CN113616393A - Ankle joint prosthesis and design method - Google Patents
Ankle joint prosthesis and design method Download PDFInfo
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- CN113616393A CN113616393A CN202111080755.3A CN202111080755A CN113616393A CN 113616393 A CN113616393 A CN 113616393A CN 202111080755 A CN202111080755 A CN 202111080755A CN 113616393 A CN113616393 A CN 113616393A
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- 210000000544 articulatio talocruralis Anatomy 0.000 title claims abstract description 46
- 238000000034 method Methods 0.000 title claims abstract description 13
- 210000004233 talus Anatomy 0.000 claims abstract description 92
- 239000004698 Polyethylene Substances 0.000 claims abstract description 21
- 229920000573 polyethylene Polymers 0.000 claims abstract description 21
- -1 polyethylene Polymers 0.000 claims abstract description 20
- 229910052751 metal Inorganic materials 0.000 claims abstract description 7
- 239000002184 metal Substances 0.000 claims abstract description 7
- 239000000843 powder Substances 0.000 claims abstract description 7
- 238000007493 shaping process Methods 0.000 claims abstract description 4
- 210000002303 tibia Anatomy 0.000 claims description 23
- 239000007787 solid Substances 0.000 claims description 16
- 210000003423 ankle Anatomy 0.000 claims description 7
- 238000003780 insertion Methods 0.000 claims description 6
- 230000037431 insertion Effects 0.000 claims description 6
- 239000000654 additive Substances 0.000 claims description 5
- 230000000996 additive effect Effects 0.000 claims description 5
- 238000004519 manufacturing process Methods 0.000 claims description 4
- 210000000988 bone and bone Anatomy 0.000 abstract description 14
- 230000007774 longterm Effects 0.000 abstract description 10
- 238000002513 implantation Methods 0.000 abstract description 6
- 230000004938 stress stimulation Effects 0.000 abstract description 6
- 230000008901 benefit Effects 0.000 abstract description 5
- 230000008467 tissue growth Effects 0.000 abstract description 3
- 239000000463 material Substances 0.000 abstract description 2
- 239000011148 porous material Substances 0.000 description 11
- 230000036770 blood supply Effects 0.000 description 5
- 230000009286 beneficial effect Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
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- 238000002844 melting Methods 0.000 description 4
- 230000008018 melting Effects 0.000 description 4
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- 230000002980 postoperative effect Effects 0.000 description 2
- 239000000602 vitallium Substances 0.000 description 2
- 206010023230 Joint stiffness Diseases 0.000 description 1
- 229910000883 Ti6Al4V Inorganic materials 0.000 description 1
- 238000005299 abrasion Methods 0.000 description 1
- 230000033115 angiogenesis Effects 0.000 description 1
- 206010003246 arthritis Diseases 0.000 description 1
- 230000008468 bone growth Effects 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
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- 239000011664 nicotinic acid Substances 0.000 description 1
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- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/3094—Designing or manufacturing processes
- A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
- A61F2002/4205—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
- A61F2002/4207—Talar components
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Engineering & Computer Science (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Manufacturing & Machinery (AREA)
- Physics & Mathematics (AREA)
- Geometry (AREA)
- Prostheses (AREA)
Abstract
The invention relates to the technical field of medical instruments, and particularly discloses an ankle joint prosthesis and a design method thereof. Through utilizing powder bed metal vibration material disk to make fashioned tibial plateau and talus top, its shaping precision is high, surface quality is good, the performance is excellent, and tibial plateau, polyethylene liner and talus top mutually support and form ankle joint false body, have and more accord with human biomechanics structure, the suitability is good, avoid causing stress to shield, make bone tissue growth lack stress stimulation and power conduction, do benefit to long-term implantation.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an ankle joint prosthesis and a design method thereof.
Background
The ankle joint bears the whole weight of the human body, plays an important role in supporting the human body, and has high freedom of movement and complex stress conditions. Ankle arthritis, collapse talus necrosis and the like seriously affect standing and walking. The ankle surgery in China mainly adopts total talus extirpation and talus peripheral joint fusion which sacrifice talus function as main components, the rehabilitation time after operation is long, joint movement is lost, the non-healing rate is high, the ankle joint loses the flexion and extension function after fusion, the gait and partial daily life of a patient are affected, and the long-term curative effect is extremely poor due to the complications of joint degeneration, joint stiffness, foot flexibility loss and the like after the operation. Compared with ankle joint fusion, ankle joint replacement retains ankle joint function, reduces postoperative lameness of patients, improves postoperative gait of patients, relieves pain, and improves life quality.
At present, the artificial joint prosthesis mostly adopts cobalt-chromium-molybdenum alloy with excellent biocompatibility and wear resistance, but the density and the elastic modulus of the artificial joint prosthesis are far higher than those of biological natural bones, the adaptability is poor, stress shielding is easy to cause, the growth of bone tissues lacks stress stimulation and force conduction, and the long-term implantation is adversely affected.
Disclosure of Invention
The invention aims to provide an ankle joint prosthesis and a design method thereof, which can enable the ankle joint prosthesis to have a structure more conforming to the biomechanics of a human body, have excellent adaptability, avoid stress shielding and enable bone tissue growth to lack stress stimulation and force conduction.
In order to achieve the purpose, the ankle joint prosthesis comprises a tibial plateau, a polyethylene liner and a talus top, wherein the polyethylene liner is arranged at the lower end of the tibial plateau, the talus top is arranged below the polyethylene liner, and the tibial plateau and the talus top are both formed by powder bed metal additive manufacturing.
Through utilizing powder bed metal vibration material disk shaping the tibial plateau with talus top, its shaping precision is high, surface quality is good, the performance is excellent, the tibial plateau polyethylene liner with talus top is mutually supported and is formed the ankle joint false body has and more accords with human biomechanics structure, the suitability is good, avoids causing stress to shield, makes the bone tissue growth lack stress stimulation and power conduction, does benefit to long-term implantation.
The tibial plateau comprises a tibial plateau porous grid surface and a tibial plateau entity, and the tibial plateau porous grid surface is arranged on the upper end surface of the tibial plateau entity.
Through the matching of the porous grid surface of the tibial platform and the tibial platform entity, the adaptability between the tibial platform and the biological natural bone of the human body can be better.
The tibia platform is provided with a clamping groove structure on the entity, the clamping groove structure comprises two rib plates and two cylinders, and each rib plate is fixedly connected with the corresponding cylinder.
The setting of draw-in groove structure can prevent the shin bone platform slippage from the shin bone, improves initial stage stability.
Wherein each rib plate is provided with a plurality of round holes.
The round holes are filled with porous structures, so that the growth of tissues like the round holes is facilitated, the blood supply of the tissues is maintained to the maximum extent, the long-term stability of the prosthesis is improved, the weight of the prosthesis is reduced, and the adverse influence of rib plate separation on the blood supply of bone tissues is prevented.
Wherein the talus crest comprises a talus crest porous grid face and a talus crest solid body, and the talus crest porous grid face is arranged on the lower end face of the talus crest solid body.
The arrangement of the talus crest porous grid surface and the talus crest solid body can enable the talus crest to be better adapted to the biological natural bone of a human body.
Wherein, the upper surface of talus top entity has two ball tops and sets up two recess between the ball top.
The groove simulates the design of a talus top concave surface of a human body, plays a role in restricting the sliding of the polyethylene liner, and has a smooth surface after the top surface of the groove is polished so as to reduce the abrasion of the polyethylene liner.
Wherein, the lower extreme of talus top entity is provided with two cylinders, and every the cylinder is kept away from the one end of talus top entity is the sphere.
Two the cylinder is kept away from the one end of talus top entity is the sphere, can conveniently insert into the talus when implanting in light more.
The invention also provides a design method of the ankle joint prosthesis, which comprises the following steps:
carrying out ankle joint talus sliding surface fitting;
designing a talus crest;
designing a tibial plateau;
an osteotomy is designed.
Wherein, carry out ankle joint talus sliding surface fitting and include: when the ankle joint talus sliding surface is fitted, a force line of a tibia is taken as a system Z axis, then two equal circles are adopted in a coronal plane to fit the talus, and a line connecting circle centers of the two circles is determined as an X axis.
Wherein, the step of designing the talus crest is as follows: respectively carrying out arch three-plane design, stable column design and double-spherical-surface joint surface design;
designing a tibial plateau includes: the tibial plateau design comprises the design of a porous surface and an internal entity, rib plate array circular holes and a polyethylene liner insertion design;
designing an osteotomy comprising: trapezoidal osteotomy design needs to make trapezoidal hypotenuse tangent with talus, topside perpendicular bisector and line of force coincidence to including the bayonet design of tibial plateau, fix a position through cylinder draw-in groove, ladder simultaneously.
According to the ankle joint prosthesis and the design method, the tibia platform and the talus top which are manufactured and molded by using the powder bed metal additive are high in forming precision, good in surface quality and excellent in performance, the tibia platform, the polyethylene liner and the talus top are matched with each other to form the ankle joint prosthesis, the ankle joint prosthesis has a structure which is more consistent with human body biomechanics, is excellent in adaptability, avoids stress shielding, enables bone tissues to grow and lack stress stimulation and force conduction, and is beneficial to long-term implantation.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.
Fig. 1 is a schematic view showing a disassembled structure of the ankle prosthesis of the present invention.
Fig. 2 is a schematic structural view of the ankle prosthesis of the present invention.
FIG. 3 is a flow chart of the ankle prosthesis design of the present invention.
FIG. 4 is a schematic representation of the inventive rider surface using a double sphere fit.
FIG. 5 is a schematic diagram of the force line coincidence and limiting design of the present invention.
FIG. 6 is a schematic view of the trapezoidal osteotomy design of the present invention.
1-tibial plateau, 11-tibial plateau porous grid surface, 12-tibial plateau solid, 2-polyethylene liner, 3-talus top, 31-talus top porous grid surface, 32-talus top solid, 321-spherical top, 322-groove, 323-column, 4-clamping groove structure, 41-rib plate, 411-round hole, 42-column and 43-step column.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.
In the description of the present invention, it is to be understood that the terms "length", "width", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like, indicate orientations or positional relationships based on the orientations or positional relationships illustrated in the drawings, and are used merely for convenience in describing the present invention and for simplicity in description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed in a particular orientation, and be operated, and thus, are not to be construed as limiting the present invention. Further, in the description of the present invention, "a plurality" means two or more unless specifically defined otherwise.
Referring to fig. 1 to 6, the present invention provides an ankle joint prosthesis, which includes a tibial plateau 1, a polyethylene liner 2 and a talar crest 3, wherein the polyethylene liner 2 is disposed at a lower end of the tibial plateau 1, the talar crest 3 is disposed below the polyethylene liner 2, and the tibial plateau 1 and the talar crest 3 are both formed by powder bed metal additive manufacturing.
The tibial plateau 1 comprises a tibial plateau porous grid surface 11 and a tibial plateau solid 12, wherein the tibial plateau porous grid surface 11 is arranged on the upper end surface of the tibial plateau solid 12.
The tibia platform entity 12 is provided with a slot structure 4, the slot structure 4 comprises two rib plates 41 and two columns 42, and each rib plate 41 is fixedly connected with the corresponding column 42.
Each rib 41 has a plurality of circular holes 411.
The talar apex 3 includes a talar apex multihole mesh face 31 and a talar apex solid body 32, and the talar apex multihole mesh face 31 is provided on a lower end face of the talar apex solid body 32.
The upper surface of the talar tip body 32 has two spherical tips 321 and a groove 322 disposed between the two spherical tips 321.
Two columns 323 are arranged at the lower end of the talar crest entity 32, and one end of each column 323 far away from the talar crest entity 32 is a spherical surface.
The thickness of the porous grid surface 11 of the tibial plateau is 1-2 mm.
The diameter of each cylinder 42 is 5-7 mm, and the thickness of each rib plate 41 is 2-4 mm.
The tail end of each cylinder 42 is provided with a stepped cylinder 4342, and the diameter of the stepped cylinder 4342 is 2-3 mm larger than that of the cylinder 42.
The porous grid surface 11 of the tibial plateau is internally provided with a first pore communicated with the porous grid surface, the rod diameter of the first pore is 0.2-0.8 mm, and the pore diameter is 0.3-1 mm.
The inside of talus roof porous grid face 31 has the second pore of intercommunication, the rod diameter in second pore is 0.2 ~ 0.8mm, and the aperture is 0.3 ~ 1 mm.
In this embodiment, the tibial plateau 1 is made of Ti6Al4V and is integrally manufactured by Selective Laser Melting (SLM) or selective Electron Beam Melting (EBM), and the talus crest 3 is made of a cobalt-chromium-molybdenum alloy and is integrally manufactured by Selective Laser Melting (SLM) or selective Electron Beam Melting (EBM).
Two parallel columns 42 are designed on the tibial plateau entity 12, and the columns 42 are connected with the tibial plateau entity 12 through the rib plate 41. The diameter of the cylinder 42 is 5-7 mm, and the thickness of the rib plate 41 is 2-4 mm, so that the clamping groove structure 4 is formed. When implanting, the draw-in groove structure 4 does benefit to initial fixation, prevents that tibial plateau 1 from coming off from the shin bone side. In addition, the design of the end of cylinder 42 has the diameter bigger step cylinder 4342, its diameter ratio cylinder 42 is 2 ~ 3mm bigger, can realize tibial plateau 1 in the location of Y axle direction, guarantees that force line position is stable, avoids the prosthesis to become flexible. The porous grid surface 11 of the tibial platform is composed of Diamond, Gyroid and I-WP of three-period extremely-small curved surfaces through an array, the first pores are communicated with the interior of the porous grid surface, the rod diameter is 0.2-0.8 mm, and the pore diameter is 0.3-1 mm. Wherein cylinder 42 is through cooperating the installation with the circular port on the shin bone, realizes accurate positioning, two in addition cylinder 42 parallel design does benefit to in the operation disect insertion, strengthens the mechanical strength of cooperation department, prevents to bear the load destruction.
The thickness of the rib plate 41 is smaller than the diameter parallel to the cylinder 42, and the beneficial effects mainly include: the inserted tibia platform has the effect of a clamping groove, the tibia platform 1 is prevented from slipping from the tibia, the initial stability is improved, in addition, 5-8 circular holes 411 are formed in the rib plate 41, the circular holes 411 are filled with porous structures, tissues can grow in the circular holes 411, the blood supply of the tissues is kept to the maximum extent, the long-term stability of the prosthesis is improved, the weight of the prosthesis is reduced, and the adverse effect of the rib plate 41 on the blood supply of the bone tissues is prevented.
The upper surface of talus top 3 is two smooth ball tops 321, and the design of human body talus top 3 concave surface is simulated to central recess 322, plays the restraint restriction effect to the slip of polyethylene liner 2. The top surface is polished and the surface is smooth to reduce the wear on the polyethylene liner 2.
Two columns 323 are designed at the lower end of the talus top 3, and the front ends of the columns 323 are spherical surfaces, so that the columns can be conveniently inserted into talus when being implanted. The post 323 is solid in the center and covered with the talus crest porous mesh surface 31, the talus crest solid 32 provides high mechanical strength, and the talus crest porous mesh surface 31 provides frictional stability for initial implantation.
The talus crest 3 is in contact with a cut human talus bone and is beneficial to the inward growth of talus tissues, the porous grid surface 31 of the talus crest is formed by three-period Diamond, Gyroid and I-WP with extremely small curved surfaces through an array, communicated second pores are arranged inside the porous grid surface, and the rod diameter is 0.2-0.8 mm and the pore diameter is 0.3-1 mm.
In summary, by designing the column 42 and the slot structure 4 on the tibial platform 1, the risk of loosening the tibial platform 1 is avoided, and the stability at the initial stage of implantation is improved;
because the communicated porous structure has the pore form imitating the trabecula bone, the bone ingrowth and the angiogenesis can be promoted. The long-term stability of the prosthesis and the tibia can be improved by coating the porous grid surface 11 of the tibial plateau on the surface of the tibial plateau 1; the long-term stability of the prosthesis and the talus can be improved by coating the talus crest porous grid surface 31 on the lower surface of the talus crest 3; in addition, the tibial platform 1 and the talus top 3 are manufactured and formed by adopting powder bed metal additive, so that the integrated manufacture of a porous structure and a solid structure can be realized, the communication of the internal pores of the porous structure is ensured, the elastic modulus of the contact surface of the porous structure and the sclerotin is reduced, and the stress shielding is avoided.
The ankle joint prosthesis provided by the invention has the advantages that the ankle joint prosthesis has a structure which is more accordant with human body biomechanics, the adaptability is excellent, stress shielding is avoided, and the growth of bone tissues is lack of stress stimulation and force conduction.
The invention also provides a design method of the ankle joint prosthesis, which comprises the following steps:
carrying out ankle joint talus sliding surface fitting;
designing a talus crest 3;
designing a tibial platform 1;
an osteotomy is designed.
Performing ankle joint talus glide plane fitting comprises: when the ankle joint talus sliding surface is fitted, a force line of a tibia is taken as a system Z axis, then two equal circles are adopted in a coronal plane to fit the talus, and a line connecting circle centers of the two circles is determined as an X axis.
The step of designing the talar crest 3 is: respectively carrying out arch three-plane design, stable column design and double-spherical-surface joint surface design;
designing the tibial plateau 1 comprises: the design of the tibial platform 1 comprises the design of a porous surface and an internal solid, the design of a rib plate 41 array round hole 411 and the design of a polyethylene liner 2 insertion type;
designing an osteotomy comprising: the trapezoidal osteotomy design needs to enable the oblique side of the trapezoid to be tangent to the talus and coincide with the force line and the top side perpendicular bisector, and the trapezoidal osteotomy design comprises a tibial platform 1 insertion type design and is simultaneously positioned through a cylindrical 42 clamping groove and a ladder.
Specifically, the design process of the ankle joint prosthesis mainly comprises ankle joint talus sliding surface fitting, talus top 3 design, tibial plateau 1 design and osteotomy design. When the ankle joint talus sliding surface is fitted, a force line of a tibia is taken as a system Z axis, then two equal circles are adopted in a coronal plane to fit the talus, and a circle center connecting line of the two circles is determined as an X axis. The talar apex 3 design mainly includes an arched tri-planar design, a stabilization column design, and a bi-spherical articular surface design. The tibial plateau 1 design includes a porous surface, solid interior design, a rib plate 41 array of circular holes 411, and a polyethylene liner 2 insert design. The trapezoidal osteotomy design needs to enable the oblique edge of the trapezoid to be tangent to the talus and coincide with the force line through the perpendicular bisector of the top edge, and the trapezoidal osteotomy design comprises an insertion type design of the tibial plateau 1 and is positioned through a clamping groove and a step of a cylinder 42.
As shown in FIG. 4, the left coronal plane and the right sagittal plane are obtained by fitting the trochlear surface of the talus apex 3 with a double sphere. When the human body is standing, the force line direction of the tibia is as shown by the arrow in fig. 4, and the force line center is located at the tibioarticular surface center in the coronal plane (fig. 4 a). Because the talus surface in the coronal plane has the characteristic of double-cambered surface concave inwards, the invention adopts two spherical surfaces to fit the talus surface, so that the ankle joint prosthesis has better biomechanical property and bionic property. In order to ensure the stability of the force line, the intersection point of the two circles is superposed with the force line, and the connecting line of the two circle centers is vertical to the force line. Thus, a cartesian coordinate system is established on the transpedicular surface, with the X-axis coinciding with the line connecting the two circle centers, in the direction to the right as viewed in fig. 4 a; the Z axis is superposed with the force line, and the direction is vertical downwards; the X axis is determined according to the Cartesian right hand rule as shown in FIG. 4 b. In fig. 4b, to ensure stability, the center of the fitted circle coincides with the force line, and the center of rotation of the tibia is the center of the fitted circle. The two circles fitted from the two viewing angles in fig. 4a and fig. 4b are two balls, and the line connecting the centers of the two balls is the tibia rotation axis.
The talar crest 3 structure as in fig. 5 was designed from two fitted spheres. In fig. 5a, two round balls are intersected to form a central groove 322, and the groove 322 can limit the matching surface to prevent the matching surface from slipping off. In fig. 5b, the talar apex 3 prosthesis is designed as an arch, the arch consisting of three planes, the center of the upper plane coinciding with and perpendicular to the force line; the right inclined plane is designed with two columns 42 perpendicular to the inclined plane and 2mm-4mm in diameter. Fig. 5c shows a three-dimensional model of the talar apex 3 design.
In the coronal plane, the ankle prosthesis is trapezoidal in shape, and the reasons for this design concept include: the contact area between the tibial osteotomy region and the tibial plateau 1 can be increased, so that the bone growth amount is increased, and the long-term stability is improved; the downward force of the tibia can be uniformly transmitted to the prosthesis through the trapezoidal structure, so that the prosthesis looseness caused by stress concentration is avoided; the stress area of the talus side is increased, the pressure of the talus and the talus top 3 prosthesis is reduced, and the bone cutting amount of the talus side is favorably reduced. Thus, the present invention employs the osteotomy strategy as shown in fig. 6, where the osteotomy in the coronal plane is shaped as an equilateral trapezoid, as shown in fig. 6a, with the midperpendicular at the top of the trapezoid coinciding with the force line of the tibia, the two oblique sides tangent to the talus, and the bottom side being the line connecting the most prominent points on the left and right sides of the talus apex 3. Two circular clamping grooves are designed on the trapezoidal top and are connected through the rib plates 41, and the clamping groove structures 4 are beneficial to early fixation of the implanted tibial platform 1. In addition, because the talus sliding surface in the talus-tibia joint surface has the characteristics of similar sphere and concavity, in order to fully simulate the biomechanics characteristics of the joint movement, the invention provides a two-sphere intersected design, the mechanical adaptability of the prosthesis is improved through the joint surface design based on the two-sphere talus fitting method, and the movement freedom degree of the ankle joint is recovered; through the trapezoidal osteotomy design, reduce the osteotomy volume of ankle joint, keep the good blood supply of shin bone talus to promote the life of prosthesis.
While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.
Claims (10)
1. An ankle joint prosthesis, characterized in that,
including tibial plateau, polyethylene liner and talus top, the polyethylene liner set up in tibial plateau's lower extreme, the talus top set up in the below of polyethylene liner, tibial plateau with the talus top is all through powder bed metal additive manufacturing shaping.
2. The ankle joint prosthesis of claim 1,
the tibial plateau comprises a tibial plateau porous grid surface and a tibial plateau entity, and the tibial plateau porous grid surface is arranged on the upper end surface of the tibial plateau entity.
3. The ankle joint prosthesis of claim 2,
the tibia platform is provided with a clamping groove structure on the entity, the clamping groove structure comprises two rib plates and two cylinders, and each rib plate is fixedly connected with the corresponding cylinder.
4. The ankle joint prosthesis of claim 3,
each rib plate is provided with a plurality of round holes.
5. The ankle joint prosthesis of claim 1,
the talus crest comprises a talus crest porous grid face and a talus crest solid body, wherein the talus crest porous grid face is arranged on the lower end face of the talus crest solid body.
6. The ankle joint prosthesis of claim 5,
the upper surface of talus roof entity has two ball tops and sets up two recess between the ball top.
7. The ankle joint prosthesis of claim 6,
the lower extreme of talus top entity is provided with two cylinders, and every the cylinder is kept away from the one end of talus top entity is the sphere.
8. The method of designing an ankle prosthesis according to claim 1, comprising the steps of:
carrying out ankle joint talus sliding surface fitting;
designing a talus crest;
designing a tibial plateau;
an osteotomy is designed.
9. The method of designing an ankle joint prosthesis according to claim 8,
performing ankle joint talus glide plane fitting comprises: when the ankle joint talus sliding surface is fitted, a force line of a tibia is taken as a system Z axis, then two equal circles are adopted in a coronal plane to fit the talus, and a line connecting circle centers of the two circles is determined as an X axis.
10. The method of designing an ankle joint prosthesis according to claim 8,
the talus crest design method comprises the following steps: respectively carrying out arch three-plane design, stable column design and double-spherical-surface joint surface design;
designing a tibial plateau includes: the tibial plateau design comprises the design of a porous surface and an internal entity, rib plate array circular holes and a polyethylene liner insertion design;
designing an osteotomy comprising: trapezoidal osteotomy design needs to make trapezoidal hypotenuse tangent with talus, topside perpendicular bisector and line of force coincidence to including the bayonet design of tibial plateau, fix a position through cylinder draw-in groove, ladder simultaneously.
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