EP1104270A2 - Moyen d'ancrage pour prothese articulaire ou autre element - Google Patents

Moyen d'ancrage pour prothese articulaire ou autre element

Info

Publication number
EP1104270A2
EP1104270A2 EP99938452A EP99938452A EP1104270A2 EP 1104270 A2 EP1104270 A2 EP 1104270A2 EP 99938452 A EP99938452 A EP 99938452A EP 99938452 A EP99938452 A EP 99938452A EP 1104270 A2 EP1104270 A2 EP 1104270A2
Authority
EP
European Patent Office
Prior art keywords
anchoring means
bore
prosthesis
bone
pin
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Withdrawn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
EP99938452A
Other languages
German (de)
English (en)
Inventor
Hans Rudolf Kriek
Nicolaas Jacobus Joseph Verdonschot
Petrus Tarasius Josephus Spierings
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.)
Novarticulate Holdings Ltd
Original Assignee
Novarticulate Holdings Ltd
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
Application filed by Novarticulate Holdings Ltd filed Critical Novarticulate Holdings Ltd
Publication of EP1104270A2 publication Critical patent/EP1104270A2/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Withdrawn legal-status Critical Current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
    • A61F2/3601—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
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
    • 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
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • 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
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • 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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated screw
    • 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
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • 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
    • 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
    • A61F2/367—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
    • A61F2/46—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
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/302—Three-dimensional shapes toroidal, e.g. rings
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/3021—Three-dimensional shapes conical frustoconical
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/30217—Three-dimensional shapes conical hollow cones, e.g. tubular-like cones
    • 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
    • A61F2002/30331—Connections 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
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
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    • 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
    • A61F2002/30331—Connections 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
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • 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
    • A61F2002/30316—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
    • A61F2002/30331—Connections 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
    • A61F2002/30362—Connections 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
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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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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    • A61F2002/30001—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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
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    • 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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A61F2002/30425—Square threads
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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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    • A61F2002/30001—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
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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
    • A61F2002/30316—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
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    • 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
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
    • 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
    • A61F2230/0065—Three-dimensional shapes toroidal, e.g. ring-shaped, doughnut-shaped
    • 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
    • A61F2230/0067—Three-dimensional shapes conical

Definitions

  • This invention relates to anchoring joint a prostheses or other component in a bone and, more particularly, to anchoring means for anchoring a joint prosthesis or other component, and a method of fitting the anchoring means, in a bone.
  • Such prostheses may, for example, comprise a replacement joint articulation, such as a metal ball and socket or other pivotal means.
  • the joint prosthesis may replace only part of the joint.
  • the ball of a ball and socket joint may be replaced with a joint prosthesis comprising an artificial replacement ball designed to sit in the original socket of a natural joint.
  • the replacement socket may be carried in or formed integrally with anchoring means comprising a cup which is arranged or shaped to be cemented into the bone surrounding the socket, such as the acetabulum (hip bone) or scapula (shoulder blade) .
  • anchoring means comprising a cup which is arranged or shaped to be cemented into the bone surrounding the socket, such as the acetabulum (hip bone) or scapula (shoulder blade) .
  • the replacement socket may be carried on or formed integrally with anchoring means comprising a pin which is inserted into an artificial bore in the acetabulum (hip bone) or scapula (shoulder bone) .
  • Procedures for fitting joint prosthesis are generally very invasive. Joints are buried deep in the human or animal body, so to replace natural joints with joint prostheses and to insert anchoring means into bone around a joint requires a large amount of tissue, including muscle, ligaments and cartilage which support the joint to be cut.
  • a hip prosthesis comprising a first fastening assembly intended for being mounted in the hip bone and an anchoring means intended for being mounted in the top end of the femur, wherein the first fastening assembly and the anchoring means are interconnected by means of a pivotable connection, wherein all parts of the hip prosthesis are so small and/or slender that they can each be arranged in the intended end position thereof via a bore in the femur, which bore extends from the lateral outer side of the femur through the femoral neck substantially in the direction of the imaginary longitudinal centre line of the femoral neck to the femoral head, wherein the anchoring means of the hip prosthesis in mounted condition comprises a tapering part, with a relatively wide, medial side of the tapering part being located adjacent the femoral neck, while a relatively narrow, lateral side of the tapering part is located adjacent the outer side of the femur.
  • the anchoring means and indeed the whole hip prosthesis, may therefore be fitted using a minimally invasive technique, in which all access to the joint is gained through the bore in the bone. This vastly reduces trauma to the area of the joint, and therefore shortens recovery time and reduces failure rate.
  • the term 'extra-medullary bore' generally refers to any bore not along the same axis as the medullary canal of a bone and, in particular, includes any bore across or through a bone .
  • the anchoring means In a first group of embodiments of the invention, which can avoid the use of cement, it is therefore preferable for the anchoring means to be radially expandable in the bore.
  • the anchoring means may be inserted into the bore and then wedged into position.
  • the whole anchoring means may be radially expanded.
  • the anchoring means may be inserted in the bore in component parts, some of which may be tapered. The component parts may be then moved in the bore longitudinally with respect to one another such that the diameter of the anchoring at a given point along its length increases. Regardless, the effect of the radial expansion is to wedge the anchoring means in position.
  • the bore may be uniformly cylindrical or itself tapered. A straight, uniformly cylindrical, bore is easier to make in the bone and may allow components of the joint prosthesis to be inserted through the bore into their intended position easily.
  • a tapered bore fits a tapered anchoring means more stabily, but may have smaller dimensions at the end of the bore remote from the joint than a uniformly cylindrical bore with the result that the components of the joint prosthesis may need to be smaller and/or more slender.
  • This type of expandable anchoring means may be used in conventional invasive surgical techniques and not just minimally invasive procedures.
  • the anchoring means may be used to fix other components for fitting in bones in human or animal bodies, not just joint prostheses, in place.
  • an expandable anchoring means may be used to secure a component comprising a plate that is fitted to the outside of a broken or fractured bone for support .
  • the bone cavity may, in this aspect, be a naturally occurring bone canal, or may be a bore formed by a surgeon especially for the prosthesis.
  • a method of anchoring a component to or in a bone comprising inserting an anchoring means into a cavity in the bone, radially expanding the anchoring means in the cavity such that the anchoring means has a tapered configuration with the narrow end of the taper furthest from the component.
  • the anchoring means may be radially expandable such that its outermost diameter exceeds the diameter of an inlet opening of the cavity.
  • the anchoring means comprises a pin and one or more retaining elements, at least one of the pin and/or retaining element being tapered.
  • the pin and retaining element (s) can be inserted in the bore separately or together, but can be moved relative to one another, substantially in the direction of their major axes, such that the diameter of the anchoring means is be increased and a tapered, wedging effect is obtained.
  • the anchoring means has two retaining elements sandwiching the pin. This provides more stable location in the bore as the pin may extend substantially along the major axis of the bore and an even load may be exerted on the retaining elements. If the anchoring means is expanded to suitable dimensions it may be fitted into the bore without the need for cement, which is used to fix most conventional joint prosthesis in place. However, the anchoring means may additionally or alternatively be cemented into position.
  • cement provides secure fixing of the anchoring means into the bone as it takes the exact form of the bore, and may seep into the bone surrounding the bore, before setting.
  • one difficulty in cementing an anchoring means in a bore through a bone from only one end is that it is difficult to prevent cement from leaking from the other and of the bore as it is injected, particularly as it preferable to pressurise the cement to drive air and fluid out of the bore in order to obtain proper fixation.
  • the anchoring means is provided with a seal for sealing the anchoring means in the bore, at an end of the bore distal to an end through which cement is injected.
  • one end of the bore is sealed and cement can be injected under pressure from the other end of the bore without leaking from the sealed end, for example into a joint cavity.
  • this type of anchoring means could be inserted into a bore in a bone from either end. It may therefore be used in conventional invasive surgical procedures. Furthermore, whilst a tapered anchoring means is preferred, this may not be essential if the anchoring means is cemented in position, since the seal enables cement to be injected under pressure from one end of the bore and adequate fixation may be obtained with other shapes of anchoring means .
  • an anchoring means for a component for fitting to or in a bone, the anchoring means insertable in a bore and having a seal for sealing the anchoring means in the bore at an end of the bore distal to the end through which cement is injected for cementing the anchoring means in place.
  • a method of cementing an anchoring means in a bore through a bone comprising inserting the anchoring means in the bore, sealing the anchoring means in the bore at one end, and injecting cement into the other end of the bore .
  • the bore is sealed in order that cement can be injected around the anchoring means in the bore without leaking past the seal, for example, into a joint cavity and interfering with a joint.
  • the seal may also facilitate placement of the anchoring means along the central axis of the bore and hold it there while the cement sets.
  • a tapering anchoring means can be inserted from a position distal to the joint, yet still be anchored securely in the bone.
  • the anchoring means comprises a single part. This provides increased strength and durability over an anchoring means comprising several sections.
  • the seal is an annular ring around the end of the anchoring means distal from where cement is introduced.
  • the seal may be an annular cap having an annular recess for engaging a resected end surface of the cortical bone wall of the bone.
  • Another alternative is for the seal to comprise an inflatable "0"-ring.
  • the anchoring means may then further comprise an internal passage for inflating the "0"-ring with air or any other suitable medium.
  • an additional seal may be provided at the end of the bore where cement is provided, such that there is a cavity between the seals surrounding the anchoring means into which cement may be introduced under pressure, for example via an orifice in the second seal.
  • the second seal may also be an annular ring extending around the anchoring means in order to assist in its axial location.
  • the provision of the cement seal at the opening where the cement is introduced may be more significant, since the other end of the cavity or bone may terminate within the bone and therefore be effectively sealed already.
  • a further aspect of the invention provides a prosthesis having an anchoring means configured for mounting in an extra-medullary bore in a bone, one end of the anchoring means being provided with an annular seal through which cement may be forced into the bone in use .
  • a further aspect of the invention provides a method of anchoring a prosthesis in an extra-medullary bore in a bone, comprising locating a tapered anchoring component in the bore, sealing the bore opening and forcing cement under pressure into the bore with the anchoring means positioned therein.
  • the bore preferably extends along approximately the imaginary longitudinal centre line of the femoral neck and the prosthesis in an artificial ball joint.
  • a relatively small and simple anchoring means may be used to support the hip prosthesis, yet this still provides stable and strong support for the prosthesis.
  • Such an anchoring means is relatively cheap to produce and causes far less trauma to the femur than conventional femoral components for hip protheses which sit in the medullary canal of the femur or extend all the way across the bone.
  • Fig. 1 is a sectional view of the top of a femur in which an anchoring means according to a first exemplary embodiment of the invention has been fitted;
  • Fig. 3 is a sectional view similar to that of Fig. 1, showing an anchoring means according to a second exemplary embodiment of the invention
  • Fig. 4 is a cross-sectional view of the anchoring means of Fig. 3, taken on the line IV-IV of Fig. 3;
  • Fig. 9 is a sectional view similar to Fig. 1, showing an anchoring means according to a fifth exemplary embodiment of the present invention.
  • Fig. 11 is a close-up sectional view similar to Fig. 1, showing an anchoring means according to a seventh exemplary embodiment of the present invention.
  • Joint prostheses may be used to replace virtually all joints in the human and animal body.
  • this invention may be used in the replacement of any joint in the human and animal body.
  • it is particularly applicable to the replacement of hip and shoulder joints and, for convenience, preferred embodiments will be described with reference to the replacement of the human hip joint, and relate, in particular, to a hip prosthesis in accordance with than described in International Patent Application No. W098/34567.
  • only an anchoring means of different embodiments of a hip prostheses is shown.
  • the anchoring means of the invention can be mounted.
  • the anchoring means in mounted condition, comprises a tapering part C.
  • a wide, medial side CM of the tapering part C is located more adjacent the femoral neck F n , while a narrower, lateral side CL of the tapering part C is located more adjacent the outer side F 0 of the femur F. Because the tapered part C tapers from the medial to the lateral side or away from the joint articulation, the hip prosthesis, when the leg is subjected to a normal load, is pressed into the bore in the femur F more and more tightly.
  • the specific geometry provides the anchoring means with a self- locking action.
  • the anchoring means of the present exemplary embodiments also comprises two retaining elements, respectively 1, 2; 11, 12; 31, 32; 41, 42.
  • the retaining elements 1, 2; 11, 12; 31, 32; 41, 42 in mounted condition bound a hole into which the pin 3, 13, 33, 43 is at least partially inserted.
  • the two retaining elements 1, 2; 11, 12; 31, 32; 41, 42 taper from a medial end CM proximal to the pivotable connection, to a lateral end CL.
  • the retaining elements 1, 2; 11, 12; 31, 32; 41, 42 are dimensioned such that they can be moved through the bore in the femur F as long as the pin 3, 13, 33, 43 is not yet fitted or inserted far enough into the hip joint cavity or bore.
  • a locking means is provided which in the present exemplary embodiment comprise a sleeve 6 having and end wall.
  • the sleeve 6 embraces or surrounds the lateral ends of the retaining elements 1, 2.
  • Means for connecting the sleeve 6 to the pin 3 is also provided and, in the present exemplary embodiment, the means for connecting the sleeve 6 to the pin 3 comprise a bolt 7.
  • an end wall bore 9 Provided in the end wall of the sleeve 6 is an end wall bore 9.
  • the pin 13 has a constant sectional profile, viewed in the longitudinal direction of the pin 13.
  • the pin 13 is provided with tapered faces 15 which are receivable in the hole bounded by the retaining elements 11, 12.
  • the tapered faces 15 and the hole formed by the retaining elements 11, 12 are provided with serrated or snap edges preventing an axial displacement of the pin 13 relative to the retaining elements 11, 12.
  • this exemplary embodiment too, has locking means comprising a sleeve
  • this sleeve 16 comprises tapering circumferential walls 20, the retaining elements 11, 12 will be pressed together during tightening of the bolt 17.
  • the tapered faces 15 of the pin 13 engage the associated tapered faces in the retaining elements 11, 12 more and more tightly.
  • the serrated snap edges of the tapered faces 15 which are clearly shown in the detail of Fig. 4 shown in Fig. 5 provide a firm connection between the pin 13 and the retaining elements 11, 12.
  • the tapered outer surface C of the retaining elements 11, 12 provides that when the hip prosthesis is subjected to a normal load, the fastening assembly is pressed into the femur F more and more tightly.
  • the wire of memory metal 45 is by a first end thereof connected to a medial end 43M of the pin 43.
  • the second end of the wire 45 is connected to a drawing plate 46.
  • the drawing plate 46 In mounted condition, the drawing plate 46 abuts against the outer side F 0 of the femur F at the location of the lateral end of the femoral bore .
  • the wire of memory metal 45 is designed such that at body temperature it tends to shorten, causing a tensile stress in the wire. During positioning of the wire 45, it is in a stretched condition, so that during positioning some play is present for fitting the pin 43 and the retaining elements 41, 42.
  • a pin 53 has a substantially conical shape, tapering from a medial end, proximal to a joint articulation 54 to a lateral end, distal to the joint articulation 54.
  • the pin 53 may be arranged to fit directly into a prepared bore in a femur from the location of the prosthesis, i.e. using a conventional (invasive) surgical technique.
  • the pin 53 is shorter than shown in Figure 9 in order that it extends only part way through the femur F and the cortical bone wall opposite the joint articulation 54 remains intact, i.e. the bore does not extend all the way through the femur F .
  • FIG. 9 is suitable for use in a minimally invasive surgical technique such as that described in W098/34567 and has a medial seal 51 is provided at its proximal end around the circumference of the pin 53.
  • the medial seal 51 is generally annular.
  • a lateral seal 52 is provided at the lateral end of the pin 53 distal from the joint articulation 54, which is again annular and disposed around the circumference of the pin 53.
  • the pin 53 is fitted in a bore 55, in this example in a femur F.
  • the medial seal 51 seals the medial end of the bore and helps to locate the pin 51 centrally in the bore .
  • the lateral seal 52 is then fitted at the distal end of the pin, and seals the lateral end of the bore.
  • the cement is delivered at a pressure generally higher than normal blood pressure in order that any fluid is driven out of the space 57 and the cement abuts the bone over the whole exposed inside surface of the bore.
  • the cement also permeates the Spongiform bone of the inside of the femur surrounding the bore to some degree dependent on the type of cement used and the pressure it is delivered at .
  • This provides a more secure interface between the cement and bone F when the cement has set .
  • the pin 53 is held rigidly in the bore. Any force exerted from the joint articulation end of the pin 53, for example through weight put on the hip prosthesis in use, forces the pin 53 towards its lateral or distal end, and due to the taper of the pin 53 forces the cement radially outwards. Thus, if the pin 53 moves at all, it pushes more and more tightly into the femur.
  • a sixth embodiment of the present invention is largely similar to the fifth embodiment shown in Fig. 10. However, in this example, a cap 60 is provided to seal the end of the bore proximal to the joint articulation 64.
  • the cap 60 has an annular recess 61 which holds a gasket or seal 62.
  • the seal engages a rim of cortical bone around a resected femoral neck to seal the bore and hold the cap 60 in place.
  • An annular resilient means 65 is provided inward of the recess 61 which presses against the inside surface of the cortical bone wall of the femoral neck to fit the cap 60 more securely.
  • the resilient means 65 need not be annular and plural separate resilient means can be provided around the cap 60 instead.
  • the pin 63 extends through the cap 60 and is attached to the cap 60 by an external screw thread 66 on the pin 63.
  • the cap is put in place first, and the pin 63 is then located and screwed into the cap 60. Due to the dimensions of the cap 60, if it is required to pass the cap 60 through the femoral bore to put the cap 60 in place for example when using the minimally invasive technique described above, the cap 60 is collapsable or made from deformable material to fit through the bore.
  • the screw thread 66 may self tap into soft material disposed on the cap 60 or engage a screw thread on the cap 60.
  • a seventh embodiment of the present invention is again largely similar to the fifth embodiment shown in Fig. 9.
  • the medial seal 55 shown in Fig. 9 is an annular inflatable seal 70.
  • the inflatable seal is connected to an air passage 71 inside the pin 73.
  • the seal is inflated such that it locates the pin 73 centrally in the bore and seals the medial or proximal end of the bore.

Landscapes

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

Abstract

On décrit un moyen d'ancrage d'une prothèse articulaire (4), qui s'évase en s'éloignant de la prothèse articulaire (4) mais peut être monté dans un trou à travers un orifice d'entrée distal de l'articulation à remplacer. Ce moyen d'ancrage peut comprendre une broche conique (53) mise en place par cimentation. Dans une forme de réalisation différente, le moyen d'ancrage peut comprendre une broche (3) et un ou plusieurs moyens de retenue (2, 3), lesquels peuvent être placés dans le trou séparément, et manoeuvrés de manière à ce qu'ils présentent un aspect conique. On obtient ainsi une broche d'ancrage conique pouvant être utilisée dans une technique de remplacement d'articulation avec effraction minimale.
EP99938452A 1998-08-10 1999-08-10 Moyen d'ancrage pour prothese articulaire ou autre element Withdrawn EP1104270A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
NL1009832A NL1009832C2 (nl) 1998-08-10 1998-08-10 Heupprothese.
NL1009832 1998-08-10
PCT/GB1999/002628 WO2000009038A2 (fr) 1998-08-10 1999-08-10 Moyen d'ancrage pour prothese articulaire ou autre element

Publications (1)

Publication Number Publication Date
EP1104270A2 true EP1104270A2 (fr) 2001-06-06

Family

ID=19767627

Family Applications (1)

Application Number Title Priority Date Filing Date
EP99938452A Withdrawn EP1104270A2 (fr) 1998-08-10 1999-08-10 Moyen d'ancrage pour prothese articulaire ou autre element

Country Status (7)

Country Link
EP (1) EP1104270A2 (fr)
JP (1) JP2002522153A (fr)
KR (1) KR20010087178A (fr)
AU (1) AU771147B2 (fr)
CA (1) CA2340155A1 (fr)
NL (1) NL1009832C2 (fr)
WO (1) WO2000009038A2 (fr)

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Also Published As

Publication number Publication date
AU5296099A (en) 2000-03-06
CA2340155A1 (fr) 2000-02-24
WO2000009038A3 (fr) 2000-09-21
JP2002522153A (ja) 2002-07-23
WO2000009038A2 (fr) 2000-02-24
NL1009832C2 (nl) 2000-02-11
KR20010087178A (ko) 2001-09-15
AU771147B2 (en) 2004-03-18

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