EP0600972A1 - Endoprothese ajustable de l'articulation de la hanche - Google Patents

Endoprothese ajustable de l'articulation de la hanche

Info

Publication number
EP0600972A1
EP0600972A1 EP92917684A EP92917684A EP0600972A1 EP 0600972 A1 EP0600972 A1 EP 0600972A1 EP 92917684 A EP92917684 A EP 92917684A EP 92917684 A EP92917684 A EP 92917684A EP 0600972 A1 EP0600972 A1 EP 0600972A1
Authority
EP
European Patent Office
Prior art keywords
hip joint
joint endoprosthesis
intermediate plate
link segment
medio
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Withdrawn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
EP92917684A
Other languages
German (de)
English (en)
Inventor
Klaus Draenert
Ortwin Piper
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.)
Draenert Klaus Drmeddrmedhabil
Dr Ing HCF Porsche AG
Original Assignee
Draenert Klaus Drmeddrmedhabil
Dr Ing HCF Porsche 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 DE4127989A external-priority patent/DE4127989A1/de
Priority claimed from DE4200749A external-priority patent/DE4200749A1/de
Application filed by Draenert Klaus Drmeddrmedhabil, Dr Ing HCF Porsche AG filed Critical Draenert Klaus Drmeddrmedhabil
Publication of EP0600972A1 publication Critical patent/EP0600972A1/fr
Withdrawn legal-status Critical Current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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • 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
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30143—Convex polygonal shapes hexagonal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30494—Cooperating protrusions and recesses, e.g. radial serrations, located on abutting end surfaces of a longitudinal connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • 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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • 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
    • 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
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable

Definitions

  • the invention relates to a hip joint endoprosthesis.
  • the setting of the head center was dependent on the choice of the angle between the femoral neck and the shaft (femoral neck-shaft angle), which has recently been selected increasingly valgisch, ie at approximately 140 °, compared to approximately 126 to 130 ° of the physiological angle. This should result in less bending and shear stress on the femoral bearing. Because of the lateralization of the resultants reflected from the ground, however, the pans were quickly worn out.
  • a hip joint prosthesis is known from FR 26 05 514 AI, in which adjustment of the prosthesis head is provided in three directions.
  • the prosthesis is made in three parts.
  • the prosthetic head which carries a joint ball on a cone, is placed on a pin fixed in the thigh bone.
  • the distance between the center of the joint ball and the central axis of the prosthesis is adjusted by means of joint balls with cones pressed in at different depths.
  • the height of the center point of the joint ball along the central axis of the prosthesis is achieved by prosthesis heads with different heights.
  • the prosthesis head is mounted in a pin attached to a prosthesis shaft; the rotation is through a screw that clamps the prosthesis head against the prosthesis shaft.
  • a hip joint prosthesis is known from EP 0 390 883 A1, which has a head part on a neck part connected with a pin, which can be arranged in one, two or three dimensions so as to be adjustable.
  • a displacement by means of two mutually perpendicular rails, for example in dovetail guides, is provided in a frontal and / or sagittal plane. It is also proposed to provide a tilting in the sagittal plane and an adjustment in the vertical direction. The settings should be fixed with screws.
  • the object of the invention is to provide an improved adjustable hip joint endoprosthesis which can be adapted to the orthopedic conditions of the patient during the operation, enables a uniform transmission of force and ensures a firm fixation of the settings.
  • the hip joint endoprosthesis according to the invention enables the prosthesis head to be adjusted in the horizontal plane without step formation along a tangent of the Shenton line in the medial end region.
  • the direction of the plane of the medio-lateral displacement is set such that it is aligned parallel to a tangent which starts from the lateral edge of the proximal metaphyseal funnel of the prosthesis and lies against the inner medial boundary of the femoral neck becomes.
  • the invention advantageously creates a hip-joint endoprosthesis that can be largely adjusted without the exchange of individual parts.
  • the prosthesis is adapted to the patient's orthopedic conditions by adjusting the prosthesis head during the operation. There are gradual adjustment options for this Provided both in the edio-lateral direction and in the torsion angle of the prosthesis by rotation about the shaft axis of the thigh bone. These settings are preferably secured by positive locking gears. A change in the settings without canceling the form closure is only possible by external forces if these would lead to the prosthesis breaking.
  • the toothing also makes it possible to adjust the prosthesis separately in both directions of movement with small forces without changing the other setting.
  • only one clamping element e.g. a threaded bolt or a foldable expanding bolt or rivet or the like means is required.
  • joint balls For the adjustment in the proximal-distal direction, it is provided to use joint balls with internal cones machined to different depths, the joint balls being of different sizes.
  • All setting and fixing means are designed and arranged in such a way that they are easily accessible to the surgeon.
  • FIG. 1 shows a thigh with an adjustable hip joint endoprosthesis according to the invention
  • FIG. 2 shows a section through a hip joint endoprosthesis in a frontal plane
  • FIG. 3 shows a section along the line III-III of FIGS. 2
  • FIG 4 shows a top view in the direction of the arrow X in FIG. 1 shows a femur 1 with a hip joint endoprosthesis surrounded by a bone cement sheath 2.
  • the endoprosthesis consists of a shaft or stem 3, a slotted segment 4 incorporated therein and a prosthetic head 5 which is movable relative to the slotted segment 4 and which carries an articulated ball 6 and which has an adjusting element 7, an intermediate plate 8 and a supporting body 9 a clamping element, which may consist of a threaded bolt 10.
  • a clamping element which may consist of a threaded bolt 10.
  • locking means 21, 22 formed from spur gear teeth 12, 13 and 15, 16 are arranged (FIG. 2).
  • the one-piece device which enables the adaptation of the endoprosthesis to the orthopedic conditions is also referred to collectively in the figures with the reference numeral 23.
  • the hip joint endoprosthesis is inserted along a shaft axis S in the femur 1 and fixed there in the bone cement sheath 2. All edges of the hip joint endoprosthesis and the adjusting device 23, including the link segment 4, are rounded as far as possible, in particular in the medio-proximal end region of the prosthesis, in order to avoid stress concentrations which can damage or destroy the bone cement sheath 2.
  • At least three adjustment directions are provided for setting an orthopedically correct position of the joint ball 6.
  • a first setting is made by linear displacement in the medio-lateral direction along a line BB '
  • a second setting is made in the proximal-distal direction by a line CC
  • a third setting is made by rotation about an axis AA, as seen on a front ⁇ valley plane according to FIG. 1 is perpendicular to the line BB '.
  • the second linear spline 13 is arranged, which forms the counterpart to the first linear spline 12 and engages in it.
  • the spur toothing 12 extends over the entire length of the link segment 4 and is arranged only on one side which lies opposite a prismatic guide 18 (FIG. 3).
  • the proximal end of the prosthesis shaft 3 and the link segment 4 are only shown schematically to explain the adjustability of the prosthesis head 5.
  • the edges of the link segment 4 and the prosthesis socket 3 are preferably rounded off in the proximal socket area as well, in order to avoid tensions and stress concentrations which could destroy the bone cement sheath 2.
  • a bore 25 in the intermediate plate 8 takes a pin
  • the first radial spur toothing 15 of the locking means 22 is arranged, which is delimited by an approximately circular segment-shaped surface. in the area of the radial spur gearing
  • the intermediate plate 8 can protrude laterally beyond the link segment 4.
  • the support body 9 rests on the intermediate plate 8, the pin 14 of the actuating element 7 projecting into a blind bore 26 of the support body 9.
  • a bore 27 with a smaller diameter is provided, through which the threaded bolt 10 through the support body 9 into an internal thread in the pin 14 of the control element 7 is screwed in.
  • the support body 9 carries the second radial spur toothing 16.
  • a circular segment-shaped surface delimiting this spur toothing 16 comprises a smaller angle than the surface delimiting the first radial spur toothing 15.
  • the support body 9 is provided with a shaft which carries an outer cone 17 at its end.
  • the joint ball 6, into which a similar inner cone is incorporated, is placed on this, the amount by which the cone 17 penetrates into the joint ball 6 being referred to as the press-in depth.
  • the adjustment in the proximal-distal direction along the line C-C is carried out by articulated balls 6 with inner cones worked in at different depths.
  • M denotes a neutral position or starting position of the center point of the joint ball 6, from which the center point of the joint ball 6 can be displaced parallel to the line B-B 'into the center of rotation of the hip joint as the desired end position.
  • N denotes a neutral position of the center M of the joint ball 6, corresponding to an initial position.
  • the center point of the joint ball 6 can be linearly displaced in the direction BB 'within limits Gl and G2 (FIG. 2).
  • G3 the center point of the joint ball 6 can be gradually adjusted by using joint balls 6 with inner cones of different depths in the direction of the line CC (FIG. 2).
  • G4 and G5 limits
  • an angle a is defined between a perpendicular to the shaft axis S and the line B-B *.
  • the line B-B * lies laterally (point b) on the funnel edge of the proximal metaphysis.
  • Point b is the projection of the lateral funnel edge in an X-ray image in the sagittal beam path a-p (anterior-posterior).
  • the line B-B 'lies at point b * against the arcuate inner boundary of the femoral neck.
  • the angle ⁇ is between 1 and 15 °, preferably between 2 and 10 °, particularly preferably between 2 and 4 °. Due to the selected angle ⁇ , a uniform force transmission is ensured by the displacement of the prosthesis head along the line B-B *, since when the prosthesis head 5 is displaced by means of the adjusting device, the Shenton line is followed without step formation.
  • the hip joint endoprosthesis is adjusted in that the prosthesis head 5 is displaced in the medio-lateral direction parallel to a tangent which is seated on the lateral edge of the proximal femoral funnel of the hip joint and engages the inner contour of the femoral neck.
  • the adjustment is preferably made after inserting the shaft 3 into a thigh bone.
  • the method for adjusting the hip joint endoprosthesis can, however, also be carried out outside the body on the X-ray image and all the necessary settings can be made there. It is also possible for the hip joint endoprosthesis to be adjusted in advance in a laboratory on the basis of X-ray images and independently of the surgical operation being carried out.
  • the control element 7 inserted into the groove 11.
  • the intermediate plate 8 and the support body 9 are placed on the Kulis ⁇ sensor segment 4 so that the pin 14 of the actuating element 7 penetrates through the bore 25 of the intermediate plate 8 into the blind hole 26 of the support body 9.
  • the arrangement is first secured by tightening the threaded bolt 10 so that the individual parts can just be shifted against each other via the spur gear teeth 12, 13 and 15, 16.
  • a joint ball 6 previously selected with regard to the press-in depth of the inner cone and ball size is placed on the cone 17 of the supporting body 9.
  • the press-in depth of the cone determines the distance between the center M of the joint ball 6 and the surface of the link segment 4.
  • the distance between the center of the joint ball 6 and the shaft axis S is then adjusted by moving the prosthesis head 5 along the direction BB 'in the groove 11 set.
  • the support body 9 has been rotated about the pin 14 of the actuating element 7, the settings are secured by tightening the threaded bolt 10.
  • the paired toothings 12, 13 and 15, 16 are braced against one another and transmit the forces acting on the joint ball 6 by positive locking to the link segment 4 and thus to the shaft 3.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

Une endoprothèse de l'articulation de la hanche comprend une tête (5) médio-latéralement mobile parallèlement à une tangente qui touche (b) le bord latéral de l'infundibulum fémoral proximal de l'articulation de la hanche et qui s'étend le long du contour intérieur courbe (b1) du col du fémur. Cette endoprothèse de l'articulation de la hanche permet d'ajuster de manière reproductible, au moyen d'une tête ajustable (5), le centre de rotation de l'articulation de la hanche. Des dentures (12, 13, 15, 16) permettent d'ajuster progressivement (avec finesse) le déplacement dans le sens médio-latéral (B-B1) et la rotation autour d'un axe (A-A1) perpendiculaire au plan de déplacement (B-B1). La fixation est assurée par une seule vis (10) qui serre l'une contre l'autre les dentures (12, 13, 15, 16) en prise. Le joint à rotule (6) est monté sur un cône (17) au-dessus de la tête de la prothèse (5) et l'on effectue le réglage en hauteur en enfonçant plus ou moins le cône dans la tête de la prothèse.
EP92917684A 1991-08-23 1992-08-21 Endoprothese ajustable de l'articulation de la hanche Withdrawn EP0600972A1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE4127989 1991-08-23
DE4127989A DE4127989A1 (de) 1991-08-23 1991-08-23 Einstellbare hueftgelenk-endoprothese
DE4200749A DE4200749A1 (de) 1992-01-14 1992-01-14 Einstellbare hueftgelenk-endoprothese
DE4200749 1992-01-14
PCT/EP1992/001925 WO1993003688A1 (fr) 1991-08-23 1992-08-21 Endoprothese ajustable de l'articulation de la hanche

Publications (1)

Publication Number Publication Date
EP0600972A1 true EP0600972A1 (fr) 1994-06-15

Family

ID=25906645

Family Applications (1)

Application Number Title Priority Date Filing Date
EP92917684A Withdrawn EP0600972A1 (fr) 1991-08-23 1992-08-21 Endoprothese ajustable de l'articulation de la hanche

Country Status (4)

Country Link
EP (1) EP0600972A1 (fr)
JP (1) JPH07502176A (fr)
AU (1) AU2407692A (fr)
WO (1) WO1993003688A1 (fr)

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8419798B2 (en) 2003-12-30 2013-04-16 Depuy Products, Inc. Joint prosthesis with infinitely positionable head
US8273093B2 (en) 2004-06-29 2012-09-25 Depuy Products, Inc. Instrumentation for recording and replicating orthopaedic implant orientation
US8444698B2 (en) 2004-12-29 2013-05-21 Depuy Products, Inc. Joint prosthesis with infinitely positionable head
US8460390B2 (en) 2004-12-29 2013-06-11 Depuy Products, Inc. System and method for replicating orthopaedic implant orientation
US8679185B2 (en) 2005-09-30 2014-03-25 DePuy Synthes Products, LLC Joint prosthesis with positionable head
US8002838B2 (en) 2008-06-11 2011-08-23 Depuy Products, Inc. Joint prosthesis with positionable head

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2575383B1 (fr) * 1984-12-27 1990-11-30 Lecestre Pierre Prothese pour articulation diarthrose
FR2578738A1 (fr) * 1985-03-14 1986-09-19 Alfieri Antoine Tige femorale autostable a appui maximum pour prothese de la hanche
FR2605514A1 (fr) * 1986-10-27 1988-04-29 Dufour Guillaume Prothese de hanche
DE3813944A1 (de) * 1988-04-26 1989-11-09 S & G Implants Gmbh Endoprothese fuer ein gelenk
DE58908744D1 (de) * 1988-09-09 1995-01-19 Draenert Klaus Hüftgelenksprothese und ihre verwendung.
DE3912753A1 (de) * 1989-04-19 1990-10-25 Joachim Dr Moebius Oberschenkelteil einer hueftgelenk-endoprothese
US5002581A (en) * 1989-11-03 1991-03-26 Dow Corning Wright Corporation Modular hip joint prosthesis with adjustable anteversion

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9303688A1 *

Also Published As

Publication number Publication date
WO1993003688A1 (fr) 1993-03-04
JPH07502176A (ja) 1995-03-09
AU2407692A (en) 1993-03-16

Similar Documents

Publication Publication Date Title
DE69512497T2 (de) Sphärische Oberarmprothese
DE69221843T2 (de) Modulare Humerusprothese
DE19834277C2 (de) Schenkelhalsendoprothese für ein künstliches Hüftgelenk
EP1615598B1 (fr) Dispositif de spondylodese
DE10065232C2 (de) Implantat zum Einsetzen zwischen Wirbelkörper sowie Operationsinstrument zur Handhabung des Implantats
EP0135755B1 (fr) Tige pour une prothèse de l'articulation de la hanche
EP1180979B1 (fr) Dispositif de fixation osseuse dote d'une articulation rotoide
EP0497803B1 (fr) Implant vertebral
DE69424093T2 (de) Mit Schrauben festgemachtes Femurteil einer Hüftgelenksprothese
DE69935399T2 (de) Proximale femorale Hülse für eine Revisionshüftprothese
DE69729140T2 (de) Instrumentarium für die Einsetzung eines chirurgischen Implantats
EP0928172B1 (fr) Prothese d'articulation du genou sans tige
DE102008045291B4 (de) Kniearthrodese-Implantat
DE69808438T2 (de) Hüftprothese
EP0187903B1 (fr) Prothèse d'articulation de la hanche
DE4133433C1 (en) Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoring
DE3538654A1 (de) Bohrsystem, enthaltend eine bohrlehre zum einsetzen einer endoprothese sowie zugehoerige prothese
EP0121491A1 (fr) Implant
WO2006084426A2 (fr) Systeme d'endoprothese pour l'articulation de la hanche
DE29918589U1 (de) Endoprothese für ein Schultergelenk
EP0600972A1 (fr) Endoprothese ajustable de l'articulation de la hanche
DE3903438C2 (de) Modulare Hüftgelenk-Endoprothese
WO2013060718A1 (fr) Adaptateur destiné à un implant et prothèse du genou
DE19951141A1 (de) Hüftgelenk-Endoprothese
DE69926715T2 (de) Femurkomponente

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 19940321

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB IT LI LU NL SE

17Q First examination report despatched

Effective date: 19981116

RAP1 Party data changed (applicant data changed or rights of an application transferred)

Owner name: DR.ING. H.C. F. PORSCHE AKTIENGESELLSCHAFT

Owner name: DRAENERT, KLAUS, DR.MED.DR.MED.HABIL.

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 19990928