EP2079403A1 - Set for producing an offset resurfacing condyle cap implant for an artificial hip joint - Google Patents
Set for producing an offset resurfacing condyle cap implant for an artificial hip jointInfo
- Publication number
- EP2079403A1 EP2079403A1 EP08803162A EP08803162A EP2079403A1 EP 2079403 A1 EP2079403 A1 EP 2079403A1 EP 08803162 A EP08803162 A EP 08803162A EP 08803162 A EP08803162 A EP 08803162A EP 2079403 A1 EP2079403 A1 EP 2079403A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- cap
- hip joint
- region
- resurfacing
- implant
- 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- Withdrawn
Links
Classifications
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- 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
- A61F2/3603—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 implanted without ablation of the whole natural femoral head
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- 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
-
- 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
- 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
- A61F2002/30891—Plurality of protrusions
- A61F2002/30892—Plurality of protrusions parallel
-
- 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
- A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
- A61F2002/30909—Nets
-
- 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
- A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
-
- 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
- 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
Definitions
- the invention relates to a hip replacement cap implant for an artificial hip joint as a surface replacement for the natural articulation surface of the hip joint head.
- Cap implants are increasingly used, which are placed over the prepared natural residual joint head of the hip joint and can then be fixed in this position.
- Cap implants consist of a cap modeled on the outer shape of the natural joint ball, which can be placed on a (partially) prepared natural residual joint head.
- the prerequisite for a stable secondary fixation is stable bone material of the residual bone. It has been proposed in DE-C-102 18 801 to couple to the condyle a pin which is placed in a corresponding cutout in the femoral neck. This pin has a surface which is provided with a three-dimensional open-meshed spatial network structure into and through which bone trabeculae of the surrounding bone material grow and provide stable secondary fixation.
- Another indication is, for example, a cyst in the hip joint head, which leads to surface defects of the condyle.
- a necrosis of the condyle can lead to surface defects, but still not justify the resection of the condyle completely and provide the patient with a short stems endoprosthesis (EP 0 878 176).
- the pin according to the already mentioned DE-C-102 18 801 has a supporting and fixing function.
- the problem is, however, the axis-appropriate positioning of the cap on the prepared residual joint head. A malposition can later lead to far-reaching consequences.
- an offset resurfacing condyle cap implant for an artificial hip joint which has a metallic cap whose wall in the area of the base edge continuously increases in cross-section so that an eccentricity results in its outer shape.
- the problem with this cap implant is the introduction of loading forces in the femoral neck. In this respect, no information can be taken from this document.
- the set according to the invention has a thin-walled metallic cap for attaching to the only milled in the pole area in shape, otherwise merely cartilaginous or refreshed hip joint head, the wall in the region of the base edge seen in cross-section of a thickness of 2 mm to 6 mm steadily increases, so that in its outer shape results in an eccentricity and the interior of which initially - seen from the base edge - has a substantially cylindrical equatorial region, which adjoins a frustoconical, conically tapered region in said pole region, with several holes in its wall, their axes parallel to the main axis of the cap, at least one pin for centering and load-bearing use in the holes in the cap on.
- the natural hip joint head is thus divided into two zones, once in the pole area and once in the equatorial area.
- the use of the cap according to the invention is possible when the equatorial area is still largely intact. It is merely cartilaginous or refreshed.
- the pole region is so damaged that it has to be shaped by means of a form milling cutter, essentially in the shape of a truncated cone, which corresponds to the frusto-conical, conically tapered region inside the cap.
- the entrance area to the interior of the cap, the equatorial area is substantially cylindrical.
- the cap implant attaches to the cartilaginous or refreshed bone, but still intact bone of the natural hip joint head.
- the implant acts like a resurfacing implant according to DE 10 2005 011 361 B4.
- sample cap which has the same outer contour as the actual cap implant
- the surgeon can determine the position of the then to be applied to the femoral head metallic cap by turning on the (residual) joint head.Due to the eccentricity of the outer shape of the cap, the surgeon with simulate the balance of the hip joint misalignment in the "trial cap”.
- the metallic implant is then placed in the same optimally positioned position as the "trial cap”.
- the pin is provided with a osteoinductive coating.
- This may include, for example, hydroxyapatite or the like.
- the metallic cap can be cemented on the hip joint head. But it is also a cementless implantable cap possible.
- the interior of the cap is at least partially provided with an open-meshed three-dimensional spatial network structure into and through which bone trabeculae can grow for a stable secondary fixation.
- Fig. 2 is a view of the interior of the cap implant of Fig. 1, and
- Fig. 3 is an isometric view of the cap implant.
- the cap implant which is created from the set, has a thin-walled metallic dome-shaped cap 1 with a major axis H.
- the input side region to the inside I of the cap 1 is referred to as the equator Z.
- the interior in the equatorial region Z of the cap 1 is substantially cylindrical. This area acts as a pure resurfacing implant with the abutment on the equatorial area of the natural hip joint head after it has been cartilaginous or refreshed.
- the pole region P of the cap 1 is frusto-conical. Accordingly, the natural hip bone must be prepared with a form cutter. Since the cap 1 is provided for indications in which the natural Pol Scheme of the hip joint head is largely destroyed or deformed, care must be taken that the loading forces are directed in particular by the pole area in the bone of the residual joint head or in the femoral neck. Serve this purpose, the pin 5, which are set in holes 4 in the wall of the cap 1. their Axes are substantially axially parallel to the main axis H of the cap first
- the interior I of the cap 1 is provided with an open-meshed three-dimensional spatial network structure 6 into which and through which bone trabeculae grow and thus ensure stable long-term fixation.
- the illustrated cap 1 can thus be implanted without cement.
- the open-mesh three-dimensional spatial network structure has been omitted.
- the pins 5 in Fig. 3 are also shown only schematically, in particular the distal end of the pin.
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Abstract
The invention relates to a set for producing an offset resurfacing condyle cap implant for an artificial hip joint. Said set comprises a thin-walled metal cap (1) to be placed on the femoral head which is milled to shape only in the pole zone (P) and which is otherwise only debrided or from which the cartilage has been removed, the wall thickness thereof in the zone of the base edge (2) continuously increasing, when seen in the cross-section, from 2 mm to 6 mm so that it has an eccentric outer shape and the interior (I) of which first having a substantially cylindrical equatorial zone (Z) to which a truncated, conically tapered zone is contiguous in the pole zone (P). The wall of the cap has a plurality of bores (4) the axes of which extend in parallel to the main axis (H) of the cap (1). The set also comprises at least one pin (5) to be inserted in the bores (4) of the cap (1) in a centering and load-bearing manner.
Description
Set zur Erstellung eines Offset-Resurfacing-Gelenkkopf- Kappenimplantates für ein künstliches Hüftgelenk Set for creating an offset resurfacing condyle implant for an artificial hip joint
Die Erfindung betrifft ein Gelenkkopf-Kappenimplantat für ein künstliches Hüftgelenk, und zwar als ein Oberflächenersatz für die natürliche Artikulationsfläche des Hüftgelenkskopfes.The invention relates to a hip replacement cap implant for an artificial hip joint as a surface replacement for the natural articulation surface of the hip joint head.
In jüngster Zeit kommen verstärkt so genannte Kappenimplantate zur Anwendung, welche über den präparierten natürlichen Restgelenkskopf des Hüftgelenk^s gesetzt werden und in dieser Lage dann fixiert werden können. Kappenimplantate bestehen aus einer der äußeren Form der natürlichen Gelenkkugel nachgebildeten Kappe, die auf einen (teil-) präparierten natürlichen Restgelenkskopf setzbar ist.More recently, so-called cap implants are increasingly used, which are placed over the prepared natural residual joint head of the hip joint and can then be fixed in this position. Cap implants consist of a cap modeled on the outer shape of the natural joint ball, which can be placed on a (partially) prepared natural residual joint head.
Voraussetzung für eine stabile Sekundärfixation ist stabiles Knochenmaterial des Restknochens. So wurde in der DE-C-102 18 801 vorgeschlagen, an die Gelenkkopfkappe einen Zapfen anzukoppeln, der in eine entsprechende Ausfräsung im Schenkelhals gesetzt wird. Dieser Zapfen weist eine Oberfläche auf, welche mit einer dreidimensionalen offenmaschigen Raumnetzstruktur versehen ist, in welche und durch welche hindurch Knochentrabekel des umliegenden Knochenmaterials wachsen und für die stabile Sekundärfixation sorgen.The prerequisite for a stable secondary fixation is stable bone material of the residual bone. It has been proposed in DE-C-102 18 801 to couple to the condyle a pin which is placed in a corresponding cutout in the femoral neck. This pin has a surface which is provided with a three-dimensional open-meshed spatial network structure into and through which bone trabeculae of the surrounding bone material grow and provide stable secondary fixation.
Es gibt jedoch Indikationen, bei denen man noch davon absehen kann, den Schenkelhals auszufräsen, um so Platz für den Zapfen zu schaffen.However, there are indications that one may still refrain from raking the femoral neck to make room for the pin.
Angeführt wird hier die so genannte Perthes-Calve-Legg-Krankheit, die ein- oder beidseitig im Bereich der Femurkopfepiphyse aseptische Knochennekrosen hervorruft. Vor allem bei Jungen vom vierten bis zwölften Lebensjahr tritt diese Krankheit auf (Pschyrembel Klinisches Wörterbuch, 259. Auflage, 2002, Seite 1285). Eine Ausheilung ohne
Deformierung ist zwar möglich, jedoch bleibt eine eventuelle Walzenoder Pilzform des Schenkelkopfes mit Abplattung der Gelenkpfanne, seltener Coxa plana oder Arthrosis deformans zurück.Cited here is the so-called Perthes-Calve-Legg disease, which causes one or both sides of the femoral epiphysis aseptic bone necrosis. Especially in boys from the fourth to the twelfth year of age, this disease occurs (Pschyrembel Clinical Dictionary, 259th Edition, 2002, page 1285). An anneal without Deformation is possible, but remains a possible roll or mushroom shape of the femoral head with flattening of the socket, rarely Coxa plana or Arthrosis deformans back.
Eine weitere Indikation ist beispielsweise eine Zyste im Hüftgelenkskopf, die zu Oberflächendefekten des Gelenkkopfes führt.Another indication is, for example, a cyst in the hip joint head, which leads to surface defects of the condyle.
Generell kann eine Nekrose des Gelenkkopfes zu oberflächenhaften Defekten führen, die es aber immer noch nicht rechtfertigen, den Gelenkkopf vollständig zu resezieren und den Patienten mit einer Kurzstielendoprothese (EP 0 878 176) zu versorgen.In general, a necrosis of the condyle can lead to surface defects, but still not justify the resection of the condyle completely and provide the patient with a short stems endoprosthesis (EP 0 878 176).
Grundsätzlich - und dies wurde in letzter Zeit verstärkt erkannt - ist es vorteilhaft, mit (Teil-)resektionen von Knochen solange wie möglich zu zögern, um bei einem eventuell später notwendigen Revisionseingriff auf mehrere Stufen der endoprothetischen Versorgung zurückgreifen zu können, von der Kurzstielendoprothese bis zur Langstielendoprothese. Der Einsatz der letztgenannten Endoprothese erfordert die vollständige Resektion des Schenkelhalses.Basically - and this has been increasingly recognized lately - it is advantageous to hesitate as long as possible with (partial) resections of bone in order to be able to resort to a plurality of stages of the endoprosthetic restoration, possibly from a later revision surgery, from the short stem endoprosthesis to for long-stemmed endoprosthesis. The use of the latter endoprosthesis requires complete resection of the femoral neck.
Der Zapfen gemäß der schon erwähnten DE-C-102 18 801 hat eine tragende und fixierende Funktion. Problematisch ist dabei jedoch die achsgerechte Positionierung der Kappe auf dem präparierten Restgelenkskopf. Eine Fehlstellung kann später dann zu weit reichenden Konsequenzen führen.The pin according to the already mentioned DE-C-102 18 801 has a supporting and fixing function. The problem is, however, the axis-appropriate positioning of the cap on the prepared residual joint head. A malposition can later lead to far-reaching consequences.
Aus der DE-U1-20 2006 017 005 ist ein Gelenkkopf-Kappenimplantat für ein künstliches Hüftgelenk mit einer dünnwandigen metallischen Kappe zum Aufsatz auf den natürlichen, lediglich entknorpelten oder angefrischten Hüftgelenkskopf mit einem proximal im Polbereich der Kappe exakt mittig angeordneten Führungsstift bekannt. Mit diesem Implantat wird angestrebt, es achsgerecht auf dem natürlichen
Gelenkkopf zu positionieren. Dabei soll der natürliche Gelenkkopf weitgehend intakt bleiben.From DE-U1-20 2006 017 005 a condyle cap implant for an artificial hip joint with a thin-walled metallic cap for attachment to the natural, merely cartilaginous or refreshed hip joint head with a proximally in the pole region of the cap exactly centered guide pin is known. With this implant, it is aspired to be true to the natural Position the condyle. The natural condyle should remain largely intact.
Aus der EP 1 872 745 A2 ist ein Offset-Resurfacing-Gelenkkopf- Kappenimplantat für ein künstliches Hüftgelenk bekannt, welches eine metallische Kappe aufweist, deren Wandung im Bereich der Basiskante sich im Querschnitt gesehen stetig vergrößert, sodass sich in ihrer Außenform eine Exzentrizität ergibt. Problematisch bei diesem Kappenimplantat ist die Einleitung von Belastungskräften in den Schenkelhals. Insofern kann diesem Dokument keinerlei Angabe entnommen werden.From EP 1 872 745 A2, an offset resurfacing condyle cap implant for an artificial hip joint is known, which has a metallic cap whose wall in the area of the base edge continuously increases in cross-section so that an eccentricity results in its outer shape. The problem with this cap implant is the introduction of loading forces in the femoral neck. In this respect, no information can be taken from this document.
Es gibt jedoch Indikationen, bei denen die Versorgung aufgrund des Krankheits- oder Abnutzungsbildes mit bekannten Kappenimplantaten nicht optimal ist. So sollen auch Fehlstehlungen des Hüftgelenkskopfes ausgeglichen werden können. Darüber hinaus soll eine Ablastung von Belastungskräften in den noch intakten Knochen des Knochenschenkels eingeleitet werden können, selbst bei weitgehend zerstörtem Polbereich bzw. beispielsweise walzenförmiger Deformierung (Perthes, s.o.). Der Operateur soll auch noch während der Operation die Möglichkeit haben Anpassungen vorzunehmen.However, there are indications where the care due to the disease or wear pattern is not optimal with known cap implants. So should also misspun the hip joint head can be compensated. In addition, a reduction of stress forces in the intact bone of the bone leg can be initiated, even with largely destroyed Polbereich or, for example, cylindrical deformation (Perthes, see above). The surgeon should also have the opportunity during the surgery to make adjustments.
Dementsprechend ist es die Aufgabe der vorliegenden Erfindung, ein Set zur Erstellung eines Offset-Resurfacing-Gelenkkopf- Kappenimplantates für ein künstliches Hüftgelenk vorzuschlagen, welches diesen vorgenannten Anforderungen gerecht wird.Accordingly, it is the object of the present invention to provide a kit for creating an offset resurfacing condyle cap implant for an artificial hip joint, which meets these aforementioned requirements.
Gelöst wird diese Aufgabe durch ein Set mit den Merkmalen des Anspruchs 1. Weitere vorteilhafte Ausführungsformen sind in den Unteransprüchen angegeben.
Demnach weist das erfindungsgemäße Set eine dünnwandige metallische Kappe zum Aufsatz auf den lediglich im Polbereich in Form gefrästen, ansonsten lediglich entknorpelten oder angefrischten Hüftgelenkskopf auf, deren Wandung im Bereich der Basiskante sich im Querschnitt gesehen von einer Stärke von 2 mm bis 6 mm stetig vergrößert, so dass sich in ihrer Außenform eine Exzentrizität ergibt und deren Innenraum zunächst - von der Basiskante gesehen - einen im wesentlichen zylindrischen Äquatorbereich aufweist, dem sich im genannten Polbereich ein kegelstumpfförmiger, sich konisch verjüngender Bereich anschließt, mit mehreren Bohrungen in ihrer Wandung, deren Achsen parallel zu der Hauptachse der Kappe verlaufen, sowfiTwenigstens einen Zapfen zum zentrierenden und Last aufnehmenden Einsatz in den Bohrungen in der Kappe auf.This object is achieved by a set having the features of claim 1. Further advantageous embodiments are specified in the subclaims. Accordingly, the set according to the invention has a thin-walled metallic cap for attaching to the only milled in the pole area in shape, otherwise merely cartilaginous or refreshed hip joint head, the wall in the region of the base edge seen in cross-section of a thickness of 2 mm to 6 mm steadily increases, so that in its outer shape results in an eccentricity and the interior of which initially - seen from the base edge - has a substantially cylindrical equatorial region, which adjoins a frustoconical, conically tapered region in said pole region, with several holes in its wall, their axes parallel to the main axis of the cap, at least one pin for centering and load-bearing use in the holes in the cap on.
Der natürliche Hüftgelenkskopf wird also in zwei Zonen eingeteilt, einmal in den Polbereich und einmal in den Äquatorbereich. Der Einsatz der erfindungsgemäßen Kappe ist dann möglich, wenn der Äquatorbereich noch weitgehend intakt ist. Er wird lediglich entknorpelt oder angefrischt. Der Polbereich hingegen ist so lädiert, dass er mit Hilfe eines Formfräsers in Form gebracht werden muss, und zwar im wesentlichen in die Form eines Kegelstumpfes, der mit dem kegelstumpfförmigen, sich konisch verjüngenden Bereich im Inneren der Kappe korrespondiert. Der Eingangsbereich zu dem Inneren der Kappe, der Äquatorbereich, ist im Wesentlichen zylindrisch ausgebildet. Hier legt sich das Kappenimplantat an den entknorpelten oder angefrischten Knochen, aber noch intakten Knochen des natürlichen Hüftgelenkskopfes an. Hier wirkt das Implantat wie ein Resurfacing- Implantat gemäß der DE 10 2005 011 361 B4.The natural hip joint head is thus divided into two zones, once in the pole area and once in the equatorial area. The use of the cap according to the invention is possible when the equatorial area is still largely intact. It is merely cartilaginous or refreshed. By contrast, the pole region is so damaged that it has to be shaped by means of a form milling cutter, essentially in the shape of a truncated cone, which corresponds to the frusto-conical, conically tapered region inside the cap. The entrance area to the interior of the cap, the equatorial area, is substantially cylindrical. Here the cap implant attaches to the cartilaginous or refreshed bone, but still intact bone of the natural hip joint head. Here, the implant acts like a resurfacing implant according to DE 10 2005 011 361 B4.
Durch die spezielle Außenform mit ihrer Exzentrizität aufgrund der stetig zunehmenden Stärke der Wandung bis zu einem Maximum und danach folgender stetiger Abnahme auf das Minimum der Wandstärke
des Materials im Bereich der Basiskante können Fehlstellungen des Hüftgelenkskopfes ausgeglichen werden.Due to the special outer shape with its eccentricity due to the steadily increasing strength of the wall up to a maximum and then following steady decrease to the minimum of the wall thickness of the material in the area of the base edge, malpositions of the hip joint head can be compensated.
Die geforderte Einleitung der auftretenden Belastungskräfte in das intakte knöcherne Gewebe des natürlichen Hüftgelenkskopfes bzw. in den Schenkelhals hinein bewerkstelligen Zapfen, die in Bohrungen in der Wandung der Kappe eingesetzt werden. Der Einsatz der Zapfen kann individuell während der Operation den Gegebenheiten angepasst werden. In den verbliebenen natürlichen Restgelenkskopf werden entsprechende Knochenbohrungen eingebracht, in welche die Zapfen bei der Implantation eingesetzt werden.The required initiation of the loading forces occurring in the intact bony tissue of the natural hip joint head or in the femoral neck in accomplish cones that are inserted into holes in the wall of the cap. The use of the pins can be individually adapted to the circumstances during the operation. In the remaining natural residual joint head appropriate bone holes are introduced, in which the pins are used during implantation.
Mit einer „Probekappe", welche dieselbe Außenkontur wie das eigentliche Kappenimplantat aufweist, kann der Operateur durch Drehen auf dem (Rest-)Gelenkskopf die Stellung der dann auf dem Hüftgelenkskopf aufzubringenden metallischen Kappe ermitteln. Aufgrund der Exzentrizität der Außenform der Kappe kann der Operateur mit der „Probekappe" einen Ausgleich der Hüftgelenkskopf- Fehlstellung simulieren. Das metallische Implantat wird dann in dieselbe, als optimal befundene Position gebracht wie die die „Probekappe".With a "sample cap", which has the same outer contour as the actual cap implant, the surgeon can determine the position of the then to be applied to the femoral head metallic cap by turning on the (residual) joint head.Due to the eccentricity of the outer shape of the cap, the surgeon with simulate the balance of the hip joint misalignment in the "trial cap". The metallic implant is then placed in the same optimally positioned position as the "trial cap".
Zur innigen Verbindung zwischen dem Zapfen und dem sie umgebenden Knochenmaterial kann vorteilhaft vorgesehen sein, dass die Zapfen mit einer osteoinduktiv wirkenden Beschichtung versehen ist. Diese kann beispielsweise Hydroxylapatit oder dgl. beinhalten. Hierdurch wird ein langfristiger inniger Verbund zwischen dem Zapfenmaterial und dem Knochenmaterial angestrebt.For intimate connection between the pin and the surrounding bone material can be advantageously provided that the pin is provided with a osteoinductive coating. This may include, for example, hydroxyapatite or the like. As a result, a long-term intimate bond between the pin material and the bone material is sought.
Die metallische Kappe kann auf dem Hüftgelenkskopf zementiert werden. Es ist aber auch eine zementlos zu implantierende Kappe möglich. In diesem Falle ist der Innenraum der Kappe wenigstens
teilweise mit einer offenmaschigen dreidimensionalen Raumnetzstruktur versehen, in die und durch welche hindurch Knochentrabekel wachsen können für eine stabile Sekundärfixation.The metallic cap can be cemented on the hip joint head. But it is also a cementless implantable cap possible. In this case, the interior of the cap is at least partially provided with an open-meshed three-dimensional spatial network structure into and through which bone trabeculae can grow for a stable secondary fixation.
Die Erfindung wird anhand eines Ausführungsbeispiels gemäß der Zeichnungsfiguren näher erläutert. Hierbei zeigt:The invention will be explained in more detail with reference to an embodiment according to the drawing figures. Hereby shows:
Fig. 1 eine Querschnittsansicht des Kappenimplantates,1 is a cross-sectional view of the cap implant,
Fig. 2 eine Ansicht auf das Innere des Kappenimplantates aus Fig. 1 , undFig. 2 is a view of the interior of the cap implant of Fig. 1, and
Fig. 3 eine isometrische Darstellung des Kappenimplantates.Fig. 3 is an isometric view of the cap implant.
Das Kappenimplantat, welches aus dem Set erstellt wird, weist eine dünnwandige metallische kalottenförmige Kappe 1 mit einer Hauptachse H auf. Der eingangsseitige Bereich zum Inneren I der Kappe 1 wird als Äquatorbereich Z bezeichnet. Das Innere im Äquatorbereich Z der Kappe 1 verläuft im Wesentlichen zylindrisch. Dieser Bereich wirkt wie ein reines Resurfacing-Implantat mit der Anlage an den Äquatorbereich des natürlichen Hüftgelenkskopfes, nachdem dieser entknorpelt oder angefrischt worden ist.The cap implant, which is created from the set, has a thin-walled metallic dome-shaped cap 1 with a major axis H. The input side region to the inside I of the cap 1 is referred to as the equator Z. The interior in the equatorial region Z of the cap 1 is substantially cylindrical. This area acts as a pure resurfacing implant with the abutment on the equatorial area of the natural hip joint head after it has been cartilaginous or refreshed.
Der Polbereich P der Kappe 1 hingegen ist kegelstumpfförmig ausgebildet. Entsprechend muss der natürliche Hüftgelenksknochen mit einem Formfräser präpariert werden. Da die Kappe 1 für Indikationen vorgesehen ist, bei denen der natürliche Polbereich des Hüftgelenkskopfes weitgehend zerstört oder aber deformiert ist, muss dafür Sorge getragen werden, dass die Belastungskräfte insbesondere vom Polbereich in den Knochen des Restgelenkskopfes bzw. in den Schenkelhals geleitet werden. Hierzu dienen die Zapfen 5, die in Bohrungen 4 in der Wandung der Kappe 1 gesetzt werden. Deren
Achsen sind im Wesentlichen achsparallel zu der Hauptachse H der Kappe 1.The pole region P of the cap 1, however, is frusto-conical. Accordingly, the natural hip bone must be prepared with a form cutter. Since the cap 1 is provided for indications in which the natural Polbereich of the hip joint head is largely destroyed or deformed, care must be taken that the loading forces are directed in particular by the pole area in the bone of the residual joint head or in the femoral neck. Serve this purpose, the pin 5, which are set in holes 4 in the wall of the cap 1. their Axes are substantially axially parallel to the main axis H of the cap first
Das Innere I der Kappe 1 ist im gezeigten Ausführungsbeispiel mit einer offenmaschigen dreidimensionalen Raumnetzstruktur 6 versehen, in welche und durch welche hindurch Knochentrabekel wachsen und so für eine stabile Langzeitfixation sorgen. Die dargestellte Kappe 1 kann also zementlos implantiert werden.In the embodiment shown, the interior I of the cap 1 is provided with an open-meshed three-dimensional spatial network structure 6 into which and through which bone trabeculae grow and thus ensure stable long-term fixation. The illustrated cap 1 can thus be implanted without cement.
Bei den Darstellungen gemäß den Figuren 2 und 3 ist die offenmaschige dreidimensionale Raumnetzstruktur weggelassen worden. Die Zapfen 5 in Fig. 3 sind auch nur schematisch dargestellt, insbesondere der distale Abschluss des Zapfens.In the illustrations according to FIGS. 2 and 3, the open-mesh three-dimensional spatial network structure has been omitted. The pins 5 in Fig. 3 are also shown only schematically, in particular the distal end of the pin.
Die formulierten Ziele werden vorliegend durch die folgenden Komponenten erreicht:The stated objectives are achieved in the present case by the following components:
1. Zapfen zur Einleitung der Belastungskräfte in intaktes Knochenmaterial.1. Journal for the introduction of the loading forces in intact bone material.
2. Die reine Resurfacing-Komponente im Äquatorbereich der Kappe. . -2. The pure resurfacing component in the equatorial region of the cap. , -
3. Die kegelstumpfförmige Ausbildung des Inneren der Kappe 1 im Polbereich.3. The frustoconical design of the interior of the cap 1 in the pole region.
4. Die äußere Exzentrizität der Kappe 1.
4. The outer eccentricity of the cap 1.
Claims
1. Set zur Erstellung eines Offset-Resurfacing-Gelenkkopf- Kappenimplantates für ein künstliches Hüftgelenk, aufweisendA kit for creating an offset hip resurfacing condyle implant for an artificial hip joint comprising
eine dünnwandige metallische Kappe (1) zum Aufsatz auf den lediglich im Polbereich (P) in Form gefrästen, ansonsten lediglich entknorpelten oder angefrischten Hüftgelenkskopf, deren Wandung im Bereich der Basiskante (2) sich im Querschnitt gesehen von einer Stärke von 2 mm bis 6 mm stetig vergrößert, so dass sich in ihrer Außenform eine Exzentrizität ergibt und deren Innenraum (I) zunächst einen im wesentlichen zylindrischen Äquatorbereich (Z) aufweist, dem sich im genannten Polbereich (P) ein kegelstumpfförmiger, sich konisch verjüngender Bereich anschließt, mit mehreren Bohrungen (4) in ihrer Wandung, deren Achsen parallel zu der Hauptachse (H) der Kappe (1 ) verlaufen,a thin-walled metallic cap (1) for attachment to the only in the pole region (P) milled in shape, otherwise merely Entrtorkelten or refreshed hip joint head whose wall in the region of the base edge (2) seen in cross-section of a thickness of 2 mm to 6 mm continuously increased, so that in its outer shape results in an eccentricity and whose interior (I) initially has a substantially cylindrical equatorial region (Z), which in the said pole region (P) adjoins a frusto-conical, conically tapering region, with a plurality of bores ( 4) in its wall whose axes are parallel to the main axis (H) of the cap (1),
sowie, wenigstens einen Zapfen (5) zum zentrierenden und Last aufnehmenden Einsatz in den Bohrungen (4) in der Kappe (1).and, at least one pin (5) for centering and load-bearing use in the bores (4) in the cap (1).
2. Set nach Anspruchi , bei dem die Oberfläche der Zapfen (5) mit einer osteoinduktiv wirkenden Beschichtung versehen ist.2. Set according Anspruchi, wherein the surface of the pin (5) is provided with a osteoinductive coating.
3. Set nach Anspruch 1 oder 2, bei dem der Innenraum (I) der Kappe (1) wenigstens teilweise mit einer offenmaschigen dreidimensionalen Raumnetzstruktur (6) versehen ist. 3. Set according to claim 1 or 2, wherein the interior (I) of the cap (1) is at least partially provided with an open-mesh three-dimensional space network structure (6).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102007041794A DE102007041794B3 (en) | 2007-08-30 | 2007-08-30 | Set for creating an offset resurfacing condyle cap implant for an artificial hip joint |
PCT/EP2008/060997 WO2009027325A1 (en) | 2007-08-30 | 2008-08-22 | Set for producing an offset resurfacing condyle cap implant for an artificial hip joint |
Publications (1)
Publication Number | Publication Date |
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EP2079403A1 true EP2079403A1 (en) | 2009-07-22 |
Family
ID=40065373
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP08803162A Withdrawn EP2079403A1 (en) | 2007-08-30 | 2008-08-22 | Set for producing an offset resurfacing condyle cap implant for an artificial hip joint |
Country Status (6)
Country | Link |
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US (1) | US20100305713A1 (en) |
EP (1) | EP2079403A1 (en) |
JP (1) | JP2010536520A (en) |
AU (1) | AU2008292255A1 (en) |
DE (1) | DE102007041794B3 (en) |
WO (1) | WO2009027325A1 (en) |
Cited By (1)
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EP2231072B1 (en) * | 2007-12-10 | 2019-05-22 | Mako Surgical Corp. | A prosthetic device and system for preparing a bone to receive a prosthetic device |
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WO2011091052A1 (en) | 2010-01-20 | 2011-07-28 | Kyle Taylor | Apparatus and methods for bone access and cavity preparation |
CN105361942B (en) | 2010-03-08 | 2018-01-09 | 康文图斯整形外科公司 | For fixing the device and method of bone implant |
WO2013025308A1 (en) * | 2011-08-13 | 2013-02-21 | Hip Innovation Technology Llc | Interlocking acetabular fixation screws and their combination with a reverse hip acetabular cup |
US9289306B2 (en) * | 2013-03-15 | 2016-03-22 | Catalyst Orthopaedics Llc | Humeral arthroplasty |
USD735338S1 (en) | 2013-10-31 | 2015-07-28 | Catalyst Orthopaedics Llc | Humeral component for shoulder arthroplasty |
WO2015089357A2 (en) | 2013-12-12 | 2015-06-18 | Conventus Orthopaedics, Inc. | Tissue displacement tools and methods |
ITMI20132154A1 (en) * | 2013-12-20 | 2015-06-21 | Adler Ortho S R L | FEMORAL COMPONENT FOR KNEE PROSTHESIS. |
DE102015212260A1 (en) * | 2014-07-09 | 2016-01-14 | Ceramtec Gmbh | All-ceramic surface replacement prosthesis with porous inside |
CN105030376B (en) * | 2015-02-10 | 2017-02-01 | 江苏奥康尼医疗科技发展有限公司 | Total hip surface replacement implant |
CN104887354B (en) | 2015-02-10 | 2017-06-30 | 江苏奥康尼医疗科技发展有限公司 | A kind of combined type high-molecular organic material artificial knee joint |
WO2019010252A2 (en) | 2017-07-04 | 2019-01-10 | Conventus Orthopaedics, Inc. | Apparatus and methods for treatment of a bone |
GB2568047B (en) * | 2017-11-01 | 2021-10-27 | Matortho Ltd | Improvements in or relating to ceramic femoral resurfacing head prosthesis |
US20220047394A1 (en) * | 2017-11-01 | 2022-02-17 | Matortho Limited | Improvements in or relating to ceramic femoral resurfacing head prosthesis |
GB2571650B (en) * | 2017-11-01 | 2020-05-27 | Matortho Ltd | Improvements in or relating to ceramic femoral resurfacing head prosthesis |
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DE102007032583B3 (en) * | 2007-07-09 | 2008-09-18 | Eska Implants Gmbh & Co.Kg | Set for creating an offset resurfacing hip joint implant |
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2007
- 2007-08-30 DE DE102007041794A patent/DE102007041794B3/en not_active Expired - Fee Related
-
2008
- 2008-08-22 JP JP2010522325A patent/JP2010536520A/en active Pending
- 2008-08-22 AU AU2008292255A patent/AU2008292255A1/en not_active Abandoned
- 2008-08-22 US US12/675,544 patent/US20100305713A1/en not_active Abandoned
- 2008-08-22 WO PCT/EP2008/060997 patent/WO2009027325A1/en active Application Filing
- 2008-08-22 EP EP08803162A patent/EP2079403A1/en not_active Withdrawn
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EP2231072B1 (en) * | 2007-12-10 | 2019-05-22 | Mako Surgical Corp. | A prosthetic device and system for preparing a bone to receive a prosthetic device |
Also Published As
Publication number | Publication date |
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AU2008292255A1 (en) | 2009-03-05 |
JP2010536520A (en) | 2010-12-02 |
US20100305713A1 (en) | 2010-12-02 |
DE102007041794B3 (en) | 2009-04-30 |
WO2009027325A1 (en) | 2009-03-05 |
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