DE102005052699B3 - Implant and clamping element for implant whereby implant has two parts which combine so that the first part is clamped against second using two-piece clamping element located in connection device - Google Patents

Abstract

Implant has two implant parts (12,14) and a clamping element (20). They are designed and work together in such as way that the first (12) implant part can be clamped against the second (14) implant part using the clamping element. The clamping element should consist of two parts which are located in a two-piece clamping element connection device. At the least, the first part of the connection device is positioned on the first clamping element piece and the second part (58) of the connection device is positioned on the second clamping element piece.

Description

The The present invention relates to a tendon for an implant comprising at least a first implant part, at least one second implant part and a tendon, wherein the implant parts and the tendon are formed and cooperate so that the first implant part is clamped with the tendon against the second implant part, wherein the tendon comprises at least two tendon parts.

Further The present invention relates to an implant with a first Implant part, a second implant part and a tendon, wherein the implant parts and the clamping member are formed in such a way and cooperate so that the first implant part with the tendon is clamped against the second implant part.

at Implants of the type mentioned are so-called modular implants. An example of this is a revision implant, which as a hip joint endoprosthesis is used. The usual one-piece shaft comprises two in such a revision implant or more parts, namely a insertable into the medullary canal of a femur shaft part and a with this connectable second shaft part, on which a prosthesis neck is formed or connected to a neck of the prosthesis can. The two shank parts are usually by means of a Tendon in the form of a clamping nut or a clamping screw, as braced from WO 94/18911 A1 against each other.

One The main problem with modular implants is that they are very high Withstand loads. Because of the modularity however, the implants stand for the connection opposite one piece or one piece ausgebil Deten implants only small space for the connection required Elements available. Furthermore, it is desirable that for connecting the implant parts, so for clamping the same by means of the tendon, if possible low powers have to be spent which would facilitate the clinical use.

A two-part tendon is for example from the DE 199 26 391 C1 known. A one-piece tendon is in the DE 197 23 339 C2 disclosed. In the DE 101 19 079 C1 a modular shaft implant is described. Other modular prostheses are from the US 5,653,765 A as well as the US 5,032,130 known.

It is therefore an object of the present invention, an implant and a Tensioning element for an implant of the type described above to improve so that the implant parts are clamped together in a simpler way can.

These Task is at a tendon of the type described above according to the invention thereby solved, it is one of the at least two tendon parts in a connection position connecting, at least two-part tendon connection device is provided and that at least a first tendon connection device part to a first tendon member and at least a second tendon connection device part a second tendon is arranged.

The embodiment according to the invention makes it possible, for example, for a tendon part to rest on the first implant part and another tendon part for the second implant part. For example, different materials can be selected for the different tendon parts, so that a friction between a tendon part and an implant part becomes particularly large, whereas a friction of abutting tendon parts is minimal. In this way, an assembly of the entire implant can be simplified and also a force, for example when screwing the parts together, can be reduced. In particular when using a three-part clamping member, in each case a clamping member part abut when connecting the implant parts to an implant part, so that a friction of the parts to be joined together must be taken into account only between the tendon parts and optionally selectively minimized. Thus, the material of the implant parts can be chosen arbitrarily, which has the advantage, for example, that at least one of the implant parts can be matched for direct contact with a bone, whereas another implant part can be optimized, for example, for connection to another implant part. In order to simplify an assembly of the implant, it is advantageous that at least two tendon connecting device connecting the at least two tendon parts in a connecting position is provided and that at least one first tendon connection device part is arranged on a first tendon part and at least one second tendon connection part on a second tendon. Thus, the tendon formed from two or more parts can be assembled prior to connection to the implant parts and then connected to these. In particular, the tendon may already be provided preassembled for a surgeon. So on the part of an operator no major effort in the Assembly of the implant required as in known implants.

Advantageous it is when the tendon at least a first and at least a second tendon part and if the first or the second Clamping member with the first or the second implant part releasably connectable is. It can be such an implant in any modular manner become. It is also possible only one of the tendon parts so that it with a the implant parts detachable is connectable. The one or more other tendon parts can then For example, as on an implant part supporting elements be formed.

Cheap is it, if one of the at least two tendon parts with the first Implant part detachable is connectable and if the other of the at least two tendon parts on the one of the at least two tendon parts and on the second Implant part supports to transfer a clamping force from the first implant part to the second implant part. So On the one hand, a connection between a tendon part and an implant part to be optimized and on the other hand, a support of a other tendon part on the other implant part.

A particularly simple and secure connection between at least one Tendon part and at least one implant part can be achieved be that one of the at least two tendon parts with the at least a first or the at least one second implant part screwed is.

In order to the tendon preferably in the radial direction a particular compact shape, it is advantageous if a first tendon connection device part is arranged at the distal end of a tendon and when the at least one second tendon connection device part on proximal end of the other tendon part is arranged. Further allows this configuration, a proximal end of the one Tensioning element, for example, optimal for connecting to a first Implant part form, whereas the distal end of the other Tender member can be optimized for engagement with an implant part.

A particularly simple way of connection between the tendon parts is achieved in that the tendon connection device is designed in the form of a bayonet connection.

conveniently, is the tendon connection device in the form of a snap or snap connection educated. So can two tendon parts, for example, by a relative movement in one axial direction are interconnected. An additional Rotation as in a bayonet connection is at a rest or Snap connection not essential.

One Particularly simple construction of the snap or snap connection is achieved in that it comprises at least one spring-mounted locking element, that in a detent position with at least one corresponding Detent member is engaged.

Cheap is it, if the first and / or the second tendon part at least includes a spring-mounted locking element and if the other Clamping member carries at least one corresponding locking member. Especially can also both to be joined together tendon parts at least comprise a resiliently mounted locking element.

Around at least in some embodiments of tendons according to the invention a symmetrical structure for to allow a symmetrical distribution of force, are favorably provided at least two locking elements. For example, these can diametrically opposite each other be arranged with respect to an axis of symmetry of the tendon. Of course you can too more than two locking elements, for example over a circumference of a tendon part be arranged distributed.

Around tensile forces In the axial direction to transfer particularly well, is it is advantageous if the at least one locking element in the radial Direction is mounted resiliently. So can force directions to connect the tendon parts with each other and the connection of the tendon be separated with implant parts. An unintentional release of the Tendon parts of each other when connecting the tendon with the Implant parts can be avoided.

A particularly secure connection of the tendon parts together achieved in that the at least one locking element is a detent wearing, in a detent position, a latching projection at least partially engages behind or embraces.

advantageously, has the locking lug on at least one locking element in the radial direction a longitudinal axis the tendon out or away. So one can connect to the tendon parts cooperating force across a longitudinal direction act of the tendon and thus, for example, across a exerted by the tendon Tension or pressure on one of the implant parts.

Cheap can it further be when the tendon connection device in shape a clamping connection is formed. For example, two Tensioner parts are connected to each other by a appropriate press fit for connecting the parts together provided is.

alternative However, it is also advantageous if the clamping connection at least a spring ring comprises for holding the two tendon parts. these can For example, simply be plugged into each other and be through the spring ring clamped together or held together.

Around a size of the tendon to keep it minimal, it is convenient if one of the at least two tendon parts has an annular groove for the spring ring and if other tendon parts have a corresponding undercut has, on which the spring ring in a connection position of Tensioner parts abuts.

According to one another preferred embodiment The invention may be provided that the tendon connection device is designed in the form of a screw connection and that the one Tendon part an internal thread and that the other tendon part a corresponding to the internal thread external thread carries. The Tendon can so before mounting the implant, for example be composed of two different tendon parts. Furthermore, as with all others already described, and even further described embodiments of tendons, depending the implant parts to be joined together, the tendon from a variety of available standing combinations of different tendon parts assembled become. For example, a set of tendon parts may be provided are used to form tendons of different shapes and Size.

Around a design of the tendon as compact as possible provide, it is advantageous if the tendon sleeve-shaped or formed substantially sleeve-shaped is. For example, it may be a part of one implant part surrounded and within another, with the first implant part too be arranged connecting implant part.

conveniently, is at least a first tendon part of a different material manufactured as at least one second tendon part. So, for example Frictional forces acting optimally between the adjoining tendon parts Be set, for example, minimized or maximized.

Advantageous it may also be, if at least a first tendon part of made of the same material as at least one second tendon part. In this way, a production cost of the tendon can be reduced become.

According to one preferred embodiment of Invention may be provided that the at least one first tendon part and the at least one second tendon part in a connection position, in which they communicate with each other by means of the tendon member connection device are connected relative to each other about a longitudinal axis of one or the other tendon member are rotatable. For example, like this in known implants rubbing surfaces between the tendon and an implant part on abutting surfaces of Be relocated tendon parts. This allows in particular a optimized selection of materials for forming the tendon, around friction forces between the adjoining clamping members to minimize. Furthermore, as well as an orientation of the tendon parts relative to each other or even individual tendon parts relative to each other To be connected implant parts are easily changed.

Around To simplify a mounting of the implant has at least one the at least two tendon parts a tool holder for a screw-in on.

Cheap is it thereby, if the tool holder a Innenvielkant or a Innenvielrund or an outside polygon or a foreign round is. This embodiment allows it, for example in an operating room existing screw-in tools for mounting the implant to use.

The Implant leaves build up particularly compact when the tool holder on a proximal End of a tendon part is arranged. It will also be characterized also a stability of the tendon and consequently also of the implant improves since a proximal portion of the tendon carrying the tool holder correspondingly can be stably formed.

Liaison forces from Tendon on the at least one implant part can be transferred very well, when the tool holder in the region of the one of the two tendon part connection device parts is arranged on one of the two tendons. This can, for example, a Can be prevented twisting of the tendon part in itself, in particular when it is screwed to the implant part.

Advantageously, one of the at least two tendon parts has a distal end, wel Ches has a tapered outer diameter. As a result, in particular a particularly good fit of the tendon part to a corresponding receptacle of one of the implant parts to be connected to one another can be achieved. Furthermore, a contact surface of the tendon part on the implant part is thus increased. For example, a self-locking connection of the tendon part with an implant part can also be achieved via an inclination of outer surfaces of the distal end with respect to a longitudinal axis of the tendon.

The variability the to be used tendon parts for different with each other to be connected implant parts and thus for the production of different Implants are improved when a first and several second, connectable to the first tendon member connectable tendon parts are provided and when the plurality of second tendon parts have different lengths in longitudinal direction having the tendon. This embodiment makes it possible an operator, even during a surgical procedure, select suitable implant parts and then the tendons required to connect them choose.

Cheap is it, if the at least two tendon parts each at least have a sliding surface, if the sliding surfaces the at least two tendon parts bear against each other and when the sliding surfaces each define a plane that is transverse or substantially transverse to a longitudinal axis of Tendon runs. Through the sliding surfaces will it be possible to move the tendon parts relative to each other when these together abut, for example when an implant part with the tendon is clamped against a second implant part.

Around a relative movement of the two, provided with sliding surfaces tendon parts it is convenient to facilitate if the sliding surfaces at least partially with a friction-reducing coating are provided. In particular, this can be designed so that even under the effect of high, the sliding surfaces against each other pressing personnel a sliding movement of the tendon parts to each other is possible.

The The object initially stated is also in an implant of the above described type according to the invention thereby solved, that the tendon is one of the tendons described above. One such a modular implant can be used in the desired manner in a human body be used. In particular, embodiments of the invention facilitate Tendon both the manufacture and the assembly of entire implant.

Cheap is it if the implant is a hip joint endoprosthesis is when the first implant part insertable into a femur bone Shank is when the second implant part connectable to the shaft Prosthesis neck is wearing a condyle or with a condyle is connectable, and when the tendon screwed to the shaft Clamping nut is. Such an implant can be used, for example, for replacement a hip joint endoprosthesis be used, ie in particular as a revision implant.

The following description of preferred embodiments of the invention used in conjunction with the drawings for further explanation. Show it:

1 a sectional view through an inventive revision implant;

2 a partially sectioned perspective view of a first embodiment of a tendon according to the invention;

3 : An enlarged perspective view of a threaded sleeve of the tendon 2 ;

4 : An enlarged perspective view of a clamping sleeve of the tendon from 2 ;

5 a longitudinal sectional view of a second embodiment of a tendon according to the invention; and

6 a longitudinal sectional view of a third embodiment of a tendon according to the invention.

In 1 is a total with the reference numeral 10 provided inventive implant shown, in the form of serving as a revision implant hip replacement. The implant 10 comprises a first implant part in the form of a shaft insertable into a medullary canal of a femur bone 12 , a second, as a neck part 14 serving implant part, which with the shaft 12 is connectable and a neck for connecting to a condyle 18 has, and a tendon in the form of a clamping nut 20 for connecting the shaft 12 with the neck part 14 ,

The shaft 12 has one in the form of an external hexagon 22 trained distal end, which can be screwed, for example, with another implant part. To the hexagon socket 22 closes a cylindrical shaft portion 24 on, which tapers in a single stage and in a second cylindrical shaft portion substantially 26 above goes in the region of its proximal end in the form of a male thread section 28 is trained. A proximal end of the shaft 12 forms a cylindrical pin section 30 which is in the direction of a longitudinal axis 32 the clamping nut 20 pointing in the proximal direction from the external thread section 28 projects.

The neck part 14 is with a hole 34 provided, the inner diameter on the proximal side an outer diameter of the shaft portion 24 corresponds, so the shaft 12 coming from distally into the neck 14 can be introduced. The hole 34 expands in a transition area 36 conical in inner diameter, creating an annular conical surface 38 is formed, whose distance from the distal end of the neck portion 14 about one third of the total length of the hole 34 is. At a proximal end of the neck 14 the hole widens 34 in the diameter twice in one stage, so that in the proximal direction facing annular surfaces 40 and 42 be formed. A longitudinal axis 44 of the neck 16 is relative to the longitudinal axis 32 the bore 34 at an angle 46 inclined by about 50 °. A proximal end of the neck 16 is with a conical outer surface 48 hen hen, so that different rod ends 18 with corresponding conical inner surfaces 50 can be put on.

The implant 10 is preferably in the form of a set, so that different shafts 12 with different neck parts 14 and different rod ends 18 can be connected to each other.

The in the 1 to 4 illustrated clamping nut 20 is a total of two parts, with a three- or multi-part design would be conceivable. A first tendon part is in the form of a clamping sleeve 52 formed, which has a constant inner diameter. A distal end of the collet 52 has an annular flange projecting from an outer surface 54 which tapers conically towards the distal end, so that a conical clamping surface 56 is formed, whose inclination relative to the longitudinal axis 32 a slope of the cone surface 38 corresponds to the longitudinal axis. An inner diameter of the clamping sleeve 52 corresponds to an inner diameter of the bore 34 distal to the transition area 36 ,

A proximal end of the collet 52 has a radial direction on the longitudinal axis 32 towards projecting annular flange 58 on which a locking member in the form of a latching nose of a total with the reference numeral 60 provided latching connection.

A second tendon part is formed by a threaded sleeve 62 holding a short sleeve section 64 comprises, the outer diameter of an outer diameter of the clamping sleeve 52 equivalent. To the sleeve section 64 is an internally threaded portion on the proximal side 66 molded, which with an external hexagon 68 is provided, which forms a tool holder. The tool holder could alternatively be designed as a polygonal, Innenvielrund or Außenvielrund. The internal thread section 66 is corresponding to the male thread section 28 designed so that the screw sleeve 62 with the shaft 12 can be screwed.

Pointing distally from the sleeve section 64 evenly distributed over a circumference six locking elements in the form of resilient lobes 70 starting, which is part of the locking device 60 form and at their distal ends in each case in the radial direction outwardly projecting Ringflanschabschnitte 72 wear. The annular flange sections are of a contact surface 74 the screw sleeve 62 forming, pointing in the distal direction end face just so far apart that the annular flange 58 between the contact surface 74 and the annular flange sections 72 can dip in a locking or connecting position. A proximal end face 76 the clamping sleeve 76 forms a further contact surface, which in an assembled position or detent position of the clamping nut 20 in which the clamping sleeve 52 and the screw sleeve 62 each other by means of the locking connection 60 are connected to the contact surface 74 is applied. Both the contact surface 74 as well as the face 76 are preferably provided with a friction-reducing coating to form sliding surfaces.

The assembly of the implant prior to insertion into a human or animal body is described in detail below with reference to 1 to 4 explained in more detail.

First, the screw sleeve with the distal side lobes 70 in the proximal end of the collet 52 introduced. The annular flange sections slide 72 the cloth 70 at the ring flange 58 on, making the rag 70 radially inward toward the longitudinal axis 32 be pivoted. Once the ring flange sections 72 the ring flange 58 can catch behind, feathers rag 70 back in their in the 1 to 3 illustrated basic position radially outwards and hold the annular flange 58 between the annular flange sections 72 and the contact surface 74 , The clamping nut 20 is now preassembled and can be used to connect the shaft 12 with the neck part 14 be used.

For this purpose, first the shaft 12 coming from distal with its proximal end in the drilling 34 introduced. Then the clamping nut 20 coming from the proximal into the hole 34 introduced with its distal end in front, with the female threaded portion 66 with the male threaded portion 28 is screwed, and indeed until the clamping surface 56 on the cone surface 38 is applied. Due to the selected inclination of the adjoining conical surface 38 and the clamping surface 56 becomes a rotation of the clamping sleeve 52 relative to the neck part 14 prevented. Another screwing of the clamping nut 20 with the neck part leads to the abutting sliding surfaces, which are formed by the contact surface 74 and the frontal area 76 , on further screwing the screw sleeve 62 on the shaft 12 glide together. The sliding surfaces are designed so that frictional forces acting between them are much smaller than between the cone surface 38 and the clamping surface 56 acting frictional forces. By means of the clamping nut 20 is the shaft in the manner described 12 immovable against the neck part 14 curious; excited.

In 5 is a second embodiment of a total reference numeral 120 provided clamping nut, which a clamping sleeve 152 that is identical to the ferrule 52 is trained. Furthermore, the clamping nut includes 120 a screw sleeve 162 , which in its essential structure with the screw sleeve 62 matches. The only difference is the formation of a tendon connection device, the clamping nut 20 in the form of the locking connection 60 designed, with the clamping nut 120 but in the form of a clamp connection 160 is trained. The clamp connection 160 has a distal direction in the axial direction of the sleeve portion 164 protruding sleeve section 178 whose inner diameter is the inner diameter of the sleeve portion 164 equivalent. An outer diameter of the sleeve portion 164 tapers in one step at the transition to the sleeve section 178 , Adjacent to a distal end of the sleeve section 178 is in an outer wall of the same an annular groove 180 formed, in which a spring washer 182 dips.

For connecting the clamping sleeve 152 with the screw sleeve 162 becomes the sleeve section 178 coming from the proximal end into a proximal end of the clamping sleeve 152 introduced, whereby the spring washer 182 when sliding on the ring flange 158 in the ring groove 180 is pressed. From this he springs back slightly in the radial direction outwards, as soon as he the ring flange 158 engages behind. The clamping sleeve 152 is so captive on the screw 162 secured.

The shaft 12 can with the clamping nut 120 in an analogous manner with the neck part 14 be connected as above for the clamping nut 20 described.

A third embodiment of a tendon according to the invention is in 6 in the form of the total with the reference numeral 220 provided clamping nut. This includes a clamping sleeve 252 , which are almost identical to the clamping sleeve 52 is formed, and a threaded sleeve 262 that essentially with the screw 162 matches. For connecting the clamping sleeve 252 with the screw sleeve 262 is a tendon connection device in the form of a screw connection 260 provided, the one at the ring flange 258 provided internal thread 284 and one on the sleeve section 278 trained external thread 286 includes, which corresponds to the internal thread 284 is trained. In this way, the screw 262 with the clamping sleeve 252 be screwed, by inserting the sleeve portion 278 coming from proximal into the annular flange 258 for screwing the screw 262 relative to the clamping sleeve 252 around the longitudinal axis 232 ,

A connection of the shaft 12 of the implant 10 with the neck part 14 done by means of the clamping nut 220 in a similar way as with the clamping nuts 20 and 120 ,

Alternatively, the tendon connection device may also be provided in the form of a bayonet connection which is located between the threaded sleeve 62 and the clamping sleeve 52 may be formed, for example by providing corresponding projections and recesses on the cloth 70 and at the ring flange 58 ,

The clamping nuts 20 . 120 and 220 are preferably made of a metal. The two parts of the clamping nuts 20 . 120 and 220 can be made of identical or different materials.

Tendons in the form of clamping nuts 20 . 120 and 220 can be formed in the form of a set, for example, the screw sleeves 62 . 162 and 262 may be formed identically, the clamping sleeves 52 . 152 and 252 each a different length in the direction of the longitudinal axis 32 may have, so that differently shaped shafts 12 and neck parts 14 can be securely connected with each other.

Claims (31)

Tendon ( 20 ; 120 ; 220 ) for an implant ( 10 ) comprising at least one first implant part ( 12 ), at least one second implant part ( 14 ) and a tendon ( 20 ; 120 ; 220 ), whereby the implant parts ( 12 . 14 ) and the tendon ( 20 ; 120 ; 220 ) are designed and cooperate in such a way that the first implant part ( 12 ) with the tendon ( 20 ; 120 ; 220 ) against the second implant part ( 14 ) is tensionable, wherein the tendon ( 20 ; 120 ; 220 ) at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ), characterized in that one of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) connecting in a connecting position, at least two-part tendon connection device ( 60 ; 160 ; 260 ) and that at least one first tendon connection device part ( 70 ; 178 ; 278 ) on a first tendon part ( 62 ; 162 ; 262 ) and at least one second tendon connection device part ( 58 ; 158 ; 258 ) on a second tendon part ( 52 ; 152 ; 252 ) is arranged. Tenter according to claim 1, characterized in that the tendon ( 20 ; 120 ; 220 ) at least a first and at least one second tendon part ( 52 . 62 ; 152 . 162 ; 252 . 262 ) and that the first or the second tendon part ( 52 . 62 ; 152 . 162 ; 252 . 262 ) with the first or the second implant part ( 12 . 14 ) is releasably connectable. Tensioning element according to one of the preceding claims, characterized in that one of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) with the first implant part ( 12 ) is detachably connectable and that the other of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) on the one of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) and on the second implant part ( 14 ) is supported for transmitting a clamping force from the first implant part ( 12 ) on the second implant part ( 14 ). Tensioning element according to one of the preceding claims, characterized in that one of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) with the at least one first or the at least one second implant part ( 12 . 14 ) is screwed. Tensioning element according to one of the preceding claims, characterized in that the at least one first tendon connection device part ( 70 ; 178 ; 278 ) at the distal end of the one tendon part ( 62 ; 162 ; 262 ) is arranged and that the at least one second tendon connection device part ( 58 ; 158 ; 258 ) at the proximal end of the other tendon part ( 52 ; 152 ; 252 ) is arranged. Tensioning element according to one of the preceding claims, characterized characterized in that the tendon connection device in shape a bayonet connection is formed. Tensioning member according to one of claims 1 to 5, characterized in that the tendon connection device ( 60 ) in the form of a latching or snap connection ( 60 ) is trained. Tensioning member according to claim 7, characterized in that the latching or snap connection ( 60 ) at least one resiliently mounted locking element ( 70 ), which in a latching position with at least one corresponding latching member ( 58 ) is engaged. Tenter according to claim 8, characterized in that the first and / or the second tendon part ( 62 ) at least one resiliently mounted locking element ( 70 ) and that the respective other tendon part ( 52 ) at least one corresponding locking member ( 58 ) wearing. Tensioning element according to one of claims 8 or 9, characterized in that at least two locking elements ( 70 ) are provided. Tensioning element according to one of claims 8 to 10, characterized in that the at least one latching element ( 70 ) is resiliently mounted in the radial direction. Tensioning element according to one of claims 8 to 11, characterized in that the at least one latching element ( 70 ) a catch ( 72 ) bears, which in a detent position a latching projection ( 58 ) at least partially engages behind or embraces. Tensioning member according to claim 12, characterized in that the latching lug ( 72 ) on at least one locking element ( 70 ) in the radial direction on a longitudinal axis ( 32 ) of the tendon ( 20 ) or away from it. Tensioning member according to one of claims 1 to 5, characterized in that the tendon connection device ( 160 ) in the form of a clamping connection ( 160 ) is trained. Tensioning member according to claim 14, characterized in that the clamping connection ( 160 ) at least one spring ring ( 182 ) for holding together the two tendon parts ( 152 . 162 ). Tensioning member according to claim 15, characterized in that one of the at least two tendon parts ( 152 . 162 ) an annular groove ( 180 ) for the spring washer ( 182 ) and that the other tendon part ( 152 ) a corresponding undercut ( 158 ), on which the spring ring ( 158 ) abuts in a connection position. Tensioning member according to one of claims 1 to 5, characterized in that the tendon connection device ( 260 ) in the form of a screw connection ( 260 ) is formed and that the one Tendon part ( 252 ) an internal thread ( 284 ) and that the other tendon part ( 262 ) to the internal thread ( 284 ) corresponding external thread ( 286 ) wearing. Tenter according to one of the preceding claims, characterized in that the tendon ( 20 ; 120 ; 220 ) is sleeve-shaped or substantially sleeve-shaped. Tensioning element according to one of the preceding claims, characterized in that at least one first tendon part ( 62 ; 162 ; 262 ) is made of a different material than at least one second tendon part ( 52 ; 152 ; 252 ). Tensioning element according to one of the preceding claims, characterized in that at least one first tendon part ( 62 ; 162 ; 262 ) is made of the same material as at least one second tendon part ( 52 ; 152 ; 252 ). Tensioning element according to one of the preceding claims, characterized in that the at least one first tendon part ( 62 ; 162 ) and the at least one second tendon part ( 52 ; 152 ) in a connecting position in which they are connected to each other by means of the tendon part connecting device ( 60 ; 160 ) are connected relative to each other about a longitudinal axis ( 32 ; 132 ) of one or the other tendon part ( 52 . 62 ; 152 . 162 ) are rotatable. Tensioning member according to one of the preceding claims, characterized in that at least one of the at least two tendon parts a tool holder ( 68 ; 168 ; 268 ) for a screwing tool. Tensioning element according to claim 22, characterized in that the tool holder ( 68 ; 168 ; 268 ) a Innenvielkant or a Innenvielrund or a Außenvielkant ( 68 ; 168 ; 268 ) or is a Außenundrund. Tensioning element according to one of claims 22 or 23, characterized in that the tool holder ( 68 ; 168 ; 268 ) at a proximal end of the one tendon part ( 62 ; 162 ; 262 ) is arranged. Tensioning element according to one of claims 22 to 24, characterized in that the tool holder ( 68 ; 168 ; 268 ) is arranged in the region of the one of the two tendon part connection device parts on one of the two tendons. Tensioning element according to one of the preceding claims, characterized in that one of the at least two tendon parts ( 52 . 62 ; 152 . 162 ; 252 . 262 ) a distal end ( 56 ; 156 ; 256 ), which has a tapered outer diameter. Tensioning element according to one of the preceding claims, characterized in that a first and a plurality of second, with the first tendon part ( 62 ; 162 ; 262 )) connectable tendon parts ( 52 ; 152 ; 252 ) are provided and that the plurality of second tendon parts ( 52 ; 152 ; 252 ) different lengths in the longitudinal direction ( 32 ; 132 ; 232 ) of the tendon ( 20 ; 120 ; 220 ) exhibit. Tensioning element according to one of the preceding claims, characterized in that the at least two tendon parts ( 52 . 62 ; 152 . 162 ) at least one sliding surface ( 74 . 76 ; 174 . 176 ), that the sliding surfaces ( 74 . 76 ; 174 . 176 ) of the at least two tendon parts ( 52 . 62 ; 152 . 162 ) abut each other and that the sliding surfaces ( 74 . 76 ; 174 . 176 ) each defining a plane which is transverse or substantially transverse to a longitudinal axis ( 32 ; 132 ) of the tendon ( 20 ; 120 ) runs. Tensioning element according to Claim 28, characterized in that the sliding surfaces ( 74 . 76 ; 174 . 176 ) are at least partially provided with a friction-reducing coating. Implant ( 10 ) with a first implant part ( 12 ), a second implant part ( 14 ) and a tendon ( 20 ; 120 ; 220 ), whereby the implant parts ( 12 . 14 ) and the tendon ( 20 ; 120 ; 220 ) are ausgebil det and cooperate so that the first implant part ( 12 ) with the tendon ( 20 ; 120 ; 220 ) against the second implant part ( 14 ) is tensionable, characterized in that the tendon ( 20 ; 120 ; 220 ) a tendon ( 20 ; 120 ; 220 ) according to any one of the preceding claims. Implant according to claim 30, characterized in that the implant ( 10 ) a hip joint endoprosthesis ( 10 ) is that the first implant part ( 12 ) a shaft insertable into a femur bone ( 12 ) is that the second implant part ( 14 ) with the shaft ( 12 ) connectable prosthesis neck ( 14 ), which is a condyle ( 18 ) or with a condyle ( 18 ) is connectable, and that the tendon ( 20 ; 120 ; 220 ) one with the shaft ( 12 ) screwed clamping nut ( 20 ; 120 ; 220 ).