DE10308141A1 - Extension sleeve for modular built-in joint prosthesis, has sleeve wall preferably formed with circumferential grooves to minimize sleeve flexural rigidity - Google Patents

Extension sleeve for modular built-in joint prosthesis, has sleeve wall preferably formed with circumferential grooves to minimize sleeve flexural rigidity Download PDF

Info

Publication number
DE10308141A1
DE10308141A1 DE10308141A DE10308141A DE10308141A1 DE 10308141 A1 DE10308141 A1 DE 10308141A1 DE 10308141 A DE10308141 A DE 10308141A DE 10308141 A DE10308141 A DE 10308141A DE 10308141 A1 DE10308141 A1 DE 10308141A1
Authority
DE
Germany
Prior art keywords
extension sleeve
wall
sleeve according
sleeve
extension
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
DE10308141A
Other languages
German (de)
Other versions
DE10308141A8 (en
DE10308141B4 (en
Inventor
Stefan Dipl.-Ing. Wallenstein
Gerhard Dipl.-Ing. Reu
Thomas Dipl.-Ing. Hermle
Thomas Dipl.-Ing. Grupp
Richard Dr.-Ing. Zeller
Andreas Pfaff
Stephan Lindner
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Priority to DE10308141A priority Critical patent/DE10308141B4/en
Priority to DE20303076U priority patent/DE20303076U1/en
Publication of DE10308141A1 publication Critical patent/DE10308141A1/en
Publication of DE10308141A8 publication Critical patent/DE10308141A8/en
Application granted granted Critical
Publication of DE10308141B4 publication Critical patent/DE10308141B4/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3672—Intermediate parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/30215—Stepped cones, i.e. having discrete diameter changes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/30217—Three-dimensional shapes conical hollow cones, e.g. tubular-like cones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30233—Stepped cylinders, i.e. having discrete diameter changes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30451—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30474—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using an intermediate sleeve interposed between both prosthetic parts to be coupled
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0029—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in bending or flexure capacity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063—Nested prosthetic parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
    • A61F2310/00407—Coating made of titanium or of Ti-based alloys

Abstract

The wall (11) of an extension sleeve (7) is preferably formed with circumferential grooves (12) to lower the flexural rigidity of the sleeve.

Description

Die Erfindung betrifft eine Verlängerungshülse für eine modular aufgebaute, in einen Röhrenknochen einsetzbare Gelenkprothese mit einem Steckzapfen zur Verbindung mit einem ersten benachbarten Modul der Gelenkprothese und mit einem sich an den Steckzapfen anschließenden hülsenförmigen Aufnahmeteil mit einem Aufnahmekanal zur Aufnahme eines Steckzapfens eines zweiten, dem ersten gegenüberliegenden Moduls der Gelenkprothese, deren Außenkontur zur Ausfüllung des Markraum-Querschnittes des die Gelenkprothese aufnehmenden Röhrenknochens ausgebildet ist.The Invention relates to an extension sleeve for a modular built up into a long bone usable joint prosthesis with a plug for connection with a first neighboring module of the joint prosthesis and with one adjoining the plug-in sleeve-shaped receiving part with a Receiving channel for receiving a pin of a second, the first opposite Module of the joint prosthesis, whose outer contour for filling the Medullary cross-section of the tubular bone receiving the joint prosthesis is trained.

Bei der Implantation von Gelenkprothesen ist es günstig, wenn die Schäfte derartiger Gelenkprothesen möglichst genau mit der Markraumgeometrie des Röhrenknochens übereinstimmen, in den sie eingesetzt werden sollen. Vor allem nach dem Austausch gelockerter Implantate ergeben sich aufgrund der individuellen Defektsituation oft Markraumgeometrien, die sich nur schwer mit Standardrevisionsimplantaten versorgen lassen. Hier ist es bekannt, ein Implantatsystem zu wählen, das aus einzelnen Modulen besteht, die intraoperativ vom Operateur ausgewählt, zusammengebaut und implantiert werden.at the implantation of joint prostheses, it is favorable if the stems of such Joint prostheses if possible exactly match the medullary canal geometry of the long bone, in which they should be used. Especially after the exchange loosened implants result from the individual defect situation often marrow geometries that are difficult with standard revision implants be supplied. Here it is known to choose an implant system that consists of individual modules, selected intraoperatively by the surgeon, assembled and be implanted.

Zur optimalen Anpassung des Implantates an den Knochen oder zum Ausgleich intraoperativ auftretender Beinlängenänderungen, werden bei modularen Implantaten Verlängerungshülsen eingesetzt. Diese werden zwischen proximalen und distalen Implantatkomponenten eingebaut.to optimal adaptation of the implant to the bone or to compensate intraoperative leg length changes, Extension sleeves are used for modular implants. These will installed between proximal and distal implant components.

Die Verlängerungshülsen werden üblicherweise über konische Steckzapfen mit dem benachbarten Modulen verbunden. In diesem Verbindungsbereich beob achtet man einen Mikroabrieb des Prothesenmaterials, der durch Relativverschiebung der beiden zusammengefügten Prothesenteile entsteht und der störend ist.The Extension sleeves are usually tapered Plug pin connected to the neighboring modules. In this connection area one observes a micro abrasion of the prosthesis material by Relative displacement of the two joined prosthesis parts arises and the disturbing is.

Es ist Aufgabe der Erfindung, eine gattungsgemäße Verlängerungshülse so auszubilden, daß dieser unerwünschte Mikroabrieb möglichst gering gehalten wird.It is the object of the invention to form a generic extension sleeve so that this undesirable Micro abrasion if possible is kept low.

Diese Aufgabe wird bei einer Verlängerungshülse der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß die Biegesteifigkeit der Wand der Verlängerungshülse gegenüber einer massiven, aus dem Material der Verlängerungshülse bestehenden Wand herabgesetzt ist.This The task is with an extension sleeve Type described above solved according to the invention in that the bending stiffness the wall of the extension sleeve opposite one massive wall made of the material of the extension sleeve is.

Es hat sich herausgestellt, daß diese Herabsetzung der Biegesteifigkeit dazu führt, daß im Bereich der Steckverbindung der Mikroabrieb herabgesetzt wird, wobei gleichzeitig der Querschnitt der Verlängerungshülse erhalten bleibt. Dieser Querschnitt ist möglichst genau an den zur Verfügung stehenden Querschnitt des Markraumes angepaßt, so daß der Markraum nach dem Einsetzen der modular aufgebauten Gelenkprothese auch im Bereich der Verlängerungshülse von dieser ausgefüllt ist und sich damit mit dem Knochen gut verbinden kann.It it has been found that this Reducing the bending stiffness leads to that in the area of the plug connection the micro abrasion is reduced, while the cross section the extension sleeve received remains. This cross section is as possible exactly at the available standing cross section of the medullary canal adjusted so that the medullary canal after insertion the modular joint prosthesis also in the area of the extension sleeve from this filled out is and can connect well with the bone.

An sich ist es aus der EP 0 792 129 B1 bekannt, am Kopfteil einer zweiteilig ausgebildeten Gelenkprothese eine umlaufende Vertiefung vorzusehen, um dadurch im Verbindungsbereich der beiden Prothesenteile den Mikroabrieb herabzusetzen, dies beschränkt sich aber auf den Kopfteil einer Gelenkprothe se. Irgendeine Anregung zur Ausgestaltung einer Verlängerungshülse ist daraus nicht zu entnehmen.In itself it is out of the EP 0 792 129 B1 It is known to provide a circumferential recess on the head part of a two-part joint prosthesis in order to thereby reduce the micro-abrasion in the connection area of the two prosthesis parts, but this is limited to the head part of a joint prosthesis. Any suggestion for the design of an extension sleeve cannot be derived from this.

Bei der ersten bevorzugten Ausführungsform ist vorgesehen, daß die Wand mindestens zweilagig ausgebildet ist mit einer inneren Lage aus einem biegesteifen Material und mit einer äußeren Lage aus einem weniger biegesteifen Material. Dadurch wird einerseits die Biegesteifigkeit der Verlängerungshülse insgesamt herabgesetzt, andererseits bleibt der Gesamtquerschnitt erhalten.at the first preferred embodiment provided that the Wall is at least two layers with an inner layer made of a rigid material and with an outer layer of one less rigid material. On the one hand, this makes the bending stiffness the overall extension sleeve reduced, on the other hand the overall cross section is retained.

Insbesondere kann die innere Lage einstückig mit dem Steckzapfen der Verlängerungshülse ausgebildet sein, das heißt, es wird im wesentlichen eine Verlängerungshülse mit geringem Außendurchmesser verwendet, und diese Verlängerungshülse wird im Bereich des Aufnahmeteils von einer zweiten Lage mit geringerer Biegesteifigkeit umgeben.In particular can the inner layer in one piece formed with the plug of the extension sleeve be, that is, it essentially becomes an extension sleeve with a small outside diameter used, and this extension sleeve is in the area of the receiving part from a second layer with less Bending rigidity surround.

Die äußere Lage kann aus einem beliebigen biokompatiblen Material bestehen, beispielsweise aus Metall, insbesondere aus Titan, wobei es dann günstig ist, wenn die äußere Lage netzförmig oder lochblechförmig ausgebildet ist. Eine andere Möglichkeit besteht darin, diese äußere Lage aus einem aufgeschäumten Material zu fertigen, beispielsweise aus einem Metallschaum, insbesondere einem Titanschaum.The outer layer can consist of any biocompatible material, for example Metal, in particular titanium, it being advantageous if the outer layer reticulated or perforated sheet is trained. Another possibility is this outer layer from a foamed To produce material, for example from a metal foam, in particular a titanium foam.

Bei einer weiteren bevorzugten Ausführungsform ist vorgesehen, daß der Querschnitt der Wand durch Vertiefungen geschwächt ist.at a further preferred embodiment it is envisaged that the Cross section of the wall is weakened by depressions.

Beispielsweise können in der Wand außenseitig Nuten angeordnet sein.For example can in the wall on the outside Grooves can be arranged.

Bei einer bevorzugten Ausführungsform trägt die Wand außenseitig mindestens eine äußere Umfangsnut, vorzugsweise sind bei der Verwendung von mehreren Umfangsnuten diese gleichmäßig über die Länge des Aufnahmeteils verteilt.In a preferred embodiment, the wall carries at least one outer circumferential groove on the outside, preferably when using a plurality of circumferential grooves, these are uniform over the Length of the receiving part distributed.

Die Nuten können auch in anderer Richtung verlaufen, beispielsweise kann die Richtung der Nuten eine achsparallele Komponente aufweisen, insbesondere können die Nuten in achsparalleler Richtung verlaufen. Dabei ist es auch möglich, derartige, in achsparalleler Richtung verlaufende Nuten und Umfangsnuten gemeinsam vorzusehen, wobei sich diese Nuten dann kreuzen.The Can groove also run in a different direction, for example the direction the grooves have an axially parallel component, in particular can the grooves run in the direction parallel to the axis. It is also there possible, such grooves and circumferential grooves running in the axis-parallel direction to be provided together, these grooves then crossing.

Günstig ist es, wenn die Wand außenseitig von einer äußeren Hülse umgeben ist. Diese kann dicht an der Außenseite der Wand des Aufnahmeteils anliegen, insbesondere kann die äußere Hülse in die außenseitigen Nuten der Wand eintauchen, beispielsweise durch Verformung im Bereich der Nuten.Is cheap it when the wall is outside of surrounded by an outer sleeve is. This can be close to the outside abut the wall of the receiving part, in particular the outer sleeve can be in the outside Immerse grooves in the wall, for example due to deformation in the area of the grooves.

Es ist aber auch möglich, daß die äußere Hülse von der Außenseite der Wand mit Ausnahme einer Verbindung mit dem Aufnahmeteil einen Abstand einhält.It is also possible that the outer sleeve of the outside the wall with the exception of a connection to the receiving part Maintains distance.

Bei einer anderen bevorzugten Ausführungsform ist der Querschnitt der Wand durch Hohlräume geschwächt.at another preferred embodiment the cross section of the wall is weakened by cavities.

Insbesondere kann der Hohlraum ein konzentrisch zu dem Aufnahmekanal angeordneter Ringraum in der Wand sein.In particular the cavity can be arranged concentrically to the receiving channel Annulus in the wall.

Bei einer bevorzugten Ausführungsform ist der Ringraum zur Einsteckseite des Aufnahmekanals hin offen.at a preferred embodiment the annular space is open to the insertion side of the receiving channel.

In der dem Aufnahmekanal benachbarten Seitenfläche des Ringraumes können Vertiefungen angeordnet sein, beispielsweise Umfangsnuten.In The side surface of the annular space adjacent to the receiving channel can be provided with depressions be, for example circumferential grooves.

Die nachfolgende Beschreibung bevorzugter Ausführungsformen der Endung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The The following description of preferred embodiments of the extension is used in connection with the drawing of the detailed explanation. Show it:

1: eine Seitenansicht einer modular aufgebauten Hüftgelenkprothese in teilweise aufgebrochener Darstellung; 1 : A side view of a modular hip prosthesis in a partially broken representation;

2: ein erstes bevorzugtes Ausführungsbeispiel einer Verlängerungshülse mit mehreren Umfangsnuten; 2 : a first preferred embodiment of an extension sleeve with a plurality of circumferential grooves;

3: eine Ansicht ähnlich 2 mit sich kreuzenden Längs- und Quernuten; 3 : a view similar 2 with intersecting longitudinal and transverse grooves;

4: eine Ansicht der Verlängerungshülse der 3 in Richtung des Pfeiles A; 4 : a view of the extension sleeve of the 3 in the direction of arrow A;

5: eine Ansicht ähnlich 2 einer Verlängerungshülse mit achsparallelen Nuten; 5 : a view similar 2 an extension sleeve with axially parallel grooves;

6: eine Längsschnittansicht eines abgewandelten Ausführungsbeispiels einer Verlängerungshülse mit einem umgebenden Distanzring; 6 : A longitudinal sectional view of a modified embodiment of an extension sleeve with a surrounding spacer ring;

7: eine Ansicht ähnlich 6 bei einer Ausführung mit einem Ringraum in der Wand des Aufnahmeteils; 7 : a view similar 6 in a version with an annular space in the wall of the receiving part;

8: eine Ansicht ähnlich 7 einer aus zwei Teilen hergestellten Verlängerungshülse; 8th : a view similar 7 an extension sleeve made of two parts;

9: eine Ansicht ähnlich 7 einer Verlängerungshülse mit einer profilierten Innenfläche des Ringraumes; 9 : a view similar 7 an extension sleeve with a profiled inner surface of the annular space;

10: eine Ansicht ähnlich 9 einer aus zwei Teilen hergestellten Verlängerungshülse; 10 : a view similar 9 an extension sleeve made of two parts;

11: eine Längsschnittansicht einer Verbindungshülse ähnlich 2 mit aufgeschobener Außenhülse, und 11 : a longitudinal sectional view of a connecting sleeve similar 2 with the outer sleeve pushed on, and

12: eine Ansicht ähnlich 11 mit einer aufgeschobenen Außenhülse, die in Umfangsnuten hinein verformt ist. 12 : a view similar 11 with a pushed on outer sleeve, which is deformed into circumferential grooves.

Die Erfindung wird am Beispiel einer Hüftgelenkprothese erörtert, die zum Einsetzen in den Femur bestimmt ist. Eine solche Gelenkprothese 1 umfaßt einen Schaft 2, der an seiner Oberseite, also an seinem proximalen Ende, einen konischen Steckzapfen 3 trägt. Die Gelenkprothese 1 umfaßt weiterhin ein Kopfteil 4, das sich gegenüber dem Schaft 2 einseitig erweitert und einen schräg abstehenden, konischen Aufsteckzapfen 5 für eine in der Zeichnung nicht dargestellte Gelenkkugel trägt. Der Aufsteckzapfen 5 ist am proximalen Ende des Kopfteiles 4 angeordnet, am distalen Ende nimmt das Kopfteil 4 eine konische Aufnahmeöffnung 6 auf, in die beispielsweise der Steckzapfen 3 des Schaftes 2 eingeschoben werden kann. Die Konizität des Steckzapfens und der Aufnahmeöffnung ist dabei so gering, daß beim festen Einschieben Selbsthemmung eintritt. Man erhält dadurch eine feste Verbindung zwischen dem Schaft 2 und dem Kopfteil 4.The invention is discussed using the example of a hip joint prosthesis which is intended for insertion into the femur. Such a joint prosthesis 1 includes a shaft 2 , which has a conical plug on its top, that is, on its proximal end 3 wearing. The joint prosthesis 1 also includes a headboard 4 that is opposite the shaft 2 expanded on one side and an obliquely projecting, conical push-on spigot 5 for a joint ball, not shown in the drawing. The push-on pin 5 is at the proximal end of the headboard 4 arranged at the distal end takes the headboard 4 a conical receiving opening 6 on, for example in the plug 3 of the shaft 2 can be inserted. The taper of the plug pin and the receiving opening is so low that self-locking occurs when firmly inserted. This gives a firm connection between the shaft 2 and the headboard 4 ,

Eine in dieser Weise aufgebaute Gelenkprothese 1 besteht im wesentlichen nur aus drei Teilen, nämlich dem Schaft 2, dem Kopfteil 4 und der in der Zeichnung nicht dargestellten Gelenkkugel.A joint prosthesis constructed in this way 1 consists essentially of only three parts, namely the shaft 2 , the headboard 4 and the joint ball, not shown in the drawing.

Bei dem Ausführungsbeispiel der 1 sind zusätzlich drei Verlängerungshülsen 7 vorgesehen, die gleich aufgebaut sind, nachfolgend wird daher nur eine dieser Verlängerungshülsen 7 näher beschrieben. Jede Verlängerungshülse 7 weist an ihrem proximalen Ende einen konischen Steckzapfen 8 auf, der vollständig dem Steckzapfen 3 des Schaftes 2 entspricht. Dieser Steckzapfen 8 ist verbunden mit einem hülsenförmigen Aufnahmeteil 9, in dem sich ein in distaler Richtung hin offener, konischer Aufnahmekanal 10 für einen Steckzapfen befindet. Dieser Aufnahmekanal 10 entspricht vollständig der Aufnahmeöffnung 6 im Kopfteil 4, der bei einer nur zweiteiligen Gelenkprothese 1 den Steckzapfen 3 des Schaftes 2 aufnimmt.In the embodiment of the 1 are three additional extension sleeves 7 provided that are constructed identically, therefore only one of these extension sleeves is below 7 described in more detail. Each extension sleeve 7 has a conical plug at its proximal end 8th on, the completely the plug 3 of the shaft 2 equivalent. This peg 8th is connected to a sleeve-shaped receiving part 9 , in which there is a conical receiving channel that is open in the distal direction 10 for a plug. This recording channel 10 corresponds completely to the receiving opening 6 in the headboard 4 with a two-part joint prosthesis 1 the plug 3 of the shaft 2 receives.

Die Verlängerungshülsen 7 sind also so ausgebildet, daß ihr Steckzapfen 8 in die Aufnahmeöffnung oder den Aufnahmekanal des proximal benachbarten Teiles eingesteckt werden kann, umgekehrt kann in jede Verlängerungshülse 7 an ihrem distalen Ende ein Steckzapfen eines distal benachbarten Prothesenteils eingeschoben werden.The extension sleeves 7 are so designed that their spigot 8th can be inserted into the receiving opening or the receiving channel of the proximally adjacent part, vice versa in each extension sleeve 7 a plug pin of a distally adjacent prosthesis part is inserted at its distal end.

Zwischen Kopfteil 4 und Schaft 2 kann eine unterschiedliche Zahl von Verlängerungshülsen eingesetzt werden, so daß dadurch die Gesamtlänge der Gelenkprothese 1 variiert werden kann, die Verlängerungshülsen 7 können dabei in ihrer Längsrichtung unterschiedlich lang ausgebildet sein, sie könnten aber auch gleich lang sein.Between the headboard 4 and shaft 2 a different number of extension sleeves can be used, so that the total length of the joint prosthesis 1 can be varied, the extension sleeves 7 can be of different lengths in their longitudinal direction, but they could also be of the same length.

Bei dem in den 1 und 2 dargestellten Ausführungsbeispiel sind in die den Aufnahmekanal 10 umgebende Wand 11 des Aufnahmeteiles 9 mehrere im Abstand zueinander angeordnete Umfangsnuten 12 eingearbeitet, durch die der Querschnitt der Wand 11 geschwächt wird. Der Außendurchmesser der Wand 11 entspricht dem Außendurchmesser des Schaftes 2 einerseits und des Kopfteiles 4 andererseits im Anschlußbereich, und dieser Außendurchmesser ist so gewählt, daß der Markraum des Röhrenknochens, in den die Gelenkprothese 1 eingesetzt werden soll, im wesentlichen vollständig ausgefüllt wird. Um dies zu erreichen, wird eine relativ große Stärke der Wand 11 benötigt, und diese Stärke der Wand würde bei massiver Ausgestaltung zu einer sehr großen Biegesteifigkeit der Verlängerungshülse 7 führen.In the in the 1 and 2 Embodiment shown are in the receiving channel 10 surrounding wall 11 of the receiving part 9 several circumferentially spaced grooves 12 incorporated through which the cross section of the wall 11 is weakened. The outside diameter of the wall 11 corresponds to the outer diameter of the shaft 2 on the one hand and the headboard 4 on the other hand in the connection area, and this outer diameter is selected so that the medullary cavity of the long bone into which the prosthetic joint 1 is to be used, is essentially completely filled out. To achieve this, the wall has a relatively large thickness 11 needed, and this thickness of the wall would with a massive design to a very large bending stiffness of the extension sleeve 7 to lead.

Durch die Umfangsnuten 12 wird jedoch die Biegesteifigkeit der Verlängerungshülse 7 gegenüber einer massiven Ausgestaltung herabgesetzt und dies führt dazu, daß der Mikroabrieb im Verbindungsbereich zwischen Steckzapfen und Aufnahmehülse auf ein Minimum reduziert wird.Through the circumferential grooves 12 however, the bending stiffness of the extension sleeve 7 reduced compared to a solid design and this means that the micro-abrasion in the connection area between the plug pin and the receiving sleeve is reduced to a minimum.

Bei dem Ausführungsbeispiel der 2 wird die Herabsetzung der Biegesteifigkeit durch die Umfangsnuten 12 erreicht, bei dem Ausführungsbeispiel der 3 sind zusätzlich zu den Umfangsnuten 12 noch achsparallele Längsnuten 13 vorgesehen, die die Umfangsnuten 12 kreuzen.In the embodiment of the 2 is the reduction in bending rigidity through the circumferential grooves 12 reached in the embodiment of 3 are in addition to the circumferential grooves 12 still axially parallel longitudinal grooves 13 provided the circumferential grooves 12 cross.

Das Ausführungsbeispiel der 5 weist nur Längsnuten 13 und keine Umfangsnuten 12 auf, in allen Fällen wird durch diese Nuten eine Herabsetzung der Biegesteifigkeit erreicht.The embodiment of the 5 has only longitudinal grooves 13 and no circumferential grooves 12 on, in all cases these grooves reduce the bending stiffness.

Eine andere Möglichkeit zur Herabsetzung der Biegesteifigkeit der relativ dicken Wand 11 wird bei dem Ausführungsbeispiel der 7 dadurch erreicht, daß in die Wand 11 ein zur distalen Seite hin offener Ringraum 14 eingearbeitet ist. Die Trennwand 15 zwischen diesem Ringraum 14 und dem Aufnahmekanal 10 erhält dadurch eine relativ geringe Wandstärke, die aus Stabilitätsgründen ausreicht, die aber nicht ausreichen würde, um den Markraum des Röhrenknochens auszufüllen. Diese Ausfüllung wird durch den Ringraum 14 und die daran anschließende Außenwand 16 vorgenommen. Die relativ dünne Trennwand 15 kann sich optimal an den Steckzapfen 15 anpassen, und zwar auch bei Verformungen, so daß der Abrieb im Verbindungsbereich weitgehend vermieden wird.Another way to reduce the bending stiffness of the relatively thick wall 11 is in the embodiment of 7 thereby achieved in the wall 11 an annulus open to the distal side 14 is incorporated. The partition 15 between this annulus 14 and the recording channel 10 is given a relatively small wall thickness, which is sufficient for reasons of stability, but which would not be sufficient to fill the medullary cavity of the long bone. This filling is through the annulus 14 and the adjoining outer wall 16 performed. The relatively thin partition 15 can optimally attach to the plug 15 adjust, even with deformations, so that the abrasion in the connection area is largely avoided.

Bei dem Ausführungsbeispiel der 7 ist eine insgesamt einstückige Ausgestaltung gewählt, bei dem Ausführungsbeispiel der 8 wird die Außenwand 16 als separate Hülse ausgebildet, die über einen Ringflansch 17 mit der Trennwand 15 verbunden ist. Die Verbindung kann auf verschiedene Weise erfolgen, beispielsweise durch Verschweißen, Verlöten, Verkleben, Verschrauben, Aufschrumpfen oder Verstiften.In the embodiment of the 7 an overall one-piece design is selected, in the embodiment of the 8th becomes the outer wall 16 formed as a separate sleeve, which has an annular flange 17 with the partition 15 connected is. The connection can be made in various ways, for example by welding, soldering, gluing, screwing, shrinking or pinning.

In den 9 bzw. 10 sind ähnliche Ausgestaltungen dargestellt wie in den 7 und 8, sie unterscheiden sich lediglich dadurch von den Ausführungsbeispielen der 7 und 8, daß die Trennwand 15 eine größere Wandstärke aufweist und dafür außenseitig mit Umfangsnuten 12 versehen ist, die im wesentlichen den Umfangsnuten 12 des Ausführungsbeispiels der 1 und 2 entsprechen.In the 9 respectively. 10 configurations similar to those shown in FIGS 7 and 8th , they differ only in the exemplary embodiments of FIG 7 and 8th that the partition 15 has a greater wall thickness and instead with circumferential grooves on the outside 12 is provided, which is essentially the circumferential grooves 12 of the embodiment of the 1 and 2 correspond.

Bei dem Ausführungsbeispiel der 11 wird über eine Verlängerungshülse 7, die entsprechend dem Ausführungsbeispiel der 2 ausgebildet ist, außenseitig noch eine dünne Hülse 18 aufgeschoben, welche die Umfangsnuten 12 außenseitig verschließt und welche in geeigneter Weise mit der Verlängerungshülse 7 verbunden wird. Bei dem Ausführungsbeispiel der 12 wird diese Hülse 18 im Bereich der Umfangsnuten 12 nach innen gebogen, so daß dadurch eine Festlegung der Hülse 18 in axialer Richtung erfolgen kann, außerdem ergibt sich eine strukturierte und damit vergrößerte Außenfläche, die die Verbindung der Gelenkprothese mit dem Knochen begünstigt.In the embodiment of the 11 is via an extension sleeve 7 which according to the embodiment of 2 is formed on the outside still a thin sleeve 18 pushed on, which the circumferential grooves 12 closes on the outside and which in a suitable manner with the extension sleeve 7 is connected. In the embodiment of the 12 will this sleeve 18 in the area of the circumferential grooves 12 bent inward, thereby fixing the sleeve 18 can take place in the axial direction, in addition there is a structured and thus enlarged outer surface which favors the connection of the joint prosthesis to the bone.

Bei dem Ausführungsbeispiel der 6 wird eine Ausgestaltung gewählt, die der der Verlängerungshülse der 7 weitgehend entspricht. Jedoch entfallen die Außenwand 16 und der Ringflansch 17. Statt dessen wird auf die Trennwand 15 eine Hülse 19 aufgeschoben, die einerseits die Verlängerungshülse 7 auf den gewünschten Außendurchmesser bringt und die andererseits weniger biegesteif ist als eine massive Wand mit demselben Außendurchmesser. Diese Hülse 19 kann aus einem beliebigen biokompatiblen Material bestehen, beispielsweise aus Metall, insbesondere Titan. Durch geeignete Formgebung läßt sich hier eine relativ geringe Biegesteifigkeit erzielen, beispielsweise kann die Hülse 19 die Form eines Netzes oder eines Lochbleches haben oder aber aus aufgeschäumtem Material bestehen. Es ergibt sich damit ein zweilagiger Aufbau mit einer durch die Trennwand 15 gebildeten inneren Lage, deren Biegesteifigkeit so gewählt ist, daß eine ausreichende Stabilität gegeben ist, deren Biegesteifigkeit aufgrund der Verwendung der weniger biegesteifen Hülse 19 insgesamt soweit herabgesetzt ist, daß Mikroabrieb vermieden werden kann.In the embodiment of the 6 a design is chosen that the extension of the 7 largely corresponds. However, the outer wall is omitted 16 and the ring flange 17 , Instead, use the partition 15 a sleeve 19 postponed the one hand the extension shell 7 brings to the desired outer diameter and on the other hand is less rigid than a solid wall with the same outer diameter. This sleeve 19 can consist of any biocompatible material, for example metal, in particular titanium. Appropriate shaping enables a relatively low bending stiffness to be achieved, for example the sleeve 19 have the shape of a net or a perforated plate or consist of foamed material. This results in a two-layer structure with one through the partition 15 formed inner layer, the bending stiffness is selected so that there is sufficient stability, the bending stiffness due to the use of the less rigid sleeve 19 is reduced so far overall that micro-abrasion can be avoided.

Claims (20)

Verlängerungshülse für eine modular aufgebaute, in einen Röhrenknochen einsetzbare Gelenkprothese mit einem Steckzapfen zur Verbindung mit einem ersten benachbarten Modul der Gelenkprothese und mit einem sich an den Steckzapfen anschließenden hülsenförmigen Aufnahmeteil mit einem Aufnahmekanal zur Aufnahme eines Steckzapfens eines zweiten, dem ersten gegenüberliegenden Moduls der Gelenkprothese, deren Außenkontur zur Ausfüllung des Markraumquerschnittes des die Gelenkprothese aufnehmenden Röhrenknochens ausgebildet ist, dadurch gekennzeichnet, daß die Biegesteifigkeit der Wand (11) der Verlängerungshülse (7) gegenüber einer massiven, aus dem Material der Verlängerungshülse (7) bestehenden Wand herabgesetzt ist.Extension sleeve for a modular joint prosthesis that can be inserted into a tubular bone with a plug pin for connection to a first adjacent module of the joint prosthesis and with a sleeve-shaped receiving part adjoining the plug pin with a receiving channel for receiving a plug pin of a second module of the joint prosthesis opposite the first one, whose outer contour is designed to fill the medullary cross-section of the tubular bone receiving the joint prosthesis, characterized in that the bending stiffness of the wall ( 11 ) the extension sleeve ( 7 ) compared to a solid one, made of the material of the extension sleeve ( 7 ) existing wall is lowered. Verlängerungshülse nach Anspruch 1, dadurch gekennzeichnet, daß die Wand (11) mindestens zweilagig ausgebildet ist mit einer inneren Lage (15) aus einem biegesteifen Material und mit einer äußeren Lage (19) aus einem weniger biegesteifen Material.Extension sleeve according to claim 1, characterized in that the wall ( 11 ) has at least two layers with an inner layer ( 15 ) made of a rigid material and with an outer layer ( 19 ) made of a less rigid material. Verlängerungshülse nach Anspruch 2, dadurch gekennzeichnet, daß die innere Lage (15) einstückig mit dem Steckzapfen (8) der Verlängerungshülse (7) ausgebildet ist.Extension sleeve according to claim 2, characterized in that the inner layer ( 15 ) in one piece with the plug ( 8th ) the extension sleeve ( 7 ) is trained. Verlängerungshülse nach Anspruch 2 oder 3, dadurch gekennzeichnet, daß die äußere Lage (19) netzförmig ausgebildet ist.Extension sleeve according to claim 2 or 3, characterized in that the outer layer ( 19 ) is network-shaped. Verlängerungshülse nach Anspruch 2 oder 3, dadurch gekennzeichnet, daß äußere Lage (19) lochblechförmig ausgebildet ist.Extension sleeve according to claim 2 or 3, characterized in that the outer layer ( 19 ) is perforated plate-shaped. Verlängerungshülse nach Anspruch 2 oder 3, dadurch gekennzeichnet, daß die äußere Lage (19) aus aufgeschäumtem Material besteht.Extension sleeve according to claim 2 or 3, characterized in that the outer layer ( 19 ) consists of foamed material. Verlängerungshülse nach Anspruch 1, dadurch gekennzeichnet, daß der Querschnitt der Wand (11) durch Vertiefungen (12, 13) geschwächt ist.Extension sleeve according to claim 1, characterized in that the cross section of the wall ( 11 ) through recesses ( 12 . 13 ) is weakened. Verlängerungshülse nach Anspruch 7, dadurch gekennzeichnet, daß in der Wand (11) außenseitig Nuten (12, 13) angeordnet sind.Extension sleeve according to claim 7, characterized in that in the wall ( 11 ) grooves on the outside ( 12 . 13 ) are arranged. Verlängerungshülse nach Anspruch 8, dadurch gekennzeichnet, daß in der Wand (11) mindestens eine äußere Umfangsnut (12) angeordnet ist.Extension sleeve according to claim 8, characterized in that in the wall ( 11 ) at least one outer circumferential groove ( 12 ) is arranged. Verlängerungshülse nach einem der Ansprüche 8 oder 9, dadurch gekennzeichnet, daß die Richtung der Nuten (13) eine achsparallele Komponente aufweist.Extension sleeve according to one of claims 8 or 9, characterized in that the direction of the grooves ( 13 ) has an axially parallel component. Verlängerungshülse nach Anspruch 10, dadurch gekennzeichnet, daß die Nuten (13) in achsparalleler Richtung verlaufen.Extension sleeve according to claim 10, characterized in that the grooves ( 13 ) run in the direction parallel to the axis. Verlängerungshülse nach einem der Ansprüche 8 bis 11, dadurch gekennzeichnet, daß die Wand (11) außenseitig von einer äußeren Hülse (16, 18) umgeben ist.Extension sleeve according to one of claims 8 to 11, characterized in that the wall ( 11 ) outside of an outer sleeve ( 16 . 18 ) is surrounded. Verlängerungshülse nach Anspruch 12, dadurch gekennzeichnet, daß die äußere Hülse (18) dicht an der Außenseite der Wand (11) des Aufnahmeteils (9) anliegt.Extension sleeve according to claim 12, characterized in that the outer sleeve ( 18 ) close to the outside of the wall ( 11 ) of the recording part ( 9 ) is present. Verlängerungshülse nach Anspruch 13, dadurch gekennzeichnet, daß die äußere Hülse (18) in die außenseitigen Nuten (12) der Wand (11) eintaucht.Extension sleeve according to claim 13, characterized in that the outer sleeve ( 18 ) in the outside grooves ( 12 ) the Wall ( 11 ) immersed. Verlängerungshülse nach Anspruch 12, dadurch gekennzeichnet, daß die äußere Hülse (16) von der Außenseite (15) der Wand (11) mit Ausnahme einer Verbindung (17) mit dem Aufnahmeteil (9) einen Abstand einhält.Extension sleeve according to claim 12, characterized in that the outer sleeve ( 16 ) from the outside ( 15 ) the Wall ( 11 ) with the exception of one connection ( 17 ) with the receiving part ( 9 ) keeps a distance. Verlängerungshülse nach Anspruch 1, dadurch gekennzeichnet, daß der Querschnitt der Wand (11) durch Hohlräume (14) geschwächt ist.Extension sleeve according to claim 1, characterized in that the cross section of the wall ( 11 ) through cavities ( 14 ) is weakened. Verlängerungshülse nach Anspruch 16, dadurch gekennzeichnet, daß der Hohlraum ein konzentrisch zu dem Aufnahmekanal (10) angeordneter Ringraum (14) in der Wand (11) ist.Extension sleeve according to claim 16, characterized in that the cavity is concentric with the receiving channel ( 10 ) arranged annulus ( 14 ) in the wall ( 11 ) is. Verlängerungshülse nach Anspruch 16, dadurch gekennzeichnet, daß der Ringraum (14) zur Einsteckseite des Aufnahmekanals (10) hin offen ist.Extension sleeve according to claim 16, characterized in that the annular space ( 14 ) to the insertion side of the receiving channel ( 10 ) is open. Verlängerungshülse nach Anspruch 17 oder 18, dadurch gekennzeichnet, daß in der dem Aufnahmekanal (10) benachbarten Seitenfläche (15) des Ringraumes (14) Vertiefungen (12) angeordnet sind.Extension sleeve according to claim 17 or 18, characterized in that in the receiving channel ( 10 ) adjacent side surface ( 15 ) of the annulus ( 14 ) Deepenings ( 12 ) are arranged. Verlängerungshülse nach Anspruch 19, dadurch gekennzeichnet, daß die Vertiefungen als Umfangsnuten (12) ausgebildet sind.Extension sleeve according to claim 19, characterized in that the depressions as peripheral grooves ( 12 ) are trained.
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DE10308141B4 (en) 2005-04-07
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