EP0000549A1 - Endoprosthesis - Google Patents

Endoprosthesis Download PDF

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Publication number
EP0000549A1
EP0000549A1 EP78100449A EP78100449A EP0000549A1 EP 0000549 A1 EP0000549 A1 EP 0000549A1 EP 78100449 A EP78100449 A EP 78100449A EP 78100449 A EP78100449 A EP 78100449A EP 0000549 A1 EP0000549 A1 EP 0000549A1
Authority
EP
European Patent Office
Prior art keywords
hollow cylinder
part
grooves
endoprosthesis
implant
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.)
Withdrawn
Application number
EP78100449A
Other languages
German (de)
French (fr)
Inventor
Peter Dipl.-Ing. Schultz
Dieter Dr. Holzrichter
Hans Dr. Seiler
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.)
Bayer AG
Original Assignee
Bayer AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to DE2734249 priority Critical
Priority to DE19772734249 priority patent/DE2734249A1/en
Application filed by Bayer AG filed Critical Bayer AG
Publication of EP0000549A1 publication Critical patent/EP0000549A1/en
Application status is Withdrawn legal-status Critical

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    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
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    • A61C8/0048Connecting the upper structure to the implant, e.g. bridging bars
    • A61C8/005Connecting devices for joining an upper structure with an implant member, e.g. spacers
    • A61C8/0054Connecting devices for joining an upper structure with an implant member, e.g. spacers having a cylindrical implant connecting part
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    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0022Self-screwing
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    • A61C8/0066Connecting devices for joining an upper structure with an implant member, e.g. spacers with positioning means
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    • A61F2002/30362Connections 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 with possibility of relative movement between the protrusion and the recess
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    • A61F2230/0067Three-dimensional shapes conical

Abstract

The endoprosthesis consists of a stem-shaped implant which is inserted into the bone, the implant consisting of two parts (1, 8). The one part (1) is designed as a hollow cylinder, which is provided on the inner side with axial grooves (6) and on the outer side with a thread (4). The top end of this part widens conically (3). The other part (8) consists of a solid cylinder (8) which can be inserted into the hollow cylinder with positive locking and has a conical widening (10) corresponding to the end section of the hollow cylinder. On the axial part there are ridges (12) in the longitudinal direction, which engage in the grooves (6) of the hollow cylindrical part (1). <IMAGE>

Description

  • Die Erfindung betrifft eine Endoprothese mit einem stielförmigen Implantat, das im Knochen fixiert wird. The invention relates to an endoprosthesis having a stem-like implant, which is fixed in the bone. Die neue Endoprothese wird in solchen Fällen angewandt, wo es auf eine genaue äquatoriale Justierung ankommt. The new stent is used in cases where it depends on a precise equatorial alignment. Typische Anwendungsfälle sind zB der Hüftgelenkersatz, Kniegelenkersatz und Zahnersatz. Typical applications are eg hip replacement, knee replacement and dentures.
  • Die Problematik der Totalendoprothese zB des Hüftgelenkes ist unter verschiedenen Aspekten zu sehen. The problems of total hip example of the hip joint can be seen from various perspectives. Zu den wichtigsten Aspekten gehört die Langzeitverankerung des Stieles im Knochen. Among the most important aspects include the long-term anchoring of the stem in the bone. Es ist bisher üblich, den Stiel mit Zement im Knochenlager zu verankern. It has been customary to anchor the stem with cement in the bone stock. Bei diesen zementverankerten Prothesen treten nach 5 bis 6 Jahren gehäuft Lockerungen auf. These cement-anchored prosthesis occurred after 5 to 6 years heaped on easing. Um auch bei jüngeren Menschen, deren Lebenserwartung über der Haltbarkeit der bisherigen Prothesen und Prothesenverankerungen liegt, einen prothetischen Hüftgelenkersatz durchführen zu können, werden in jüngster Zeit auch unterschiedlichst profilierte Stiele erprobt. To be able to perform in younger people whose life expectancy is about the durability of the previous prostheses and prosthetic anchors, a prosthetic hip replacement, also A diversity profiled stems are tested recently. Diese werden mit einem bisher nicht vermeidbaren Spiel im Knochen eingepaßt. They are fitted with a previously avoidable game in the bone. Durch längere Entlastung des Beines werden Bewegungen des Implantates gering gehalten,um so eine knöcherne Ummauerung und Fixierung des Prothesenstieles zu erreichen. Movements of the implant can be kept low, so as to achieve a bony encasement and fixation of the prosthesis stem by prolonged relief of the leg. Durch das bisher nicht vermeidbare Spiel kann darüber hinaus die gelenkgerechte Stellung des Implantates nicht gewährleistet werden. By not been preventable game beyond can not be ensured, the joint fair position of the implant.
  • Die bisherigen Verankerungsarten bringen folgende Nachteile mit sich: The previous anchor types bring the following disadvantages:
    • 1. Bei sofortiger Belastbarkeit zementverankerter Prothesen treten ungünstige Wechselwirkungen mit dem Gewebe auf. 1. In case of immediate load zementverankerter prostheses adverse interactions occur with the tissue.
    • 2. Zementfreie Verankerungen lassen bislang kaum die Möglichkeit des exakten, gelenkgerechten Ausrichtens zu. 2. Cement-free anchors have been too little possibility of the exact, joint-friendly alignment. Das nicht vermeidbare Spiel des Implantates ermöglicht Wackelbewegungen. The unavoidable play of the implant allows wobbling. Dadurch bildet sich ein minderwertiges Fixationsgewebe. This an inferior fixation tissue forms.
  • Der Erfindung liegt daher die Aufgabe zugrunde, ein Implantat zu entwickeln, das zementlos und gelenkgerecht eingesetzt werden kann und sofort belastbar ist. The invention is therefore based on the object to develop an implant that can be inserted without cement and joints meet and is immediately resilient.
  • Diese Aufgabe wird erfindungsgemäß dadurch gelöst, daß das Implantat aus zwei Teilen besteht und das eine Teil als Hohlzylinder ausgebildet ist, der auf der Innenseite mit axialen Nuten und auf der Außenseite mit einem Gewinde versehen ist und am oberen Ende einen konischen Endabschnitt aufweist und daß das andere Teil als ein in den Hohlzylinder formschlüssig einsetzbarer Vollzylinder mit in die Nuten eingreifenden axialen Stegen und einer dem Endabschnitt entsprechenden konischen Erweiterung ausgebildet ist. This object is inventively achieved in that the implant consists of two parts and which is formed a part of a hollow cylinder which is provided on the inside with axial slots and on the outside with a thread and a conical end portion at the upper end and in that the other part is formed as a form-fit can be inserted into the hollow cylinder with solid cylinder engaging in the grooves axial ridges and a corresponding end portion of the conical extension. Mittels des Außengewindes läßt sich der Hohlzylinder zementfrei und ohne Spiel bei sofortiger Belastbarkeit im Knochen verankern. By means of the external thread of the hollow cylinder can be cementless and anchor without clearance with immediate load in the bone. Der Nuten-Steg-FormscHLuß ermöglicht eine gelenkgerechteäquatoriale radiale Ausrichtung des Prothesenkopfes am oberen Ende des Vollzylinders. The groove web-form closure allows a hinge-compliant equatorial radial orientation of the prosthesis head at the upper end of solid cylinder. Durch die konische Ausbildung von Hohl- und Vollzylinder am oberen Ende wird eine Verklemmung des eingeschraubten Hohlzylinders bei Erreichen der gewünschten Endstellung bewirkt und eine Rotationsstabilität der Prothese erreicht. Due to the conical shape of hollow and solid cylinders at the upper end of which a clamping of the screwed-in hollow cylinder on reaching the desired end position is effected and reaches a rotational stability of the prosthesis.
  • Vorteilhaft sind auch auf der Außenseite des Hohlzylinders axiale Nuten mit einer Breite von 1 bis 8 mm eingefräst. axial grooves are advantageously milled having a width of 1 to 8 mm on the outer side of the hollow cylinder. Darüber hinaus ist es günstig, wenn die äußere Oberfläche des Hohlzylinders aufgerauht ist. Moreover, it is favorable when the outer surface of the hollow cylinder is roughened.
  • Im Laufe der Zeit kann das Knochengewebe in diese äußeren Nuten einwachsen, was eine zusätzliche Rotationsstabllisierung bewirkt. Over time, the bone tissue can grow into these outer grooves, which causes an additional Rotationsstabllisierung.
  • Mit der Erfindung werden folgende Vorteile erzielt: The invention affords the following advantages:
    • 1. Durch die Zweiteilung der Prothese läßt sich der Kopfteil unabhängig von der Endstellung des festgeklemmten Hohlzylinders gelenkgerecht, radial ausgerichtet fixieren. 1. By the division of the prosthesis, the head portion can be independent of the final position of the clamped hollow cylinder joint just fix radially oriented.
    • 2. Mittels des Gewindes läßt sich das Implantat spielfrei und damit ohne Beeinträchtigung des Fixationsgewebes verankern. 2. By means of the thread can be the implant without play and thus anchor without affecting the fixation of the tissue.
    • 3. Das Implantat kann zementlos eingesetzt werden. 3. The implant can be inserted without cement. Wechselwirkungen mit dem Gewebe werden ausgeschaltet. Interactions with the tissue off.
    • 4. Die äußeren Nuten des Hohlzylinders bewirken neben dem in Endstellung verklemmenden oberen konischen Teil bei bereits fest verankerter Prothese durch einwachsendes Fixationsgewebe eine zusätzliche Rotationsstabilität. 4. The outer grooves of the hollow cylinder adjacent to the wedging effect in the end position the upper conical part at already anchored prosthesis by ingrowing tissue fixation an additional rotational stability.
    • 5. Die Verankerung durch ein Gewinde vergrößert die Oberfläche des Implantates und verbessert dadurch die Haftung. 5. The anchoring by a thread increases the surface area of ​​the implant thereby improving the adhesion.
    • 6. Die spielfreie, .gelenkgerechte Verankerung erweitert die Anwendungsmöglichkeit von isoelastischen Werkstoffen. 6. The backlash-free, .gelenkgerechte anchor expands the applicability of Isoelastic materials.
  • Im folgenden wird die Erfindung am Beispiel einer in der Zeichnung dargestellten Obersehenkelhalsprothese näher erläutert. In the following the invention is explained in detail using the example of a Obersehenkelhalsprothese shown in the drawing.
  • Es zeigen: Show it:
    • Figur 1 eine Draufsicht (senkrecht zur Achse des Außenteiles) Figure 1 is a plan view (perpendicular to the axis of the outer part)
    • Figur 2 einen vergrößerten Querschnitt AA gemäß Fig. 1, Figure 2 is an enlarged cross-section AA of FIG. 1,
    • Figur 3 eine Draufsicht des vollzylindrischen Innenteiles, Figure 3 is a plan view of the solid-cylindrical inner part,
    • Figur 4 einen vergrößerten Querschnitt BB gemäß Fig. 3, Figure 4 is an enlarged cross-section BB shown in FIG. 3,
    • Figur 5 eine modifizierte Ausführung, bei der die Nuten zur radialen Fixierung an dem konischen Endabschnitt des hohlzylindrischen Außenteiles angebracht sind. 5 shows a modified embodiment in which the grooves are mounted for radial fixing of the conical end portion of the hollow cylindrical outer part.
  • Das hohlzylindrische Außenteil 1 (Gewindehülse gemäß Fig. 1) besteht aus der geraden Hülse 2 und dem konischen Endabschnitt 3. Im Bereich der Hülse 2 ist ein Gewinde 4 (s. Fig. 1 und 2), zB M 18 x 1,5 eingeschnitten. The hollow cylindrical outer part 1 (threaded sleeve of FIG. 1) consists of the straight sleeve 2 and 3 the tapered end portion in the region of the sleeve 2, a thread 4 (s. Fig. 1 and 2), for example M 18 x 1.5 incised , Außerdem sind auf der Außenseite mehrere axiale Nuten 5 mit einer Breite zwischen 1 bis 8 mm eingefräst. In addition, a plurality of axial grooves 5 are milled having a width of between 1 and 8 mm on the outside. Die Tiefe der Nuten 5 entspricht der Gewindetiefe (uU auch tiefer), so daß der Gewindesteg durch die Nuten vollständig unterbrochen wird. The depth of the grooves 5 corresponding to the thread depth (possibly even lower), so that the thread ridge is completely interrupted by the grooves. Die Innenfläche der Hülse 2 ist mit einer Vielzahl gleichmäßig über den Umfang verteilter dreieckförmiger Nuten 6 versehen (zB 24 Zähne mit einem Modul von 0,5 mm). The inner surface of the sleeve 2 is provided with a plurality of uniformly distributed over the circumference of triangular grooves 6 (for example 24 teeth with a modulus of 0.5 mm).
  • Der obere Endabschnitt 3 des Hohlzylinders 1 ist konisch erweitert und besitzt am oberen Rand Gewinde 7 für Arretierschrauben. The upper end portion 3 of the hollow cylinder 1 is flared and has at the top thread 7 for locking screws.
  • Das vollzylindrische Innenteil 8 gemäß Fig. 3 und 4 besteht aus dem zylindrischen Stiel 9, der konischen Erweiterung 10 und dem Kopfansatz 11. Der Stiel 9 ist mit axialen, gleichmäßig über den Umfang verteilten dreieckigen Stegen 12 (s.Fig. 4) versehen. The fully cylindrical inner part 8 of Fig. 3 and 4 consists of a cylindrical stem 9, the conical extension 10 and the head restraint 11. The stem 9 is provided with axial, evenly distributed over the circumference triangular webs 12 (s.Fig. 4). Die Stege 12 sind so geformt, daß sie beim Zusammenbau von Innenteil 8 und Außenteil 1 formschlüssig in die dreieckförmigen Nuten 6 eingreifen. The webs 12 are shaped so that they positively engage in the triangular grooves 6 in the assembly of the inner part 8 and outer part. 1 Auf diese Weise ist das Innenteil 8 in zusammengebautem Zustand radial fixiert. In this way the inner part is radially fixed in the assembled state. 8 Die konische Erweiterung 10 hat die gleiche Steigung wie der konische Endabschnitt 3 des Außenteiles. The conical extension 10 has the same slope as the tapered end portion 3 of the outer part. Die in das Gewinde 7 (Fig. 1) eingeschraubten Imbusschrauben greifen in die Ring- nut 13 (Fig. 3) und sorgen für einen Preßsitz des Innenteiles 9 im Außenteil 1. Der Kopfansatz 11 ist in üblicher Weise (s. Fig. 5) gekrümmt ausgebildet. In the thread 7 (Fig. 1) screwed socket head screws engage the ring nut 13 (Fig. 3) and provide an interference fit of the inner member 9 in the outer part 1. The head restraint 11 in a conventional manner (s. Fig. 5) curved. Die Außenfläche der Hülse 2 ist aufgerauht, um ein besseres Anwachsen des Kallus zu ermöglichen. The outer surface of the sleeve 2 is roughened to provide a better growth of the callus. Sämtliche Teile sind aus einem Edelstahl für medizinische Anforderungen gefertigt. All parts are made of stainless steel for medical needs. Eine Fertigung mit einem Emailüberzug ist ebenfalls möglich. A production with an enamel coating is also possible.
  • Fig. 5 zeigt eine modifizierte Ausführung. Fig. 5 shows a modified embodiment. Der Endabschnitt 3 des Hohlzylinders 1 geht hier in eine zylindrische Öffnung 14 über. The end portion 3 of the hollow cylinder 1 is here via a cylindrical opening in the fourteenth Die Nuten 6 zur radialen Fixierung des vollzylindrischen Innenteiles 8 sind längs der Mantelfläche dieser zylindrischen Öffnung 14 eingefräst. The grooves 6 for the radial fixation of the full cylindrical inner part 8 are provided along the lateral surface of this cylindrical opening 14 milled. Der übrige Teil des Hohlzylinders 1 trägt keine Nuten. The remaining part of the hollow cylinder 1 carries no grooves. In entsprechender Weise ist das vollzylindrische Innenteil auf einem kurzen Stück 15 mit axialen Stegen 12 versehen, die fcrmschlUssig in die Nuten 6 eingreifen. Similarly, the full inner cylindrical part is provided on a short piece 15 having axial ridges 12 that engage in the grooves fcrmschlUssig. 6 Diese Ausführung hat sich vor allem dann bewährt, wenn man zu kleineren Dimensionen übergehen will (Reduzierung von Durchmesser und Länge des hohlzylindrischen Außenteiles). This embodiment has proved especially if one wants to proceed to smaller dimensions (reduction of the diameter and length of the hollow cylindrical outer part).
  • Zum Einsetzen des zweiteiligen Implantates wird in den Knochen ein dem Gewinde 4 entsprechendes Muttergewinde geschnitten. For insertion of the two-part implant into the bone the screw thread 4 corresponding nut thread is cut. Dann wird das Außenteil 1 eingeschraubt. Then the outer part 1 is screwed. Anschließend wird das Innenteil 8 eingesetzt und mittels der in die Gewinde 7 eingeschraubten Imbusschrauben fixiert. Subsequently, the inner member 8 is inserted and fixed by means of screwed into the thread 7 Allen screws. Die radiale Feinverzahnung 6, 12 ermöglicht eine sehr genaue Justierung in radialer Richtung. The radial fine toothing 6, 12 allows for a very accurate adjustment in the radial direction. Aufgrund der exakten Justiermöglichkeit, der stabilen Fixierung und der großen Oberfläche der Hülse 2 ist das neue Implantat allen bisher eingesetzten Prothesen überlegen. Due to the precise adjustment facility, the stable fixation and the large surface of the sleeve 2, the new implant is superior to all prostheses used previously.
  • Wird die Prothesenkombination bei einem Kniegelenkersatz benutzt, so wird der hohlzylindrische Außenteil 1, wie oben beschrieben, im Schienbeinknochen verankert. If the prosthesis used in a combination of knee joint replacement, the hollow cylindrical outer part 1 is, as described above, anchored in the tibia bone. Das Innenteil 8.trägt dann an Stelle des Kopfansatzes 11 eine Bodenplatte mit Abrollflächen für die gelenkförmigen Tragflächen des im Oberschenkel fixierten Prothesenteiles. The inner member then 8.trägt in place of the head restraint 11 has a base plate with rolling surfaces for the hinge-shaped wings of the fixed in the femoral prosthesis component. Eine genauere Beschreibung einer Kniegelenk - Endoprothese findet sich aB in der DE-OS 22 44 064. Im Rahmen dieser Anmeldung soll lediglich auf die zweiteilige Ausbildung des im Unter- bzw. Oberschenkel verankerbaren Teiles hingewiesen werden, die eine genaue äquatorialle Justierung der Gelenkteile ermöglicht. A more detailed description of a knee - endoprosthesis aB can be found in DE-A 22 44 064. In the context of this application is to be merely pointed out the two-part design of anchored in the lower or upper leg part that enables accurate äquatorialle adjustment of the joint parts.
  • Eine weitere Anwendung ist der künstliche Zahnersatz. Another application is the artificial dentures. In diesem Fall wird zunächst nur der hohlzylindrische Teil (etwa gemäß Fig. 1) im Kiefer fixiert. In this case, only the hollow cylindrical portion is first (for example according to Fig. 1) fixed to the jaws. Der einsteckbare vollzylindrische Teil trägt den künstlichen Zahn und wird erst dann im Hohlzylinder fixiert, wenn dieser fest im Kiefer eingewachsen ist (in der Regel nach ca. 2 Wochen). The plug-in fully cylindrical part carrying the artificial tooth and is only fixed in the hollow cylinder when it is firmly grow in the jaw (usually after about 2 weeks). Dies hat den Vorteil, daß der im Kiefer fixierte Teil störungsfrei einwachsen kann und nicht durch vorzeitige Belastungen zB beim Kauen in seiner Lage verändert wird. This has the advantage that the fixed in the jaw part can grow smoothly and not by premature stress is, for example, changes its position during chewing. Davon abgesehen ist die äquatoriale Justierung des Zahnersatzes im Gegensatz zur einteiligen Zahnprothese unproblematisch. apart from the equatorial alignment of the prosthesis in contrast to the one-piece dental prosthesis is unproblematic.

Claims (4)

1. Endoprothese bestehend aus einem stielförmigen Implantat, das in den Knochen eingesetzt wird, dadurch gekennzeichnet, daß das Implantat aus zwei Teilen besteht und das eine Teil als Hohlzylinder (1,2) ausgebildet ist, der auf der Innenseite mit axialen Nuten (6) und auf der Außenseite mit einem Gewinde (4) versehen ist und am oberen Ende einen konischen Endabschnitt (3) aufweist, und daß das andere Teil als ein in den Hohlzylinder (1) formschlüssig einsteckbarer Vollzylinder (8) mit in die Nuten eingreifenden axialen Stegen (12) und einer dem Endabschnitt entsprechenden konischen Erweiterung (10) ausgebildet ist. 1. endoprosthesis consisting of a stem-like implant, which is inserted into the bone, characterized in that the implant consists of two parts and the one part as a hollow cylinder (1,2) is formed which on the inside with axial grooves (6) and is provided on the outside with a thread (4) and at the upper end a tapered end portion (3), and that the other part as a into the hollow cylinder (1) engages positively insertable full cylinder (8) engaging in the grooves axial webs (12) and a corresponding end portion of the conical extension (10) is formed.
2. Endoprothese:nach Anspruch 1, dadurch gekennzeichnet, daß auf der Außenseite des Hohlzylinders (2) axiale Nuten mit einer Breite von 1 bis 8 mm eingefräst sind. 2. Endoprosthesis: according to claim 1, characterized in that on the outside of the hollow cylinder (2) are milled axial grooves having a width of 1 to 8 mm.
3. Endoprothese nach Anspruch 1 bis 2, dadurch gekennzeichnet, daß die äußere Oberfläche des Hohlzylinders (1) aufgerauht ist. 3. Endoprosthesis according to claim 1 to 2, characterized in that the outer surface of the hollow cylinder (1) is roughened.
4 . 4th Endoprothese nach Anspruch 1 bis 3, dadurch gekennzeichnet, daß der konische Endabschnitt (3) des Hohlzylinders (1) mit einer zylindrischen Öffnung (14) abgeschlossen ist, längs deren Mantelfläche die axialen Nuten (6) angeordnet sind. Endoprosthesis the axial grooves (6) are arranged according to claim 1 to 3, characterized in that the conical end portion (3) of the hollow cylinder (1) having a cylindrical opening (14) is completed, along its lateral surface.
EP78100449A 1977-07-29 1978-07-20 Endoprosthesis Withdrawn EP0000549A1 (en)

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DE19772734249 DE2734249A1 (en) 1977-07-29 1977-07-29 Femoral neck prosthesis

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