthesis 10 is greater than 1 / 3 of the maximum size in the width direction of the prosthesis 10, so that although the reliability of the connection between the first mounting column 11 and the femur is improved, it will be difficult to arrange the second mounting column 12 on both sides of the first mounting column 11 at the bottom of the prosthesis 10, and therefore, the second mounting column 12 is arranged at both ends in the length direction of the prosthesis 10, that is, the second mounting column 12 is arranged at the front end and the rear end of the prosthesis 10, so that in order to ensure the stable connection of the prosthesis 10 and the femur, the second mounting column 12 needs to be provided with at least two.

[0057] In order to make the implantation of the prosthesis 10 have a certain immediate stability, in the embodiment shown in FIGS. 2 and 4, the overhanging end of the first mounting column 11 is provided with a first check convex platform 111, and the overhanging end of the second mounting column 12 is provided with a second check convex platform 121. The first check convex platform 111 and the second check convex platform 121 respectively have a platform surface arranged adjacent to the lower surface 102 of the placed prosthesis, when the first mounting column 11 and the second mounting column 12 are respectively inserted into the corresponding mounting holes, part of the bone tissue will be embedded in the recess between the check convex platform and the mounting column column body, and the bone tissue located in the recess and the platform surface of the first check convex platform 111 and the second check convex platform 121 form abutting cooperation in the direction of the mounting column column core, which prevents the first mounting column 11 and the second mounting column 12 from being pulled outwards, thereby making the prosthesis 10 have immediate stability. After the prosthesis 10 is implanted for a period of time, the bone tissue continues to grow to fill the recess between the check convex platform and the mounting column column body, thereby ensuring the long-term stability of the implanted prosthesis.

[0058] Further, the diameter of the first mounting hole drilled on the femoral section should be smaller than the outer contour of the first non-return boss 111, and the diameter of the second mounting hole drilled on the femoral section should be smaller than the outer contour of the second non-return boss 121. To this end, the diameter of the positioning hole 21 and the second positioning hole 32 is equal to or smaller than the maximum outer diameter of the second mounting column 12, and the diameter of the first positioning hole 31 is equal to or smaller than the maximum outer diameter of the first mounting column 11.

[0059] The second mounting column 12 is arranged adjacent to the outer periphery of the prosthesis 10 and is more easily observed than the first mounting column 11. Therefore, to improve the accuracy of the implantation position of the prosthesis 10, the second mounting column 12 also provides guidance for the implantation and mounting operation.

[0060] In the first embodiment shown in Fig. 4, the overhanging end faces of the first mounting column 11 and the second mounting column 12 have the same distance from the lower surface 102 of the prosthesis 10, i.e. the overhanging height of the first mounting column 11 and the second mounting column 12 is the same. On this basis, the first non-return boss 111 and the second non-return boss 112 are in the form of a truncated cone, the first non-return boss 111 arranged immediately adjacent to the overhanging end face of the first mounting column 11 is connected to the overhanging end face of the first mounting column 11 via a first boss conical surface 111a, and the second non-return boss 121 arranged immediately adjacent to the overhanging end face of the second mounting column 12 is connected to the overhanging end face of the second mounting column 12 via a second boss conical surface 121a, so that the taper of the first boss conical surface 111a is greater than or equal to the taper of the second boss conical surface 121a, i.e. ∠α < ∠β in Fig. 5. In this way, when the prosthesis 10 is pressed downward in the posture shown in Fig. 4, the second mounting column 12 is more easily inserted into the corresponding hole drilled on the femur than the first mounting column 11, thereby providing guidance for the mounting of the first mounting column 11. In this embodiment, the cores of the three mounting columns are located in the same plane, and the plane is perpendicular to the lower surface 102 of the prosthesis 10 and parallel to the length direction of the prosthesis 10. In this way, when the prosthesis 10 is pressed downward, the stability of the prosthesis 10 in the length direction can be ensured. When the prosthesis 10 is pressed downward to the position, the lower surface 102 of the prosthesis 10 is in contact with the femoral section, which can limit the deflection displacement of the prosthesis 10 to the two sides in the width direction, thereby achieving effective positioning of the prosthesis 10.

[0061] In the second embodiment, as shown in Fig. 9, the distance between the overhanging end face of the second mounting column 12 and the lower surface 102 of the prosthesis is greater than the distance between the overhanging end face of the first mounting column 11 and the lower surface 102 of the prosthesis, i.e. h2>h1 in Fig. 10, and the protruding height of the second mounting column 12 is greater than the protruding height of the first mounting column 11. When the prosthesis 10 is pressed downward in the posture shown in Fig. 9, the second mounting column 12 will be connected to the hole in the femoral section before the first mounting column 11. When the second mounting column 12 is inserted into the hole in the femur, the posture of the prosthesis 10 is maintained and the prosthesis 10 is further pressed downward, which ensures reliable connection between the first mounting column 11 and the femur. In the second embodiment, the maximum distance between the second stop protrusion 121 and the lower surface 102 of the prosthesis is greater than the maximum distance between the first stop protrusion 11 and the lower surface 102 of the prosthesis, i.e. d2>d1 in Fig. 10. When the second stop protrusion 121 arranged adjacent to the overhanging end face of the second mounting column 12 is accommodated in the mounting hole of the femur, the positioning of the prosthesis 10 is implemented. In the second embodiment, the taper of the first protrusion taper face 111a is equal to the taper of the second protrusion taper face 121a of the second stop protrusion 232, i.e. ∠α=∠β in Fig. 10. Specifically, the second embodiment is provided with three second mounting columns 12, the column shapes of the three second mounting columns 12 are the same, the protruding heights of the three second mounting columns 12 are the same, and the three second mounting columns 12 are symmetrically arranged relative to the symmetry axis a shown in Fig. 8, which effectively maintains the posture of the prosthesis 10 during the pressing process of the prosthesis 10 and avoids large-angle deflection of the prosthesis 10.

[0062] In the first and second embodiments, the first stop protrusion 111 and the second stop protrusion 121 are conical platforms, which have a taper face 14a extending outward from the overhanging end of the mounting column to the lower surface 102 of the prosthesis and a circular platform 14b connecting the taper face 14a and the column body of the mounting column. That is, the first stop protrusion 111 and the second stop protrusion 121 include a taper face 14a with a small bottom diameter and a large top diameter, and the upper edge of the taper face 14a is connected to the column face of the mounting column or the stop protrusion taper face 14a above it through the horizontally arranged platform 14b. In other embodiments, the first stop protrusion 111 and the second stop protrusion 121 can also be annular platforms with parallel upper and lower platforms, or can be arranged in the form of protrusions or protrusions around the column body of the mounting column, so that the platform adjacent to the lower surface 102 of the prosthesis can be matched with the bone tissue to prevent the mounting column from being pulled out of the mounting hole of the femur along the column core.

[0063] In the first and second embodiments, in order to increase the anti-falling performance of the prosthesis 10, as shown in Figs. 2 and 7, the overhanging end of the first mounting column 11 is provided with at least two first stop protrusions 111, and the column body of the second mounting column 12 is provided with at least two second stop protrusions 121. In other embodiments, the number of first stop protrusions 111 and second stop protrusions 121 can be one, two or more than two according to requirements.

[0064] In the prostheses 10 of Embodiments One and Two, the bottom part is provided with two or more mounting columns, and to facilitate the implantation operation, the first mounting column 11 and the second mounting column 12 are arranged perpendicularly to the lower surface 102 of the prosthesis.

[0065] To ensure the long-term stability of the trochlear prosthesis, as shown in Figs. 2, 3 and 6, the lower surface 102 of the prosthesis is provided with bone ingrowth holes 13 for bone tissue ingrowth. The bone ingrowth holes 13 are blind holes, i.e. the bone ingrowth holes 13 are arranged spaced apart from the upper surface 101 of the prosthesis, so as to ensure that the upper surface 101 of the prosthesis can present a continuous smooth curved surface, thereby stably and reliably providing support and sliding guidance for the patella. In Embodiment One, the hole opening of the bone ingrowth hole 13 is directed obliquely outward below the prosthesis 10, i.e. the hole bottom of the bone ingrowth hole 13 is adjacent to the center of the upper surface 101 of the prosthesis, and the hole opening is directed away from the side where the center of the upper surface 101 of the prosthesis is located. As shown in Fig. 6, the hole core line of the bone ingrowth hole 13 intersects the lower surface 102 of the prosthesis, and the hole core line of the bone ingrowth hole 13 intersects the vertical line passing through the center of the lower surface 102 of the prosthesis above the lower surface 102 of the prosthesis, or the hole core line of the bone ingrowth hole 13 and the vertical line passing through the center of the lower surface 102 of the prosthesis are non-coplanar straight lines and the common perpendicular line thereof is located above the lower surface 102 of the prosthesis. In the implanted state of the prosthesis 10, the bone tissue can grow into the bone ingrowth hole 13 to form biological fixation, thereby ensuring the long-term stability of the implanted prosthesis. The hole cavity of the bone ingrowth hole 13 is obliquely arranged. Compared with the common bone ingrowth hole whose hole cavity is arranged perpendicularly to the lower surface 102 of the prosthesis, the bone tissue can grow obliquely upward into the bone ingrowth hole 13 and abut against the hole wall of the bone ingrowth hole 13, which can effectively limit the displacement of the prosthesis 10 away from the femoral cross section direction, thereby avoiding the occurrence of loosening or falling off of the prosthesis 10 after long-term implantation.

[0066] As shown in Fig. 6, in Embodiment One, the bone ingrowth hole 13 includes a first hole 131 and a second hole 132, and the hole core line of the first hole 131 and the hole core line of the second hole 132 intersect above the lower surface 102 of the prosthesis, or the hole core line of the first hole 131 and the hole core line of the second hole 132 are non-coplanar straight lines and the common perpendicular line segment thereof is located above the lower surface 102 of the prosthesis. In the present case, the upper and lower are the up-down positions shown in Figs. 4 and 9, i.e. the left side shown in Figs. 6 and 11 is the upper side, and the right side is the lower side.

[0067] As shown in Fig. 6, the cavities of the first holes 131 and the second holes 132 are arranged in a splayed manner, so that the bone tissue growing into the cavities is locked with the prosthesis 10, thereby ensuring the close connection between the lower surface 102 of the prosthesis and the cross section of the femur. In the embodiment, the bone engaging holes 13 are distributed on the lower surface 102 of the prosthesis, so that the bone tissue can grow into the prosthesis 10 as much as possible and be connected more closely with the prosthesis. In order to facilitate the processing, the first holes 131 and the second holes 132 are arranged on the two sides of the symmetry axis a of the prosthesis, so that the processing of the first holes 131 and the second holes 132 can be simultaneously performed from the two sides of the lower surface 102 of the prosthesis in one processing procedure. Further, in the embodiment, the first holes 131 with parallel cores form a first hole group, and the second holes 132 with parallel cores form a second hole group, and the first hole group and the second hole group are arranged on the two opposite sides of the lower surface 102 of the prosthesis. In this way, the processing drills of the first holes 131 and the second holes 132 are arranged in parallel and spaced apart, and the processing drills are arranged on the two sides of the lower surface 102 of the prosthesis, so that the processing and forming of all the bone engaging holes 13 can be realized.

[0068] Further, in the first embodiment, the cavities of the adjacent bone engaging holes 13 in the same hole group are connected. As shown in Figs. 2 and 6, the adjacent walls of the two bone engaging holes 13 arranged adjacently and having parallel cores are penetrated to form notches 134, so that the newly grown bone tissue is integrated and connected more closely and firmly with the prosthesis 10. In other embodiments, the bottoms of the two bone engaging holes 13 arranged adjacently and having non-parallel cores can also be penetrated.

[0069] As shown in Figs. 7, 9 and 11, two second mounting posts 22 are arranged at the rear end of the prosthesis 10. The first hole 131 and the second hole 132 cannot be machined on the lower surface 102 of the prosthesis 10 between the two second mounting posts 22 due to the obstruction of the second mounting posts 22. Therefore, the bone-anchoring hole 13 in the second embodiment further comprises a third hole 33. The hole core line of the third hole 33 intersects the plane in which the hole core line of the first hole 131 or the second hole 132 lies. In this way, more bone-anchoring holes 33 can be arranged on the lower surface 102 of the prosthesis 10, and the third hole 33 can further limit the displacement of the prosthesis 10 on the femoral section. Similarly, for the convenience of machining, the third holes 33 with parallel hole core lines form a third hole group. In the same way as in the first embodiment, the bone-anchoring holes 13 in the second embodiment are arranged on the entire lower surface 102 of the prosthesis 10. As shown in Fig. 13, the first hole 131 and the second hole 132 are arranged on the two sides of the symmetry axis a of the prosthesis 10, and the third hole 33 is arranged between the first mounting post 11 and the second mounting post 12 on the two sides of the symmetry axis a of the prosthesis 10. The hole core line of the third hole 33 is perpendicular to the plane in which the hole core line of the first hole 131 or the second hole 132 lies. The difference between the second embodiment and the first embodiment is that the third hole 33 is in communication with the hole bottom of the first hole 131 or the second hole 132 arranged adjacent thereto, forming a through hole 135 as shown in Fig. 7, so that the bone tissue can be connected as a whole at the through hole 135.

[0070] As shown in Fig. 7, the bone-anchoring holes 13 are arranged on the two sides of the prosthesis 10 in the second embodiment. The bone-anchoring holes 13 arranged on the side of the prosthesis 10 are arranged at the bottom of the side wall surface 103 of the prosthesis 10 or at the joint between the side wall surface 103 of the prosthesis 10 and the lower surface 102 of the prosthesis 10. In this way, the newly generated bone tissue can grow upwards and abut against the bottom of the side wall surface 103 of the prosthesis 10, effectively limiting the displacement of the prosthesis 10 in the width direction.

[0071] In a preferred embodiment, the distance between the hole bottom of the bone-anchoring hole 13 and the lower surface 102 of the prosthesis 10 is less than 2 mm. In this way, more bone tissue can be allowed to grow into the prosthesis 10 while ensuring the stability of the bottom structure of the prosthesis 10, thereby ensuring the long-term reliability of the prosthesis 10.

[0072] When the trolley prosthesis 10 is in the implanted state, the first mounting column 11 and the second mounting column 12 at the bottom of the prosthesis 10 pass through the femoral section and are accommodated in the femur, so that the lower surface 102 of the prosthesis can be attached to the femoral section. The size of the trolley prosthesis 10 implanted outward from the femoral section is the maximum distance between the upper surface 101 and the lower surface 102 of the prosthesis. Compared with the widely used assembly product, the prosthesis 10 omits the base plate component, so that the height of the implanted prosthesis relative to the femoral section is reduced, that is, the space occupied by the replaced prosthesis in the animal joint capsule is reduced, on the one hand, facilitating the suturing operation of the animal joint capsule by the surgeon, and on the other hand, making the movement space of the patella in the animal joint capsule more spacious, and the sliding movement of the patella more smooth and unobstructed. Compared with the trolley replacement system disclosed in Chinese patent CN217723822U, the first mounting column 11 and the second mounting column 12 and the bone engaging hole 13 are added at the bottom of the prosthesis 10, so that the height of the implanted prosthesis is maintained without additional base plate or fixing member, so as to ensure sufficient movement space in the joint capsule, thereby improving the reliability and stability of the implanted trolley prosthesis while ensuring the smooth movement of the joint after the prosthesis is implanted.

[0073] In order to avoid the accidental slipping of the test mold 20 during the pose adjustment process, or the test mold 20 and the pad 30 slipping from the hands of the surgeon during the operation process, and the test mold 20 and the pad 30 being contaminated with bacteria, the lower surface 202 of the test mold is provided with anti-slip texture, and the upper surface 301 and the lower surface 302 of the pad are respectively provided with anti-slip texture.

[0074] As shown in FIG. 14, in order to ensure that the height of the test mold 20 is consistent with the height of the prosthesis 10, the bottom of the anti-slip texture on the lower surface 202 of the test mold should be located in the same planar base surface 23, that is, the base surface 23 is the bottom reference of the height of the test mold 20. Further, in order to match the first mounting column 11 arranged perpendicularly to the lower surface 102 of the prosthesis, the hole core line of the positioning hole 21 is also perpendicular to the base surface 23, and the positioning hole 21 is arranged at the front end or the rear end of the test mold 20.

[0075] The base surface 23 is provided with concave grooves or holes to form anti-skid texture. In the first embodiment shown in Fig. 14, the peaks of the anti-skid texture are also located in the same planar peak surface 25, and the base surface 23 is parallel to the peak surface 25. In the implanted state of the prosthesis 10, the bone is displaced along the length direction of the trochlear groove formed by the upper surface 101 of the prosthesis. In the evaluation of the position of the upper surface 201 of the trial, in order to avoid the trial 20 slipping in the length direction of the femoral section when the bone or the bone prosthesis is displaced in the trochlear groove formed by the upper surface 201 of the trial, the base surface 23 is preferably provided with a trial groove 24 extending along the width direction of the trial 20. In the first embodiment shown in Figs. 14 and 15, the base surface 23 is provided with a trial groove 24 extending along the width direction of the trial 20, and the trial grooves 24 are arranged at equal intervals in the length direction of the trial 20 to form a striped texture. In the second embodiment shown in Fig. 18, the base surface 23 is provided with grooves extending along the width direction and the length direction of the trial 20, and these grooves form a chessboard-shaped anti-skid texture at the bottom of the trial 20. In other embodiments, the anti-skid texture provided on the trial 20 and the pad 30 can also be wavy curve grooves extending along the width direction of the trial 20 or the pad 30, or honeycomb-shaped or grid-shaped textures, which are determined according to the need to prevent the trial 20 or the pad 30 from slipping.

[0076] As shown in Fig. 15, in order to avoid the interference between the needles inserted into the positioning holes 21, the hole core line of the adjusting hole 22 is arranged at an acute angle γ with the base surface 23. The distance between the lower hole ends of the two adjusting holes 22 symmetrically arranged on the two sides of the trial 20 is greater than 1 / 2 of the width direction dimension of the trial 20 at this position, so that the needles have a certain distance after being inserted into the femoral section, which can avoid the interference between the two needles and also allow each needle to have a certain adjusting range. In order to facilitate the observation of the posture of the adjusting needle, the upper hole of the adjusting hole 22 is outwardly folded to form a flared ring 221, and the inner ring of the flared ring 221 is arranged at an angle, with the upper part adjacent to the side wall surface of the trial 20 and the lower part away from the side wall surface of the trial 20.

[0077] As shown in FIG. 12 and FIG. 14, the upper surface 201 of the test mold is a smooth surface as a whole, which is in a groove shape with the middle low and the two sides high in the width direction, and in a hill shape with the middle high and the two sides low in the length direction. The upper hole edge of the positioning hole 21 is provided with a planar recess 211 for abutting against the end face of the drilling machine. Since the upper surface 201 of the test mold is in a hill shape with the middle high and the two sides low in the length direction, and the positioning hole 21 is arranged at the two ends of the test mold 20 in the length direction, the planar recess 211 at the upper hole edge of the positioning hole 21 is adjacent to the table surface of the center of the test mold 20, and the table surface is connected to the high side of the upper surface 201 of the test mold through a vertical cylindrical surface 212, and the table surface away from the center of the test mold 20 is connected to the low side of the upper surface 201 of the test mold to form a joint edge 213, as shown in FIG. 16, and the table surface of the planar recess 211 is in a C-shaped ring shape as a whole. Further, in order to improve the positioning accuracy of the implantation position of the prosthesis 10 and ensure that the hole core of the drill rod drilled hole coincides with the hole core of the positioning hole 21, as shown in FIG. 17, the hole core line of the positioning hole 21 is perpendicular to the base surface 23, and the table surface of the planar recess 211 is perpendicular to the hole core line of the positioning hole 21.

Claims

1. A biologic pulley groove replacement assembly, characterized by: The prosthesis (10), the test model (20), and the cushion block (30) are provided. The upper surface (101) of the prosthesis is a continuous curved surface constituting a trochlear groove, and the lower surface (102) of the prosthesis is flat as a whole. The lower surface (102) of the prosthesis is provided with a first mounting column (11) arranged centrally and a second mounting column (12) arranged adjacent to the outer periphery of the prosthesis (10). The column body of the first mounting column (11) and the second mounting column (12) extends away from the side where the upper surface (101) of the prosthesis is located. The upper surface (201) of the test model is in overall conformity with the contour of the upper surface (101) of the prosthesis. The lower surface (202) of the test model is flat as a whole. The maximum height difference between the upper surface (201) and the lower surface (202) of the test model is consistent with the maximum height difference between the upper surface (101) and the lower surface (102) of the prosthesis. The test model (20) is provided with a positioning hole (21) penetrating through the upper surface (201) and the lower surface (202) of the test model and an adjusting hole (22) penetrating through the side wall surface (203) and the lower surface (202) of the test model. The position of the hole core of the positioning hole (21) on the lower surface (202) of the test model is consistent with the position of the column core of the second mounting column (12) on the lower surface (102) of the prosthesis. The cushion block (30) is in the form of a plate as a whole. The cushion block (30) is provided with a first positioning hole (31) and a second positioning hole (32) penetrating through the upper surface (301) and the lower surface (302) of the cushion block. The position of the hole core of the first positioning hole (31) on the lower surface (302) of the cushion block is consistent with the position of the column core of the first mounting column (11) on the lower surface (102) of the prosthesis. The position of the hole core of the second positioning hole (32) on the lower surface (302) of the cushion block is consistent with the position of the column core of the second mounting column (12) on the lower surface (102) of the prosthesis.

2. The biologic glenoid replacement assembly of claim 1, wherein: The lower surface (102) of the prosthesis is provided with a bone-integrating hole (13) for bone tissue growth. The lower surface (202) of the test model is provided with anti-slip textures. The upper surface (301) and the lower surface (302) of the cushion block are respectively provided with anti-slip textures.

3. The biologic glenoid replacement assembly of claim 2, wherein: The outer peripheral contours of the lower surface (102) of the prosthesis, the lower surface (202) of the test model, and the lower surface (302) of the cushion block are consistent. The prosthesis (10), the test model (20), and the cushion block (30) are respectively arranged in axial symmetry. The symmetry axes of the prosthesis (10), the test model (20), and the cushion block (30) are parallel to the length direction of the lower surface of the components and located at the center in the width direction of the lower surface of the components.

4. The biologic glenoid replacement assembly of claim 2, wherein: The bone-integrating hole (13) is a blind hole. The hole opening of the bone-integrating hole (13) is inclined outward and points downward of the prosthesis (10). The bone-integrating hole (13) includes a first hole (131) and a second hole (132). The hole core lines of the first hole (131) and the second hole (132) intersect above the lower surface (102) of the prosthesis. Alternatively, the hole core lines of the first hole (131) and the second hole (132) are in different planes and the common perpendicular line segment of the two hole core lines is located above the lower surface (102) of the prosthesis. The bone-integrating holes (13) are arranged on the lower surface (102) of the prosthesis, the first holes (131) with parallel hole cores form a first hole group, the second holes (132) with parallel hole cores form a second hole group, the first hole group and the second hole group are arranged on opposite sides of the lower surface (102) of the prosthesis. The two second mounting columns (12) are symmetrically arranged on the two sides of the lower surface (102) of the prosthesis, and the area between the two second mounting columns (12) is arranged with third holes (133), the plane where the hole core line of the third hole (133) is located is perpendicular to the plane where the hole core line of the first hole (131) or the second hole (132) is located, and the third holes (133) with parallel hole cores form a third hole group.

5. The biologic glenoid replacement assembly of claim 4, wherein: Adjacent hole walls of two bone-integrating holes (13) arranged adjacent to each other and having parallel hole cores are formed with notches (134); the bottom of the bone-integrating hole (13) is arranged on the bottom of the side wall surface of the prosthesis (10) or the joint between the side wall surface of the prosthesis (10) and the lower surface (102) of the prosthesis (10), and the distance between the hole bottom of the bone-integrating hole (13) and the lower surface (102) of the prosthesis (10) is less than 2 mm.

6. The biologic glenoid replacement assembly of claim 4, wherein: The outer contour of the first mounting column (11) is larger than the outer contour of the second mounting column (12); the size of the first mounting column (11) in the width direction of the prosthesis (10) is greater than 1 / 3 of the maximum size in the width direction of the prosthesis (10), and the second mounting column (12) is arranged at the front end and the rear end of the prosthesis (10).

7. The biologic glenoid replacement assembly of claim 1, wherein: The overhanging end of the first mounting column (11) is provided with a first check boss (111), and the overhanging end of the second mounting column (12) is provided with a second check boss (121).

8. The biologic glenoid replacement assembly of claim 7, wherein: The maximum distance between the platform of the second check boss (121) and the lower surface (102) of the prosthesis is greater than the maximum distance between the platform of the first check boss (111) and the lower surface (102) of the prosthesis, Or the first check boss (111) arranged adjacent to the overhanging end surface of the first mounting column (11) is connected to the overhanging end surface of the first mounting column (11) through a first boss taper surface (111a), and the second check boss (121) arranged adjacent to the overhanging end surface of the second mounting column (12) is connected to the overhanging end surface of the second mounting column (12) through a second boss taper surface (121a), the taper of the first boss taper surface (111a) is greater than or equal to the taper of the second boss taper surface (121a), Or the protruding height of the column body of the second mounting column (12) is greater than or equal to the protruding height of the column body of the first mounting column (11). The first mounting column (11) and the second mounting column (12) are in the shape of a cylinder as a whole, and the column core of the first mounting column (11) and the column core of the second mounting column (12) are perpendicular to the lower surface (102) of the prosthesis.

9. The biologic glenoid replacement assembly of claim 8, wherein: The hole diameter of the positioning hole (21) and the second positioning hole (32) is less than or equal to the maximum outer diameter of the second mounting column (12), and the hole diameter of the first positioning hole (31) is less than or equal to the maximum outer diameter of the first mounting column (11). ​ 10. The biologic glenoid replacement assembly of claim 2, wherein: The upper surface (101) of the prosthesis is a smooth curved surface, the upper surface (101) of the prosthesis is in a form of a groove with a low middle and high sides in the width direction of the prosthesis (10), and the upper surface (101) of the prosthesis is in a form of a hill with a high middle and low sides in the length direction of the prosthesis (10); the upper surface (201) of the test mold includes a curved surface part, and the curved surface part of the upper surface (201) of the test mold is consistent with the upper surface (101) of the prosthesis; the bottom of the anti-skid texture of the lower surface (202) of the test mold is located in the same planar base surface (23), the hole core line of the positioning hole (21) is perpendicular to the base surface (23), and the hole core line of the adjusting hole (22) is arranged at an acute angle γ with the base surface (23); the anti-skid texture provided on the test mold (20) includes a test mold groove (24) extending along the width direction of the test mold (20).

11. The use method of the biological-type trochlear groove replacement assembly according to any one of claims 1-10, comprising the following steps: A. maintaining the fitting state of the lower surface (202) of the test mold and the femoral section, applying a needle rod to penetrate the adjusting hole (22) and insert into the femoral section, and realizing the preliminary positioning of the test mold (20); B. judging whether the sliding direction and the inclination angle of the upper surface (201) of the test mold are consistent with the designed displacement path of the patella, if yes, entering step C, if not, removing the needle rod and adjusting the posture of the test mold (20), and returning to step A; C. applying a second drill rod to penetrate the positioning hole (21) on the test mold (20) and drill a second mounting hole on the femoral section; D. maintaining the connection state of each second drill rod and the femoral section, removing the needle rod, and leading the test mold (20) out along the rod body of the second drill rod after separating the test mold (20) from the femoral section; E. leading each second drill rod to be arranged in the second positioning hole (32) of the pad (30), and then guiding and fitting the pad (30) to the femoral section along the rod body of the second drill rod, applying a first drill rod to penetrate the first positioning hole (31) on the pad (30) and drill a first mounting hole on the femoral section; F. leading the pad (30) to be separated from the femoral section and led out along the rod body of the first drill rod and the second drill rod, and removing the first drill rod and the second drill rod; G. leading the first mounting column (11) of the prosthesis (10) to abut against the hole opening of the first mounting hole, and leading the second mounting column (12) to abut against the hole opening of the second mounting hole, pressing and fixing the prosthesis (10) on the femoral section and fitting the lower surface (101) of the prosthesis (10) to the femoral section, and completing the implantation of the prosthesis (10).

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