阅读说明：本技术 一种通用型人工全肘关节假体 (General artificial full elbow joint prosthesis ) 是由 郭卫 于 2021-10-09 设计创作，主要内容包括：本发明涉及一种通用型人工全肘关节假体,包括：肱骨柄,所述肱骨柄的上端用于插入肱骨髓腔并与之紧固连接；关节体部,所述关节体部的上端与所述肱骨柄连接；尺骨柄,所述尺骨柄的下端用于插入尺骨髓腔并与之紧固连接,所述尺骨柄的上端与所述关节体部通过单纯屈伸机制的铰链结构形成铰链关节。本发明能够广泛应用于肘关节创伤、退行性关节病、类风湿关节炎、肿瘤等重建,实现肢体结构恢复的目的,同时实现肘关节即刻稳定和应力降低等优点的完美结合,从而使患者远期肘关节功能得到显著改善。(The invention relates to a universal artificial full elbow joint prosthesis, which comprises: the upper end of the humerus handle is used for being inserted into a humerus medullary cavity and is fixedly connected with the humerus medullary cavity; an articular body portion having an upper end connected to the humeral stem; the lower end of the ulna handle is used for being inserted into an ulna medullary cavity and fixedly connected with the ulna medullary cavity, and the upper end of the ulna handle and the joint body part form a hinge joint through a hinge structure of a pure flexion-extension mechanism. The invention can be widely applied to reconstruction of elbow joint trauma, degenerative joint disease, rheumatoid arthritis, tumor and the like, realizes the aim of limb structure recovery, and simultaneously realizes the perfect combination of the advantages of immediate elbow joint stabilization, stress reduction and the like, thereby obviously improving the long-term elbow joint function of a patient.)

1. A universal artificial total elbow prosthesis, comprising:

the upper end of the humerus handle (1) is used for being inserted into a humerus medullary cavity (4) and is fixedly connected with the humerus medullary cavity;

a joint body (2), the upper end of the joint body (2) is connected with the humerus handle (1);

the ulna joint comprises an ulna handle (3), wherein the lower end of the ulna handle (3) is used for being inserted into an ulna medullary cavity (5) and fixedly connected with the ulna medullary cavity, and the upper end of the ulna handle (3) and the joint body part (2) form a hinge joint through a hinge structure of a simple flexion-extension mechanism.

2. Universal artificial total elbow joint prosthesis according to claim 1, characterized in that the joint body (2) comprises an extension extending towards the humerus side and a hinge integrally connected with the extension.

3. Universal artificial total elbow joint prosthesis according to claim 2, characterized in that the lower end of the humeral stem (1) forms a cone joint end, the lower end of the humeral stem (1) being directly cone-jointed with the extension of the joint body (2);

or, the lower end of the humerus handle (1) is connected with a defect section with a proper length in a tapered mode, and the defect section is connected with the extending part of the joint body part (2) in a tapered mode.

4. Universal artificial total elbow joint prosthesis according to claim 1, characterized in that the humeral stem (1) and the ulnar stem (3) are designed with an eversion carrying angle of 8 °.

5. The universal artificial total elbow joint prosthesis according to claim 2, wherein the part of the extension part of the joint body part (2) contacting with the self bone surface of the humeral medial and lateral condyles and the proximal end of the handle part of the ulnar stem (3) inserted into the ulnar medullary cavity (5) are both prepared with a porous metal trabecular bone structure with a pore size of 200-800 μm and complete communication by using 3D printing technology, and the porosity is 50-80%.

6. Universal artificial total elbow prosthesis according to any of claims 1 to 5, characterized in that the humeral stem (1) and the medullary humeral cavity (4) and the ulnar stem (3) and the medullary ulnar cavity (5) are of both types of cement fixation or titanium slurry spray biological fixation.

Technical Field

The invention relates to an artificial prosthesis, in particular to a general artificial full-elbow joint prosthesis based on a 3D printing technology, and belongs to the technical field of medical instruments.

Background

Elbow bone tumors accounted for 1% of the incidence of systemic bone tumors. With the development of chemoradiotherapy technology, it becomes possible to locally remove tumor and retain upper limbs. However, due to the dense anatomy of the elbow, which is important, the partial resection may result in instability and loss of function of the wrist joint. After the resection of the tumor around the elbow joint, the elbow joint needs to be reconstructed to stabilize the function of the elbow joint, but the number of reconstruction methods is small. Only a few reconstruction methods have been available for selection before the advent of artificial total elbow joints. The defects of joint fusion, resection, allograft bone joint transplantation and the like respectively cause complications such as limited elbow joint movement and unstable joints after operation. For small bone defects, arthrodesis or resection-plasty is often chosen. Arthrodesis results in limited motion of the elbow joint after surgery and resection-plasty results in postoperative joint instability. For larger defects, allogenic elbow joint transplantation can be used, but the incidence of postoperative complications can be as high as 70%, and infection, joint instability and elbow joint dislocation can occur. Despite firm internal fixation, the chance of postoperative bone nonunion is still high (about 15%), and additional patients may develop allograft bone resorption. For functional reconstruction after resection of a tumor around an elbow joint, no better method than artificial elbow joint replacement exists at present.

The artificial elbow joint replacement is used for trauma, degenerative joint diseases, rheumatoid arthritis and the like, and the reconstruction effect is good in a few cases of elbow tumors due to the adoption of the artificial elbow joint replacement. The cases of ulna proximal or humerus distal tumor resection and elbow joint artificial prosthesis reconstruction generally need to use individualized elbow joint prosthesis replacement, and the complications are nerve injury, infection and prosthesis mechanical failure. The failure rate of the hinge type artificial joint replacement after elbow joint resection is high, and the reasons include: the ulna medullary cavity is thin, so that the bone cement with ideal amount is difficult to inject, and the ulna stem is not firmly fixed; secondly, the elbow joint has frequent bending and stretching activities, and the stress on the handle of the artificial elbow joint is large, thus being easy to cause looseness.

At present, 18 cases of patients with artificial elbow joint replacement of the humeral distal tumor type reported in the literature have complications including 3 cases of aseptic loosening, 2 cases of infection, 1 case of radial nerve injury, and 1 case of periprosthetic fracture. I report 18 cases of reconstructing elbow joint function by artificial total elbow joint replacement after elbow joint peripheral tumor resection, the postoperative early complications are few, the loosening incidence rate is only l cases, the prosthesis stem penetrates out of cortical bone for 2 cases, and the cases of prosthesis stem fracture and prosthesis infection are not found. The problems with the full elbow prosthesis are also apparent. As the ulna medullary cavity is thin and has a bending radian, the mechanical looseness of the whole elbow joint is easy to occur in the long term, and the reconstruction of the elbow joint fails after the tumor is resected. Because the contact surface of the prosthesis and the autogenous bone adopts the design of a 3D printing metal bone trabecula structure, the artificial prosthesis can be quickly integrated with the far end of the humerus and the near end of the ulna, the stress concentration on the prosthesis during the flexion and extension of the elbow joint is effectively reduced, and the mechanical complications such as the loosening and the fracture of the prosthesis are greatly reduced.

Disclosure of Invention

In view of the above problems, it is an object of the present invention to provide a universal artificial total elbow prosthesis based on 3D printing technology.

In order to achieve the purpose, the invention adopts the following technical scheme: a universal artificial full elbow prosthesis comprising: the upper end of the humerus handle is used for being inserted into a humerus medullary cavity and is fixedly connected with the humerus medullary cavity; an articular body portion having an upper end connected to the humeral stem; the lower end of the ulna handle is used for being inserted into an ulna medullary cavity and fixedly connected with the ulna medullary cavity, and the upper end of the ulna handle and the joint body part form a hinge joint through a hinge structure of a pure flexion-extension mechanism.

Preferably, the joint body part comprises an extension part extending towards the humerus side and a hinge part integrally connected with the extension part.

The universal artificial total elbow joint prosthesis preferably has a tapered end formed at the lower end of the humerus stem, and the lower end of the humerus stem is directly tapered with the extension part of the joint body part;

or, the lower end of the humerus handle is connected with a defect section with a proper length in a tapered mode, and the defect section is connected with the extending part of the joint body in a tapered mode.

The universal artificial total elbow joint prosthesis is characterized in that preferably, the humerus side prosthesis and the ulna side prosthesis are designed with eversion carrying angles of 8 degrees.

Preferably, the part of the extension part of the joint body part, which is contacted with the self bone surface of the inner and outer humeral condyles and the proximal end of the handle part, which is inserted into the ulna cavity, of the ulna stem is provided with a porous metal bone trabecular structure with the pore size of 200-800 mu m and is completely communicated by adopting a 3D printing technology, and the porosity is 50-80%.

The universal artificial full elbow joint prosthesis preferably adopts two types of cement fixation or titanium slurry spraying biological fixation for the humerus stem and the humerus medullary cavity and the ulna stem and the ulna medullary cavity.

Due to the adoption of the technical scheme, the invention has the following advantages:

1. the invention is designed into a non-customized hinge type elbow joint prosthesis, can be widely applied to reconstruction of elbow joint trauma, degenerative joint disease, rheumatoid arthritis and tumor after resection, realizes the aim of limb structure recovery, and simultaneously realizes the perfect combination of the advantages of immediate elbow joint stability and stress reduction, thereby obviously improving the long-term elbow joint function of a patient.

2. The invention can rebuild the elbow joint flexion and extension function, recover the normal length of limbs and provide conditions for normal mechanical conduction after the upper limb bone is damaged.

3. In order to resist the stress of rearward displacement and axial rotation, the invention designs the joint body part positioned between the inner and outer condyles of the humerus, and simultaneously reserves the inner and outer condyles of the humerus so as to reserve the muscle attachment points on the inner and outer condyles as much as possible.

4. According to the invention, the integration of the prosthesis and the bone contact surface is increased by adopting a 3D printing pore structure at the part of the extension part of the joint body part, which is contacted with the self bone surface of the internal and external humeral condyles and the near end surface of the handle part, of which the ulna handle is inserted into the ulna medullary cavity 5, so that the stress concentration on the full elbow joint prosthesis during the elbow joint bending and stretching is effectively reduced, and the mechanical complications such as loosening and breaking of the full elbow joint prosthesis are greatly reduced.

5. The invention adopts the assembly design, thereby being applicable to the large bone defect caused by the resection of the tumor at the far end of the humerus or the near end of the ulna.

Drawings

FIG. 1 is a schematic structural diagram of a universal artificial total elbow prosthesis according to an embodiment of the present invention;

fig. 2 is a schematic diagram illustrating the general artificial total elbow joint prosthesis according to the embodiment of the present invention in a state after being implanted.

The various reference numbers in the figures:

1-humeral stem; 2-a joint body; 3-ulna stem; 4-humeral medullary cavity; 5-ulna medullary cavity.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings. It is to be understood that the embodiments described are only a few embodiments of the present invention, and not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

In the description of the present invention, it should be noted that the terms "upper", "lower", "inside", "outside", and the like indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, and are only for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the system or element referred to must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention.

In the description of the present invention, it should be noted that, unless otherwise explicitly specified or limited, the terms "mounted," "disposed," and "connected" are to be construed broadly, e.g., as meaning either a fixed connection, a removable connection, or an integral connection; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.

The invention provides a universal artificial full elbow joint prosthesis, which comprises: the upper end of the humerus handle is used for being inserted into a humerus medullary cavity and is fixedly connected with the humerus medullary cavity; the upper end of the joint body part is connected with the humerus handle; the elbow joint comprises an ulna handle, wherein the lower end of the ulna handle is used for being inserted into an ulna medullary cavity and fixedly connected with the ulna medullary cavity, and the upper end of the ulna handle and the joint body part form a hinge joint through a hinge structure of a simple flexion-extension mechanism, so that the flexion-extension function of the elbow joint can be rebuilt, the normal length of limbs can be recovered, and conditions are provided for normal mechanical conduction after the upper limb bone is damaged. The invention is designed into a non-customized hinge type elbow joint prosthesis, can be widely applied to reconstruction of elbow joint trauma, degenerative joint disease, rheumatoid arthritis and tumor after resection, realizes the aim of limb structure recovery, and simultaneously realizes the perfect combination of the advantages of immediate elbow joint stability and stress reduction, thereby obviously improving the long-term elbow joint function of a patient.

The general artificial total elbow joint prosthesis provided by the embodiment of the invention is described in detail below with reference to the accompanying drawings.

As shown in fig. 1 and 2, the invention provides a universal artificial total elbow joint prosthesis, which comprises: the upper end of the humerus handle 1 is used for being inserted into and fixedly connected with a humerus medullary cavity 4; the upper end of the joint body part 2 is connected with the humeral handle 1; the ulna handle 3, the lower end of the ulna handle 3 is used for inserting into the ulna medullary cavity 5 and is connected with the ulna medullary cavity in a fastening mode, the upper end of the ulna handle 3 and the joint body 2 form a hinge joint through a hinge structure of a simple flexion-extension mechanism, therefore, the elbow joint flexion-extension function can be rebuilt, the normal length of limbs can be recovered, and conditions are provided for normal mechanical conduction after upper limb bone defect.

In the above embodiment, the joint body 2 preferably includes an extension extending toward the humeral side and a hinge portion integrally connected to the extension, and the extension can be firmly connected between the medial and lateral humeral condyles while retaining the medial and lateral humeral condyles to retain the muscular attachment point on the medial and lateral humeral condyles as much as possible, so that the stress of posterior shift and axial rotation can be effectively resisted.

In the above embodiment, preferably, the lower end of the humeral stem 1 forms a tapered end, and the lower end of the humeral stem 1 is directly tapered with the extension of the joint body 2 (suitable for the case of short lesion resection range); alternatively, a defect segment (not shown) with a suitable length may be tapered at the lower end of the humeral stem 1, and the defect segment may be tapered with an extension of the joint body 2 (suitable for a case where the range of lesion resection is long), thereby achieving the combination of different defect lengths in the operation.

In the above embodiment, the humeral stem 1 and the ulnar stem 3 are preferably designed with an eversion carrying angle of 8 °, whereby an eversion of 8 ° of the total elbow prosthesis can be allowed.

In the above embodiment, preferably, the part of the extension part of the joint body 2 contacting with the self bone surface of the inner and outer humeral condyles and the proximal end of the handle part of the ulnar handle 3 inserted into the ulnar medullary cavity 5 are both prepared with a porous metal bone trabecular structure with a pore size of 200-800 μm and complete communication by using a 3D printing technology, and the porosity is 50% -80%, so as to provide a growing space for the new bone tissue, so that the new bone tissue can creep into the pore structure, thereby quickly realizing bone integration with the distal humerus and the proximal ulna, effectively reducing stress concentration on the full elbow joint prosthesis during elbow flexion and extension, and greatly reducing mechanical complications such as loosening and fracture of the full elbow joint prosthesis.

In the above embodiment, the humeral stem 1 and the humeral medullary cavity 4 and the ulnar stem 3 and the ulnar medullary cavity 5 may be fixed by cement or biological fixation by spraying titanium slurry.

Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.