CH647942A5 - Femurkopf-prothese. - Google Patents
Femurkopf-prothese. Download PDFInfo
- 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
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
-
- 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
- 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
- A61F2/30728—Collars; Bone edge protectors
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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
- A61F2/30721—Accessories
- A61F2/30739—Devices 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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- 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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- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/367—Proximal or metaphyseal parts of shafts
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06166—Sutures
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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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- A61F2/02—Prostheses implantable into the body
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- A61F2/02—Prostheses implantable into the body
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- A61F2002/3006—Properties of materials and coating materials
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- 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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- 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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- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections 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
-
- 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
- A61F2230/0017—Angular shapes
- A61F2230/0026—Angular shapes trapezoidal
-
- 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
- A61F2230/0043—L-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
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0095—Saddle-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
- 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
- A61F2310/00011—Metals or alloys
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- 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)
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.
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 |
Family
ID=4343697
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CH8700/80A CH647942A5 (de) | 1980-11-25 | 1980-11-25 | Femurkopf-prothese. |
Country Status (3)
Country | Link |
---|---|
AT (1) | AT383489B (de) |
CH (1) | CH647942A5 (de) |
DE (1) | DE3132543C2 (de) |
Families Citing this family (10)
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)
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 |
-
1980
- 1980-11-25 CH CH8700/80A patent/CH647942A5/de not_active IP Right Cessation
-
1981
- 1981-08-17 AT AT0359181A patent/AT383489B/de not_active IP Right Cessation
- 1981-08-18 DE DE3132543A patent/DE3132543C2/de not_active Expired
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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