FR2697996A1 - Femoral prosthesis assembly - has shank whose end can receive series of necks connected to spherical head in variety of positions - Google Patents

Femoral prosthesis assembly - has shank whose end can receive series of necks connected to spherical head in variety of positions Download PDF

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Publication number
FR2697996A1
FR2697996A1 FR9214120A FR9214120A FR2697996A1 FR 2697996 A1 FR2697996 A1 FR 2697996A1 FR 9214120 A FR9214120 A FR 9214120A FR 9214120 A FR9214120 A FR 9214120A FR 2697996 A1 FR2697996 A1 FR 2697996A1
Authority
FR
France
Prior art keywords
modular assembly
assembly according
frustoconical
neck
base
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.)
Granted
Application number
FR9214120A
Other languages
French (fr)
Other versions
FR2697996B1 (en
Inventor
J Dr Benoliel
P Dr Calas
M Dr Caillol
E Dr Cohen
G Dr Cohen
G Dr Moumas
J Dr Negre
Simonnet Dr Jh
F Dr Vedel
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.)
Medinov SA
Original Assignee
Medinov SA
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 Medinov SA filed Critical Medinov SA
Priority to FR9214120A priority Critical patent/FR2697996B1/en
Priority to DE4407227A priority patent/DE4407227A1/en
Publication of FR2697996A1 publication Critical patent/FR2697996A1/en
Application granted granted Critical
Publication of FR2697996B1 publication Critical patent/FR2697996B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30136—Rounded shapes, e.g. with rounded corners undulated or wavy, e.g. serpentine-shaped or zigzag-shaped
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30171—Concave polygonal shapes rosette- or star-shaped
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
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    • A61F2002/30179—X-shaped
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
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    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30181—Y-shaped
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30339—Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • A61F2002/30355—Cylinder of elliptical or oval basis
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • 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
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
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    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • A—HUMAN NECESSITIES
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    • 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
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    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
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    • 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
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    • 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
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    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-shaped
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0058—X-shaped
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/006—Y-shaped

Abstract

The femoral prosthesis assembly comprises a femoral shank (1) designed to receive a series of necks (2) connected to a spherical head. Each neck consists of a conical base (2a) which fits into a matching recess in the proximal end of the shank, and has an adjustable positioning element (2b) on its end which can be set at different angles. The opposite end of the neck has a truncated conical tip (2c) which engages with a socket in the spherical head. ADVANTAGE - Wider range of fittings.

Description

ENSEMBLE MODULAIRE POUR PROTHESE DE HANCHE. MODULAR ASSEMBLY FOR HIP PROSTHESIS.

L'invention concerne plus particulièrement le secteur technique des implants chirurgicaux, notamment les prothèses de hanche. The invention relates more particularly to the technical sector of surgical implants, in particular hip prostheses.

On rappelle, d'une manière parfaitement connu pour un homme du métier, qu'une prothèse de hanche présente une tige fémorale destinée à être impactée dans le canal médullaire du fémur. La partie supérieure de la tige est prolongée angulairement par une partie faisant office de col, conformée pour recevoir directement, ou d'une manière rapportée, une tête sphérique fémorale apte à coopérer avec la cavité cotyloïde de l'os illiaque. Ces prothèses sont conformées pour être impactées dans le canal médullaire avec ou sans ciment. It will be recalled, in a manner perfectly known to a person skilled in the art, that a hip prosthesis has a femoral stem intended to be impacted in the medullary canal of the femur. The upper part of the rod is angularly extended by a part serving as a neck, shaped to receive directly, or in a reported manner, a spherical femoral head capable of cooperating with the acetabular cavity of the iliac bone. These prostheses are shaped to be impacted in the medullary canal with or without cement.

Un problème rencontré se situe au niveau du règlage de l'antéversion du col. En effet, la prothèse, notamment la tige fémorale de forme générale anatomique, se cale dans le fémur selon un angle correspondant à sa grande éllipse. A problem encountered lies in the adjustment of the anteversion of the cervix. Indeed, the prosthesis, in particular the femoral stem of general anatomical shape, is wedged in the femur at an angle corresponding to its large ellipse.

Or, dans de nombreux cas, l'angle anatomique d'antéversion ne correspond pas à l'angle d'antéversion du col par rapport à la tige. However, in many cases, the anatomical anteversion angle does not correspond to the anteversion angle of the cervix relative to the rod.

Dans certains cas, cet angle antomique qui est de l'ordre de 15 degrés, peut atteindre des valeurs beaucoup plus importantes de l'ordre de 60 degrés. Il en résulte des risques importants de luxation de la prothèse étant donné que, dans ce cas, l'angle du col de la tige fémorale ne correspond plus à l'anatomie du patient considéré.In certain cases, this antomic angle which is of the order of 15 degrees, can reach much larger values of the order of 60 degrees. This results in significant risks of dislocation of the prosthesis since, in this case, the angle of the neck of the femoral stem no longer corresponds to the anatomy of the patient considered.

Pour tenter de remédier à ces inconvénients, on a proposé des prothèses de hanches à caractère modulaire notamment au niveau du col. In an attempt to remedy these drawbacks, modular hip prostheses have been proposed, in particular at the level of the neck.

Dans ce but, la partie proximale de la tige fémorale est agencée pour recevoir de manière rapportée une série de cols pouvant présenter des angulations différentes pour se rapprocher de l'angle anatomique considéré de chaque cas pathologique à traiter. Cet état de la technique peut être illustré par l'enseignement des brevets FR 85.06214, FR 89.00871, FR 91.03150, FR 89.11677, FR 86.15930. Ces différents brevets enseignent des solutions diverses permettant l'adaptation du col au niveau de la tige.For this purpose, the proximal part of the femoral stem is arranged to receive in a reported manner a series of necks which can have different angulations in order to approach the anatomical angle considered for each pathological case to be treated. This state of the art can be illustrated by the teaching of the patents FR 85.06214, FR 89.00871, FR 91.03150, FR 89.11677, FR 86.15930. These different patents teach various solutions allowing the adaptation of the neck to the level of the rod.

Les solutions proposées ne donnent pas entière satisfaction, car ,soit elles ne permettent pas d'obtenir différentes orientations angulaires dans un plan horizontal, soit, si elles permettent de telles orientations, ces dernières ne sont pas contrôlées ce qui peut s'avérer délicat au moment de l'impaction et du choix par le praticien. The solutions proposed are not entirely satisfactory, because either they do not allow different angular orientations to be obtained in a horizontal plane, or, if they allow such orientations, the latter are not controlled, which can prove to be difficult moment of impaction and choice by the practitioner.

L'invention s'est fixée pour but de remédier à ces inconvénients de manière sûre, simple et efficace. The object of the invention is to remedy these drawbacks in a safe, simple and effective manner.

Le problème que se propose de résoudre l'invention est d'obtenir à volonté différentes angulations du col en fonction du cas à traiter afin de s'adapter à l'angle d'antéversion anatomique considéré avec la possibilité de contrôler la rotation du col par rapport à la tige fémorale pour obtenir une parfaite stabilité. The problem which the invention proposes to solve is to obtain at will different angulations of the cervix according to the case to be treated in order to adapt to the anatomical anteversion angle considered with the possibility of controlling the rotation of the cervix by compared to the femoral stem to obtain perfect stability.

Pour résoudre un tel problème, il a été conçu et mis au point un ensemble modulaire pour prothèse de hanche comprenant une tige fémorale recevant de manière rapportée et interchangeable, une série de cols aptes à coopérer avec une tête sphérique fémorale. Selon l'invention, chaque col présente une embase tronconique commune apte à être emmanchée dans un alésage de forme tronconique complémentaire formé angulairement dans la partie proximale de la tige et d'une manière angulaire à son axe vertical, ladite embase étant prolongée par un élément de positionnement destiné à être engagé, selon différentes orientations angulaires, dans des formes complémentaires établies dans le fond de l'alésage avec capacité de blocage angulaire dans la position considérée. To solve such a problem, it has been designed and developed a modular assembly for hip prosthesis comprising a femoral stem receiving in a reported and interchangeable manner, a series of necks capable of cooperating with a spherical femoral head. According to the invention, each neck has a common frustoconical base capable of being fitted into a complementary frustoconical bore formed angularly in the proximal part of the rod and in an angular manner with its vertical axis, said base being extended by an element positioning intended to be engaged, according to different angular orientations, in complementary shapes established in the bottom of the bore with angular locking capacity in the position considered.

Pour résoudre le problème posé d'assurer une stabilité antirotatoire l'élément de positionnement est constitué par un bossage. To resolve the problem posed of ensuring anti-rotation stability, the positioning element is constituted by a boss.

Avantageusement, le bossage est formé de manière coaxiale à l'embase tronconique et s'étend sur la quasi totalité de sa largeur. Advantageously, the boss is formed coaxially with the frustoconical base and extends over almost its entire width.

Pour résoudre le problème posé d'obtenir différentes orientations angulaires contrôlées dans le plan horizontal, les formes complémentaires établies dans le fond de l'alésage de la tige sont formées par des empreintes en creux disposées angulairement les unes par rapport aux autres. To solve the problem of obtaining different angular orientations controlled in the horizontal plane, the complementary shapes established in the bottom of the bore of the rod are formed by recesses in the hollow arranged angularly with respect to each other.

Avantageusement, les empreintes sont soit au nombre de deux en étant décalées à 90 , soit au nombre de trois en étant décalées de 6001 soit au nombre de quatre en étant décalées de 450
A partir de cette conception de base et compte tenu du problème posé d'obtenir une pluralité d'angulations correspondant à l'antéversion considérée, soit l'embase conique de chaque col, à l'opposé de l'élément de positionnement, est prolongée coaxialement par une portée tronconique recevant la tête fémorale, soit l'embase conique est prolongée selon différentes orientations angulaires par une portée tronconique recevant la tête fémorale.Advantageously, the imprints are either two in number being offset by 90, or three in number by being offset by 6001 or four in number by being offset by 450
From this basic design and taking into account the problem posed of obtaining a plurality of angulations corresponding to the anteversion considered, ie the conical base of each neck, opposite the positioning element, is extended coaxially by a frustoconical bearing receiving the femoral head, or the conical base is extended according to different angular orientations by a frustoconical bearing receiving the femoral head.

L'invention est exposée ci-après plus en détail à l'aide des dessins annexés dans lesquels
- La figure 1 est une vue partielle de la partie proximale d'une tige fémorale agencée selon l'invention.The invention is set out below in more detail with the aid of the appended drawings in which
- Figure 1 is a partial view of the proximal part of a femoral stem arranged according to the invention.

- La figure 2 est une vue de face du col. - Figure 2 is a front view of the neck.

- La figure 3 est une vue de côté correspondant à la figure 2. - Figure 3 is a side view corresponding to Figure 2.

- La figure 4 est, à plus grande échelle, une vue de dessus correspondant à la figure 1 montrant la forme des empreinte. - Figure 4 is, on a larger scale, a top view corresponding to Figure 1 showing the shape of the imprints.

- Les figures 4a et 4b montrent d'autres dispositions des empreintes. - Figures 4a and 4b show other arrangements of the imprints.

- La figure 5 est, à plus grande échélle, une vue de dessous correspondant à la figure 3 montrant le bossage de positionnement. - Figure 5 is, on a larger scale, a bottom view corresponding to Figure 3 showing the positioning boss.

- La figure 6 montre le montage du col au niveau de la partie correspondante de la tige fémorale. - Figure 6 shows the mounting of the neck at the corresponding part of the femoral stem.

- Les figures 7 et 8 montrent des exemples nullement limitatifs des cols modulaires selon différentes orientations angulaires. - Figures 7 and 8 show non-limiting examples of modular necks according to different angular orientations.

Les figures 9 et 10 à plus grande échelles des vues à coupe transversale considérées selon la ligne A-A de la figure 6 montrant différentes orientations angulaires du col dans le plan horizontal. FIGS. 9 and 10 on a larger scale of the cross-section views viewed along line A-A of FIG. 6 showing different angular orientations of the neck in the horizontal plane.

L'ensemble modulaire comprend de manière connue une tige fémorale désignée dans son ensemble par (1) recevant de manière rapportée une série de cols (2). Ces cols reçoivent une tête fémorale sphérique (3) (tracé traits interrompus figure 6). The modular assembly comprises in known manner a femoral rod designated as a whole by (1) receiving in a reported manner a series of necks (2). These necks receive a spherical femoral head (3) (dashed lines in Figure 6).

Chaque col (2) présente une embase tronconique commune (2a). Cette embase (2a) est conformée pour être emmanchée dans un alésage tronconique de forme complémentaire (la) établi dans la partie proximale de la tige fémorale (1). Notamment, l'alésage (la) est disposé angulairement par rapport à l'axe vertical de la tige (figure 1).  Each neck (2) has a common frustoconical base (2a). This base (2a) is shaped to be fitted into a frustoconical bore of complementary shape (la) established in the proximal part of the femoral stem (1). In particular, the bore (la) is arranged angularly relative to the vertical axis of the rod (Figure 1).

Selon une caractéristique importante de l'invention, l'embase tronconique (2a) présente, en débordement de sa face de dessous, un élément de positionnement (2b) destiné à être engagé dans des formes complémentaires (lob) établies dans le fond de l'alésage (la).  According to an important characteristic of the invention, the frustoconical base (2a) has, overhanging its underside, a positioning element (2b) intended to be engaged in complementary shapes (lob) established in the bottom of the bore.

Plus particulièrement, comme le montrent les figures 2, 3 et 5, cet élément de positionnement (2b) est constitué par un bossage de section méplate.More particularly, as shown in Figures 2, 3 and 5, this positioning element (2b) is constituted by a boss of flat section.

Ce bossage (2b) est formé de manière coaxiale à l'embase tronconique (2a) et s'étend sur la quasi totalité de sa petite base (figure 5). Les bords rectilignes parallèles (2b1) (2b2) du bossage (2b) sont raccordés transversalement par un demi-cercle (2b3).This boss (2b) is formed coaxially with the frustoconical base (2a) and extends over almost all of its small base (Figure 5). The parallel rectilinear edges (2b1) (2b2) of the boss (2b) are connected transversely by a semicircle (2b3).

Les formes complémentaires (il), établies dans le fond de l'alésage tronconique (la) de la tige, sont formées par des empreintes diamètrales en creux disposées angulairement les unes par rapport aux autres pour conférer au col (2) différentes orientations angulaires dans un plan horizontal, en fonction de l'engagement du bossage (2) dans l'une ou l'autre de ces empreintes (il). Avantageusement, et comme le montre la figure 4, ces empreintes sont au nombre de deux en étant disposées de manière symétriques à 900 en formant une croix. The complementary forms (II), established in the bottom of the frustoconical bore (Ia) of the rod, are formed by hollow diametrical imprints arranged angularly with respect to each other to give the neck (2) different angular orientations in a horizontal plane, depending on the engagement of the boss (2) in one or the other of these imprints (it). Advantageously, and as shown in FIG. 4, these imprints are two in number, being arranged symmetrically at 900 by forming a cross.

On n'exclut pas d'autres dispositions des empreintes (1 b). Par exemple, comme le montre la figure 4a, les empreintes sont au nombre de trois en étant décalées de 600. A la figure 4b, les empreintes sont au nombre de quatreen étant décalées de 450
Il est donc possible d'obtenir un règlage du col (2) par rapport à la tige (1), par cadrans successifs de 9001 600 ou 450 De la même façon que pour le méplat (2b), les bords transversaux des empreintes sont constitués par un demi-cercle (1b1).Other provisions of fingerprints are not excluded (1b). For example, as shown in Figure 4a, the footprints are three in number being offset by 600. In Figure 4b, the footprints are four in number being offset by 450
It is therefore possible to obtain an adjustment of the neck (2) relative to the rod (1), by successive dials of 9001 600 or 450 In the same way as for the flat (2b), the transverse edges of the imprints are formed by a semicircle (1b1).

L'embase conique (2a) de chaque cone est prolongée à l'opposé du méplat (2b) par une portée tronconique (2c) destinée à recevoir la tête fémorale (3). Cette portée tronconique (2c) peut être formée soit d'une manière coaxiale à l'embase tronconique (2a) (figure 6), soit de manière angulaire à cette embase. Dans ce dernier cas, la portée tronconique (2c) peut être orientée selon une pluralité d'angulation (Q (3...) (figures 2, 7, 8). A noter, d'une manière connue, que l'embase tronconique (2a) et la portée (2b) peuvent être raccordées directement ou par des portées intermédiaires (2d, 2e). The conical base (2a) of each cone is extended opposite the flat (2b) by a frustoconical bearing (2c) intended to receive the femoral head (3). This frustoconical bearing (2c) can be formed either coaxially with the frustoconical base (2a) (Figure 6), or angularly with this base. In the latter case, the frustoconical bearing surface (2c) can be oriented according to a plurality of angulations (Q (3 ...) (Figures 2, 7, 8). Note, in a known manner, that the base frustoconical (2a) and the bearing surface (2b) can be connected directly or by intermediate bearing surfaces (2d, 2e).

D'une manière importante, ces zones intermédiaires de raccordement (2d) (2e) peuvent autoriser un décalage latéral variable (6) connu sous le nom d'ANTEPOSITION (tracé traits interrompus) (figure 7). Importantly, these intermediate connection zones (2d) (2e) can allow a variable lateral offset (6) known as ANTEPOSITION (dashed lines) (Figure 7).

Ce décalage latéral (6) est indépendant de la modularité d'angulation (a, fur..) connu sous le nom d'ANTEVERSlON. This lateral offset (6) is independent of the angularity modularity (a, fur ..) known under the name of ANTEVERSlON.

On conçoit, qu'en combinant les différentes angulations possibles du col (2) et son montage dans la tige selon différentes angulations contrôlées résultant de l'engagement du méplat (2b) dans l'une quelconque des empreintes (1 b), on obtient une pluralité d'angulations du col (2) par rapport à la tige (1). It is understood that by combining the different possible angulations of the neck (2) and its mounting in the rod according to different controlled angulations resulting from the engagement of the flat (2b) in any one of the indentations (1b), one obtains a plurality of angulations of the neck (2) relative to the rod (1).

Bien évidemment, la tige fémorale (1) peut présenter différents profils en section et autres agencements pour être impactée dans le canal médullaire avec ou sans ciment. Obviously, the femoral stem (1) can have different profiles in section and other arrangements to be impacted in the medullary canal with or without cement.

Les avantages ressortent bien de la description, en particulier on souligne et on rappelle
- l'orientation angulaire contrôlée du col par rapport à la tige.The advantages are apparent from the description, in particular it is emphasized and recalled
- the controlled angular orientation of the neck relative to the rod.

- la stabilité anti-rotatoire. - anti-rotation stability.

- la multiplicité des angulations obtenues par la combinaison de la conformation du col en tant que tel et de son positionnement angulaire par rapport à la tige avec des effets d'ANTEVERSlON et d'ANTEPOSITION. - The multiplicity of angulations obtained by the combination of the conformation of the cervix as such and its angular positioning with respect to the rod with effects of ANTEVERSlON and ANTEPOSITION.

- la facilité de réglage autour de l'axe du col en peropératoire par l'utilisation de jeu de cols amovibles d'essais.  - the ease of adjustment around the axis of the neck intraoperatively by the use of a set of removable trial necks.

Claims (5)

REVENDICATIONS -1- Ensemble modulaire pour prothèse de hanche comprenant une tige fémorale (1) recevant de manière rapportée et interchangeable une série de cols (2) aptes à coopérer avec une tête sphérique humérale (3), caractérisé en ce que chaque col (2) présente une embase tronconique commune (2a) apte à être emmanchée dans un alésage de forme tronconique complémentaire (la) formé angulairement dans la partie proximale de la tige (1) et d'une manière angulaire à son axe vertical, ladite embase (2a) étant prolongée par un élément de positionnement (2b) destiné à être engagé selon différentes orientations angulaires, dans des formes complémentaires (lob) établies dans le fond de l'alésage (la) avec capacité de blocage angulaire dans la position considérée.-1- Modular assembly for hip prosthesis comprising a femoral stem (1) receiving in a reported and interchangeable manner a series of necks (2) capable of cooperating with a spherical humeral head (3), characterized in that each neck (2) has a common frustoconical base (2a) able to be fitted into a complementary frustoconical bore (la) formed angularly in the proximal part of the rod (1) and in an angular manner with its vertical axis, said base (2a) being extended by a positioning element (2b) intended to be engaged according to different angular orientations, in complementary shapes (lob) established in the bottom of the bore (la) with angular locking capacity in the position considered. -2- Ensemble modulaire selon la revendication 1, caractérisé en ce que l'élément de positionnement (2b) est constitué par un bossage (2b) de section méplate symétrique.-2- Modular assembly according to claim 1, characterized in that the positioning element (2b) is constituted by a boss (2b) of symmetrical flat section. -3- Ensemble modulaire selon la revendication 2, caractérisé en ce que le bossage (2b) est formé de manière coaxiale à l'embase tronconique (2a) et s'étend sur la quasi totalité de sa largeur.-3- Modular assembly according to claim 2, characterized in that the boss (2b) is formed coaxially with the frustoconical base (2a) and extends over almost its entire width. -4- Ensemble modulaire selon la revendication 1 caractérisé en ce que les formes complémentaires (il), établies dans le fond de l'alésage (la) de la tige (1), sont formées par des empreintes en creux disposées angulairement les unes par rapport aux autres.-4- Modular assembly according to claim 1 characterized in that the complementary shapes (it), established in the bottom of the bore (la) of the rod (1), are formed by indentations angularly arranged one by one compared to others. -5- Ensemble modulaire selon la revendication 4 caractérisé en ce que les empreintes (lob) sont au nombre de deux, trois ou quatre, en étant décalées respectivement de 90 , 60 , 450 -6- Ensemble modulaire selon l'une quelconque des revendications 2 à 5 caractérisé en ce que les bords rectilignes du bossage (2b) et des empreintes (1b) sont raccordés par un demi-cercle.-5- Modular assembly according to claim 4 characterized in that the indentations (lob) are two, three or four, being offset respectively by 90, 60, 450 -6- Modular assembly according to any one of the claims 2 to 5 characterized in that the rectilinear edges of the boss (2b) and of the indentations (1b) are connected by a semicircle. -7- Ensemble modulaire selon la revendication 1 caractérisé en ce que l'embase conique (2a) de chaque col, à l'opposé de l'élément de positionnement (2b) est prolongée coaxialement par une portée tronconique (2c) recevant la tête fémorale.-7- Modular assembly according to claim 1 characterized in that the conical base (2a) of each neck, opposite the positioning element (2b) is extended coaxially by a frustoconical bearing (2c) receiving the head femoral. -8- Ensemble modulaire selon la revendication 1 caractérisé en ce que l'embase conique (2a) de chaque col à l'opposé de l'élément (2b) de positionnement, est prolongée selon différentes orientations angulaires par une portée tronconique (2c) recevant la tête fémorale.-8- Modular assembly according to claim 1 characterized in that the conical base (2a) of each neck opposite the element (2b) for positioning, is extended according to different angular orientations by a frustoconical bearing (2c) receiving the femoral head. -9- Ensemble modulaire selon l'une quelconque des revendications 7 et 8 caractérisé en ce que l'embase conique (2a), à l'opposé de l'élément de position (2b), est prolongée par des portées intermédiaire de raccordement selon différents décalages latéraux, par une portée conique et une portée tronconique (2c) recevant la tête fémorale. -9- Modular assembly according to any one of claims 7 and 8 characterized in that the conical base (2a), opposite the position element (2b), is extended by intermediate bearing surfaces according to different lateral offsets, by a conical bearing and a frustoconical bearing (2c) receiving the femoral head.
FR9214120A 1992-11-17 1992-11-17 Modular set for hip prosthesis. Expired - Fee Related FR2697996B1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
FR9214120A FR2697996B1 (en) 1992-11-17 1992-11-17 Modular set for hip prosthesis.
DE4407227A DE4407227A1 (en) 1992-11-17 1994-03-04 Femoral prosthesis assembly

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FR9214120A FR2697996B1 (en) 1992-11-17 1992-11-17 Modular set for hip prosthesis.
DE4407227A DE4407227A1 (en) 1992-11-17 1994-03-04 Femoral prosthesis assembly

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EP0712617A1 (en) * 1994-11-18 1996-05-22 Tornier Sa Spherical humeral prosthesis
FR2729292A1 (en) * 1995-01-12 1996-07-19 Medinov Sa Modular assembly of femoral rods for prosthetic hips
WO1997033538A1 (en) * 1996-03-12 1997-09-18 Societe Civile Groupe Grion Orthopaedic surgery assembly for a hip prosthesis with a removable neck
US5776200A (en) * 1995-02-15 1998-07-07 Smith & Nephew, Inc. Tibial trial prosthesis and bone preparation system
FR2763501A1 (en) * 1997-05-26 1998-11-27 Groupe Lepine Shoulder prosthesis assembly
FR2777772A1 (en) * 1998-04-28 1999-10-29 Depuy France SHOULDER RECONSTRUCTION PROSTHESIS
WO2000064384A1 (en) * 1999-04-27 2000-11-02 Steinicke Maschinen- Und Werkzeugbau Ag Endoprosthesis, especially for an artificial hip joint
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US6284002B1 (en) * 1999-05-27 2001-09-04 Nicholas G. Sotereanos Proximal femoral replacement implant and method of implanting the same
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US6953479B2 (en) 2001-07-16 2005-10-11 Smith & Nephew, Inc. Orthopedic implant extension
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US6197063B1 (en) * 1997-04-11 2001-03-06 Smith & Nephew, Inc. Modular humeral prosthesis and method
FR2763501A1 (en) * 1997-05-26 1998-11-27 Groupe Lepine Shoulder prosthesis assembly
US7189261B2 (en) 1998-04-03 2007-03-13 Smith & Nephew, Inc. Modular humeral prosthesis and method
US7758650B2 (en) 1998-04-03 2010-07-20 Smith & Nephew, Inc. Modular humeral prosthesis and method
FR2777772A1 (en) * 1998-04-28 1999-10-29 Depuy France SHOULDER RECONSTRUCTION PROSTHESIS
EP0953321A1 (en) * 1998-04-28 1999-11-03 Depuy France Shoulder reconstruction prosthesis
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US6284002B1 (en) * 1999-05-27 2001-09-04 Nicholas G. Sotereanos Proximal femoral replacement implant and method of implanting the same
US7985261B2 (en) 1999-10-01 2011-07-26 Medidea, Llc Anti-impingement femoral prostheses
USRE44803E1 (en) 1999-10-01 2014-03-11 Medidea, Llc Anti-impingement femoral prostheses
WO2001070139A3 (en) * 2000-03-22 2002-05-23 Synthes Usa Skeletal reconstruction cages
US6673114B2 (en) 2000-05-03 2004-01-06 Smith & Nephew, Inc. Multi modular trialing system and instrumentation
US6616697B2 (en) 2001-03-13 2003-09-09 Nicholas G. Sotereanos Hip implant assembly
US6953479B2 (en) 2001-07-16 2005-10-11 Smith & Nephew, Inc. Orthopedic implant extension
US7097663B1 (en) 2001-12-17 2006-08-29 Smith & Nephew, Inc. Modular prosthesis system with novel locking mechanism
US10492922B2 (en) 2002-02-19 2019-12-03 DePuy Synthes Products, Inc. Intervertebral implant
US10660765B2 (en) 2003-02-06 2020-05-26 DePuy Synthes Products, Inc. Intervertebral implant
US10064740B2 (en) 2003-02-06 2018-09-04 DePuy Synthes Products, LLC Intervertebral implant
US9039775B2 (en) 2003-03-31 2015-05-26 DePuy Synthes Products, Inc. Spinal fixation plates
US9320549B2 (en) 2003-03-31 2016-04-26 DePuy Synthes Products, Inc. Spinal fixation plates
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US8048167B2 (en) 2005-08-30 2011-11-01 Depuy Products, Inc. Orthopaedic implant kit, orthopaedic surgery kit and associated method
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US9283075B2 (en) 2006-01-20 2016-03-15 Zimmer, Inc. Shoulder arthroplasty system
US11298234B2 (en) 2006-01-20 2022-04-12 Zimmer, Inc. Shoulder arthroplasty system
US9770334B2 (en) 2006-01-20 2017-09-26 Zimmer, Inc. Shoulder arthroplasty system
US10383735B2 (en) 2006-01-20 2019-08-20 Zimmer, Inc. Shoulder arthroplasty system
US11696837B2 (en) 2006-02-27 2023-07-11 DePuy Synthes Products, Inc. Intervertebral implant with fixation geometry
US10512548B2 (en) 2006-02-27 2019-12-24 DePuy Synthes Products, Inc. Intervertebral implant with fixation geometry
WO2008003597A1 (en) * 2006-07-03 2008-01-10 Aesculap Ag & Co. Kg Implant
US10137003B2 (en) 2007-11-16 2018-11-27 DePuy Synthes Products, Inc. Low profile intervertebral implant
US10543102B2 (en) 2007-11-16 2020-01-28 DePuy Synthes Products, Inc. Low profile intervertebral implant
US9744049B2 (en) 2007-11-16 2017-08-29 DePuy Synthes Products, Inc. Low profile intervertebral implant
US10531960B2 (en) 2008-11-07 2020-01-14 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly
US10433976B2 (en) 2008-11-07 2019-10-08 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly
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US9737407B2 (en) 2010-09-13 2017-08-22 Derek James Wallace McMinn Prosthetic component
US10507117B2 (en) 2010-12-21 2019-12-17 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
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US11458027B2 (en) 2010-12-21 2022-10-04 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US20130211535A1 (en) * 2012-02-10 2013-08-15 Stryker Ireland Ltd. Femoral prosthesis with an offset head
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US10130492B2 (en) 2014-10-22 2018-11-20 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
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