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CN108210130B - Talus prosthesis - Google Patents

Talus prosthesis Download PDF

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Publication number
CN108210130B
CN108210130B CN201810017896.2A CN201810017896A CN108210130B CN 108210130 B CN108210130 B CN 108210130B CN 201810017896 A CN201810017896 A CN 201810017896A CN 108210130 B CN108210130 B CN 108210130B
Authority
CN
China
Prior art keywords
material part
metal material
joint surface
caulking groove
talus prosthesis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201810017896.2A
Other languages
Chinese (zh)
Other versions
CN108210130A (en
Inventor
段宏
屠重棋
方向
熊燕
张闻力
罗翼
刘宏远
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
West China Hospital of Sichuan University
Original Assignee
West China Hospital of Sichuan University
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by West China Hospital of Sichuan University filed Critical West China Hospital of Sichuan University
Priority to CN201810017896.2A priority Critical patent/CN108210130B/en
Publication of CN108210130A publication Critical patent/CN108210130A/en
Application granted granted Critical
Publication of CN108210130B publication Critical patent/CN108210130B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006Properties of materials and coating materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30092Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4207Talar components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The invention relates to a talus prosthesis, which comprises a total talus prosthesis body, wherein the total talus prosthesis body comprises an upper non-metal material part and a lower metal material part, the non-metal material part and the metal material part can be assembled in a combined way, the non-metal material part comprises a pulley joint surface and a medial malleolus joint surface, the metal material part comprises a subtalar joint surface, the non-metal material part or the metal material part comprises a talaroot joint surface, and the metal material part is provided with 4-5 fixing nail channels. The space between the lower joint surface and/or the space between the boat joint surface is of a porous bone trabecular structure or is provided with a hydroxyapatite coating. The detachable nonmetallic material part and the detachable metallic material part are convenient to replace during repair; the area adjacent to the bone adopts a bone trabecula porous structure or is provided with a hydroxyapatite coating, so that bone fusion can be promoted; the outer flange a fills the void outside the calcaneus, increasing stability.

Description

Talus prosthesis
Technical Field
The invention relates to the technical field of medical appliances, in particular to a talus prosthesis.
Background
The talus is the largest irregular bone of human body and can be divided into three parts of head, neck and body. The total of the talus is 7 joint surfaces, namely the navicular joint surface, the calcaneus anterior joint surface, the calcaneus middle joint surface, the calcaneus posterior joint surface, the medial malleolus joint surface, the lateral malleolus joint surface and the pulley joint surface, which are the joints for transmitting the body gravity to the feet, and have important biomechanical functions.
About 60% -70% of the talar surface is covered by articular cartilage and the remainder by periosteum, the talar itself has no independent blood supply, and is supplied with blood only through ligaments and joint capsules. Primary talar tumors account for about 0.3% of the whole body, and the main pathological type is giant bone tumor, which often affects the whole talus, and has high recurrence rate. Talar resection may reduce the rate of recurrence but may leave dysfunction. In addition to tumors, local trauma and suppurative infections can also cause severe damage to the talus, and surgical treatment is still currently the mainstay of joint fusion, as well as leaving behind dysfunction.
Disclosure of Invention
The present invention aims to provide a talar prosthesis that can replace the talus as compared to joint fusion, the talar prosthesis replacement functioning better than after joint fusion; the talus prosthesis comprises a total talus prosthesis body, wherein the total talus prosthesis body is divided into an upper part and a lower part, and the upper part and the lower part can be assembled in a combined way, so that the replacement is convenient during repair.
In order to achieve the above purpose, the invention adopts the following technical scheme:
a talus prosthesis comprising a total talus prosthesis body comprising an upper non-metallic material portion and a lower metallic material portion, the non-metallic material portion and the metallic material portion being combinable, the non-metallic material portion comprising a trochlear articular surface and a medial malleolus articular surface, the metallic material portion comprising a subtalar articular surface, the non-metallic material portion or the metallic material portion comprising a navicular articular surface, the metallic material portion being provided with a staple channel.
Further, the top surface of the metal material part is provided with an embedding groove, and the bottom of the nonmetal material part is embedded in the embedding groove. The top surface of the metal material part is provided with an embedding groove, and the bottom of the nonmetal material part is embedded in the embedding groove; alternatively, the bottom surface of the nonmetallic material part is provided with an embedding groove, and the top of the metallic material part is embedded in the embedding groove.
Further preferably, when the caulking groove is provided in the metal material section, the caulking groove side wall has a notch opening upward; when the caulking groove is arranged on the nonmetallic material part, the side wall of the caulking groove is provided with a notch with a downward opening. Wherein the non-metallic material portion and the metallic material portion are both related to the lateral malleolus joint surface.
Further, the inferior articular surface and/or the navicular articular surface is of a porous bone trabecular structure.
It is further preferred that the subtalar joint surface and/or the navicular joint surface is coated with hydroxyapatite.
Further, the part of the metal material corresponding to the tarsal sinus is protruded outwardly to form an outer protrusion A to fill the tarsal sinus and the tarsal sinus canal.
Preferably, the nonmetallic material part is made of a polymer material or medical ceramic, and the metallic material part is made of titanium alloy, nickel-based alloy, stainless steel, titanium-nickel alloy, cobalt-chromium alloy, copper-based alloy, tantalum alloy or the like. The polymer material may be high density polyethylene, polylactic acid, high modulus aromatic polyamide, carbon fiber, composite material thereof, etc.
The metal material part is further provided with four fixing nail channels on the joint surface, and the four fixing nail channels penetrate through the bottom surface of the caulking groove.
Further, the talus prosthesis further comprises a fixing nail matched with the fixing nail channel, an external thread is arranged on a nail cap of the fixing nail, and an internal thread matched with the nail cap is arranged on the fixing nail channel.
Compared with the prior art, the invention has the following beneficial effects:
the detachable nonmetallic material part and the detachable metallic material part are convenient to replace during repair; the area adjacent to the bone adopts a bone trabecula porous structure or is provided with a hydroxyapatite coating, so that bone fusion can be promoted; the outer flange a fills the void outside the calcaneus, increasing stability.
Drawings
Fig. 1 is a schematic structural view of embodiment 1;
FIG. 2 is a schematic view of the structure of embodiment 1 without showing the staples;
FIG. 3 is a schematic structural view of a metal material portion in example 1;
FIG. 4 is a schematic structural view of a non-metallic material portion;
fig. 5 is a schematic structural view of embodiment 2;
FIG. 6 is a schematic structural view of a metal material portion in example 2;
fig. 7 is a schematic view of the structure of embodiment 3 without showing the staples;
in the figure: 1-nonmetallic material part, 2-metallic material part, 3-fixed nail, 11-protruding part, 21-caulking groove, 22-notch, 23-fixed nail way, 24-outer convex part A, 25-distance boat joint surface, 26-step part and 27-outer edge.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings, in order to make the objects, technical solutions and advantages of the present invention more apparent.
Example 1
As shown in fig. 1 and 2, the talus prosthesis disclosed in this embodiment includes a total talus prosthesis body, where the total talus prosthesis body is an anatomical structure, and the total talus prosthesis body includes an upper non-metal material portion 1 and a lower metal material portion 2, where the non-metal material portion 1 and the metal material portion 2 can be assembled in a combined manner, so that the non-metal material portion 1 is easy to replace during repair, and corresponds to the distal end of tibia. The top surface of the metal material part 2 is provided with a caulking groove 21, the bottom of the nonmetal material part 1 is embedded in the caulking groove 21, the bottom of the nonmetal material part 1 is in interference fit with the caulking groove 21, the side wall of the caulking groove 21 is provided with a notch 22 with an upward opening, and the nonmetal material part 1 is conveniently pried through the notch 22. Of course, the metal material part 2 may be embedded in the non-metal material part 1, the bottom surface of the non-metal material part 1 is provided with the embedded groove 21, the top of the metal material part 2 is embedded in the embedded groove 21, and the side wall of the embedded groove 21 is provided with the notch 22 with the opening facing downwards.
The nonmetallic material part 1 is made of a high polymer material or medical ceramic, and the metallic material part 2 is made of titanium alloy, nickel base alloy, stainless steel, titanium nickel alloy, cobalt chromium alloy, copper base alloy, tantalum alloy or the like. The polymer material may be high density polyethylene, polylactic acid, high modulus aromatic polyamide, carbon fiber, composite material thereof, etc.
Metal material portion
The non-metallic material portion 1 includes a pulley articular surface and a medial malleolus articular surface, the metallic material portion 2 includes a subtalar articular surface and a navicular articular surface 25, and both the non-metallic material portion 1 and the metallic material portion 2 relate to the lateral malleolus articular surface. The subtalar joint surface includes the anterior calcaneus joint surface, the middle calcaneus joint surface and the posterior calcaneus joint surface.
As shown in fig. 3, the metallic material portion 2 is provided with a staple channel 23. Four fixing nail channels 23 are arranged on the inferior articular surface in the embodiment, and the four 4 fixing nail channels 23 penetrate through the bottom surface of the caulking groove 21 for fixing the talus and the calcaneus. As shown in fig. 3, the talus prosthesis further comprises a fixed nail 3 matched with the fixed nail channel 23, an external thread is arranged on a nail cap of the fixed nail 3, an internal thread matched with the nail cap is arranged on the fixed nail channel 23, when in use, the fixed nail 3 is arranged in the fixed nail channel 23, and the fixed nail 3 is locked with the talus prosthesis by utilizing the nail cap and the internal thread of the fixed nail channel 23, so that the stability is high. The staple 3 in this embodiment is a full-threaded locking screw. The staples 3 may be coated with a hydroxyapatite coating. The distribution and the direction of the fixing nails 3 are as shown in fig. 5, the fixing nails 3 incline outwards from the nail cap to the nail tail, and the side positions can be in a fan shape.
As shown in fig. 3, a stepped portion 26 is provided on the metal material portion 2 so as to protrude upward from the side of the caulking groove 21, and an outer edge 27 of the top surface of the stepped portion 26 is provided on the outer side surface of the stepped portion 26 from the boat joint surface 25.
As shown in fig. 4, the upper part of the nonmetallic material part 1 is provided with a protruding part 11 matched with the step part 26, and as shown in fig. 2, when the nonmetallic material part 1 and the metallic material part 2 are assembled together, the protruding part 11 is positioned above the step part 26, and the bottom of the protruding part 11 is wrapped by the upturned outer edge 27 of the step part 26.
The metal material part 2 can be 3D printed, and can also be prepared by other process methods, and in the embodiment, hydroxyapatite can be selectively sprayed on the lower joint surface or a 3D printed porous structure is adopted to promote bone ingrowth. Wherein, the joint surface 25 is a polished surface. On the basis of the anatomical structure, the part of the metal material part 2 corresponding to the tarsal sinus is outwards protruded to form an outer convex part A24 so as to fill the tarsal sinus and the tarsal sinus tube, and the outer convex part A24 fills the gap on the outer side from the calcaneus, thereby increasing the stability. The outer flange a24 is also porous bone trabecular structure and/or has a hydroxyapatite coating.
The total talus prosthesis body in the embodiment comprises a detachable non-metal material part 1 and a metal material part 2, so that the replacement is convenient during repair; the lower surface of the total talus prosthesis body adopts a bone trabecula porous structure in the area adjacent to calcaneus, so that bone ingrowth can be promoted; the outer flange a24 fills the void on the outside from the calcaneus, increasing stability.
Example 2
This embodiment differs from embodiment 1 in that: as shown in fig. 5 and 6, the level 25 is also a porous bone trabecular structure and/or the level 25 is coated with a hydroxyapatite coating to fuse and stabilize the level. Also located on the articular surface 25 from the navicular joint is a staple channel 23 in which staple channel 23, in use, staples 3 are fitted for securing the talus and navicular bones. I.e. if the articular surface is porous bone trabecular structure or has a hydroxyapatite coating, the articular surface may be nailed 3.
Example 3
This embodiment differs from embodiment 1 in that: as shown in fig. 7, the joint surface 25 of the boat in this embodiment is a nonmetallic material portion 1.
The detachable nonmetallic material part and the detachable metallic material part are convenient to replace during repair; the area adjacent to the bone adopts a bone trabecula porous structure or is provided with a hydroxyapatite coating, so that bone fusion can be promoted; the outer flange a fills the void outside the calcaneus, increasing stability.
There are, of course, many other embodiments of the invention that can be made by those skilled in the art in light of the above teachings without departing from the spirit or essential scope thereof, but that such modifications and variations are to be considered within the scope of the appended claims.

Claims (5)

1. The talus prosthesis is characterized by comprising a total talus prosthesis body, wherein the total talus prosthesis body comprises an upper non-metal material part (1) and a lower metal material part (2), the non-metal material part (1) and the metal material part (2) can be assembled in a combined way, the non-metal material part (1) comprises a pulley joint surface and a medial malleolus joint surface, the metal material part (2) comprises a subtalar joint surface, the non-metal material part (1) or the metal material part (2) comprises a navicular joint surface (25), and a fixing nail channel (23) is arranged on the metal material part (2);
the top surface of the metal material part (2) is provided with a caulking groove (21), the bottom of the nonmetal material part (1) is embedded in the caulking groove (21), and the bottom of the nonmetal material part (1) is in interference fit with the caulking groove (21); or, the bottom surface of the nonmetallic material part (1) is provided with an embedding groove (21), and the top of the metallic material part (2) is embedded in the embedding groove (21); when the caulking groove (21) is arranged on the metal material part (2), a notch (22) with an upward opening is arranged on the side wall of the caulking groove (21); when the caulking groove (21) is arranged on the nonmetallic material part (1), a notch (22) with a downward opening is arranged on the side wall of the caulking groove (21);
the part of the metal material part (2) corresponding to the tarsal sinus is outwards protruded to form an outer convex part A (24) so as to fill the tarsal sinus and the tarsal sinus tube;
four fixing nail channels (23) are arranged on the joint surface below the joint surface, and the four fixing nail channels (23) penetrate through the bottom surface of the caulking groove (21); the nail head of the fixing nail (3) is provided with external threads, and the fixing nail channel (23) is provided with internal threads matched with the nail head.
2. A talus prosthesis as defined in claim 1, wherein: the non-metallic material part (1) and the metallic material part (2) both relate to the lateral malleolus joint surface.
3. A talus prosthesis as defined in claim 2, wherein: the inferior articular surface and/or the navicular articular surface (25) are of a bone trabecular structure.
4. A talus prosthesis as defined in claim 2, wherein: has a hydroxyapatite coating from the lower articular surface and/or from the navicular articular surface (25).
5. A talus prosthesis as defined in claim 1, wherein: the nonmetallic material part (1) is made of a high polymer material or medical ceramic, and the metallic material part (2) is made of titanium alloy, nickel base alloy, stainless steel, titanium nickel alloy, cobalt chromium alloy, copper base alloy or tantalum alloy.
CN201810017896.2A 2018-01-08 2018-01-08 Talus prosthesis Active CN108210130B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201810017896.2A CN108210130B (en) 2018-01-08 2018-01-08 Talus prosthesis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201810017896.2A CN108210130B (en) 2018-01-08 2018-01-08 Talus prosthesis

Publications (2)

Publication Number Publication Date
CN108210130A CN108210130A (en) 2018-06-29
CN108210130B true CN108210130B (en) 2023-09-08

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Family Applications (1)

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CN109846580A (en) * 2019-02-14 2019-06-07 中国人民解放军陆军军医大学第一附属医院 Personalized range bone prosthese with biological function and preparation method thereof
CN111419480A (en) * 2020-03-27 2020-07-17 中国人民解放军陆军军医大学第一附属医院 Individualized subtalar joint fusion cage and manufacturing method thereof
JP2023538143A (en) * 2020-08-20 2023-09-06 パラゴン・アドバンスト・テクノロジーズ・インコーポレイテッド Total talus implant and method
WO2022040623A1 (en) * 2020-08-21 2022-02-24 Paragon Advanced Technologies, Inc. Implant for focal talus defects and method
CN112137766B (en) * 2020-09-18 2024-05-10 湖南华翔医疗科技有限公司 Replacement navicular bone used in orthopedic operation
CN114081687A (en) * 2021-11-30 2022-02-25 北京爱康宜诚医疗器材有限公司 Matched stack formula ankle joint talus side false body
AU2023237876A1 (en) * 2022-03-21 2024-08-15 Arthrex, Inc. Patient specific total talus for total ankle arthroplasty
WO2024118877A2 (en) * 2022-11-30 2024-06-06 Paragon 28, Inc. Talar implants and implant systems
CN117204987B (en) * 2023-11-07 2024-03-01 北京爱康宜诚医疗器材有限公司 Talus prosthesis

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