FR2776917A1 - Medullary canal plug for use with femoral prosthesis - Google Patents

Medullary canal plug for use with femoral prosthesis Download PDF

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Publication number
FR2776917A1
FR2776917A1 FR9804331A FR9804331A FR2776917A1 FR 2776917 A1 FR2776917 A1 FR 2776917A1 FR 9804331 A FR9804331 A FR 9804331A FR 9804331 A FR9804331 A FR 9804331A FR 2776917 A1 FR2776917 A1 FR 2776917A1
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France
Prior art keywords
plug
opening
flanges
flange
medullary canal
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Granted
Application number
FR9804331A
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French (fr)
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FR2776917B1 (en
Inventor
Jean Louis Prudhon
Jacques Caton
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Groupe Lepine SAS
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Groupe Lepine SAS
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Priority to FR9804331A priority Critical patent/FR2776917B1/en
Publication of FR2776917A1 publication Critical patent/FR2776917A1/en
Application granted granted Critical
Publication of FR2776917B1 publication Critical patent/FR2776917B1/en
Anticipated expiration legal-status Critical
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • 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
    • 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
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
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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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    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
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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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    • A61F2002/30316—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
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30327—The prosthesis having different structural features at different locations within the same prosthesis differing in diameter
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • 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
    • A61F2/30767—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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30879—Ribs
    • 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
    • A61F2/30767—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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2/30767—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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
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    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
    • A—HUMAN NECESSITIES
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    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00365—Proteins; Polypeptides; Degradation products thereof
    • A61F2310/00383—Gelatin

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The plug (1) is made from a biocompatible material such as a gelatin and has two or more flexible collars (5) which press against the inner surface of the medullary canal bone cortex. It has a series of slits (10,11) which are offset relative to one another to allow air to pass through but prevent leakage of prosthesis cement.

Description

La présente invention concerne un bouchon médullaire.The present invention relates to a spinal plug.

Il est classique, lors de la mise en place d'une prothèse osseuse fixée au moyen d'un ciment polymérisable, de délimiter le fond de la cavité destinée à recevoir la prothèse et le ciment au moyen d'un bouchon médullaire. Un tel bouchon permet de séparer de manière étanche cette cavité et le reste du canal médullaire, pour prévenir la diffusion du ciment dans ce canal. De plus et surtout, cette étanchéité et l'immobilisation du bouchon dans le canal médullaire permettent une mise en pression du ciment lors de l'engagement de la prothèse dans la cavité, afin d'accroître la pénétration de ce ciment et d'éliminer les éventuelles bulles d'air.15 Les bouchons médullaires existants présentent les inconvénients, lorsqu'ils assurent la parfaite étanchéité de la cavité et qu'ils sont à même d'être immobilisés axialement dans le canal médullaire, d'être difficiles à  It is conventional, when placing a bone prosthesis fixed by means of a polymerizable cement, to delimit the bottom of the cavity intended to receive the prosthesis and the cement by means of a medullary plug. Such a plug makes it possible to seally seal this cavity and the rest of the medullary canal, to prevent the diffusion of cement in this canal. In addition and above all, this tightness and immobilization of the plug in the medullary canal allow the cement to be pressurized during the engagement of the prosthesis in the cavity, in order to increase the penetration of this cement and eliminate the possible air bubbles. 15 The existing medullary plugs have the disadvantages, when they ensure perfect sealing of the cavity and when they are able to be immobilized axially in the medullary canal, of being difficult to

enfoncer et à positionner au niveau adéquat dans ce canal.  push in and position at the appropriate level in this channel.

Des détériorations des bouchons ou des positionnements défectueux de ceux-ci peuvent se produire lors de cet enfoncement, et le retrait d'un bouchon détérioré, coincé  Deterioration of the plugs or defective positioning thereof may occur during this insertion, and the removal of a damaged plug, stuck

en fond de cavité, est très délicat à réaliser.  at the bottom of the cavity, is very difficult to achieve.

Des bouchons de plus faible diamètre réduisent cet inconvénient mais au détriment de l'étanchéité de la cavité et de leur immobilisation axiale, ce qui se répercute sur la possibilité de mise en pression du ciment. En outre, les bouchons existants ne permettent pas de solutionner le problème de la subsistance de bulles d'air au niveau de la partie distale de la prothèse, ces bulles pouvant être à l'origine de fendillements de la gaine de ciment sous l'effet des contraintes répétées que subit la prothèse, en particulier lorsqu'il s'agit d'une prothèse fémorale. Ces fendillements engendrent un risque de prise de jeu progressif de la prothèse, pouvant  Smaller diameter plugs reduce this drawback but to the detriment of the tightness of the cavity and their axial immobilization, which has repercussions on the possibility of pressurizing the cement. In addition, the existing plugs do not make it possible to solve the problem of the subsistence of air bubbles at the level of the distal part of the prosthesis, these bubbles being able to be the source of cracking of the cement sheath under the effect repeated stresses that the prosthesis undergoes, in particular when it is a femoral prosthesis. These splits generate a risk of progressive play of the prosthesis, which may

conduire à un descellement. La présente l'invention vise à remédier à ces inconvénients et à ce problème importants.  lead to loosening. The present invention aims to remedy these drawbacks and this important problem.

A cet effet, le bouchon médullaire qu'elle concerne présente un diamètre tel qu'il vient étroitement au contact de la corticale lors de son introduction dans le canal médullaire, et comprend au moins un passage aménagé à travers lui; ce passage a une section telle10 qu'il permet un écoulement de l'air au travers du bouchon et a une configuration tortueuse définissant une pluralité de chicanes, ces chicanes rendant très difficile, voire impossible, l'écoulement du ciment au travers du bouchon. Ce bouchon autorise ainsi le passage d'air à travers lui lors de son introduction dans le canal médullaire. Il n'y a donc pas, comme cela est le cas des  To this end, the medullary plug which it concerns has a diameter such that it comes into close contact with the cortex when it is introduced into the medullary canal, and comprises at least one passage arranged through it; this passage has a section such that it allows air to flow through the plug and has a tortuous configuration defining a plurality of baffles, these baffles making it very difficult, if not impossible, for the flow of cement through the plug. This plug thus allows the passage of air through it when it is introduced into the medullary canal. There is therefore not, as is the case of

bouchons de la technique antérieure, de piégeage d'air au-delà du bouchon côté distal lors de cette introduction, ni de création d'une surpression importante de cet air20 lors de l'enfoncement du bouchon.  plugs of the prior art, trapping air beyond the distal side plug during this introduction, or creating a significant overpressure of this air20 when the plug is pressed.

Le bouchon peut par conséquent être facilement mis en place sans risque de détérioration et être positionné au niveau adéquat dans le canal médullaire, tout en prenant étroitement appui contre la corticale, donc en  The plug can therefore be easily inserted without risk of deterioration and be positioned at the appropriate level in the medullary canal, while pressing closely against the cortex, therefore

assurant une parfaite étanchéité de la cavité et en étant parfaitement immobilisé dans ledit canal.  ensuring perfect sealing of the cavity and being perfectly immobilized in said channel.

De plus, il n'apparaît guère souhaitable de créer la surpression précitée au niveau de l'os spongieux distal, comme cela est le cas des bouchons de la technique antérieure, pour des raisons physiologiques. Le bouchon selon l'invention permet également de solutionner ce  In addition, it does not seem desirable to create the above-mentioned overpressure in the distal cancellous bone, as is the case with plugs of the prior art, for physiological reasons. The plug according to the invention also makes it possible to resolve this

problème spécifique.specific problem.

En outre, ledit passage peut recevoir, lors de l'introduction de la prothèse dans la cavité, l'air d'éventuelles bulles distales formées dans le ciment. Le volume dudit passage est alors mis légèrement en surpression sans que cela ne constitue une gêne particulière, les bulles ayant généralement des dimensions réduites. Le bouchon favorise ainsi l'élimination de ces bulles.5 De préférence, le bouchon comprend au moins deux collerettes flexibles aptes à prendre appui contre la  In addition, said passage can receive, during the introduction of the prosthesis into the cavity, the air of any distal bubbles formed in the cement. The volume of said passage is then slightly overpressure without this constituting a particular discomfort, the bubbles generally having reduced dimensions. The stopper thus promotes the elimination of these bubbles. 5 Preferably, the stopper comprises at least two flexible collars capable of bearing against the

corticale; chacune de ces collerettes présente une ouverture et l'ouverture d'une collerette est largement décalée angulairement par rapport à l'ouverture d'une10 collerette adjacente.  cortical; each of these flanges has an opening and the opening of a flange is largely angularly offset relative to the opening of an adjacent flange.

Ces collerettes, par leur prise d'appui, permettent une immobilisation fiable du bouchon, et participent à la configuration tortueuse du passage aménagé au travers de ce bouchon. De plus, elles15 délimitent entre elles des espaces relativement importants, pouvant recevoir l'air d'éventuelles bulles distales lors de l'introduction de la prothèse dans la  These collars, by their support socket, allow reliable immobilization of the plug, and participate in the tortuous configuration of the passage arranged through this plug. In addition, they define relatively large spaces between them, which can receive air from any distal bubbles when the prosthesis is inserted into the

cavité, sans surpression gênante.cavity, without annoying overpressure.

Le bouchon peut comprendre une portion circulaire proximale d'épaisseur périphérique plus importante que celle des collerettes, de manière à présenter une relative rigidité radiale et transversale, cette portion ayant un diamètre légèrement inférieur à celui des collerettes et comprenant elle aussi une ouverture largement décalée25 angulairement par rapport à l'ouverture que comprend la  The plug may comprise a proximal circular portion of greater peripheral thickness than that of the flanges, so as to have a relative radial and transverse rigidity, this portion having a diameter slightly smaller than that of the flanges and also comprising a widely angularly offset opening25 compared to the opening that includes the

collerette immédiatement adjacente.  immediately adjacent collar.

Cette portion forme une tête anti-basculement et, n'étant que peu ou pas déformable radialement, constitue un moyen de limitation de l'enfoncement du bouchon,  This portion forms an anti-tilting head and, being only slightly or not radially deformable, constitutes a means of limiting the insertion of the plug,

prévenant tout endommagement des collerettes.  preventing any damage to the flanges.

Avantageusement, l'ouverture d'au moins la collerette la plus distale est constituée par une encoche radiale. Cette encoche tend à se fermer lorsque la collerette est déformée par sa prise d'appui contre la corticale et que le bouchon est en position d'immobilisation. Cette fermeture assure la parfaite  Advantageously, the opening of at least the most distal collar is constituted by a radial notch. This notch tends to close when the flange is deformed by its support against the cortex and the plug is in the immobilized position. This closure ensures perfect

étanchéité du bouchon.sealing of the cap.

Le décalage angulaire des ouvertures est de préférence maximum, c'est-à-dire de 180 , d'une collerette, ou le cas échéant de ladite portion  The angular offset of the openings is preferably maximum, that is to say 180, of a flange, or if necessary of said portion

circulaire, à la collerette immédiatement adjacente.  circular, to the immediately adjacent flange.

Selon une forme de réalisation préférée de l'invention, le bouchon est réalisé en matière résorbable biocompatible. Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée du bouchon  According to a preferred embodiment of the invention, the stopper is made of absorbable biocompatible material. For a good understanding, the invention is again described below with reference to the appended schematic drawing representing, by way of nonlimiting example, a preferred embodiment of the stopper

médullaire qu'elle concerne.medullary it concerns.

La figure 1 en est une vue en perspective; la figure 2 en est une vue en bout, côté proximal; la figure 3 en est une vue de côté alors qu'il est mis en place dans le canal médullaire d'un fémur recevant une tige fémorale, et les figures 4 et 5 en sont des vues de côté dans  Figure 1 is a perspective view; Figure 2 is an end view, proximal side; Figure 3 is a side view while it is in place in the medullary canal of a femur receiving a femoral stem, and Figures 4 and 5 are side views in

le cas de deux canaux médullaires de diamètres différents.  the case of two medullary canals of different diameters.

Les figures représentent, sous différents angles, un bouchon médullaire 1 servant à délimiter le fond d'une cavité osseuse, cette cavité étant destinée à recevoir une prothèse et un ciment polymérisable de fixation de cette prothèse. Ainsi que le montre la figure 3, le bouchon 1 est destiné à séparer de manière étanche cette cavité 2 et le reste du canal médullaire 3, pour prévenir la diffusion du ciment dans ce canal 3, et à permettre une mise en pression du ciment lors de l'engagement de la prothèse 4 dans la cavité 2, afin d'accroître la pénétration de ce  The figures represent, from different angles, a medullary plug 1 serving to delimit the bottom of a bone cavity, this cavity being intended to receive a prosthesis and a polymerizable cement for fixing this prosthesis. As shown in FIG. 3, the plug 1 is intended for sealingly separating this cavity 2 and the rest of the medullary canal 3, to prevent the diffusion of the cement in this canal 3, and to allow pressurization of the cement during of the prosthesis 4 engaging in the cavity 2, in order to increase the penetration of this

ciment et d'éliminer les éventuelles bulles d'air.  cement and remove any air bubbles.

Le bouchon 1 est réalisé en une matière résorbable présentant un certain degré de flexibilité, telle qu'une gélatine biocompatible, et comprend trois collerettes 5 et une portion circulaire proximale 6, reliées les unes aux autres par des portions centrales rétrécies 7. Chaque collerette 5 présente une épaisseur qui diminue en direction de son bord périphérique, de sorte que sa zone périphérique présente une certaine souplesse telle que montrée à la figure 4. Une encoche radiale 10 est aménagée dans cette zone. Comme le montre plus particulièrement la figure 1, les encoches 10 de deux collerettes 5 adjacentes sont  The plug 1 is made of an absorbable material having a certain degree of flexibility, such as a biocompatible gelatin, and comprises three flanges 5 and a proximal circular portion 6, connected to each other by narrowed central portions 7. Each flange 5 has a thickness which decreases towards its peripheral edge, so that its peripheral zone has a certain flexibility as shown in FIG. 4. A radial notch 10 is arranged in this zone. As shown more particularly in FIG. 1, the notches 10 of two adjacent collars 5 are

aménagées avec un décalage angulaire de 180 .  fitted with an angular offset of 180.

La portion 6 a une épaisseur périphérique plus importante que celle des collerettes 5, de manière à  The portion 6 has a greater peripheral thickness than that of the flanges 5, so as to

présenter une relative rigidité radiale et transversale.  have relative radial and transverse rigidity.

Elle a un diamètre légèrement inférieur à celui des collerettes 5 et comprend une encoche radiale 11 décalée angulairement de 180 par rapport à l'encoche 10 que comprend la collerette 5 immédiatement adjacente. En pratique, les collerettes 5 présentent un diamètre tel qu'elles viennent étroitement au contact de la corticale 15 lorsque le bouchon 1 est introduit dans le canal 3, en se déformant le cas échéant pour s'adapter au diamètre de ce canal, ainsi que cela apparaît aux figures  It has a diameter slightly smaller than that of the flanges 5 and comprises a radial notch 11 angularly offset by 180 relative to the notch 10 that comprises the flange 5 immediately adjacent. In practice, the flanges 5 have a diameter such that they come into close contact with the cortex 15 when the plug 1 is introduced into the channel 3, deforming if necessary to adapt to the diameter of this channel, as well as it appears in the figures

4 et 5.4 and 5.

La portion 6 forme une tête anti-basculement, permettant la stabilisation axiale du bouchon 1. Elle est peu ou pas déformable radialement et constitue de plus, lorsque le canal 3 a un diamètre inférieur à celui des collerettes 5 comme le montre la figure 4, un moyen de30 limitation de l'enfoncement du bouchon 1, intervenant  The portion 6 forms an anti-tilting head, allowing the axial stabilization of the plug 1. It is little or not radially deformable and also constitutes, when the channel 3 has a diameter less than that of the flanges 5 as shown in FIG. 4, a means of limiting the depression of the plug 1, intervening

avant tout risque de détérioration des collerettes 5.  before any risk of damage to the flanges 5.

Ces collerettes 5, portions 6, 7 et encoches 10, 11 forment un passage aménagé à travers le bouchon 1, ce passage ayant une section telle qu'il permet un écoulement de l'air au travers du bouchon 1 et une configuration tortueuse définissant une pluralité de chicanes qui rendent très difficile, voire impossible, l'écoulement du ciment au travers de ce bouchon 1. L'invention fournit ainsi un bouchon médullaire présentant l'avantage de remédier aux inconvénients des bouchons de la technique antérieure, notamment en pouvant être facilement mis en place sans risque de détérioration et être positionné au niveau adéquat dans le canal médullaire, tout en prenant étroitement appui contre la corticale, donc en assurant une parfaite étanchéité de la10 cavité osseuse et en étant parfaitement immobilisé dans  These flanges 5, portions 6, 7 and notches 10, 11 form a passage arranged through the plug 1, this passage having a section such that it allows air to flow through the plug 1 and a tortuous configuration defining a plurality of baffles which make it very difficult, even impossible, for the cement to flow through this plug 1. The invention thus provides a medullary plug having the advantage of overcoming the drawbacks of plugs of the prior art, in particular by being able to be easily put in place without risk of deterioration and be positioned at the appropriate level in the medullary canal, while pressing closely against the cortex, therefore ensuring perfect sealing of the bone cavity and being perfectly immobilized in

ledit canal.said channel.

Il va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle en embrasse, au contraire, toutes les variantes de réalisation. Ainsi, la portion 6 pourrait  It goes without saying that the invention is not limited to the embodiment described above by way of example but that it embraces, on the contrary, all the variant embodiments. So portion 6 could

être remplacée par une ou plusieurs collerettes 5 supplémentaires.  be replaced by one or more additional collars 5.

Claims (4)

REVENDICATIONS 1 - Bouchon médullaire, caractérisé en ce qu'il présente un diamètre tel qu'il vient étroitement au contact de la corticale lors de son introduction dans le5 canal médullaire (3), et en ce qu'il comprend au moins un passage aménagé à travers lui; ce passage a une section  1 - Medullary plug, characterized in that it has a diameter such that it comes into close contact with the cortex when it is introduced into the medullary canal (3), and in that it comprises at least one passage arranged at through him; this passage has a section telle qu'il permet un écoulement de l'air au travers du bouchon (1) et a une configuration tortueuse définissant une pluralité de chicanes, ces chicanes rendant très10 difficile, voire impossible, l'écoulement du ciment au travers du bouchon (1).  such that it allows air to flow through the plug (1) and has a tortuous configuration defining a plurality of baffles, these baffles making it very difficult, if not impossible, for the flow of cement through the plug (1) . 2 - Bouchon selon la revendication 1, caractérisé en ce qu'il comprend au moins deux collerettes flexibles (5) aptes à prendre appui contre la corticale (15); chacune de ces collerettes (5) présente une ouverture (10) et l'ouverture (10) d'une collerette (5) est largement décalée angulairement par rapport à l'ouverture (10) d'une collerette (5) adjacente.  2 - Stopper according to claim 1, characterized in that it comprises at least two flexible collars (5) capable of bearing against the cortex (15); each of these flanges (5) has an opening (10) and the opening (10) of a flange (5) is largely angularly offset relative to the opening (10) of an adjacent flange (5). 3 - Bouchon selon la revendication 1 ou la revendication 2, caractérisé en ce qu'il comprend une portion circulaire proximale (6) d'épaisseur périphérique plus importante que celle des collerettes (5), de manière à présenter une relative rigidité radiale et transversale, cette portion (6) ayant un diamètre légèrement inférieur à celui des collerettes (5) et comprenant elle aussi une ouverture (11) largement décalée angulairement par rapport à l'ouverture (10) que comprend la collerette (5)3 - Stopper according to claim 1 or claim 2, characterized in that it comprises a proximal circular portion (6) of greater peripheral thickness than that of the flanges (5), so as to have a relative radial and transverse rigidity , this portion (6) having a diameter slightly less than that of the flanges (5) and also comprising an opening (11) largely angularly offset relative to the opening (10) that comprises the flange (5) immédiatement adjacente.immediately adjacent. 4 - Bouchon selon l'une des revendications 1 à 3,  4 - Stopper according to one of claims 1 to 3, caractérisé en ce que l'ouverture d'au moins la collerette (5) la plus distale est constituée par une encoche radiale (10).  characterized in that the opening of at least the most distal flange (5) is constituted by a radial notch (10). - Bouchon selon l'une des revendications 1 à 4,  - Cap according to one of claims 1 to 4, caractérisé en ce qu'il est réalisé en matière résorbable  characterized in that it is made of absorbable material biocompatible.biocompatible.
FR9804331A 1998-04-02 1998-04-02 MEDULAR CAP Expired - Lifetime FR2776917B1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001060288A1 (en) * 2000-02-18 2001-08-23 Isotis N.V. Plug for insertion into a bone canal

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0006408A1 (en) * 1978-06-30 1980-01-09 HOWMEDICA INTERNATIONAL, INC. Zweigniederlassung Kiel Auxiliary device insertable in a medullary canal for ensuring the fixation of an implanted prosthesis
US4245359A (en) * 1978-03-28 1981-01-20 Sulzer Brothers Limited Plug for openings produced by operative procedures in medullated bones
US4293962A (en) * 1980-02-14 1981-10-13 Zimmer Usa, Inc. Bone plug inserting system
US4447915A (en) * 1981-02-18 1984-05-15 Sulzer Brothers Limited Expandable medullary canal plug
DE19542351A1 (en) * 1995-11-14 1997-05-15 Jansson Volkmar Priv Doz Dr Me Closure device for closing off opening to medulla

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4245359A (en) * 1978-03-28 1981-01-20 Sulzer Brothers Limited Plug for openings produced by operative procedures in medullated bones
EP0006408A1 (en) * 1978-06-30 1980-01-09 HOWMEDICA INTERNATIONAL, INC. Zweigniederlassung Kiel Auxiliary device insertable in a medullary canal for ensuring the fixation of an implanted prosthesis
US4293962A (en) * 1980-02-14 1981-10-13 Zimmer Usa, Inc. Bone plug inserting system
US4447915A (en) * 1981-02-18 1984-05-15 Sulzer Brothers Limited Expandable medullary canal plug
DE19542351A1 (en) * 1995-11-14 1997-05-15 Jansson Volkmar Priv Doz Dr Me Closure device for closing off opening to medulla

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001060288A1 (en) * 2000-02-18 2001-08-23 Isotis N.V. Plug for insertion into a bone canal
US6752833B2 (en) 2000-02-18 2004-06-22 Isotis N.V. Plug for insertion into a bone canal

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