DE102020109617A1 - Hip socket and revision hip joint endoprosthesis - Google Patents

Abstract

In order to improve an acetabulum, in particular for a revision hip joint endoprosthesis, comprising a joint socket for implantation in the pelvic bone of a patient and at least one plate-shaped fastening tab, so that an optimal fastening of the acetabulum is made possible on the patient, it is proposed that the at least one fastening tab be connected to the The joint socket can be coupled non-positively and / or positively and that the hip socket comprises a coupling device for the non-positive and / or form-fitting coupling of the at least one fastening tab to the joint socket in a coupling position.

Description

The present invention relates to an acetabular cup, in particular for a revision hip joint endoprosthesis, comprising a joint socket for implantation in the pelvic bone of a patient and at least one plate-shaped fastening tab.

Furthermore, the present invention relates to a revision hip joint endoprosthesis comprising an acetabulum, which in an implantation position receives a socket insert with a spherical joint head receptacle, and a hip shaft with a joint head for forming a ball joint in cooperation with the joint head receptacle corresponding to the joint head.

Hip sockets and hip joint endoprostheses of the type described at the beginning are known in various variants. They are used when a hip joint prosthesis is implanted or replaced for the first time in a patient. An orthopedic surgeon faces various challenges, particularly during revision surgery in which a hip joint endoprosthesis is replaced. For example, due to a failure and / or due to the explantation, i.e. the removal of the originally implanted acetabulum, bone defect situations exist that are relatively undefined, that is to say have a high degree of variance. In particular, this makes it more difficult to attach an acetabulum to be subsequently implanted in the form of a revision socket. Very often there are only very few bones and therefore hardly any anchoring options for the revision cup in order to achieve a pure press-fit anchoring or a screw connection of the acetabulum. In these cases, so-called revision sockets with fastening straps are used. However, these do not always optimally suit the respective situation in the patient's pelvis.

It is therefore an object of the present invention to improve an acetabulum and a hip joint endoprosthesis of the type described at the outset in such a way that an optimal attachment of the acetabulum to the patient is made possible.

This object is achieved according to the invention in an acetabulum of the type described at the outset in that the at least one fastening tab can be coupled non-positively and / or positively to the joint socket and that the acetabulum has a coupling device for non-positively and / or positively coupling the at least one fastening tab to the Includes joint socket in a coupling position.

The proposed further development makes it possible in particular to position an acetabulum in the form of a revision socket in the desired manner on the pelvis of a patient. The at least one fastening tab can then, depending on the specific situation with the patient, also be positioned in the desired manner and coupled to the socket in an optimal fastening position with a positive and / or non-positive fit, for example directly or indirectly, as will be explained below with reference to relevant embodiments . In particular, the coupling device enables the at least one fastening tab to be connected to the joint socket in a simple manner. In contrast to acetabular cups, in which fastening straps are permanently fixed, the acetabular cup, further developed as proposed, can be optimally implanted in a wide variety of situations. An indirect coupling of the at least one fastening tab to the joint socket can in particular be realized in that the at least one fastening tab is arranged or formed on a carrier or a carrier element, and that the carrier or the carrier element can be coupled to the joint socket in a force-fitting and / or form-fitting manner . The coupling device is then designed to couple the carrier or the carrier element to the joint socket. It should also be noted at this point that a hip socket developed as proposed can be used both to form a hip joint endoprosthesis, which is used for primary care, and to form a revision hip joint endoprosthesis, which is used for a prosthesis revision.

In order to obtain, in particular, a high level of stability and a simplified surgical procedure when fastening the acetabulum to the bone, it is advantageous if at least one fastening tab is fixedly arranged or formed on the joint socket. In particular, this can be formed in one piece, for example monolithically, with the joint socket.

In order to be able to fix the acetabulum to a bone, for example with bone screws, it is advantageous if the at least one fastening tab comprises at least one fastening element opening. In particular, two, three, four or more fastening element openings can be provided. Fastening element openings of this type can in particular be formed by bores in the fastening tab.

It is advantageous if the at least one fastening element opening defines a conical or hollow spherical inner surface. In particular, the at least one fastening element opening can extend from an upper side to a Taper the underside of the at least one fastening tab conically. This makes it possible in particular to use screws with countersunk heads in order to fix the fastening tab on the bone. As a result, edges and protrusions that come into contact with bone and soft tissue and could damage them can be minimized during implantation. Hollow spherical inner surfaces allow a flat contact of spherical screw heads.

The at least one fastening tab can be connected to the joint socket in a simple manner if the coupling device comprises at least one first coupling element and at least one second coupling element, which are arranged or formed on the one hand on the joint socket and on the other hand on the at least one fastening tab or assigned to it, and if the at least one first coupling element and the at least one second coupling element are in non-positive and / or positive engagement in the coupling position. An assignment of one of the coupling elements to the at least one fastening tab can in particular be achieved in that the coupling element is arranged or formed on the carrier or carrier element on which the at least one fastening tab is arranged.

The coupling device can be designed in a simple manner if the at least one first coupling element is designed in the form of a coupling projection and if the at least one second coupling element is designed in the form of a coupling receptacle. In particular, the coupling receptacle can be designed to correspond to the at least one coupling projection. In principle, the coupling projection can be arranged on the joint socket or on the fastening element or on a carrier or carrier element on which the fastening element is arranged or formed. Alternatively, instead of this coupling projection, a coupling receptacle can also be provided, which then interacts with a coupling projection on the joint socket in the coupling position.

For simple handling of the acetabulum, it is advantageous if the coupling device is designed in the form of a screw connection device, a clamping device and / or in the form of a bayonet connection device. Thus, the joint socket and the at least one fastening element or a carrier or carrier element on which the at least one fastening element is arranged can, in particular, be coupled to one another quickly, easily and reliably.

In particular for a simple design of a screw connection device, it is advantageous if the coupling receptacle comprises an internal thread and if the corresponding coupling projection comprises an external thread corresponding to the internal thread. In addition, handling of the acetabulum can also be simplified in this way. For example, the component with the coupling receptacle can be screwed onto the coupling projection from the outside. The joint socket can optionally also be used without additional fastening straps, for example for an initial implantation. If necessary, one or more further fastening options can be created from the outside during the surgical procedure by screwing a carrier or carrier element with the at least one further fastening tab onto the joint socket. A receptacle for a joint socket insert with a spherical joint head receptacle remains unchanged.

In order to enable high stability of the acetabulum in the coupling position, it is advantageous if the at least one first coupling element or the at least one second coupling element are arranged or formed in one piece, in particular monolithically, on the at least one fastening tab.

According to an advantageous embodiment of the invention it can be provided that the coupling projection is designed in the form of a sleeve-shaped coupling insert and that the joint socket forms the coupling receptacle for the sleeve-shaped coupling insert. Such a coupling insert is therefore not arranged on the outside of the joint socket, but in the coupling receptacle. A joint socket insert with a spherical joint head receptacle is usually inserted into the joint socket. This is still possible, because the joint socket insert can then be inserted into the sleeve-shaped coupling insert. This configuration enables high stability of the connection between the coupling insert and the joint socket. At this point it should be noted that the sleeve-shaped coupling insert, which as a whole defines the coupling projection, in particular forms a carrier for the at least one fastening tab.

As already mentioned, a high stability of a connection of the coupling insert and the joint socket in the coupling position can be achieved in particular by the coupling insert being arranged in the coupling position between the joint socket and a joint socket insert received therein. For example, a double clamp connection can be formed here, on the one hand between the coupling insert and the joint socket and on the other hand between the joint socket insert and the Coupling insert. Alternatively, it can also be provided that the coupling insert has an articulation surface for forming a dual mobility prosthesis, the articulation surface interacting with a corresponding articulation surface of a joint socket insert. In this case, the joint socket insert also has a spherical joint head receptacle (544) in order to receive a joint head arranged or formed on a hip shaft to form a ball joint.

In order to be able to ensure, in particular, a permanently stable attachment of the acetabulum to the patient's bone, it is advantageous if the coupling insert and the joint socket are in force-fitting and / or form-fitting engagement in the coupling position.

It is advantageous if the sleeve-shaped coupling insert has an outer first conical clamping surface and if the first clamping surface is designed to correspond to an inner, second conical clamping surface of the joint socket. This configuration enables in particular the formation of a clamping connection between the first and the second clamping surface and thus between the coupling insert and the joint socket.

In order to be able to achieve high stability of the connection between the coupling insert and the joint socket, it is advantageous if the first clamping surface and the second clamping surface form a self-locking connection between the coupling insert and the joint socket in the coupling position. Such a self-locking clamping connection can be specified depending on the selected material or the selected materials from which the coupling insert on the one hand and the joint socket on the other hand are formed, as well as taking into account a cone angle of the first and second clamping surface as required. The roughness of the surface can also play a role as a parameter in such a connection. As an alternative or in addition, a controlled cold welding could also be used for the connection between the coupling insert and the joint socket. For example, a two-part screw can be coupled with a predetermined tightening torque, with a loosening torque then being greater than the tightening torque in the case of such a cold welding. For example, the loosening torque can be more than 20 Nm, but the tightening torque only 10 Nm. This can be achieved in particular by a structural design of the surface pressure, which leads to partial cold welding.

Furthermore, it is advantageous if the coupling insert has an inner third conical clamping surface and if the third clamping surface is designed to correspond to an outer fourth conical clamping surface of the joint socket insert. In this way, a conical connection can also be formed between the third and fourth clamping surface, similar to that between the first and second clamping surface.

In order to be able to achieve a particularly stable connection between the coupling insert and the joint socket insert, it is advantageous if the third clamping surface and the fourth clamping surface in the coupling position form a self-locking connection between the coupling insert and the joint socket insert. As with an optionally provided self-locking connection between the first and second clamping surface, such a self-locking connection between the third and fourth clamping surface can be achieved by fulfilling the conditions required for self-locking, i.e. in particular a corresponding cone angle depending on the material pairing joint socket insert on the one hand and coupling insert on the other .

Particularly high stability in the connection between the acetabulum and the patient's pelvis can be achieved, for example, in that the at least one fastening tab is formed in one piece, in particular monolithically, with the coupling insert.

In order to allow a high degree of variability in the fastening of the acetabulum to the patient's bone, it is advantageous if the coupling insert has one, two, three or more fastening straps. These can be formed in one piece with the coupling insert or optionally releasably connectable, for example by means of a force-fit and / or form-fit connection.

According to a further preferred embodiment of the invention it can be provided that the coupling projection is designed in the form of a sleeve-shaped socket section of the joint socket, that the coupling device comprises a coupling ring which defines the coupling receptacle, and that the coupling ring in the coupling position surrounds the sleeve-shaped socket section, in particular by force - and / or form-fitting. In this case, the coupling ring thus in particular forms a carrier or a carrier element on which the at least one fastening tab is arranged or formed. The coupling ring and the joint socket are designed, as described, in such a way that they are in force and / or form-fitting engagement in the coupling position. This enables high stability of the acetabulum itself and thus also high stability for fastening the acetabulum to the patient's pelvis.

The at least one fastening tab is advantageously designed in one piece, in particular monolithically, with the coupling ring. In particular, relative movements between the fastening tab and the coupling ring can thus be excluded. In this embodiment, the coupling ring forms a type of carrier or carrier element for the at least one fastening tab.

In order to allow a high degree of flexibility in the fastening of the joint socket to the patient's bone, it is advantageous if the coupling ring has one, two, three or more fastening straps.

In order to be able to couple the coupling ring and the joint socket to one another in a particularly simple and rapid manner, it is advantageous if the sleeve-shaped socket section and the coupling ring form components of a bayonet connection device. In the case of bayonet connection devices, it is customary for the components to be coupled to one another to first be moved towards one another and then to be rotated relative to one another about an axis which is defined by the direction of movement towards one another. In this way, in particular, defined connection positions or coupling positions can be achieved. Alternatively, to fasten the coupling ring to the sleeve-shaped socket section, they can be coupled to one another via a snap connection or a press fit.

The coupling ring preferably covers a maximum of 5%, in particular a maximum of 2%, of an outer surface of the joint socket. The socket is almost completely free and can come into contact with the patient's bone. In particular, this configuration makes it possible to provide optional fastening perforations on the joint socket, which allow the inclusion of fastening elements in the form of bone screws, for example, in order to screw the joint socket directly onto the bone.

In order to be able to hold the coupling ring on the joint socket securely and in particular in a defined manner in the coupling position, it is advantageous if the joint socket has a receiving groove that faces outwards and if the coupling ring is held in the coupling position in the receiving groove. Such a configuration in the coupling position at most enables a rotation of the coupling ring and the joint socket relative to one another about a longitudinal axis defined by the coupling ring.

The coupling between the joint socket and the coupling ring can be achieved in a simple manner in particular that the receiving groove is laterally bounded by a first ring flange and a second ring flange and that the two ring flanges run parallel to one another. For example, the coupling ring can be supported on both ring flanges in the coupling position.

In order to enable the coupling ring to be optimally supported on the receiving groove, it is advantageous if the first ring flange, which is arranged further away from a circumferential edge of the joint socket, has a constant or essentially constant width. For example, when the coupling ring does not have a constant width, it is ensured in this way that, regardless of a rotational position of the coupling ring relative to the joint socket, the coupling ring can reliably rest on the first ring flange. In particular, in a case where the coupling ring has sections in the circumferential direction whose width is smaller than in areas between these sections, the coupling ring cannot slip over the first ring flange regardless of a rotational or rotational position relative to a longitudinal axis of the coupling ring if a Width of the first ring flange is constant.

It is advantageous if the coupling ring defines a coupling ring longitudinal axis and if a coupling ring width of the coupling ring varies in the radial direction with respect to the coupling ring longitudinal axis over a circumference of the coupling ring. Such a configuration enables a bayonet connection device to be formed between the coupling ring and the joint socket in a particularly simple manner. For example, the coupling ring can be designed to be complementary to the second ring flange, so that it can be pushed over the second ring flange in an engaged position and then rotated relative to it in order to be held in the coupling position between the two ring flanges in a non-positive and / or form-fitting manner.

It is advantageous if the second annular flange, which is arranged less far from the circumferential edge, defines an annular flange width and an annular flange longitudinal axis and if the annular flange width varies in the radial direction relative to the annular flange longitudinal axis over a circumference of the annular flange. In particular, a variation of the ring flange width can be provided in such a way that it is complementary to the coupling ring width. As described, this enables, in particular, the movement of the coupling ring in an engagement position over the second annular flange and the transfer of the acetabulum from the engagement position into the coupling position by rotating the coupling ring around the longitudinal axis of the annular flange relative to the joint socket.

For the formation of a bayonet connection device for coupling the joint socket and the coupling ring, it is particularly advantageous if the coupling ring width has at least two, in particular three or four, maxima of coupling ring areas extending over part of the circumference of the coupling ring and if the second ring flange has a corresponding number of ring flange areas extending over part of its circumference having a minimum ring flange width and when the coupling ring areas and the ring flange areas extend over mutually corresponding angular areas with respect to the ring flange longitudinal axis and the coupling ring longitudinal axis coinciding with this in the coupling position. The more maxima of the coupling ring width and corresponding minimum ring flange widths are provided, the more different positions can be provided for bringing the coupling ring and the joint socket into engagement. This increases, in particular, flexibility in the coupling between the coupling ring and the joint socket, in particular intraoperatively for a surgeon.

It is favorable if the coupling ring can be transferred from a release position, in which it is separated from the joint socket, to an intermediate position by a movement parallel to the longitudinal axis of the annular flange in the direction of the first annular flange, when the coupling ring can be transferred from the intermediate position by rotating around the longitudinal axis of the annular flange can be transferred into the coupling position and when the coupling ring is held in the coupling position between the first annular flange and the second annular flange. In the manner described, a bayonet connection device in particular can be formed in a simple manner between the joint socket and the coupling ring which enables the parts to be coupled and, if necessary, released from one another, then in the reverse order.

According to a further advantageous embodiment of the invention, it can be provided that the coupling projection is designed in the form of a fastening tab projection and the coupling receptacle in the form of a corresponding fastening tab receptacle, that the fastening tab projection is arranged or configured on the at least one fastening tab, that the fastening tab receptacle is arranged or is formed and that the fastening tab projection and the fastening tab are in the coupling position non-positively and / or positively engaged. The proposed further development enables, in particular, a direct coupling of an individual fastening strap to the joint socket. The fastening tab receptacle can be arranged or formed on the joint socket on a flange, for example a circumferential annular flange, or a flange section, which are arranged or embodied, for example, in the area of a circumferential edge of the joint socket. Thus, if necessary, the fastening tab can also be brought into engagement intraoperatively with a joint socket that is already temporarily or permanently coupled to the patient's pelvis. In particular, an optimal fastening of the joint socket to the pelvic bone can be achieved intraoperatively, specifically through individual adaptation and positioning of the fastening strap, which can be coupled to the joint socket.

In order to bring the fastening tab into engagement in a particularly simple manner with a fastening tab receptacle which is arranged or formed in the area of a flange arranged or formed on the circumferential edge of the joint socket, it is advantageous if the fastening tab projection is arranged or protruding from an underside of the at least one fastening tab is trained. This in particular enables the fastening tab and the joint socket to be brought into engagement from above, that is to say towards the edge of the joint socket. In particular, an intraoperative coupling of the fastening tab and the joint socket can be implemented easily and safely in this way.

In order to enable a secure connection between the fastening tab and the joint socket in the coupling position, it is advantageous if the fastening tab projection defines at least one undercut. The fastening tab receptacle can in particular comprise a corresponding projection which, in the coupling position, engages in the at least one undercut. In particular, one, two or three undercuts can be provided.

The joint socket and the fastening tab can be brought into engagement with one another in the coupling position in a simple and secure manner if the fastening tab projection and the fastening tab receptacle are T-shaped in cross-section. In particular, with appropriate dimensioning, a movement along a direction of movement predetermined by the fastening tab receptacle between the fastening tab projection and the fastening tab receptacle can be performed in the coupling position in a defined manner. The fastening tab and the joint socket can then still be moved relative to one another when they assume the coupling position. Thus, a surgeon can bring the fastening tab into an optimal fastening position relative to the joint socket, for example by moving the fastening tab in the fastening element receptacle relative to the joint socket.

The joint socket can be designed in a simple manner if the fastening tab receptacle is designed in the form of a fastening tab groove.

It is favorable if the fastening tab groove is opened pointing in a direction parallel to a longitudinal axis of the joint socket. This makes it possible in particular to introduce the fastening tab projection into the fastening tab receptacle in a direction parallel to the longitudinal axis of the joint socket.

It is favorable if the fastening lug groove defines an insertion area and a coupling area and if a fastening lug groove width is greater in the insertion area than in the coupling area. This configuration makes it possible in particular to introduce the fastening tab projection in the insertion area into the fastening tab groove and then, for example, to move the fastening tab projection from the insertion area into the coupling area along a direction of extent defined by the fastening tab receptacle. In particular, complementary shapes, for example undercuts on the fastening tab projection and the fastening tab groove, can be brought into engagement when the fastening tab projection is transferred from the insertion area into the coupling area.

It is advantageous if the fastening tab receptacle is designed concentrically with respect to the longitudinal axis of the joint socket and extends over a receptacle circumferential angle of less than 180 °. In particular, the mounting circumferential angle can be smaller than 130 °. Such a configuration makes it possible, in particular, to also arrange stationary fastening straps on the joint socket, so that an additional fastening strap that can be coupled to the joint socket can be variably positioned, for example, in the specified angular range on the joint socket.

It is favorable if the fastening tab projection is designed concentrically with respect to the longitudinal axis of the joint socket and extends over a projection circumferential angle and if the projection circumferential angle is smaller than the receiving circumferential angle, in particular smaller than 50%. In particular, the projection circumferential angle can be smaller than 35% of the receiving circumferential angle. The smaller the projection circumferential angle, the greater the variability in the positioning of the fastening tab on the joint socket.

In order to be able to insert the fastening tab projection easily and safely into the fastening tab receptacle, it is advantageous if the insertion area extends over a circumferential angle which corresponds at least to the projection circumferential angle.

According to a further preferred embodiment of the invention it can be provided that the at least one fastening tab has an upper side and an underside and that the underside is designed in the form of a bone abutment surface. The underside is thus designed in such a way that it is suitable for coming into contact with a bone. For example, the fastening tab can be made from a biocompatible material or provided with a biocompatible coating, in particular the underside.

In order to enable the fastening strap to be optimally adapted to the bone, it is advantageous if the bone abutment surface is rough.

In order to achieve permanent attachment of the joint socket to the bone in particular, it is advantageous if the bone abutment surface has an osteointegrative coating.

It is favorable if the acetabulum, in particular the joint socket and the at least one fastening tab, are made from a body-compatible implant material. In particular, the implant material can be titanium or a titanium alloy. In this way, the risk of a rejection reaction after implantation of the acetabulum can be minimized.

The at least one fastening tab is preferably designed to be flat or essentially flat, at least in sections. In this way, it can be optimally adapted to flat bone areas.

The at least one fastening tab is advantageously curved at least in sections. In particular, it can be designed with a constant or changing radius of curvature. A curved section of the at least one fastening tab can be optimally adapted, in particular, to curved bone sections in order to achieve flat contact between the fastening tab and the bone.

In order to enable a flat contact of the fastening tab also in the area of concavo-convex curved bone surfaces, it is advantageous if the at least one fastening tab is designed to be concavo-convexly curved at least in sections.

Preferably, the at least one fastening tab has a constant or im Essentially constant thickness. If the thickness is sufficiently small, the at least one fastening tab can optionally be adapted intraoperatively to the patient's bone contour, for example by cold forming, in particular bending.

According to a further preferred embodiment of the invention it can be provided that the at least one fastening tab has a fastening tab length based on at least one first or second coupling element and that the fastening tab length is smaller than a maximum diameter of the at least one first or second coupling element. In particular, the fastening length can be smaller than a diameter of the coupling ring or a diameter of the sleeve-shaped coupling insert. In particular, a compact hip span can be provided for revision operations.

In order to enable the joint socket to grow optimally into the bone, it is advantageous if the joint socket has an outer surface in the form of a bone abutment surface and that the outer surface has an osteointegrative coating.

The object set at the beginning is also achieved according to the invention in a hip joint endoprosthesis of the type described at the beginning in that the acetabulum is designed in the form of one of the preferred embodiments of acetabular cups described above.

Equipping a hip joint endoprosthesis with such an acetabular cup has, in particular, the advantages described above in connection with preferred embodiments of acetabular cups.

A particularly stable revision hip joint endoprosthesis can in particular be achieved if the sleeve-shaped coupling insert of the acetabulum is arranged in the coupling position between the joint socket and the joint socket insert.

1. 1. Hüftpfanne (12; 212; 412), insbesondere für eine Revisionshüftgelenkendoprothese (14; 214; 414), umfassend eine Gelenkpfanne (16; 216; 416) zum Implantieren in den Beckenknochen (10) eines Patienten und mindestens eine plattenförmige Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422), dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (22; 218, 220, 222; 418, 420, 422) mit der Gelenkpfanne (16; 216; 416) kraft- und/oder formschlüssig koppelbar ist und dass die Hüftpfanne (12; 212; 412) eine Kopplungseinrichtung (42; 242; 442) zum kraft- und/oder formschlüssigen Koppeln der mindestens einen Befestigungslasche (22; 218, 220, 222; 418, 420, 422) mit der Gelenkpfanne (16; 216; 416) in einer Kopplungsstellung umfasst.
2. 2. Hüftpfanne nach Satz 1, dadurch gekennzeichnet, dass an der Gelenkpfanne (16) mindestens eine Befestigungslasche (18, 20) feststehend, insbesondere einstückig, weiter insbesondere monolithisch, angeordnet oder ausgebildet ist.
3. 3. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) mindestens eine Befestigungselementdurchbrechung (88, 90; 288, 290; 488, 490) umfasst, insbesondere zwei, drei, vier oder mehr Befestigungselementdurchbrechungen (88, 90; 288, 290; 488, 490), wobei insbesondere die mindestens eine Befestigungselementdurchbrechung (88, 90; 288, 290; 488, 490) eine konische Innenfläche (92, 94; 292, 294; 492, 494) definiert, insbesondere sich von einer Oberseite (56, 96; 256, 296; 456, 496) zu einer Unterseite (58, 98; 258, 298; 458, 498) der mindestens einen Befestigungslasche (18, 20, 22; 218, 220, 222) verjüngend.
4. 4. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Kopplungseinrichtung (42; 242; 442)mindestens ein erstes Kopplungselement (44; 244; 444) und mindestens ein zweites Kopplungselement ( 46; 246; 446) umfasst, die einerseits an der Gelenkpfanne (16; 216; 416) und andererseits an der mindestens einen Befestigungslasche ( 22; 218, 220, 222; 418, 420, 422) angeordnet oder ausgebildet oder dieser zugeordnet sind, und dass das mindestens eine erste Kopplungselement (44; 244; 444) und das mindestens eine zweite Kopplungselement ( 46; 246; 446) in der Kopplungsstellung kraft- und/oder formschlüssig in Eingriff stehen.
5. 5. Hüftpfanne nach Satz 4, dadurch gekennzeichnet, dass das mindestens eine erste Kopplungselement (44; 244; 444) in Form eines Kopplungsvorsprungs (48; 248; 448) ausgebildet ist und dass das mindestens eine zweite Kopplungselement (46; 246; 446) in Form einer Kopplungsaufnahme (50; 250; 450) ausgebildet ist, insbesondere korrespondierend zum mindestens einen Kopplungsvorsprung (48; 248; 448).
6. 6. Hüftpfanne nach Satz 4 oder 5, dadurch gekennzeichnet, dass die Kopplungseinrichtung (242) in Form einer Schraubverbindungseinrichtung, einer Klemmeinrichtung und/oder in Form einer Bajonettverbindungseinrichtung (318) ausgebildet ist.
7. 7. Hüftpfanne nach Satz 5 oder 6, dadurch gekennzeichnet, dass die Kopplungsaufnahme ein Innengewinde umfasst und dass der korrespondierende Kopplungsvorsprung ein zum Innengewinde korrespondierendes Außengewinde umfasst.
8. 8. Hüftpfanne nach einem der Sätze 4 bis 7, dadurch gekennzeichnet, dass das mindestens eine erste Kopplungselement (44; 444) oder das mindestens eine zweite Kopplungselement (246) einstückig, insbesondere monolithisch, an der mindestens einen Befestigungslasche (22; 218, 220, 222; 418, 420, 422) angeordnet oder ausgebildet sind.
9. 9. Hüftpfanne nach einem der Sätze 5 bis 8, dadurch gekennzeichnet, dass der Kopplungsvorsprung (448) in Form eines hülsenförmigen Kopplungseinsatzes (552) ausgebildet ist und dass die Gelenkpfanne (416) die Kopplungsaufnahme (450) für den hülsenförmigen Kopplungseinsatz (552) bildet.
10. 10. Hüftpfanne nach Satz 9, dadurch gekennzeichnet, dass der Kopplungseinsatz (552) in der Kopplungsstellung zwischen der Gelenkpfanne (416) und einem in dieser aufgenommenen Gelenkpfanneneinsatz (542) angeordnet ist.
11. 11. Hüftpfanne nach Satz 9 oder 10, dadurch gekennzeichnet, dass der Kopplungseinsatz (552) und die Gelenkpfanne (416) kraft- und/oder formschlüssig in der Kopplungsstellung in Eingriff stehen.
12. 12. Hüftpfanne nach einem der Sätze 9 bis 11, dadurch gekennzeichnet, dass der hülsenförmige Kopplungseinsatz (552) eine äußere erste konische Klemmfläche (554) aufweist und dass die erste Klemmfläche (554) korrespondierend zu einer inneren zweiten konischen Klemmfläche (556) der Gelenkpfanne (416) ausgebildet ist.
13. 13. Hüftpfanne nach Satz 12, dadurch gekennzeichnet, dass die erste Klemmfläche (554) und die zweite Klemmfläche (556) in der Kopplungsstellung eine selbsthemmende Verbindung zwischen dem Kopplungseinsatz (552) und der Gelenkpfanne (416) ausbilden.
14. 14. Hüftpfanne nach einem der Sätze 9 bis 13, dadurch gekennzeichnet, dass der Kopplungseinsatz (552) eine innere dritte konische Klemmfläche (558) aufweist und dass die dritte Klemmfläche (558) korrespondierend zu einer äußeren vierten konischen Klemmfläche (560) des Gelenkpfanneneinsatzes (542) ausgebildet ist.
15. 15. Hüftpfanne nach Satz 14, dadurch gekennzeichnet, dass die dritte Klemmfläche (558) und die vierte Klemmfläche (560) in der Kopplungsstellung eine selbsthemmende Verbindung zwischen dem Kopplungseinsatz (552) und dem Gelenkpfanneneinsatz (542) ausbilden.
16. 16. Hüftpfanne nach einem der Sätze 9 bis 15, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (418, 420, 422) einstückig, insbesondere monolithisch, mit dem Kopplungseinsatz (552) ausgebildet ist.
17. 17. Hüftpfanne nach einem der Sätze 9 bis 16, dadurch gekennzeichnet, dass der Kopplungseinsatz (552) eine, zwei, drei oder mehr Befestigungslaschen (418, 420, 422) trägt.
18. 18. Hüftpfanne nach einem der Sätze 5 bis 17, dadurch gekennzeichnet, dass der Kopplungsvorsprung (248) in Form eines hülsenförmigen Pfannenabschnitts (320) der Gelenkpfanne (216) ausgebildet ist, dass die Kopplungseinrichtung (242) einen Kopplungsring (314) umfasst, welcher die Kopplungsaufnahme (250) definiert, und dass der Kopplungsring (314) in der Kopplungsstellung den hülsenförmigen Pfannenabschnitt (320) umgibt, insbesondere kraft- und/oder formschlüssig.
19. 19. Hüftpfanne nach Satz 18, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (218, 220, 222) einstückig, insbesondere monolithisch, mit dem Kopplungsring (314) ausgebildet ist.
20. 20. Hüftpfanne nach Satz 18 oder 19, dadurch gekennzeichnet, dass der Kopplungsring (314) eine, zwei, drei oder mehr Befestigungslaschen (218, 220, 222) trägt.
21. 21. Hüftpfanne nach einem der Sätze 18 bis 20, dadurch gekennzeichnet, dass der hülsenförmige Pfannenabschnitt (320) und der Kopplungsring (314) Komponenten einer Bajonettverbindungseinrichtung (318) bilden.
22. 22. Hüftpfanne nach einem der Sätze 18 bis 21, dadurch gekennzeichnet, dass der Kopplungsring (314) höchstens 5%, insbesondere höchstens 2%, einer äußeren Oberfläche der Gelenkpfanne (216) überdeckt.
23. 23. Hüftpfanne nach einem der Sätze 18 bis 22, dadurch gekennzeichnet, dass die Gelenkpfanne (216) eine von ihr nach außen weg weisend geöffnete Aufnahmenut (322) aufweist und dass der Kopplungsring (314) in der Kopplungsstellung in der Aufnahmenut (322) gehalten ist.
24. 24. Hüftpfanne nach Satz 23, dadurch gekennzeichnet, dass die Aufnahmenut (322) seitlich von einem ersten Ringflansch (324) und einem zweiten Ringflansch (326) begrenzt ist und dass die beiden Ringflansche (324, 326) parallel zueinander verlaufen.
25. 25. Hüftpfanne nach Satz 24, dadurch gekennzeichnet, dass der von einem umlaufenden Rand (226) der Gelenkpfanne (216) weiter entfernt angeordnete erste Ringflansch (324) eine konstante oder im Wesentlichen konstante Breite (328) aufweist.
26. 26. Hüftpfanne nach einem der Sätze 18 bis 24, dadurch gekennzeichnet, dass der Kopplungsring (314) eine Kopplungsringlängsachse (336) definiert und dass eine Kopplungsringbreite (338) des Kopplungsrings (314) in radialer Richtung bezogen auf die Kopplungsringlängsachse (336) über einen Umfang des Kopplungsrings (314) variiert.
27. 27. Hüftpfanne nach einem der Sätze 24 bis 26, dadurch gekennzeichnet, dass der vom umlaufenden Rand (226) weniger weit entfernt angeordnete zweite Ringflansch (326) eine Ringflanschbreite (330) und eine Ringflanschlängsachse (332) definiert und dass die Ringflanschbreite (330) in radialer Richtung bezogen auf die Ringflanschlängsachse (332) über einen Umfang des Ringflansches (326) variiert.
28. 28. Hüftpfanne nach Satz 26 oder 27, dadurch gekennzeichnet, dass die Kopplungsringbreite (338) mindestens zwei, insbesondere drei oder vier, Maxima von sich über einen Teil des Umfangs des Kopplungsrings (314) erstreckende Kopplungsringbereiche (340) aufweist und dass der zweite Ringflansch (326) eine entsprechende Anzahl von sich über einen Teil seines Umfangs erstreckende Ringflanschbereiche (334) mit einer minimalen Ringflanschbreite (330) aufweist und dass sich die Kopplungsringbereiche (340) und die Ringflanschbereiche (334) über einander entsprechende Winkelbereiche bezogen auf die Ringflanschlängsachse (332) und die mit dieser in der Kopplungsstellung zusammenfallende Kopplungsringlängsachse (336) erstrecken.
29. 29. Hüftpfanne nach einem der Sätze 24 bis 28, dadurch gekennzeichnet, dass der Kopplungsring (314) von einer Lösestellung, in welcher er von der Gelenkpfanne (216) getrennt ist, durch eine Bewegung parallel zur Ringflanschlängsachse (332) in Richtung auf den ersten Ringflansch (324) in eine Zwischenstellung überführbar ist, dass der Kopplungsring (314) von der Zwischenstellung durch eine Drehung um die Ringflanschlängsachse (332) in die Kopplungsstellung überführbar ist und dass der Kopplungsring (314) in der Kopplungsstellung zwischen dem ersten Ringflansch (324) und dem zweiten Ringflansch (326) gehalten ist.
30. 30. Hüftpfanne nach einem der Sätze 4 bis 29, dadurch gekennzeichnet, dass der Kopplungsvorsprung (48) in Form eines Befestigungslaschenvorsprungs (52) und die Kopplungsaufnahme (50) in Form einer korrespondierenden Befestigungslaschenaufnahme (54) ausgebildet sind, dass der Befestigungslaschenvorsprung (52) an der mindestens einen Befestigungslasche (22) angeordnet oder ausgebildet ist, dass die Befestigungslaschenaufnahme (54) an der Gelenkpfanne (16) angeordnet oder ausgebildet ist und dass der Befestigungslaschenvorsprung (52) und die Befestigungslaschenaufnahme (54) in der Kopplungsstellung kraft- und/ oder formschlüssig in Eingriff stehen.
31. 31. Hüftpfanne nach Satz 30, dadurch gekennzeichnet, dass der Befestigungslaschenvorsprung (52) von einer Unterseite (58) der mindestens einen Befestigungslasche (22) abstehend angeordnet oder ausgebildet ist.
32. 32. Hüftpfanne nach Satz 30 oder 31, dadurch gekennzeichnet, dass der Befestigungslaschenvorsprung (52) mindestens einen Hinterschneidung (62) definiert.
33. 33. Hüftpfanne nach einem der Sätze 30 bis 32, dadurch gekennzeichnet, dass der Befestigungslaschenvorsprung (52) und die Befestigungslaschenaufnahme (54) im Querschnitt T-förmig ausgebildet sind.
34. 34. Hüftpfanne nach einem der Sätze 30 bis 33, dadurch gekennzeichnet, dass die Befestigungslaschenaufnahme (54) in Form einer Befestigungslaschennut (64) ausgebildet ist.
35. 35. Hüftpfanne nach Satz 34, dadurch gekennzeichnet, dass die Befestigungslaschennut (64) in einer Richtung parallel zu einer Gelenkpfannenlängsachse (30) weisend geöffnet ist.
36. 36. Hüftpfanne nach Satz 34 oder 35, dadurch gekennzeichnet, dass die Befestigungslaschennut (64) einen Einführbereich (66) und einen Kopplungsbereich (68) definiert und dass eine Befestigungslaschennutbreite (70) im Einführbereich (66) größer ist als im Kopplungsbereich (68).
37. 37. Hüftpfanne nach einem der Sätze 30 bis 36, dadurch gekennzeichnet, dass die Befestigungslaschenaufnahme (54) bezogen auf die Gelenkpfannenlängsachse (30) konzentrisch ausgebildet ist und sich über einen Aufnahmeumfangswinkel (74) von weniger als 180° erstreckt.
38. 38. Hüftpfanne nach Satz 37, dadurch gekennzeichnet, dass der Befestigungslaschenvorsprung (52) bezogen auf die Gelenkpfannenlängsachse (30) konzentrisch ausgebildet ist und sich über einen Vorsprungumfangswinkel (76) erstreckt und dass der Vorsprungumfangswinkel (76) kleiner ist als der Aufnahmeumfangswinkel (74), insbesondere kleiner als 50%, weiter insbesondere kleiner als 35%.
39. 39. Hüftpfanne nach Satz 38, dadurch gekennzeichnet, dass sich der Einführbereich (66) über einen Umfangswinkel (78) erstreckt, welcher mindestens dem Vorsprungumfangswinkel (76) entspricht.
40. 40. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) eine Oberseite (56, 96; 256, 296; 456, 496) und eine Unterseite (58, 98; 258, 298; 458, 498) aufweist und dass die Unterseite (58, 98; 258, 298; 458, 498) in Form einer Knochenanlagefläche ausgebildet ist.
41. 41. Hüftpfanne nach Satz 40, dadurch gekennzeichnet, dass die Knochenanlagefläche rau ist.
42. 42. Hüftpfanne nach Satz 40 oder 41, dadurch gekennzeichnet, dass die Knochenanlagefläche eine osteointegrative Beschichtung (162; 362; 562) aufweist.
43. 43. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Hüftpfanne (12; 212; 412), insbesondere die Gelenkpfanne (16; 216; 416) und die mindestens eine Befestigungslasche (18, 20, 22; 218; 220, 222; 418, 420, 422), aus einem körperverträglichen Implantatwerkstoff ausgebildet ist, insbesondere aus Titan oder eine Titanlegierung.
44. 44. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) mindestens abschnittsweise eben oder im Wesentlichen eben ausgebildet ist.
45. 45. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) mindestens abschnittsweise gekrümmt ist, insbesondere mit einem konstanten oder sich ändernden Krümmungsradius.
46. 46. Hüftpfanne nach Satz 45, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (418, 420) mindestens abschnittsweise konkavo-konvex gekrümmt ausgebildet ist.
47. 47. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) eine konstante oder im Wesentlichen konstante Dicke aufweist.
48. 48. Hüftpfanne nach einem der Sätze 4 bis 47, dadurch gekennzeichnet, dass die mindestens eine Befestigungslasche (18, 20, 22; 218, 220, 222; 418, 420, 422) eine Befestigungslaschenlänge ausgehend vom mindestens einen ersten oder zweiten Kopplungselement (246; 444, 446) aufweist und dass die Befestigungslaschenlänge kleiner ist als ein maximaler Durchmesser des mindestens einen ersten oder zweiten Kopplungselements (246; 444).
49. 49. Hüftpfanne nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Gelenkpfanne (16; 216; 416) eine Außenfläche (170; 370; 570) in Form einer Knochenanlagefläche aufweist und dass die Außenfläche (170; 370; 570) eine osteointegrative Beschichtung aufweist.
50. 50. Hüftgelenkendoprothese (14; 214; 414) umfassend eine Hüftpfanne (12; 212; 412), welche in einer Implantationsstellung einen Gelenkpfanneneinsatz (542) mit einer hohlkugeligen Gelenkkopfaufnahme (544) aufnimmt, und einen Hüftschaft (546) mit einem Gelenkkopf (548) zur Ausbildung eines Kugelgelenks (550) im Zusammenwirken mit der zum Gelenkkopf (548) korrespondierend ausgebildeten Gelenkkopfaufnahme (544), dadurch gekennzeichnet, dass die Hüftpfanne (12; 212; 412) in Form einer Hüftpfanne (12; 212; 412) nach einem der voranstehenden Sätze ausgebildet ist.
51. 51. Hüftgelenkendoprothese nach Satz 50 soweit dieser direkt oder indirekt auf Satz 9 rückbezogen ist, dadurch gekennzeichnet, dass der hülsenförmige Kopplungseinsatz (552) in der Kopplungsstellung zwischen der Gelenkpfanne (416) und dem Gelenkpfanneneinsatz (542) angeordnet ist.

The above description therefore includes in particular the embodiments of acetabular cups and hip joint prostheses defined below in the form of numbered sentences:

1. 1. acetabulum ( 12th ; 212 ; 412 ), especially for a revision hip joint prosthesis ( 14th ; 214 ; 414 ), comprising a joint socket ( 16 ; 216 ; 416 ) for implantation in the pelvic bone ( 10 ) of a patient and at least one plate-shaped fastening strap ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ), characterized in that the at least one fastening tab ( 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) with the socket ( 16 ; 216 ; 416 ) can be coupled non-positively and / or positively and that the acetabulum ( 12th ; 212 ; 412 ) a coupling device ( 42 ; 242 ; 442 ) for non-positive and / or positive coupling of the at least one fastening strap ( 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) with the socket ( 16 ; 216 ; 416 ) includes in a coupling position.
2. 2. Hip socket according to sentence 1, characterized in that the joint socket ( 16 ) at least one mounting bracket ( 18th , 20th ) is fixed, in particular in one piece, further in particular monolithically, arranged or formed.
3. 3. Hip socket according to one of the preceding sentences, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) at least one fastening element opening ( 88 , 90 ; 288 , 290 ; 488 , 490 ) includes, in particular two, three, four or more fastening element openings ( 88 , 90 ; 288 , 290 ; 488 , 490 ), whereby in particular the at least one fastening element opening ( 88 , 90 ; 288 , 290 ; 488 , 490 ) a conical inner surface ( 92 , 94 ; 292 , 294 ; 492 , 494 ) defined, in particular extending from an upper side ( 56 , 96 ; 256 , 296 ; 456 , 496 ) to a subpage ( 58 , 98 ; 258 , 298 ; 458 , 498 ) of the at least one mounting bracket ( 18th , 20th , 22nd ; 218 , 220 , 222 ) rejuvenating.
4. 4. Hip socket according to one of the preceding sentences, characterized in that the coupling device ( 42 ; 242 ; 442 ) at least one first coupling element ( 44 ; 244 ; 444 ) and at least one second coupling element ( 46 ; 246 ; 446 ), which on the one hand is attached to the joint socket ( 16 ; 216 ; 416 ) and on the other hand on the at least one fastening strap ( 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) are arranged or designed or assigned to this, and that the at least one first coupling element ( 44 ; 244 ; 444 ) and the at least one second coupling element ( 46 ; 246 ; 446 ) are frictionally and / or positively engaged in the coupling position.
5. 5. acetabulum according to sentence 4, characterized in that the at least one first coupling element ( 44 ; 244 ; 444 ) in the form of a coupling projection ( 48 ; 248 ; 448 ) is formed and that the at least one second coupling element ( 46 ; 246 ; 446 ) in the form of a coupling recording ( 50 ; 250 ; 450 ) is formed, in particular corresponding to the at least one coupling projection ( 48 ; 248 ; 448 ).
6. 6. acetabulum according to sentence 4 or 5, characterized in that the coupling device ( 242 ) in the form of a screw connection device, a clamping device and / or in the form a bayonet connector ( 318 ) is trained.
7. 7. hip socket according to sentence 5 or 6, characterized in that the coupling receptacle comprises an internal thread and that the corresponding coupling projection comprises an external thread corresponding to the internal thread.
8. 8. Hip socket according to one of sentences 4 to 7, characterized in that the at least one first coupling element ( 44 ; 444 ) or the at least one second coupling element ( 246 ) in one piece, in particular monolithically, on the at least one fastening tab ( 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) are arranged or designed.
9. 9. Hip socket according to one of sentences 5 to 8, characterized in that the coupling projection ( 448 ) in the form of a sleeve-shaped coupling insert ( 552 ) is formed and that the joint socket ( 416 ) the coupling recording ( 450 ) for the sleeve-shaped coupling insert ( 552 ) forms.
10. 10. Hip socket according to sentence 9, characterized in that the coupling insert ( 552 ) in the coupling position between the joint socket ( 416 ) and a socket insert accommodated in this ( 542 ) is arranged.
11. 11. Hip socket according to sentence 9 or 10, characterized in that the coupling insert ( 552 ) and the socket ( 416 ) are frictionally and / or positively engaged in the coupling position.
12. 12. Hip socket according to one of sentences 9 to 11, characterized in that the sleeve-shaped coupling insert ( 552 ) an outer first conical clamping surface ( 554 ) and that the first clamping surface ( 554 ) corresponding to an inner second conical clamping surface ( 556 ) the socket ( 416 ) is trained.
13. 13. Hip socket according to sentence 12th , characterized in that the first clamping surface ( 554 ) and the second clamping surface ( 556 ) in the coupling position a self-locking connection between the coupling insert ( 552 ) and the socket ( 416 ) train.
14. 14. Hip socket according to one of sentences 9 to 13, characterized in that the coupling insert ( 552 ) an inner third conical clamping surface ( 558 ) and that the third clamping surface ( 558 ) corresponding to an outer fourth conical clamping surface ( 560 ) of the acetabular insert ( 542 ) is trained.
15. 15. Hip socket according to sentence 14th , characterized in that the third clamping surface ( 558 ) and the fourth clamping surface ( 560 ) in the coupling position a self-locking connection between the coupling insert ( 552 ) and the socket insert ( 542 ) train.
16. 16. Hip socket according to one of sentences 9 to 15, characterized in that the at least one fastening tab ( 418 , 420 , 422 ) in one piece, in particular monolithically, with the coupling insert ( 552 ) is trained.
17. 17. Hip socket according to one of sentences 9 to 16, characterized in that the coupling insert ( 552 ) one, two, three or more fastening straps ( 418 , 420 , 422 ) wearing.
18. 18. Hip socket according to one of sentences 5 to 17, characterized in that the coupling projection ( 248 ) in the form of a sleeve-shaped socket section ( 320 ) the socket ( 216 ) is designed that the coupling device ( 242 ) a coupling ring ( 314 ) which includes the coupling receptacle ( 250 ) and that the coupling ring ( 314 ) in the coupling position the sleeve-shaped socket section ( 320 ) surrounds, in particular non-positively and / or positively.
19. 19. Hip socket according to sentence 18th , characterized in that the at least one fastening tab ( 218 , 220 , 222 ) in one piece, in particular monolithically, with the coupling ring ( 314 ) is trained.
20. 20. Hip socket according to sentence 18th or 19, characterized in that the coupling ring ( 314 ) one, two, three or more fastening straps ( 218 , 220 , 222 ) wearing.
21. 21. Hip socket after one of the sentences 18th until 20th , characterized in that the sleeve-shaped socket section ( 320 ) and the coupling ring ( 314 ) Components of a bayonet connection device ( 318 ) form.
22. 22. Hip socket after one of the sentences 18th to 21, characterized in that the coupling ring ( 314 ) at most 5%, in particular at most 2%, of an outer surface of the joint socket ( 216 ) covered.
23. 23. Hip socket after one of the sentences 18th until 22nd , characterized in that the joint socket ( 216 ) a receiving groove that is open facing outwards ( 322 ) and that the coupling ring ( 314 ) in the coupling position in the mounting groove ( 322 ) is held.
24. 24. Hip socket according to sentence 23, characterized in that the receiving groove ( 322 ) on the side of a first ring flange ( 324 ) and a second ring flange ( 326 ) is limited and that the two ring flanges ( 324 , 326 ) run parallel to each other.
25. 25. Hip socket according to sentence 24 , characterized in that the edge ( 226 ) the socket ( 216 ) farther away arranged first ring flange ( 324 ) a constant or essentially constant width ( 328 ) having.
26. 26. Hip socket after one of the sentences 18th until 24 , characterized in that the coupling ring ( 314 ) a coupling ring longitudinal axis ( 336 ) and that a coupling ring width ( 338 ) of the coupling ring ( 314 ) in the radial direction in relation to the longitudinal axis of the coupling ring ( 336 ) over a circumference of the coupling ring ( 314 ) varies.
27. 27. Hip socket after one of the sentences 24 until 26th , characterized in that the edge from the circumferential edge ( 226 ) less distant second ring flange ( 326 ) a ring flange width ( 330 ) and a ring flange longitudinal axis ( 332 ) and that the ring flange width ( 330 ) in the radial direction in relation to the longitudinal axis of the ring flange ( 332 ) over a circumference of the ring flange ( 326 ) varies.
28. 28. Hip socket according to sentence 26th or 27, characterized in that the coupling ring width ( 338 ) at least two, in particular three or four, maxima of itself over part of the circumference of the coupling ring ( 314 ) extending coupling ring areas ( 340 ) and that the second ring flange ( 326 ) a corresponding number of ring flange areas extending over part of its circumference ( 334 ) with a minimum ring flange width ( 330 ) and that the coupling ring areas ( 340 ) and the ring flange areas ( 334 ) over corresponding angular ranges in relation to the longitudinal axis of the ring flange ( 332 ) and the coupling ring longitudinal axis coinciding with this in the coupling position ( 336 ) extend.
29. 29. Hip socket after one of the sentences 24 until 28 , characterized in that the coupling ring ( 314 ) from a release position in which it is removed from the socket ( 216 ) is separated by a movement parallel to the longitudinal axis of the ring flange ( 332 ) in the direction of the first ring flange ( 324 ) can be transferred into an intermediate position that the coupling ring ( 314 ) from the intermediate position by rotating around the longitudinal axis of the ring flange ( 332 ) can be transferred into the coupling position and that the coupling ring ( 314 ) in the coupling position between the first ring flange ( 324 ) and the second ring flange ( 326 ) is held.
30. 30. Hip socket according to one of sentences 4 to 29, characterized in that the coupling projection ( 48 ) in the form of a fastening tab projection ( 52 ) and the coupling recording ( 50 ) in the form of a corresponding mounting bracket mount ( 54 ) are designed so that the fastening tab projection ( 52 ) on the at least one mounting bracket ( 22nd ) is arranged or designed so that the fastening tab receptacle ( 54 ) on the socket ( 16 ) is arranged or designed and that the fastening tab projection ( 52 ) and the fastening strap holder ( 54 ) are frictionally and / or positively engaged in the coupling position.
31. 31. Hip socket according to sentence 30th , characterized in that the fastening tab projection ( 52 ) from a bottom ( 58 ) of the at least one mounting bracket ( 22nd ) is arranged or formed protruding.
32. 32. Hip socket according to the sentence 30th or 31, characterized in that the fastening tab projection ( 52 ) at least one undercut ( 62 ) Are defined.
33. 33. Hip socket after one of the sentences 30th until 32 , characterized in that the fastening tab projection ( 52 ) and the fastening strap holder ( 54 ) are T-shaped in cross-section.
34. 34. Hip socket after one of the sentences 30th up to 33, characterized in that the fastening tab receptacle ( 54 ) in the form of a fastening tab groove ( 64 ) is trained.
35. 35. Hip socket according to sentence 34 , characterized in that the fastening tab groove ( 64 ) in a direction parallel to a longitudinal axis of the acetabulum ( 30th ) is open pointing.
36. 36. Hip socket according to the sentence 34 or 35, characterized in that the fastening tab groove ( 64 ) an introductory area ( 66 ) and a coupling area ( 68 ) and that a fastening plate groove width ( 70 ) in the lead-in area ( 66 ) is greater than in the coupling area ( 68 ).
37. 37. Hip socket after one of the sentences 30th until 36 , characterized in that the fastening tab receptacle ( 54 ) based on the longitudinal axis of the joint socket ( 30th ) is concentric and extends over a mounting circumference angle ( 74 ) extends less than 180 °.
38. 38. Hip socket according to sentence 37, characterized in that the fastening tab projection ( 52 ) based on the longitudinal axis of the joint socket ( 30th ) is concentric and extends over a projection circumferential angle ( 76 ) and that the projection circumferential angle ( 76 ) is smaller than the mounting circumference angle ( 74 ), in particular less than 50%, further in particular less than 35%.
39. 39. Hip socket according to the sentence 38 , characterized in that the lead-in area ( 66 ) over a circumferential angle ( 78 ) which extends at least to the projection circumferential angle ( 76 ) is equivalent to.
40. 40. Hip socket according to one of the preceding sentences, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) a top ( 56 , 96 ; 256 , 296 ; 456 , 496 ) and a subpage ( 58 , 98 ; 258 , 298 ; 458 , 498 ) and that the underside ( 58 , 98 ; 258 , 298 ; 458 , 498 ) is designed in the form of a bone abutment surface.
41. 41. Hip socket according to the sentence 40 , characterized in that the bone abutment surface is rough.
42. 42. Hip socket according to the sentence 40 or 41, characterized in that the bone contact surface has an osteointegrative coating ( 162 ; 362 ; 562 ) having.
43. 43. Hip socket according to one of the preceding sentences, characterized in that the hip socket ( 12th ; 212 ; 412 ), especially the socket ( 16 ; 216 ; 416 ) and the at least one fastening strap ( 18th , 20th , 22nd ; 218 ; 220 , 222 ; 418 , 420 , 422 ), is formed from a body-compatible implant material, in particular from titanium or a titanium alloy.
44. 44. Hip socket according to one of the preceding sentences, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) is at least partially planar or essentially planar.
45. 45. Hip socket according to one of the preceding sentences, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) is curved at least in sections, in particular with a constant or changing radius of curvature.
46. 46. Hip socket according to sentence 45, characterized in that the at least one fastening tab ( 418 , 420 ) is formed concavo-convex curved at least in sections.
47. 47. Hip socket according to one of the preceding sentences, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) has a constant or substantially constant thickness.
48. 48. Hip socket according to one of sentences 4 to 47, characterized in that the at least one fastening tab ( 18th , 20th , 22nd ; 218 , 220 , 222 ; 418 , 420 , 422 ) a fastening strap length based on at least one first or second coupling element ( 246 ; 444 , 446 ) and that the fastening strap length is smaller than a maximum diameter of the at least one first or second coupling element ( 246 ; 444 ).
49. 49. Hip socket according to one of the preceding sentences, characterized in that the joint socket ( 16 ; 216 ; 416 ) an outer surface ( 170 ; 370 ; 570 ) in the form of a bone abutment surface and that the outer surface ( 170 ; 370 ; 570 ) has an osteointegrative coating.
50. 50. Hip joint endoprosthesis ( 14th ; 214 ; 414 ) comprising an acetabulum ( 12th ; 212 ; 412 ), which in an implantation position has an acetabular insert ( 542 ) with a spherical joint head holder ( 544 ) and a hip stem ( 546 ) with a swivel head ( 548 ) to form a ball joint ( 550 ) in cooperation with the joint head ( 548 ) correspondingly designed joint head holder ( 544 ), characterized in that the acetabulum ( 12th ; 212 ; 412 ) in the form of an acetabulum ( 12th ; 212 ; 412 ) is designed according to one of the preceding sentences.
51. 51. Hip joint endoprosthesis according to theorem 50 insofar as this is directly or indirectly related to sentence 9, characterized in that the sleeve-shaped coupling insert ( 552 ) in the coupling position between the joint socket ( 416 ) and the socket insert ( 542 ) is arranged.

• 1: eine perspektivische schematische Gesamtansicht eines Teils eines menschlichen Beckenknochens mit daran festgelegter Hüftpfanne;
• 2: eine schematische perspektivische Ansicht der Hüftpfanne aus 1;
• 3: eine Draufsicht auf die Hüftpfanne aus 2;
• 4: eine Schnittansicht längs Linie 4-4 in 3;
• 5: eine perspektivische Ansicht eines weiteren Ausführungsbeispiels einer Hüftpfanne mit an einem Kopplungsring angeordneten Befestigungslaschen;
• 6: eine perspektivische Ansicht der Hüftpfanne aus 5 in einer Koppl u ngsstell u ng;
• 7: eine Draufsicht auf die Anordnung in 6;
• 8: eine perspektivische Ansicht eines Ausführungsbeispiels eines hülsenförmigen Kopplungseinsatzes mit Befestigungslaschen; und
• 9 eine Ansicht der Anordnung aus 8 von unten.

The following description of preferred embodiments of the invention is used in conjunction with the drawings to provide a more detailed explanation. Show it:

• 1 : a perspective schematic overall view of a part of a human pelvic bone with an acetabular socket fixed thereon;
• 2 : a schematic perspective view of the acetabulum 1 ;
• 3 : a top view of the acetabulum 2 ;
• 4th Figure 4 is a sectional view taken along line 4-4 in 3 ;
• 5 : a perspective view of a further exemplary embodiment of an acetabulum with fastening straps arranged on a coupling ring;
• 6th : a perspective view of the acetabulum 5 in a coupling position;
• 7th : a top view of the arrangement in 6th ;
• 8th : a perspective view of an embodiment of a sleeve-shaped coupling insert with fastening tabs; and
• 9 a view of the arrangement 8th from underneath.

In 1 is schematically a human pelvic bone 10 shown, on which a first embodiment of an acetabulum 12th a revision hip joint prosthesis 14th is fixed.

The acetabulum 12th includes a socket 16 that are in the pelvic bones 10 is implantable. The one in the 1 until 4th illustrated embodiment of the acetabulum 12th are a total of three fastening straps 18th , 20th and 22nd arranged. The fastening tabs 18th , 20th and 22nd are plate-shaped.

The joint socket 16 is in the form of half a hollow dome 24 formed and defines a circumferential edge 26th . The edge 26th is in the form of a flange 28 from the hollow dome 24 in the radial direction based on a longitudinal axis of the joint socket 30th educated.

The two fastening straps 18th and 20th are as extensions of the flange 28 in the form of elongated platelets 32 and 34 educated. The two plates 32 and 34 each define a platelet level 36 respectively 38, based on one from the edge 26th defined entrance level 40 are slightly angled.

The fastening tabs 18th and 20th are therefore fixed, namely in one piece or monolithic, on the joint socket 16 arranged or formed.

The fastening tab 22nd on the other hand is with the joint socket 16 directly non-positively and / or positively designed to be coupled.

Around the fastening tab 22nd with the socket 16 to couple includes the acetabulum 12th a coupling device 42 for non-positive and / or positive direct coupling of the fastening strap 22nd with the socket 16 in a coupling position, as shown schematically in the 1 until 4th is shown.

The coupling device 42 comprises a first coupling element 44 and a second coupling element 46 . The first coupling element 44 is on the socket 16 arranged or formed. The second coupling element 46 is on the fastening strap 22nd arranged or formed. The first coupling element is in the coupling position 44 and the second coupling element 46 non-positively and / or positively engaged.

The first coupling element 44 is with the one in the 1 until 4th illustrated embodiment of the acetabulum 12th in the form of a coupling projection 48 educated. The second coupling element 46 is in the form of a coupling recording 50 formed, namely corresponding to the coupling projection 48 .

The first coupling element 44 is in one piece, namely monolithic, on the fastening strap 22nd arranged or formed.

The coupling projection 48 is in the form of a mounting tab protrusion 52 formed, the coupling receptacle 50 in the form of a fastening tab projection 52 corresponding fastening strap holder 54 . This is the fastening tab protrusion 52 directly on the fastening strap 22nd arranged or formed. The fastening strap mount 54 is directly on the socket 16 arranged or formed.

The fastening tab projection is in the coupling position 52 and the fastening tab receptacle 54 non-positively and / or positively engaged, as shown schematically in the 1 until 4th is shown.

The plate-shaped fastening strap 22nd defines a top 56 and a bottom 58 . The tab protrusion 52 is at a first end region of the fastening strap 22nd from the bottom 58 arranged or formed protruding.

The tab protrusion 52 and the fastening tab receptacle 54 are T-shaped in cross-section, as shown in FIG 4th is easy to recognize in the section. This particular cross-sectional shape defines the projection of the fastening tab 52 two undercuts pointing away from each other 62 .

The fastening strap mount 54 is in the form of a fastening tab groove 64 educated. This is in a direction parallel to the longitudinal axis of the joint socket 30th pointing open.

The fastening tab groove 64 defines a lead-in area 66 and a coupling area 68 .

One fastening tab groove width 70 in the lead-in area 66 is larger than the width of a fastening tab groove 72 in the coupling area 68 .

The different fastening tab groove widths 70 and 72 allow the mounting tab protrusion 52 in the lead-in area 66 into the fastening tab groove 64 can be introduced.

The fastening strap mount 54 is related to the longitudinal axis of the joint socket 30th designed concentrically and extends over a receiving circumferential angle 74 . This is the one in the 1 until 4th illustrated embodiment smaller than 180 °. In the illustrated embodiment of the acetabulum 12th is the mounting circumference angle 74 about 110 °.

The tab protrusion 52 is related to the longitudinal axis of the joint socket 30th also formed concentrically and extends over a projection circumferential angle 76 . This is smaller than the angle of the mounting circumference 74 . The one in the 1 until 4th illustrated embodiment of the acetabulum 12th is the protrusion circumference angle 76 less than 50% of the mounting circumference angle 74 , even smaller than 35% of the angle of the mounting circumference 74 . The projection perimeter angle 76 is about 30 ° in the illustrated embodiment.

The lead-in area 66 extends over a circumferential angle 78 , which is at least the projection circumferential angle 76 is equivalent to. This enables a user to use the fastening tab protrusion 52 parallel to the longitudinal axis of the joint socket 30th towards the edge 26th to move towards and in the insertion area 66 into the fastening tab groove 64 to introduce.

After inserting the tab protrusion 52 into the fastening tab groove 64 can then use the fastening tab 22nd around the socket axis 30th in the fastening tab groove 64 are moved, namely in the coupling area 68 into it. Facing each other, the fastening tab groove 64 partially delimiting edge sections 80 then reach into the undercuts 62 a. A movement of the fastening tab 22nd is so form-fitting in the fastening lug groove 64 out, so when the fastening tab projection 52 and the fastening tab groove 64 are at least partially engaged. The fastening tab protrusions overlap 52 and the coupling area 68 at least partially over that of the fastening tab projection 52 defined projection circumference angle 76 .

Since the projection circumference angle 76 is significantly smaller than that due to the coupling area 68 defined circumferential angles 79 , it is possible to use the fastening tab 22nd in different angular positions based on the longitudinal axis of the joint socket 30th can be adjusted continuously in the coupling position and relative to the joint socket 16 to position.

The fastening tabs 18th , 20th and 22nd stand in the radial direction in relation to the longitudinal axis of the joint socket 30th from the socket 16 away. Free ends 82 , 84 and 86 the fastening straps 18th , 20th and 22nd are rounded.

The fastening tabs 18th and 20th each include two fastening element openings 88 . The fastening tab 22nd includes a fastener aperture 90 .

The fastener openings 88 and 90 are designed in the form of bores and each define a conical inner surface 92 respectively 94, extending from the tops 96 respectively 56 to subpages 98 respectively 58 the fastening straps 18th and 20th taper 22 and 22 respectively.

The special design of the fastening element openings 88 and 90 allows the acetabulum 12th with bone screws 100 , whose threaded section 102 the fastening holes 88 respectively 90 interspersed, on the pelvic bone 10 to be determined. Due to the conical inner surfaces 92 respectively 94 can bone screws 100 with countersunk heads 104 be used so that their head surfaces 106 that from the threaded section 102 point away, flush with the tops 96 or 56 of the fastening tabs 18th , 20th respectively 22nd are arranged when the acetabulum 12th in the pelvic bone 10 is anchored.

The joint socket 16 has further openings that are circular in cross section 108 as well as two slot-like openings 110 on which a direct attachment of the joint socket 16 on the pelvic bone 10 with further bone screws not shown in the figures.

It is also coaxial with the longitudinal axis of the joint socket 30th at the joint socket 16 a breakthrough 112 arranged, which is used to receive a coupling projection which is arranged or formed on a joint socket insert, not shown in the figures.

In the 5 until 7th is a further embodiment of an overall with the reference number 212 designated hip socket for a revision hip joint endoprosthesis 214 shown schematically. It should be noted that the revision hip prosthesis 214 can also be used for primary care, i.e. when replacing a patient's natural hip joint for the first time with a prosthesis. This also applies to all the exemplary embodiments of revision hip joint endoprostheses described below.

The acetabulum 212 includes a socket 216 those in the form of a hollow dome 224 is trained.

The acetabulum 212 includes a total of three fastening straps 218 , 220 and 222 that are in one piece, namely monolithically with a coupling ring 314 are trained. The coupling ring 314 forms a carrier element 316 showing the fastening tabs 218 , 220 and 222 wearing.

At the acetabulum 212 are the fastening tabs 218 , 220 and 222 indirectly non-positively and / or positively, namely by means of the carrier element 316 , with the socket 216 connectable. This is made possible by a coupling device 242 for non-positive and / or positive indirect coupling of the fastening straps 218 , 220 and 222 with the socket 16 in a coupling position, which is shown schematically in the 6th and 7th is shown.

The coupling device 242 comprises a first coupling element 244 and a second coupling element 246 on the one hand at the joint socket 216 and on the other hand on the coupling ring 314 and thus indirectly on the fastening straps 218 , 220 and 222 are arranged or formed. The first coupling element is in the coupling position 244 and the second coupling element 246 non-positively and / or positively engaged.

The first coupling element 244 is in the form of a coupling projection 248 formed, the second coupling element 246 in the form of a coupling recording 250 corresponding to the coupling projection 248 is trained.

The coupling device 242 is in the form of a bayonet connector 318 educated.

The fastening tabs 218 , 220 and 222 are in one piece, namely monolithic, with the coupling ring 314 formed so that the second coupling element 246 in one piece, namely monolithically, with the fastening straps 218 , 220 and 222 is trained.

At the acetabulum 212 is the coupling projection 248 in the form of a sleeve-shaped pan section 320 the socket 216 educated. The coupling ring 314 defines the coupling recording 250 . In the coupling position, the coupling ring surrounds 314 the sleeve-shaped pan section 320 , namely positively and / or positively. The coupling ring covers it 314 no more than 5% of an outer surface of the acetabulum 216 .

The bayonet connector 318 comprises the sleeve-shaped cup section 320 and the coupling ring 314 .

At the joint socket 216 is related to a longitudinal axis of the joint socket 230 a receiving groove that is open and pointing radially outward 322 formed in which the coupling ring 314 is held in the coupling position.

From a surrounding edge 226 the socket 216 stands in the radial direction in relation to the longitudinal axis of the joint socket 230 an annular flange 326 away. The receiving groove 322 is from the ring flange 326 as well as an annular flange running parallel to this 324 limited.

The one from the edge 226 first annular flange arranged further away 324 has a constant width 328 on. The second ring flange 326 has an annular flange width 330 and defines a ring flange longitudinal axis 332 .

The ring flange width 330 varies over a circumference of the annular flange 326 based on the longitudinal axis of the ring flange 332 . There are a total of three ring flange areas each extending over part of the circumference 334 formed that has a minimum annular flange width 330 exhibit. The one in the 5 until 7th The illustrated embodiment is the minimum annular flange width 330 realized in that the annular flange 326 in these ring flange areas 334 is interrupted.

The coupling ring 314 defines a coupling ring longitudinal axis 336 . A coupling ring width 338 of the coupling ring 314 in the radial direction based on the longitudinal axis of the coupling ring 336 varies over a circumference of the coupling ring 314 .

The one in the 5 until 7th illustrated embodiment of the acetabulum 212 has the coupling ring width 338 three maxima in the form of themselves over part of the circumference of the coupling ring 314 extending coupling ring areas 340 on. The number of coupling ring areas 340 thus corresponds to the ring flange areas 334 .

The coupling ring areas described 340 and the annular flange areas 334 extend over corresponding angular ranges in relation to the longitudinal axis of the ring flange 332 . In the coupling position, this coincides with the longitudinal axis of the coupling ring 336 together.

The ring flange areas 334 and the coupling ring areas 338 are so arranged and formed that the coupling ring 314 from a release position, which is shown schematically in 5 is shown in which the coupling ring 314 So from the socket 216 is separated by a movement in a direction parallel to the longitudinal axis of the ring flange 332 via the second ring flange 326 can be pushed until it is at the first ring flange 324 strikes. The coupling ring 314 is then in an intermediate position on the joint socket 216 .

Starting from this intermediate position, the coupling ring 314 by rotating around the longitudinal axis of the ring flange 332 be transferred into the coupling position. The coupling ring is in the coupling position 314 between the first ring flange 324 and the second ring flange 326 kept as shown schematically in 6th and 7th is shown.

The fastening tabs 218 and 220 are in the form of flat plates 232 and 234 educated.

The fastening tabs 218 and 220 have analogous to the fastening straps 18th and 20th Fastening element openings 288 on. On the fastening strap 222 is a fastener opening 290 educated.

The fastener openings 288 and 290 point conically from the respective upper side 256 respectively 296 to the respective subpage 258 respectively 298 the fastening straps 222 respectively 218 and 220 tapered inner surfaces 294 respectively 292 on.

At the joint socket 216 are in the same way as with the joint socket 16 three perforations with a circular cross-section 308 as well as two slot-like openings 310 designed to set the joint socket 216 on the patient's pelvic bone with bone screws. The arrangement and design of the openings 308 and 310 enables a high degree of variability in the attachment of the joint socket 216 on the pelvic bone.

In a variant of the acetabulum not shown in the figures 212 is only the ring flange 324 intended. The coupling ring 314 in this case has a constant width 328 over the entire circumference. One in the direction of the longitudinal axis of the joint socket 230 facing inner surface of the coupling ring 314 is provided with an internal thread, the socket section 320 that is between the edge 226 and the ring flange 324 extends, with a corresponding external thread. This configuration makes it possible to screw the coupling ring and the joint socket to one another. Instead of the bayonet connector 318 at the acetabulum 212 a coupling device in the form of a screw connection device is then provided here.

Another embodiment of a revision hip joint endoprosthesis 414 is schematically in 8th shown. It includes an acetabulum 412 that have a socket insert in an implantation position 542 with a spherical joint head holder 544 records. The revision hip joint endoprosthesis also includes 414 a hip stem 546 with a joint head 548 , which in cooperation with the correspondingly designed joint head receptacle 544 a ball joint 550 trains.

The acetabulum 12th and 212 can be used in an analogous manner according to the socket insert 542 trained socket insert, not shown in the figures, to form a ball joint with the joint head held on the hip shaft together with a hip shaft, which is anchored in a femoral cavity of a femur of the patient.

The joint socket 416 is in its basic structure in particular the joint socket 216 similar. However, it has no ring flanges 324 and 326 on. At the joint socket 416 however, openings are also circular in cross section 508 and slot-like openings 510 to fix the joint socket 416 formed on the patient's pelvic bone.

The acetabulum 412 also includes three fastening straps 418 , 420 and 422 that came with the acetabulum 416 can be coupled in a coupling position. To do this, includes the acetabulum 412 also a coupling device 442 with a first coupling element 444 in the form of a coupling projection 448 and a second coupling element 446 in the form of a coupling recording 450 .

The coupling projection 448 is in the form of a sleeve-shaped coupling insert 552 formed, which is a carrier element 516 for the fastening straps 418 , 420 and 422 forms. These are in one piece, in particular monolithically, with the coupling insert 552 educated. The coupling insert 552 thus carries three fastening straps 418 , 420 and 422 .

The fastening tabs 418 and 420 are plate-shaped and curved concavo-convex. The fastening tabs 418 , 420 and 422 each have several fastening element openings 488 or 490, which are analogous to the fastening straps 18th and 20th or 22 conical inner surfaces 492 respectively 494 exhibit.

At the acetabulum 412 forms the joint socket 416 the coupling recording 450 for the sleeve-shaped coupling insert 552 .

The coupling insert is in the coupling position 552 between the socket 416 and the socket insert received in this 542 arranged. The coupling insert is here 552 and the socket 416 non-positively and / or positively engaged.

The sleeve-shaped coupling insert 552 has an outer first conical clamping surface 554 on. This corresponds to an inner second conical clamping surface 556 the socket 416 educated. The clamping surfaces 554 and 556 form a self-locking connection between the coupling insert in the coupling position 552 and the socket 416 the end.

Furthermore, the coupling insert 552 an inner third conical clamping surface 558 on. This corresponds to an outer fourth conical clamping surface 560 the socket insert 542 educated. Between the clamping surfaces 558 and 560 a self-locking connection is also formed in the coupling position, namely between the coupling insert 552 and the socket insert 542 .

The coupling insert 552 can be in different orientations relative to the socket 416 based on the longitudinal axis of the joint socket 430 with the socket 416 be coupled. In this way, there are almost any number of possibilities, the openings 508 and 510 relative to the fastening element openings 488 and 490 to arrange and align. This allows a highly flexible attachment of the acetabulum 412 the patient on the pelvic bone.

In all of the described exemplary embodiments of acetabular cups, the fastening tabs have 18th , 20th , 22nd , 218 , 220 , 222 respectively 418 , 420 and 422 a top 56 , 96 , 256 , 296 respectively 456 , 496 and a bottom 58 , 98 , 258 , 298 respectively 458 , 498 on. The undersides 58 , 98 , 258 , 298 respectively 458 , 498 are designed in the form of a bone abutment surface. This is rough and optionally has an osteointegrative coating 162 , 362 respectively 562 on.

The acetabulum 12th , 212 and 412 , in particular the joint sockets 16 , 216 and 416 as well as the fastening straps 18th , 20th , 22nd , 218 , 220 and 222 as 418 , 420 and 422 , are made from a body-compatible implant material. In the exemplary embodiments described, this is titanium. Alternatively, in other exemplary embodiments, it can also be a titanium alloy.

The fastening tabs 18th , 20th , 22nd , 218 , 220 , 222 , 418 , 420 and 422 are flat in sections and / or curved in sections. In different exemplary embodiments, constant or changing radii of curvature are provided.

The fastening tabs 18th , 20th , 22nd , 218 , 220 , 222 , 418 , 420 and 422 have a constant or substantially constant thickness.

The fastening tabs 18th , 20th , 22nd , 218 , 220 , 222 , 418 , 420 , 422 each have a fastening strap length that is smaller than a diameter of the coupling ring 314 or the coupling insert 552 .

The joint sockets 16 , 216 and 416 each have an outer surface 170 , 370 respectively 570 on, which optionally carries an osteointegrative coating in certain embodiments.

All of the above-described embodiments of acetabular cups 12th , 212 and 412 allow an individual attachment to the pelvic bone of a patient, regardless of a specific bone situation, which, in particular, after the explantation of a previously inserted joint socket, often only results precisely in the course of the explantation. A surgeon then has the option of choosing the acetabulum accordingly 12th , 212 respectively 412 as well as the variable arrangement of the respective fastening straps relative to the respective joint socket to realize an optimal fastening of the acetabulum on the pelvic bone of the patient.

All described embodiments of acetabular cups 12th , 212 and 412 can be used in particular as part of hip joint prostheses for an initial replacement of a natural hip joint and as part of revision hip joint prostheses.

List of reference symbols

10

Pelvic bones

12th

Acetabulum

14th

Revision hip joint prosthesis

16

Joint socket

18th

Fastening tab

20th

Fastening tab

22nd

Fastening tab

24

Hollow dome

26th

edge

28

flange

30th

Longitudinal axis of the acetabulum

32

Tile

34

Tile

36

Platelet level

38

Platelet level

40

Entrance level

42

Coupling device

44

first coupling element

46

second coupling element

48

Coupling projection

50

Coupling recording

52

Fastening tab protrusion

54

Fastening strap mount

56

Top

58

bottom

60

End area

62

Undercut

64

Fastening tab groove

66

Lead-in area

68

Coupling area

70

Fastening lug groove width

72

Fastening lug groove width

74

Mounting circumference angle

76

Projection circumference angle

78

Circumferential angle

79

Circumferential angle

80

Edge section

82

end

84

end

86

end

88

Fastening element opening

90

Fastening element opening

92

Inner surface

94

Inner surface

96

Top

98

bottom

100

Bone screw

102

Threaded section

104

Countersunk head

106

Head surface

108

Breakthrough

110

Breakthrough

112

Breakthrough

162

Coating

170

Exterior surface

212

Acetabulum

214

Revision hip joint prosthesis

216

Joint socket

218

Fastening tab

220

Fastening tab

222

Fastening tab

224

Hollow dome

226

edge

230

Longitudinal axis of the acetabulum

232

Tile

234

Tile

242

Coupling device

244

first coupling element

246

second coupling element

248

Coupling projection

250

Coupling recording

256

Top

258

bottom

282

end

284

end

286

end

288

Fastening element opening

290

Fastening element opening

292

Inner surface

294

Inner surface

296

Top

298

bottom

308

Breakthrough

310

Breakthrough

312

Breakthrough

314

Coupling ring

316

Support element

318

Bayonet connector

320

Pan section

322

Receiving groove

324

first ring flange

326

second ring flange

328

broad

330

Ring flange width

332

Ring flange longitudinal axis

334

Ring flange area

336

Coupling ring longitudinal axis

338

Coupling ring width

340

Coupling ring area

362

Coating

370

Exterior surface

412

Acetabulum

414

Revision hip joint prosthesis

416

Joint socket

418

Fastening tab

420

Fastening tab

422

Fastening tab

430

Longitudinal axis of the acetabulum

442

Coupling device

444

first coupling element

446

second coupling element

448

Coupling projection

450

Coupling recording

456

Top

458

bottom

482

end

484

end

486

end

488

Fastening element opening

490

Fastening element opening

492

Inner surface

494

Inner surface

496

Top

498

bottom

508

Breakthrough

510

Breakthrough

516

Support element

542

Socket insert

544

Swivel head mount

546

Hip stem

548

Swivel head

550

Ball joint

552

Coupling insert

554

first conical clamping surface

556

second conical clamping surface

558

third conical clamping surface

560

fourth conical clamping surface

562

Coating

570

Exterior surface

Claims (25)

Hip socket (12; 212; 412), in particular for a revision hip joint endoprosthesis (14; 214; 414), comprising a joint socket (16; 216; 416) for implantation in the pelvic bone (10) of a patient and at least one plate-shaped fastening strap (18, 20) , 22; 218, 220, 222; 418, 420, 422), characterized in that the at least one fastening tab (22; 218, 220, 222; 418, 420, 422) force with the joint socket (16; 216; 416) - and / or can be coupled in a form-fitting manner and that the acetabulum (12; 212; 412) has a coupling device (42; 242; 442) for the force-fitting and / or form-fitting coupling of the at least one fastening tab (22; 218, 220, 222; 418, 420, 422) with the joint socket (16; 216; 416) in a coupling position. Acetabulum after Claim 1 , characterized in that at least one fastening tab (18, 20) is fixed, in particular in one piece, further in particular monolithically, arranged or formed on the joint socket (16). Acetabulum after Claim 1 or 2 , characterized in that the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) comprises at least one fastening element opening (88, 90; 288, 290; 488, 490), in particular two, three , four or more fastening element openings (88, 90; 288, 290; 488, 490), in particular the at least one fastening element opening (88, 90; 288, 290; 488, 490) having a conical inner surface (92, 94; 292, 294; 492, 494), in particular extending from an upper side (56, 96; 256, 296; 456, 496) to an underside (58, 98; 258, 298; 458, 498) of the at least one fastening tab (18, 20, 22 ; 218, 220, 222) tapering. Hip socket according to one of the preceding claims, characterized in that the coupling device (42; 242; 442) comprises at least one first coupling element (44; 244; 444) and at least one second coupling element (46; 246; 446) which are on the one hand on the joint socket (16; 216; 416) and on the other hand on the at least one fastening tab (22; 218, 220, 222; 418, 420, 422) are arranged or formed or assigned to this, and that the at least one first coupling element (44; 244; 444 ) and the at least one second coupling element (46; 246; 446) in the coupling position are non-positively and / or positively engaged, in particular the at least one first coupling element (44; 244; 444) in the form of a coupling projection (48; 248; 448) and that the at least one second coupling element (46; 246; 446) is in the form of a coupling receptacle (50; 250; 450), in particular corresponding to the at least one coupling projection (48 ; 248; 448). Acetabulum after Claim 4 , characterized in that the coupling device (242) is designed in the form of a screw connection device, a clamping device and / or in the form of a bayonet connection device (318). Acetabulum after Claim 4 or 5 , characterized in that a) the coupling receptacle comprises an internal thread and that the corresponding coupling projection comprises an external thread corresponding to the internal thread and / or b) the at least one first coupling element (44; 444) or the at least one second coupling element (246) in one piece, in particular monolithic, on which at least one fastening tab (22; 218, 220, 222; 418, 420, 422) are arranged or formed. Acetabulum according to one of the Claims 3 until 6th , characterized in that the coupling projection (448) is designed in the form of a sleeve-shaped coupling insert (552) and that the joint socket (416) forms the coupling receptacle (450) for the sleeve-shaped coupling insert (552). Acetabulum after Claim 7 , characterized in that the coupling insert (552) a) is arranged in the coupling position between the joint socket (416) and a joint socket insert (542) received therein and / or b) and the joint socket (416) is non-positively and / or positively in the coupling position are in engagement. Acetabulum after Claim 7 or 8th , characterized in that the sleeve-shaped coupling insert (552) has an outer first conical clamping surface (554) and that the first clamping surface (554) is designed to correspond to an inner, second conical clamping surface (556) of the joint socket (416), in particular the first The clamping surface (554) and the second clamping surface (556) form a self-locking connection between the coupling insert (552) and the joint socket (416) in the coupling position. Acetabulum according to one of the Claims 7 until 9 , characterized in that the coupling insert (552) has an inner third conical clamping surface (558) and that the third clamping surface (558) is designed to correspond to an outer fourth conical clamping surface (560) of the joint socket insert (542), the third clamping surface in particular (558) and the fourth clamping surface (560) in the coupling position form a self-locking connection between the coupling insert (552) and the joint socket insert (542). Acetabulum according to one of the Claims 7 until 10 , characterized in that a) the at least one fastening tab (418, 420, 422) is designed in one piece, in particular monolithically, with the coupling insert (552) and / or b) the coupling insert (552) has one, two, three or more fastening tabs ( 418, 420, 422) carries. Acetabulum according to one of the Claims 3 until 11 , characterized in that the coupling projection (248) is designed in the form of a sleeve-shaped socket section (320) of the joint socket (216), that the coupling device (242) comprises a coupling ring (314) which defines the coupling receptacle (250), and that the The coupling ring (314) in the coupling position surrounds the sleeve-shaped socket section (320), in particular in a non-positive and / or form-fitting manner. Acetabulum after Claim 12 , characterized in that the at least a) one fastening tab (218, 220, 222) is formed in one piece, in particular monolithically, with the coupling ring (314) and / or b) the coupling ring (314) has one, two, three or more fastening tabs ( 218, 220, 222) carries and / or c) the sleeve-shaped socket section (320) and the coupling ring (314) form components of a bayonet connection device (318) and / or d) the coupling ring (314) at most 5%, in particular at most 2%, an outer surface of the socket (216). Acetabulum after Claim 12 or 13th , characterized in that the joint socket (216) has a receiving groove (322) which is open facing outwards and that the coupling ring (314) is held in the coupling position in the receiving groove (322). Acetabulum after Claim 14 , characterized in that the receiving groove (322) is laterally bounded by a first ring flange (324) and a second ring flange (326) and that the two ring flanges (324, 326) run parallel to one another, in particular that of a circumferential edge (226 ) the first annular flange (324) arranged further away from the joint socket (216) has a constant or substantially constant width (328). Acetabulum according to one of the Claims 12 until 15th , characterized in that the coupling ring (314) defines a coupling ring longitudinal axis (336) and that a coupling ring width (338) of the coupling ring (314) varies in the radial direction relative to the coupling ring longitudinal axis (336) over a circumference of the coupling ring (314). Acetabulum after Claim 15 or 16 , characterized in that a) the second ring flange (326) which is arranged less far from the circumferential edge (226) defines a ring flange width (330) and a ring flange longitudinal axis (332) and that the ring flange width (330) in the radial direction based on the ring flange longitudinal axis ( 332) varies over a circumference of the annular flange (326) and / or b) the coupling ring width (338) has at least two, in particular three or four, maxima of coupling ring regions (340) extending over part of the circumference of the coupling ring (314) and that the second ring flange (326) has a corresponding number of ring flange areas (334) extending over part of its circumference with a minimum ring flange width (330) and that the coupling ring areas (340) and the ring flange areas (334) extend over corresponding angular areas based on the Ring flange longitudinal axis (332) and the coupling ring that coincides with this in the coupling position ngsachse (336) and / or c) the coupling ring (314) from a release position, in which it is separated from the socket (216), by a movement parallel to the ring flange longitudinal axis (332) in the direction of the first ring flange (324) in an intermediate position can be transferred, that the coupling ring (314) can be transferred from the intermediate position into the coupling position by rotating around the longitudinal axis of the annular flange (332) and that the coupling ring (314) is in the coupling position between the first annular flange (324) and the second annular flange ( 326) is held. Acetabulum according to one of the Claims 3 until 17th , characterized in that the coupling projection (48) is in the form of a fastening tab projection (52) and the coupling receptacle (50) is in the form of a corresponding fastening tab receptacle (54), that the fastening tab projection (52) is arranged on the at least one fastening tab (22) or is designed that the fastening tab receptacle (54) is arranged or formed on the joint socket (16) and that the fastening tab projection (52) and the fastening tab receptacle (54) are in force and / or form-locking engagement in the coupling position. Acetabulum after Claim 18 , characterized in that the fastening tab projection (52) a) is arranged or formed protruding from an underside (58) of the at least one fastening tab (22) and / or b) defines at least one undercut (62) and / or c) and the fastening tab receptacle (54) are T-shaped in cross section. Acetabulum after Claim 18 or 19th , characterized in that the fastening tab receptacle (54) is designed in the form of a fastening tab groove (64), wherein in particular the fastening tab groove (64) a) is open pointing in a direction parallel to a longitudinal axis (30) of the joint socket and / or b) an insertion area ( 66) and a coupling area (68) and that a fastening tab groove width (70) in the insertion area (66) is greater than in the coupling area (68). Acetabulum according to one of the Claims 18 until 20th , characterized in that the fastening tab receptacle (54) is designed concentrically with respect to the joint socket longitudinal axis (30) and extends over a receiving circumferential angle (74) of less than 180 °, in particular the fastening tab projection (52) being concentric with reference to the joint socket longitudinal axis (30) is formed and extends over a projection circumferential angle (76) and that the projection circumferential angle (76) is smaller than the receiving circumferential angle (74), in particular smaller than 50%, further in particular smaller than 35%, with the insertion area (66) in particular extending over a circumferential angle (78) extends which corresponds at least to the projection circumferential angle (76). Hip socket according to one of the preceding claims, characterized in that the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) has an upper side (56, 96; 256, 296; 456, 496) and has an underside (58, 98; 258, 298; 458, 498) and that the underside (58, 98; 258, 298; 458, 498) is designed in the form of a bone abutment surface, wherein in particular the bone abutment surface a) is rough and / or b) has an osteointegrative coating (162; 362; 562). Hip socket according to one of the preceding claims, characterized in that a) the hip socket (12; 212; 412), in particular the joint socket (16; 216; 416) and the at least one fastening tab (18, 20, 22; 218; 220, 222 ; 418, 420, 422), is formed from a body-compatible implant material, in particular from titanium or a titanium alloy, and / or b) the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) is at least partially flat or essentially flat and / or c) the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) is curved at least partially, in particular with a constant or changing radius of curvature wherein in particular the at least one fastening tab (418, 420) is designed to be concavo-convex curved at least in sections. Hip socket according to one of the preceding claims, characterized in that a) the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) has a constant or substantially constant thickness and / or b) the at least one fastening tab (18, 20, 22; 218, 220, 222; 418, 420, 422) has a fastening tab length starting from the at least one first or second coupling element (246; 444, 446) and that the fastening tab length is smaller than a maximum diameter of the at least one first or second coupling element (246; 444) and / or c) the joint socket (16; 216; 416) has an outer surface (170; 370; 570) in the form of a bone abutment surface and that the outer surface (170; 370; 570 ) has an osteointegrative coating. Hip joint endoprosthesis (14; 214; 414), in particular revision hip joint endoprosthesis (14; 214; 414), comprising an acetabulum (12; 212; 412) which, in an implantation position, receives a socket insert (542) with a spherical joint head receptacle (544), and a Hip shaft (546) with a joint head (548) for forming a ball joint (550) in cooperation with the joint head receptacle (544) corresponding to the joint head (548), characterized in that the acetabulum (12; 212; 412) is in the form of an acetabulum (12; 212; 412) according to one of the preceding claims, wherein in particular the sleeve-shaped coupling insert (552) is arranged in the coupling position between the joint socket (416) and the joint socket insert (542).

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