CN215228299U - Bone cement injection device - Google Patents
Bone cement injection device Download PDFInfo
- Publication number
- CN215228299U CN215228299U CN202023216389.3U CN202023216389U CN215228299U CN 215228299 U CN215228299 U CN 215228299U CN 202023216389 U CN202023216389 U CN 202023216389U CN 215228299 U CN215228299 U CN 215228299U
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- Prior art keywords
- upper cover
- screw
- bone cement
- screw rod
- blocks
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- Expired - Fee Related
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- 239000002639 bone cement Substances 0.000 title claims abstract description 50
- 238000002347 injection Methods 0.000 title claims abstract description 34
- 239000007924 injection Substances 0.000 title claims abstract description 34
- 238000003825 pressing Methods 0.000 description 6
- 230000000694 effects Effects 0.000 description 4
- 229920003229 poly(methyl methacrylate) Polymers 0.000 description 4
- 239000004926 polymethyl methacrylate Substances 0.000 description 4
- 229910000389 calcium phosphate Inorganic materials 0.000 description 3
- 239000001506 calcium phosphate Substances 0.000 description 3
- 235000011010 calcium phosphates Nutrition 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- QORWJWZARLRLPR-UHFFFAOYSA-H tricalcium bis(phosphate) Chemical compound [Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O QORWJWZARLRLPR-UHFFFAOYSA-H 0.000 description 3
- 230000009286 beneficial effect Effects 0.000 description 2
- 210000000988 bone and bone Anatomy 0.000 description 2
- 239000004568 cement Substances 0.000 description 2
- 238000004140 cleaning Methods 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- 239000000843 powder Substances 0.000 description 2
- 238000007711 solidification Methods 0.000 description 2
- 230000008023 solidification Effects 0.000 description 2
- 210000003781 tooth socket Anatomy 0.000 description 2
- -1 acrylic ester Chemical class 0.000 description 1
- 239000000853 adhesive Substances 0.000 description 1
- 230000001070 adhesive effect Effects 0.000 description 1
- 229910052586 apatite Inorganic materials 0.000 description 1
- 230000003013 cytotoxicity Effects 0.000 description 1
- 231100000135 cytotoxicity Toxicity 0.000 description 1
- 238000005034 decoration Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000009472 formulation Methods 0.000 description 1
- 230000020169 heat generation Effects 0.000 description 1
- 238000006703 hydration reaction Methods 0.000 description 1
- 229910052588 hydroxylapatite Inorganic materials 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 239000007791 liquid phase Substances 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000012567 medical material Substances 0.000 description 1
- 239000000178 monomer Substances 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- VSIIXMUUUJUKCM-UHFFFAOYSA-D pentacalcium;fluoride;triphosphate Chemical compound [F-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O VSIIXMUUUJUKCM-UHFFFAOYSA-D 0.000 description 1
- 230000000704 physical effect Effects 0.000 description 1
- 230000004962 physiological condition Effects 0.000 description 1
- 238000006116 polymerization reaction Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
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- Surgical Instruments (AREA)
Abstract
A bone cement injection device comprises a puncture needle head; the first thread groove is formed in the top of the puncture needle head; the needle tube is installed in the first thread groove in a threaded mode, and the top end and the bottom end of the needle tube are both provided with openings; the upper cover is arranged at the top end of the needle tube; the second thread groove is formed in the bottom of the upper cover and is in threaded connection with the needle tube; the through hole is formed in the inner wall of the top of the second thread groove; the first screw rod is arranged in the through hole, the top end of the first screw rod extends out of the upper cover, and the bottom end of the first screw rod extends into the needle tube. The utility model provides a bone cement injection device has the injection comparatively lightly, the using-way is more, and the great advantage of injection pressure.
Description
Technical Field
The utility model relates to the technical field of medical equipment, especially, relate to a bone cement injection device.
Background
Bone cement is a common name of bone cement, is a medical material used for orthopedic surgery, has a popular name due to partial physical properties and appearance and properties after solidification rather like white cement for building and decoration, and forms two systems in the development process: PMMA bone cement with poor biocompatibility and calcium phosphate bone cement with good biocompatibility, wherein the ratio of PMMA bone cement: the traditional acrylic ester bone cement represented by polymethyl methacrylate bone cement is a room-temperature self-setting adhesive consisting of powder and liquid. However, PMMA belongs to a biological inert material, cannot form organic chemical interface combination with host bone tissues, and has limited clinical application due to the defects of heat generation in the solidification polymerization process, monomer cytotoxicity, limited operable time and the like; CPC bone cement: calcium phosphate cements, originally proposed by Brown and Chow in the united states in the 80's 20 th century, CPC was hydrated by a blend of one or more calcium phosphate powders with a liquid phase for formulation, and self-setting under physiological conditions, such as: the bone cement is subjected to hydration reaction under the conditions of temperature (37 ℃) and humidity (100%) to obtain a solidified product-hydroxyapatite or calcium-permeable apatite which is close to human bone tissues, so that the bone cement has certain degradability and good biocompatibility, bone cement needs to be injected in medical clinic, and an injection device needs to be used during injection.
Through the retrieval, application number is CN 211911781U's utility model discloses a bone cement injection device among the prior art, including the needle tubing, sectional type push rod and pjncture needle, the sectional type push rod cup joints in the needle tubing, the needle tubing comprises body and end cover, the detachable body front end that is fixed in of end cover, the both ends opening of body, the sectional type push rod is by annotating pole section soon and straight push rod section, annotate the pole section soon and articulate with straight push rod section, annotate the pole section soon and include the threaded rod, the front end of threaded rod is fixed with the ball seat, straight push rod section includes the connecting rod, one side of connecting rod is fixed with the ball pivot, the opposite side of connecting rod is fixed with the piston, the handheld portion of pjncture needle is connected through luer male joint of luer female joint with the end cover. Although the front end of the needle tube of the device is detachable, the bone cement can be quickly filled into the needle tube, and gaps of the bone cement can be prevented; the push rod of the device adopts a sectional type hinge structure, and the end face of the front section can be kept in fit with the end face of the bone cement when the rear section is injected in a spiral mode, so that the aim of saving labor can be fulfilled, and the injection amount of the bone cement can be accurately controlled when the front section is injected.
However, the main driving method is manual pressing, which not only wastes time and labor, but also is single, and in order to ensure the injection density, the injection pressure is usually high, and manual injection is difficult.
Therefore, there is a need to provide a new bone cement injection device to solve the above technical problems.
SUMMERY OF THE UTILITY MODEL
The technical problem solved by the utility model is to provide a bone cement injection device that has injection comparatively lightly, the using-way is more, and injection pressure is great.
In order to solve the technical problem, the utility model provides a bone cement injection device includes: a puncture needle head; the first thread groove is formed in the top of the puncture needle head; the needle tube is installed in the first thread groove in a threaded mode, and the top end and the bottom end of the needle tube are both provided with openings; the upper cover is arranged at the top end of the needle tube; the second thread groove is formed in the bottom of the upper cover and is in threaded connection with the needle tube; the through hole is formed in the inner wall of the top of the second thread groove; the first screw rod is arranged in the through hole, the top end of the first screw rod extends out of the upper cover, and the bottom end of the first screw rod extends into the needle tube; the rubber block is fixedly arranged at the bottom end of the first screw rod and is in sliding contact with the inner wall of the needle tube; the electric mechanism is arranged on the upper cover; a manual engagement mechanism disposed on the upper cover.
Preferably, electric mechanism includes tooth's socket, support, motor, gear and guiding mechanism, the tooth's socket is seted up on one side of first screw rod, the support sets up the top of upper cover is located one side of first screw rod, motor fixed mounting be in on the support, gear fixed mounting be in on the output shaft of motor, one side of gear extends to in the tooth's socket, guiding mechanism sets up on the upper cover.
Preferably, guiding mechanism includes two guide slots, two slides, two guide blocks and two second screw rods, two the guide slot is seted up respectively the both sides of first screw rod, two the slide is all seted up cover, two the slide is respectively with two the guide slot is corresponding, two the guide block is slidable mounting respectively two in the slide, two one side that the guide block is close to each other extends to two respectively in the guide slot, two the second screw rod is respectively the screw thread install two on the one side inner wall that the slide was kept away from each other, two the one end that the second screw rod is close to each other is located two respectively in the slide and respectively with two the guide block rotates to be connected, two the one end that the second screw rod was kept away from each other all extends to outside the upper cover.
Preferably, manual meshing mechanism includes two screw thread blocks and two third screw rods, two equal slidable mounting of screw thread block is in the through-hole, two the top of screw thread block all extends to outside the upper cover, two the screw thread block is located respectively the both sides of first screw rod, two the third screw rod is threaded respectively and is installed on the both sides inner wall of through-hole, two the one end that the third screw rod is close to each other all is located in the through-hole and respectively with two the screw thread block rotates to be connected, two the one end that the third screw rod was kept away from each other all extends to outside the upper cover.
Preferably, the two second screws and the two third screws are distributed in a circular array in equal intervals, arc-shaped thread grooves are formed in the side, close to each other, of each of the two thread blocks, and the two arc-shaped thread grooves are matched with the first screws.
Preferably, two positioning grooves are formed in the top of the upper cover, positioning blocks are slidably mounted in the two positioning grooves, and the tops of the two positioning blocks extend to the outside of the upper cover and are fixedly connected with the two thread blocks respectively.
Preferably, the bracket is provided with a bolt, and the bolt is in threaded connection with the upper cover.
Compared with the prior art, the utility model provides a bone cement injection device has following beneficial effect:
the utility model provides a bone cement injection device:
1. the puncture needle head, the needle tube and the upper cover which are connected through threads are convenient to separate, the cleaning is convenient, the bone cement pouring is also convenient, the first screw rod arranged in the through hole can be used for abutting against the rubber block so as to push out the bone cement, the gear driven by the motor can be meshed with the tooth groove on the first screw rod so as to drive the first screw rod and the rubber block to move, the pressing type is more labor-saving than the pressing type, the positioning can be carried out during electric adjustment through the guide mechanism, and the movement stability is improved;
2. through two third screw rod driven screw thread pieces in the manual meshing mechanism can mesh with first screw rod to provide another kind of drive mode, compare the push type also comparatively laborsaving, be convenient for mesh mutually with the external screw thread of first screw rod through arc thread groove, improve the stability of screw thread piece motion through constant head tank and locating piece, it is better to keep the effect, is convenient for demolish support and motor through the bolt.
Drawings
Fig. 1 is a front sectional structural view of a preferred embodiment of a bone cement injection device according to the present invention;
FIG. 2 is an enlarged schematic view of portion A shown in FIG. 1;
FIG. 3 is an enlarged schematic view of a portion B shown in FIG. 1;
fig. 4 is a schematic top sectional view of the upper cover of the present invention.
Reference numbers in the figures: 1. a puncture needle head; 2. a first thread groove; 3. a needle tube; 4. an upper cover; 5. A second thread groove; 6. a through hole; 7. a first screw; 8. a rubber block; 9. a tooth socket; 10. a support; 11. a motor; 12. a gear; 13. a guide groove; 14. a slideway; 15. a guide block; 16. a second screw; 17. a thread block; 18. and a third screw.
Detailed Description
The present invention will be further described with reference to the accompanying drawings and embodiments.
Please refer to fig. 1, fig. 2, fig. 3 and fig. 4 in combination, wherein fig. 1 is a schematic sectional view of a preferred embodiment of a bone cement injection device according to the present invention; FIG. 2 is an enlarged schematic view of portion A shown in FIG. 1; FIG. 3 is an enlarged schematic view of a portion B shown in FIG. 1; fig. 4 is a schematic top sectional view of the upper cover of the present invention. The bone cement injection device includes: a puncture needle head 1; the first thread groove 2 is formed in the top of the puncture needle head 1; the needle tube 3 is installed in the first thread groove 2 in a threaded mode, and the top end and the bottom end of the needle tube 3 are both provided with openings; the upper cover 4 is arranged at the top end of the needle tube 3; the second thread groove 5 is formed in the bottom of the upper cover 4, and the second thread groove 5 is in threaded connection with the needle tube 3; the through hole 6 is formed in the inner wall of the top of the second thread groove 5; the first screw 7 is arranged in the through hole 6, the top end of the first screw 7 extends out of the upper cover 4, and the bottom end of the first screw 7 extends into the needle tube 3; the rubber block 8 is fixedly arranged at the bottom end of the first screw 7, and the rubber block 8 is in sliding contact with the inner wall of the needle tube 3; an electric mechanism arranged on the upper cover 4; manual meshing mechanism, manual meshing mechanism sets up on the upper cover 4, through threaded connection's puncture needle 1, needle tubing 3 and upper cover 4 separation of being convenient for, it is convenient not only to wash, and it is also comparatively convenient to pour bone cement, and the first screw rod 7 of installation can contradict block rubber 8 in the through-hole 6 to push out bone cement.
Electric mechanism includes tooth's socket 9, support 10, motor 11, gear 12 and guiding mechanism, tooth's socket 9 sets up on one side of first screw rod 7, support 10 sets up the top of upper cover 4 is located one side of first screw rod 7, 11 fixed mounting of motor are in on the support 10, gear 12 fixed mounting be in on the output shaft of motor 11, one side of gear 12 extends to in the tooth's socket 9, guiding mechanism sets up on the upper cover 4, gear 12 that drives through motor 11 can with the tooth's socket 9 meshing on the first screw rod 7 to drive first screw rod 7 and block rubber 8 and remove, it is comparatively laborsaving to compare the push type.
The guide mechanism comprises two guide grooves 13, two slide ways 14, two guide blocks 15 and two second screw rods 16, the two guide grooves 13 are respectively arranged at two sides of the first screw rod 7, the two slide ways 14 are respectively arranged on the upper cover 4, the two slide ways 14 are respectively corresponding to the two guide grooves 13, the two guide blocks 15 are respectively installed in the two slide ways 14 in a sliding manner, one sides of the two guide blocks 15 close to each other are respectively extended into the two guide grooves 13, the two second screw rods 16 are respectively installed on the inner walls of one sides of the two slide ways 14 far away from each other in a threaded manner, one ends of the two second screw rods 16 close to each other are respectively located in the two slide ways 14 and are respectively and rotatably connected with the two guide blocks 15, one ends of the two second screw rods 16 far away from each other are respectively extended out of the upper cover 4, and can be positioned during electric adjustment through the guide mechanism, the stability of the movement is improved.
Manual meshing mechanism includes two screw thread blocks 17 and two third screw rods 18, two equal slidable mounting of screw thread block 17 is in the through-hole 6, two the top of screw thread block 17 all extends to outside the upper cover 4, two the screw thread block 17 is located respectively the both sides of first screw rod 7, two the third screw rod 18 is threaded respectively and is installed on the both sides inner wall of through-hole 6, two the one end that third screw rod 18 is close to each other all is located in the through-hole 6 and respectively with two the screw thread block 17 rotates and connects, two the one end that third screw rod 18 kept away from each other all extends to outside the upper cover 4, through two third screw rod 18 driven screw thread blocks 17 in the manual meshing mechanism can mesh with first screw rod 7 to provide another kind of drive mode, it is also comparatively laborsaving to compare the push type.
The two second screw rods 16 and the two third screw rods 18 are distributed in a circular array in an equal division manner, arc-shaped thread grooves are formed in the side, close to each other, of each of the two thread blocks 17, the two arc-shaped thread grooves are matched with the first screw rods 7, and the arc-shaped thread grooves are meshed with the external threads of the first screw rods 7 conveniently.
Two constant head tanks have been seted up at the top of upper cover 4, two equal slidable mounting has the locating piece in the constant head tank, two the top of locating piece all extends to outside the upper cover 4 and respectively with two screw thread block 17 fixed connection improves the stability of screw thread block 17 motion through constant head tank and locating piece, keeps the effect better.
The support 10 is provided with a bolt, the bolt is in threaded connection with the upper cover 4, and the support 10 and the motor 11 are convenient to detach through the bolt.
The utility model provides a bone cement injection device's theory of operation as follows:
when bone cement is poured, firstly, the device is inverted, then the puncture needle head 1 is screwed and taken down, then the motor 11 is started, the output shaft of the motor 11 drives the gear 12 to rotate, the gear 12 drives the first screw 7 to slide along the two guide grooves 13 and the guide block 15 under the meshing action with the tooth grooves 9, meanwhile, the first screw 7 drives the rubber block 8 to be close to the upper cover 4, the motor 11 is closed after the rubber block 8 is close to the upper cover 4, at the moment, the bone cement is poured through the opening of the needle tube 3, the puncture needle head 1 is reinstalled after the pouring is finished, then the motor 11 can be started, the output shaft of the motor 11 is reversely rotated to extrude the bone cement through the rubber block 8, and therefore the bone cement is discharged from the puncture needle head 1;
when the motor 11 is inconvenient to use or damaged, the mode is switched, firstly, the two third screw rods 18 are respectively rotated during switching, the two third screw rods 18 are enabled to push the two thread blocks 17 to be close to and attached to the first screw rod 7, at the moment, the two arc-shaped thread grooves are meshed with the external thread of the first screw rod 7, then, the two second screw rods 16 are rotated, the two second screw rods 16 are enabled to drive the two guide blocks 15 to slide in the two slide ways 14, so that the guide grooves 13 on the first screw rods 7 are separated, finally, the bolts on the support 10 are dismounted, the motor 11 of the support 10 is dismounted, the gear 12 is dismounted at the moment, the first screw rods 7 are rotated, the first screw rods 7 are enabled to rotate and move downwards through the meshing effect of the arc-shaped thread grooves on the first screw rods 7 and the two thread blocks 17, so that bone cement is extruded through the rubber blocks 8, and the two modes are labor-saving compared with a pressing mode.
Compared with the prior art, the utility model provides a bone cement injection device has following beneficial effect:
the utility model provides a bone cement injection device, the puncture needle head 1, the needle tube 3 and the upper cover 4 which are connected by screw thread are convenient to separate, not only cleaning is convenient, bone cement is convenient to pour, the first screw 7 arranged in the through hole 6 can resist the rubber block 8, thereby bone cement is pushed out, the gear 12 driven by the motor 11 can be meshed with the tooth socket 9 on the first screw 7, thereby driving the first screw 7 and the rubber block 8 to move, which is more labor-saving compared with a pressing type, positioning can be carried out during electric adjustment by a guide mechanism, the stability of movement is improved, the thread block 17 driven by two third screws 18 in a manual meshing mechanism can be meshed with the first screw 7, thereby another driving mode is provided, the pressing type is more labor-saving compared, and the outer thread of the first screw 7 can be meshed conveniently through an arc thread groove, the stability of the movement of the thread block 17 is improved through the positioning groove and the positioning block, the effect is kept better, and the support 10 and the motor 11 are convenient to detach through bolts.
It should be noted that the device structure and the accompanying drawings of the present invention mainly describe the principle of the present invention, and in the technology of this design principle, the settings of the power mechanism, the power supply system, the control system, etc. of the device are not completely described, and the details of the power mechanism, the power supply system, and the control system can be clearly known on the premise that those skilled in the art understand the principle of the present invention.
The above only is the embodiment of the present invention, not limiting the scope of the present invention, all the equivalent structures or equivalent processes of the present invention are used in the specification and the attached drawings, or directly or indirectly applied to other related technical fields, and the same principle is included in the protection scope of the present invention.
Claims (7)
1. A bone cement injection device, comprising:
a puncture needle head;
the first thread groove is formed in the top of the puncture needle head;
the needle tube is installed in the first thread groove in a threaded mode, and the top end and the bottom end of the needle tube are both provided with openings;
the upper cover is arranged at the top end of the needle tube;
the second thread groove is formed in the bottom of the upper cover and is in threaded connection with the needle tube;
the through hole is formed in the inner wall of the top of the second thread groove;
the first screw rod is arranged in the through hole, the top end of the first screw rod extends out of the upper cover, and the bottom end of the first screw rod extends into the needle tube;
the rubber block is fixedly arranged at the bottom end of the first screw rod and is in sliding contact with the inner wall of the needle tube;
the electric mechanism is arranged on the upper cover;
a manual engagement mechanism disposed on the upper cover.
2. The bone cement injection apparatus according to claim 1, wherein the electric mechanism includes a tooth groove opened on one side of the first screw, a bracket provided on a top of the upper cover and located on one side of the first screw, a motor fixedly installed on the bracket, a gear fixedly installed on an output shaft of the motor, one side of the gear extending into the tooth groove, and a guide mechanism provided on the upper cover.
3. The bone cement injection apparatus according to claim 2, wherein the guide mechanism comprises two guide grooves, two slide ways, two guide blocks and two second screw rods, two the guide slot is seted up respectively the both sides of first screw rod, two the slide is all seted up cover on, two the slide respectively with two the guide slot is corresponding, two the guide block is slidable mounting respectively two in the slide, two one side that the guide block is close to each other extends to two respectively in the guide slot, two the second screw rod is respectively the screw thread and installs two on the one side inner wall that the slide was kept away from each other, two the one end that the second screw rod is close to each other is located two respectively in the slide and respectively with two the guide block rotates to be connected, two the one end that the second screw rod was kept away from each other all extends to outside the upper cover.
4. The bone cement injection apparatus according to claim 3, wherein the manual engagement mechanism includes two screw blocks and two third screws, the two screw blocks are slidably mounted in the through hole, the tops of the two screw blocks extend out of the upper cover, the two screw blocks are respectively located at two sides of the first screw, the two third screws are respectively threadedly mounted on inner walls at two sides of the through hole, ends of the two third screws close to each other are respectively located in the through hole and rotatably connected with the two screw blocks, and ends of the two third screws far away from each other extend out of the upper cover.
5. The bone cement injection device according to claim 4, wherein the two second screws and the two third screws are equally distributed in a circular array, and arc-shaped thread grooves are formed in the sides of the two thread blocks, which are close to each other, and are matched with the first screws.
6. The bone cement injection device according to claim 4, wherein the top of the upper cover is provided with two positioning grooves, positioning blocks are slidably mounted in the two positioning grooves, and the tops of the two positioning blocks extend out of the upper cover and are fixedly connected with the two thread blocks respectively.
7. The bone cement injection apparatus according to claim 2, wherein a bolt is provided on the bracket, and the bolt is threadedly coupled with the upper cover.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202023216389.3U CN215228299U (en) | 2020-12-28 | 2020-12-28 | Bone cement injection device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202023216389.3U CN215228299U (en) | 2020-12-28 | 2020-12-28 | Bone cement injection device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN215228299U true CN215228299U (en) | 2021-12-21 |
Family
ID=79488299
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202023216389.3U Expired - Fee Related CN215228299U (en) | 2020-12-28 | 2020-12-28 | Bone cement injection device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN215228299U (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN118303964A (en) * | 2024-06-11 | 2024-07-09 | 江苏乐铠生物技术有限公司 | Bone cement monomer quartering distributor |
-
2020
- 2020-12-28 CN CN202023216389.3U patent/CN215228299U/en not_active Expired - Fee Related
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN118303964A (en) * | 2024-06-11 | 2024-07-09 | 江苏乐铠生物技术有限公司 | Bone cement monomer quartering distributor |
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| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20211221 |
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| CF01 | Termination of patent right due to non-payment of annual fee |