EP1922032A2 - Jeu d'endoprotheses comportant un instrument de distraction - Google Patents

Jeu d'endoprotheses comportant un instrument de distraction

Info

Publication number
EP1922032A2
EP1922032A2 EP06793380A EP06793380A EP1922032A2 EP 1922032 A2 EP1922032 A2 EP 1922032A2 EP 06793380 A EP06793380 A EP 06793380A EP 06793380 A EP06793380 A EP 06793380A EP 1922032 A2 EP1922032 A2 EP 1922032A2
Authority
EP
European Patent Office
Prior art keywords
endoprothesensatz
distraction instrument
projection
tip
transverse channel
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Withdrawn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
EP06793380A
Other languages
German (de)
English (en)
Inventor
Arnold Keller
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.)
Waldemar Link GmbH and Co KG
Original Assignee
Waldemar Link GmbH and Co KG
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 Waldemar Link GmbH and Co KG filed Critical Waldemar Link GmbH and Co KG
Publication of EP1922032A2 publication Critical patent/EP1922032A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

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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
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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
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    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
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    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4641—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for disconnecting
    • 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
    • A61F2002/4688—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means
    • A61F2002/4692—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means fluid
    • A61F2002/4693—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means fluid hydraulic
    • 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
    • A61F2002/4688—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means
    • A61F2002/4692—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means fluid
    • A61F2002/4694—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means fluid pneumatic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes

Definitions

  • the invention relates to an endoprosthesis set comprising a plug connection with a projection on one and a receptacle on another segment and a distraction instrument.
  • endoprostheses which consist of several segments.
  • endoprostheses for long-bone replacement such as the femur
  • large forces due to leverage at joints of the segments on the coupling devices used there must therefore withstand considerable loads Sic are dimensioned correspondingly strong.
  • Sic Sic
  • endoprostheses which are subject to high mechanical stresses during operation, it can lead to a kind of cold welding
  • the segments can then be separated only with great effort. This is time consuming and leads to prolonged operation times Since considerable forces must be applied to lots, there is also the Danger of impairment of the patient by reaction forces, and also a not inconsiderable risk of injury to surgeon and patient due to slipping tools.
  • a Endoprothesensatz comprising a plug connection with a projection on one and a receptacle on another segment and a distraction instrument
  • the front side of the projection laterally partially overlapping transverse channel is provided in the overlap-free region of the distraction with a frontally acting on the projection displacement surface at its tip is used so that it is moved upon actuation of the distraction instrument against the insertion direction.
  • Lower is here understood to mean a greater distance from the edge of the receiving opening.
  • the invention is based on the recognition that by means of the transverse channel an independent access to a crucial point of the connector is provided, from which a separation of the projection from the receptacle is easy to accomplish. This point is in itself inaccessible to the reason of the recording.
  • the cross channel opens the access.
  • a particularly expedient embodiment is a thread feeding device with an internal thread arranged in the transverse channel and an external thread arranged on the distraction instrument.
  • the distraction instrument advantageously has a handle.
  • it is designed as a rotary knob. This can be done safely, and it can be applied to the required torque for the thread feeding device.
  • the tip of the distraction instrument is preferably designed as a cone. It can be a full cone or a truncated cone. For reasons of injury safety with the distraction instrument removed, a truncated tip design is beneficial.
  • a rotationally symmetrical design of the tip makes it possible that the separating effect of the distraction instrument is independent of its orientation to the endoprosthesis. This is particularly important if the advancement of the distraction instrument is associated with a rotational movement, as in the case of the thread advancing device.
  • the outer edge of the projection is preferably hardened. This allows him to safely absorb the considerable forces occurring when separating the segments. It may be appropriate to arrange a plurality of transverse channels distributed over the circumference of the segment. This does not necessarily take place on a regular basis. For two channels, they can be offset by 90 degrees, for example. One achieves that the respective tips act on the projection in two levels. Jamming of the projection in the receiving opening can thus be solved even easier.
  • a preferred variant of the distraction instrument is that the displacement surface is formed as a lateral surface of an eccentric. This eccentric is introduced during insertion of the distraction instrument in the transverse channel so that it has a small extent in the direction of insertion. If the distraction instrument is inserted in the transverse channel, so that the displacement surface is located behind the projection in the direction of insertion, then the distraction instrument can be rotated about its axis. In this case, the outer surface formed as an eccentric rotates, whereby the expansion increases in the insertion direction. The displacement surface thereby comes into abutment against the front side of the projection, and acted upon further actuation of the distraction instrument with a force directed against the insertion direction. The projection is thereby pushed out of the receiving opening.
  • the displacement surface is formed on the outer jacket of an expansion element.
  • the expansion element may be a pressure bellows, which is acted upon by a liquid or a gas. This makes it possible to introduce the expansion element in a slackened state in the transverse channel until it is inserted so far that the displacement surface on the front side of the projection can act. Then, in a second step, the expansion element is actuated by, for example, compressed gas is supplied. The expansion element expands, wherein the outer surface acts as a displacement surface and exerts a force acting against the insertion direction force on the projection. The projection is thereby forced out of the recording.
  • a plug may be provided. It is expediently such that it neither rests against the projection in the inserted state nor protrudes outward from the transverse channel. The risk of loosening or emigration of the plug then does not exist. Irritations of the surrounding tissue are likewise not to be feared.
  • the plug is not introduced too far or too little deep into the transverse channel, it is advantageous to provide a depth stop. It can be designed as a shoulder arranged in the desired depth of the transverse channel or on the plug itself. It is important that it does not protrude outward from the contour of the endoprosthesis, and that it is not in contact with the protrusion.
  • the distraction instrument is made in two parts.
  • One part is formed by one working section, the other by an operating section. They can be connected with each other via a quick coupling. This may be a tongue and groove connection, if for the feed as described a thread is provided.
  • the part formed by the working section can remain permanently on the endoprosthesis.
  • the part formed by the operating portion is adapted to be attached as needed and connected by means of the quick coupling with the working portion for separating the segments. It is understood that in this case the one formed by the working section Part is dimensioned so that it does not contact the projection in the inserted state and also does not protrude beyond the contour of the endoprosthesis.
  • Figure 1 is a plan view of the endoprosthesis.
  • Fig. 2 is an enlarged detail of the
  • Fig. 3 are sectional views corresponding to
  • Fig. 5 Schematic representations concerning the stages in the separation of the segments with the variants of the distraction tools.
  • an elongated endoprosthesis as a replacement for a long bones, such as the femur. It consists of several segments 1, 2 of different lengths, two of which are shown in Fig. 1. They have an approximately rod-like shape. They are connected to each other via a connector 3. At the junctions a rotation lock 4 is also formed in the form of cooperating noses and grooves.
  • a mold-speaking female cone is formed as a centrally disposed receiving opening 32 in the axial direction.
  • the mutually facing end faces of the segments 1, 2 are almost flush against each other.
  • the distance between the outer edge of the male cone 31 from the edge 22 of the receiving opening 32 forms a Einstecktiefenanno 34.
  • Male and female cone 31, 32 are made with tight tolerances, so that there is a play-free connector 3 with a tight fit.
  • a transverse channel 4 is provided on the segment 2 with the receiving opening. It is oriented transversely to the axis 36 of the receiving opening 32, that is in the radial direction. It is arranged at such a distance from the edge 22 of the receiving opening 32 that its central axis 46 (seen in the insertion direction 30) is behind the actual bottom of the receiving opening 32. Their distance from the edge 22 of the receiving opening 32 is greater than the Einstecktiefenstory 34, in the illustrated embodiment, but not more than the amount of half the width of the transverse channel 4. With this arrangement of the transverse channel 4 is achieved that the edge 11 of the male cone 31 in the inserted state in the outer, that is, the edge 22 towards the facing half of the transverse channel 4 is located.
  • the transverse channel 4 has an internal thread 45. It is preferably designed as a fine thread to allow a high power transmission.
  • a blind plug 5 may be used in the transverse channel 4. It is provided with an external thread 55 which runs in the internal thread 45. He has on its outwardly directed end face on a hexagonal recess 57 for receiving a hexagonal wrench (not shown). He can thus easily in the transverse channel 4 on and again be unscrewed. At its outwardly directed end face a circumferential stop shoulder 54 is provided. It protrudes beyond the length of the external thread 55. It is designed to interact with a corresponding circumferential recess 44 to the transverse channel 4. It prevents too deep screwing of the dummy plug 5 and thus a contact between the underside of the dummy plug 5 and the inserted male cone 31. The blind plug 4 therefore does not migrate from the transverse bore 4 in implanted endoprosthesis.
  • the endoprosthesis set according to the invention furthermore comprises a distraction instrument 6. It has a working section 61 with a rod-like shaft 62 and an external thread 65 arranged on its outer region. It runs in a tip 63, which is designed as a cone. At least the tip 63 is hardened.
  • the distraction instrument 6 also has an actuation section 66. It comprises a guide piece 67, the extension of which forms the rod-like shaft 62, and a T-piece 68 attached to the T-shape. It serves to allow the surgeon to turn the instrument 6 by hand.
  • a first step the segments 1, 2 to be separated are uncovered. It is not necessary that much space is created. It is important that an access route to the transverse channel 4 with the blind plug 5 inserted is free.
  • a second step the blind plug 5 is unscrewed. This can be done with a standard hexagon wrench. The transverse channel 4 is then open.
  • the distraction instrument 6 is set. It is for this purpose with its tip 63 first inserted into the transverse channel 4 until the external thread 65 abuts on the rod-like shaft 62 on the internal thread 45 of the transverse channel 4.
  • the tip 63 is located in the central axis 46 of the transverse channel 4 and thus seen in the insertion direction 30 of the connector 3 behind the outer edge 11 of the male cone 31, and laterally offset so far that it does not contact the cone 31.
  • the distraction instrument 6 is rotated by the surgeon by means of the toggle piece 68 by hand in a clockwise direction.
  • the distraction instrument 6 thereby screws into the transverse channel 4 until the tip 63 strikes the edge 11 of the male cone 31 with its bevel facing the edge 22 of the receiving opening 32.
  • the distraction instrument 6 can now be further rotated, the male cone 31 being pressed with the further forward movement of the tip 63 due to its wedge effect from the receiving opening 32 until the segments 1, 2 are finally separated in step 5 (FIG. 3e).
  • the segment thus dissolved can now be removed for explantation.
  • the rod-like shaft 62 ' is provided with an eccentric 65' instead of an external thread 65.
  • the eccentric 65 ' is dimensioned so that it is completely immersed in the transverse channel 4 so far that it lies in the insertion direction 32 behind the end face of the male cone 31, and preferably rests there.
  • the shaft 62 ' has in its upper portion on a circular outer contour which is tuned to the diameter of the transverse channel 4 such that a guide of the shaft 62' and thus the
  • Distraction instrument 6 ' is reached in the inserted state.
  • the position of the eccentric 65 'when inserted into the transverse channel 4 is shown in Fig. 5a.
  • the distraction instrument 6 ' is then actuated by rotation, as explained, with the eccentric 65' rotating in the direction of the arrow shown in Fig. 5b. This results in an area of its designed as Exzenterbahn
  • Displacement surface with the end face of the male cone 31 in contact which has an appreciably greater distance from the axis of rotation of the eccentric 65 '.
  • a pressure bellows 65 '' is arranged on the shaft 62 '' of the distraction instrument 6 ''. It is connected to a pressure liquid connection 69 via an inner line (not shown).
  • the pressure bellows 65 '' slackened and has only a small outer diameter.
  • a pressure fluid preferably an isotonic water solution, is then supplied via the pressure liquid connection 69 to the pressure bellows 65 "via an inner connecting channel (not illustrated).

Landscapes

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

Abstract

L'invention concerne un jeu d'endoprothèses comprenant un système de raccordement par emboîtement avec une projection sur un segment et une cavité sur un autre segment, ainsi qu'un instrument de distraction. Selon l'invention, il est prévu un canal transversal débouchant dans la cavité, qui recouvre au moins en partie la face avant de la projection, latéralement. Dans sa zone de non chevauchement, l'instrument de distraction peut être mis en place, au niveau de sa pointe, avec une surface de déplacement agissant de manière frontale sur la projection, de sorte à être déplacé à l'encontre du sens de mise en place, lorsque l'instrument de distraction est actionné. La notion de plus profondément signifie une plus grande distance du bord de l'ouverture de réception.
EP06793380A 2005-09-09 2006-09-09 Jeu d'endoprotheses comportant un instrument de distraction Withdrawn EP1922032A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE202005014269U DE202005014269U1 (de) 2005-09-09 2005-09-09 Endoprothesensatz mit Distraktionsinstrument
PCT/EP2006/066198 WO2007028832A2 (fr) 2005-09-09 2006-09-09 Jeu d'endoprotheses comportant un instrument de distraction

Publications (1)

Publication Number Publication Date
EP1922032A2 true EP1922032A2 (fr) 2008-05-21

Family

ID=37442131

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06793380A Withdrawn EP1922032A2 (fr) 2005-09-09 2006-09-09 Jeu d'endoprotheses comportant un instrument de distraction

Country Status (3)

Country Link
EP (1) EP1922032A2 (fr)
DE (1) DE202005014269U1 (fr)
WO (1) WO2007028832A2 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE202008011178U1 (de) 2008-08-22 2009-12-31 Deru Gmbh Endoprothese mit einer Steckverbindung und verbesserter Drehsicherung
EP3381410A1 (fr) * 2017-03-31 2018-10-03 Waldemar Link GmbH & Co. KG Douille de raccordement pour tiges d'ancrage de deux prothèses disposées en regard
EP3498230B1 (fr) * 2017-12-15 2020-10-28 Waldemar Link GmbH & Co. KG Système de tige d'endoprothèse modulaire doté de l'élément de rotation
ES2899356T3 (es) * 2019-04-26 2022-03-11 Link Waldemar Gmbh Co Pieza de cuello de ensayo para una endoprótesis de articulación

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DE3340767A1 (de) * 1983-11-08 1985-05-15 Mecron Medizinische Produkte Gmbh, 1000 Berlin Bausatz fuer eine resektionsprothese
DE8510531U1 (de) * 1985-04-04 1986-02-06 Mecron Medizinische Produkte Gmbh, 1000 Berlin Implantat
US4787907A (en) * 1987-02-03 1988-11-29 Techmedica, Inc. Morse taper
DE4028510C2 (de) * 1990-09-07 1994-12-01 Link Waldemar Gmbh Co Endoprothese
DE9106437U1 (de) * 1991-02-08 1992-04-16 Effner GmbH, 1000 Berlin Bausatz für eine Hüftgelenkprothese
US5571198A (en) * 1994-01-21 1996-11-05 David A. Drucker Acetabular shell with selectively available bone screw holds
DE19722923B4 (de) * 1997-02-06 2008-04-10 Ceramtec Ag Innovative Ceramic Engineering Werkzeug zum Einsetzen einer keramischen Einsatzschale in eine metallische Außenschale einer zweiteiligen Gelenkpfannen-Prothese
EP0995412B1 (fr) * 1998-10-23 2004-03-31 Centerpulse Orthopedics Ltd. Cupule articulaire artificielle
DE10206627A1 (de) * 2002-02-15 2003-08-28 Diocom B V Körpergelenk ersetzendes Titanimplantat mit einem oder mehreren Grundkörpern
US6786931B2 (en) * 2002-08-27 2004-09-07 Depuy Products, Inc. Device, system and method for separation of modular orthopaedic elements

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Also Published As

Publication number Publication date
WO2007028832A3 (fr) 2007-07-19
WO2007028832A2 (fr) 2007-03-15
DE202005014269U1 (de) 2007-01-18

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