CH647942A5 - Femurkopf-prothese. - Google Patents

Femurkopf-prothese. Download PDF

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Publication number
CH647942A5
CH647942A5 CH8700/80A CH870080A CH647942A5 CH 647942 A5 CH647942 A5 CH 647942A5 CH 8700/80 A CH8700/80 A CH 8700/80A CH 870080 A CH870080 A CH 870080A CH 647942 A5 CH647942 A5 CH 647942A5
Authority
CH
Switzerland
Prior art keywords
prosthesis
trochanter
shaft
head prosthesis
support
Prior art date
Application number
CH8700/80A
Other languages
English (en)
Inventor
Bernhard Georg Prof Dr M Weber
Original Assignee
Sulzer Ag
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 Sulzer Ag filed Critical Sulzer Ag
Priority to CH8700/80A priority Critical patent/CH647942A5/de
Priority to AT0359181A priority patent/AT383489B/de
Priority to DE3132543A priority patent/DE3132543C2/de
Publication of CH647942A5 publication Critical patent/CH647942A5/de

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Classifications

    • 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802Equipment for handling bone cement or other fluid fillers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
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    • A61F2/30728Collars; Bone edge protectors
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    • 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
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    • A61F2/30739Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
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    • A61F2002/3006Properties of materials and coating materials
    • A61F2002/30065Properties of materials and coating materials thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
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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
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0071Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof thermoplastic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017Angular shapes
    • A61F2230/0026Angular shapes trapezoidal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0043L-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0095Saddle-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Prostheses (AREA)

Description

Die Erfindung betrifft eine in den Femur implantierbare Femurkopf-Prothese.
Infolge von Abbauerscheinungen und Déminéralisation des Knochen-Materials ist der Femurknochen, in den eine Hüftgelenk-Prothese eingesetzt werden soll - insbesondere in sogenannten Reoperationsfällen, bei denen eine früher eingesetzte Prothese durch eine neue ersetzt werden muss - im Höhenbereich des Adam-Bogens sehr oft nicht mehr gesund und tragfähig, während der als Muskelansatz wichtige grosse Trochanter noch keine krankhaften Veränderungen aufweist. Es besteht daher das Problem, dass der Knochen im Bereich des Adam-Bogens auf dem ganzen Umfang entfernt und ersetzt werden muss, während der grosse Trochanter erhalten bleiben sollte.
Aufgabe der Erfindimg ist es, eine Femurkopf-Prothese, insbesondere eine Reoperations-Prothese, zu schaffen, die eine Möglichkeit bietet, den grossen Trochanter funktionsfähig zu erhalten, obwohl der Knochen in einem gewissen Höhenbereich um den Adam-Bogen herum vollständig reseziert werden muss oder gar nicht mehr vorhanden ist.
Erfindungsgemäss wird diese Aufgabe gelöst durch eine lateral am Schaft der Prothese fixierte flächenhafte Trochanterstütze, die mit Bohrungen für das Fixieren des Trochanters und/oder von an ihm angreifenden Muskeln und Bändern versehen ist.
Mit der Erfindung werden der operativ entsprechend vorbereitete Trochanter und/oder die an ihm angreifenden Muskeln und Bänder auf der Trochanterstütze durch Annähen und zusätzliches Einwachsen von Gewebe fixiert, ohne dass eine direkte Verbindung aus natürlicher Gewebesubstanz zum Stamm des resezierten Femurknochens besteht. Die Fläche der Trochanterstütze kann dabei mit Vorteil gegen den Schaft satteldachartig abgewinkelt sein, um eine verbesserte Übertragung der von den Muskeln hervorgerufenen Torsionskräfte zu erreichen.
Sehr häufig ist es notwendig, während der Implantations-Operation die Höhe des Prothesenkopfes - unabhängig von der Höhenlage des Resektionsschnittes im Femurknochen -an einen Bezugspunkt des Skelettes, beispielsweise an das gegenseitige Gelenk oder den unteren Beckenrand, anzupassen. Dieses Anpassen kann erheblich erleichtert werden, wenn die Trochanterstütze lösbar auf den Prothesenschaft aufschiebbar ist, wobei die Trochanterstütze beispielsweise einen ringähnlichen Ansatz mit einer an die Form des Schaftes angepassten Durchstecköffnung hat. Auf diese Weise kann der Operateur aus einem Bausatz von Trochanterstüt-
zen, deren Ansätze unterschiedlich abgestufte Höhen haben, verschiedene Exemplare des Bausatzes versuchsweise während der Operation einsetzen und unter Umständen auswechseln, um möglichst eine optimale Anpassung der Höhenlage des Gelenkkopfes an die individuellen Grössenver-hältnisse des einzelnen Patienten zu erreichen.
Im folgenden wird die Erfindung anhand eines Ausführungsbeispiels im Zusammenhang mit der Zeichnung näher erläutert.
Fig. 1 ist ein Schnitt I-I von Fig. 2 oder 3 und zeigt eine Trochanterstütze im Längsschnitt, die am Schaft der Femurkopf-Prothese befestigt ist.
Fig. 2 und 3 sind eine Ansicht von links und eine Aufsicht auf eine vom Schaft der Prothese gelöste Trochanterstütze nach Fig. 1, während
Fig. 4 ein Schnitt IV-IV von Fig. 3 ist.
Der in Fig. 1 gezeigte Schaft einer Femurkopf-Prothese gehört zu einer sogenannten Reoperations-Prothese, die als Zweit- oder Drittprothese bei Patienten Verwendung findet, bei denen eine früher eingesetzte Femurkopf-Prothese aus irgendwelchen Gründen, beispielsweise wegen Lockerung, reoperiert und ersetzt werden muss. Der im wesentlichen geradlinige, in dem Femurknochen mittels Knochenzement zu fixierende Unterteil 1 des Schaftes geht oben in den Prothesenhals 2 über, in dem beispielsweise Öffnungen 3 für den Einsatz von Instrumenten vorgesehen sind. Der Prothesenhals 2 endet in einem Konus 4, auf den der nicht gezeigte Kugelkopf der Prothese aufgesetzt wird.
Lateral ist am Schaft bzw. am Prothesenhals 2 lösbar eine Trochanterstütze 5 befestigt, beispielsweise auf einen schwalbenschwanzartigen Ansatz 6 an der lateralen Begrenzung des Schaftes aufgeschoben. Die Trochanterstütze 5 besteht im wesentlichen aus einer satteldachartig geneigten Auflagefläche 7, die mit einer Vielzahl von in zwei Reihen angeordneten Bohrungen 8 und 9 versehen ist. Die äussere Reihe der Bohrungen 8 dient zum Teil zum Durchführen von Nahtmaterial, mit dem der grosse Trochanter und/oder die an ihm angreifenden Muskeln und Bänder auf der Auflagefläche 7 befestigt werden; in die nicht für den Durchtritt von Nahtmaterial benötigten Bohrungen 8 der äusseren Reihe und diejenigen 9 der inneren Reihe kann Gewebe einwachsen oder Knochenzement eindringen. Dieser wird den Bohrungen 9 der inneren Reihe beispielsweise über eine vertikale Längsbohrung 10 hinter dem Scheitel der Auflagefläche 7 zugeführt, mit der die Bohrungen 9 der inneren Reihe in Verbindung stehen.
Parallel zur Längsbohrung 10 verläuft «unter dem Dach» eine Ausnehmung 11, die zur Aufnahme des Ansatzes 6 des Prothesenschaftes in ihrem Oberteil sich nach oben konisch erweiternd schwalbenschwanzförmig ausgebildet ist (Fig. 4).
In der unteren Hälfte hat die Trochanterstütze 5 einen ringähnlichen Ansatz 12, der eine Durchstecköffnung 13 für den Unterteil des Prothesenschaftes hat; diese Durchstecköffnung 13 ist in ihrer Form an das distal an den Prothesenhals 2 anschliessende obere Ende des Schaftunterteils 1 ange-passt.
Wie bereits erwähnt, kann bei den einzelnen Elementen eines Bausatzes von Trochanterstützen 5 die Höhe H des Ansatzes 12 variieren und beispielsweise in Stufen von 3 oder 5 mm grösser werden. Damit wird - da sich der Ansatz 12 auf dem resezierten Femurknochen abstützt - die Höhe des Gelenkkopfes über der Femurschnittfläche noch während der Operation veränderbar.
Im Bereich des Ansatzes 12 sind zusätzliche Bohrungen und Kanäle 14 vorhanden, in die Knochenzement eindringen kann, um die Fixierung der Trochanterstütze 5 der Prothese zu verbessern.
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Sowohl der Prothesenschaft mit seinem Hals 2 als auch die Trochanterstütze 5 können aus einem der in der Implantattechnik verwendeten Werkstoffe oder Kombinationen davon gefertigt sein; mit Vorteil bestehen jedoch Schaft und
647 942
Hals 2 aus Metall oder einer Metall-Legierung, während sich für die Trochanterstütze 5 in erster Linie ein thermoplastischer Kunststoff, vorzugsweise Polyäthylen der Klassifikationen HDPE und UHMW, anbietet.
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S
1 Blatt Zeichnungen

Claims (4)

647 942
1. In den Femur implantierbare Femurkopf-Prothese, gekennzeichnet durch eine lateral am Schaft der Prothese fixierte flächenhafte Trochanterstütze (5), die mit Bohrungen (8,9) für das Fixieren des Trochanters und/oder von an ihm angreifenden Muskeln oder Bändern versehen ist.
2. Femurkopf-Prothese nach Anspruch 1, dadurch gekennzeichnet, dass die Trochanterstütze (5) lösbar auf den Prothesenschaft aufschiebbar ist.
2
PATENTANSPRÜCHE
3. Femurkopf-Prothese nach Anspruch 2, dadurch gekennzeichnet, dass die Trochanterstütze (5) einen ringähnlichen Ansatz (12) mit einer an die Form des Schaftes ange-passten Durchstecköffnung (13) hat.
4. Femurkopf-Prothese nach Anspruch 1, dadurch gekennzeichnet, dass die Fläche (7) der Trochanterstütze (5) gégen den Schaft satteldachartig abgewinkelt ist.
CH8700/80A 1980-11-25 1980-11-25 Femurkopf-prothese. CH647942A5 (de)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CH8700/80A CH647942A5 (de) 1980-11-25 1980-11-25 Femurkopf-prothese.
AT0359181A AT383489B (de) 1980-11-25 1981-08-17 Femurkopfendoprothese
DE3132543A DE3132543C2 (de) 1980-11-25 1981-08-18 Femurkopfendoprothese

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CH8700/80A CH647942A5 (de) 1980-11-25 1980-11-25 Femurkopf-prothese.

Publications (1)

Publication Number Publication Date
CH647942A5 true CH647942A5 (de) 1985-02-28

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ID=4343697

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Application Number Title Priority Date Filing Date
CH8700/80A CH647942A5 (de) 1980-11-25 1980-11-25 Femurkopf-prothese.

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AT (1) AT383489B (de)
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DE (1) DE3132543C2 (de)

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB8520360D0 (en) * 1985-08-14 1985-09-18 Thackray C F Ltd Joint prosthesis
US5314494A (en) * 1987-11-03 1994-05-24 Orthopaedic Technology B.V. Endo-prosthesis, a femoral head prosthesis and an acetabulum prosthesis
FR2666982B1 (fr) * 1990-09-21 1993-06-25 Impact Endoprothese orthopedique de moignon d'amputation de membre.
US5211666A (en) * 1991-04-22 1993-05-18 New York University Hip joint femoral component endoprosthesis with a lateral load-transferring support surface
US5258035A (en) * 1992-05-29 1993-11-02 Intermedics Orthopedics, Inc. Femoral prosthesis with wedge having opposed tapers
DE59308898D1 (de) * 1993-10-20 1998-09-24 Sulzer Orthopaedie Ag Endoprothesenschaft, insbesondere einer Femurschaftprothese, mit zugeordnetem Implantat
FR2732891B1 (fr) * 1995-04-12 1997-10-24 Setiey Louis Prothese femorale de reconstruction et ancillaire pour sa pose
FR2778090B1 (fr) * 1998-05-04 2000-10-06 Michel Porte Element de prothese de hanche a appui cortical externe pour fractures trochanteriennes et pince passe-cable pour la mise en place d'un tel element
FR2855395B1 (fr) * 2003-05-27 2006-02-24 Faher Mohcine Implant femoral de prothese de hanche
FR2892922B1 (fr) * 2005-11-08 2008-07-18 Ortho I D Sarl Implant trochanterien pour accrochage rapide du trochanter

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH543881A (de) * 1971-10-21 1973-11-15 Mathys Robert Schultergelenkkopfprothese
DE2555717C3 (de) * 1975-12-11 1981-11-19 Joachim Prof. Dr.Med. 6200 Wiesbaden Eichler Trochanterplatte für Hüftgelenkendoprothesen
CH622943A5 (en) * 1977-11-30 1981-05-15 Sulzer Ag Trochanter plate

Also Published As

Publication number Publication date
DE3132543A1 (de) 1982-06-03
DE3132543C2 (de) 1984-01-26
AT383489B (de) 1987-07-10
ATA359181A (de) 1986-12-15

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