Patent Application
20220096242
The present invention relates to the field of artificial knee joint replacement, and particularly to an MTS medial tibial plateau patch, a modular MTS medial tibial plateau patch, and a minimally invasive replacement method thereof, which are applied to minimally invasive surgery replacement of patients with obvious wear of tibial articular surfaces, cartilage loss, or tibial deformity.
With the advent of the aging society of China and the rapid development of medical and health services, the average life span is prolonged gradually, and arthritis, as degeneration, becomes a major medical problem which troubles the middle-aged and elderly people in today's society. The incidence of arthritis is particularly high in the knee joint which is a major weight-bearing joint. In addition, the obesity problem which is increasingly serious and sports injuries caused by various factors play a role in promoting the occurrence and development of knee osteoarthritis. The affected knee joint surface and cartilage are damaged, and obvious wear and loss of the surface cause pains and a limitation on the activity range of the knee joint, seriously influencing the daily life and work of a patient.
Current surgical protocols adopted at home and abroad include total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and high tibial osteotomy (HTO).
The existing surgical protocols have the following disadvantages. 1. In the total knee arthroplasty, the medial and lateral compartments or/and the patellofemoral compartment as well as the cruciate ligaments are resected completely or partially, resulting in large surgical injuries; the total knee arthroplasty is undoubtedly impractical or inelegant for a patient only with single-compartment arthritis and sacrifices normal articular surfaces and ligaments, resulting in poor proprioception and a dissatisfaction rate after the total knee arthroplasty up to 20%. Once the arthroplasty has complications, such as infection, looseness, wear, dislocation, or the like, a revision surgery is a destructive surgery, has great difficulty, requires a special prosthesis, and is quite expensive. 2. In the unicompartmental knee arthroplasty, only the unilateral compartment articular surfaces of the tibia and the femur are resected, and a tibial prosthesis, a femoral prosthesis, and a liner prosthesis are implanted, resulting in good proprioception; however, components of this arthroplasty have limited service lives, the tibial plateau is loose, a liner has a high dislocation incidence, excessive bones are resected, and when being the total knee arthroplasty, a revision surgery has great difficulty and requires an extra accessory, such as a block, or the like, for fixation, which limits popularization of the unicompartmental knee arthroplasty. 3. The high tibial osteotomy is only effective for a gonitis patient with tibial deformity and requires an extra steel plate for fixation, resulting in a high cost; activities are required to be restricted after the high tibial osteotomy, which does not conform to the idea and demand of quick recovery of orthopedics patients. Researches show that a patient after the osteotomy has an altered anatomical position during the arthroplasty, and the functional effect is poorer than the functional effect of primary arthroplasty on a patient.
An object of the present invention is to provide an MTS medial tibial plateau patch, a modular MTS medial tibial plateau patch, and a minimally invasive replacement method thereof, which are used for solving the problems of large surgical injuries, high difficulty, short service lives, looseness of the tibial plateau, a high dislocation incidence of a liner, excessive resected bones, or the like, in the prior art.
In order to achieve the above-mentioned object, the present invention provides the following technical solution.
An MTS medial tibial plateau patch includes an articular surface provided with an arc-shaped recessed area and a bottom surface provided with 3 stand columns which are distributed triangularly or 2 longitudinal keels having non-parallel distribution or 2 triangular keel wings.
Each stand column and the bottom surface have an included angle of 20-40 degrees.
Each stand column is provided with 3-4 arc-shaped grooves which are distributed evenly.
Each longitudinal keel has a taper of 3-7 degrees.
Each longitudinal keel is provided with 3-5 convex ridges which are distributed uniformly.
Each triangular keel wing is provided with 2-4 anti-rotation arc grooves. The bottom surface takes the form of one of a surface with grid-shaped concave bone cement grooves, a surface with a plurality of dovetail-shaped bone cement grooves which are distributed longitudinally, and a polished surface without grooves.
The MTS medial tibial plateau patch has a D-shaped cross section and is bionically designed according to the anatomical form of the tibial plateau of the knee joint of a Chinese person, and prostheses have models 1-6 with different sizes.
The MTS medial tibial plateau patch further includes a plurality of tibial plateau patches with different thicknesses of 3-14 mm.
The articular surface has an equal thickness in a front-rear direction.
The MTS medial tibial plateau patch is made of VE high cross-linked polyethylene.
A modular MTS medial tibial plateau patch includes a tibial support and a liner, wherein the tibial support includes an upper surface provided with a conical protrusion and a bottom surface provided with 3-4 stand columns which are distributed triangularly or 2-3 longitudinal keels having non-parallel distribution; and the liner includes an articular surface provided with an arc-shaped recessed area and a lower surface provided with a conical recess;
the tibial support and the liner are locked by the conical protrusion of the tibial support and the conical recess of the liner.
The bottom surface of the tibial support is provided with a bone-trabecula porous structure layer with a thickness of 1-5 mm.
The tibial support is made of medical titanium alloy or cobalt chromium molybdenum alloy or polyether ether ketone (PEEK) or derivatives thereof, and the liner is made of VE high cross-linked polyethylene.
A minimally invasive replacement method for replacing the MTS medial tibial plateau patch or the modular MTS medial tibial plateau patch includes: exposing the tibial medial or lateral plateau of the affected limb of a patient with a minimally invasive surgery method with a small incision of a parapatellar approach; resecting bone tissue of the affected tibia according to coronal inversion and eversion angles as well as a sagittal retroversion angle planned before a surgery; and implanting the MTS medial tibial plateau patch onto the tibia after resection, wherein the integrated MTS medial tibial plateau patch is fixed to the tibia after resection by cement, and the modular MTS medial tibial plateau patch is biologically fixed to the tibia after resection.
The above-mentioned technical solution of the present invention has the following beneficial effects.
In the above-mentioned solution, the MTS medial tibial plateau patch and the modular MTS medial tibial plateau patch according to the present invention have simple structures and good form similarity and accord with anatomical features of Chinese people; the MTS medial tibial plateau patch and the modular MTS medial tibial plateau patch are convenient to implant, instruments are simple, the surgery is minimally invasive, important soft tissue is not touched, the patient recovers rapidly after the surgery, and outpatient surgery treatment may be expected to achieve hospital discharge on the same day; the MTS medial tibial plateau patch is fixed firmly and has strong wear resistance and high biocompatibility; for the minimally invasive replacement method of the MTS medial tibial plateau patch or the modular MTS medial tibial plateau patch, the quantity of resected bones is small, a revision surgery is simple, and the difficulty of total knee arthroplasty is not increased; and the MTS medial tibial plateau patch may reduce metal ion toxicity and anaphylactic reaction and does not affect nuclear magnetic resonance imaging.
1. bottom surface; 2. concave bone cement groove; 3. stand column; 4. longitudinal keel; 5. liner; 6. protrusion; 7. recess; 8. tibial support; 9. triangular keel wing; 10. dovetail-shaped bone cement groove; 11. cylindrical keel wing.
To make the technical problems to be solved, technical solutions and advantages of the present invention more apparent, the following detailed description is given with reference to the accompanying drawings and embodiments.
The present invention provides an MTS medial tibial plateau patch, a modular MTS medial tibial plateau patch, and a minimally invasive replacement method thereof, which are used for solving the problems of large surgical injuries, high difficulty, short service lives, looseness of the tibial plateau, a high dislocation incidence of a liner, and excessive resected bones in the prior art.
The bottom surface takes the form of one of a surface with grid-shaped concave bone cement grooves, a surface with a plurality of dovetail-shaped bone cement grooves which are distributed longitudinally, and a polished surface without grooves.
The MTS medial tibial plateau patch according to the present invention has a thickness of 3-14 mm and may correct the deformity of the force line of the coronal plane within 0-15 degrees and recover the original tension of the joint ligament and the force line of the joint, so as to relieve pains. The MTS medial tibial plateau patch is made of VE high cross-linked polyethylene, thus reducing metal ion toxicity and anaphylactic reaction without influences on nuclear magnetic resonance imaging. The VE high cross-linked polyethylene has wear resistance which is extremely high, and compared with an existing common ultrahigh molecular weight polyethylene material, the VE high cross-linked polyethylene has good wear resistance, high bending strength, and high fatigue resistance, and has an elastic modulus closer to the elastic modulus of the cartilage of the articular surface of a human body, such that the articular surface of the MTS medial tibial plateau patch is better fitted with the articular surface of the human body. The MTS medial tibial plateau patch according to the present invention is fixed by cement and may be combined with free radicals after implanted, thus reducing the oxidation rate of the material.
A tibial support is made of medical titanium alloy or cobalt chromium molybdenum alloy or polyether ether ketone (PEEK) or derivatives thereof, and the liner is made of VE high cross-linked polyethylene.
The MTS medial tibial plateau patch according to the present invention may be set to have different thicknesses and different sizes according to shapes of human bones and has models 1-6, a front-back diameter and a left-right diameter achieve good matching effects, so as to correct different degrees of deformity of the force line of a patient, and the patient using the MTS medial tibial plateau patch according to the present invention has kinematic mechanical characteristics closer to the kinematic mechanical characteristics by a natural joint.
The articular surface of the MTS medial tibial plateau patch according to the present invention has an equal thickness in a front-rear direction, and an osteotomy angle is determined according to original retroversion of the joint to realize a normal backward rolling action of the joint in flexion and extension activities and recover the original eccentricity of the joint.
As shown in
The MTS medial tibial plateau patch further includes a plurality of tibial plateau patches with different thicknesses of 3-14 mm.
The articular surface has an equal thickness in the front-rear direction.
As shown in
The bottom surface of the tibial support 8 is provided with a bone-trabecula porous structure layer with a thickness of 2-3 mm. The liner 5 has a thickness of 4-12 mm and may correct the deformity of the coronal plane within 0-15 degrees.
The modular MTS medial tibial plateau patch includes the bone-trabecula metal tibial support 8 with the best bone ingrowth performance currently and the liner 5 made of VE high cross-linked polyethylene, has an elastic modulus and porosity close to the elastic modulus and porosity of normal bone tissue, and is fixed biologically; the liner 5 is made of the VE high cross-linked polyethylene with wear resistance which is extremely high, and a prosthesis made of such a material may be combined with free radicals after implanted to reduce the oxidation rate of the material, and has vibration absorption and buffering effects, thus avoiding the stress shielding problem after a traditional surgery.
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An embodiment of the present invention provides a minimally invasive replacement method for replacing the MTS medial tibial plateau patch or the modular MTS medial tibial plateau patch, including: exposing the tibial medial or lateral plateau of the affected limb of a patient with a minimally invasive surgery method with a small incision of a parapatellar approach; resecting bone tissue of the affected tibia according to coronal inversion and eversion angles as well as a sagittal retroversion angle planned before a surgery; and implanting the MTS medial tibial plateau patch or the modular MTS medial tibial plateau patch onto the tibia after resection, wherein the MTS medial tibial plateau patch is fixed to the tibia after resection by cement, and the modular MTS medial tibial plateau patch is biologically fixed to the tibia after resection.
In the above-mentioned solution, the MTS medial tibial plateau patch and the modular MTS medial tibial plateau patch according to the present invention have simple structures, are convenient to implant and fixed firmly, and have low revision frequency; the surgery is minimally invasive, an incision is small, bone mass and soft tissue may be reserved to the maximum extent, a patient recovers rapidly after the surgery, a current troublesome clinical problem may be solved, better service is provided for the patient, and a market prospect is broad.
Each of the embodiments in the description is described progressively, and each of the embodiments is focused on its differences from other embodiments. The identical or similar portions in each of the embodiments can refer to one another.
In the description of the present invention, it is to be understood that terms such as “upper” and “one end” should be construed to refer to the orientation as then described or as shown in the drawings. These relative terms are for convenience of description and do not indicate or imply that the device or element referred to must have a particular orientation, or be constructed or operated in a particular orientation, and thus cannot be construed to limit the present application.
In the description of the present invention, it should be noted that unless specified or limited otherwise, the terms “provided” and “connected” are used broadly, and may be, for example, fixed connections, detachable connections, or integral connections; may also be direct connections or indirect connections via intervening structures. The fixed connections may be common technical solutions, such as welding, threaded connections, clamping, or the like. The above terms can be understood by those skilled in the art according to specific situations.
It should be noted that the above descriptions are merely preferred embodiments of the present invention, and those skilled in the art may make various improvements and refinements without departing from the principle of the invention. All such modifications and refinements are intended to be covered by the present invention.
| Number | Date | Country | Kind |
|---|---|---|---|
| 201910180639.5 | Mar 2019 | CN | national |
This application is the national stage entry of International Application No. PCT/CN2019/082730, filed on Apr. 15, 2019, which is based upon and claims priority to Chinese Patent Application No. 201910180639.5, filed on Mar. 11, 2019, the entire contents of which are incorporated herein by reference.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/CN2019/082730 | 4/15/2019 | WO | 00 |
