阅读说明：本技术 全肩假体 (Full shoulder prosthesis ) 是由 S·泰皮克 于 2018-04-06 设计创作，主要内容包括：本发明涉及一种用于肩关节的全假体。该全假体是所谓的反向型全假体,其在肱骨中具有凹形部件并且在肩胛骨上具有凸起部件。(The present invention relates to a kind of total prosthetics for shoulder joint.The total prosthetic is so-called reversal total prosthetic, has protruding part with female component in humerus and on shoulder blade.)

1. a kind of full shoulder prosthesis of reversal, comprising:

(i) female component 300, the female component are adapted for attachment to proximal humerus, and

(ii) protruding part, the protruding part include spherical head 200 and the bone anchor 100 for being adapted for attachment to shoulder blade,

Wherein, the female component 300 includes the recessed portion 301 suitable for accommodating the spherical head 200, and wherein, described Female component 300 provides at least about 180 ° of coverage area of the spherical head 100.

2. full shoulder prosthesis as described in claim 1,

Wherein, the female component provides about 180 ° to about 200 ° of coverage area of the spherical head 100.

3. full shoulder prosthesis as claimed in claim 1 or 2,

Wherein, the female component 300 has main body 302 made of biocompatible polymer, and the biocompatibility is poly- Closing object is, for example, polyether-ether-ketone (PEEK).

4. full shoulder prosthesis as claimed in any one of claims 1-3,

Wherein, the female component 300 is provided with made of reinforcing material in the region contacted with the spherical head 200 Ring 303,

Wherein, the reinforcing material is, for example, the PEEK enhanced.

5. such as full shoulder prosthesis of any of claims 1-4,

Wherein, the rear side of the female component 300 be at least partially coated with porous layer, especially metal porous layer and/or The porous layer of ceramic material, the metal are, for example, titanium, and the ceramic material is, for example, hydroxyapatite.

6. full shoulder prosthesis according to any one of claims 1 to 5,

Wherein, the spherical head 200 is made of metal, such as is made of such as cobalt-chromium metal alloy or the spherical shape Head is made of ceramic materials, such as is made of or mixtures thereof aluminium oxide, zirconium oxide.

7. such as full shoulder prosthesis of any of claims 1-6,

Wherein, the bone anchor 100 is formed as including the screw with the main body 101 of screw thread 104, wherein the screw Main body 101 includes the neck 102 for being adapted for attachment to the spherical head 200 in its distal end,

Wherein, the main body 101 of the screw is, for example, cylindricality tubular body, and/or

Wherein, the neck 102 is, for example, the neck of taper.

8. such as full shoulder prosthesis of any of claims 1-7,

Wherein, the bone anchor 100 includes the tubular body 101 with hollow core 103.

9. full shoulder prosthesis as claimed in claim 8,

Wherein, the tubular body 101 of the bone anchor includes multiple holes 105, and the multiple hole is preferably about the bone anchor The periphery of the main body of firmware is arranged.

10. full shoulder prosthesis as claimed in any one of claims 7-9,

Wherein, the main body 101 of the bone anchor is equipped with recessed portion 106 in the end of the neck 102, for being attached to The spherical head 200,

Wherein, the recessed portion 106 of the bone anchor is, for example, screwdriver recessed portion.

11. such as full shoulder prosthesis of any of claims 1-10,

Wherein, the bone anchor 100 is made of metal, for example, being made of titanium or being made of the titanium alloy of such as titanium-aluminum-niobium.

12. full shoulder prosthesis as claimed in claim 11,

Wherein, the metal that the bone anchor is made is at least partially coated with porous layer, especially for example, gold of titanium The porous layer of the ceramic material of the porous layer of category and/or for example, hydroxyapatite.

13. a kind of method for shoulder surgery, including planting full shoulder prosthesis described according to claim 1 any one of -12 Enter in subject's body in need.

Technical field

The present invention relates to a kind of total prosthetics for shoulder joint.The total prosthetic is so-called reversal, is had in humerus Female component and on shoulder blade have protruding part.

Background technique

Full shoulder joint modeling is joint replacement with fastest developing speed at present.Its improvement for being partly due to implantation material Clinical performance, also due to the acceptance of reversal prosthese increases.In anatomical form prosthese, humeral head is by similarly sized and shape Prosthese head replace, most commonly be located at humerus handle proximal end.Glenoid cavity is also by the implantation closely similar with natural shape Object replaces, and is usually fixed by screw and is suitable for secondary bone ingrowing.

In reversal prosthese, the shapes and sizes in joint are closely similar, but simply reverse: proximal humerus has now There is shallow cavity and shoulder blade carries relatively flat large radius head.Rotation center is transferred in shoulder blade by this --- at present still Do not know whether this facilitates clinical effectiveness, but motion range usually will increase.

Current process still has problem: dislocation, joint wear and the failure for being permanently attached to bone.

It is solve the most of of the important plastic surgery intervention in place of the fundamental difference of the present invention and conventional method Problem.In addition, method of the invention can shorten operating time, and significantly reduce the wound of surgical procedure.

Summary of the invention

The invention discloses a kind of full shoulder prosthesis of reversal.The proximal humerus being fixed below the excision plane of humeral head In female component be deep cup, which covers about 180 ° or more, for example, about 180 ° of the prosthese head for being fixed to shoulder blade To about 200 °.The acetabular cup of the depth cup and total hip prostheses is closely similar, and the cancellous bone preferably by being fixed with pressure to reaming In bed, Quadratic Stability is then carried out by the ingrowing of bone.

Protruding part is that the femur displacement in spherical head, with total hip arthroplasty is closely similar.Protruding part is attached Be connected to omoplate bone anchor, which can be shaped as tubular screw, and by the subchondral bone of glenoid cavity, Then it is inserted into shoulder blade along the long axis of shoulder blade, is cut partially into all three flat bones to form shoulder blade triplet.

Prosthese of the invention provides large-scale shockless movement, superior stability and concise timesaving operation.This The prosthese of invention is suitable for the mankind and veterinary science.

Therefore, one aspect of the present invention is related to a kind of full shoulder prosthesis of reversal, comprising:

(i) it is adapted for attachment to the female component 300 of proximal humerus, and

(ii) protruding part, the protruding part include spherical head 200 and the bone anchor for being adapted for attachment to shoulder blade 100,

Wherein, female component 300 includes the recessed portion 301 suitable for accommodating spherical head 200, and wherein, female component 300 provide at least about 180 ° of coverage area of spherical head 100.

Another aspect of the present invention relates to a kind of methods for shoulder surgery, including Using prosthesis as described above is had In the subject's body needed.

Full shoulder prosthesis of the invention places the spherical joint of a depth inside humerus, and the center of the spherical joint is leaned on just Its nearly physical slot, even if the spherical joint is reversal.Traditional reversal shoulder prosthesis very close to shoulder blade places rotation Turn center, and wherein the flat head portion of large radius is attached to shoulder blade.Anatomic prostheses or the stability of reversal prosthese by The limitation in its shallow joint.Prosthese of the invention provides excellent stability, and by depending on optimal material and hinge The fine structure for connecing geometry provides extremely low abrasion.

The fixation device of two components is unique for the joint, by surgical operation simplification and is safe.By It is lower in implantation material and surgery cost, it is contemplated that a large amount of operating times can be saved.

Detailed description of the invention

Hereinafter, the preferred embodiment of the present invention has been described with reference to the drawings.

Fig. 1 shows the perspectives and plans of the omoplate component of the preferred embodiment of prosthese according to the present invention.

Fig. 2 shows the perspective views of the humerus cup of the preferred embodiment of prosthese according to the present invention.

Fig. 3 to 11 shows the surgical procedure for being implanted into prosthese according to the present invention.

Figure 12 and 13 shows the embodiment of the humerus cup of implantation dog humerus.

Specific embodiment

Fig. 1 a shows the perspective view of shoulder blade anchoring screw 100.The cylindricality tubular body 101 of anchoring screw is in its distal end Upper carrying conical neck 102.Hollow core 103 leaves most of bone in situ.There are many holes 105 between screw thread 104, Help quickly to be integrated into the revascularization that bone is carried out in bone and in the core of anchoring screw.Illustrate only these in the figure Three column in hole, but preferably, the hole is arranged around the entire periphery of screw.Preferred material for anchoring screw 100 is titanium One of alloy, most preferably titanium-aluminum-niobium have high intensity, but also have excellent biocompatibility.It is whole in order to improve bone It closes, the anchoring screw can be coated with POROUS TITANIUM and/or hydroxyapatite.

Fig. 1 b shows the orthogonal view of fixing screws 100 and installation to the shoulder blade head 200 of conical neck 102.In The end of conical neck 102, anchoring screw are provided with screwdriver recessed portion 106.The neck of anchoring screw can be intubationization, To allow that the neck is inserted on guidance pin using intubationization screwdriver.It shoulder blade head can be by one of suitable metal alloy It is made (such as cobalt-chromium), or is more preferably made of high-strength ceramic (such as or mixtures thereof aluminium oxide, zirconium oxide).

Fig. 2 shows the perspective views of humerus cup 300.Recessed portion 301 is suitable for receiving spherical head 200.Recessed portion covering At least about 180 ° of head reaches about 190 ° or about 200 ° preferably even to obtain the bigger resistance relative to dislocation, but still There are enough shockless movement ranges.The main body 302 of cup can be made of biocompatible polymer, such as polyether-ether-ketone (PEEK), ring 303 and at the ring shaped contact portion with head can be set, which is made of reinforcing material, in particular The PEEK ring of enhancing, for example, the PEEK ring 303 of fibre reinforced.Abrasion of ring when hinged with ceramic head is extremely low.Cup Rear side, far from the side of protruding part can be coated with porous titanium layer and/or hydroxyapatite layer.It is shone for radioactive ray It mutually identifies, cup can be equipped with radiography label, for example, the becket 304 at its equator.

Fig. 3 to 11 shows the sequence of the surgical procedure for being implanted into shoulder prosthesis according to the present invention.The sequence is It is carried out on the plastic pattern of dog shoulder joint, there is the anatomical structure closely similar with the shoulder of people.The present invention is equally suitable For the mankind and certain animal species, especially dog.

Fig. 3 shows the reaming of the hemispherical cavity in humerus.Humeral head is above the crossover position from head to neck It is removed by plane osteotomy.

Fig. 4, which is shown, sells insertion shoulder blade for guidance.Starting point is located at the center of glenoid cavity；Direction is along shoulder blade The line that three flat planes meet.Find direction appropriate can by the edge of glenoid cavity to the bone at glenoid cavity rear Head carries out minor operation exposure to assist.Aiming at relative to about 90 degree of glenoid cavity is another selection.

Fig. 5, which is shown, cuts shoulder blade at core device cylindricality with short cannula type to carry out into the first step of core.

Fig. 6 shows the second step for further cutting shoulder blade at core device using longer cannula type.The length of the cutter Degree prevents the accurate guiding on guidance pin, but cutting part is once accurately centered in using the first chopped cutter guidance pin On, which can be safely used for completing into core.

Fig. 7 shows the view observed after the completion of implantation material Cheng Xin towards glenoid cavity.Note that cutting part is entering omoplate Bone is left at quadrate bone rear under glenoid cartilage before ridge.

Fig. 8 shows the insertion of shoulder blade anchoring screw.Screw is positioned at by entering and leaving bone in multiple positions In shoulder blade-bone along these cutting parts the expected quick and strong integration that will cause implantation material of periosteal reaction.

Once being inserted into screw, the head of prosthese is attached to anchoring screw by accurate taper fit, as shown in Figure 9.Neck The length in portion can be changed by the depth of anchoring insertion or be changed by selecting the head with different cup depths, such as Usually to for example total hip joint is done as.

Figure 10 shows the humerus cup being inserted into its ready chamber.The insertion is preferably cementless, but a replacement Embodiment is by bone cement come fixed cup.

Figure 11 shows simplified full shoulder prosthesis.Due to the neck of omoplate component have compared with the diameter on head it is small straight Diameter, so prosthese has very large-scale shockless movement.It is expected on anchoring piece almost without bending --- this illustrates to close It is very shallow to save broad-mouthed receptacle for holding liquid chamber, the big variation of joint force vector cannot be resisted.

Figure 12 shows the tangential view of the humerus cup in insertion dog corpse.The quality of porous bone is very in this region It is good, and stablizing in no traditional rod should be able to be reliably achieved and fixed.

Figure 13 is the perspective view of humerus cup, and size appropriate and the position of the humerus cup is shown.