AU2004216605A1 - Prosthesis for the gleniod cavity of the scapula - Google Patents

Prosthesis for the gleniod cavity of the scapula Download PDF

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Publication number
AU2004216605A1
AU2004216605A1 AU2004216605A AU2004216605A AU2004216605A1 AU 2004216605 A1 AU2004216605 A1 AU 2004216605A1 AU 2004216605 A AU2004216605 A AU 2004216605A AU 2004216605 A AU2004216605 A AU 2004216605A AU 2004216605 A1 AU2004216605 A1 AU 2004216605A1
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AU
Australia
Prior art keywords
prosthesis
glenoid cavity
seat
intended
scapula
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
AU2004216605A
Other versions
AU2004216605B2 (en
Inventor
Laurent Beguin
Denis Bouttens
Yann Brunnarius
Charles Cohn
Geert Declercq
Jean Grimberg
Dominique Huguet
Eric Lesprit
Pierre Massart
Bruno Rio
Jacques Teissier
Bruno Toussaint
Bruno Zipoli
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.)
Biomet France SARL
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Biomet France SARL
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Filing date
Publication date
Application filed by Biomet France SARL filed Critical Biomet France SARL
Publication of AU2004216605A1 publication Critical patent/AU2004216605A1/en
Application granted granted Critical
Publication of AU2004216605B2 publication Critical patent/AU2004216605B2/en
Ceased legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4081Glenoid components, e.g. cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
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    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
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    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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    • A61F2002/30331Connections 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
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    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30334Cone of elliptical or oval basis
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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)
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  • Prostheses (AREA)

Abstract

The prosthesis consists of a base with anchoring screws and a plate designed to receive male and female inserts. The outer surface of its peripheral rim is in the shape of a truncated Morse cone to engage with a male insert having an aperture of matching shape, and it has cavities to receive a female insert that clips into place.

Description

I
AUSTRALIA
PATENTS ACT 1990 COMPLETE SPECIFICATION NAME OF APPLICANT(S):: Biomet France AND Laurent Beguin AND Denis Bouttens AND Charles Cohn AND Bruno Rio AND Jean Grimberg AND Dominique Huguet AND Eric Lesprit AND Pierre Massart AND Geert Declercq AND Bruno Zipoli AND Bruno Toussaint AND Jacques Teissier ADDRESS FOR SERVICE: DAVIES COLLISON CAVE Patent Attorneys Level 10, 10 Barrack Street,Sydney, New South Wales, Australia, 2000 INVENTION TITLE: Prosthesis for the glenoid cavity of the scapula The following statement is a full description of this invention, including the best method of performing it known to me/us:-
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PROSTHESIS FOR THE GLENOID CAVITY OF THE SCAPULA The invention concerns a prosthesis for the glenoid cavity of the scapula and relates generally to shoulder prostheses.
Depending on the nature of the pathology affecting a patient's shoulder (pain, arthrosis, polyarthritis, tendon or muscle problems, trauma, etc.), it is sometimes necessary to fit a prosthesis of the glenoid cavity, especially when said glenoid cavity has been destroyed partially or completely, but also when a rupture of the rotator cuff is observed.
Traditionally, this prosthesis is in the form of a seat which is fixed in said glenoid cavity of the scapuia, or at least what remains of this. Such a glenoid cavity is described, for example, in document FR-A-2 683 142.
The glenoid cavity prostheses known at present are intended to receive an insert which is intended to cooperate with the humeral head or with a humeral implant, and they are thus in the form of a concavity of substantially complementary shape generally not congruent with said humeral head or with said humeral implant. In other words, the insert is generally a female component.
However, depending on the pathology observed, it may sometimes be necessary to use not a female component, but instead a male component, which is then in the form of a spherical or substantially spherical head fixed on the seat of the glenoid cavity prosthesis. In this case, it is therefore generally necessary to employ another glenoid cavity prosthesis in order to permit use of such a male insert.
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2 In other words, the prosthesis in question does not provide the modular character which is desired by practitioners, but which is also desirable from the economic point of view.
Document FR-A-2 652 498 has described a total shoulder prosthesis having a certain modular character. In this document, both the humeral implant and the glenoid cavity prosthesis comprise complementary elements which provide for this modular character. As regards the glenoid cavity prosthesis, these elements are fixed to the periphery of the seat, in particular by cooperation of an internal thread on the insert and an external thread on the seat. However, in use, this mode of fixation is found to be unsatisfactory on account of the risks of micro-movements which may occur and which may thus cause risks of loosening of the glenoid cavity prosthesis. In parallel, in the movements of the articulation in question, wear is observed in the glenoid cavity bone in the area of which said prosthesis is implanted, inherent to the implant, resulting in a rupturing of the fixation means of the seat constituting the implant.
The object of the present invention is to make available a prosthesis for the glenoid cavity of the scapula which also has this modular character and overcomes the disadvantages mentioned above.
This prosthesis for the glenoid cavity of the scapula comprises a seat, intended to be fixed to the glenoid cavity of the patient to be treated by means of anchoring screws, said seat comprising a plate able to receive a female insert, and said seat being able to receive a male insert, said inserts being intended to cooperate with the humeral head of the shoulder joint in question or with a humeral implant fitted in the area of said joint.
-3- This prosthesis is characterized: in that the outer face of the peripheral rim, with which the seat is provided, is configured as a truncated morse cone able to cooperate with a male insert provided with a bearing surface of complementary shape, and in that the plate of the seat is provided with means intended to cooperate with a female insert in order to ensure that the latter is fixed by clipping into it.
According to the invention, the seat is provided with two through-holes, each of them inclined by an angle value of between 200 and 350 relative to the general plane of the plate, and being intended to permit the passage of anchoring screws into the glenoid cavity.
According to the invention, the face of the seat, intended to come into contact with the bone of the glenoid cavity, is bulged and is provided with a stem intended to be implanted in said glenoid cavity.
In addition, this same face advantageously has two flat areas situated at end positions relative to the bulged part, and thus situated on either side of the bulged zone and intended to bear inside the glenoid cavity, after suitable reaming. This being so, these flat areas provide a stabilizing function for the prosthesis, avoiding the tilting phenomena inherent to the anatomical functioning of the joint, and reinforcing the primary stability of said prosthesis.
In addition, and according to another characteristic of the invention, the stem continuing the face of the seat intended to come into contact wirh the bone of the glenoid cavity is provided with holes in such a way as to promote secondary fixation of the prosthesis by bone growth or migration.
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4 According to the invention, the means ensuring the cooperation and fixation of the female insert with the plate of the seat consist of blind holes able to cooperate with pins of suitable diameter issuing from the lower part of the female insert, or of recesses formed at the internal periphery of and inside the seat and able to cooperate with projections of corresponding dimensions issuing from the base of the female insert.
According to another characteristic of the invention, the through-holes in the plate are each provided with an expansion socket which is able to cooperate with the anchoring screws and which is intended to immobilize said screw in the orientation chosen by the practitioner. This socket is itself provided with peripheral studs projecting from its outer envelope, said studs being intended to be received in corresponding recesses formed in a ring welded inside said holes.
The manner in which the invention is realized and the advantages which derive from it will be better appreciated from the following illustrative embodiment which is given as a nonlimiting example and with reference to the attached figures.
Figure 1 is a diagrammatic perspective view of the seat of the glenoid cavity prosthesis according to the invention, provided with its anchoring screws.
Figure 2 is a side view of the seat from Figure 1.
Figure 3 is a diagrammatic cross-sectional view of the seat from Figure 1.
Figure 4 is a diagrammatic persnective view of the seat according to the invention in a simplified version and seen from above.
5 Figure 5 is a diagrammatic perspective view of the seat O from Figure 4 seen from below.
SFigure 6 is a detail from Figure Figure 7 is a diagrammatic perspective view of an expansion socket according to the invention.
O
\D Figure 8 is a diagrammatic perspective view of a ring according to the invention, intended to cooperate with the socket from Figure 7, and of which Figure 9 is a O plan view.
Figure 10 is a diagrammatic perspective view of the seat of the glenoid cavity prosthesis according to the invention, provided with a female insert.
Figure 11 is a side view of Figure Figure 12 is a diagrammatic perspective bottom view of the female insert according to the invention.
Figure 13 is a diagrammatic perspective view of the seat of the glenoid cavity according to the invention, provided with a male insert according to the invention.
Figure 14 is a side view of Figure 13.
Figure 15 is a diagrammatic perspective bottom view of the male insert according to the invention.
The prosthesis for the glenoid cavity of the scapula according to the present invention has thus been shown in Figures 1 to 6. Basically, this prosthesis consists of a seat comprising a plate which is intended to be fixed by anchoring in the osseous glenoid cavity of the patient to be treated, after preparation, and in particular reaming, by the practitioner.
I
6 This seat thus has a substantially plane front or O upper face, called the plate and a lower face Sintended to come into contact with the bone. According Sto one characteristic of the invention, this lower face is bulged as can be seen from Figures 2 and 5. In addition, the lower face has two flat areas (23) situated on either side of the bulged shape This particular shape helps give a certain stability to the
\O
IND prosthesis when it is being fitted. Indeed, the combination of the bulged shape and of the flat areas cooperating with reamed zones previously formed Sin the osseous glenoid cavity makes it possible, in the first instance, to optimize the contact between bone and implant and, in addition, to avoid the phenomena of tilting of the seat, and thus of the prosthesis, which phenomena are inherent to the actual functioning of the shoulder joint.
This stability is additionally optimized by the presence of a stem oriented substantially perpendicularly with respect to the seat and continuing said bulged part This stem is intended to be positioned in a bore which the practitioner has formed beforehand in the osseous glenoid cavity.
According to one characteristic of the invention, this stem is provided with a through-hole along its generatrix and a through-hole at its lower end.
These through-holes are intended to promote the holding of the prosthesis by secondary fixation (bone migration and growth) By virtue of i-s structure, this seat makes it possible to preserve as much as possible of the bone of the gienoid cavity.
7 Consequently the seat is anchored in the glenoid cavity by means of two anchoring screws For this purpose, the plate of the seat is provided with two inclined through-holes in order to promote the passage of the screws around an immobilizing system described below in more detail.
These screws can be oriented by approximately 12° relative to the axis of the holes in order to allow the practitioner to place them in the supraglenoid and infraglenoid tubercles.
The holes are inclined by an angle value of about relative to the plane containing the upper face of the plate of the seat. The screws, advantageously made of titanium alloy or stainless steel, are selfdrilling, self-tapping and retrocutting. The conical core of the rods and the cylindrical threading with which they are provided promote anchoring in the bone, and in particular in the glenoid cavity in question.
The screw head is conical and has a quadruple threading intended to cooperate with the immobilizing system.
More precisely, the screw head is provided with four parallel threads opening out at the lower base of the head at an angle of 90° between two consecutive threads. These four threads are intended to cooperate with a corresponding quadruple threading formed in the inner wall of the immobilizing system, described below in more detail. By means of this quadruple threading, the practitioner is aided in his task of introducing the screws, insofar as the number of possibilities of locking the screw to the immobilizing system is multiplied by sixteen.
The immnobilizing system, to which reference has been made above, is formed by an expansion sockez (24) and a ring This socket is slit (26) along one of its generatrices, so as to allow its expansion. It has a 8 quadruple internal threading (27) intended to cooperate with the quadruple threading of the heads of the screws This being the case, screwing of the screw into the socket (24) spreads the latter apart, and it is then immobilized, in the area of the ring (25) welded in each of the holes situated inside the seat, at the orientation desired by the practitioner. Tn addition, the base of the socket (24) is provided with .three studs (28) which project from the envelope of the ball, are periodically distributed and are intended to be received in corresponding recesses (29) of said ring This being the case, by virtue of the cooperation between the studs (28) and the recesses the socket (24) cannot turn during fitting of the screws by the practitioner.
According to the invention, the plate of the seat is provided at its periphery with a rim of particular shape, since it is in the form of a morse cone, or, more exactly, a truncated morse cone. It is intended to cooperate with the male insert described below in more detail.
The female insert (10) according to the invention has been shown in Figures 10 to 12. It is intended to cooperate with the seat described above. This insert is made in particular of polyethylene. It has a minimum thickness of 5 mm in the area of its thinnest zone. It is provided, on its lower face with two positioning and fixing pins (12) which are intended to cooperate, by clipping action, with blind holes (22) formed in the plate of the seat.
This female insert (10) thus clips onto said seat, on the one hand through the cooperation of the pins (12) with the holes and, on the other hand, through the cooperation between the internal periDheral edge (14) of the insert on the inner wall (15) of the peripheral rim of the seat. In addition, the
I
9 antero-posterior zones (30) of the insert have increased material, making it possible to increase the life of the implant. This is because, given the stressing of the insert in this area, inherent to the mode of functioning of the joint, greater wear is generally observed at this level. Finally, the lower face (13) of the insert is provided with cutouts (11) guaranteeing the passage of the screw heads The upper face (16) of the insert is of concave shape, in particular of anatomical shape, able to cooperate with the humeral head or with a humeral implant in the context of the use of a total shoulder prosthesis.
The use of a male insert in relation with the seat according to the invention has been shown in Figures 13 to 15. This male insert (17) is of hemispherical shape, its pole (18) being provided with a hole (19) intended to allow it to be fitted on the seat by a suitable ancillary device, or to be removed therefrom.
This male insert (17) is made of stainless steel, for example. It is fixed on the seat by conical engagement on the morse cone formed at the periphery of the rim of said seat. More precisely, it is engaged in the area of its lower internal wall as will be seen in Figure 15. This fixation is additionally secured by means of a screw passing through the hole (19) and being screwed into a threaded hole (31) formed on the plate of the seat All the benefits of the prosthesis according to the invention will be appreciated, in particular its modular character which allows the practitioner, using a standard seat, to use an insert adapted to the trauma or to the pathology, said insert being able to be positioned easily and rezliably, avoiding thdisadvantages associated with the phenomena o migration and instability, both of the seat and of the inserts.
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-9A- Throughout this specification and the claims which follow, unless the context requires otherwise the word "comprise", or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.
The reference to any prior art in this specification is not, and should not be taken as an acknowledgment or any form of suggestion that, that prior art forms part of the common general knowledge of Australia.

Claims (12)

1. Prosthesis for the glenoid cavity of the scapula, comprising a seat intended to be fixed to the glenoid cavity of the patient to be treated by means of anchoring screws said seat (1) comprising a plate able to receive a male insert and said seat being able to receive a female insert said inserts (10, 17) being intended to cooperate with the humeral head of the shoulder joint in question or a humeral implant fitted in the area of said joint, characterized: in that the outer face of the peripheral rim with which the seat is provided, is configured as a truncated morse cone able to cooperate with a male insert (17) provided with a bearing surface of complementary shape, and in that the plate of the seat is provided with means (22) intended to cooperate with a female insert (10) in order to ensure that the latter is fixed by clipping into it.
2. Prosthesis for the glenoid cavity of the scapula according to Claim 1, characterized in that the plate is provided with two through-holes each of them inclined by an angle value of between 200 and 350 relative to the general plane of the plate, and being intended to permit the passage of anchoring screws into the glenoid cavity.
3. Prosthesis for the glenoid cavity of the scapula according to either of Claims 1 and 2, characterized in that the rear face of the seat, intended to cooperate with the glenoid cavity, is bulged and is provided with a stem (6) intended to be implanted in said glenoid cavity. I 11
4. Prosthesis for the glenoid cavity of the scapula Q^ according to Claim 3, characterized in that the )rear face of the seat intended to cooperate with the glenoid cavity, has two flat areas (23) situated at end positions relative to the bulged part and thus situated on either side of the bulged zone and intended to bear inside the \O \O glenoid cavity. Cq Prosthesis for the glenoid cavity of the scapula according to either of Claims 3 and 4, characterized in that the stem continuing the rear face of the seat is provided with holes (7, 8) in such a way as to promote secondary fixation of the prosthesis by bone growth or migration.
6. Prosthesis, for the glenoid cavity of the scapula according to one of Claims 1 to 5, characterized in that the means ensuring the cooperation and fixation of the female insert (10) with the plate of the seat consist of blind holes (22) able to cooperate with pins (12) of suitable diameter issuing from the lower part of the female insert or of recesses formed at the internal periphery of and inside the seat and able to cooperate with projections of corresponding dimensions issuing from the base of the female insert.
7. Prosthesis for the glenoid cavity of the scapula according to one of Claims 1 to 6, characterized in that the holes in the plate are each provided with an expansion socket (24) which is able to cooperate with the anchoring screws and which is intended to immobilize said screw in the orientation chosen by the practitioner. 12
8. Prosthesis for the glenoid cavity of the scapula according to one of Claims 1 to 7, characterized in that the anchoring screws are self- drilling, self-tapping and retrocutting.
9. Prosthesis for the glenoid cavity of the scapula according to Claim 7, characterized in that the ball (24) is provided with peripheral studs (28) projecting from its outer envelope, said studs (28) being intended to be received in corresponding recesses or indentations (29) formed in a ring (25) welded in said holes (4) Prosthesis for the glenoid cavity of the scapula according to one of Claims 6 to 9, characterized in that the female insert (10) is provided with two fixing pins (12) intended to clip into the holes (22) formed in the plate of the seat and in that its lower face is provided with cutouts (11) intended to permit the passage of the heads of the anchoring screws
11. Prosthesis for the glenoid cavity of the scapula according to one of Claims 6 to 10, characterized in that the female insert (10) has an increased thickness in the area of its antero-posterior zones
12. Prosthesis for the glenoid cavity of the scapula according to one of Claims 1 to 11, characterized in that the anchoring screws can be oriented by an angle value of approximately 120 inside the through-holes of the plate (2) I -13-
13. A prosthesis for the glenoid cavity of the scapula substantially as hereinbefore described with reference to the drawings.
14. The steps, features, compositions and compounds disclosed herein or referred to or indicated in the specification and/or claims of this application, individually or collectively, and any and all combinations of any two or more of said steps or feaures. DATED this 2 8 t h day of September, 2004 BIOMET FRANCE, LAURENT BEGUIN, DENIS BOUTTENS, CHARLES COHN, BRUNO RIO, JEAN GRIMBERG, DOMINIQUE HUGUET, ERIC LESPRIT, PIERRE MASSART, JACQUES TEISSIER, BRUNO TOUSSAINT, BRUNO ZIPOLI, GEERT DECLERCQ By Their Patent Attorneys DAVIES COLLISON CAVE
AU2004216605A 2003-10-01 2004-09-29 Prosthesis for the gleniod cavity of the scapula Ceased AU2004216605B2 (en)

Applications Claiming Priority (2)

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FR03.11511 2003-10-01
FR0311511A FR2860426B1 (en) 2003-10-01 2003-10-01 GLENOID CAVITY PROSTHESIS OF SCAPULA

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JP4624052B2 (en) 2011-02-02
FR2860426B1 (en) 2006-05-26
EP1520561A1 (en) 2005-04-06
DE602004025317D1 (en) 2010-03-18
ATE456338T1 (en) 2010-02-15
ES2340926T3 (en) 2010-06-11
EP1520561B1 (en) 2010-01-27
FR2860426A1 (en) 2005-04-08

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