DE19932388C1 - Thigh endoprosthesis for above-the-knee amputees, comprises shaft in which stump can be housed, comprising stem covered with volume structure and support - Google Patents

Thigh endoprosthesis for above-the-knee amputees, comprises shaft in which stump can be housed, comprising stem covered with volume structure and support

Info

Publication number
DE19932388C1
DE19932388C1 DE1999132388 DE19932388A DE19932388C1 DE 19932388 C1 DE19932388 C1 DE 19932388C1 DE 1999132388 DE1999132388 DE 1999132388 DE 19932388 A DE19932388 A DE 19932388A DE 19932388 C1 DE19932388 C1 DE 19932388C1
Authority
DE
Germany
Prior art keywords
thigh
stump
endoprosthesis
stem part
housed
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 - Fee Related
Application number
DE1999132388
Other languages
German (de)
Inventor
Hans Grundei
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 DE19857907A external-priority patent/DE19857907C1/en
Application filed by Eska Implants GmbH and Co KG filed Critical Eska Implants GmbH and Co KG
Priority to DE1999132388 priority Critical patent/DE19932388C1/en
Priority to JP2001510395A priority patent/JP2003504153A/en
Priority to DE50000961T priority patent/DE50000961D1/en
Priority to EP00936758A priority patent/EP1119319B1/en
Priority to ES00936758T priority patent/ES2186650T3/en
Priority to US09/913,036 priority patent/US6709466B1/en
Priority to PCT/EP2000/004552 priority patent/WO2001005335A1/en
Priority to AT00936758T priority patent/ATE229775T1/en
Publication of DE19932388C1 publication Critical patent/DE19932388C1/en
Application granted granted Critical
Priority to HK02100810.6A priority patent/HK1039741B/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

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
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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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    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
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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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    • A61F2002/3006—Properties of materials and coating materials
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    • A61F2002/3007—Coating or prosthesis-covering structure made of elastic material, e.g. of elastomer
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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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    • 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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    • 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
    • A61F2230/0067—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

Abstract

Thigh endoprosthesis, comprises a shaft, in which the stump can be housed and leading to a knee, lower leg and foot, comprising a stem covered with a volume structure and a support.

Description

Die vorliegende Erfindung bezieht sich auf eine Oberschenkelstumpf- Endoprothese für eine exoprothetische Versorgung eines im Oberschenkelbereich beinamputierten Patienten. Dabei ist der Oberschenkelstumpf in einen Schaft ziehbar, dem sich die Nachbildung eines Knie-, Unter- und Fußteils der Prothese anschließt. Die Endoprothese weist ein proximales Stielteil auf, das in einen Femurstumpf setzbar ist, wobei das Stielteil zumindest teilweise mit einer offenmaschigen, dreidimensionalen Raumnetzstruktur bedeckt ist und an seinem distalen Ende einen konischen Adapter aufweist, mittels dessen ein Kondylenersatz, der der Form natürlicher Kondylen eines Kniegelenks nachgebildet ist, an das Stielteil gekoppelt ist. Eine derartige Oberschenkelstumpf- Endoprothese ist beschrieben in dem Patent 198 57 907, zu welchem das vorliegende Patent in einem Zusatzverhältnis steht.The present invention relates to a thigh stump Endoprosthesis for an exoprosthetic treatment of a thigh area leg amputees. The thigh stump is in a shaft pullable, which is the replica of a knee, lower and foot part of the prosthesis connects. The endoprosthesis has a proximal stem part that fits into one Femur stump can be placed, the stem part at least partially with a open mesh, three-dimensional network structure is covered and attached to his distal end has a conical adapter, by means of which a Condylar replacement, the shape of the natural condyles of a knee joint is reproduced, is coupled to the stem part. Such a thigh stump Endoprosthesis is described in patent 198 57 907, to which the this patent is in an additional relationship.

Der vorliegenden Erfindung liegt die Aufgabe zugrunde, das Wahrnehmungsgefühl des Patienten noch weiterhin zu steigern. Diese Aufgabe wird mit dem Gegenstand des Anspruchs 1 gelöst.The present invention has for its object that To further increase the patient's sense of perception. This task is solved with the subject matter of claim 1.

Erfindungsgemäß ist mit dem Kondylenersatz eine keilförmige Unterlage verbunden, welche die natürliche Valgität, d. h. also die Winkelstellung des Femurstumpfes in Richtung medial, wiederherstellt. Hierdurch werden die Kräfteverteilungen den entsprechenden Verteilungen in einem gesunden Bein nachempfunden. Dies bedeutet, daß mit dem Keil eine Parallelität zwischen der Unterseite des Keiles und den Gleitflächen eines künstlichen Kniegelenkes hergestellt werden kann unter weitgehender Beibehaltung des natürlichen CCD- Winkels. Eine Vergleichmäßigung der Belastung entlang der Prothesenachse wird hierdurch erzielt.According to the invention, the condyle replacement is a wedge-shaped base connected, which the natural valgity, d. H. so the angular position of the Femoral stump towards the medial, restored. This will make the Force distributions the corresponding distributions in a healthy leg  modeled. This means that with the wedge there is a parallelism between the Underside of the wedge and the sliding surfaces of an artificial knee joint can be produced while largely maintaining the natural CCD Angle. The load is evened out along the axis of the prosthesis achieved through this.

Aus dem Bereich der Chirurgie ist ein Implantat bekannt (US 5,766,251), welches als keilförmiges Ausgleichsstück ausgebildet ist, welches Korrekturen beispielsweise hinsichtlich des Valgitätswinkels gestattet. Der Einsatz des keilförmigen Implantates findet unter anderem statt im Gelenkbereich der Tibia, womit das Tibiaplateau dem Neigungswinkel des keilförmigen Implantates entsprechend einseitig angehoben wird. Einen Hinweis auf die Verwendung dieses Implantates bei der Versorgung eines beinamputierten Patienten ist dieser Druckschrift nicht zu entnehmen.An implant is known from the field of surgery (US Pat. No. 5,766,251) is designed as a wedge-shaped compensating piece, which corrections allowed, for example, with regard to the angle of valgity. The use of the wedge-shaped implant takes place in the joint area of the tibia, with which the tibial plateau corresponds to the angle of inclination of the wedge-shaped implant is raised accordingly on one side. A note on the use of this The implant for the care of a leg amputee is this Document cannot be removed.

Gemäß einer bevorzugten Ausführungsform liegt der Keilwinkel in einem Bereich zwischen 5 und 9°. Die 5° werden vorzugsweise bei männlichen Patienten, die 9° maximal bei weiblichen Patienten zur Anwendung kommen.According to a preferred embodiment, the wedge angle is in a range between 5 and 9 °. The 5 ° are preferred in male patients, the 9 ° maximally used in female patients.

Bevorzugt ist die Unterlage mit der stoßdämpfenden Schicht der Oberschenkelstumpf-Endoprothese verbunden.The base with the shock-absorbing layer is preferred Thigh stump endoprosthesis connected.

Besonders bevorzugt wird die Ausbildung der Unterlage aus einem stoßdämpfenden Kissen, so daß Belastungen nicht direkt in den Femurstumpf eingeleitet werden.The formation of the base from one is particularly preferred shock absorbing pillow so that loads are not directly in the femur stump be initiated.

Zu diesem Zwecke ist die Unterlage bevorzugt aus Silikon hergestellt, ebenso wie die optional vorhandene stoßdämpfende Schicht in der Oberschenkelstumpf- Endoprothese gemäß Hauptpatent.For this purpose, the pad is preferably made of silicone, as well the optionally available shock-absorbing layer in the thigh stump Endoprosthesis according to the main patent.

Die Erfindung wird anhand eines Ausführungsbeispiels gemäß der einzigen Zeichnungsfigur beispielhaft näher erläutert. The invention is based on an embodiment according to the only one Drawing figure explained in more detail by way of example.  

Die einzige Zeichnungsfigur zeigt schematisch einen Oberschenkelstumpf 1 mit einer in dem Femurstumpf 5 implantierten Oberschenkelstumpf-Endoprothese, wie er im wesentlichen auch im Hauptpatent dargestellt ist. Vorliegend werden dieselben Bezugszeichen verwendet wie im Hauptpatent.The only drawing figure schematically shows a thigh stump 1 with a thigh stump endoprosthesis implanted in the femoral stump 5 , as is essentially also shown in the main patent. The same reference numerals are used in the present case as in the main patent.

Ein intramedulärer Stiel 4 bildet das proximale Stielteil, welches in den Markraum des Femurstumpfes gesetzt ist. Die Oberfläche des Stielteils 4 ist mit einer offenmaschigen, dreidimensionalen Raumnetzstruktur 6 belegt, durch welche hindurch Knochentrabekel wachsen können, so daß das Stielteil 4 nach einer gewissen Einheilphase, was den Substratfluß betrifft, quasi Bestandteil des natürlichen Knochens geworden ist.An intramedular stem 4 forms the proximal stem part, which is placed in the medullary canal of the femoral stump. The surface of the stem part 4 is covered with an open-mesh, three-dimensional network structure 6 , through which bone trabeculae can grow, so that the stem part 4 has become part of the natural bone after a certain healing phase, as far as the substrate flow is concerned.

Dem Stielteil 4 schließt sich distalseitig ein konischer Adapter 7 an. Mittels dieses konischen Adapters 7 ist distalseitig der Kondylenersatz 11 mit dem Stielteil 4 gekoppelt.The stem part 4 is followed by a conical adapter 7 on the distal side. By means of this conical adapter 7 , the condyle replacement 11 is coupled to the stem part 4 on the distal side.

Das Kondylenersatzteil 8 ist der Form 11 natürlicher Kondylen eines Kniegelenks nachgebildet.The condyle replacement part 8 is modeled on the shape 11 of natural condyles of a knee joint.

Der Kondylenersatz 8 ist vorliegend mit einer stoßdämpfenden Schicht 10 aus Silikon beschichtet.In the present case, the condyle replacement 8 is coated with a shock-absorbing layer 10 made of silicone.

Mit dem Kondylenersatz 8 bzw. mit der deckenden stoßdämpfenden Schicht verbunden ist die Unterlage 16. Die Unterlage 16 ist keilförmig ausgebildet und weist einen Keilwinkel zur Horizontalen im Bereich von 5° < α < 9° auf.The base 16 is connected to the condyle replacement 8 or to the covering shock-absorbing layer. The base 16 is wedge-shaped and has a wedge angle to the horizontal in the range of 5 ° <α <9 °.

Die Unterlage 16 besteht vorliegend aus einem dämpfenden Kissen und unterstützt somit im gezeigten Ausführungsbeispiel die Abdämpfung von Stoßbelastungen auf die Knie-, Unterschenkel- und Fußteile 3. Der Keilwinkel α der Unterlage 16 wird patientenindividuell bestimmt, so, daß die Unterseite 17 der Unterlage 16 im wesentlichen parallel verläuft zu der Ebene der Gleitbahnen der künstlichen Kondylen eines angekoppelten künstlichen Kniegelenks.The pad 16 in the present case consists of a cushioning cushion and thus supports in the exemplary embodiment shown the absorption of shock loads on the knee, lower leg and foot parts 3 . The wedge angle α of the support 16 is determined individually for the patient, so that the underside 17 of the support 16 runs essentially parallel to the plane of the slideways of the artificial condyles of a coupled artificial knee joint.

Hierdurch wird ein hohes Maß an einer Gleichverteilung der Belastungen in der Gesamtprothese erreicht.This ensures a high degree of uniform distribution of the loads in the Overall prosthesis reached.

Claims (5)

1. Oberschenkelstumpf-Endoprothese für eine exoprothetische Versorgung eines im Oberschenkelbereich beinamputierten Patienten, wobei der Oberschenkelstumpf (1) in einen Schaft (2) ziehbar ist, dem sich die Nachbildung eines Knie-, Unterschenkel- und Fußteils (3) der Prothese anschließt, aufweisend ein proximales Stielteil (4), das in einen Femurstumpf (5) setzbar ist, wobei das Stielteil (4) zumindest teilweise mit einer offenmaschigen, dreidimensionalen Raumnetzstruktur (6) bedeckt ist und an seinem distalen Ende einen konischen Adapter (7) aufweist, mittels dessen ein Kondylenersatz (8), der der Form (11) natürlicher Kondylen eines Kniegelenks nachgebildet ist, an das Stielteil (4) gekoppelt ist, nach dem Patent 198 57 907, mit einer keilförmigen Unterlage (16), die mit dem Kondylenersatz (8) verbunden ist.1. Thigh stump endoprosthesis for an exoprosthetic treatment of a leg amputated in the thigh area, wherein the thigh stump ( 1 ) can be pulled into a shaft ( 2 ), which is followed by the replica of a knee, lower leg and foot part ( 3 ) of the prosthesis a proximal stem part ( 4 ) which can be placed in a femoral stump ( 5 ), the stem part ( 4 ) being at least partially covered with an open-mesh, three-dimensional network structure ( 6 ) and having a conical adapter ( 7 ) at its distal end whose condylar replacement ( 8 ), which is modeled on the shape ( 11 ) of natural condyles of a knee joint, is coupled to the stem part ( 4 ), according to patent 198 57 907, with a wedge-shaped base ( 16 ) which is connected to the condylar replacement ( 8 ) connected is. 2. Oberschenkelstumpf-Endoprothese nach Anspruch 1, bei der der Keilwinkel α der Unterlage (16) im Bereich 5° < α < 9° liegt.2. Thigh stump endoprosthesis according to claim 1, wherein the wedge angle α of the base ( 16 ) is in the range 5 ° <α <9 °. 3. Oberschenkelstumpf-Endoprothese nach Anspruch 1 oder 2, bei der die Unterlage (16) mit der stoßdämpfenden Schicht (10) verbunden ist.3. femoral stump endoprosthesis according to claim 1 or 2, wherein the base ( 16 ) with the shock-absorbing layer ( 10 ) is connected. 4. Oberschenkelstumpf-Endoprothese nach einem der Ansprüche 1 bis 3, bei der die Unterlage (16) aus einem stoßdämpfenden Kissen besteht.4. Thigh stump endoprosthesis according to one of claims 1 to 3, wherein the pad ( 16 ) consists of a shock-absorbing cushion. 5. Oberschenkelstumpf-Endoprothese nach Anspruch 4, bei der die Unterlage aus Silikon besteht.5. Thigh stump endoprosthesis according to claim 4, wherein the Pad made of silicone.
DE1999132388 1998-12-16 1999-07-14 Thigh endoprosthesis for above-the-knee amputees, comprises shaft in which stump can be housed, comprising stem covered with volume structure and support Expired - Fee Related DE19932388C1 (en)

Priority Applications (9)

Application Number Priority Date Filing Date Title
DE1999132388 DE19932388C1 (en) 1998-12-16 1999-07-14 Thigh endoprosthesis for above-the-knee amputees, comprises shaft in which stump can be housed, comprising stem covered with volume structure and support
ES00936758T ES2186650T3 (en) 1999-07-14 2000-05-20 ENDOPROTESIS OF THREAD DOLL FOR AN EXOPROTESIC APPLICATION.
DE50000961T DE50000961D1 (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for an exoprosthetic restoration
EP00936758A EP1119319B1 (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for an exoprosthetic treatment
JP2001510395A JP2003504153A (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for exoprosthesis
US09/913,036 US6709466B1 (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for an exoprosthetic treatment
PCT/EP2000/004552 WO2001005335A1 (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for an exoprosthetic treatment
AT00936758T ATE229775T1 (en) 1999-07-14 2000-05-20 THIGH STUMP ENDOPROSIS FOR AN EXOPROSTHETIC RESTORATION
HK02100810.6A HK1039741B (en) 1999-07-14 2002-02-01 Thigh stump endoprosthesis for an exoprosthetic treatment

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19857907A DE19857907C1 (en) 1998-12-16 1998-12-16 Thigh stump endoprosthesis, for patients with amputated legs, comprises shaft, proximal section and three dimensional spatial net
DE1999132388 DE19932388C1 (en) 1998-12-16 1999-07-14 Thigh endoprosthesis for above-the-knee amputees, comprises shaft in which stump can be housed, comprising stem covered with volume structure and support

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Cited By (4)

* Cited by examiner, † Cited by third party
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DE10339209A1 (en) * 2003-08-20 2005-03-31 Eska Implants Gmbh & Co. Transition adapter
WO2005087145A1 (en) * 2004-03-12 2005-09-22 University College London Prosthetic limb attachment
EP2759281A1 (en) * 2013-01-29 2014-07-30 Les Hôpitaux Universitaires de Genève Implant for lower limb amputation
DE102014115676B3 (en) * 2014-10-28 2015-11-05 Dieter Föllmer prosthesis system

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DE4208247C1 (en) * 1992-03-14 1993-10-14 Eska Medical Gmbh & Co Bone replacement implant
DE4338746A1 (en) * 1993-11-12 1995-05-18 Otmar Dr Behr Internal prosthesis for amputation stump
US5766251A (en) * 1992-03-13 1998-06-16 Tomihisa Koshino Wedge-shaped spacer for correction of deformed extremities
DE19857907C1 (en) * 1998-12-16 2000-04-13 Eska Implants Gmbh & Co Thigh stump endoprosthesis, for patients with amputated legs, comprises shaft, proximal section and three dimensional spatial net

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DE3125268C2 (en) * 1981-06-24 1984-04-12 C. Nicolai GmbH & Co KG, 3000 Hannover Implant
US5766251A (en) * 1992-03-13 1998-06-16 Tomihisa Koshino Wedge-shaped spacer for correction of deformed extremities
DE4208247C1 (en) * 1992-03-14 1993-10-14 Eska Medical Gmbh & Co Bone replacement implant
DE4338746A1 (en) * 1993-11-12 1995-05-18 Otmar Dr Behr Internal prosthesis for amputation stump
DE19857907C1 (en) * 1998-12-16 2000-04-13 Eska Implants Gmbh & Co Thigh stump endoprosthesis, for patients with amputated legs, comprises shaft, proximal section and three dimensional spatial net

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10339209A1 (en) * 2003-08-20 2005-03-31 Eska Implants Gmbh & Co. Transition adapter
DE10339209B4 (en) * 2003-08-20 2006-04-20 Eska Implants Gmbh & Co. Transition adapter
WO2005087145A1 (en) * 2004-03-12 2005-09-22 University College London Prosthetic limb attachment
US8268011B2 (en) 2004-03-12 2012-09-18 University College London Prosthetic limb attachment
EP2759281A1 (en) * 2013-01-29 2014-07-30 Les Hôpitaux Universitaires de Genève Implant for lower limb amputation
WO2014118701A1 (en) * 2013-01-29 2014-08-07 Les Hopitaux Universitaires De Geneve Implant for lower limb amputation
US9724212B2 (en) 2013-01-29 2017-08-08 Les Hopitaux Universitaires De Geneve Implant for lower limb amputation
AU2014210770B2 (en) * 2013-01-29 2018-02-01 Les Hopitaux Universitaires De Geneve Implant for lower limb amputation
DE102014115676B3 (en) * 2014-10-28 2015-11-05 Dieter Föllmer prosthesis system
US10828163B2 (en) 2014-10-28 2020-11-10 Sven Zarling Prosthesis system

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