CN1213283A - 固定装置和包括该固定装置的假体 - Google Patents

固定装置和包括该固定装置的假体 Download PDF

Info

Publication number
CN1213283A
CN1213283A CN97193010A CN97193010A CN1213283A CN 1213283 A CN1213283 A CN 1213283A CN 97193010 A CN97193010 A CN 97193010A CN 97193010 A CN97193010 A CN 97193010A CN 1213283 A CN1213283 A CN 1213283A
Authority
CN
China
Prior art keywords
fixture
groove
bone
bone cavity
cavity
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
CN97193010A
Other languages
English (en)
Other versions
CN1142750C (zh
Inventor
B·阿尔布雷克松
L·卡尔松
M·雅各布松
T·雷斯伦德
S·温贝格
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.)
AstraZeneca AB
Original Assignee
Astra AB
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 Astra AB filed Critical Astra AB
Publication of CN1213283A publication Critical patent/CN1213283A/zh
Application granted granted Critical
Publication of CN1142750C publication Critical patent/CN1142750C/zh
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0022—Self-screwing
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws
    • 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
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
    • 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
    • A61F2/30749—Fixation appliances for connecting prostheses to the body
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30233—Stepped cylinders, i.e. having discrete diameter changes
    • 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
    • A61F2002/30317—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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections 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
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2002/30574—Special structural features of bone or joint prostheses not otherwise provided for with an integral complete or partial collar or flange
    • 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
    • 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
    • A61F2002/3082—Grooves
    • 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
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • 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
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • A61F2002/30863—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface the entry end surface having flutes, relief grooves, starter notches or bevelled indentations
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • 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
    • A61F2002/3678—Geometrical features
    • A61F2002/369—Stepped shaft, i.e. having discrete diameter changes
    • 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
    • A61F2220/0008—Fixation appliances for connecting prostheses to the body
    • 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
    • A61F2230/0063—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
    • A61F2250/0039—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

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Epidemiology (AREA)
  • Dentistry (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Dental Prosthetics (AREA)

Abstract

本发明涉及一种用于插入并永久固定在骨组织内形成的骨腔(32)中的固定装置。该固定装置包括一个固定装置构件(2),此构件(2)有一个插入端表面(10)和一个配置螺纹的圆柱形的周边表面(6),和多个圆周方向上间隔的切削凹槽(9)。此切削凹槽(9)在邻近所述插入端表面(10)的带螺纹的圆周表面(6)的前部的、自攻丝端部分(7)内形成,并且此切削凹槽(9)轴向通向所述的插入端表面(10)。多个圆周方向上间隔的骨组织收集和骨组织分配沟槽(17)在带螺纹的圆周表面(6)的后部的、无自攻丝部分(8)内形成。沟槽(17)径向向外开口并至少部分地沿固定装置构件(2)的纵向延伸,和每个沟槽(17)在其前端与其中一个所述切削凹槽(9)连接用于收集从切削凹槽来的切掉的骨物质(B)并径向地将骨物质引导出沟槽(17)以便在固定装置插入过程中在圆周方向上围绕骨腔(32)的内壁分配切掉的骨物质(B)。

Description

固定装置和包括该固定装置的假体
发明的技术领域
本发明涉及在人骨骼或骨组织内固定的固定装置。更具体地涉及一种带螺纹的。自攻丝的固定装置，该固定装置特别适用于将髋关节假体在股骨颈内形成的腔中永久性固定。从申请人的WO93/16663中可知按照权利要求1前绪部分的固定装置。本发明还涉及这样固定装置的使用、包括这样固定装置的假体、和固定固定装置的方法。
背景技术
英国大不列颠专利GB1291470公开了一种用于在骨组织中，特别用于在颌骨中固定牙齿假体的假体固定装置。此固定装置包括一个大体上空心的外部带螺纹的螺栓。以螺纹是用来拧入钻了孔并预先攻了螺纹的骨腔中以便永久植入。邻近其远端或插入端，此螺栓配置许多径向小孔，每个孔从带螺纹的外表面通入中心槽中。这些径向小孔是用来促进新生成的骨组织在愈合过程中整合生长。最后向内生长形成一个“旋转固定”，它防止固定装置不希望的旋出和松动。在此文献中，也设想不仅是新形成的骨组织，包括由于固定装置插入腔中引起的分开的松散的骨组织也可参与在径向孔中的整合生长。中心槽向下通入螺栓的远端表面，散落的骨组织收集在中心槽内。
英国专利EP-A1-0237505也公开了一种用于在骨组织中永久固定。特别是永久固定牙齿假体的固定装置，该专利讲述上面按照GB1291 470的固定装置的一种改进，目的是避免一个确认的缺点，此缺点是刮掉的骨组织从螺栓的中心槽向下落在骨腔的底部，因此扰乱了固定装置的底部的骨整合作用。为此，在EP-A1-0237505的固定装置中除去了中心槽，并且用一个或多个只与固定装置外部圆柱形表面相通的周边空腔代替径向通孔。结果，固定装置的远端表面是完整的，于是防止了松散的骨组织向下落在骨腔的底部。在圆柱形表面内的每一个周边空腔的边缘形成一个尖锐的切削刃口用于在固定装置拧入骨组织时自攻丝。这种现有技术固定装置的一个基本的特点是：这样选择周边空腔的总的组织收集体积使得能包含和储存所有被切削口刮下来的骨组织。
美国专利US 5 129 901公开了一种自攻丝、自钻孔、套管的髋螺钉用于在矫形骨外科手术中临时固定。此螺钉设计成最大限度减少热坏死并能在螺钉的插入和移出两个过程中有效除去刮下来的骨组织(称作“碎片”)，因此便利了螺钉的插入和随后从那里移出。螺钉有一个中心孔，此孔在螺钉的切端表面开口并用来接收一个钻孔导向销。螺钉的外部圆周表面邻近螺钉的切入端有较短的螺纹部分，而在其后端有较长的无螺纹的柄部分。柄部分的直径小于带螺纹部分的直径。在邻近切入端的带螺纹部分形成沿圆周方向间隔的第一对较短的、周边的和纵向的腔或“凹槽”。这些凹槽沿螺纹形成自攻丝的刃口并通向螺钉的前端面。当螺钉钻入骨中时这些凹槽将切下的骨碎片向后引入一个环形空间，此空间在已钻骨通道的内壁和减小了直径的柄部分的周边之间形成。还有在一个与钻入端向后间隔并的轴向位置处的带螺纹部分内形成一对反向的切削凹槽，并且此对反向切削凹槽安排成在从骨中旋出螺钉时切入骨中。
相似的凹槽也在美国专利US4537185中公开过，在上述的美国专利US 5 129 901中引证过。在美国专利US 4 537 185中的自攻丝、自身钻孔固定螺钉配置与凹槽或沟槽相交的外部螺纹。这些沟槽沿固定装置形成自攻丝的切削刃口，并在固定装置前部的、无螺纹的端部提供钻齿。
在本说明书引言中已叙述过的WO93/16663中公开了一种用于永久固定在人股骨颈中的髋关节假体。此假体包括一个形成阶状的固定装置，它包括一个前部圆柱形第一固定装置构件和一个后部栓状、圆柱形的与第一固定装置构件刚性连接或成整体的第二固定装置构件、和一个由固定装置的后端支承的假体头。两个固定装置构件中的每一个在它们的插入端都有一个螺纹外表面，此螺纹外表面配置有短的尖锐刃口的切削凹槽。第一固定装置构件是自攻丝进入较窄的孔中，此孔是沿一预定轴线钻通网状骨中的股骨颈而成的，而第二构件是自攻丝进入较宽的圆柱形腔内，此腔是在股骨颈的网状骨中切成的并与窄孔是共轴的。切削凹槽的轴向长度大体上小于螺纹部分的总轴向长度。更特别地，第二构件的切削凹槽限制在较短的前端部分，此部分向内稍微逐渐变细以便在插入和拧入较宽的腔中时方便固定装置的插入和对准中心。因此，第二构件的有螺纹外表面的主要部分是完整的，即没有凹槽，并用来与预形成腔的内壁建立一种希望的机械的螺丝连接。与上述按照EP-A1-0 237 505的固定装置对比，第二固定装置构件的切削凹槽一直向前延伸并通向该固定装置构件的前端表面。由于这种结构，被切削凹槽切下或擦掉的骨组织将以向前的方向，即以插入方向从凹槽中退出并进入空腔。
如在WO93/16663中所讨论的那样，固定装置优选地是与股骨颈的硬的皮质骨的内部啮合以便减少固定装置的机械松动的危险。然而，在第二固定装置构件和皮质骨之间的机械接触限制在有螺纹表面的周边较少的部分。其余部分，第二固定装置构件的有螺纹表面的主要部分不与皮质骨啮合，而仅主要地与较软的网状骨接触。结果，仅第二固定装置构成的较小部分与“硬”骨处于机械啮合并参与从头部向股骨颈传送负载。
本发明的目的在于克服或至少减小这个问题。因此，本发明的一个特殊目的是改进WO93/16663中公开的那种类型的固定装置并更全面地增强骨和假体固定装置之间的机械连接，借此实现较强的永久性固定。
本发明的公开内容
按照本发明，提供一种用于插入并永久固定在骨组织内形成的腔中的固定装置，该固定装置包括一个固定装置构件，此构件有一个插入端表面和一个配置螺纹的圆柱形周边表面，并有多个在圆周上间隔开的切槽，这些切槽在邻近所述插入端表面的带螺纹的圆周表面的前部的、自攻丝端部分中形成并且这些切槽轴向通向所述的插入端表面。此固定装置的特征在于：它还包括形成在后部的带螺纹的圆周表面的无自攻丝部分上的多个在圆周上间隔开的组织收集和组织分配沟槽，所述的各个沟槽径向向外开口并至少局部沿固定装置构件的轴向延伸，每个沟槽在其前端开口，轴向通向其中一个所述切槽用于从那里收集切掉的骨物质和径向地从沟槽中引导出骨物质以便在固定装置插入过程中在圆周上围绕腔的内壁分配所收集的切掉的骨物质。
按照本发明，还提供一种假体，特别是一种包括这样固定装置的髋关节假体。
本发明还包括使用这样的固定装置用于在骨组织内固定一种假体，尤其是永久性固定。
按照本发明用于在骨组织内固定一种固定装置的方法包括以下步骤：在骨组织内形成一个腔；提供一种有切削凹槽的自攻丝的固定装置用于在固定装置插入骨腔过程中在腔的内壁形成内螺纹，并且该固定装置有带螺纹的外圆周表面以便与骨腔的所述内螺纹啮合；将所述固定装置插入所述骨腔中，借此形成骨腔的内螺纹并且使固定装置的带螺纹的外圆周表面与所述内螺纹啮合，其中方法的特征在于：在固定装置插入骨腔和形成内螺纹过程中，为形成内螺纹被切削凹槽切掉的骨物质在圆周上围绕骨腔的内壁被收集和分配。
当发明的固定装置插入骨腔时，固定装置构件的前部的自攻丝部分将切入骨腔的内壁并在其内形成螺纹以便随后与固定装置构件的后部的、无自攻丝部分螺纹啮合。在固定装置插入骨腔过程切下的并最终落入螺纹切削凹槽内的骨物质将从凹槽向后移以便进入收集沟槽内。骨物质的这种向后运动是由于事实上骨腔壁对在切削凹槽和收集沟槽中的松散骨物质施加向后的摩擦力和由于事实上一旦骨物质进入收集沟槽中，骨物质受到一个由跟随其后的骨物质施加的向后的压力。因此，切削凹槽能起双重作用，有常规的螺纹切削功能以及迫使新切下的骨物质向后进入收集沟槽内的功能。
当收集沟槽以上述方式用骨物质填充时，拧入骨腔的固定装置的连续旋转导致收集沟槽内骨物质径向地移出固定装置并压向骨腔内壁。
因为切削凹槽是在前进方向开口，所以部分切下来的骨物质向前移动并脱落进入骨腔，即在固定装置构件的前端表面的前面。当拧入操作结束这个端表面接近骨腔的底表面时，在腔内存在的骨物质将被挤压在这两个表面之间。固定装置的最后拧紧作用将因此变得很强，向后的骨物质压力施加在切削凹槽内存在的骨物质上，这个压力依次转换为对在收集沟槽内存在的骨物质的向后的压力。结果，在最后的拧入操作过程中得到最后的、有力的从收集沟槽中径向排放骨物质。事实是切削凹槽在前进的方向开口因此保证在拧入操作结束时从收集沟槽向骨腔内壁将骨物质有效地径向排出。
因为沟槽是在无自攻丝螺纹的部分形成的，所以沟槽的外边缘不会起切削刃口的作用，因此沿沟槽不会有任何切下来的骨物质，这样的沟槽可以对沟槽中的骨物质产生方向向内的径向压缩力并因此抵消了希望的排放效果。
当发明的固定装置拧入骨腔时产生的从固定装置中径向流出的松散骨物质，作为固定装置旋转的结果，将围绕骨腔的内壁在圆周方向上分配。产生的效果解决或至少基本上减小了在软的网状骨中不良的固定的问题。发生的骨物质的自动分配可称作骨物质的“自身移植”。当有螺纹的切削凹槽切入皮质骨中时，本发明导致硬质的皮质骨物质从切削凹槽切入皮质骨中的那部分骨腔向只有较软的网状骨的骨腔部分有利的位移或“移植”。因为网状骨有几乎是海绵状、具有非常多小空洞的结构，并因为这些小空洞中的某些空洞朝向骨腔向内开口，从收集沟槽排放的硬骨物质将有效地填满这些空洞，这样围绕固定装置形成一个大体上管状层的皮质骨。结果，增强与固定装置的螺纹的机械啮合。
然而，应观察到切掉的骨物质的上述自体移植也发生在固定装置只拧入网状骨中的情况下。在这种情况，切掉的网状骨的骨物质，按照本发明，作为一种围绕骨腔的内壁的紧密层分配，因此比未触动的、海绵骨能较好的固定固定装置。
这样，收集和分配沟槽的主要功能是围绕固定装置分配或移植骨物质，因此加强了固定装置的固定。
沟槽还能防止由于固定装置损坏或堵塞在除掉的骨髓和内骨膜中营养供给的正常通道而造成的皮质骨坏死的出现。由于(ⅰ)圆周上间隔的收集沟槽的结构，这些沟槽至少局部地轴向延伸超过固定装置的后部，和(ⅱ)事实上这些沟槽将包含可以构成新骨生长的繁殖地的骨物质，收集沟槽与其内的新骨生长物将形成向皮质骨供给营养的通道，因此防止坏死。
此外，从上述GB1,291,470本身已知的收集沟槽还有另一个作用，即在沟槽内发生的新骨物质的向内生长有助于加强固定装置的机械固定。为了达到有效的自体移植，切削凹槽和收集沟槽的总体积应被限制并尤其小于被螺纹切削凹槽切掉的骨物质的总体积，或至少小于收集在切削凹槽内的切掉的骨物质的总体积。这点与上述EP-A1-0237505叙述的固定装置正好矛盾，该固定装置的径向孔被设计成能接收和储存在固定装置插入过程中切掉的全部骨物质。本发明的固定装置的骨储存体积的这样限制可以通过变化切削凹槽和/或收集沟槽的深度、宽度和长度等参数来达到。
为了使骨料进入和通过沟槽的向后运动更有效，沟槽优选地可以有比切削凹槽的横截面小的横截面，借此对松散的骨物质产生一个“漏斗效应”。当在骨腔内存在的骨物质向后压入切削凹槽时，一个给定的对切削凹槽内的骨物质的向后压力转变成对沟槽内骨物质一个较大的向后压力，尤其是在最后的拧入操作过程中。通过给沟槽一个比切削凹槽小的圆周宽度可以达到沟槽的这样减小的横截面。由于“节约”与骨腔壁机械啮合需要的螺纹，这个解决办法是有利的。另一个能产生上述“漏斗效应”的解决办法是增加切削凹槽的径向深度。这两种办法也可以组合。
沟槽优选地沿固定装置的纵向方向轴向地被引导。沟槽也可以这样方向倾斜使得固定装置的旋转有助于骨物质向后移动通过和移出沟槽。
在优选的实施方案中，每个沟槽的前端如沿拧入方向所见通向相应切削凹槽的后部，借此完成切掉的骨物质从切削凹槽出来和进入凹槽的有效的引导或传送。
可以想像不是所有的切削凹槽都需要连接到相应的沟槽上。
本发明的更多的方向和细节从所附的权利要求书和下面的参照附图对本发明的两个例证性实施方案的叙述中会更明显。
附图简要说明
图1是按照本发明的固定装置的第一个实施方案的正面透视图，此固定装置打算用在髋关节假体中。
图2是示于图1的固定装置的纵剖面图，
图3是示于图1的固定装置的端视图，
图4是放大的局部端视图，详细图解了切削凹槽和收集与分配沟槽，
图5是人股骨颈的局部剖面图，带有一个在其中形成的用于接收图1中固定装置的空腔，
图6是相应于图5的局部透视图并图解了骨腔的断面形状，
图7是相应于图5的剖面图，示于图1的固定装置在这里已被插入骨腔中，
图8是局部剖面图，它示意地图解了收集和分配沟槽的功能，
图9是相应于图5的剖面图，在这里第二个实施方案的固定装置已被插入骨腔中，及
图10是示于图9的第二个实施方案的切削凹槽和收集与分配沟槽的局部正面侧视图，图解了第二实施方案的功能。
本发明的优选实施方案的详述
图1和2图解3按照本发明的固定装置的第一实施方案，该固定装置打算用于在人股骨颈中髋关节假体的永久性固定，一般在WO93/16663中公开的那种类型的固定装置一个圆柱形的第一固定装置构件1和一个栓状的、圆柱形第二固定装置构件2。第二固定装置构件2配置一个圆周边凸缘3，此凸缘由于紧靠在切割面(图5中标号33)而限制固定装置插入，沿此切割面股骨颈的头部已被去掉。第一固定装置构件1具有带螺纹的外表面，此外表面在固定装置的插入端5处配置一些短的尖锐刃口的切削凹槽4以便自攻丝进入已钻好、较窄的孔中(图5中标号30)。
第二固定装置构件2也有带螺纹的外表面，其轴向长度在图2中用标号6标出并且第二固定装置构件2有一前部的、较短的自攻丝端部分7和一后部的、较长的、无自攻丝啮合部分8。8个等间隔的锐利刃口切削凹槽9在前端部7内的圆周方向上间隔开以便自攻丝进入预先钻好的骨腔中(图5中标号32)，该骨腔与窄的、钻好的孔30是同轴的。切削凹槽9轴向通到第二固定装置构件2的径向端面10。前部的自攻丝端部分7是稍微锥形的以便在固定装置插入过程中引导和对中固定装置。
如在图3和4更详细图解那样，提供8个切削凹槽9，每个切削凹槽由径向壁11和与之垂直的底壁12确定。固定装置的拧入方向由箭头13表示。在每对邻接的切削凹槽，例如图4中切削凹槽9a和9b之间，间隙表面14从后部切削凹槽9a，如沿旋转方向所见，在底壁12的前缘向在前面的切削凹槽9b延伸，如沿旋转方向所见，在切削凹槽9b的切削刃口15处与径向壁11的径向外边缘重合。
从图4最清楚显示，每个间隙表面14与圆柱形外表面的切线16形成一个角度α，借此保证希望的自攻丝的功能。
8个在圆周方向上间隔的、径向开口的收集和分配沟槽17在后部，无自攻丝部分8形成并以与固定装置的纵向轴线平行的方向延伸。在前端，每个沟槽17通向一个相关的切削凹槽9。沟槽17沿圆周方向相对于切削凹槽9是这样偏置使得每个沟槽17的后部纵向边缘，如沿拧入方向13所见，与上述的相应凹槽9的切削刃口15重合。
在图解的实施方案中，每个沟槽17有一个大本上半圆柱形边界壁18并且相对于切削凹槽9尺寸是这样确定的，使得切削凹槽9比沟槽17在圆周方向上较宽以及在径向上较深。因此，切削凹槽9有一个比收集沟槽17较大的径向横截面。最好是，切削凹槽9和相应的沟槽17之间的过渡是平滑的圆形。
在所图解的实施方案中，沟槽17沿基本上无自攻丝部分8的全长延伸，但沟槽17也可以在本发明的范围内是较短的。还有，因为许多切削凹槽9有和没有收集沟槽，所以可以提供不同长度的收集沟槽17。
现在参照图5-8进一步说明沟槽17的功能。从图5和6最清楚地显示，钻孔30和切削的骨腔32是这样的定位和取向使得在如图7中所示安装固定装置的地方在硬的皮质骨34和后部无自攻丝部分8之间存在螺纹啮合。切割骨表面33的断面是非圆形的。如由图6连同图5特别显示，骨腔32的内壁由硬的皮质骨34的两个下侧部分与一个软的，网状骨的中间窄“线”36以及一个相当大的网状骨38的上面部分形成的。
当第二固定装置构件2拧入骨腔32中时，切削凹槽9将从区域34切掉皮质骨以及从区域36和38切掉网状骨。切掉的骨物质然后几乎立即充满相当小的切削凹槽9中并由于对着骨腔32的内壁的轴向摩擦作用，切掉的骨物质向后压入并收集在相应的沟槽17中，如在图8中用空心箭头示意指示的那样。在此图中，切掉的骨物质指示B并以较暗的背景表示。固定装置的轴向拧入方向用箭头44表示。
当沟槽17被充满时，其后从切削凹槽9提供的物质B将对在沟槽17中已经存在的物质施加一个轴向向后的压力。当由于向后摩擦力和向后压缩力的联合作用沟槽17被完全充满时，继续拧入和切掉的骨物质将引起骨物质从收集沟槽17径向流出并进入网状骨38的空洞中，如图8中标号40示意表示的那样。尤其，从图6中区域34来的皮质骨物质将会移动(自体移植)至网状骨区域36和38，因此在固定装置周围得到皮质骨的良好分配从而增强固定装置的固定。
将会意识到切削凹槽9和收集沟槽17的总体积应比，在拧入操作过程中切掉的骨物质的总体积小，最好是小很多。应该是这样以便保证沟槽17被迅速填满并尽快触发此分配作用。
由于切削凹槽9轴向向前开口，如在图8中在标号46处是明显的，部分切掉的骨物质B将轴向向前落入骨腔32中。在拧入过程结束时，这些骨物质将压缩在端表面10和骨腔32的底壁50之间。固定装置的最后紧固将有效地挤压这些“俘获”的骨物质，这些骨物质借此将有力向后压上升进入沟槽17并分配在骨腔32的内壁上。
图9和10图解3按照本发明的固定装置的第二个实施方案。此第二实施方案很大程度上与上述实施方案相似，由于这个理由相同的部分在此不予叙述。因此，相同的元件给出相同的标号。在图9中示出在局部安装时的固定装置，而图10是一个断开的放大的视图图解3操作的模式。
图9和10中的第二实施方案与图1-8的第一实施方案不同之处在于收集沟槽17相对于固定装置的纵向是倾斜的，以便在拧入操作过程中固定装置的旋转促进沟槽17中骨物质的向后运动。因此，沟槽17的入口端位于其封闭后端的前面，如沿拧入方向13所见那样。还有，第二实施方案说明事实上沟槽17可比第一实施方案短些。

Claims (20)

1．一种用于插入和永久固定在骨组织中形成的骨腔(32)内的固定装置(1,2)，它包括一个固定装置构件(2)，该固定装置构件有一个插入端表面(10)和一个配置螺纹的圆柱形周边表面(6)、和多个在圆周方向上间隔的切削凹槽(9)，这些切削凹槽在前部的、邻近所述插入端表面(10)的带螺纹圆周表面(6)的自攻丝端部分(7)内形成，并且切削凹槽轴向通向所述插入端表面(10)，其特征在于多个在后部的、带螺纹圆周表面(6)的无自攻丝部分(8)内形成的在圆周方向上间隔的骨组织收集和骨组织分配沟槽(17)，所述沟槽(17)径向向外开口并至少局部地沿固定装置构件(2)的纵向延伸，每个沟槽(17)在其前端连接到其中一个所述切削凹槽(9)，用于从那里收集切掉的骨物质(B)并径向地将其引导出沟槽(17)以便在固定装置(1,2)插入过程中在圆周方向上围绕骨腔(32)的内壁分配切掉的骨物质(B)。
2．如权利要求1所述的固定装置，其特征在于切削凹槽(9)和收集与分配沟槽(17)的总骨组织收集体积比在固定装置(1、2)插入过程中切掉的骨物质(B)的总体积小。
3．如权利要求1或2所述的固定装置，其特征在于切削凹槽(9)和收集与分配沟槽(17)的总骨组织收集体积比在固定装置(1、2)插入过程中在所述沟槽(17)中收集的骨物质(B)的总体积小。
4．如权利要求1-3中任一所述的固定装置，其特征在于沟槽(17)的横截面比切削凹槽(9)的横截面小。
5．如权利要求4所述的固定装置，其特征在于沟槽(17)的圆周宽度比切削凹槽(9)的圆周宽度小。
6．如权利要求4或5所述的固定装置，其特征在于沟槽(17)的径向深度比切削凹槽(9)的径向深度小。
7．如前述权利要求任一所述的固定装置，其特征在于沟槽(17)只沿固定装置构件(2)的纵向延伸。
8．如前述权利要求任一所述的固定装置，其特征在于沟槽(17)相对于固定装置构件(2)的纵向倾斜使得在将固定装置(1、2)插入骨腔(32)过程中固定装置的旋转运动促进沟槽(17)内的骨物质(B)的向后运动。
9．如前述权利要求任一所述的固定装置，其特征在于沟槽(17)沿固定装置构件(2)的纵向延伸超过无自攻丝部分(8)的主要部分。
10．一种假体，例如一个髋关节假体，包括一个如权利要求1-9的任一所述的固定装置。
11．使用如权利要求1-9的任一所述的固定装置在骨组织中固定假体。
12．一种在骨组织中固定上述固定装置的方法，包括以下步骤：在骨组织中形成一个骨腔(32)；提供一个自攻丝的固定装置(1、2)，该固定装置有切削凹槽(9)用于在固定装置(1,2)插入骨腔(32)过程中在骨腔(32)内壁形成内螺纹，该固定装置还有带螺纹的外圆周表面用于与骨腔(32)的所述内螺纹啮合；和将所述固定装置(1、2)插入所述骨腔(32)中，借此形成所述的骨腔(32)的内螺纹并使固定装置(1、2)的带螺纹的外圆周表面与所述内螺纹啮合；其特征在于，在固定装置(1、2)插入骨腔(32)和形成内螺纹的过程中，为形成所述内螺纹而被切削凹槽(9)切掉的骨物质(B)在圆周方向围绕骨腔(32)的内壁被收集和分配。
13．如权利要求12所述的方法，其特征在于至少部分地在皮质骨组织(34)中形成骨腔(32)，这样使得切掉的皮质骨物质(B)在插入固定装置(1、2)过程中在圆周上围绕骨腔(32)的内壁被分配。
14．如权利要求12所述的方法，其特征在于骨腔(32)只是在网状骨组织(38)中形成。
15．如权利要求12-14的任一所述的方法，其特征在于所述切掉的骨物质(B)是从一个或多个在圆周方向上间隔的沟槽(17)中分配出来，而沟槽(17)是在固定装置(1、2)的外螺纹圆周表面的后部无自攻丝啮合部分(8)内形成的。
16．如权利要求15所述的方法，其特征在于切削凹槽(9)和收集与分配沟槽(17)的总骨组织收集体积比在固定装置(1、2)插入过程中切掉的骨物质(B)的总体积小。
17．如权利要求15或16所述的方法，其特征在于切削凹槽(9)和收集与分配沟槽(17)的总骨组织收集体积比在所述沟槽(17)中收集的骨物质(B)的总体积小。
18．如权利要求12-17的任一所述的方法，其特征在于所述骨腔(32)具有一个底表面(34)，并且所述固定装置(1、2)插入所述骨腔(32)到这样的轴向程度，使得在固定装置(1、2)的最后紧固过程中存在于骨腔(32)内、在固定装置(1、2)和所述底表面(50)之间的切掉的骨物质(B)沿与固定装置(1、2)插入方向相反的方向被向后压，以便促进切掉的骨物质(B)的收集和在圆周方向上的分配。
19．如权利要求12-18的任一所述的方法，其特征在于所述固定装置(1、2)是永久地固定在所述骨腔(32)中。
20．如权利要求19所述的方法，还包括将假体连接在所述固定装置(1、2)上的步骤。
CNB971930104A 1996-01-19 1997-01-16 固定装置和包括该固定装置的假体 Expired - Fee Related CN1142750C (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9600208A SE9600208D0 (sv) 1996-01-19 1996-01-19 Fixture and prosthesis including the same
SE96002084 1996-01-19

Publications (2)

Publication Number Publication Date
CN1213283A true CN1213283A (zh) 1999-04-07
CN1142750C CN1142750C (zh) 2004-03-24

Family

ID=20401091

Family Applications (1)

Application Number Title Priority Date Filing Date
CNB971930104A Expired - Fee Related CN1142750C (zh) 1996-01-19 1997-01-16 固定装置和包括该固定装置的假体

Country Status (25)

Country Link
US (1) US6610099B1 (zh)
EP (1) EP0874605B1 (zh)
JP (1) JP3990454B2 (zh)
KR (1) KR100293766B1 (zh)
CN (1) CN1142750C (zh)
AR (1) AR005497A1 (zh)
AT (1) ATE253338T1 (zh)
AU (1) AU723598B2 (zh)
BR (1) BR9707295A (zh)
CA (1) CA2241976C (zh)
CZ (1) CZ290891B6 (zh)
DE (1) DE69725961T2 (zh)
ES (1) ES2210491T3 (zh)
HU (1) HU222361B1 (zh)
IL (1) IL125376A (zh)
IS (1) IS4792A (zh)
NO (1) NO311323B1 (zh)
NZ (1) NZ326506A (zh)
PL (1) PL186068B1 (zh)
RU (1) RU2189200C2 (zh)
SE (1) SE9600208D0 (zh)
TR (1) TR199801375T2 (zh)
TW (1) TW353022B (zh)
WO (1) WO1997025939A1 (zh)
ZA (1) ZA97373B (zh)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105832435A (zh) * 2016-03-18 2016-08-10 广州市健齿生物科技有限公司 一种基于选区激光熔化技术的牙科种植体
CN112971886A (zh) * 2017-12-30 2021-06-18 深圳市立心科学有限公司 固定韧带的挤压钉及其装配具

Families Citing this family (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2253809T5 (es) 1997-02-11 2009-05-25 Zimmer Spine, Inc. Sistema de colocacion de placas cervicales anteriores.
AU6145998A (en) 1997-02-11 1998-08-26 Gary Karlin Michelson Skeletal plating system
IT1293832B1 (it) * 1997-08-07 1999-03-10 Massimo Corigliano Impianto dentale osteointegrato
GB2346327A (en) * 1999-01-26 2000-08-09 Javier Cabrera Bipolar screw microprosthesis of the hip
US6284002B1 (en) 1999-05-27 2001-09-04 Nicholas G. Sotereanos Proximal femoral replacement implant and method of implanting the same
GB9919810D0 (en) * 1999-08-20 1999-10-27 Walker Peter S Conservative hip replacement
WO2001024737A1 (en) 1999-10-06 2001-04-12 Astra Tech Ab Implant
DE10021527C1 (de) * 2000-05-03 2001-12-06 Aesculap Ag & Co Kg Schenkelhalsprothese
US6616697B2 (en) 2001-03-13 2003-09-09 Nicholas G. Sotereanos Hip implant assembly
US6783553B2 (en) 2001-10-24 2004-08-31 James B. Grimes Prosthesis
US7008227B2 (en) 2002-03-04 2006-03-07 Carmichael Robert P Self-drilling implant
GB0207170D0 (en) * 2002-03-26 2002-05-08 Mcminn Derek J W Hip joint prosthesis
US6695883B2 (en) 2002-04-11 2004-02-24 Theodore W. Crofford Femoral neck fixation prosthesis
FR2841764B1 (fr) 2002-07-05 2005-05-20 Newdeal Sa Vis d'osteosynthese et de compression auto-taraudante et auto-forante
US20040078084A1 (en) * 2002-10-22 2004-04-22 Ricardo Albertorio Prosthetic implant and method of use
US20040230195A1 (en) * 2003-05-14 2004-11-18 Inion Ltd. Soft-tissue screw
US7135044B2 (en) * 2004-03-09 2006-11-14 Howmedics Osteonics Corp. Modular prosthesis kits
US7749259B2 (en) * 2005-04-08 2010-07-06 Warsaw Orthopedic, Inc. Slotted screw for use with a vertebral member
WO2006136637A2 (es) * 2005-06-24 2006-12-28 Eloy Antonio Martinez Albal Implante dental de corona rotatoria
ES2264650B1 (es) * 2005-06-24 2007-11-16 Eloy Antonio Martinez Albal Implante dental de corona rotatoria.
CN1907240B (zh) * 2005-08-03 2011-03-16 比德曼莫泰赫有限公司 骨锚固件
US8172906B2 (en) * 2006-04-14 2012-05-08 United Orthopedic Corporation Artificial joint fixation mechanism
US8579985B2 (en) * 2006-12-07 2013-11-12 Ihip Surgical, Llc Method and apparatus for hip replacement
FR2908287B1 (fr) * 2007-12-18 2009-04-10 Paris Implants Implants dentaires monoblocs visses
US8801799B2 (en) 2008-07-24 2014-08-12 Howmedica Osteonics Corp. Femoral head prosthesis
EP2712564B1 (en) 2010-02-26 2017-04-05 Biedermann Technologies GmbH & Co. KG Bone screw
ITAN20120048A1 (it) * 2012-05-02 2013-11-03 Cizeta Surgical Societa A Responsa Bilita Limita Vite per impianti per chirurgia ossea.
DE102012015480A1 (de) 2012-08-07 2014-02-13 Gunter Tannhäuser Hohlwand-Dübel
US9387027B2 (en) * 2012-12-13 2016-07-12 Jonathon Yigal Yahav Implantable fixture
US9554916B2 (en) * 2014-06-04 2017-01-31 Sarah Miller Apparatus and method for replacement of a metatarsophalangeal joint with interphalangeal fusion
EP3503827A4 (en) 2016-08-24 2020-08-05 Integrity Implants Inc. ADJUSTABLE BONE FIXATION SYSTEMS
WO2020005971A1 (en) * 2018-06-26 2020-01-02 Integrity Implants, Inc. Length adjustable modular screw system
WO2019204562A1 (en) * 2018-04-18 2019-10-24 Wapner Peter Removable orthopedic screws
RU2695623C1 (ru) * 2018-09-10 2019-07-24 Сергей Сергеевич Горшков Способ имплантации остеинтегрируемого протеза

Family Cites Families (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US425372A (en) * 1890-04-08 William s
US2472103A (en) * 1945-03-13 1949-06-07 Josef H Giesen Modified bone screw holder for surgical drills
US3458882A (en) * 1967-03-27 1969-08-05 Gerald W Kelly Thread-cutting device
SE332486B (zh) 1968-12-09 1971-02-08 Aga Ab
US4537185A (en) 1983-06-10 1985-08-27 Denis P. Stednitz Cannulated fixation screw
CH671150A5 (zh) * 1986-10-13 1989-08-15 Jaquet Orthopedie
SE455155B (sv) 1986-02-12 1988-06-27 Inst For Tillempad Bioteknolog Skruvformat festelement for permanent forankring i benvevnad
DE3708638A1 (de) * 1987-03-17 1988-09-29 Grafelmann Hans L Selbstschneidendes einschraubbares knochenimplantat fuer zahnaerztliche zwecke
US4978506A (en) 1988-05-18 1990-12-18 Westinghouse Electric Corp. Corrosion product monitoring method and system
DE9014542U1 (zh) 1990-10-20 1991-01-03 Howmedica Gmbh, 2314 Schoenkirchen, De
US5129901A (en) * 1991-06-10 1992-07-14 Decoste Vern X Cannulated orthopedic screw
GB9201231D0 (en) 1992-01-21 1992-03-11 Howmedica Tibial element for a replacement knee prosthesis
SE9200597D0 (sv) * 1992-02-28 1992-02-28 Astra Ab Hip joint prosthesis ii
SE510158C2 (sv) 1992-10-29 1999-04-26 Medevelop Ab Förankringselement för uppbärande av proteser samt användning av sådant förankringselement för fixering av proteser
DE69420947T2 (de) * 1993-02-10 2000-05-18 Sulzer Spine Tech Inc Werkzeugsatz zur stabilisierung der wirbelsäule
US6021617A (en) * 1993-03-08 2000-02-08 Sheahan; James P. Leak localizing using a combination of penetrating devices and barriers
SE9301407D0 (sv) 1993-04-27 1993-04-27 Medevelop Ab Foer implantation i vaevnad avsett foerankringsorgan foer uppbaerande av proteser, artificiella ledkomponenter eller dylikt
US5370662A (en) * 1993-06-23 1994-12-06 Kevin R. Stone Suture anchor assembly
US5405396A (en) 1993-07-01 1995-04-11 Zimmer, Inc. Tibial prosthesis
AU696997B2 (en) * 1994-09-15 1998-09-24 Howmedica Osteonics Corp. Conically-shaped anterior fusion cage and method of implantation
US5562371A (en) * 1995-06-07 1996-10-08 Lock-N-Stitch International Tap with a non-cutting pilot
DE19601340C1 (de) 1996-01-16 1997-06-05 Eska Implants Gmbh & Co Schenkelhalsendoprothese für ein künstliches Hüftgelenk
EP0932379A4 (en) 1996-08-21 2006-06-21 Ind Res Ltd PROSTHESIS OF REPLACEMENT OF AN ARTICULATION
US5842865A (en) * 1997-09-12 1998-12-01 Sulzer Calcitek Inc. Self-tapping implant with multiple concave tapping channels

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105832435A (zh) * 2016-03-18 2016-08-10 广州市健齿生物科技有限公司 一种基于选区激光熔化技术的牙科种植体
CN105832435B (zh) * 2016-03-18 2018-12-25 广州市健齿生物科技有限公司 一种基于选区激光熔化技术的牙科种植体
CN112971886A (zh) * 2017-12-30 2021-06-18 深圳市立心科学有限公司 固定韧带的挤压钉及其装配具
CN112971886B (zh) * 2017-12-30 2022-01-04 深圳市立心科学有限公司 固定韧带的挤压钉及其装配具

Also Published As

Publication number Publication date
RU2189200C2 (ru) 2002-09-20
AU1459697A (en) 1997-08-11
HUP9902463A3 (en) 2000-01-28
CN1142750C (zh) 2004-03-24
AU723598B2 (en) 2000-08-31
TR199801375T2 (xx) 1998-10-21
NO311323B1 (no) 2001-11-19
NO983235D0 (no) 1998-07-14
DE69725961D1 (de) 2003-12-11
IS4792A (is) 1998-07-01
ES2210491T3 (es) 2004-07-01
SE9600208D0 (sv) 1996-01-19
IL125376A0 (en) 1999-03-12
KR19990077371A (ko) 1999-10-25
US6610099B1 (en) 2003-08-26
EP0874605A1 (en) 1998-11-04
NO983235L (no) 1998-07-14
PL327612A1 (en) 1998-12-21
IL125376A (en) 2004-07-25
HUP9902463A2 (hu) 1999-11-29
EP0874605B1 (en) 2003-11-05
AR005497A1 (es) 1999-06-23
BR9707295A (pt) 1999-07-20
ZA97373B (en) 1997-07-21
WO1997025939A1 (en) 1997-07-24
JPH11504844A (ja) 1999-05-11
NZ326506A (en) 1998-11-25
TW353022B (en) 1999-02-21
HU222361B1 (hu) 2003-06-28
ATE253338T1 (de) 2003-11-15
CZ290891B6 (cs) 2002-11-13
KR100293766B1 (ko) 2002-06-20
DE69725961T2 (de) 2004-08-12
CA2241976A1 (en) 1997-07-24
CZ224998A3 (cs) 1999-01-13
CA2241976C (en) 2005-01-04
PL186068B1 (pl) 2003-10-31
JP3990454B2 (ja) 2007-10-10

Similar Documents

Publication Publication Date Title
CN1142750C (zh) 固定装置和包括该固定装置的假体
CN1185991C (zh) 一种植入物
US9707059B2 (en) Self-clearing self-cutting implant
US6273722B1 (en) Hybrid press fit-threaded dental implant
US5338197A (en) Dental implant having cutting means
EP0828460B1 (en) Reduced friction screw-type dental implant
EP0412845A1 (en) Dental implant anchor
RU98115583A (ru) Крепежное приспособление и протез, включающий это приспособление
US20110137354A1 (en) Bone screw
WO2011132007A2 (en) Dental implant, dental abutment and dental kit
US20220226078A1 (en) Dental implant with improved threading

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C14 Grant of patent or utility model
GR01 Patent grant
C19 Lapse of patent right due to non-payment of the annual fee
CF01 Termination of patent right due to non-payment of annual fee