DE19709514C1 - Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente - Google Patents

Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente

Info

Publication number
DE19709514C1
DE19709514C1 DE1997109514 DE19709514A DE19709514C1 DE 19709514 C1 DE19709514 C1 DE 19709514C1 DE 1997109514 DE1997109514 DE 1997109514 DE 19709514 A DE19709514 A DE 19709514A DE 19709514 C1 DE19709514 C1 DE 19709514C1
Authority
DE
Germany
Prior art keywords
implant
bone
magnetic core
core
reinforcement body
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.)
Expired - Lifetime
Application number
DE1997109514
Other languages
English (en)
Inventor
Hans Grundei
Wolfram Thomas
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.)
ORTHODYNAMICS GMBH, DE
Original Assignee
Eska Implants GmbH and Co KG
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
Priority claimed from DE19652608A external-priority patent/DE19652608C1/de
Application filed by Eska Implants GmbH and Co KG filed Critical Eska Implants GmbH and Co KG
Priority to DE1997109514 priority Critical patent/DE19709514C1/de
Application granted granted Critical
Publication of DE19709514C1 publication Critical patent/DE19709514C1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A—HUMAN NECESSITIES
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • 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
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
    • 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
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

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Description

Die vorliegende Erfindung bezieht sich auf ein Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente gemäß des Hauptpatents 196 52 608.
Das im Hauptpatent offenbarte Prophylaxe-Implantat weist in seiner einfachsten Ausführungsform einen dünnwandigen hohlen Armierungskörper mit einer solch großen Anzahl von Durchbrechungen in seiner Außenwandung auf, daß das Verhältnis der Gesamtflächen der Durchbrechungen zu der Gesamtoberfläche wenigstens 1 : 2 beträgt. Die Grundidee, die diesem Implantat zugrunde liegt, besagt, daß das osteoporotisch befallene Knochenmaterial durch Ausfräsung oder Ausbohrung entfernt wird, wobei die Ausfräsung oder Ausbohrung der Formgebung des besagten Armierungskörpers angepaßt ist. Dieser Armierungskörper wird in den so ausgeräumten Knochen gesetzt und das so präparierte Knochensegment wieder verschlossen. Es verbleibt also zunächst ein hohlbleibender Armierungskörper im Inneren des betroffenen Knochensegmentes. Aufgrund der örtlichen Gegebenenheiten und gegebenenfalls einer rauhen Oberfläche des Armierungskörpers wächst nun Knochenmaterial von außen in das Innere des Armierungskörpers hinein, und zwar so lange, bis dieser vollständig mit natürlicher Spongiosa gefüllt ist. Dieser Spongiosa haftet nicht mehr der Mangel des osteoporotisch befallenen Knochenmaterials an; die Struktur und die Stabililität des befallenen Knochens ist somit wiederhergestellt.
Der Armierungskörper gemäß Hauptpatent kann mit einem die Heilung fördernden und beschleunigenden Mittel gefüllt sein, wobei insbesondere an Hydroxylapatit oder an eine alpha-Trikalciumphosphat-Keramik gedacht wird. Dieses Material ist bioresorbierbar, so daß nach einer Resorption des Materials im Laufe der Zeit natürliches Knochenmaterial in das Innere des Armierungskörpers hineinwächst.
Es ist Aufgabe der vorliegenden Erfindung, das Einorganisieren von Spongiosa in den Armierungskörper des Prophylaxe-Implantats gemäß Hauptpatent noch weiter zu beschleunigen.
Diese Aufgabe wird mit dem Gegenstand des Anspruchs 1 gelöst.
Die vorliegende Erfindung macht sich die sogenannte magnetisch induzierte Elektrostimulation in der Orthopädie zunutze, wie sie ausführlich in der einschlägigen Fachliteratur beschrieben ist. Beispielsweise sei hingewiesen auf den Aufsatz "Magnetfeldtherapie und magnetisch induzierte Elektrostimulation in der Orthopädie", W. Kraus, DE-Z-Orthopäde (1984) 13 : 78 bis 92.
Im Übrigen sind Implantate, die sich mit der Elektrostimulation beschäftigen, bekannt geworden aus der US-A-4,195,367 und der DE-A-34 14 992. Diese betreffen jedoch im wesentlichen Implantate, an denen Elektroden befestigt sind. An diese werden vorzugsweise niederfrequente elektrische Spannungen angelegt, so daß ein festes und sicheres Verwachsen des Implantates mit dem umgebenden Knochengewebe gewährleistet sein soll. Eine in einem mit Füllmaterial gefüllten Raum angeordnete Spule wird im Stand der Technik nicht angedacht.
Die auf dem magnetischen Kern angeordnete Spule ist in dieser Konfiguration anzusehen als die Sekundärwicklung eines Transformator, dessen Primärwicklung von extern her an den Patienten gelegt wird. Ein niederfrequenter Wechselstrom in der Primärwicklung erzeugt eine ebenso niederfrequente Spannung an den Klemmen der Sekundärwicklung auf dem magnetischen Kern. In der Sekundärwicklung fließt dann über das Füllmaterial im Inneren des Armierungskörpers ein elektrischer Strom, welcher das Knochenwachstum in bekannter Weise stimuliert.
Als Resultat wird der Armierungskörper schneller von natürlicher Spongiosa durchwachsen, wodurch die Struktur und die Stabilität des befallenen Knochens deutlich schneller wiederhergestellt wird.
Gemäß einer vorteilhaften Weiterbildung kann vorgesehen sein, daß der magnetische Kern als Gewindespindel ausgebildet ist, welche gemäß des Hauptpatents dazu dient, die in diesem Falle aus Kunststoff bestehende zylindrische Hülse des Armierungskörpers durch Drehung der Gewindespindel zu stauchen, um so eine Wanderungsneigung des Implantates im Knochenkanal zu unterbinden.
Gemäß einer weiteren vorteilhaften Ausführungsform ist vorgesehen, daß das Kopfteil einen in das Innere des Armierungskörpers ragenden Fortsatz mit einer die zentrierte Lage des magnetischen Kerns sichernden Aufnahme aufweist. Das Kopfteil und der Fortsatz kann beispielsweise und bevorzugterweise aus einer geeigneten Keramik bestehen. Ist beispielsweise die Spitze des magnetischen Kerns kegelförmig ausgebildet, so ist die Aufnahme vorzugsweise komplementär hierzu in der Keramik vorgesehen.
Die Erfindung wird anhand eines Ausführungsbeispiels anhand der Zeichnungsfiguren näher erläutert. Hierbei zeigt:
Fig. 1 die Ansicht des Implantates, teilweise weggebrochen,
Fig. 2 eine schematische Ansicht der Implantationslage des Implantates aus Fig. 1 im Femurschenkelhals, und
Fig. 3 eine schematische Ansicht der Implantationslage des Implantates in einem Wirbelkörper.
Wie in Fig. 1 schematisch dargestellt, ist der Armierungskörper 1 vorliegend eine im wesentlichen zylindrische Hülse 5 mit den Merkmalen des Implantates gemäß des Hauptpatents. Darüberhinaus ist im Inneren der Hülse 5 ein magnetischer Kern 30 zentriert angeordnet. Der magnetische Kern 30 trägt eine Spule 31, welche die Sekundärwicklung eines Transformators ist, der gebildet ist aus der Spule 31 und einer extern an den Patientkörper heranzuführenden Primärwicklung oder Spule nicht dargestellt, durch welche ein niederfrequenter Wechselstrom von ca. 0,2 bis 20 Hz geleitet wird, um die Therapie einzuleiten. Dieser Wechselstrom im Primärkreis erzeugt einen Strom im Sekundärkreis, nämlich in der Spule 31 und in dem zwischen beiden Spulenklemmen befindlichen Füllmaterial im Inneren der Hülse 5.
Das Kopfteil 6 der Hülse 5 weist einen in das Innere des Armierungskörpers 1 ragenden Fortsatz 33 auf, der an seinem stirnseitigen Ende eine komplementär zu der Spitze des magnetischen Kerns 30 ausgebildete Aufnahme 32 aufweist. Das Kopfteil 6 besteht vorzugsweise aus einer körperverträglichen Keramik.
Fig. 2 veranschaulicht zur Vervollständigung des Bildes die Implantationslage des Implantates im Schenkelhals des Femurs 11. Eine ähnliche Ausführungsform der Armierungshülse 1 kann vorgesehen sein zum Einsatz in einem Wirbelkörper 34, wie dies in Fig. 3 dargestellt ist. Freilich sind die Dimensionen andere als bei dem Implantat, welches in den Schenkelhals eines Femurs eingesetzt werden soll.

Claims (3)

1. Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente, insbesondere des Schenkelhalses, der Wirbelsäule und des Handgelenkes, nach einem der Ansprüche 1 bis 11 oder 13 und 14 des Hauptpatents 196 52 608, bei dem im mit Füllmaterial gefüllten Armierungskörper (1) auf einem darin zentriert angeordneten magnetischen Kern (30) eine elektrische Spule (31) angeordnet ist, die von extern anregbar ist.
2. Implantat nach Anspruch 1, bei dem der magnetische Kern (30) als Gewindespindel ausgebildet ist.
3. Implantat nach Anspruch 1 oder 2, bei dem das Kopfteil (6) des Armierungskörpers einen in das Innere des Armierungskörpers (1) ragenden Fortsatz (33) mit einer die zentrierte Lage des magnetischen Kerns (30) sichernden Aufnahme (32) aufweist.
DE1997109514 1996-12-18 1997-03-10 Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente Expired - Lifetime DE19709514C1 (de)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1847227A1 (de) * 2006-04-19 2007-10-24 Neue Magnetodyn GmbH Elektrisches Marknagelsystem

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4195367A (en) * 1976-03-19 1980-04-01 Werner Kraus Long-term endoprosthesis
DE3414992A1 (de) * 1984-04-19 1985-10-31 Werner Dipl.-Ing. 8000 München Kraus Knochenimplantat
DE19652608C1 (de) * 1996-12-18 1998-08-27 Eska Implants Gmbh & Co Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4195367A (en) * 1976-03-19 1980-04-01 Werner Kraus Long-term endoprosthesis
DE3414992A1 (de) * 1984-04-19 1985-10-31 Werner Dipl.-Ing. 8000 München Kraus Knochenimplantat
DE19652608C1 (de) * 1996-12-18 1998-08-27 Eska Implants Gmbh & Co Prophylaxe-Implantat gegen Frakturen osteoporotisch befallener Knochensegmente

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
KRAUS, W.: "Magnetfeldtherapie und magnetisch induzierte Elektrostimulation in der Orthopädie", Orthopäde (1984) 13, S.78-92 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1847227A1 (de) * 2006-04-19 2007-10-24 Neue Magnetodyn GmbH Elektrisches Marknagelsystem
WO2007118457A1 (de) * 2006-04-19 2007-10-25 Neue Magnetodyn Gmbh Elektrisches marknagelsystem
US9439694B2 (en) 2006-04-19 2016-09-13 Neue Magnetodyn Gmbh Electrical intramedullary nail system

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