EP2170223A1 - Endoprothèse à structure bombée - Google Patents

Endoprothèse à structure bombée

Info

Publication number
EP2170223A1
EP2170223A1 EP07764621A EP07764621A EP2170223A1 EP 2170223 A1 EP2170223 A1 EP 2170223A1 EP 07764621 A EP07764621 A EP 07764621A EP 07764621 A EP07764621 A EP 07764621A EP 2170223 A1 EP2170223 A1 EP 2170223A1
Authority
EP
European Patent Office
Prior art keywords
intermediate part
endoprosthesis according
projection
endoprosthesis
projections
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Withdrawn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
EP07764621A
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
Link America Inc
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 Link America Inc filed Critical Link America Inc
Priority claimed from PCT/EP2007/005181 external-priority patent/WO2008151644A1/fr
Publication of EP2170223A1 publication Critical patent/EP2170223A1/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Withdrawn legal-status Critical Current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
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof

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 side each have 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 interact 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 made flush to allow for compensatory movements in the AP and LM (lateral-medial) directions.
  • the sliding surfaces are correspondingly contour-displaced, for example a flat sliding surface is combined with a sliding surface curved in the manner of a cylindrical shell.
  • the stabilization happens through the natural ligaments.
  • fibrosis often occurs, ie the tissue surrounding the prosthesis multiplies. Due to unimpeded growth, the tissue can penetrate into interstices of the prosthesis. This can cause the patient pain and / or the functionality of the prosthesis is limited.
  • the invention is based on the above-mentioned prior art, the object to improve an endoprosthesis of the type mentioned in that an undesirable fibrosis is avoided.
  • 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 surface - and top one each
  • movement plane is to be understood broadly and also includes curved contours.
  • side surface includes the surfaces of the intermediate part which are not part of the sliding surfaces.
  • a component is said to be self-supporting if it can withstand all loads acting on it and no load-bearing reinforcement of the component is required.
  • the entire load of the endoprosthesis rests on the intermediate part. It is thus highly loaded along the hinge axis.
  • the term intermediate part only denotes that part of the corresponding component which is traversed by force paths in at least one possible load state of the implanted prosthesis.
  • the intermediate part has a projection on at least one side surface.
  • the projection By means of the projection, during a rotation, as well as during a linear movement, of the joint and thus also of the intermediate part, undesired tissue material growing laterally next to the endoprosthesis, the so-called fibrosis, can be pushed back. Penetration of this fabric material can be counteracted or even prevented in this way. The risk that the joint with the endoprosthesis according to the invention is restricted in its mobility by excessive fibrosis formation can thus be counteracted. Pain, as can occur conventionally in such a fibrosis due to the tissue material growing in the movement region of the intermediate part, is avoided thanks to the device according to the invention. An otherwise possibly required operative removal of this fabric material is not required thanks to the embodiment according to the invention.
  • the shape of the projection is arbitrary per se. In principle, however, the projection should preferably have no sharp edges with which the tissue could be injured.
  • the projection is crowned.
  • the crowning of the projection need only be one-dimensional, so that therefore results in a substantially cylinder shell-like shape; but it may also preferably be two-dimensional, so that a substantially spherical design results, wherein the curvature in the Level of Spannreifs and perpendicular to it can be different.
  • the projection extends over the entire length of the respective outer side.
  • Particularly expedient is an arrangement of the projection on a medial longitudinal side of the intermediate part. In this area, for example, when implanting the endoprosthesis according to the invention on the ankle joint, the malleolus medialis is located. Especially in this area, it can be an undesirable
  • Fibrosis come whose harmful effects are prevented thanks to the prosthesis according to 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 curvature. It is not necessary here that the circular center on which the circular arc is based lies centrally in the intermediate part. 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 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 danger of tearing off or shearing tissue material is thus effectively counteracted.
  • a projection may expediently also be provided on the adjoining outer sides. In the case of a rectangular configuration, this means that such a projection is formed on the anterior, the posterior and the medial side of the intermediate part.
  • the intermediate part is preferably made of plastic, e.g. Polyethylene material, manufactured.
  • the projections may be made of the same material. If this is the case, intermediate part and projections can also be manufactured as a one-piece component. The boundary between the two then arise due to their respective function: the intermediate part is the part of the component which actually bears tension in at least one natural load state of the prosthesis, that is, is traversed by force paths.
  • the parts of the component which under normal circumstances are stress-free and serve only to combat fibrosis.
  • the projections can also consist of a different material than the intermediate part.
  • the projections must be attached to the intermediate part. This can be done both mechanically and chemically (e.g., by gluing). By such a multi-part design, it is possible to choose the material of the projections as compatible as possible.
  • a plastic such as Polyethylene, which can be used for the intermediate part, the
  • Tissue contact leads to abrasion and subsequently to possible inflammation.
  • Protective layer can be mounted on the projections.
  • This protective layer preferably consists of a tissue-compatible, abrasion-resistant material. Yes, after design of the projections, the protective layer as a cap or partial ripening be executed.
  • the protective layer itself may be mechanically or chemically attached to the protrusions.
  • FIG. 1 is a front view of a lower portion of the FIG. 1
  • Fig. 2 is a bottom view of the variant of FIG. 1;
  • Fig. 3 is a front view of the prosthesis shown in FIGS. 1 and 2.
  • 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 sliding surfaces.
  • the endoprosthesis according to the illustrated embodiment essentially has 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.
  • the tibial component 1 is firmly connected to the tibia 91.
  • the fibula bone 90 runs parallel to the tibia bone 91.
  • the prosthesis further comprises a component 4 which is connected to the talus 92. It is saddle-shaped and has a convex arch on its upper side
  • 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 has a sliding surface 24 formed congruently with the sliding surface 44 of the ankle bone component 4. 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 plane 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 shin component 1 and the ankle 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).
  • the intermediate part 2 preferably consists of a sliding-plastic material, in particular polyethylene. However, it should not be excluded that other materials with sufficient strength and lubricity can be used.
  • Fig. 1 shows the endoprosthesis at its intended implantation site at the distal end of the tibial bone 91.
  • the tibial bone 91 forms at its distal end a plateau on which the tibial component 1 of the endoprosthesis according to the invention is arranged.
  • This plateau is laterally medially limited 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 comprise the plateau of the tibial bone.
  • a projection 39 is formed on at least one longitudinal side 33 of the intermediate part 2, expediently on the medial side, for avoiding or reducing the fibrotic tissue material 99.
  • the projection protrudes with respect to a congruent to the intermediate part 2 contour.
  • the projection preferably has an arcuate outer contour, wherein the arc extends over the entire length.
  • the projection 39 is expediently curved in two dimensions, that is to say it has a spherical surface shape.
  • the radii of curvature are different in size, a slight curvature in the horizontal plane (as shown in Fig. 2) and a greater curvature in a frontal plane (as shown in Fig. 1).
  • the center 30 of the circle defined by the radius of curvature is preferably not centrally located in the intermediate part 2, 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 front side and the back of the intermediate part 2 are each provided with a projection 39 'and 39''. As can be seen in Fig. 3, they are formed differently from the projection 39, namely cylinder shell-like. In addition, they do not extend over the entire height of the intermediate part 2.
  • a curvature-like transition between the projections 39, 39 ', 39'' is not required, but expediently, the geometries are so chosen that the transition is stepless.
  • the lateral longitudinal side intermediate part 2 expediently has no projection. This serves to ensure the clearance of the intermediate part 2. Furthermore, this has the advantage that a clear orientation of the intermediate part 2 is thus predetermined, whereby the risk of installation in a wrong position is reduced.
  • the projection 39 is usually made in one piece with the intermediate part 2. 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 secured to the intermediate part 2 by suitable fastening means.
  • suitable fastening means offers the advantage that a particularly slippery material which is particularly suitable for contact with the fibrotic fabric material 99 can be selected for the projection 39, without adversely affecting the mechanical strength of the intermediate part 2.
  • the projection 39 is provided with a protective layer 50 in the areas where contact with fabric material 99 is expected.
  • a protective layer 50 in the areas where contact with fabric material 99 is expected.
  • an intermediate piece 2 with a projection 39 is not limited to ankle endoprostheses.

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)
  • Sliding-Contact Bearings (AREA)
  • Shafts, Cranks, Connecting Bars, And Related Bearings (AREA)

Abstract

L'invention concerne une endoprothèse destinée à remplacer une articulation, des surfaces de glissement étant formées par une pièce intermédiaire (2), lesquelles surfaces présentent un contour différent et déterminent des plans de mouvement pour un palier respectif. Selon l'invention, la pièce intermédiaire (2) présente, sur au moins une face latérale, une saillie (39), de préférence bombée, permettant d'éviter une fibrose.
EP07764621A 2007-06-12 2007-06-12 Endoprothèse à structure bombée Withdrawn EP2170223A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2007/005181 WO2008151644A1 (fr) 2007-06-12 2007-06-12 Endoprothèse à structure bombée

Publications (1)

Publication Number Publication Date
EP2170223A1 true EP2170223A1 (fr) 2010-04-07

Family

ID=41527419

Family Applications (1)

Application Number Title Priority Date Filing Date
EP07764621A Withdrawn EP2170223A1 (fr) 2007-06-12 2007-06-12 Endoprothèse à structure bombée

Country Status (8)

Country Link
EP (1) EP2170223A1 (fr)
JP (1) JP2010528790A (fr)
CN (1) CN101815485A (fr)
AR (1) AR068317A1 (fr)
AU (1) AU2007354788A1 (fr)
BR (1) BRPI0721821A2 (fr)
IL (1) IL202560A0 (fr)
MX (1) MX2009013481A (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104605962A (zh) * 2015-02-09 2015-05-13 北京市春立正达医疗器械股份有限公司 一种踝关节假体

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2008151644A1 *

Also Published As

Publication number Publication date
CN101815485A (zh) 2010-08-25
AR068317A1 (es) 2009-11-11
IL202560A0 (en) 2010-06-30
MX2009013481A (es) 2010-01-27
AU2007354788A1 (en) 2008-12-18
JP2010528790A (ja) 2010-08-26
BRPI0721821A2 (pt) 2013-02-13

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