DE4320086C3 - Modular shank for a Revisionshüftprothesensystem - Google Patents

Modular shank for a Revisionshüftprothesensystem

Info

Publication number
DE4320086C3
DE4320086C3 DE19934320086 DE4320086A DE4320086C3 DE 4320086 C3 DE4320086 C3 DE 4320086C3 DE 19934320086 DE19934320086 DE 19934320086 DE 4320086 A DE4320086 A DE 4320086A DE 4320086 C3 DE4320086 C3 DE 4320086C3
Authority
DE
Grant status
Grant
Patent type
Prior art keywords
shaft
portion
sleeve
elements
revisionshüftprothesensystem
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
DE19934320086
Other languages
German (de)
Other versions
DE4320086A1 (en )
DE4320086C2 (en )
Inventor
Peter Brehm
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.)
Brehm Peter
Original Assignee
Brehm Peter
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
Grant date

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30739Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
    • AHUMAN NECESSITIES
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
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    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
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    • A61F2/30728Collars; Bone edge protectors
    • AHUMAN NECESSITIES
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    • A61F2/00Filters 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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    • A61F2/30Joints
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    • A61F2/30734Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
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    • A61F2/3672Intermediate parts of shafts
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    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30159Concave polygonal shapes
    • A61F2002/30171Concave polygonal shapes rosette- or star-shaped
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    • A61F2/00Filters 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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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30339Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
    • A61F2002/30344Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends one cone being convex and the other being concave
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    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • A61F2002/30434Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws using bolts
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    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625Necks
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • A61F2002/3678Geometrical features
    • A61F2002/3686Geometrical features bent
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • A61F2002/3678Geometrical features
    • A61F2002/3694Geometrical features with longitudinal bores
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/005Rosette-shaped, e.g. star-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063Nested prosthetic parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Description

Die Erfindung richtet sich auf einen Schaft für ein Revisionshüftprothesen system umfassend einen in den Oberschenkelknochen einschlagbaren Ver ankerungsabschnitt, einen den Verankerungsabschnitt verlängernden Ab schnitt und einen abgewinkelten Gelenkkugelabschnitt zum Aufsetzen der Gelenkkugel, wobei eine durchgehende Längsbohrung vorgesehen ist, in die von dem Gelenkkugelabschnitt her eine bis in den Verankerungsab schnitt reichende Sicherungsschraube einsetzbar ist, wobei die Längsboh rung wenigstens im Bereich des Verankerungsabschnittes als Gewindeboh rung ausgebildet ist, und wobei der Verbindungsabschnitt wenigstens teil weise durch eine Mehrzahl über Konusabschnitte ineinander steckbarer Hülsen-Elemente gebildet ist, die ebenfalls eine Längsbohrung aufweisen. The invention is directed to a shaft for a Revisionshüftprothesen system comprising anchoring section has a United breakable into the femur, a lengthening the anchoring portion cut off and an angled joint ball portion for mounting the joint ball, with a continuous longitudinal bore is provided, into which one of the ball joint portion thereof to in the Verankerungsab reaching securing screw section is insertable, wherein the Längsboh tion at least in the region of the anchoring portion is formed as a tapped hole tion, and wherein said connecting portion at least partially by a plurality of via cone sections interengaging plug sleeve elements is formed, which likewise have a longitudinal bore.

Ein vergleichbarer Schaft ist aus der DE 32 05 577 C3 bekannt. A similar shaft is known from DE 32 05 577 C3. Der vorbekannte Schaft weist Elemente auf, welche als Verlängerungsstücke bezeichnet werden und an ihrem einen Ende einen konischen Steckzapfen und an ihrem anderen Ende eine konische Steckhülse auf weisen, welche in korrespondierende Steckhülsenab schnitte bzw. Steckzapfenabschnitte benachbarter Ele mente derart einsetzbar sind, daß eine selbsthemmende Verbindung entsteht. The known shank has elements, which are referred to as extended portions and at one end a tapered spigot and at its other end a conical plug-in sleeve in ways which cuts into corresponding Steckhülsenab or plug pin portions adjacent ele ments are insertable such that a self-locking connection arises.

Durch die Ausbildung der Steckverbindung als selbst hemmend soll eine einfache Montage erreicht werden. By forming the connector as a self-locking easy mounting to be achieved. Es wird dort ausgeführt, daß die selbsthemmende Ko nusverbindung eine ausreichend feste Haltekraft gegen ein Auseinanderbewegen der Teile erzeuge, wobei zu dem ein erhebliches Drehmoment übertragen werden könne. It is stated there that the self-locking Ko nusverbindung a sufficiently strong holding force against a movement apart of the parts generating, at which a substantial torque can be transferred. Weiterhin könne die Konusverbindung im Falle einer Reoperation wieder leicht gelöst werden. Furthermore, the conical connection can be in case of reoperation easily released.

Zur Erzielung einer optimalen Längsstabilität und für die intraoperative Handhabung ist eine solche selbst hemmende Verbindung jedoch nicht zufriedenstellend. To achieve optimum longitudinal stability and for intraoperative handling, however, such a self-locking connection is not satisfactory.

Auch aus DE 89 11 046 U1 ist ein modular aufgebau ter Schaft bekannt, wobei zur Verbindung der einzelnen Elemente einerseits ebenfalls wiederum Konusabschnit te an den zu verbindenden Elementen und an einer klemmend aufschiebbaren Haltehülse vorgesehen sind, wobei die zu verbindenden Elemente darüber hinaus aber auch in Richtung senkrecht zur Längsachse form schlüssig ineinandergeschoben werden. From DE 89 11 046 U1 discloses a modular aufgebau ter shaft is known, being also in turn Konusabschnit te to the elements to be connected and a clamping slide-holding sleeve is provided for connecting the individual elements on the one hand, the members to be joined but in addition also in direction are pushed into one another perpendicular to the longitudinal axis of a form fit. Diese Verbin dungstechnik ist auch intraoperativ nur sehr schwer handhabbar. The joints has applications technology also intraoperatively very difficult to handle.

Die DE 33 36 004 C2 beschreibt ebenfalls einen ver längerbaren Schaft bzw. einen Adapter, wobei Konus teile durch zylindrische Hülsen zusammengehalten wer den und darüber hinaus noch eine Schraubverbindung senkrecht zur Längsachse der Elemente zur Erzielung einer axialfesten Verbindung vorgesehen sind. The DE 33 36 004 C2 also describes a ver längerbaren shank and an adapter, said conical parts by cylindrical sleeves held together who a screw are provided perpendicular to the longitudinal axis of the elements to achieve an axially fixed connection to and beyond the moment.

Bei der aus DE 40 31 520 A1 vorgesehenen Konus verbindung ist ein Konus als Spreizkonus ausgebildet, der mit Hilfe einer axial von oben eingeführten Spreiz schraube aufspreizbar und damit fixierbar ist. When provided from DE 40 31 520 A1 tapered connection, a cone is formed as a spreading cone, the screw with the aid of an axially introduced from above spreading spread apart and thus be fixed. Die vor bekannte Lösung ermöglicht allerdings nur eine Siche rung einer einzigen Konusverbindung und nicht mehre re derartiger Verbindungen eines vollständig modular aufgebauten Schaftes. The prior known solution, however, only a Siche enables tion of a single cone joint and not several re such compounds of a fully modular shank.

In der EP 0 368 488 A1 wird eine Konusverbindung beschrieben, die zur axialen Verbindung an dem Konus abschnitt einen Bolzenansatz aufweist, der in eine ent sprechende Ausnehmung am Boden der Konusausneh mung einrastet. In EP 0368488 A1 a tapered connection is described in sections for the axial connection of the cone having a pin boss, which engages in a recess ent speaking at the bottom of Konusausneh determination.

Aus der EP 0 290 735 ist eine weitere Konusverbin dung bekannt, welche mittels einer Nase als Verdrehsi cherung ausgestaltet ist. From EP 0290735 a further Konusverbin dung is known which is configured by means of a nose as Verdrehsi insurance.

Ein gattungsgemäßer Schaft ist aus der EP 0 243 298 A2 bekannt. A generic shaft is known from EP 0243298 A2. Bei diesem vorbekannten Schaft wird eine axial verlaufende Schraube dazu ver wendet, einen Endkeil in axialer Richtung anzuziehen, um hierdurch Spreizteile nach außen zu drücken und damit in der Knochenbohrung zu verspannen. In this known shaft an axially extending screw is to ver applies to attract an end wedge in the axial direction to thereby press expanding parts outwardly and thus be tightened in the bone hole. Es wird mit der Schraube also eine radiale Verspreizung der am unteren Ende angebrachten Spreizteile bewerkstelligt. It is thus accomplished with the screw a radial bracer the attached at the lower end expanding parts.

Ausgehend von diesem bekannten Stand der Technik liegt der Erfindung die Aufgabe zugrunde, einen Schaft der eingangs genannten Art so auszugestalten, daß er aus einer praktisch beliebigen Zahl relativ kleiner Ele mente zusammensetzbar ist, wobei insbesondere eine freie, individuell angepaßte Einstellung des Antetor sions-Winkels möglich sein soll. Starting from this known prior art, the invention has for its object to embody a shaft of the type mentioned that it elements made of practically any desired number of relatively small Ele be assembled, in particular a free, individually adapted adjust the Antetor sions angle should be possible.

Diese Aufgabe wird erfindungsgemäß dadurch gelöst, daß im Bereich des Gelenkkugelabschnittes eine versenkte Ringschulter als axiale Anlage für einen Kopf der Sicherungsschraube ausgebildet ist, um durch Anziehen der Sicherungsschraube die Hülsen-Elemente nach Positionierung derselben gegeneinander zu verspannen, wobei in dem Gelenkkugelabschnitt und in den Hülsen Gewindebohrungsabschnitte vorgesehen sind. This object is inventively achieved in that a slotted annular shoulder is formed as axial abutment for a head of the locking screw in the region of the joint ball portion to clamp by tightening the securing screw the sleeve elements after positioning the same against each other, wherein in the joint ball portion and in the sleeves threaded hole sections are provided.

Diese Ausgestaltung ermöglicht es, unter Verwen dung einer Mehrzahl von untereinander gleichen Hül senelementen eine optimale Längenanpassung des Pro thesenschaftes zu realisieren, wobei bereits vor der Operation die einzelnen Elemente zum Ausprobieren der optimalen Konfiguration zusammensteckbar sind und die Elemente bei der Operation dann in übersichtli cher Weise vormontiert auf dem üblicherweise verwen deten Sieb liegen können. This configuration makes it possible under USAGE dung a plurality of mutually identical Sleeve Shirt senelementen an optimal length adjustment of the Pro to realize synthesis shaft, whereby the individual elements for testing the optimum configuration can be plugged together prior to surgery and the elements in the operation then in übersichtli cher manner can pre-assembled on the commonly used does sieve lie.

Die erfindungsgemäße Ausgestaltung ermöglicht es, daß der Operateur den Revisions-Prothesenschaft wäh rend der Operation den Knochenverhältnissen anpas sen kann, dh es können Verankerungsabschnitte zum Einheilen in verschiedenen Durchmessern vorgesehen werden. The inventive design permits the surgeon the revision prosthesis stem currency rend the operation anpas the bone ratios can sen, ie it can be anchor portions provided for healing in various diameters. Die Prothesenlänge kann in der Abstimmung zur Beinlänge mit Hilfe unterschiedlich langer Hülsen elemente vorgegeben werden, ohne daß hierdurch die Festigkeit, wie z. The prosthesis length can be specified in the vote for the leg length using different length sleeves elements, without thereby affecting the strength such. B. bei einer selbsthemmenden Konus verbindung, verloren geht. B., connection lost in a self-locking cone goes. Bei implantiertem Prothe senschaft hat der Operateur die Möglichkeit, die Ante torsion nachträglich festzulegen. An implanted prosthetic ence the operator has the option of Ante twist set afterwards. Dies ist besonders des halb von Bedeutung, weil es andernfalls zu überhöhten Rotationskräften kommen kann, die die Veränderungs situation zusätzlich belasten. This is especially the semi-important, because it can cause excessive rotational forces Otherwise, the situation the variation additional burden. Es ist erfindungsgemäß problemlos möglich, die Antetorsion den ursprüngli chen Verhältnissen anzupassen. It is perfectly possible according to the invention to adjust the antetorsion the Original Painting and fair.

Neben einem einfachen Zusammenbau des Prothe senschaftes ermöglicht die erfindungsgemäße Lösung auch ein einfaches Zerlegen, da durch das Lösen der zentralen Sicherungsschraube gleichzeitig alle Verbin dungen gelöst werden und keine selbsthemmenden Klemmverbindungen mit Hilfe gesonderter Werkzeuge gelöst werden müssen. In addition to a simple assembly of the prosthetic senschaftes the inventive solution also allows for easy dismantling because Join all applications are solved by releasing the central locking screw simultaneously, and no self-locking clamp connections using separate tools must be solved. Dementsprechend ist auch der Revisions-Prothesenwechsel problemlos möglich, ohne daß vor allem zusätzliche Knochendefekte entstehen würden. Accordingly, the revision prosthetic replacement is easily possible without additional especially bone defects would occur. Die Prothese kann als Ganzes entfernt werden oder auch teilweise, dh eine Hülse oder mehrere Hül sen, je nach Bedarf. The prosthesis can be removed as a whole or in part, that is a sleeve or more sen Sleeve Shirt, according to need. Erfindungsgemäß muß keine geson derte Sicherungsmutter für die Sicherungsschraube vorgesehen werden und das axiale Verspannen und Ver binden aller Hülsenelemente einschließlich des gelenk kugelseitigen Abschnitts und des Verankerungsab schnitts können durch diesen Gewindeabschnitt einer seits und die Anlage des Kopfes der Sicherungsschraube andererseits verbunden werden. According to the invention no geson-made locking nut for the locking screw has to be provided and the axial bracing and Ver bind all the sleeve members including the ball joint-side portion and the Verankerungsab section can be connected by this threaded portion of a hand, and the installation of a head of the locking screw on the other.

Zusammenfassend ermöglicht es die erfindungsgemä ße Lösung also, die Prothese zunächst unfixiert zusam menzustecken, so daß sie in der erforderlichen Größe als eine Art Probeimplantat zur Überprüfung integriert werden kann und, sofern die gewählte Größe sich pas send erweist, kann dann eine Fixierung in situ erfolgen, so daß das Probeimplantat gleichzeitig auch das endgül tige Implantat ist. In summary, it allows the inventive SSE solution so initially menzustecken the prosthesis together unfixed so that they can be integrated into the required size as a kind of trial implant to check and, if the selected size is pas send proving a fixation in situ can then be so that the trial implant is also the definitive term implant.

In weiterer Ausgestaltung der Erfindung ist vorgese hen, daß das Hülsen-Element so gestattet ist, daß sich beim Zusammenstecken eine etwa zylinderförmige Mantelfläche ergibt. In a further embodiment of the invention is hen vorgese that the sleeve member is allowed that an approximately cylindrical surface results in plugging together.

Nach der Erfindung lassen sich auf das jeweils oberste Hülsenelement Gelenkkugelabschnitte mit unterschied licher Abkröpfung (CCD-Winkel) aufsetzen. According to the invention (CCD angle) can be the uppermost sleeve element joint ball portions having different Licher bend put. Damit ist eine optimale Einstellung des CCD-Winkels möglich. For optimum adjustment of the CCD angle is possible. Weiterhin kann der Gelenkkugelabschnitt relativ zum Schaft nach dessen Implantation durch Verdrehen in optimaler Weise eingestellt und der eingestellte Ante torsions-Winkel mit der Sicherungsschraube fixiert wer den. Furthermore, the ball joint portion can be adjusted relative to the shaft after its implantation by twisting in an optimum manner and the set Ante torsional angle with the locking screw fixed to who.

Der Gelenkkugelabschnitt kann einen Konusab schnitt aufweisen, auf welchen die Gelenkkugel mit ei ner entsprechenden Konusbohrung aufsetzbar ist. The joint ball section may have a Konusab on which the joint ball can be placed with egg ner corresponding conical bore cut.

Eine weitere Ausgestaltung der Erfindung ergibt sich aus Unteranspruch 5. Another embodiment of the invention arises from the dependent claim. 5

Nachfolgend wird die Erfindung anhand eines bevor zugten Ausführungsbeispiels in Verbindung mit der Zeichnung dargestellt. The invention based on a before ferred embodiment is shown in conjunction with the drawings. Dabei zeigen: They show:

Fig. 1 eine Ansicht eines erfindungsgemäßen Revi sionshüftprothesen-Schaftes in der Konfiguration ent sprechend einer ersten Größe, Fig. 1 is a view of a Revi sionshüftprothesen-stem according to the invention accordingly in the configuration of a first size,

Fig. 2 eine Fig. 1 entsprechende Darstellung einer größeren Konfiguration, Fig. 2 is a Fig. 1 representation corresponding to a larger configuration,

Fig. 3 einer Schnittdarstellung der Konfiguration nach Fig. 1 im auseinandergezogenen Zustand und Fig. 3 a sectional view of the configuration of FIG. 1 in an exploded condition, and

Fig. 4 einen Schnitt längs der Linie IV-IV in Fig. 3. Fig. 4 shows a section along the line IV-IV in Fig. 3.

Ein in der Zeichnung dargestellter Revisionshüftpro thesen-Schaft 1 umfaßt einen Verankerungsabschnitt 2 und einen abgekröpften Gelenkkugelabschnitt 3 sowie einen Verlängerungsabschnitt 4 des Verankerungsab schnitts 2 der aus zwei Hülsen-Elementen 5 bzw. 5 ' zu sammengesetzt ist. A shown in the drawing Revisionshüftpro thesen shaft 1 comprises an anchoring portion 2 and a cranked ball joint section 3, and an extension portion 4 of the section 2 of the Verankerungsab 'is sammengesetzt of two sleeve elements 5 and 5 respectively. Diese Hülsen-Elemente 5 bzw. 5 ' unterscheiden sich durch eine unterschiedliche axiale Länge, wobei beim Ausführungsbeispiel nach Fig. 3 ein Hülsen-Element 5 eingesetzt ist, während beim Ausfüh rungsbeispiel nach Fig. 1 ein Hülsen-Element 5 und ein Hülsen-Element 5 ' kombiniert sind. These sleeve elements 5 and 5 'are distinguished by a different axial length, the embodiment according to Fig. 3, a sleeve element 5 is inserted, while in the exporting approximately example of FIG. 1, a sleeve element 5 and a sleeve element are combined 5 '.

Die Verbindung der einzelnen Elemente der modular aufgebauten Prothese erfolgt über Konusabschnitte, dh Konusansätze 6 und Konusausnehmungen 7 . The connection of the individual elements of the modular prosthesis is achieved by cone sections, ie cone approaches 6 and Konusausnehmungen. 7

Im Ausführungsbeispiel weist der Varankerungsab schnitt 2 einen Konuszapfen 6 auf und der Gelenkkugel abschnitt 3 eine Konusausnehmung 7 . In the embodiment, the cut Varankerungsab 2 shows a conical peg 6 on and the ball joint section 3, a conical recess. 7

Jedes Hülsen-Element 5 bzw. 5 ' weist ebenfalls eine Konusausnehmung 7 auf und einen Konusabschnitt 6 , der gegenüber der Mantelfläche 8 unter Ausbildung ei ner Ringschulter 9 derart verjüngt ist, daß im zusam mengesetzten Zustand (vgl. Fig. 1 und 3) die Mantelflä che 8 im wesentlichen zylinderförmig ausgebildet ist. Each sleeve element 5 and 5 'likewise has a conical recess 7, and a cone section 6, which is tapered relative to the circumferential surface 8 to form ei ner annular shoulder 9 so that in together quantitative translated state (see FIG. FIGS. 1 and 3) the Mantelflä surface 8 is substantially cylindrical in shape.

Die Hülsen 5 , 5 ' und der Gelenkkugelabschnitt 3 wei sen eine Längsbohrung 10 mit einer Längsachse 11 auf. 10, the sleeves 5, 5 'and the ball joint section 3 wei sen a longitudinal bore having a longitudinal axis. 11 Der Verankerungsabschnitt 2 ist mit einer Gewinde bohrung 10 b versehen. The anchoring section 2 is provided with a threaded bore 10 b. In den Hülsenelementen 5 , 5 ' sind Längsbohrungsabschnitte 10 c mit Innengewinde vorgesehen. In the sleeve elements 5, 5 'longitudinal bore portions 10 are provided with internal thread c. Ein entsprechender Gewindebohrungsab schnitt 10 d ist auch in dem Gelenkkugelabschnitt 3 aus gebildet. A corresponding cut Gewindebohrungsab 10 d is formed in the ball joint section 3 of. Am äußersten Ende dieses Abschnitts 10 d ist eine Ringschulter 16 vorgesehen, an die sich ein Ab schnitt 10 e anschließt. At the extreme end of this portion 10 d is an annular shoulder 16 is provided, to which a cut from 10 e connects.

In den Abschnitt 10 e ist eine Sicherungsschraube 12 einführbar, deren Kopf 13 zur Anlage an der Ringschul ter 16 kommt und deren entferntes Ende in den Gewin deabschnitt 10 b eingreift, so daß durch das Anziehen dieser Sicherungsschraube die einzelnen Teile in den verspannten Zustand überführt werden können. In the portion 10 e, a locking screw 12 is inserted, the head 13 comes to rest against the annular school ter 16 and whose distal end deabschnitt in the threaded 10 b engages, so that the individual parts are transferred in the clamped state by tightening this securing screw can.

Durch Auswahl eines geeigneten Gelenkkugelab schnitts 3 kann der Winkel in optimaler Weise den spe zifischen Gegebenheiten angepaßt werden, wobei es zu dem möglich ist, bei implantiertem Verankerungsab schnitt 2 den Gelenkkugelabschnitt 3 um die Längsach se 11 zu verdrehen und einzustellen. By selecting a suitable Gelenkkugelab section 3, the angle can be adapted in an optimum manner the spe-specific circumstances, whereby it is possible to, when implanted Verankerungsab section 2 the ball joint section 3 se to the Längsach 11 to rotate and adjust.

Der Verankerungsabschnitt 2 weist an seiner Außen seite längs verlaufende Rippen 14 auf, welche sich radial nach außen erstrecken, wie dies in insbesondere in Fig. 4 erkennbar ist und welche zur Erzielung einer Fe sten Verankerung dienen. The anchoring section 2 has on its outside longitudinally extending ribs 14 which extend radially outwardly, as can be seen in particular in Fig. 4 and which serve to achieve a most Fe anchorage.

Als Material wird im Ausführungsbeispiel eine Titan- Legierung verwendet. As the material in the embodiment, a titanium alloy is used. Auf den Gelenkkugelabschnitt 3 kann bei klinischer Notwendigkeit eine Fine 15 aufge steckt werden, die in unterschiedlichen Größen vorrätig gehalten werden kann. On the joint ball in Section 3 clinical need, a Fine 15 can be attached, which can be kept available in different sizes. Diese Fine 15 kann um die Längsachse 11 verdreht werden und so den abgespalte nen Trochanter major unabhängig vom Antetorsions winkel annähern. This Fine 15 can be rotated about the longitudinal axis 11 and so the greater trochanter abgespalte NEN independently converge from Antetorsions angle. Die Fine 15 wird durch eine Schraube 17 gesichert. The Fine 15 is secured by a screw 17th

Claims (5)

  1. 1. Schaft für ein Revisionshüftprothesensystem umfassend einen in den Oberschenkelknochen einschlagbaren Verankerungsabschnitt ( 2 ), einen den Verankerungsabschnitt ( 2 ) verlängernden Abschnitt und einen ab gewinkelten Gelenkkugelabschnitt ( 3 ) zum Aufsetzen der Gelenkkugel, wobei eine durchgehende Längsbohrung ( 10 ) vorgesehen ist, in die von dem Gelenkkugelabschnitt ( 3 ) her eine bis in den Verankerungsab schnitt ( 2 ) reichende Sicherungsschraube ( 12 ) einsetzbar ist, wobei die Längsbohrung ( 10 ) wenigstens im Bereich des Verankerungsabschnit tes ( 2 ) als Gewindebohrung ausgebildet ist, und wobei der Verbin dungsabschnitt wenigstens teilweise durch eine Mehrzahl über Konus abschnitte ( 6 bzw. 7 ) ineinander steckbarer Hülsen-Elemente ( 5 , 5 ') gebildet ist, die ebenfalls eine Längsbohrung ( 10 ) aufweisen, dadurch gekennzeichnet , daß im Bereich des Gelenkkugelabschnittes ( 3 ) eine versenkte Ringschulter ( 16 ) als axiale Anlage für einen Kopf ( 13 ) der Sicherun 1. Shaft for a Revisionshüftprothesensystem comprising a breakable in the thigh bone anchorage portion (2), prolonging one of the anchoring portion (2) section and a starting angular ball joint portion (3) for mounting the joint ball, with a continuous longitudinal bore (10) is provided in the of the ball joint section (3) establishes a into the Verankerungsab section (2) is insertable reaching the locking screw (12), wherein the longitudinal bore (10) is formed at least in the region of Verankerungsabschnit tes (2) as a threaded bore, and wherein the connection portion at least portions partially defined by a plurality of through cone (6 or 7) into each plug sleeve elements (5, 5 ') is formed also having a longitudinal bore (10), characterized in that in the region of the joint ball portion (3) has a recessed annular shoulder (16) as axial abutment for a head (13) of Sicherun gsschraube ( 12 ) ausgebildet ist, um durch Anziehen der Siche rungsschraube ( 12 ) die Hülsen-Elemente ( 5 , 5 ') nach Positionierung derselben gegeneinander zu verspannen, wobei in dem Gelenkkugelab schnitt ( 3 ) und in den Hülsen ( 5 , 5 ') Gewindebohrungsabschnitte ( 10 d bzw. 10 c) vorgesehen sind. is formed gsschraube (12) to approximately screw by tightening the Siche (12), the sleeve elements (5, 5 ') by positioning the same to clamp against each other, cut in the Gelenkkugelab (3) and (in the sleeves 5, 5' 10) threaded bore portions (d and 10 are provided c).
  2. 2. Schaft nach Anspruch 1, dadurch gekennzeich net, daß jedes Hülsen-Element ( 5 , 5 ') so gestaltet ist, daß sich beim Zusammensetzen eine etwa zylinder förmige Mantelfläche ( 8 ) ergibt. 2. Shaft according to claim 1, characterized in that each sleeve element (5, 5 ') is designed such that an approximately cylindrical lateral surface (8) results in the assembly.
  3. 3. Schaft nach Anspruch 1, dadurch gekennzeich net, daß Gelenkkugelabschnitte ( 3 ) mit unter schiedlicher Abkröpfung aufsetzbar sind. 3. Shaft according to claim 1, characterized in that the joint ball portions (3) are placed with below schiedlicher bend.
  4. 4. Schaft nach Anspruch 1, dadurch gekennzeich net, daß der Gelenkkugelabschnitt ( 3 ) einen Konus abschnitt zum Aufsetzen der Konusbohrung der Gelenkkugel aufweist. 4. shank having according to claim 1, characterized in that the joint ball portion (3) has a conical portion for seating the conical bore of the joint ball.
  5. 5. Schaft nach Anspruch 1, dadurch gekennzeich net, daß eine Fine ( 15 ) auf den Gelenkkugelabschnitt ( 3 ) aufsteckbar und durch eine Schraube ( 17 ) fixierbar ist. 5. Shaft according to claim 1, characterized in that a fine (15) attachable to the ball joint section (3) and by a screw (17) is fixable.
DE19934320086 1993-06-17 1993-06-17 Modular shank for a Revisionshüftprothesensystem Expired - Lifetime DE4320086C3 (en)

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DE202004019264U1 (en) * 2004-12-13 2006-04-27 Waldemar Link Gmbh & Co. Kg Prosthesis for replacement of bone has mechanism for connecting replacement body with remaining bone section and a shank which can be inserted in bone cavity and it is fixed to face of bone section
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DE102011085135A1 (en) * 2011-10-24 2013-04-25 Peter Brehm Adapters for an implant and prosthetic knee joint
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FR2799115B1 (en) * 1999-10-01 2003-02-21 Jean Claude Bouvet modular stem for hip prosthesis
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US8348953B2 (en) 2008-01-10 2013-01-08 Peter Brehm Method and apparatus for impacting bone material
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US9050150B2 (en) 2012-08-20 2015-06-09 Zimmer, Inc. Trochanter attachment device
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US6494913B1 (en) 1998-03-17 2002-12-17 Acumed, Inc. Shoulder prosthesis
US7918892B2 (en) 1998-03-17 2011-04-05 Acumed Llc Shoulder prosthesis
DE202004019264U1 (en) * 2004-12-13 2006-04-27 Waldemar Link Gmbh & Co. Kg Prosthesis for replacement of bone has mechanism for connecting replacement body with remaining bone section and a shank which can be inserted in bone cavity and it is fixed to face of bone section
US7785370B2 (en) 2006-11-13 2010-08-31 Howmedica Osteonics Corp. Modular humeral head
US7785371B2 (en) 2006-11-13 2010-08-31 Howmedica Osteonics Corp. Modular humeral head
DE102011085135A1 (en) * 2011-10-24 2013-04-25 Peter Brehm Adapters for an implant and prosthetic knee joint
WO2013060718A1 (en) * 2011-10-24 2013-05-02 Peter Brehm Adapter for an implant and knee joint prosthesis
DE102011085135B4 (en) * 2011-10-24 2016-03-31 Peter Brehm Adapters for an implant and prosthetic knee joint
DE202012102017U1 (en) 2012-06-01 2013-09-03 Peter Brehm Device for biasing a taper connection

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DE4320086C2 (en) 1995-10-12 grant

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