ES2278028T3 - Endoprotesis de articulacion tibiotarsiana. - Google Patents
Endoprotesis de articulacion tibiotarsiana. Download PDFInfo
- Publication number
- ES2278028T3 ES2278028T3 ES02732467T ES02732467T ES2278028T3 ES 2278028 T3 ES2278028 T3 ES 2278028T3 ES 02732467 T ES02732467 T ES 02732467T ES 02732467 T ES02732467 T ES 02732467T ES 2278028 T3 ES2278028 T3 ES 2278028T3
- Authority
- ES
- Spain
- Prior art keywords
- component
- forms
- intermediate piece
- tibia
- sliding surfaces
- 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.)
- Expired - Lifetime
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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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- 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
-
- 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
- A61F2310/00179—Ceramics or ceramic-like structures
Abstract
Endoprótesis de sustitución de la articulación tibiotarsiana, que está constituida por un componente (4) que se ha de unir con el astrágalo (2) y que forma una superficie de deslizamiento cilíndrica (10) del lado superior, un componente (3) que se ha de unir con la tibia (1) y que forma una superficie de deslizamiento (7) del lado inferior, y una pieza intermedia (5) que forma dos superficies de deslizamiento (15, 16) que cooperan con las superficies de deslizamiento (7, 10) de los componentes antes citados de tal manera que queda fijada su dirección frontal, caracterizada porque la pieza intermedia (5) es de forma de cuña en el plano frontal.
Description
Endoprótesis de articulación tibiotarsiana.
Se conoce como sustitutivo de la articulación
tibiotarsiana una endoprótesis que está constituida por un
componente que se ha de unir con el astrágalo, un componente que se
ha de unir con la tibia y una pieza intermedia (documento
DE-U-8812806; folleto ``LINK
S.T.A.R. Totale Sprunggelenkprothese [H. Kofoed] de la compañía
Waldemar Link (GmbH & Co.), Hamburgo). El componente de
astrágalo y la pieza intermedia cooperan a través de superficies de
deslizamiento cilíndricas que facilitan la flexión y la extensión en
el plano sagital. El componente de tibia y la pieza intermedia
forman superficies de deslizamiento cooperantes que permiten una
rotación alrededor del eje vertical. Pueden ser de construcción
plana para hacer posibles movimientos de compensación en dirección
AP y LM. La estabilización se efectúa por medio del ligamento
natural.
En la prótesis conocida las superficies de
deslizamiento de los lados superior e inferior de la pieza
intermedia están orientadas paralelas una a otra en el plano
frontal. Esto es consecuente debido a que las superficies de
deslizamiento naturales del astrágalo y de la tibia deberán ser
sustituidas por las superficies de deslizamiento protésicas, sin
que esté ligada a esto una variación direccional. Sin embargo, se ha
visto que no es raro que los ligamentos laterales y mediales de la
articulación presenten una tensión diferente después de la
operación, de lo que pueden resultar molestias.
La invención hace posible evitar esta falta de
equilibrio proporcionando una pieza intermedia que está configurada
en forma de cuña en el plano frontal. Los ejes de dirección de las
superficies de deslizamiento situados en el plano frontal no corren
paralelos uno a otro, sino bajo un ángulo que está comprendido
normalmente entre 1º y 12º. Según las condiciones previamente
encontradas, el médico puede determinar si y qué ángulo desea
prever entre los ejes de articulación mediante una selección de la
pieza intermedia adecuada. Esto puede efectuarse eventualmente
también por vía intraoperativa.
Se conoce ciertamente una endoprótesis de
articulación tibiotarsiana (documento
EP-A-1097680) en la que las
superficies de deslizamiento situadas entre el componente de
astrágalo y la pieza intermedia forman partes de una superficie
cónica. Sin embargo, no se desprende de esto el modo en que están
colocadas estas superficies de deslizamiento en el plano
frontal.
Para que la pieza intermedia permanezca
correctamente orientada con respecto a su forma de cuña, se fija su
orientación convenientemente de manera forzosa desde el astrágalo o
desde la tibia haciendo que los pares de superficies de
deslizamiento cooperantes estén construidos correspondientemente de
manera que determinen la dirección. Es adecuada para ello
especialmente la articulación entre el astrágalo y la pieza
intermedia.
La patente
FR-A-2676917 revela una endoprótesis
de articulación tibiotarsiana con piezas intermedias diferentes.
Se explica seguidamente la invención con más
detalle haciendo referencia al dibujo, que ilustra un ejemplo de
realización ventajoso. Muestran:
La figura 1, una sección sagital a través de la
articulación equipada con la prótesis,
La figura 2, la prótesis desplegada en abanico y
vista en perspectiva,
La figura 3, una sección frontal a través de la
pieza intermedia y
La figura 4, una vista en perspectiva de la
disposición de los huesos y partes de prótesis correspondientes
antes de la instalación de la pieza intermedia.
Entre la tibia 1 y el astrágalo 2 hay que
disponer la prótesis, la cual está constituida por el componente de
tibia 3, el componente de astrágalo 4 y la pieza intermedia 5. El
componente de tibia 3 presenta una parte 6 de forma de placa cuyo
lado inferior 7 forma una superficie de deslizamiento plana. Unos
salientes 8 sirven para la fijación en rebajos de resección
correspondientes 9 de la tibia 1.
El componente de astrágalo 4 forma una
superficie de deslizamiento 10 abombada en forma convexa, la cual es
de configuración cilíndrica. Lleva un nervio 11 que está situado en
la dirección del movimiento relativo de la pieza intermedia durante
los movimientos de flexión y extensión. Asimismo, el componente de
astrágalo presenta unas facetas laterales 12 destinadas a cooperar
con superficies de deslizamiento correspondientes de la tibia 1 y
del peroné 13.
La pieza intermedia 5 posee un lado superior
plano 15 conjugado de la superficie de deslizamiento 7 y una
superficie de deslizamiento 16 del lado inferior que está formada de
manera congruente con la superficie de deslizamiento 10 del
componente de astrágalo 4. Contiene una ranura 17 destinada a
recibir el nervio 11. La pieza intermedia 5 es guiada así
lateralmente con relación al componente de astrágalo 4. Le son
permitidos solamente movimientos de flexión y extensión.
\newpage
Los componentes 3 y 4 están constituidos
convenientemente por metal y la pieza intermedia 5 es de un plástico
favorable para el deslizamiento, tal como polietileno. Sin embargo,
se pueden emplear también otros materiales con resistencia y
capacidad de deslizamiento suficientes, por ejemplo cerámica.
Como consecuencia de la forma congruente de las
superficies de deslizamiento 10 y 16, y debido también al nervio 11
en cooperación con la ranura 17, la pieza intermedia 5 no puede
girar alrededor del eje vertical con respecto al componente de
astrágalo 4. Por tanto, su orientación está fijada por la del
componente de astrágalo. Aunque la forma de realización mostrada
excluye por completo tales movimientos de rotación, son imaginables
también realizaciones en las que estos son inhibidos únicamente por
la configuración de las superficies de deslizamiento, para lo cual
éstas están configuradas, por ejemplo, en forma elipsoidal.
En la sección frontal según la Figura 3 la pieza
intermedia está configurada en forma de cuña. Su superficie de
deslizamiento superior 15 encierra con la dirección de la superficie
de deslizamiento inferior 16 un ángulo de cuña 18 que está
comprendido preferiblemente entre 1º y 12º. En la mayoría de los
casos, este ángulo está entre 3º y 8º.
Tan pronto como el cirujano, según se muestra en
la figura 4, ha implantado el componente de tibia 3 y el componente
de astrágalo 4, puede determinar por medio de instrumentos adecuados
si sus superficies de deslizamiento 7 y 10, respectivamente, en
dirección LM discurren paralelas o en ángulo una con otra cuando
están tensados los ligamentos laterales. En correspondencia con
esto, el cirujano selecciona una pieza intermedia adecuada 5.
Claims (5)
1. Endoprótesis de sustitución de la
articulación tibiotarsiana, que está constituida por un componente
(4) que se ha de unir con el astrágalo (2) y que forma una
superficie de deslizamiento cilíndrica (10) del lado superior, un
componente (3) que se ha de unir con la tibia (1) y que forma una
superficie de deslizamiento (7) del lado inferior, y una pieza
intermedia (5) que forma dos superficies de deslizamiento (15, 16)
que cooperan con las superficies de deslizamiento (7, 10) de los
componentes antes citados de tal manera que queda fijada su
dirección frontal, caracterizada porque la pieza intermedia
(5) es de forma de cuña en el plano frontal.
2. Endoprótesis de sustitución de la
articulación tibiotarsiana según la reivindicación 1,
caracterizada porque las superficies de deslizamiento (10,
16) cooperantes en el componente de astrágalo (4) y en la pieza
intermedia (5) cooperan sustancialmente de forma no rotativa con
respecto al eje vertical.
3. Endoprótesis según la reivindicación 1,
caracterizada porque las superficies de deslizamiento (7, 15)
cooperantes en el componente de tibia (4) y en la pieza intermedia
(5) cooperan de forma rotativa con respecto al eje vertical.
4. Endoprótesis según una de las
reivindicaciones 1 a 3, caracterizada porque el ángulo de
cuña (18) está comprendido entre 1º y 12º.
5. Sistema de endoprótesis de sustitución de la
articulación tibiotarsiana que están constituidas por un componente
(4) que se ha de unir con el astrágalo (2) y que forma una
superficie de deslizamiento (10) del lado superior, un componente
(3) que se ha de unir con la tibia (1) y que forma una superficie de
deslizamiento (7) del lado inferior, y una pieza intermedia (5) que
forma dos superficies de deslizamiento (15, 16) que cooperan con
las superficies de deslizamiento de los componentes antes citados de
tal manera que queda fijada su dirección frontal,
caracterizado porque están disponibles piezas intermedias
diferentes que presentan en sección frontal ángulos de cuña
diferentes entre la superficie de deslizamiento superior (15) y la
superficie de deslizamiento inferior (16).
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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PCT/EP2002/002573 WO2003075802A1 (de) | 2002-03-08 | 2002-03-08 | Sprunggelenk-endoprothese |
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ES2278028T3 true ES2278028T3 (es) | 2007-08-01 |
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ES02732467T Expired - Lifetime ES2278028T3 (es) | 2002-03-08 | 2002-03-08 | Endoprotesis de articulacion tibiotarsiana. |
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JP (1) | JP4202268B2 (es) |
KR (1) | KR100764974B1 (es) |
CN (1) | CN1321621C (es) |
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MX (1) | MXPA04008723A (es) |
WO (1) | WO2003075802A1 (es) |
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2002
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- 2002-03-08 EP EP02732467A patent/EP1482874B1/de not_active Expired - Lifetime
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- 2002-03-08 CN CNB02828481XA patent/CN1321621C/zh not_active Expired - Fee Related
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EP1482874B1 (de) | 2007-01-03 |
AU2002304840A1 (en) | 2003-09-22 |
US20030181985A1 (en) | 2003-09-25 |
MXPA04008723A (es) | 2005-06-08 |
WO2003075802A1 (de) | 2003-09-18 |
JP2006503601A (ja) | 2006-02-02 |
CN1321621C (zh) | 2007-06-20 |
KR100764974B1 (ko) | 2007-10-08 |
JP4202268B2 (ja) | 2008-12-24 |
CN1622791A (zh) | 2005-06-01 |
DK1482874T3 (da) | 2007-04-02 |
AU2002304840B2 (en) | 2008-05-08 |
ATE349981T1 (de) | 2007-01-15 |
KR20050002845A (ko) | 2005-01-10 |
US6852130B2 (en) | 2005-02-08 |
BR0215631A (pt) | 2004-12-21 |
DE50209198D1 (de) | 2007-02-15 |
EP1482874A1 (de) | 2004-12-08 |
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