EP4003238A1 - Combinaison d'une pièce d'augmentation et d'une pièce de remplacement pour combler un défaut osseux - Google Patents

Combinaison d'une pièce d'augmentation et d'une pièce de remplacement pour combler un défaut osseux

Info

Publication number
EP4003238A1
EP4003238A1 EP20742748.5A EP20742748A EP4003238A1 EP 4003238 A1 EP4003238 A1 EP 4003238A1 EP 20742748 A EP20742748 A EP 20742748A EP 4003238 A1 EP4003238 A1 EP 4003238A1
Authority
EP
European Patent Office
Prior art keywords
bone
outer shell
inner body
shell piece
augment
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.)
Pending
Application number
EP20742748.5A
Other languages
German (de)
English (en)
Inventor
Helmut D. Link
Gunnar Erb
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Waldemar Link GmbH and Co KG
Original Assignee
Waldemar Link GmbH and Co KG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Waldemar Link GmbH and Co KG filed Critical Waldemar Link GmbH and Co KG
Publication of EP4003238A1 publication Critical patent/EP4003238A1/fr
Pending legal-status Critical Current

Links

Classifications

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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
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    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0023—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in porosity

Definitions

  • the invention relates to an augment for a bone defect, in particular a tibial head augment for a knee joint endoprosthesis. It comprises a sleeve-like inner body for implantation at one end of an elongated bone.
  • the inner body has a channel extending from top to bottom through the sleeve for receiving a prosthesis shaft and a wall surrounding the channel, an outer side of the wall being designed as a bone abutment surface on a bone border surrounding the inner body (including cancellous bone areas inside and cortical areas outside) .
  • augments are typically used, which are designed as cone-like sleeves in particular to adapt to the shape of the epiphysis and the metaphysis. They are implanted into the bone end so that they are sunk and surrounded by the cortical edge of the bone end like a quiver.
  • the invention is based on the object of creating an improved augment which, in such cases, enables bone to be preserved and promotes regeneration.
  • an augment for a bone defect in particular a tibial head augment, comprising an inner body which is designed as a (regular or irregular) shaped sleeve, in particular a cone, for implantation at one end (epiphysis and metaphysis) of an elongated bone
  • the Inner body comprises a channel extending from top to bottom through the sleeve for receiving a prosthesis and / or a prosthesis shaft and a wall surrounding the channel, with an outer side of the wall being designed as a bone contact surface on a bone border surrounding the inner body
  • an outer shell piece provided as a bone replacement piece to fill (filler) a defect (cortical gap) on the outside of the bone border on the inner body and is not dimensioned circumferentially, so that it covers only part of the outer circumference of the inner body in the circumferential direction.
  • doubled is understood to mean that an additional structural element is applied to a base body (in the present case: inner body).
  • the additional structural element here: outer shell piece
  • the additional element is firmly connected to the base body, be it through a continuous connection or several individual connections.
  • the additional element can differ from the base body in terms of material properties, for example stiffness, porosity, surface properties, etc., but it does not have to.
  • a bone window is understood to mean an opening that has arisen due to a (usually undesired) defect in bone material, in particular in the cortical region.
  • the channel is a through opening that extends the height of the augment from top to bottom.
  • a prosthesis or a prosthesis part can be received therein, in particular the shaft of the prosthesis can be pushed through.
  • the invention is based on the idea of creating a filler piece by means of the doubled-up outer shell piece which closes the bone window, hence the undesired opening at the bone end.
  • the bone window is closed and undesired contact of the augment itself with the surrounding soft tissue is avoided.
  • reinforcement and stiffening are achieved, so that thanks to the doubled outer shell piece, the actual augment is also supported in the area of the bone window.
  • the remaining parts of the bone border in the area without doubling
  • the chance remains ensures that the bone is partially regenerated.
  • the outer shell piece is carried out as an image of the bone defect (bone window). This enables a particularly precise replacement of the bone defect and ensures optimal support.
  • the outer shell piece is formed by means of an additive manufacturing process, in particular by means of 3D printing.
  • the outer shell piece has a contour on its outer surface that is identical to the bone border.
  • the outer shell piece thus continues the outer contour of the bone end and thus blends in with its surroundings in a favorable manner. In this way, irritation of the surrounding tissue can be prevented. Furthermore, the regeneration behavior of the bone can be improved as a result.
  • the outer shell piece preferably has an at least substantially constant thickness (thickness) in the circumferential direction. This results in a similarity in shape, i. H.
  • the outer contour of the outer shell piece is geometrically similar to the contour of the outside of the wall of the inner body.
  • “geometrically similar" means that the outer contour of the outer shell piece is at least essentially produced by a central stretching of the outer contour of the inner body.
  • the inner body forming the core of the augment is expediently free of the outer shell piece in the region of its lower end. This means that the outer shell piece does not extend all the way down, but rather a surrounding area of the inner body below remains free of the outer shell piece. There is no need for a thickening in the lower area of the inner body caused by the outer shell piece. This is easier to insert into the bone quiver formed on the head.
  • the outer surface of the outer shell piece is advantageously made different from the outer side of the wall of the inner body.
  • Particularly preferred is a configuration of the outer shell piece such that it has a solid (non-porous) outer surface.
  • the doubling is located where the outer surface is designed differently (solid), in particular the outer surface of the outer shell is made solid, while the outside of the wall of the inner body has porosities. Due to the massive design, it is matched to the closed surface structure of the adjacent bone border. Furthermore, the massive surface counteracts the undesired growth of soft tissues.
  • the outer surface of the outer shell piece thus differs from the surface of the outer side of the wall of the inner body, which is expediently designed to be porous. This favors a bone integration of the augment on the inside of the bone in the bone quiver, more precisely in the cancellous bone or cortex of the bone present there.
  • the outer shell piece advantageously has anchoring grooves or holes or bores on its outside. These allow the inclusion of fasteners for additional anchoring to the remaining bone.
  • the anchoring grooves are designed to receive fastening wires, in particular cerclage wires. In this way, a secure and surgically easy-to-use additional attachment and stabilization, especially of the fragile residual bone, can be achieved.
  • the outer shell piece is expediently made more rigid than the inner body. It is thus better adapted to the higher rigidity of the bone in its border area, see above that overall there is a flow of force that is better adapted to the anatomical conditions at the end of the bone.
  • the outer shell piece is expediently made of the same material as the inner body, but is more rigid due to different shapes. The higher rigidity can in particular be achieved by the fact that the outer shell piece has a lower porosity than the inner body, and is preferably made solid.
  • the outer shell piece has a freely preselectable outline contour which can be adapted to the bone defect, in particular the end of the tibia.
  • the determination of the bone defect and the selection of the outline contour of the outer shell based thereon are preferably carried out on a CT (or other computer-assisted imaging method) of the patient's affected bone.
  • a design of the outer shell piece tailored to the individual anatomical conditions of the respective patient can be implemented so that optimal bone support and, if necessary, regeneration are obtained.
  • the outer shell piece expediently has a support saddle in its lower area. This is intended to that the outer shell piece can rest with it on a cortical loading area of the elongated bone in order to achieve a flush connection of the outer shell piece to the surrounding bone. If necessary, the placement also enables a reliable transmission of force between the outer shell piece and the hard cortical area of the elongated bone that is well suited for force transmission.
  • the support saddle is preferably arranged higher on the augment than the lower end of the inner body. This offers the advantage that the implant is free at its lower end from the outer shell piece protruding outwards, so that it is narrower overall at the lower end and can be inserted more easily into the bone quiver at the bone end.
  • Transitions between the outer shell piece on the one hand and the inner body on the other hand are preferably made rounded.
  • the thickness of the outer shell piece is usually not constant, but varies depending on the position. In particular, the thickness varies along the circumference and / or over the height of the outer shell piece. A finer adaptation to the bone defect and its dimensions can thus be achieved.
  • the outer shell piece is advantageously provided with a receptacle for screw fastening at its upper end.
  • the outer shell piece can also be securely anchored towards the top, from where the load is applied in the implanted state.
  • a screw connection can be provided on a tibial plateau of a knee joint endoprosthesis.
  • the outer shell piece can be welded to the inner body.
  • it is preferably designed or manufactured unitarily with the inner body, in particular by means of an additive manufacturing process, such as, for example, 3D printing or selective laser sintering (SLS) or electron beam melting (EBM).
  • SLS selective laser sintering
  • EBM electron beam melting
  • the outer shell piece is expediently designed so that it merges at its upper end into the inner body, where the outer contour of the inner body is preferably retained.
  • the contour at the upper end of the augment is always the same, regardless of whether or how the outer shell is designed. This enables simplified use and, in particular, allows the surgeon to switch to another augment, for example one without an outer shell piece, even during the operation (intraoperatively).
  • the inner body can expediently be provided with a slot penetrating the wall from top to bottom.
  • the slot enables the augment to be compressed so that the outer circumference of the augment can be varied in this way.
  • the slot is preferably not open, but is formed by two mutually mutually overlapping tongues, between which a labyrinth-like free space is created. So an undesired passage of material, for example bone cement for fastening an endoprosthesis, through the wall of the augment can be prevented, since the free space functions as a labyrinth seal. Furthermore, the overlapping tongues enable length compensation so that the change in the outer circumference of the augment caused by compression can be compensated for.
  • outer shell pieces can also be provided. It applies to each of them that they are not designed to be circumferential and also do not completely enclose the inner body in their entirety. It also applies here that the outer shell pieces are only partially arranged in order to fill or close corresponding imperfections in the surrounding bone border. However, the multiple outer shell pieces do not necessarily have to be arranged in one plane, but can also be arranged at different heights, that is to say in different planes. This makes it possible to compensate for bone defects even in regions of the bone that are further away from the bone end.
  • the invention also relates to a method for Her provide an augment for a bone defect, in particular a tibial head augment for a knee joint endoprosthesis to summarize an inner body which is designed as a (regular or irregular) shaped sleeve, in particular a cone, for implantation on a End of an elongated bone, where the inner body comprises a channel extending from top to bottom through the sleeve for receiving a prosthesis shaft and a wall surrounding the channel, an outer side of the wall being designed as a bone contact surface on a bone border surrounding the inner body, with the steps: measuring one end of an elongated bone; Determining a bone defect in a bone border surrounding the augment; Determine an outer shell piece with a contour to fill in the bone defect; and manufacture a hybrid body comprising the augment and the outer shell piece, preferably by means of an additive method, in particular 3D printing, EBM or SLM. At least the outer shell piece is expediently produced with an oversize.
  • an additive method in particular
  • FIG. 1 is a schematic view showing an augment according to the present invention in connection with a knee joint endoprosthesis
  • FIGS. 2a, b show a frontal and lateral view of a first embodiment arranged in the knee joint for an augment according to the invention
  • Fig. 3 is a perspective view of the augment according to the first embodiment
  • 5a-c show a frontal, lateral and posterior view of the second embodiment arranged on the tibial bone
  • 6a-c show a frontal and two lateral views of a third embodiment arranged on the tibial bone; 7a, b computer-aided diagnostic images for bone degeneration at the knee joint;
  • FIG. 8a b show a lateral and frontal view of a computer simulation for an augment according to a fourth embodiment
  • FIG. 9a b perspective views of a manufactured
  • FIGS. 11a-c are perspective views of augments according to a fifth embodiment.
  • FIG. 12 is a front view of the fifth embodiment arranged on the tibial bone.
  • the invention is explained below with reference to an example for an augment for a knee joint endoprosthesis, more precisely for an augment arranged on the proximal head of the tibia.
  • the augment is to be distinguished from the prosthesis, i.e. the augment is not an element of the actual prosthesis.
  • the augment strengthens the bone and thus increases or improves its capacity for the prosthesis.
  • He inventive augments can of course also be provided on their bones.
  • Figure 1 shows a schematic view of a knee joint end prosthesis, which is characterized in its entirety with the reference number 9 be. It comprises a femoral component 91 to be arranged on the femur bone (not shown) and a tibial component to be arranged on the proximal end of a tibial bone 99, which has a tibial plateau 93 with a bearing piece 92 arranged thereon and a distally protruding shaft 94 with ribs 94 ' Includes attachment. Also shown is a Augment according to the invention, which is designated in its entirety with the reference number 1.
  • the tibial bone 99 is referred to as the tibial head 98 and has a bone border 97 surrounding the augment 1, more precisely at least the inner body 2, like a girdle.
  • FIGS. 2a, b show a view from the front (FIG. 2a) and from the side (FIG. 2b).
  • FIGS. 2a, b show a view from the front (FIG. 2a) and from the side (FIG. 2b).
  • the tibial component of the knee joint endoprosthesis 9 inserted on the tibial head 98 can be seen, the tibial plateau 93 with the bearing piece 92 resting on the top of the tibial head.
  • the shaft 94 of the knee joint endoprosthesis 9 protrudes downwards, the distal part of which can be seen in the illustration by a cutout.
  • the tibial head 98 In the frontal view, the tibial head 98 essentially surrounds the augment 1, in particular its inner body 2, to the extent that this largely corresponds to the desired normal condition. However, the actual defect can be seen in the late ral view, as shown in Fig. 2b. It can be clearly seen there that the tibial head 98 lacks a considerable portion of the bone border 97, so that a bone window 96 of considerable size is present. At this point, the inner body 2 of the augment, unlike at the other points, is not surrounded by the bone border 97 and is therefore not fully sunk into the tibial head, but would be accessible from the outside. However, as already explained in the introduction to the description, this is undesirable.
  • the augment according to the invention provided with an outer shell piece 3, which is positioned and dimensioned so that it is arranged exactly in the area of the bone window 96 and fills this.
  • FIG. 2b where the outer shell piece 3 fills the bone window 96 formed by the bone defect on the tibial head 98.
  • the bone border 97 is thus practically completed again.
  • the inner body 2 lies protected within the tibial head 98, specifically in the bone quiver formed there.
  • FIG. 3 A perspective view of this augment 1 is shown in FIG. 3.
  • the inner body 2 can be seen, of which part of the outer circumference is covered by the outer shell piece 3.
  • the inner body 2 has a porous surface design 20, while the outer shell piece 3 has a continuous, solid (ie non-porous) surface design 30 .
  • the surface design 30 is smooth, but more number of anchoring grooves 4 are provided for better attachment, which are arranged in parallel in the hori zontal direction for receiving cerclage wires (not shown).
  • the outer shell piece 3 does not cover the entire outer circumference of the inner body 2, but only partially covers a defined point.
  • the outer shell piece 3 has a saddle 32 at its lower end. This is designed to connect at the lower end of the bone window 96 to the tibial bone 99 present there, more precisely to the hard outer cortical bone area of the tibial bone 99, which is well suited for load transfer.
  • the outer shell piece 3 according to the invention not only is the bone window 96 closed in the bone border 97, that is to say the covering function is restored, but it can also an improved power transmission into the tibial head 98 takes place, so that a supporting function is also achieved. A sagging is prevented.
  • transitions between the inner body 2 with its porous surface design 20 and the outer shell piece 3 are, as can also be clearly seen in FIG. 3, rounded. This avoids irritation of the surrounding tissue and also acts as a tolerance compensation in order to achieve a better closure of the bone window 96.
  • the augment 1 is provided with a cutout 14. This is designed to create sufficient free space for inserting the shaft 94 in the event of an off-center position of the shaft 94 of the endoprosthesis, and thus to avoid a collision between the shaft 94 and the lower portion of the augment 1.
  • the outer shell piece 3 merges into a cover plate 5 common to the inner body 2, which is essentially closed except for a large opening for access to the channel 10 in the inner body 2 through which the shaft 94 of the tibial Component of the knee joint endoprosthesis 9 is inserted.
  • the cover plate 5 has a receptacle for a screw fastening 50 with which the outer shell piece 3 can optionally be screwed to the tibial plateau 93.
  • FIGS. 4 and 5 show a frontal and a lateral view of the second embodiment.
  • the inner body 2, which is narrow in cross section, is clearly seen, which is partially covered by an outer shell piece 3 ′ extending over part of its outer circumference like an apron.
  • the surface design of the outer shell piece 3 ' is also like already in the first embodiment, made solid, with anchoring grooves 4 arranged thereon for cerclage wires.
  • additional openings 40 are provided, which act as receptacles for further fastening means, in particular wires. A further increase in the fastening security and the positioning accuracy can thus be achieved.
  • the additional openings 40 form anchoring points to which suture materials can be attached to fix muscles and / or tendons.
  • the design of the shape of the outer shell piece 3 ′ depends on the bone window 96 on the tibial head 98 to be filled.
  • the outside of the outer shell piece 3 ' can extend beyond the actual bone window 96, so that an even better covering effect results.
  • FIG. 6a-c A third embodiment is shown in Fig. 6a-c.
  • the frontal and a lateral view according to FIGS. 6a and 6b essentially correspond to FIGS. 5a and 5b.
  • a second outer shell piece 3 * is provided in the third embodiment, which is arranged in another (Namely lower) level.
  • Fig. 6 c shows a further lateral view.
  • This enables secondary bone defects, which can occur elsewhere, for example, such as the secondary bone defect 96 'further distal, to be treated with a suitable 3 * to cover outer shell piece.
  • the scope of the invention is thus expanded considerably, since the invention is therefore also suitable for implantation in the case of severe or multiple bone defects.
  • a large-area bone defect 96 ′′ can be seen at the tibial head 98 in FIG. 7b. This is to be treated.
  • the positioning and dimensions of the bone defect 96 ′′ are determined and from this it is determined how the outer shell piece 3 of an inventive eye is made must be in order to cover or fill this bone defect and a bone window formed thereby. This is usually done first as part of a computer-aided generation of the relevant information. These are visualized in FIGS. 8a and 8b. You can see the Aug ment with its inner body 2 and the outer shell piece 3 in a computer simulation, the outer shell piece 3 is positioned and dimensioned to cover the bone defect 96 ′′.
  • FIG. 9 b shows a view into the channel 10 of the inner body 2, which is intended to receive the shaft 94. In the left-hand area of FIG.
  • the outer shell piece 3 arranged on the lateral side can be seen, as determined in computer diagnostics (compare FIGS. 7b and 8a).
  • anchoring grooves 4 for Cercla wires are angeord net.
  • the outer shell piece is therefore custom-made for the special bone defects and anatomical conditions of the exact knee that was measured. In this way, the patient receives optimal care, even and especially for difficult indications, where, due to the bone defects, it was difficult or impossible to carry out a supply with conventional augments.
  • step 101 there is a measurement of the affected bone or joint in step 101, as shown in FIGS. 7a and 7b.
  • step 102 there is a determination of a bone end defect in the bone border surrounding the augment, whereupon it is determined in step 103 how the outer shell piece 3 must be made and what contour and positioning it should have to cover the bone defect. If this has been determined, the corresponding data are finally output in step 104 to a control unit for a additive manufacturing process, which ultimately leads to
  • Step 105 a corresponding augment is produced.
  • FIGS. 11a-c and 12 A fifth embodiment is shown in FIGS. 11a-c and 12. This embodiment differs from the others essentially in that the wall for creating a large cavity 10 is made particularly thin and a vertical slot 6 runs through the wall of the inner body 2, as can be seen in the perspective view according to FIG. 11b . If the outer shell piece 3 is also arranged in the region of the slot, the slot 6 also extends into this.
  • the slot 6 is not open out leads, but is formed by two oppositely overlapping tongues 61, 62, between which a labyrintharti ger free space 60 is created.
  • the slot 6 functions as a kind of labyrinth seal and thus acts as a barrier against undesired passage of material through the slot 6, for example cement used in the channel 10 to fix the prosthesis shaft 94 (not shown in FIGS. 11, 12) the tibial bone 99.
  • the outer circumference of the augment can be compressed so that it can also be inserted into a somewhat smaller bone quiver at the end of the bone.
  • An elastic design of the augments also offers the advantage that, as a result of the elastic restoring force, the surrounding bone tissue can be stimulated in a positive manner and thus stimulated to bone formation.
  • the channel 10 is made wide in such a way that the inner body 2 only has a relatively thin wall. This means that there is a lot of space available for receiving a prosthesis shaft 94, also with regard to a polyaxial mounting of the prosthesis shaft 94 (not shown in FIG. 12) in the bone 9.
  • both the aspect of the thin wall as well as the aspect of the slot 6 are not limited to the fifth embodiment, but can also be provided individually or jointly in other embodiments, including the previous first to fourth embodiment. Otherwise, the fifth embodiment essentially corresponds to the previous embodiments, so that a further detailed explanation can be dispensed with.

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

Abstract

La présente invention concerne une pièce d'augmentation pour un défaut osseux, en particulier une pièce d'augmentation de plateau tibial pour une endoprothèse du genou. Elle comprend un corps intérieur (2) en forme de manchon afin d'être implantée sur une extrémité d'un os long (99). Une surface extérieure du corps intérieur (2) est formée comme une surface de butée osseuse (20) contre le bord osseux (97) environnant. Selon l'invention, une pièce d'enveloppe extérieure (3) est prévue, laquelle est doublée comme une pièce de remplacement de l'os à l'extérieur du corps intérieur (2) pour combler un défaut au niveau du bord osseux (97) cortical et qui n'est pas dimensionnée circonférentiellement de manière à ne couvrir qu'une partie de la circonférence extérieure du corps intérieur (2) dans la direction circonférentielle. La pièce d'enveloppe extérieure (3) doublée forme une pièce de comblement pour un défaut osseux (fenêtre osseuse 96) à l'extrémité de l'os. Une fermeture de la fenêtre osseuse (96) est obtenue et un contact indésirable de la pièce d'augmentation avec les tissus mous environnants est évité. En outre, la pièce d'augmentation est donc également soutenue dans la zone de la fenêtre osseuse (96). Les parties encore présentes du bord osseux (97) peuvent être ainsi conservées, ce qui permet de préserver au maximum la substance osseuse naturellement présente.
EP20742748.5A 2019-07-24 2020-07-23 Combinaison d'une pièce d'augmentation et d'une pièce de remplacement pour combler un défaut osseux Pending EP4003238A1 (fr)

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EP19188179 2019-07-24
PCT/EP2020/070791 WO2021013923A1 (fr) 2019-07-24 2020-07-23 Combinaison d'une pièce d'augmentation et d'une pièce de remplacement pour combler un défaut osseux

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AU2022314046A1 (en) * 2021-07-20 2024-03-07 Paragon 28, Inc. Implant augmentation systems and methods of use
EP4268771B1 (fr) * 2022-04-25 2024-04-10 Heraeus Medical GmbH Dispositif d'augmentation et procédé d'ajustement d'un dispositif d'augmentation
WO2024047127A1 (fr) * 2022-08-30 2024-03-07 Waldemar Link Gmbh & Co. Kg Implant médical, en particulier augmentation conique
CN116211549A (zh) * 2023-02-02 2023-06-06 安徽省公共卫生临床中心(安徽省传染病医院) 一种股骨假体及使用方法

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US7842093B2 (en) * 2006-07-18 2010-11-30 Biomet Manufacturing Corp. Method and apparatus for a knee implant
FR2989568B1 (fr) * 2012-04-19 2014-09-05 Teknimed Implant espaceur de remplacement temporaire d'une prothese de genou
US9532879B2 (en) * 2012-09-20 2017-01-03 Depuy Ireland Unlimited Company Femoral knee prosthesis system with augments and multiple lengths of sleeves sharing a common geometry
US9668873B2 (en) * 2013-03-08 2017-06-06 Biomet Manufacturing, Llc Modular glenoid base plate with augments
US10149763B2 (en) * 2015-01-12 2018-12-11 Howmedica Osteonics Corp. Multipurpose void filling prosthesis
MX2018000004A (es) * 2015-07-09 2018-01-24 Link Waldemar Gmbh Co Dispositivo de aumento de la funda para una junta articulada.
US10603180B2 (en) * 2017-07-17 2020-03-31 Aaron MARLOW Tapered fixation device for a knee replacement
WO2019046579A1 (fr) * 2017-08-31 2019-03-07 Smith & Nephew, Inc. Augmentation peropératoire d'implant
CN108618837A (zh) * 2018-05-30 2018-10-09 上海交通大学医学院附属第九人民医院 个体化骨缺损填充用金属内固定器、其制备方法及用途

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