EP0871418A1 - Hüftgelenkprothese - Google Patents

Hüftgelenkprothese

Info

Publication number
EP0871418A1
EP0871418A1 EP96942366A EP96942366A EP0871418A1 EP 0871418 A1 EP0871418 A1 EP 0871418A1 EP 96942366 A EP96942366 A EP 96942366A EP 96942366 A EP96942366 A EP 96942366A EP 0871418 A1 EP0871418 A1 EP 0871418A1
Authority
EP
European Patent Office
Prior art keywords
hip
socket insert
inserts
intermediate element
prosthesis
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Withdrawn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
EP96942366A
Other languages
English (en)
French (fr)
Inventor
Hartmut Kälberer
Hans-Georg Pfaff
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.)
Cerasiv GmbH Innovatives Keramik Engineering
Original Assignee
Cerasiv GmbH Innovatives Keramik Engineering
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 DE19622583A external-priority patent/DE19622583A1/de
Application filed by Cerasiv GmbH Innovatives Keramik Engineering filed Critical Cerasiv GmbH Innovatives Keramik Engineering
Publication of EP0871418A1 publication Critical patent/EP0871418A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02Inorganic materials
    • A61L27/10Ceramics or glasses
    • A61L27/105Ceramics or glasses containing Al2O3
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30113Rounded shapes, e.g. with rounded corners circular
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30138Convex polygonal shapes
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    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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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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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30378Spherically-shaped protrusion and recess
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30492Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2002/3054Special 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
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    • A61F2002/3443Acetabular cups with an anti-luxation elevated rim portion, e.g. on the inner shell
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/34Acetabular cups
    • A61F2002/3445Acetabular cups having a number of shells different from two
    • A61F2002/3448Multiple cups made of three or more concentric shells fitted or nested into one another
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/34Acetabular cups
    • A61F2002/3453Acetabular cups having a non-hemispherical convex outer surface, e.g. quadric-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0058Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0006Rounded shapes, e.g. with rounded corners circular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017Angular shapes
    • A61F2230/0019Angular shapes rectangular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00179Ceramics or ceramic-like structures
    • A61F2310/00185Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide

Definitions

  • the invention relates to a hip joint prosthesis according to the preamble of claim 1.
  • a hip joint prosthesis with three spherical domes lying one inside the other is known from utility model FR 2 715 828.
  • the spherical outer dome is made of a biocompatible, rigid material such as INOX steel or titanium, which is provided on the outside with radial unevenness for fastening in the socket of the pelvic bone.
  • the spherical inner cap is made of a hard, biocompatible material such as aluminum oxide ceramic or a similar material, with a low coefficient of friction in relation to the material from which the head of the adjoining thigh element is made.
  • the spherical intermediate cap consists of a semi-rigid material such as plastic, in particular polyethylene.
  • intermediate caps or intermediate elements made of plastic can trigger osteolysis through high abrasion if there is no form-fitting connection between the sliding shell and the plastic jacket.
  • a positive connection can be achieved by melting the plastic casing, as described in EP 0 554 214 A1. However, this can lead to the destruction of the molecular structure and thus trigger wear.
  • the invention has for its object to improve a hip joint prosthesis according to the preamble of claim 1 such that the risk of osteolysis is largely eliminated
  • the intermediate element consists of an upper part and a lower part, that the upper part and lower part can be connected to one another and that the socket insert is anchored between the upper part and lower part, prevents wear on the intermediate element and thereby reduces the risk of osteolysis.
  • the pan insert is on all sides except for its spherical bulge from the intermediate element, i.e. the upper and lower part sheathed so that there are no vacancies where abrasion can occur.
  • connection of the upper part to the lower part can be carried out in a variety of ways. Screw connections via a thread, snap connections, pinning, gluing or welding have proven to be expedient.
  • the pan insert can be made of metal or ceramic. This invention is preferably suitable for all ceramic pan inserts.
  • Expedient recesses are expediently provided in the pan insert and in the adjoining lower part, in which inserts are introduced to secure the rotation.
  • the socket insert is fixed in its position in the intermediate element.
  • the inserts can e.g. B. pins, sliding blocks or key systems or wedges and z. B. made of metal or plastic.
  • the inserts advantageously completely fill the cutouts.
  • FIG. 1 shows, indicated in section, a metallic prosthesis shell 1 which can be implanted in the socket of a pelvic bone, not shown.
  • a metallic prosthesis shell 1 which can be implanted in the socket of a pelvic bone, not shown.
  • 1 ribs or a thread 10 are arranged on the outside of the prosthesis shell.
  • An intermediate element 4 made of plastic is inserted into the prosthesis shell 1, which in turn encases a ceramic socket insert 2.
  • the outer contour of the intermediate element 4 is adapted to the shape of the prosthesis shell 1 and consists of an upper part 5 and a lower part 6.
  • the lower part 6 faces the thigh bone and has a bulge 11 for receiving the socket insert 2.
  • the intermediate element 4 is completely covered by the intermediate element 4 except for its spherical bulge 3.
  • the upper part 6 also covers the bearing surface 12 adjacent to the bulge 3.
  • the upper part 5 covers the pan insert 2 on its back and is connected to the lower part 6 in a variety of ways.
  • the spherical bulge 3 serves to receive the head of a thigh element.
  • Fig. 1 shows an embodiment in the event that the patient has a displacement, i.e. that the socket insert 2 must be installed asymmetrically in the prosthesis shell 1.
  • 2 shows a symmetrical installation of the socket insert 2 in the prosthesis shell 1.
  • Figures 3 to 5 show different connections of the upper part 5 to the lower part 6. This connection is designated by X in Figures 1 and 2.
  • Fig. 1 In Figures 1 and 2.
  • the upper part 5 is connected or screwed to the lower part 6 via a thread 7.
  • 8 shows a snap connection 8.
  • the pan insert 2 consists of a ceramic, such as an alumina ceramic. However, any other ceramic can also be used.
  • FIGS. 6 and 7 show embodiments similar to that shown in FIGS. 1 and 2, but in addition recesses 15 are provided in the socket insert 2 and in the adjoining lower part 6, in which inserts 16 are introduced for securing against rotation. These inserts 16 completely fill the recesses 15 and are made of metal or plastic.
  • FIG. 8 shows a section along the line AA and FIG. 9 shows a section along the line BB in FIG. 7. In FIG. 8, a pin 17 and in FIG. 9 a slot nut 18 with a rectangular cross section are introduced into the recess 15.

Landscapes

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

Abstract

Die Erfindung betrifft eine Hüftgelenkprothese mit einer metallischen Prothesenschale (1) mit einem Pfanneneinsatz (2) mit einer kugelförmigen Ausbuchtung (3) und einem zwischen der Prothesenschale (1) und dem Pfanneneinsatz (2) angeordneten Zwischenelement (4) aus Kunststoff. Zur Vermeidung von Osteolyse wird vorgeschlagen, daß das Zwischenelement (4) aus einem Oberteil (5) und einem Unterteil (6) besteht, daß Oberteil (5) und Unterteil (6) miteinander verbindbar sind und daß der Pfanneneinsatz (2) zwischen Oberteil (5) und Unterteil (6) verankert ist.

Description

Hüftgelenkprothese
Die Erfindung betrifft eine Hüftgelenkprothese nach dem Oberbegriff des Anspruchs 1.
Aus dem Gebrauchsmuster FR 2 715 828 ist eine Hüftgelenkprothese mit drei ineinanderliegenden kugelförmigen Kalotten bekannt.
Die kugelförmige Außenkalotte besteht aus einem biokompatiblen, starren Werkstoff wie INOX-Stahl oder Titan, welche an der Außenseite mit radialen Unebenheiten zur Befestigung in der Gelenkpfanne des Beckenknochens versehen ist.
Die kugelförmige Innenkalotte besteht aus einem harten, biokompatiblen Werkstoff wie beispielsweise Aluminiumoxidkeramik oder einem ähnlichen Material, mit einem niedrigen Reibungskoeffizienten in bezug auf das Material, aus dem der Kopf des daran anschließenden Oberschenkelelements besteht.
Die kugelförmige Zwischenkalotte besteht aus einem halbstarren Material wie Kunststoff, insbesondere Polyethylen.
Ein Problem bei Zwischenkalotten oder Zwischenelementen aus Kunststoff ist, daß diese durch hohen Abrieb Osteolyse auslösen können, wenn keine formschlüssige Verbindung zwischen der Gleitschale und dem Kunststoff-Mantel besteht. Andererseits kann eine formschlüssige Verbindung durch Schmelzen des Kunststoff-Mantels erreicht werden, wie in EP 0 554 214 A1 beschrieben. Dies kann jedoch zur Zerstörung der Molekülstruktur führen und damit Verschleiß auslösen.
Der Erfindung liegt die Aufgabe zugrunde, eine Hüftgelenkprothese nach dem Oberbegriff des Anspruchs 1 derart zu verbessern, daß die Gefahr von Osteolyse weitgehend aufgehoben ist
Erfindungsgemäß wird diese Aufgabe durch die kennzeichnenden Merkmale des Anspruchs 1 gelöst. Dadurch, daß das Zwischenelement aus einem Oberteil und einem Unterteil besteht, daß Oberteil und Unterteil miteinander verbindbar sind und daß der Pfanneneinsatz zwischen Oberteil und Unterteil verankert ist, wird der Verschleiß des Zwischenelements vermieden und dadurch die Gefahr von Osteolyse vermindert.
In bevorzugter Ausführungsform ist der Pfanneneinsatz allseitig bis auf seine kugelförmige Ausbuchtung vom Zwischenelement, d.h. dem Ober- und Unterteil ummantelt, so daß keine freien Stellen vorhanden sind, an denen ein Abrieb auftreten kann.
Die Verbindung des Oberteils mit dem Unterteil kann auf die verschiedensten Arten durchgeführt werden. Als zweckmäßig erweisen sich Schraubver¬ bindungen über ein Gewinde, Schnappverbindungen, Verstiftungen, Kleben oder Schweißen.
Der Pfanneneinsatz kann aus Metall oder Keramik hergestellt sein. Bevorzugt eignet sich diese Erfindung für alle keramischen Pfanneneinsätze.
Zweckmäßigerweise sind im Pfanneneinsatz und im angrenzenden Unterteil gegenüberliegende Aussparungen vorgesehen, in denen zur Rotationssicherung Einsätze eingebracht sind. Hierdurch sitzt der Pfanneneinsatz in seiner Lage fixiert im Zwischenelement. Die Einsätze können z. B. Stifte, Nutensteine bzw. Paßfedersysteme oder Keile sein und z. B. aus Metall oder Kunststoff gefertigt sein. Zur besseren Fixierung füllen die Einsätze die Aussparungen vorteilhafterweise vollständig aus.
Weitere Merkmale der Erfindung ergeben sich aus den Figuren, die nachfolgend beschrieben sind.
Fig. 1 zeigt angedeutet im Schnitt eine metallische Prothesenschale 1, die in die nicht gezeigte Gelenkpfanne eines Beckenknochens implantierbar ist. Zur besseren Verankerung sind an der Außenseite der Prothesenschale 1 Rippen oder ein Gewinde 10 angeordnet. In die Prothesenschale 1 ist ein Zwischenelement 4 aus Kunststoff eingesetzt, das wiederum einen keramischen Pfanneneinsatz 2 ummantelt. Das Zwischenelement 4 ist mit seiner äußeren Kontur an die Form der Prothesenschale 1 angepaßt und besteht aus einem Oberteil 5 und einem Unterteil 6.
Das Unterteil 6 ist zum Oberschenkelknochen gewandt und weist eine Ausbuchtung 11 zur Aufnahme des Pfanneneinsatzes 2 auf. Der Pfanneneinsatz
2 ist dabei bis auf seine kugelförmige Ausbuchtung 3 vollständig vom Zwischenelement 4 ummantelt. Besonders hervorzuheben ist, daß das Oberteil 6 auch die der Ausbuchtung 3 benachbarte Auflagefläche 12 abdeckt. Das Oberteil 5 deckt den Pfanneneinsatz 2 auf seiner Rückseite ab und ist mit dem Unterteil 6 auf die verschiedensten Arten und Weisen verbunden. Die kugelförmige Ausbuchtung 3 dient zur Aufnahme des Kopfes eines Oberschenkelelements.
Fig. 1 zeigt eine Ausführungsform für den Fall, daß der Patient eine Displasie hat, d.h. daß der Pfanneneinsatz 2 unsymmetrisch in die Prothesenschale 1 eingebaut werden muß. Fig. 2 zeigt einen symmetrischen Einbau des Pfanneneinsatzes 2 in der Prothesenschale 1.
Die Figuren 3 bis 5 zeigen verschiedene Verbindungen des Oberteils 5 mit dem Unterteil 6. Diese Verbindung ist in den Figuren 1 und 2 mit X bezeichnet. In Fig.
3 ist das Oberteil 5 mit dem Unterteil 6 über ein Gewinde 7 verbunden bzw. verschraubt. Fig. 8 zeigt eine Schnappverbindung 8.
Hierzu sind am Oberteil 5 und Unterteil 6 einzelne kleine Erhebungen angeordnet, die beim Einpassen des Oberteils 5 in das Unterteil 6 ineinandergreifen und so eine gute Verbindung schaffen. Fig. 5 zeigt eine Verstiftung 9. Hierzu ist im Unterteil 6 und Oberteil 5 eine Bohrung 13 eingebracht, in die ein durchgehender Stift 14 eingebracht ist.
Der Pfanneneinsatz 2 besteht aus einer Keramik, wie z.B. einer Aluminiumoxidkeramik. Es ist jedoch auch jede andere Keramik einsetzbar.
Die Figuren 6 und 7 zeigen Ausführungsformen ähnlich der in den Fig. 1 und 2 gezeigten, jedoch sind zusätzlich im Pfanneneinsatz 2 und im angrenzenden Unterteil 6 gegenüberliegende Aussparungen 15 vorgesehen, in denen zur Rotationssicherung Einsätze 16 eingebracht sind. Diese Einsätze 16 füllen die Aussparungen 15 vollständig aus und bestehen aus Metall oder Kunststoff. Fig. 8 zeigt einen Schnitt entlang der Linie A-A und Fig. 9 einen Schnitt entlang der Linie B-B in Fig. 7. In Fig. 8 ist ein Stift 17 und in Fig. 9 ein im Querschnitt rechteckiger Nutenstein 18 in die Aussparung 15 eingebracht.
Mit diesen Einsätzen 16 ist eine Verdrehsicherung des Pfanneneinsatzes 2 im Zwischenelement 4 erreicht.

Claims

Patentansprüche
1.) Hüftgelenkprothese mit einer metallischen Prothesenschale (1) mit einem Pfanneneinsatz (2) mit einer kugelförmigen Ausbuchtung (3) und einem zwischen der Prothesenschale (1) und dem Pfanneneinsatz (2) angeordneten Zwischenelement (4) aus Kunststoff, dadurch gekennzeichnet, daß das Zwischenelement (4) aus einem Oberteil (5) und einem Unterteil (6) besteht, daß Oberteil (5) und Unterteil (6) miteinander verbindbar sind und daß der Pfanneneinsatz (2) zwischen Oberteil (5) und Unterteil (6) verankert ist.
2.) Hüftgelenkprothese nach Anspruch 1 , dadurch gekennzeichnet, daß der Pfanneneinsatz (2) allseitig bis auf seine kugelförmige Ausbuchtung (3) vom Zwischenelement (4) ummantelt ist.
3.) Hüftgelenkprothese nach einem der Ansprüche 1 oder 2, dadurch gekennzeichnet, daß die Verbindung des Oberteils (5) mit dem Unterteil
(6) über Gewinde (7), Schnappverbindungen (8) , Verstiftungen (9) , Kleben oder Schweißen erfolgt.
4.) Hüftgelenkprothese nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß der Pfanneneinsatz (2) aus Keramik besteht.
5.) Hüftgelenkprothese nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, daß im Pfanneneinsatz (2) und im angrenzenden Unterteil (6) gegenüberliegende Aussparungen (15) vorgesehen sind, in denen zur Rotationssicherung Einsätze (16) eingebracht sind.
6.) Hüftgeienkprothese nach Anspruch 5, dadurch gekennzeichnet, daß die Einsätze (16) Stifte (17), Nutensteine (18) oder Keile sind.
7.) Hüftgeienkprothese nach Anspruch 5 oder 6, dadurch gekennzeichnet, daß die Einsätze (16) die Aussparungen (15) vollständig ausfüllen.
8.) Hüftgeienkprothese nach einem der Ansprüche 5 bis 7, dadurch gekennzeichnet, daß die Einsätze (16) aus Metall oder Kunststoff gefertigt sind.
EP96942366A 1995-12-19 1996-12-06 Hüftgelenkprothese Withdrawn EP0871418A1 (de)

Applications Claiming Priority (7)

Application Number Priority Date Filing Date Title
DE19547514 1995-12-19
DE19547514 1995-12-19
DE19547814 1995-12-20
DE19547814 1995-12-20
DE19622583A DE19622583A1 (de) 1995-12-19 1996-06-05 Hüftgelenkprothese
DE19622583 1996-06-12
PCT/EP1996/005455 WO1997022311A1 (de) 1995-12-19 1996-12-06 Hüftgelenkprothese

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EP0871418A1 true EP0871418A1 (de) 1998-10-21

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US (1) US6224633B1 (de)
EP (1) EP0871418A1 (de)
JP (1) JP2000501965A (de)
CA (1) CA2239801A1 (de)
TW (1) TW386873B (de)
WO (1) WO1997022311A1 (de)

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KR100358191B1 (ko) * 2000-02-16 2002-10-25 한국과학기술원 시멘트 사용 인공관절 스템용 자켓 및 이것을 구비한 인공관절
JP4224303B2 (ja) 2001-05-22 2009-02-12 ユニ・チャーム株式会社 陰唇間パッド及びその包装体
KR100801942B1 (ko) 2001-05-22 2008-02-12 유니챰 가부시키가이샤 음순간 패드
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CA2239801A1 (en) 1997-06-26
WO1997022311A1 (de) 1997-06-26
JP2000501965A (ja) 2000-02-22
US6224633B1 (en) 2001-05-01
TW386873B (en) 2000-04-11

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