EP1962728A1 - Endoprothese dotee d'une partie intermediaire - Google Patents

Endoprothese dotee d'une partie intermediaire

Info

Publication number
EP1962728A1
EP1962728A1 EP06829523A EP06829523A EP1962728A1 EP 1962728 A1 EP1962728 A1 EP 1962728A1 EP 06829523 A EP06829523 A EP 06829523A EP 06829523 A EP06829523 A EP 06829523A EP 1962728 A1 EP1962728 A1 EP 1962728A1
Authority
EP
European Patent Office
Prior art keywords
intermediate part
endoprosthesis according
endoprosthesis
sliding surface
projection
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Withdrawn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
EP06829523A
Other languages
German (de)
English (en)
Inventor
Arnold Keller
Hakon Kofoed
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.)
Link America Inc
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 EP1962728A1 publication Critical patent/EP1962728A1/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Withdrawn legal-status Critical Current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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • 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
    • A61F2/38—Joints for elbows or knees
    • 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
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442—Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425—Intervertebral or spinal discs, e.g. resilient made of articulated components
    • 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
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • 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
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4205—Tibial components
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4207—Talar components
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Definitions

  • the invention relates to an endoprosthesis for replacement of a joint comprising a component to be connected to a lower bone, which has an upper-side sliding surface, a component to be connected to an upper bone, which has a lower-side sliding surface, and an intermediate part which is attached to its lower part - And top each having a counter-sliding surface which forms a bearing with the sliding surfaces of the aforementioned components.
  • Such endoprostheses are used, for example, to replace the ankle.
  • the components and the intermediate part cooperate via sliding surfaces which allow flexion and extension in a sagittal plane.
  • the sagittal plane is a plane defined by the AP direction and the vertical axis.
  • the component on the tibia and the intermediate part form cooperating sliding surfaces that allow rotation about the vertical axis. They can be designed to allow compensating movements in the AP and LM (lateral-medial) directions. So that
  • the sliding surfaces are correspondingly contour different, for example, a flat sliding surface is combined with a cylindrical surface curved like a sliding surface.
  • the stabilization happens through the natural ligaments.
  • the entire load of the endoprosthesis rests on the intermediate part. It is highly charged.
  • under high load "working" of the intermediate part usually made of polyethylene can occur.
  • under increased loads such as may occur, for example, as a result of movement dynamics (especially when climbing stairs or jumping)
  • it can lead to overloading and thus uncontrolled deformation of the intermediate part.
  • Excessive wear, cold flow or even failure of the prosthesis due to material failure can be the result. This is especially true when the intermediate part is made thin, as is usually the case as a result of the contour difference of the sliding surfaces.
  • the invention is based on the object of improving an endoprosthesis of the type mentioned at the beginning in such a way that, while retaining multiple degrees of freedom, it can safely carry high loads.
  • an endoprosthesis for replacement of a joint comprising a component to be connected to a lower bone having an upper-side sliding surface, a component to be connected to an upper bone having a lower-side sliding surface and an intermediate portion attached to its lower and
  • Each upper side has a sliding surface, which with the sliding surfaces of the vorge
  • Designate components each have a movement plane for a bearing, the sliding surfaces of the intermediate part are contour different, provided according to the invention that a tensioning rim surrounds the intermediate part at the side surfaces and is arranged on the intermediate part free of the determined by the contour different sliding surfaces planes of movement.
  • the term movement plane is to be understood broadly and also includes curved contours.
  • the Spannreif as a relative to the polyethylene tensile strength Umgürtung increases the resulting total modulus of elasticity of the intermediate part.
  • the Spannreif is of such a material that it has at least fifty times, preferably at least two hundred times higher elastic modulus than the polyethylene.
  • the Spannreif as a high tensile Umgürtung an elastic or plastic deformation of the intermediate part is counteracted under load. The intermediate part can thus withstand even higher loads without deforming. This can with the Spannreif invention
  • Reinforcement of the intermediate part can be achieved. Thanks to the inventive arrangement of Spannreifs the movement surfaces, as determined by the sliding surfaces of the upper and lower bearing remain free. Thus, despite the reinforcement by the hoop, the mobility of the endoprosthesis in all joint functions is maintained. This applies not only to the normal range of motion of the endoprosthesis, but also in more extensive movements, as they can occur in buckling (for example, buckling of the foot).
  • the hoop is made of a two-zone, with a circumferentially circumferential belt zone and a Spetzschutzzone, which adjoins the belt zone.
  • the expansion protection zone need not be provided circumferentially, but it is generally sufficient if it is provided on two opposite sides.
  • the expansion protection zone additionally counteracts diverging of the outer sections of the intermediate part under high bending stress.
  • the upper and lower edge of the Spannreifs is adapted to the contour of the respective adjacent sliding surface.
  • the edge of the Spannreifs has a constant distance from the edge of the adjacent sliding surface. If, for example, the one sliding surface is a plane, then its edge is a straight line and the corresponding edge of the clamping rim is likewise a straight line; is the corresponding arched sliding surface, so the edge is circular arc and the corresponding edge of Spannreifs also a circular arc with a circular arc-shaped edge.
  • the clamping strip has at its lower edge at least on two sides a chamfer, which is designed such that it smoothly merges into the intermediate part.
  • the clamping ring on its inside preferably has a bead-like protrusion, which engages in a corresponding recess on the intermediate part.
  • the Spannreif is secured against undesired displacement from its intended position.
  • it can also be provided other attachment techniques, such as a bond or a clamp, which is generated in particular by shrinking the Spannreifs on the intermediate part.
  • a positive connection such as pinning or screwing.
  • the clamping strip is dimensioned such that its upper edge and its lower edge around it have a distance of at least 1 mm, preferably between 1.5 and 2.5 mm, to the edge of the respective sliding surface. This ensures that even at high, leading to a compression of the intermediate part of the load or wear of the intermediate part, an undesirable contact between the clamping ring and the sliding surfaces of the components of the prosthesis can be prevented.
  • the tensioning strip has a convex projection on at least one outer side.
  • the projection By means of the projection, during a rotation, as well as during a linear movement, the joint and thus also the intermediate part, together with the tensioning ring, can be pushed back laterally next to the endoprosthesis, growing undesired tissue material. Penetration of this tissue material, the so-called fibrosis, can be counteracted or even prevented in this way.
  • the risk that the joint is limited with the endoprosthesis according to the invention by an excessive formation of fibrosis in its mobility, can be met with it.
  • a particular advantage of this development is that with the preferably made of metal strapping basically a touch of the bone or the fabric material can be done, while in the conventional alone consisting of a polyethylene material intermediate parts contact with the bone or the fabric material was not desirable because this leads to unwanted polyethylene abrasion.
  • the design according to the invention uses the hoop in two ways, namely its structure for forming the convex projection to push back the fibrosis and its material, which permits contact with the fibrotic tissue in the first place.
  • the crowning of the projection need only be one-dimensional, so that therefore results in a substantially cylinder shell-like shape; however, it may preferably also be two-dimensional, so that a substantially spherical design results, wherein the curvature may be different in the plane of the hoop and perpendicular thereto.
  • the spherical projection extends over the entire length of the respective outer side.
  • Particularly expedient is an arrangement of the spherical projection on a medial longitudinal side of the Spannreifs. In this area is located, for example, in an implantation of the endoprosthesis according to the invention on the ankle of Malleolus media lis. Especially in this area can lead to unwanted fibrosis, whose harmful effects are prevented thanks to the development of the invention.
  • the arrangement extending over the entire length also has the advantage that the desired effect of restraining can be achieved even in the case of a nonrotatory, for example linear, forward and backward movement of the intermediate part.
  • the contour of the crowned projection is chosen so that it is circular arc in plan view. Such a contour is favorable in the production and results in a uniform curvature of the projection without major changes in the course of curvature. It is not necessary here that the circular center on which the circular arc is based is in the center of the hoop. Conveniently, it is offset in the direction of the opposite lateral side. This results in an eccentricity, due to which a greater repression of the fibrotic tissue material is achieved at larger rotational deflections of the intermediate joint piece.
  • the outer surface of the crowned projection is preferably made smooth. Preferably, it may be polished. This results in a low-slip behavior, especially under the influence of tissue fluid. The risk of tearing or shearing tissue material is thus effectively countered.
  • the spherical projection can be expediently also provided on the adjacent outer sides. In a rectangular design, this means that at the anterior, the posterior and the medial side of the Spannreifs such a spherical projection is formed.
  • Fig. 2 fanned the prosthesis of Figure 1 in a perspective view.
  • FIG. 4 is a partial cross-sectional view of the hoop with an intermediate part of the prosthesis
  • FIG. 5 shows a front view of a lower region of the tibia with a part of a variant of the endoprosthesis according to FIGS. 1 to 4;
  • FIG. 6 shows a view from below of the variant according to FIG. 5; FIG. and
  • the prosthesis according to the invention is an ankle prosthesis. It should be noted that the invention can also be applied to other types of endoprostheses, for example intervertebral endoprostheses. It is essential that the endoprosthesis has two bearings whose planes of motion are determined by contour-different sliding surfaces.
  • the endoprosthesis according to the illustrated embodiment has essentially three components.
  • the first component is a tibial component 1, which is designed to be located at the lower end of a tibial bone 91. It has a plate-shaped part 10, whose underside forms a flat sliding surface 11. On the upper side of the plate-shaped part 10 there is provided an anchoring body 12 provided with projections, which serves for fastening the tibial component 1 in corresponding resection recesses of the tibia 91.
  • the prosthesis further comprises an ankle bone component 4.
  • a convex curved sliding surface 44 On her a guide rib 46 is arranged, which lies in the AP direction. It serves as a guide during a bending and stretching movement of the ankle.
  • an intermediate part 2 is arranged between the tibial component 1 and the ankle component 4. It has on its upper side a flat sliding surface 21, which is formed to match the sliding surface 11 of the tibial component 1. On its underside, the intermediate part 2 a Congruent to the sliding surface 44 of the ankle component 4 trained sliding surface 24. It also has a groove 26 which is formed for longitudinally displaceable receiving the rib 46. Thus, the intermediate part 2 is guided laterally in relation to the ankle component 4. Only bending and stretching movements are possible. In contrast, the flat sliding surfaces 11, 21 allow any movement in a horizontal plane, both longitudinal and transverse movements as well as in particular a rotation about the vertical axis.
  • the tibial component 1 and the talar component 4 expediently consist of metal, for example a cobalt-chromium alloy, which are provided on their respective outside with a bone growth-promoting coating (for example calcium phosphate).
  • a clamping strip 3 according to the invention is provided. It consists of a cobalt chromium alloy with a modulus of elasticity about four hundred times that of the polyethylene material of the intermediate part 2.
  • the clamping strip 3 is made of a flat strip material. It has a thickness of, for example, 1 mm.
  • the clamping strip 3 has a contour in horizontal section corresponding to the outer contour of the intermediate part 2. In the illustrated embodiment, this is a square contour. But it could just as well be provided another contour, z. B. round for a version as an intervertebral prosthesis. Its dimensions are chosen so that it tightly encloses the intermediate part 2.
  • the hoop 3 has a circumferential belt zone 36 in its upper portion. It counteracts a deformation of the intermediate part 2 under load in all lateral directions (in the longitudinal and in the transverse direction).
  • the belt zone 36 still includes an expansion protection zone 37.
  • the expansion protection zone 37 which also includes the chamfer 32, additionally stabilizes the outer regions of the concave sliding surface 24 and thus counteracts in a particularly effective manner the divergent force component 96 resulting from the convex design of the sliding surface 44.
  • the intermediate part 2 is reinforced thanks to the invention Spannreifs. As a result, an undesirable deflection is counteracted even under high load.
  • the Spannreif 3 is just executed at its upper edge 31. This results in a constant distance to the Kan te the upper sliding surface 21.
  • the clamping strip on its longitudinal sides 33 (which are aligned parallel to the rib 46) an arcuate configuration. It is designed so that there is a constant distance of the lower edge 34 of the clamping ring 3 to the edge of the lower sliding surface 24 in this area.
  • the clamping strip 3 has a straight lower edge. This in turn results in a constant distance from the corresponding edge of the sliding surface 24.
  • the lower edge of the Spannreifs apron-like pulled down and also has a chamfer 32.
  • the latter is designed so that it forms a continuous plane with the corresponding side surface 22 of the intermediate part 2. Thanks to the beveling, an additional reinforcement results, especially in a region which is particularly stressed by the divergent forces (see arrow 96), without this resulting in an undesirable limitation of the mobility.
  • the intermediate part 2 has a flange 20 in the region of its upper sliding surface 21. Against the underside of the clamping strip 3 is pushed flush, so that there is a smooth transition on the outside between the flange 20 and the outer surface of the clamping ring 3.
  • FIGS. 5 to 7 a variant of the ankle endoprosthesis according to FIGS. 1 to 4 is shown as a further exemplary embodiment.
  • 5 shows the endoprosthesis at its intended implantation location at the distal end of the implant.
  • bia-bone 91 For reasons of clarity, only the tibial component 1, the intermediate part 2 and a varied tensioning rim 3 'are represented by the endoprosthesis.
  • the fibular bone 90 runs parallel to the tibia bone 91.
  • the tibia bone 91 forms a plateau at its distal end, on which the tibial component 1 of the endoprosthesis according to the invention is arranged.
  • This plateau is bounded medially laterally by an extension of the tibial bone 91, the so-called malleolus medialis 93, and laterally by a corresponding extension of the fibular bone 90, namely the malleolus lateralis 94. They include the plateau of the tibial bone 91 and thus the tibial component 1 of the endoprosthesis fork-like. This can be clearly seen in FIG.
  • tissue material (fibrosis) 99 occurs frequently in the area between the malleolus medialis 93 and the intermediate part 2 or the tether 3 'arranged around it. This can cause pain that could not only be very uncomfortable for the patient, but in many cases also require surgery to remove the tissue material 99.
  • a projection 39 is formed on at least one longitudinal side 33 of the clamping rim 3 ', expediently on the medial side. The projection protrudes with respect to a congruent to the intermediate part 2 contour. Such a protrusion projecting beyond the congruent contour can also be provided on endoprostheses which have contact surfaces which have the same shape.
  • the projection preferably has an arcuate outer contour, wherein the arc extends over the entire length.
  • the projection 39 is suitably curved two-dimensionally, that is to say it has a spherical surface shape (see Fig. 7a).
  • the radii of curvature are different in size, a slight curvature in the horizontal plane (as shown in Fig. 6) and a greater curvature in a frontal plane (as shown in Fig. 7a).
  • the center 30 of the circle defined by the radius of curvature is preferably not centrally located in the clamping rim 3 ', but eccentrically laterally and preferably also offset from the front.
  • the outside of the projection 39 is smooth.
  • an option is realized, namely that the frontal side and the back of the Spannreifs 3 'are each provided with a projection 39 f and 39''.
  • They are expediently designed in accordance with the projection 39, but may also be deviating in shape (for example, in the shape of a cylinder jacket rather than in the manner of a sphere, as shown in FIG.
  • a curvature-like transition between the projections 39, 39 ', 39'' is not required, but expediently the geometries are chosen such that the transition is step-free.
  • the lateral longitudinal side of the clamping rim 3 'expedient has no projection. This serves to ensure the clearance of the hoop. Furthermore, this has the advantage that an unambiguous orientation of the hoop 3 'is predetermined so that the risk of installation in a wrong position is reduced.
  • the tightening collar 3 ' is preferably made of a metal material, in particular titanium or a cobalt Chromium alloy manufactures. It can thus come into contact with the fibrotic tissue material 99, without any fear of impairing the surrounding tissue.
  • a retraction of the fibrotic tissue material 39 is achieved thanks to the projection 39. An ingrowth of the fibrotic tissue material 99 in the area of the endoprosthesis is thus effectively counteracted.
  • the projection 39 is usually made in one piece with the clamping strip 3 '. However, it should not be excluded that a multi-part construction is selected, in which the projection 39 is designed as a separate part and is attached to the clamping ring 3 'by suitable fastening means.
  • the latter offers the advantage that a particularly slippery and especially suitable for contact with the fibrotic fabric material 99 material may be selected for the projection 39, without it on the mechanical strength as a reinforcing element, as they are for the selection of the material for the hoop 3 of Meaning, arrives.
  • Design of a hoop with a projection 39 is not limited to ankle endoprostheses.

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

Abstract

L'invention concerne une endoprothèse de remplacement d'une articulation dans laquelle des surfaces coulissantes de contours différents sont formées par une pièce intermédiaire (2) et définissent des plans de déplacement correspondants pour des supports (1). Selon l'invention une virole de serrage entoure la pièce intermédiaire et ses surfaces latérales et y est agencée de manière à être située hors des plans de déplacement définis par les surfaces coulissantes de différents contours. Cela permet d'obtenir un renfort même d'endoprothèses qui présentent une biomécanique complexe à plusieurs degrés de liberté.
EP06829523A 2005-12-12 2006-12-12 Endoprothese dotee d'une partie intermediaire Withdrawn EP1962728A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US74910305P 2005-12-12 2005-12-12
US75507906P 2006-01-03 2006-01-03
PCT/EP2006/011937 WO2007068440A1 (fr) 2005-12-12 2006-12-12 Endoprothese dotee d'une partie intermediaire

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EP1962728A1 true EP1962728A1 (fr) 2008-09-03

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EP06829523A Withdrawn EP1962728A1 (fr) 2005-12-12 2006-12-12 Endoprothese dotee d'une partie intermediaire

Country Status (9)

Country Link
US (2) US20070173944A1 (fr)
EP (1) EP1962728A1 (fr)
JP (1) JP2009518156A (fr)
KR (1) KR20080085032A (fr)
AU (1) AU2006326312A1 (fr)
BR (1) BRPI0619626A2 (fr)
IL (1) IL192127A0 (fr)
RU (1) RU2426520C2 (fr)
WO (1) WO2007068440A1 (fr)

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WO2008151644A1 (fr) * 2007-06-12 2008-12-18 Link America, Inc. Endoprothèse à structure bombée
GR1007297B (el) * 2009-10-21 2011-06-06 Ελευθεριος Σπυριδωνα Νικας Ολικη αρθροπλαστικη ποδοκνημικης
US8668743B2 (en) * 2010-11-02 2014-03-11 Adam D. Perler Prosthetic device with multi-axis dual bearing assembly and methods for resection
GB2500918A (en) * 2012-04-05 2013-10-09 Biomet Uk Healthcare Ltd A prosthetic ankle with sliding engaging components
US9480571B2 (en) 2012-12-27 2016-11-01 Wright Medical Technology, Inc. Ankle replacement system and method
US10080573B2 (en) 2012-12-27 2018-09-25 Wright Medical Technology, Inc. Ankle replacement system and method
CA2836651C (fr) 2012-12-27 2016-03-22 Wright Medical Technology, Inc. Systeme de prothese de cheville et methode
US9974588B2 (en) 2012-12-27 2018-05-22 Wright Medical Technology, Inc. Ankle replacement system and method
US9918724B2 (en) 2012-12-27 2018-03-20 Wright Medical Technology, Inc. Ankle replacement system and method
BR112015022274A2 (pt) 2013-03-14 2017-07-18 Wright Medical Tech Inc sistema e método de substituição de tornozelo
AU2016388305B2 (en) * 2015-01-20 2019-06-06 Exactech, Inc. Talar implant for modifying joint kinematics
AU2016398429B2 (en) 2016-03-23 2019-09-12 Wright Medical Technology, Inc Fixation apparatus and method for total ankle replacement
JP2018011963A (ja) * 2017-08-03 2018-01-25 ライト メディカル テクノロジー インコーポレイテッドＷｒｉｇｈｔ Ｍｅｄｉｃａｌ Ｔｅｃｈｎｏｌｏｇｙ， Ｉｎｃ． 矯正インプラント補強物、システム、および方法
US11013607B2 (en) 2017-09-22 2021-05-25 Encore Medical, L.P. Talar ankle implant
EP3501432A1 (fr) 2017-12-20 2019-06-26 Stryker European Holdings I, LLC Instrumentation pour articulation
US11872137B2 (en) 2021-06-15 2024-01-16 Wright Medical Technology, Inc. Unicompartmental ankle prosthesis

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Also Published As

Publication number Publication date
US20070173944A1 (en) 2007-07-26
US20100204799A1 (en) 2010-08-12
IL192127A0 (en) 2008-12-29
BRPI0619626A2 (pt) 2011-10-04
KR20080085032A (ko) 2008-09-22
RU2426520C2 (ru) 2011-08-20
RU2008127783A (ru) 2010-01-20
JP2009518156A (ja) 2009-05-07
WO2007068440A1 (fr) 2007-06-21
AU2006326312A2 (en) 2008-10-16
AU2006326312A1 (en) 2007-06-21

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