DE2826690C2 - - Google Patents
Info
- Publication number
- DE2826690C2 DE2826690C2 DE2826690A DE2826690A DE2826690C2 DE 2826690 C2 DE2826690 C2 DE 2826690C2 DE 2826690 A DE2826690 A DE 2826690A DE 2826690 A DE2826690 A DE 2826690A DE 2826690 C2 DE2826690 C2 DE 2826690C2
- Authority
- DE
- Germany
- Prior art keywords
- head
- bearing insert
- adapter
- handle
- adapter head
- 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
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
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4684—Trial or dummy prostheses
-
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
-
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
-
- 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
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/305—Snap connection
-
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
-
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- 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
- A61F2/34—Acetabular cups
- A61F2002/348—Additional features
- A61F2002/349—Shell having a wavy or undulated peripheral rim
-
- 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
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
-
- 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
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3625—Necks
- A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- 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
- A61F2250/0064—Sets comprising a plurality of prosthetic parts of different sizes
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Description
Die Erfindung betrifft eine Vorrichtung zum Anpassen des
Kopfes einer Oberschenkelendoprothese an die natürliche Ge
lenkpfanne von Hüftgelenken.
Während bisher ein Totalersatz eines natürlichen Hüftgelenks
recht erfolgreich war, ist der dazu erforderliche chirurgi
sche Aufwand hinsichtlich Komplikation und Dauer erheblich.
Da die Operation sehr lange dauert, ist das Risiko von Kompli
kationen und Infektionen sehr hoch und das chirurgische
Trauma insbesondere bei älteren Patienten extrem. Aus diesem
Grund haben Entwicklungen stattgefunden, die darauf deuten,
daß bei einem zunehmenden Anteil der Hüftgelenksbehandlungen
ein Teilersatz vorzuziehen ist. In der US-PS 38 63 273 ist
ein teilprothetisches Hüftimplantat mit einem Femoralschaft
mit einem verkleinerten Metallkugelkopf beschrieben, der
sich in einem Kunststoff-Lagereinsatz drehen kann, der in
einem Metallkopf verriegelt ist, welcher seinerseits inner
halb einer natürlichen Hüftgelenkpfanne sitzt. Diese Anordnung
wird für den Fall eines Bruchs des Femoralhalses oder in
solchen Fällen empfohlen, bei denen die Funktion der Hüftge
lenkpfanne nicht beeinträchtigt ist. Diese bekannte Anordnung
wird jedoch nicht zum Ausmessen der Kopfgröße einer zu im
plantierenden Hüftgelenkoberschenkelendoprothese verwendet.
Da das Hüftteilimplantat die Größe der natürlichen Hüftpfanne
ausnutzt, müssen die Protheseköpfe in unterschiedlichen Größen
verfügbar sein, um den natürlichen Femoralkopf simulieren und
eine gute Passung zwischen der natürlichen Hüftgelenkpfanne
und dem Prothesekopf zu gewährleisten. Köpfe für Teilprothesen
stehen im allgemeinen mit Kugelradien von 20,6 mm, 21,4 mm,
22,2 mm, 23,0 mm, 23,8 mm, 24,6 mm, 25,4 mm, 26,2 mm und 26,9 mm
zur Verfügung.
Die erfindungsgemäße Vorrichtung ist besonders geeignet für
das Bestimmen der Größe einer implantierbaren Hüftgelenkendo
prothese. Während der Außenkopf, der für das endgültige Implan
tat verwendet wird, im allgemeinen aus Metall besteht und seine
Oberfläche feinstpoliert ist, bestehen die Anpaßköpfe aus
Kunststoff, um beim Anpassen die Möglichkeit von Schäden an
der natürlichen Hüftgelenkpfanne zu reduzieren. Somit ist
eine Verwendung dieser teuren prothetischen Komponenten zu
Anpaßzwecken nicht erforderlich.
Das versuchsweise Einpassen eines Prothesekopfes in die natür
liche Hüftgelenkpfanne, um die erforderliche Größe zu be
stimmen, ist zeitraubend und dehnt den chirurgischen Eingriff
unnötig aus. Ein zu großer Kopf kann sich dabei in der Pfanne
festsetzen und in der Fermoralprothese lockern; er muß dann
mit einem Spezialwerkzeug entfernt werden.
Die der Erfindung zugrundeliegende Aufgabe besteht darin,
eine chirurgische Vorrichtung der oben umrissenen Gattung
anzugeben, die ein einfaches Ausmessen der natürlichen
Pfannengröße ohne großen technischen Aufwand und ohne über
mäßigen Zeitverlust ermöglicht.
Diese Aufgabe wird erfindungsgemäß dadurch gelöst, daß
die Vorrichtung aus einem Anpaßkopf, aus einem Lagereinsatz,
der herausnehmbar in den Anpaßkopf einsetzbar ist, und aus
einer Hüftgelenkoberschenkelendoprothese oder einem Griff mit
einem Kopf an einem Ende besteht, und daß der Lagereinsatz
abnehmbar und drehbar auf dem Kopf der Hüftgelenkoberschenkel
endoprothese oder dem Kopf des Griffes aufgesetzt ist.
Zweckmäßige Weitergestaltungen ergeben sich aus den Unter
ansprüchen.
Die erfindungsgemäße chirurgische Vorrichtung ermöglicht es,
verschieden große Anpaßköpfe schnell auf einen Lagereinsatz
aufzusetzen und von ihm zu lösen, um die Einpassung in eine
natürliche Hüftgelenkpfanne prüfen zu können. Dann kann
die Vorrichtung aus der Hüftgelenkpfanne durch einfaches Ziehen
am Griff oder am Femoralschaft entfernt werden, ohne dabei
befürchten zu müssen, daß sich der Anpaßkopf von der Anordnung
löst und in der Hüftgelenkpfanne stecken bleibt. Mit leichtem
Druck des Fingers auf den vom Anpaßkopf her zugänglichen La
gereinsatz läßt sich der Femoralkopf/Lagereinsatz sofort und
leicht vom Anpaßkopf lösen, wonach ein geeigneter Anpaß
kopf anderer Größe aufgesetzt und dann das Anpaßverfahren wie
derholt werden kann. Hat man den Anpaßkopf mit der erforder
lichen Größe auf diese Weise ausgewählt, kann man ihn mit dem
Lagereinsatz entfernen und die endgültige Protheseanordnung
zusammensetzen und auf die übliche Weise in ihre Sollage brin
gen.
Die Erfindung wird nachfolgend an Ausführungsbeispielen an
Hand der beigefügten Zeichnung näher erläutert. In der Zeich
nung zeigt:
Fig. 1 teilweise im Schnitt und auseinandergezogen
eine chirurgische Vorrichtung zum Anpassen des
Kopfes einer Hüftgelenkoberschenkelendoprothese
an die natürliche Gelenkpfanne von Hüftgelenken,
Fig. 2 einen Teilschnitt der Vorrichtung nach Fig. 1,
Fig. 3 eine teilgeschnittene Darstellung einer ande
ren Ausführungsform mit einem Griff.
In Fig. 1 ist eine Hüftgelenkoberschenkelendoprothese 10 mit
einem Schaft 11 und einem Kragen 12 gezeigt. Der Schaft 11
soll chirurgisch in die Medulla des Oberschenkelknochens ein
gesetzt werden; der Kragen 12 bietet dabei eine Auflagerfläche
für das resezierte Ende eines natürlichen Oberschenkelknochens.
Ein Hals 13 der Hüftgelenkoberschenkelendoprothese verjüngt sich,
um ein Drehen in einem Lagereinsatz zu ermöglichen. Ihr Kopf
14 weist eine feinstpolierte Kugelfläche aus Metall auf, de
ren Radius geringer als der eines natürlichen Femoralkopfes
ist. Die Kugelfläche muß jedoch größer als halbkugelförmig
sein, wie dies nachfolgend erläutert wird. Der Schaft 11 be
steht in der Regel aus einem Metall wie einer Kobaltchromle
gierung oder nichtrostendem Stahl. Alternativ kann zum Anpas
sen ein Griff geeigneter Gestalt mit ähnlich geformten Kopf 43
vorgesehen sein.
Ein Lagereinsatz 20 umfaßt einen im wesentlichen zylindrischen
Körper mit einer Vielzahl herabhängender, voneinander getrenn
ter flexibler Arme 21, die länger sind als die Kugelfläche
des Kopfes 14 hoch ist, und einen starren zylindrischen An
satz 22 kleineren Durchmessers. Der Lagereinsatz 20 besteht
aus einem reibungsarmen Werkstoff mit einer für den Verwen
dungszweck ausreichenden Festigkeit und Flexibilität wie bei
spielsweise Polyäthylen oder Polypropylen. Es ist nicht er
forderlich, physiologisch inerte Materialien wie Silikon
zu verwenden, da die Vorrichtung nur zum Anpassen dient und
nicht permanent eingepflanzt werden soll. Es werden in der Regel
Werkstoffe verwendet, die sterilisierbar sind, so daß sie sich
wiederholt einsetzen lassen. Schließlich kann der Lager
einsatz auch aus einer Kombination mehrerer unterschiedli
cher Werkstoffe, beispielsweise ausschließlich aus oder
unter Verwendung von Metall bestehen.
Die Innenfläche 23 des Lagereinsatzes 20 ist kugelförmig und
geringfügig größer als der Kopf 14. Das geringe Spiel trägt
zu einer ungestörten Bewegung der Vorrichtung bei. Die Innen
fläche 23 des Einsatzes soll einen größeren Teil einer Kugel
fläche als der Kopf 14 bilden, so daß sich die nachgiebigen
Arme 21 über die Außenfläche des Kopfes 14 erstrecken. Die
Enden der Arme 21 sind mit einer gewölbten Schrägung versehen,
um das Einführen des Kopfes 14 in den Lagereinsatz 20 zu er
leichtern. Die Mantelflächen der Arme 21 weisen im Bereich
ihrer freien Enden Ringsegmente 25 auf, wobei weiterhin unter
einem Winkel von 45° geschrägte Vorderkanten 26 vorgesehen
sind. Die Ringsegmente 25 bewirken eine Sperrung, wenn sie in
einer entsprechenden Ringnut 35 eines Anpaßkopfes 30 sitzen.
Die rückwärtige Kante jedes Ringsegments 25 kann ebenfalls
geschrägt sein oder unter 90° zur Zylinderaußenfläche der Arme
21 verlaufen. Das Ringsegment 25 kann eine flache zylindrische
Außenfläche haben oder im Querschnitt V-förmig zugespitzt
oder halbkreisförmig sein; die Ringnut 35 des Anpaßkopfes 30
muß komplementär gestaltet sein. Die hier gezeigte Gestalt
ist bevorzugt, da sie gegen Beschädigungen beständiger ist.
Die äußeren Abmessungen des Lagereinsatzes 20 wählt man ent
sprechend den Innenabmessungen unterschiedlicher Anpaßköpfe
30; vorzugsweise verwendet man jedoch einen Lagereinsatz 20
in nur einer Größe, damit er nicht wiederholt abgenommen und
wieder aufgesetzt zu werden braucht. Auf diese Weise wird der
zum Anpassen der Prothese erforderliche Zeitaufwand gering
gehalten.
Der Anpaßkopf 30 besteht aus einem zweckmäßigen Material;
es ist darauf hinzuweisen, daß er nicht permanent eingepflanzt
wird.
Die Anpaßköpfe 30 werden in der Regel mit einer vielzahl von
Kugeldurchmessern hergestellt; repräsentative Größen sind
bereits angegeben worden. Damit die Wahl leicht fällt und der
Anpaßvorgang nicht zu lange dauert, kann man die Anpaßkopfe
30 zur Größenkennung unterschiedlich einfärben oder kennzeich
nen. Da vorzugsweise nur ein einziger Lagereinsatz 20 in nur
einer Größe verwendet wird, sollten alle Anpaßköpfe 30 die
gleiche Innenkontur aufweisen - mit der möglichen Ausnahme der
geschrägten Einführfläche 31, die ein leichtes und schnelles
Einsetzen des Lagereinsatzes 20 erleichtert. Eine Mittelboh
rung 32, welche den rückwärtigen starren Ansatz 22 des Lager
einsatzes 20 aufnimmt, weist einen kleineren Durchmesser als
eine weitere Mittelbohrung 33 des Anpaßkopfes auf; zwischen
diesen Mittelbohrungen befindet sich ein geschrägter Übergangs
abschnitt 34. Alternativ kann man beide Bohrungen 32, 33 mit
gleichem Durchmesser ausführen. In diesem Fall hat auch der
Lagereinsatz 20 einen konstanten Außendurchmesser. Die Ring
nut 35 befindet sich neben der Einführfläche 31 des Anpaßkopfes
30 und nimmt die Ringsegmente 25 des Lagereinsatzes 20 auf.
Nach Fig. 2 sind die verschiedenen Teile der Vorrichtung so
zusammengebaut, daß sie zum Anpassen bereit sind. Zunächst
wird der Lagereinsatz 20 auf den Kopf 14 der Prothese aufge
setzt, wobei aufgrund ihrer Elastizität die Arme 21 des Lager
einsatzes 20 sich ausreichend aufspreizen können und sich
dann um den Kopf 14 legen.
Diese Anordnung wird dann in den Innenraum 33 des Anpaßkopfes
30 eingesetzt, wobei sich die freien Enden der Arme 21 ein
wärts biegen, bis die Ringsegmente 25 in die Ringnut 35 des
Anpaßkopfes 30 einrasten. Die gesamte Anordnung ist dann
starr in sich versperrt. Versuche, sie auseinanderzuziehen, sind
vergeblich, da, wenn man am Schaft 11 zieht, der Kopf 14 die
Arme 21 auswärts und damit die Ringsegmente 25 noch fester
in die Ringnut 35 drückt.
Die Anordnung läßt sich jedoch schnell und leicht auseinan
dernehmen, wenn man auf den rückwärtigen starren Ansatz 22
des Lagereinsatzes 20 drückt, wo er in der Mittelbohrung 32
des Anpaßkopfes 30 offenliegt. Dabei werden die Ringsegmente
25 keilartig einwärts bewegt, wobei auch die Arme 21, deren
Innenkrümmung sich über die Kugelaußenfläche des Kopfes 14
hinauserstreckt, einwärts zum Hals 13 der Femoralprothese 10
eingebogen werden, so daß der Lagereinsatz 20 nun leicht aus
dem Anpaßkopf 30 entfernt werden kann.
Der Kopf einer in den natürlichen Oberschenkelknochen einzu
setzenden Femoralprothese hat eine feinstpolierte Außenfläche,
die während des Anpassens versehentlich zerkratzt oder be
schädigt werden kann, so daß die teure Prothese unbrauchbar
wird. Um die Möglichkeit eines Schadens auszuschließen, ver
wendet man zusammen mit dem Anpaßkopf und dem Lagereinsatz
für ein versuchsweises Bestimmen der Kopfgröße einen Griff.
Dieser Griff umfaßt einen Kopf, der nach Größe und Gestalt
demjenigen der Femoralprothese entspricht.
Ein Griff 41 nach Fig. 3 weist an einem Ende einen Kopf 43
und einen Lagereinsatz 44 auf, die mit einem Bolzen 46 aus
nichtrostendem Stahl zusammengehalten werden. Der Kopf 43
besteht aus nichtrostendem Stahl, obgleich auch andere Werk
stoffe wie Acetalharze eingesetzt werden können. Der Kopf 43
hat eine axiale Mittelbohrung, einen Schaft 49 mit einem
Außengewinde zur Fixierung eines Sperrkragens 42 und eine
Teilkugelfläche an seinem anderen Ende, welche in den kugel
förmigen Innenraum des Lagereinsatzes 44 paßt. Die aus dem
Kopf 43 und dem Lagereinsatz 44 mit dem Griff 41 bestehende
Anordnung läßt sich dann in den Anpaßkopf 40 einrasten, wobei
der Sperrkragen 42 auf den Schaft 49 des Kopfes 43 aufge
schraubt wird um die Anordnung mit dem Anpaßkopf zu ver
riegeln.
Der Lagereinsatz 44 ist im wesentlichen dem in Fig. 1 und 2
gezeigten Lagereinsatz 20 entsprechend ausgestaltet, weist
jedoch keinen rückwärtigen Ansatz 22 auf, sondern hat statt
dessen eine Öffnung 45 an seinem rückwärtigen Ende, welche
den Bolzen 46 aufnimmt, mit welchem der Lagereinsatz 44 und
der Kopf 43 an dem Griff 41 festgelegt sind.
Der Kopf 43, welcher anstatt des Kopfes 14 nach Fig. 1 und 2
verwendet wird, ist mit einer Kugelfläche dargestellt, die
kleiner als halbkugelig ist. Die Kugelfläche des Kopfes 43
braucht indessen keine Teilfläche zu sein, sondern kann auch
eine Vollkugelfläche sein. Da die obere Fläche des Kopfes
43 kleiner als halbkugelig und mit dem Bolzen 46 am Lagerein
satz 44 sicher befestigt ist, tritt keine Kraft auf, welche
den Lagereinsatz 44 im Anpaßkopf 40 versperrt, wenn die An
ordnung aus dem Anpaßkopf herausgezogen wird. Wenn man also
den Sperrkragen 42 lockert, lassen sich der Griff 41, der Kopf
43 und der Lagereinsatz leicht und schnell aus dem Anpaßkopf
40 ziehen und in ihn einsetzen. Wenn die Anordnung in dem An
paßkopf 40 verriegelt werden soll, wird der Sperrkragen 42
gegen den Lagereinsatz 44 geschraubt, so daß das Ringsegment
47 des Lagereinsatzes 44 fest in die Nut 48 des Anpaßkopfes
gedrückt wird und es unmöglich ist, den Anpaßkopf 40 vom
Griff 41 abzuziehen.
Nachdem der Anpaßkopf 40 in die Hüftgelenkpfanne eingeführt
und auf sitz geprüft worden ist, zieht man ihn am Griff 41
wieder heraus, schraubt den Kragen 42 auf, zieht den Anpaßkopf
40 schnell und leicht ab und kann nun einen Anpaßkopf 40 ande
rer Größe aufsetzen und den Sperrkragen 42 festziehen. Dann
wird der Vorgang wiederholt.
Claims (7)
1. Chirurgische Vorrichtung zum Anpassen des Kopfes
einer Oberschenkelendoprothese an die natürliche Gelenk
pfanne von Hüftgelenken, dadurch gekennzeich
net, daß die Vorrichtung aus einem Anpaßkopf (30, 40),
aus einem Lagereinsatz (20, 44), der herausnehmbar in den
Anpaßkopf (30, 40) einsetzbar ist, und aus einer Hüftgelenk
oberschenkelendoprothese (10) oder einem Griff (41) mit
einem Kopf (43) an einem Ende besteht, und daß der Lager
einsatz (20, 44) abnehmbar und drehbar auf dem Kopf (14)
der Hüftgelenkoberschenkelendoprothese (10) oder dem
Kopf (43) des Griffes (41) aufgesetzt ist.
2. Vorrichtung nach Anspruch 1 dadurch gekennzeichnet,
daß der Lagereinsatz (20) ein im wesentlichen zylinderför
miges Bauteil mit einem starren Ansatz (22) ist und in ei
ner eine Ringnut (35) aufweisenden Mittelbohrung (32, 33)
des Anpaßkopfes (30) aufnehmbar ist, und daß an dem Lager
einsatz (20) nachgiebige Arme (21) vorgesehen sind, welche
an ihrem Außenumfang in die Ringnut (35) einrastbare Ring
segmente (25) tragen und den Kopf (14) der Hüftgelenkendo
prothese (10) lösbar umgreifen.
3. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet,
daß der Lagereinsatz (44), dessen an seinen nachgiebigen
Armen vorgesehene Ringsegmente (47) in die Ringnut (35)
einer Mittelbohrung (33) des Anpaßkopfes (40) einrastbar
sind, und der Kopf (43) des Griffes (41) mittels eines Bol
zens (46) miteinander verbunden sind, welcher in einen End
abschnitt des Griffes (41) eingeschraubt ist, und daß die
aus Lagereinsatz (44) und Kopf (43) bestehende Einheit
mittels eines Sperrkragens (42) in dem Anpaßkopf (40) lös
bar gehalten ist.
4. Vorrichtung nach Anspruch 3, dadurch gekennzeichnet,
daß der Lagereinsatz (44) eine Mittelöffnung (45) und der
Kopf (43) eine axial verlaufende Zentralbohrung zum Durch
tritt des Bolzens (46) aufweisen, und daß der Kopf (43)
des Griffes (41) einen Schaft (49) mit einem Außengewinde
aufweist, auf welches der Sperrkragen (42) schraubbar ist.
5. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet,
daß der starre zylindrische Ansatz (22) einen kleineren
Durchmesser als der übrige zylinderförmige Körper des Lager
einsatzes (20) aufweist.
6. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet,
daß der Lagereinsatz (20, 44) aus dem gleichen Material
wie der Anpaßkopf (30) besteht.
7. Vorrichtung nach Anspruch 3, dadurch gekennzeichnet,
daß der gewölbte Innenraum des Lagereinsatzes (44), in wel
chen der Kopf (43) eingesetzt ist, ein größeres Volumen
als der Kopf (43) des Anpaßgriffes (41) aufweist.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US05/817,551 US4135517A (en) | 1977-07-21 | 1977-07-21 | Femoral prosthesis trial fitting device |
Publications (2)
Publication Number | Publication Date |
---|---|
DE2826690A1 DE2826690A1 (de) | 1979-02-01 |
DE2826690C2 true DE2826690C2 (de) | 1987-11-19 |
Family
ID=25223337
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19782826690 Granted DE2826690A1 (de) | 1977-07-21 | 1978-06-15 | Vorrichtung fuer eine hueftgelenkprothese |
Country Status (9)
Country | Link |
---|---|
US (1) | US4135517A (de) |
JP (1) | JPS5422994A (de) |
AU (1) | AU521866B2 (de) |
CA (1) | CA1118957A (de) |
CH (1) | CH638093A5 (de) |
DE (1) | DE2826690A1 (de) |
FR (1) | FR2397828A1 (de) |
GB (1) | GB2001247B (de) |
SU (1) | SU841571A3 (de) |
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Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3813699A (en) * | 1973-01-15 | 1974-06-04 | R Giliberty | Prosthetic hip joint |
US3818512A (en) * | 1973-05-08 | 1974-06-25 | Y Shersher | Artificial hip-joint with detachable insert |
US3863273A (en) * | 1973-09-20 | 1975-02-04 | Meditec Inc | Orthopedic prosthetic implant devices |
US4044403A (en) * | 1976-11-01 | 1977-08-30 | Howmedica, Inc. | Implantable joint prosthesis |
-
1977
- 1977-07-21 US US05/817,551 patent/US4135517A/en not_active Expired - Lifetime
-
1978
- 1978-06-14 CA CA000305445A patent/CA1118957A/en not_active Expired
- 1978-06-15 DE DE19782826690 patent/DE2826690A1/de active Granted
- 1978-07-20 FR FR7821469A patent/FR2397828A1/fr active Granted
- 1978-07-20 GB GB787830436A patent/GB2001247B/en not_active Expired
- 1978-07-20 JP JP8889278A patent/JPS5422994A/ja active Granted
- 1978-07-20 CH CH786178A patent/CH638093A5/de not_active IP Right Cessation
- 1978-07-20 AU AU38196/78A patent/AU521866B2/en not_active Expired
- 1978-07-21 SU SU782643646A patent/SU841571A3/ru active
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE102014104707A1 (de) * | 2014-04-02 | 2015-10-08 | Aesculap Ag | Implantatsystem |
Also Published As
Publication number | Publication date |
---|---|
GB2001247B (en) | 1982-02-10 |
JPS5422994A (en) | 1979-02-21 |
FR2397828A1 (fr) | 1979-02-16 |
CA1118957A (en) | 1982-03-02 |
FR2397828B1 (de) | 1981-01-09 |
CH638093A5 (de) | 1983-09-15 |
JPS628178B2 (de) | 1987-02-21 |
DE2826690A1 (de) | 1979-02-01 |
US4135517A (en) | 1979-01-23 |
GB2001247A (en) | 1979-01-31 |
AU3819678A (en) | 1980-01-24 |
SU841571A3 (ru) | 1981-06-23 |
AU521866B2 (en) | 1982-05-06 |
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