CH661862A5 - Endoprothesenschaft. - Google Patents

Endoprothesenschaft. Download PDF

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Publication number
CH661862A5
CH661862A5 CH23/84A CH2384A CH661862A5 CH 661862 A5 CH661862 A5 CH 661862A5 CH 23/84 A CH23/84 A CH 23/84A CH 2384 A CH2384 A CH 2384A CH 661862 A5 CH661862 A5 CH 661862A5
Authority
CH
Switzerland
Prior art keywords
shaft
bone
endoprosthesis
prosthesis
socket
Prior art date
Application number
CH23/84A
Other languages
English (en)
Inventor
Friedrich Josef Dr Esper
Walter Dr Gohl
Original Assignee
Bosch Gmbh Robert
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 Bosch Gmbh Robert filed Critical Bosch Gmbh Robert
Publication of CH661862A5 publication Critical patent/CH661862A5/de

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
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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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • 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
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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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    • A61F2/00—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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    • A61F2/00—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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    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/308—Blind bores, e.g. of circular cross-section oblong
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30807—Plurality of blind bores
    • 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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30807—Plurality of blind bores
    • A61F2002/30808—Plurality of blind bores parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30807—Plurality of blind bores
    • A61F2002/3081—Plurality of blind bores inclined obliquely with respect to each other
    • 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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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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    • A—HUMAN NECESSITIES
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    • 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
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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
    • 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
    • A61F2230/0034—D-shaped

Landscapes

  • 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)

Description

661 862

Claims (4)

PATENTANSPRÜCHE
1. Endoprothesenschaft für eine Hüftgelenk-Endopro-these mit zugkraftentlastender Wirkung, gekennzeichnet durch Vertiefungen (11) mit dazwischen befindlichen Rippen (12) auf der Oberseite (6) im oberen Teil des Schaftes (1).
2. Endoprothesenschaft nach Anspruch 1, dadurch gekennzeichnet, dass die Vertiefungen (11) in Richtung senkrecht zur Längsrichtung des Schaftes (1) unterbrochen sind unter Ausbildung eines Steges (13) in der Mitte der Oberseite (6) des Schaftes (1).
3. Endoprothesenschaft nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass die Oberseite (6) des Schaftes (1) Noppen (7) zur Zugkraftaufnahme und/oder die Unterseite (4) des Schaftes (1) Noppen (5) zur Druckkraftaufnahme und/oder die Schaftseitenflächen (8) Vertiefungen (9) zur Kraftaufnahme aufweisen.
4. Endoprothesenschaft nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass der Schaft (1) aus einem
T riazinharz/Kohlefaser-Verbundwerkstoff besteht.
Die Erfindung geht aus von einem Endoprothesenschaft nach der Gattung des unabhängigen Anspruchs. Die Femur-komponente einer Hüftgelenk-Endoprothese muss dauerhaft fest im Restknochen verankert sein. Eine Voraussetzung dafür ist die Beachtung des Wolff sehen Transformationsgesetzes, wie es in J. Wolff, «Das Gesetz der Transformation der Knochen», Hirschwald, Berlin 1892 beschrieben ist. Demnach ist die Anpassung des prothetisch versorgten, lebenden Restknochens an den durch die Resektion zwangsläufig gestörten Kraftverlauf nur möglich, wenn dieser nicht zu stark von dem natürlichen Verlauf abweicht. Vor allem sind unphysiologische Zugspannungsspitzen im Bereich der Resektionsebene zu vermeiden. Dies bedeutet, dass der Prothesenschaft so gestaltet sein muss, dass der Kraftübergang in den Restknochen möglichst gleichmässig über den gesamten Knochen/Prothesen-Verbund geschieht. — Eine Schaftprothese mit Zugentlastung wurde bereits von Ritter angegeben (vgl. A. Grünert, C. H. Schweickert, «Die Zuggurt-Hüften-doprothese», Ber. orthop. Unfall-Chir. 86,49 — 66,1977). Bei dieser Prothese wird zusätzlich ein Zuggurt zwischen lateraler und medialer Seite der Prothese angebracht, die es erforderlich macht, dass zur Befestigung des Gurtes sowohl der Restknochen als auch die Prothese durchbohrt werden, um die Verankerungsschraube für den Gurt befestigen zu können. Eine derartige Zugentlastung ist naturgemäss sehr aufwendig, erfordert eine Änderung der Operationstechnik — sie wird schwieriger — und verlangt schliesslich auch ein neues Instrumentarium, gemessen an den Prothesen ohne eine derartige Zugentlastung.
Der erfmdungsgemässe Endoprothesenschaft mit den kennzeichnenden Merkmalen des Anspruchs 1 hat demgegenüber den Vorteil, dass durch die angegebene Profilierung des Schaftes, das System Schaft-Restknochen derart versteift wird, dass die Belastungsverhältnisse des Knochens hauptsächlich auf der medialen Seite denen im gesunden Femur nahe kommen. Besonders wird der Kraftfluss in und nahe der Resektionsebene den natürlichen Verhältnissen angenähert, wodurch eine unerwünschte Knochendeformation und als Folge davon eine Prothesenlockerung verhindert wird. Die Operationstechnik muss nicht geändert werden und die Schaftprofilierung wirkt sich auch nicht erschwerend auf die Operationstechnik aus.
Durch die in den abhängigen Ansprüchen aufgeführten Massnahmen sind vorteilhafte Weiterbildung und Verbesserungen des im Anspruch 1 angegebenen Endoprothesen-schaftes möglich. Besonders vorteilhaft ist es, wenn die Vertiefungen in Richtung senkrecht zur Längsrichtung des Schaftes unterbrochen sind unter Ausbildung eines Steges in der Mitte der Oberseite des Schaftes, da hierdurch nochmals eine sehr effektive Sicherung gegen das Verdrehen des Prothesenschaftes geschaffen wird.
Ein Ausführungsbeispiel der Erfindung ist in der Zeichnung dargestellt und in der nachfolgenden Beschreibung näher erläutert. Es zeigen Figur 1 eine Draufsicht auf die Unterseite (a), eine Seitenansicht (b) sowie eine Draufsicht auf die Oberseite des erfindungsgemässen Endoprothesenschaf-tes sowie Figur 2 die Seitenansicht eines erfindungsgemässen Endoprothesenschaftes im Femur zur Erläuterung der auftretenden Kraftverhältnisse.
Der Endoprothesenschaft besteht aus dem eigentlichen Schaft 1, dem auf der Resektionsebene aufliegenden Kragen 2 sowie einem Konus 3, der als Träger für die nichtdarge-stellte Femurkugel dient. Auf der Unterseite 4 des Schaftes 1 befinden sich Noppen 5 zur Druckkraftaufnahme, während die Oberseite 6 des Schaftes 1 Noppen 7 zur Zugkraftaufnahme aufweist. Die Seitenflächen 8 schliesslich weisen Vertiefungen 9 mit einem Tragrippeneffekt in Schaftlängsrichtung auf, die ebenfalls eine vor allem für den medialen Fe-murbereich entlastende Wirkung haben. Das gleiche gilt für die Kehlen 10 im Schaftkragen 2. Auf der Oberseite 6 des Schaftes 1 sind im oberen Teil in der Nähe des Kragens 2 Vertiefungen 11 mit dazwischen befindlichen Rippen 12 vorgesehen, wobei die Vertiefungen 11 in der Mitte der Oberseite 6 unterbrochen sind unter Bildung eines Steges 13, der ebenfalls Kräfte aufnehmen soll. Voraussetzung für die Kraftaufnahme in allen Fällen ist, dass der Knochen möglichst schnell und ohne wesentliche Bindegewebebildung in die Vertiefungen hinein- bzw. an die Erhöhungen heranwächst.
Schaft 1, Kragen 2 und Konus 3 bestehen aus einem Stück und können prinzipiell aus jedem für derartige Endoprothesen geeigneten Material hergestellt sein. Besonders bewährt hat sich als derartiges Material ein Triazinharz/Kohle-faser-Verbundwerkstoff, wie er zusammen mit der Herstellung von Prothesen aus einem derartigen Material in der DE-OS 2 941 369 beschrieben ist. Figur 2 zeigt die Kraftverhältnisse im Prothesen/Knochenverbund. In dieser Figur ist auch die Femurkugel 14 angedeutet. Der Restknochen ist mit 15 bezeichnet. Die aufgebrachte Last P erzeugt im Prothesenschaft 1 ein Biegemoment. Dadurch entsteht im Knochenbereich B eine zusätzliche Belastung. Diese kann durch Abfangen der Zugkräfte im Bereich A vermindert werden. Dies geschieht durch die Zugentlastungsrippen 12 auf der Oberseite 6 des Schaftes 1, wenn der Knochen, wie oben schon erwähnt — in die Vertiefungen hineingewachsen ist. Der in die Vertiefungen 11 zwischen die Rippen 12 eingewachsene Knochen nimmt grossflächig die Zugkräfte auf der lateralen Seite des Implantates auf und entlastet damit die mediale Seite, insbesondere die kritische Stelle bei B.
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1 Blatt Zeichnungen
CH23/84A 1983-01-18 1984-01-04 Endoprothesenschaft. CH661862A5 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19833301415 DE3301415A1 (de) 1983-01-18 1983-01-18 Endoprothesenschaft

Publications (1)

Publication Number Publication Date
CH661862A5 true CH661862A5 (de) 1987-08-31

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CH23/84A CH661862A5 (de) 1983-01-18 1984-01-04 Endoprothesenschaft.

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US (1) US4535487A (de)
CH (1) CH661862A5 (de)
DE (1) DE3301415A1 (de)
FR (1) FR2539295A3 (de)
IT (1) IT8420470V0 (de)

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Also Published As

Publication number Publication date
US4535487A (en) 1985-08-20
IT8420470V0 (it) 1984-01-10
FR2539295B3 (de) 1984-12-28
FR2539295A3 (fr) 1984-07-20
DE3301415A1 (de) 1984-07-19

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