EP0183744A1 - Systeme d'articulation artificiel et son procede d'implantation - Google Patents

Systeme d'articulation artificiel et son procede d'implantation

Info

Publication number
EP0183744A1
EP0183744A1 EP85902504A EP85902504A EP0183744A1 EP 0183744 A1 EP0183744 A1 EP 0183744A1 EP 85902504 A EP85902504 A EP 85902504A EP 85902504 A EP85902504 A EP 85902504A EP 0183744 A1 EP0183744 A1 EP 0183744A1
Authority
EP
European Patent Office
Prior art keywords
artificial joint
joint system
bone
fibers
wires
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.)
Ceased
Application number
EP85902504A
Other languages
German (de)
English (en)
Inventor
Rüdiger SCHEUNEMANN
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.)
Fried Krupp AG
Original Assignee
Fried Krupp 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 claimed from DE19843420035 external-priority patent/DE3420035A1/de
Priority claimed from DE19843423667 external-priority patent/DE3423667A1/de
Application filed by Fried Krupp AG filed Critical Fried Krupp AG
Publication of EP0183744A1 publication Critical patent/EP0183744A1/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • A—HUMAN NECESSITIES
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    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A—HUMAN NECESSITIES
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61F2/367—Proximal or metaphyseal parts of 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3672—Intermediate parts of 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61F2/4607—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 hip femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
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    • A61F2002/30143—Convex polygonal shapes hexagonal
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30782—Apertures or holes, e.g. of circular cross section inclined obliquely
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30886—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts externally-threaded
    • 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
    • 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
    • A61F2002/365—Connections of heads to necks
    • 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
    • A61F2002/3652—Connections of necks to 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2002/3678—Geometrical features
    • A61F2002/368—Geometrical features with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • 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
    • A61F2220/0033—Connections 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section

Definitions

  • the invention relates to an artificial joint system for cementless implantation, which contains an implant and a clamping device and which e.g. for artificial
  • Hip joints, artificial knee joints / artificial elbow joints can be used.
  • such joint systems are also to be detected with an intermediate piece (bone neck part) running in the direction of the bone neck, carrying an articular head associated with the joint socket, and a clamping device, by means of which the intermediate piece can be pressed against the bone in the resection plane.
  • a tensioning device should in particular also be understood to mean a shaft which runs in the longitudinal direction of the tubular bone and can be inserted into a bore in the tubular bone and which has a head region which is provided with a threaded bore which runs perpendicular to the resection plane and into which the intermediate piece is screwed.
  • the invention further relates to a method for implanting such a joint system.
  • the object of the invention is to create an artificial joint system and to provide a method and a surgical instrument for its implantation, with which the natural flow of force in the tubular bone can be completely restored after healing.
  • a permanent or lifelong connection or anchoring of the artificial joint system to the natural bones is to be ensured, and thus repeat operations during implantations are to be reduced or avoided entirely
  • the clamping device or, in particular, the shaft is completely or partially absorbable and that the side of the implant or its support piece facing the plane of resection of the bone or that of the intermediate piece is an upper which promotes its ingrowth into the bone ⁇ surface.
  • An implant with an adapter is preferably inserted in such a way that it rests on the resection level medially on the cortex under tension.
  • Tubular bones on the surface or the tensioning system of the intermediate piece are so far degraded that no unphysiological force transmission via the shaft of the implant or via the tensioning system in the bones is possible.
  • This artificial joint system can advantageously be used for all tubular bones, i.e. for artificial hip joints, artificial knee joints, artificial elbow joints, etc.
  • a preload between the implant and residual bone on the resection level and a connection of the shaft or generally a tensioning device to the bone reduce it of the unphysiological flow of force
  • the second phase after the operation the natural one grows. Bone at the resection level with the implant so that a firm bond is created at the resection level.
  • the tensioning device or the shaft and the intermediate piece consist entirely or partially of bioactive and / or osteoinductive material of an inorganic or organic nature, or also mixtures thereof.
  • bioactive and / or osteoinductive material of an inorganic or organic nature, or also mixtures thereof.
  • Tricalcium phosphate, hydroxyapatite and bio glasses are preferably used.
  • the parts mentioned can also only be coated with this material, in particular the use of resorbable material is recommended.
  • the preferably radially symmetrical intermediate piece on the side facing the resection plane to enlarge the surface to provide additional surface structures, for example holes or knobs, which promote ingrowth.
  • additional surface structures for example holes or knobs, which promote ingrowth.
  • a central hole in the intermediate piece promotes ingrowth of the bone tissue into the intermediate piece on the resection level.
  • an artificial joint system brings advantages in which the implant or the intermediate piece and / or the shaft in a body-compatible and preferably metallic or composite material the pressure-resistant core is provided on the bone side with a transition structure in which the flexible metallic wires or flexible fibers that are permanently anchored in the core, hedgehog-like or brush-like, preferably perpendicular to the implant surface, in the form of springs (spirals) of the matrix, which is wholly or partially resorbable towards the resection level.
  • the modulus of elasticity of the wires or fibers is matched to that of the tissue later surrounding the matrix.
  • the use of such a matrix is also advantageous for the shaft, fibers and wires penetrating the matrix like brushes from the core of the shaft.
  • the described designs promote the growth of natural bone on the resection level with the implant by means of a chemism and / or by enlarging the surface of the implant.
  • the wires or fibers firmly connected to the implant core are preferably selected so that they are also in the bone composite with loads of all kinds, such as tensile, compressive, bending, torsional and shear forces, fulfill two conditions:
  • the wires or fibers it is also possible for the wires or fibers to have a uniform tension and strength over their length and for the wires or fibers to emerge from the implant surface at an uneven distance from one another, in particular in groups.
  • the fiber or wire arrangement serves to completely or partially enclose them after the implantation of the bone free of connective tissue.
  • the distance between the wires or fibers should be so large that the supply of bone tissue between the individual wires or fibers can take place without interference.
  • the wires respectively . Fibers can only absorb and transmit forces after the ingrowth of the bone tissue.
  • it makes sense to fill the spaces between the wires or fibers with a completely or partially absorbable bioactive and / or osteoinductive material.
  • the substance introduced into the implant on the bone side is completely or partially absorbed by the physiological influence and replaced by natural bone.
  • the gaps are preferably filled with natural bone substance (cancellous bone).
  • the spring-like fibers or wires are regrown by the bone individually and without interference. This on the one hand increases the adhesive surface between the bone and the implant, and on the other hand creates a connection between the bone and the implant when the natural bone is enclosed without connective tissue, even if there is no chemical reaction between them.
  • a wire or fiber thickness and / or length of different sizes is preferably also used, as a result of which this, in particular, of the bone substance can be adjusted in the resection plane with regard to the modulus of elasticity.
  • the structure of the fibers or wires can be spiral or corrugated. If the spiral shape is selected, the spiral can be cylindrical, conical or parabolic and preferably have an incline which is equal to or greater than the spiral wire diameter.
  • the spiral wire thickness decreases towards the spiral tip.
  • the spiral wire thickness can also be varied. Possibly. for absorbing shear forces, it is still possible to provide the spiral with a core which is firmly connected to the implant core. There exists between the spiral and the soul. , • sometimes no fixed connection on the bone side.
  • the elasticity modules between the bone tissue and the spiral are matched to one another by the choice of the spring constants. This results in loads on the bone and the implant, e.g. with alternating bending loads, no micro movements between spring (spiral) and the adjacent bone.
  • the fibers or wires uniform strength is achieved through different fiber geometries in the fiber itself or with respect to the neighboring fibers, and through different fiber materials.
  • the fibers or wires are preferably arranged offset from one another.
  • the wire or fiber thickness is preferably less than
  • the matrix or wires and fibers described above enable the formation of a fiber-reinforced bone in the interface between the implant and the bone, with which a firm physical bond between the natural bone and the implant can be ensured at the resection level.
  • the artificial joint system can consist of a shaft which can be screwed into the tubular bones or firmly anchored by means of a wedge effect, or a tensioning device, an intermediate piece and a sliding surface, the artificial joint head # .
  • the intermediate piece and sliding surface can either be inseparably or separably connected to one another, preferably via a screw connection or via a cone.
  • a different type of clamping device (without shaft)
  • it should preferably consist of a plate that comes to rest on the cortex on the opposite side to the resection plane with a central threaded hole or several small threaded holes into which a threaded pin standing perpendicular to the resection plane, with which the Intermediate piece is provided, can be screwed in.
  • a plate also geometrically adapted to the respective bone on the contact surface of the intermediate piece, which plate extends beyond the resection plane into the cancellous area immersed.
  • a shaft is used as part of a tensioning device, this is provided with a threaded hole running perpendicular to the resection plane in order to achieve the pretensioning of the intermediate piece.
  • a device is attached to the head or foot of the shaft, preferably an internal or external hexagon, which enables the shaft to be simply screwed into the tubular bone during the operation in order to achieve a pretension.
  • the shaft can either consist of a solid or perforated core, which in turn can consist of both metallic and fiber composite materials.
  • a more slowly absorbable material is used to coat the shaft material than for the intermediate piece. This has the advantage that the fixed anchoring forms at the intermediate piece before the flow of force in the shaft is canceled.
  • the central inner bore provided in the core of the shaft and / or the openings provided in the jacket are preferably filled with resorbable, bioactive and / or osteoinductive material.
  • a surgical instrument which corresponds to its outer contour and which is provided with a threaded pin which is perpendicular to the resection plane and which can be screwed into the threaded bore of the shaft for precise guidance.
  • FIG. 1 shows a cross section through an artificial joint implant with shaft, inserted into a femur, 2 a cross-section of a joint prosthesis implanted by means of a clamping device,
  • the artificial joint inserted in the tubular bones 4 consists of a shaft 3 and an intermediate piece 2 (bone neck part) screwed into the shaft 3 via a threaded pin 5 of the intermediate piece.
  • the intermediate piece 2 On the side of the intermediate piece 2 facing away from the resection plane 6, the intermediate piece 2 has a conical pin 7, on which the artificial joint head 1, the sliding surface, is fastened via a corresponding bore.
  • the shaft 3 has a threaded bore 8 in its upper head region, which runs perpendicular to the resection plane 6.
  • the threaded bore runs approximately at an angle o of 50 ° to the common longitudinal axis of the shaft 3 and the tubular bone 4. In the present case, the angle is 53.5 °.
  • the pin 5 of the intermediate piece 2 has a threaded section 10 corresponding to the threaded bore 8.
  • An external hexagon 11 is attached to the head of the shaft, which enables the shaft to be simply screwed into the tubular bones during the operation.
  • the shaft 3 is otherwise radially symmetrical and has a central bore (not shown) and openings in the jacket (not shown).
  • Resorbable, bioactive and / or osteoinductive material, in particular cancellous bone, for example can be filled into the shaft via the inner bore of the shaft 3 and the jacket openings become.
  • the artificial joint system, in particular the intermediate piece 2 and the shaft 3, on the bone side consist of a completely or partially resorbable matrix which is resorbed after the implantation and replaced by natural bone.
  • the artificial joint system consists either of a metallic material that ends in a brush-like manner on the bone side or of one Fiber composite material, in which a part of the fibers also runs out like a brush on the bone side.
  • the wires or fibers that run out in a brush-like manner on the bone are firmly connected to the core material of the intermediate part or shaft.
  • the bioactive / osteoinductive substance introduced into the interstices between these fibers or wires on the bone side is completely or partially resorbed by the organism and replaced by natural bones, whereby the bone grows undisturbed and completely around the individual fibers or individual wires, which are arranged in this way, that they do not overlap or cross, but stand like hedgehog spines perpendicular to the plane of resection or at an angle optimized to the plane of resection.
  • all fibers or fiber groups run parallel to one another.
  • a fiber-reinforced bone is thus created at the resection level 6, which ensures a firm physical bond between the natural bone and the implant.
  • the shaft 3 introduced into the tubular bones 4 serves as a counter-bearing to the intermediate piece 2 to achieve the required pretension in the first phase after the implantation.
  • the shaft 3 is preferably coated with absorbable bioactive and / or osteoinductive material; after the implantation, the coating is resorbed by the organism to such an extent and enclosed by the connective tissue that the force flow present in the first phase is gradually reduced under load. Finally, the flow of force takes place exclusively without interference via the resection level. This is possible because at the intermediate piece 2 at the resection level 6, similar a bone fracture healing, a tight physical and / or chemical connection between the bone and the intermediate piece 2.
  • the shaft itself can consist of either a solid or perforated core.
  • the core of the shaft 3 can consist of a metallic as well as a fiber composite material.
  • a more slowly absorbable material is preferably used to coat the shaft material than in the intermediate piece 2. This has the advantage that the fixed anchoring is only formed in the intermediate piece 2 before the force flow in the shaft is eliminated.
  • the intermediate piece 2 consists of a core made of fiber composite or metallic material.
  • the support surface 12 of the intermediate piece 2 to the resection plane 6 can be provided with additional macroscopic surface structures to increase the surface.
  • the contact surface 12 is arranged in relation to the residual bone in such a way that the force is introduced vertically from the intermediate piece of the implant into the residual bone.
  • a plate or bulge 13 made from bioactive and / or osteoinductive material or from one described in the claims and below is adapted to the respective bone in the spongy area on the bearing surface 12 of the intermediate piece 2 Structure exist.
  • the artificial joint system shown in FIG. 2, which is introduced into the long bones 4, has, like the joint system described in FIG. 1, an artificial joint head 1 and an intermediate piece 2 with a pin 5 carrying a thread 10.
  • a different type of clamping device is used here, which in the present case consists of a plate 14 adapted to the bone surface with a threaded bore for receiving the pin 5.
  • the tensioning device for the intermediate piece 2 used here instead of the shaft 3 according to FIG. 1 can either consist of non-resorbable material that can be removed after the bone has grown into the intermediate piece, or of wholly or partially absorbable material.
  • the clamping systems can consist of the commercially available systems / used for bone fracture healing or of special screw and / or wedge connections on the side opposite the cortex to the resection level.
  • the intermediate piece 2 carries a plate 15 made of bioactive and / or osteoinductive material or the wires or fibers already mentioned, which are adapted to the contact surface of the residual bone in the resection plane 6.
  • the intermediate piece 2 is inserted into the bone after a corresponding preparation of the tubular bone 4, which essentially consists of the production of the resection plane and a bore perpendicular to the resection plane 6 through the bone 4. It goes without saying that an operating instrument is used for the production, which has an outer contour 6 corresponding to the support surface or plate 15 of the intermediate piece.
  • the pin 5 of the intermediate piece is then in the prepared
  • the threaded pin is tightened so that the defined prestress between the bone 4 and the intermediate piece 2 or the support plate 15 is reached.
  • the sections of shaft or intermediate piece parts shown in FIGS. 3 to 8, which face the bone, have a special matrix 22 in which hedgehog-like or brush-like metallic anchors that are permanently anchored in the implant core, preferably running perpendicular to the implant surface Wires or composite materials are included.
  • FIG. 3 shows a metallic core 24 and cylindrical metal wires 21 fastened to the surface thereof, which are fastened to the boundary surface 23 on a boundary layer 23 coated with an adhesive.
  • the space 22 (the Jfctrix) is filled with a completely or partially absorbable bioactive and / or osteoinductive material.
  • the wires 25 are conically shaped. 3 and 4, core 24 and wires are formed uniformly from a single material, in the present case metal.
  • spiral-shaped composite material fibers 26 are fastened to a metallic core 24 in the implant shown in FIG.
  • the implant according to FIG. 6 additionally has a core 27, which is surrounded by a composite material spiral 23 with a decreasing spiral radius.
  • This spiral 28 and the core 27 are both likewise fastened to the implant core surface. It is both possible to design the core 27 and the spiral 28 enveloping it from the same or different material, metals or composite materials being considered in each case.
  • the implant shown in FIG. 5 has spiral-shaped metal wires 29 and 30, the spiral radius being constant in the former case and becoming smaller in the second case as the distance from the implant core 24 increases.
  • spirals with different diameters, or those whose pitch is greater than or equal to the respective spiral diameter.
  • the metal wires 29 and 30 extend far into the implant core 24 made of composite material.
  • wires or fibers in FIGS. 3 to 8 protrude from the implant surface at uniform or non-uniform intervals, individually or in groups, their distance is chosen so that the bone tissue between them can be supplied without interference.

Abstract

Système d'articulation artificiel où, grâce à la combinaison d'une prétension définie de l'implant au plan de résection (6) et d'une tige (3) entièrement ou partiellement résorbable ou d'un système de tension, après un temps de transition suivant l'implantation, la pièce intermédiaire (2) de l'implant se lie au plan de résection (6) avec l'os résiduel et la tige (3) nécessaire pour le temps de transition dans le tube de l'os (4) à la surface extérieure ou le système de tension de la pièce intermédiaire est dégradé à tel point qu'aucun transfert de force non physiologique n'est plus possible dans l'os par la tige (3) de l'implant ou le système de tension.
EP85902504A 1984-05-08 1985-05-04 Systeme d'articulation artificiel et son procede d'implantation Ceased EP0183744A1 (fr)

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
DE3416872 1984-05-08
DE3416872 1984-05-08
DE3420035 1984-05-29
DE19843420035 DE3420035A1 (de) 1984-05-29 1984-05-29 Kuenstliches gelenksystem mit idealer natuerlicher krafteinleitung
DE3423667 1984-06-27
DE19843423667 DE3423667A1 (de) 1984-05-08 1984-06-27 Implantat fuer knochen- und zahnwurzelersatz mit spezieller uebergangsstruktur zwischen knochen und implantatkern und knochenseitig ganz oder teilweise resorbierbarer matrix

Publications (1)

Publication Number Publication Date
EP0183744A1 true EP0183744A1 (fr) 1986-06-11

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EP85902504A Ceased EP0183744A1 (fr) 1984-05-08 1985-05-04 Systeme d'articulation artificiel et son procede d'implantation

Country Status (3)

Country Link
US (1) US4904264A (fr)
EP (1) EP0183744A1 (fr)
WO (1) WO1985005027A1 (fr)

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Also Published As

Publication number Publication date
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WO1985005027A1 (fr) 1985-11-21

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