强生-狂关节置换与假体设计-课件.ppt
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1、Author|PowerPoint title goes here|April XX,2012CORAIL SYSTEM1PPT课件Author|PowerPoint title goes here|April XX,2012 CORAIL SYSTEM DESIGNERSARTRO GROUP FOUNTED IN 19812PPT课件Author|PowerPoint title goes here|April XX,2012 1984 TITAN stem launched钛合金柄上市 1985 Clinical trails of TITAN/HA临床试验 1986 1st impla
2、ntation of the CORAIL stem 第一个假体柄植入体内 1996 FDA approval FDA 通过 2005 Corail AMTHISTORICAL RECORD历史回顾3PPT课件Author|PowerPoint title goes here|April XX,2012CORAIL DESIGN PRINCIPL设计原理SURFACE TREATMENT表面处理RANGE OF IMPLANTS假体尺寸SURGICAL TECHNIQUE外科技术CLINICAL RESULTS临床结果4PPT课件Author|PowerPoint title goes her
3、e|April XX,2012 RELIABLE PRIMARY STABILITY 可靠的初始稳定性 LONG TERM BIOLOGICAL FIXATION 长期的生物固定 PROXIMAL LOAD TRANSFER 近端负荷传导CORAIL DESIGN PRINCIPLES设计原理5PPT课件Author|PowerPoint title goes here|April XX,2012CORAIL DESIGN PRINCIPLES设计原理6PPT课件Author|PowerPoint title goes here|April XX,2012FEMORAL HEADS 股骨头Al
4、umina(Biolox Forte)氧化铝Tribological properties摩擦学属性Compatible with alumina or cobalt chrome liners 与氧化铝或钴铬内衬匹配CORAIL DESIGN PRINCIPLES设计原理7PPT课件Author|PowerPoint title goes here|April XX,2012Straight stem直柄Thin distal tip远端较细CORAIL DESIGN PRINCIPLES设计原理8PPT课件Author|PowerPoint title goes here|April XX
5、,2012135 neck angle 颈干角12/14 Morse taper锥度Progressive offset 偏心距逐渐扩大CORAIL DESIGN PRINCIPLES设计原理9PPT课件Author|PowerPoint title goes here|April XX,2012 四边形横截面 轴向及旋转稳定性CORAIL DESIGN PRINCIPLES设计原理10PPT课件Author|PowerPoint title goes here|April XX,2012Double taper geometry gives stero-stability 双锥度设计提供 立
6、体稳定性CORAIL DESIGN PRINCIPLES设计原理11PPT课件Author|PowerPoint title goes here|April XX,2012Progressive horizontal macrostructure on the proximal stem柄的近端逐渐扩大的横行结构CORAIL DESIGN PRINCIPLES设计原理12PPT课件Author|PowerPoint title goes here|April XX,2012Horizontal proximal macrostructure近端横行结构 Size 9 =11 grooves沟
7、Size 20=21 grooves沟CORAIL DESIGN PRINCIPLES设计原理13PPT课件Author|PowerPoint title goes here|April XX,2012Vertical distal macrostructre 远端垂直结构CORAIL DESIGN PRINCIPLES设计原理14PPT课件Author|PowerPoint title goes here|April XX,2012 Optional collar for calcar loading 股骨距负荷-带领,不带领CORAIL DESIGN PRINCIPLES设计原理15PPT
8、课件Author|PowerPoint title goes here|April XX,2012HYDROXYAPATITE Bioactive coating 生物活性涂层CORAIL DESIGN PRINCIPLES设计原理16PPT课件Author|PowerPoint title goes here|April XX,2012BONE COMPOSITION骨组成 ORGANIC PHASE 有机期 30%collagen胶元,specific proteins特殊蛋白质 MINERAL PHASE 矿物质期 60%carbonated apatite 碳酸磷灰石 WATER 水
9、10%17PPT课件Author|PowerPoint title goes here|April XX,2012HYDROXYAPATITE羟基磷灰石Chemical Formula化学分子式 Ca10(PO4)6(OH)2Similar to the mineral phase of human bone与人类骨的矿物质期相似 Biocompatible,non resorbable生物相容,不可吸收Osteo-conductive properties骨传导性18PPT课件Author|PowerPoint title goes here|April XX,2012 NON TOXIC无
10、毒 NON INFLAMMATORY不引起炎症反应 NON ALLERGIC无过敏反应 NON CARCINOGENIC 不引起癌症HYDROXYAPATITE19PPT课件Author|PowerPoint title goes here|April XX,2012 Coating thickness涂层厚度 =150m Coatings 200mrisk of delamination 脱层的危险HYDROXYAPATITE20PPT课件Author|PowerPoint title goes here|April XX,2012ADVANTAGES优点 Increased bone in
11、growth 增加骨内生 No fibrous tissue interposition 无纤维组织插入 Gap filling 孔隙充填HYDROXYAPATITE21PPT课件Author|PowerPoint title goes here|April XX,2012 New bone formation 新骨形成 HA coating HA涂层 Metal 金属HYDROXYAPATITENO FIBROUS TISSUE INTERPOSITION 无纤维组织插入22PPT课件Author|PowerPoint title goes here|April XX,2012HYDROXY
12、APATITE Why is Corail fully coated?为何全涂层?Long term stability长期的稳定性 Biological seal against wear debris生物性封闭,以抵抗磨屑 No distal granulomas 没有远端肉芽肿23PPT课件Author|PowerPoint title goes here|April XX,2012LONG TERM STABILITY长期稳定性“The complete absence of femoral endosteal cortical osteolysis in spite of the a
13、bundance of particles is reassuring.The explanation may be that the extensive HA coating of the stem seals the whole interface and blocks the passage of particles.”虽然有大量的磨损颗粒,但没有股骨骨内膜的皮质骨溶解。原因可能是广泛的HA涂层封闭了所有的交界面阻止了微粒的通道。Rokkum et al JBJS Vol 81B,1999HYDROXYAPATITE24PPT课件Author|PowerPoint title goes
14、here|April XX,2012Prevention of thigh pain大腿痛的防止 No fibrous tissue distally远端没有纤维组织 No distal micromotion没有远端微动Minimise thigh pain最小化大腿痛New bone formationHYDROXYAPATITE25PPT课件Author|PowerPoint title goes here|April XX,2012From Corail to Corail AMT26PPT课件Author|PowerPoint title goes here|April XX,201
15、2Articul/eze Mini Taper:AMTThinner neck更薄的颈部设计=Improved range of motion更大的活动度27PPT课件Author|PowerPoint title goes here|April XX,2012 Polished taper 抛光的锥部 Better resistance to PE wear 减少PE磨损Articul/eze Mini Taper:AMT28PPT课件Author|PowerPoint title goes here|April XX,2012 AMT taperOld taperMini taper短小的
16、锥部 12/14 Improved range of motion 更大的ROM No skirt effect无假裙现象Articul/eze Mini Taper:AMT29PPT课件Author|PowerPoint title goes here|April XX,2012Thinner neck更薄的颈部设计 Elliptico-trapezoidal shape 2 flat surfaces Frontal(向位):12 mm Sagittal(矢向位):9.15 mmArticul/eze Mini Taper:AMT30PPT课件Author|PowerPoint title
17、 goes here|April XX,2012 New impaction hole新打入孔Articul/eze Mini Taper:AMT31PPT课件Author|PowerPoint title goes here|April XX,2012Standard range:KS Available sizes:(new)8;9;10;11;12;13;14;15;16;18;20 Without collar outside of France NSA:135 Indications:Primary THR;Revision stage 1 and 232PPT课件Author|Po
18、werPoint title goes here|April XX,2012Articul/eze HeadsCobalt chrome-22.225 mm:+4medium+7 long33PPT课件Author|PowerPoint title goes here|April XX,2012Cobalt chrome:28 mm:+1.5 short neck+5medium(standard)+8.5 long+12 extra long Articul/eze Heads34PPT课件Author|PowerPoint title goes here|April XX,2012Arti
19、cul/eze RangeCeramic:28 mm,36mm:+1.5 short neck +5 medium(Standard)+8.5 long 32 mm:+1short neck+5 medium(Standard)+9long35PPT课件Author|PowerPoint title goes here|April XX,201297.7%Survivorship at 10 years89%of patients without thigh pain(大腿痛)0.8%stress shielding Gr.III应力遮挡JP Vidalain and the Artro Gr
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