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FR2579454A1 - Glenohumeral prosthesis - Google Patents

Glenohumeral prosthesis Download PDF

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Publication number
FR2579454A1
FR2579454A1 FR8505198A FR8505198A FR2579454A1 FR 2579454 A1 FR2579454 A1 FR 2579454A1 FR 8505198 A FR8505198 A FR 8505198A FR 8505198 A FR8505198 A FR 8505198A FR 2579454 A1 FR2579454 A1 FR 2579454A1
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FR
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Patent type
Prior art keywords
element
spherical
glenoid
head
intended
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Withdrawn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
FR8505198A
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French (fr)
Original Assignee
Rambert Andre
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

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Threaded wires, pins or screws; Nuts therefor
    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
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    • A61F2/4059Humeral shafts
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
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    • A61F2/4081Glenoid components, e.g. cups
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
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    • A61F2002/30245Partial spheres
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
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    • A61F2002/3038Connections 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 made by pushing a key or a peg into a mating slot or hole
    • A61F2002/30382Connections 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 made by pushing a key or a peg into a mating slot or hole made by pushing lateral pegs into mating lateral slots or bores
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. at discrete positions
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
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    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/3079Stepped or enlarged apertures, e.g. having discrete diameter changes
    • A61F2002/30794Stepped or enlarged apertures, e.g. having discrete diameter changes the enlarged portion being used for receiving and hiding a screw head, a nut or a closing cap
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0071Three-dimensional shapes spherical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00017Iron- or Fe-based alloys, e.g. stainless steel

Abstract

This prosthesis comprises, on the one hand, a humeral element 2 comprising a head 7 in the shape of a spherical cap linked, through the centre of its internal face, to an anchoring rod 9 intended to be engaged and fixed in the medullary canal of the humerus 4, after resection of its head, and, on the other hand, a glenoid element 3 in the shape of a portion of a spherical cap intended to be applied, through its external convex face 3a, against the glenoid cavity 6, and whose internal concave face 3b, having the same radius as the spherical head 7 of the humeral element 2, is intended to act as a support therefor, means being provided in order to allow it to be fixed to the glenoid cavity 6. <IMAGE>

Description

"Prothèse glénohum & le" "Prosthetics & the glénohum"
La présente. The current. invention concerne une prothèse gléno-humérale, c'est-à-dire une prothèse destinée à restaurer l'articulation de l'épaule lorsque la cavité glénoldienne et la tête de l'humérus sont atteintes de manière irrécupérable, tandis que la coiffe qui surmonte cette articulation et s'oppose à tout déplacement de la tête de l'humérus vers le haut est réparable ou n'est pas atteinte. invention relates to a glenohumeral prosthesis, that is to say a prosthesis intended to restore the shoulder joint when the glénoldienne cavity and the head of the humerus suffer from unrecoverable manner, while the cap which overcomes this articulation and opposes any displacement of the humeral head upwards is repairable or not reached.

Cette prothèse comprend, en combinaison, d'une part un élément huméral comportant une tête en forme de calotte sphérique liée, par le centre de sa face interne, à une tige d'ancrage destinée à être engagée et fixée dans le canal médullaire de l'humérus, après résection de sa tête et, d'autre part, un élément glénoidien en forme de segment de calotte sphérique destiné à être appliqué, par sa face externe convexe, contre la cavité glénoldienne et dont la face interne concave, de même rayon que la tête sphérique de l'élément huméral, est destinée à lui servir d'appui, des moyens étant prévus pour permettre sa fixation à la cavité glénoldienne. This prosthesis comprises, in combination, firstly a humeral component having a spherical segment-shaped head linked through the center of its internal face to an anchoring rod intended to be engaged and fixed in the medullary canal of humerus after resection of the head and, on the other hand, a spherical cap segment shaped glenoid element to be applied, with its convex external face, against the glénoldienne cavity and the concave inner face of the same radius that the spherical head of the humeral element, is intended to serve as a bearing surface, means being provided to enable its attachment to the glénoldienne cavity.

Suivant une forme d'exécution simple de l'invention, les moyens pour la fixation de l'élément glénoidien à la cavité glénoidienne comprennent, essentiellement, deux pattes latérales externes percées, sensiblement parallèles l'une à l'autre et rattachées à sa face externe, à proximité de son sommet, de manière à pouvoir embrasser l'épaisseur de l'omoplate, de part et d'autre de la partie inférieure de la cavité glénoldienne et lui être fixées par des vis. According to a simple embodiment of the invention, the means for fixing the glenoid element to the glenoid cavity comprise essentially two outer side flaps drilled substantially parallel to one another and attached at its opposite externally, near its apex, so as to embrace the thickness of the blade, on either side of the lower part of the cavity and glénoldienne be it fixed by screws.

Pour améliorer la tenue de l'élément glénoidien dans la cavité glénoîdienne, ces moyens de fixation peuvent comprendre, en outre, un pion radial externe engageable dans l'alésage d'une douille filetée extérieurement et destinée à être vissée dans un trou préalablement foré dans le fond de la cavité glénoldienne. To improve the holding of the glenoid element to the glenoid cavity, the attachment means may further comprise an external radial pin engageable in the bore of an externally threaded sleeve and intended to be screwed into a previously drilled hole in the bottom of the cavity glénoldienne.

Ce pion radial et l'alésage de la douille qui lui sert de logement peuvent être cylindriques, mais pour améliorer encore la tenue de l'élément glénoldien, ils sont avantageusement tronconiques de pentes complémentaires, permettant leur liaison par coincement réciproque en fin d'engagement de l'un dans l'autre. This radial pin and the bore of the sleeve which serves as a housing may be cylindrical, but to further enhance the holding of the glénoldien element, they are preferably tapered complementary slopes, allowing their reciprocal connection by clamping the end of engagement from one into the other.

Par ailleurs, de préférence, pour faciliter sa mise en place, le filetage externe de la douille est conique, la fente radiale pour son vissage à l'aide d'un tournevis étant aménagée à son extrémité de grand diamètre. Moreover, preferably, to facilitate its implementation, the external thread of the sleeve is tapered, the radial slot for screwing with a screwdriver is fitted at its large diameter end.

Pour faciliter la mise en place de l'élément huméral et permettre sa fixation sans recours. To facilitate the implementation of the humeral component and allow fixing without recourse. a un ciment, sa tige d'ancrage porte un filetage externe conique- et la tête humérale lui est fixée de manière amovible et de manière à permettre le réglage de leur position angulaire relative. a cement, its anchoring rod has an external thread conically and the humeral head is attached thereto detachably and so as to allow adjustment of their relative angular position.

En effet, la position angulaire de la tige d'ancrage en fin de vissage dans le canal médullaire de l'humérus ne pouvant pas être préétablie, il est bien évidemment nécessaire de pouvoir régler la position angulaire désirée de la tête humérale indépendamment de celle de sa tige d'ancrage. Indeed, the angular position of the anchor rod at the end of screwing into the medullary canal of the humerus can not be predetermined, it is obviously necessary to be able to adjust the desired angular position of the humeral head independently of that of its anchoring rod.

Suivant une forme d'exécution préférée de l'invention, les moyens de fixation amovible de la tête sphérique de l'élément huméral à sa tige d'ancrage et de réglage de leur position angulaire relative comprennent, ménagés sur leurs faces d'assemblage, elles-mêmes aménagées, respectivement, au pied d'une embase de la tête sphérique et au sommet de la tige d'ancrage, un puits tronconique et un bossage ou pion tronconique, de pentes complémentaires, aptes à s'engager l'un dans l'autre, dans la position angulaire relative désirée et à permettre leur liaison par coincement en fin d'engagement. According to a preferred embodiment of the invention, the removable fixing means of the spherical head of the humeral component to the anchor rod and adjusting their relative angular position comprise, arranged on their assembly faces, themselves arranged, respectively, at the foot of a base of the spherical head and the top of the anchor rod, a conical well and a frustoconical boss or peg, complementary slopes, suitable for engaging one in the other, in the desired relative angular position and to allow their connection by clamping the end of engagement.

De préférence, le bossage tronconique est prévu à l'extrémité supérieure de la tige d'ancrage et le puits tronconique est ménagé dans l'embase de la tête sphérique. Preferably, the frustoconical boss is provided at the upper end of the anchor rod and the frustum-well is formed in the base of the spherical head. Cette disposition permet en effet d'améliorer la tenue de l'assemblage de la tête humérale à sa tige d'ancrage, en complétant leurs moyens de liaison. This arrangement makes it possible to improve the strength of the assembly of the humeral head to its anchoring rod, completing their connecting means. En effet, dans ce cas, ces moyens peuvent comprendre, en outre, un trou traversant ménagé coaxialement dans le fond du puits tronconique, un trou taraudé ménagé coaxialement dans le bossage tronconique et une vis d'assemblage vissable dans le trou taraudé après avoir traversé le trou traversant du puits tronconique, le diamètre de la tête de cette vis étant supérieur à celui du trou traversant du puits tronconique. Indeed, in this case, such means may comprise, moreover, a through hole formed coaxially in the bottom of the tapered wells, a coaxially arranged threaded hole in the frusto-conical boss and a cap screw screwed into the tapped hole after passing through the through hole of the tapered wells, the diameter of the head of this screw being greater than that of the through hole of the tapered wells.

Cette vis garantit donc la tenue de l'assemblage. This screw thus guarantees the strength of the assembly.

Dans ce cas, si nécessaire, la calotte sphérique de la tête humérale présente une échancrure pour le passage et la mise en place de la vis d'assemblage. In this case, if necessary, the spherical cap of the humeral head has a recess for the passage and the introduction of the screw assembly.

Suivant une forme d'exécution simple de l'invention, les moyens permettant le réglage de la position angulaire relative de la tête sphéri que de l'élément huméral et de sa tige d'ancrage comprennent, d'une part, une rangée circulaire de trous cylindriques ménagée concentriquement au bossage tronconique, dans la face d'appui de l'extrémité supérieure de la tige d'ancrage et, d'autre part, au moins un ergot cylindrique de même diamètre que les trous précités, prévu en saillie sur la partie de la face d'appui de l'embase de la tête sphérique entourant le puits tronconique et apte à être engagé dans l'un choisi des trous de la rangée circulaire précitée. According to a simple embodiment of the invention, the means for adjusting the relative angular position of the head Spheri that of the humeral element and its anchoring rod comprise, on the one hand, a circular row of cylindrical holes concentrically arranged in the frustoconical boss in the bearing face of the upper end of the anchor rod and, secondly, at least one cylindrical pin of the same diameter as said holes, provided in projection on the part of the bearing face of the base of the spherical head surrounding the frusto-conical wells and adapted to be engaged in a selected one of the holes of said circular array.

Suivant une forme d'exécution préférée de l'invention, la tête humérale est en un métal inaltérable et bio-compatible, tel qu'en acier inoxydable, la face interne concave du segment sphérique constituant l'élément glénoldien est recouverte d'un revêtement en une matière relativement souple et présentant un faible coefficient de frottement par rapport à l'acier. According to a preferred embodiment of the invention, the humeral head is in a stable metal and biocompatible, such as stainless steel, the concave inner side of the spherical segment forming the glénoldien element is covered with a coating a relatively flexible material and having a low coefficient of friction with respect to steel. Ce revêtement peut, par exemple, être réalisé en une matière plastique telle qu'un polyamide ou autre similaire. This coating may, for example, be made of a plastic material such as polyamide or the like.

De toute façon, l'invention sera bien comprise à l'aide de la description qui suit, en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme d'exécution de cette prothèse Anyway, the invention will be better understood using the following description, in reference to the accompanying drawings showing by way of example, one embodiment of this prosthesis
Figure 1 en est une vue en perspective montrant les deux éléments de cette prothèse fixés sur leur os respectif, en position écartée Figure 1 is a perspective view showing the two elements of the prosthesis attached to their respective bones, in the separated position
Figure 2 est une vue en coupe axiale de la prothèse mise en place Figure 2 is a view in axial section of the prosthesis establishment
Figure 3 est une vue en plan par-dessus de la tige d'ancrage de l'élément huméral. Figure 3 is a plan top view of the anchor rod of the humeral element.

Cette prothèse est destinée à être utilisée pour une articulation de l'épaule lorsque la tête humérale et la cavité glénoldienne, trop atteintes, sont irréparables, la coiffe étant elle-même réparable ou pas atteinte. This prosthesis is intended to be used for a shoulder joint when the humeral head and the glénoldienne cavity, with too are irreparable, the cap itself being repairable or not reached.

Comme le montre plus spécialement la figure 1, cette prothèse comprend un élément huméral (2) et un élément glénoidien (3). As more specifically shown in Figure 1, this prosthesis comprising a humeral element (2) and a glenoid element (3). L'élément huméral (2) est destiné à être fixé dans l'extrémité supérieure, préalablement réséquée et forée, d'un humérus (4), tandis que l'élément glénoldien (3) est destiné à être fixé contre l'omoplate (5) de manière à recouvrir et remplacer sa cavité glénoidienne (6). The humeral element (2) is intended to be fixed in the upper end, previously resected and drilled, a humerus (4), while the glénoldien element (3) is intended to be attached against the scapula ( 5) so as to cover and replace the glenoid cavity (6).

L'élément huméral (2) comprend une tête (7) en forme de calotte sphérique portée, par le centre de sa face interne, par une embase (8) liée de manière amovible et de manière à permettre le réglage de sa position angulaire à une tige d'ancrage (9) destinée à être enfoncée et fixée dans le canal médullaire (4a) de l'humérus (4). The humeral element (2) comprises a head (7) in the form of a spherical cap reach, through the center of its inner face, by a base (8) connected removably and so as to allow adjustment of its angular position an anchor rod (9) to be pressed and fixed into the medullary canal (4a) of the humerus (4).

Dans l'exemple illustré sur le dessin, pour permettre la liaison amovible de la tête sphérique (7) et de son embase (8) à la tige (9) avec la position angulaire souhaitée, comme le montre la figure 2, l'embase (8) et la tige (9) présentent des surfaces annulaires d'appui, respectivement (8a) et (9a). In the example illustrated in the drawing, to allow the detachable connection of the spherical head (7) and its base (8) to the shaft (9) with the desired angular position, as shown in Figure 2, the base (8) and the rod (9) have annular bearing surfaces, respectively (8a) and (9a). perpendiculaires à l'axe de révolution (11) de la tige (9) et, en outre, d'une part, l'embase (8) présente, au centre de sa surface d'appui (8a), un puits tronconique (12) et, d'autre part, la tige (9) porte, au centre de sa surface d'appui (9a), un pion tronconique (13) de profil complémentaire de celui du puits (12) et apte à s'engager dans ce dernier de manière à obtenir, en fin d'engagement, une liaison par coincement entre la tige (9) et l'embase (8) et, par conséquent, la tête sphérique (7). perpendicular to the axis of revolution (11) of the rod (9) and, further, on the one hand, the base (8) has, at the center of its bearing surface (8a), a conical well ( 12) and, on the other hand, the rod (9) carries, in the center of its supporting surface (9a), a tapered pin (13) of profile complementary to that of the well (12) and adapted to engage in the latter so as to obtain, at the end of engagement, bonding by wedging between the rod (9) and the base (8) and, therefore, the spherical head (7).

Par ailleurs, la tige d'ancrage (9) de l'élément huméral (2) dans l'humérus (4) porte un filetage extérieur (9b) tronconique permettant sa fixation dans le canal médullaire (4a) de l'humérus (4) par vissage, la conicité du filetage (9b) ayant pour effet de permettre un engagement beaucoup plus rapide de la tige (9) dans le canal médullaire (4a). Furthermore, the anchor rod (9) of the humeral element (2) into the humerus (4) carries an external thread (9b) tapered for fixing it into the medullary cavity (4a) of the humerus (4 ) by screwing, the taper of the thread (9b) having the effect of allowing a much faster engagement of the rod (9) in the medullary canal (4a).

On peut remarquer que la fixation de la tige (9) dans le canal médullaire (4a) par vissage rend indispensable les possibilités de réglage de la position angulaire de la tête sphérique (7) et de son embase (8) par rapport à la tige (9) puisqu'il est évidemment impossible de connaître la position angulaire de cette dernière en fin de vissage. It may be noted that the fixing of the rod (9) in the medullary canal (4a) by screwing makes necessary the setting possibilities of the angular position of the spherical head (7) and its base (8) relative to the rod (9) since it is obviously impossible to know the angular position of the latter at the end of screwing.

La fixation de la tige (9) dans le canal médullaire (4a) par vissage présente évidemment l'avantage d'éliminer toute nécessité d'emploi d'un ciment ou autre produit de scellement. Fixing the rod (9) in the medullary canal (4a) by screwing has the obvious advantage of eliminating any requirement for the use of cement or other sealant.

Pour améliorer la tenue de l'assemblage de la tête sphérique (7) à la tige (9), comme le montre la figure (2), d'une part, l'embase (8) présente, dans le fond du puits (12), un trou traversant (14) coaxial à l'axe (11) du puits (12) et, d'autre part, le pion (13) présente un trou taraudé (15) coaxial à son axe (11). To improve the strength of the assembly of the spherical head (7) to the rod (9), as shown in Figure (2), on the one hand, the base (8) has, in the well bottom ( 12), a through hole (14) coaxial with the axis (11) of the well (12) and, secondly, the pin (13) has a threaded hole (15) coaxial to its axis (11).

Il est ainsi possible, après engagement du puits (12) sur le pion (13), de compléter l'assemblage de la tête sphérique (7) à la tige (9) par la mise en place, dans le trou taraudé (15), d'une vis (16) traversant le trou (14) et dont la tête (16a) possède un diamètre supérieur à celui du trou traversant (14). It is thus possible, after engagement of the well (12) on the pin (13), to complete the assembly of the spherical head (7) to the rod (9) by the introduction, into the threaded hole (15) , a screw (16) passing through the hole (14) and whose head (16a) has a larger diameter than the through hole (14).

Pour permettre l'engagement de la vis (12) dans le trou taraudé (15) après pré-assemblage de la tête (7) à la tige (9), la tête sphérique (7) présente, dans sa zone située au-dessus du trou traversant (14), une échancrure (17). To allow engagement of the screw (12) into the tapped hole (15) after pre-assembly of the head (7) to the rod (9), the spherical head (7) has in its region located above the through hole (14), an indentation (17).

Pour améliorer encore l'assemblage de la tête sphérique (7) à sa tige (9) en s'opposant à tout pivotement indésirable de la tête (9) autour de l'axe (11), la tige (9) demeurant elle-même immobile en rotation dans le canal médullaire (4a), il est prévu, comme le montre notamment la figure 3, une rangée circulaire de trous cylindriques (18) ménagés dans la face d'appui (9a) de la tige (9), concentriquement au pion tronconique (13). To further improve the assembly of the spherical head (7) at its shaft (9) in opposing any undesirable pivoting of the head (9) about the axis (11), the rod (9) itself residing even non-rotatably into the medullary canal (4a) is provided, as shown in particular in Figure 3, a circular array of cylindrical holes (18) formed in the bearing face (9a) of the rod (9), concentrically with the tapered pin (13).

il est aussi prévu, en saillie sur la face d'appui (8a) de l'embase (8), deux ergots cylindriques (19) aptes à s'engager dans l'un choisi des trous cylindriques (18). there is also provided, projecting from the support face (8a) of the base (8), two cylindrical lugs (19) adapted to engage in a selected one of cylindrical holes (18). A cet effet, l'ergot (19) a une forme complémentaire de celle des trous cylindriques (18). To this end, the lug (19) has a shape complementary to that of the cylindrical holes (18).

Il faut noter que les trous cylindriques (18) peuvent être utilisés pour l'entraînement en rotation de la tige (9) lors de son vissage dans le canal médullaire (4a) de l'humérus (4). It should be noted that the cylindrical holes (18) can be used for the rotational drive of the rod (9) when it is screwed into the medullary canal (4a) of the humerus (4).

Comme le montre les figures 1 et 2, l'élément glénoldien (3) se présente sous la forme d'un segment de calotte sphérique destiné à être fixée à l'omoplate (5) avec sa face externe convexe (3a) appliquée contre la cavité glénoldienne (6), tandis que sa face interne concave (3b) est destinée à recevoir et servir d'appui à la tête sphérique (7) de l'élément huméral. As shown in Figures 1 and 2, the glénoldien element (3) is in the form of a spherical cap segment for attachment to the scapula (5) with its convex external face (3a) applied against the glénoldienne cavity (6), while its concave internal face (3b) is designed to receive and serve as support for the spherical head (7) of the humeral element. A cet effet, la face interne concave (3b) de l'élément glénoidien (3) possède un rayon identique à celui de la tête sphérique (7) de l'élément huméral (2). To this end, the concave inner face (3b) of the glenoid element (3) has a radius identical to that of the spherical head (7) of the humeral element (2).

La fixation de l'élément glénoidien (3) à l'omoplate (5) est obtenue au moyen de deux pattes radiales externes (21) percées d'un trou (22), sensiblement parallèles l'une à l'autre et rattachées à la face externe convexe (3a) de l'élément (3), de manière à pouvoir embrase ser l'épaisseur de l'omoplate (5) de part et d'autre de la partie inférieure de la cavité glénoldienne (6) et lui être fixées par des vis (23) enfoncées dans cette partie de l'omoplate (5). Fixing the glenoid element (3) to the scapula (5) is obtained by means of two external radial lugs (21) pierced with a hole (22) substantially parallel to each other and attached to the convex outer face (3a) of the element (3), so as to be engulfed ser thickness of the scapula (5) on either side of the lower part of the glénoldienne cavity (6) and it be fixed by screws (23) pressed into this part of the scapula (5).

Cette fixation peut être améliorée, comme montré sur la figure 2, par l'engagement, dans l'alésage (24a) d'une douille filetée extérieure ment (24), préalablement vissée dans le fond de la cavité glénoidienne, d'un pion radial externe (25) porté par la face externe convexe (3a) de l'élément glénoidien (3). This attachment can be improved, as shown in Figure 2, by engagement in the bore (24a) of an outer threaded sleeve ment (24), previously screwed into the bottom of the glenoid cavity, a peg radially outer (25) carried by the convex outer face (3a) of the glenoid element (3).

De préférence, le pion (25) et l'alésage (24a) de la douille (24) sont tronconiques à faibles pentes, assurant une meilleure fixation de l'élément glénolclien par suite de leur coincement réciproque en fin d'engagement de l'un dans l'autre. Preferably, the pin (25) and the bore (24a) of the sleeve (24) are frustoconical with gentle slopes, ensuring better attachment of the glénolclien element as a result of their mutual wedging the end of engagement of the one inside the other.

Pour faciliter sa mise en place, le filetage externe de la douille (24) est conique, la fente radiale (24a) pour son vissage à l'aide d'un tournevis étant prévue à son extrémité de plus grand diamètre. To facilitate its implementation, the external thread of the sleeve (24) is tapered, the radial slot (24a) for screwing with a screwdriver is provided at its end of larger diameter.

Naturellement, la mise en place de la douille filetée (24) nécessite l'exécution préalable d'un forage tronconique (26) dans le fond de la cavité glénoïdienne (6). Of course, the introduction of the threaded sleeve (24) requires prior performance of a frustoconical bore (26) in the bottom of the glenoid cavity (6).

Dans l'exemple illustré sur le dessin, la tête sphérique (7), son embase (8) et sa tige d'ancrage (9) sont en acier inoxydable, de même que la partie (27a) correspondant à la face externe convexe (3a) de l'élément (3), ainsi que ses pattes de fixation (21), son pion radial (25) et la douille filetée (24) dont l'alésage (24a) lui sert de logement. In the example illustrated in the drawing, the spherical head (7), its base (8) and anchor rod (9) are made of stainless steel, as well as the portion (27a) corresponding to the convex outer face ( 3a) of the element (3) and its fastening tabs (21), the radial pin (25) and the threaded sleeve (24) whose bore (24a) serves as a housing. Dans ces conditions, et pour améliorer le confort et le fonctionnement de cette prothèse, sa partie (27b) correspondant à sa face interne concave (3b) est constituée par une pièce qui est fixée à la partie (27a) par des vis (28) et qui est réalisée en un matériau relativement souple et présentant, par rapport à l'acier inoxydable, un faible coefficient de frottement. Under these conditions, and to improve the comfort and the operation of the prosthesis, its portion (27b) corresponding to the concave inner face (3b) is constituted by a member which is fixed to the portion (27a) by screws (28) and which is made of a relatively flexible material and having, with respect to stainless steel, a low coefficient of friction. Cette pièce peut être réalisée, par exemple, en polyamide ou en polyéthylène. This part can be achieved, for example, polyamide or polyethylene.

Claims (14)

    - REVENDICMlONS - - REVENDICMlONS -
  1. 1.- Prothèse gléno-hunzérale, caractérisée en ce qu'elle comprend, en combinaison, d'une part un élément huméral (2) comportant une tête (7) en forme de calotte sphérique liée, par le centre de sa face interne, à une tige d'ancrage (9) destinée à être engagée et fixée dans le canal médullaire de l'humérus (4), après résection de sa tête et, d'autre part, un élément glénol-dien (3) en forme de segment de calotte sphérique destiné à être appliqué, par sa face externe convexe (3a), contre la cavité glénoldienne (6) et dont la face interne concave (3b), de même rayon que la tête sphérique (7) de l'élément huméral (2), est destinée à lui servir d'appui, des moyens étant prévus pour permettre sa fixation à la cavité glénoldienne (6). 1.- prosthesis glenohumeral hunzérale, characterized in that it comprises, in combination, firstly a humeral element (2) having a head (7) in the form of a spherical cap bonded by the center of its inner face, to an anchoring rod (9) intended to be engaged and fixed in the medullary canal of the humerus (4), after resection of the head and, on the other hand, a glénol-dien element (3) in form of spherical cap segment to be applied, with its convex external face (3a) against the glénoldienne cavity (6) and the concave internal face (3b) of the same radius as the spherical head (7) of the humeral element (2) is intended to serve as a bearing surface, means being provided to enable its attachment to the glénoldienne cavity (6).
  2. 2.- Prothèse selon la revendication 1, caractérisée en ce que les moyens pour la fixation de l'élément glénoidien (3) à la cavité glénoidienne (6) comprennent, essentiellement, deux pattes latérales externes percées (21), sensiblement parallèles l'une à l'autre et rattachées à sa face externe (3b), à proximité de son sommet, de manière à pouvoir embrasser llépaisseur de l'omoplate (5), de part et d'autre de la partie inférieure de la cavité glénoldienne (6) et lui être fixées par des vis (23). 2. Prosthesis according to Claim 1, characterized in that the means for fixing the glenoid element (3) to the glenoid cavity (6) comprises, essentially, two external lateral lanced tabs (21) substantially parallel to the to each other and attached to its outer face (3b), near its top, so as to embrace llépaisseur of the scapula (5), on either side of the lower part of the cavity glénoldienne ( 6) and be fixed to it by screws (23).
  3. 3.- Prothèse selon la revendication 2, caractérisée en ce que les moyens de fixation de l'élément glénoidien (3) à la cavité glénoldienne (6) comprennent, en outre, un pion radial externe (25) engageable dans l'alésage (24a) d'une douille (24) filetée extérieurement et destinée à être vissée dans un trou préalablement foré dans le fond de la cavité glénoidienne (6). 3. A prosthesis according to claim 2, characterized in that the fixing means of the glenoid element (3) to the glénoldienne cavity (6) further comprises, an outer radial pin (25) engageable in the bore ( 24a) of a sleeve (24) externally threaded and designed to be screwed into a previously drilled hole in the bottom of the glenoid cavity (6).
  4. 4.- Prothèse selon la revendication 3, caractérisée en ce que le pion radial (25) et l'alésage (24a) de la douille (24) sont cylindriques. 4. Prosthesis according to claim 3, characterized in that the radial pin (25) and the bore (24a) of the sleeve (24) are cylindrical.
  5. 5.- Prothèse selon la revendication 3, caractérisée en ce que le pion radial (25) et l'alésage (24a) de la douille (24) sont tronconiques de pentes complémentaires, permettant leur liaison par coincement réciproque en fin d'engagement de l'un dans l'autre. 5. A prosthesis according to claim 3, characterized in that the radial pin (25) and the bore (24a) of the sleeve (24) are tapered complementary slopes, allowing their reciprocal connection by clamping the end of engagement of one in the other.
  6. 6.- Prothèse selon l'une quelconque des revendications 3 à 5, caractérisée en ce que le filetage externe de la douille (24) est conique, la fente radiale (24b) pour son vissage à l'aide d'un tournevis étant aménagée à son extrémité de plus grand diamètre. 6. A prosthesis according to any one of claims 3 to 5, characterized in that the external thread of the sleeve (24) is tapered, the radial slot (24b) for screwing with a screwdriver being arranged at its end of larger diameter.
  7. 7.- Prothèse selon l'une quelconque des revendications précédentes, caractérisée en ce que la tige d'ancrage (9) de l'élément huméral (2) porte un filetage externe conique (9b) et la tête humérale (7) lui est fixée de manière amovible et de manière à permettre le réglage de leur position angulaire relative. 7. A prosthesis according to any preceding claim, characterized in that the anchor rod (9) of the humeral element (2) has a conical external thread (9b) and the humeral head (7) it is and removably attached so as to allow adjustment of their relative angular position.
  8. 8.- Prothèse selon la revendication 7, caractérisée en ce que les moyens de fixation amovible de la tête sphérique (7) de l'élément huméral (2) à sa tige d'ancrage (9) et de réglage de leur position angulaire relative comprennent, ménagés sur leurs faces d'assemblage (8a,9a), elles-mêmes aménagées, respectivement, au pied d'une embase (8) de la tête sphérique (7) et au sommet de la tige d'ancrage (9), un puits tronconique (12) et un bossage ou pion tronconique (13), de pentes complémentaires, aptes à s'engager l'un dans l'autre, dans la position angulaire relative désirée et à permettre leur liaison par coincement en fin d'engagement. 8. A prosthesis according to claim 7, characterized in that the removable fastening means of the spherical head (7) of the humeral element (2) with its anchoring rod (9) and their relative angular position adjustment include, arranged on their assembly faces (8a, 9a), which are themselves arranged respectively at the foot of a base (8) of the spherical head (7) and the top of the anchor rod (9) a tapered shaft (12) and a boss or tapered pin (13), of complementary slopes, suitable for engaging one in the other, in the desired relative angular position and to allow their connection by wedging at the end of 'commitment.
  9. 9.- Prothèse selon la revendication 8, caractérisée en ce que le bossage tronconique (13) est prévu à l'extrémité supérieure de la tige d'ancrage (9) et le puits tronconique (12) est ménagé dans l'embase (8) de la tête sphérique (7). 9. A prosthesis according to claim 8, characterized in that the frusto-conical boss (13) is provided at the upper end of the anchor rod (9) and the tapered shaft (12) is provided in the base (8 ) of the spherical head (7).
  10. 10.- Prothèse selon la revendication 8 ou la revendication 9, caractérisée en ce que les moyens de fixation amovible de la tête sphérique (7) de l'élément huméral (2) à sa tige d'ancrage (9) et de réglage de leur position angulaire relative comprennent, en outre, un trou traversant (14) ménagé coaxialement dans le fond du puits tronconique (12), un trou taraudé (15) ménagé coaxialement dans le bossage tronconique (13) et une vis d'assemblage (16) vissable dans le trou taraudé (15) après avoir traversé le trou traversant (14) du puits tronconique (12), le diamètre de la tête (16a) de cette vis (16) étant supérieur à celui du trou traversant (14) du puits tronconique (12). 10. The prosthesis of claim 8 or claim 9, characterized in that the removable fastening means of the spherical head (7) of the humeral element (2) with its anchoring rod (9) and adjusting their relative angular position comprise, in addition, a through hole (14) coaxially formed in the bottom of the frustoconical bore (12), a threaded bore (15) coaxially formed in the frustoconical boss (13) and a screw assembly (16 ) screwable into the threaded hole (15) after passing through the through hole (14) of the tapered shaft (12), the diameter of the head (16a) of this screw (16) being greater than that of the through hole (14) tapered well (12).
  11. 11.- Prothèse selon la revendication 10, caractérisé en ce que la calotte qui forme la tête sphérique (7) de l'élément ~ huméral (2) présente une échancrure (17) coaxiale au trou taraudé (15). 11. A prosthesis according to claim 10, characterized in that the cap which forms the ball head (7) of the humeral element ~ (2) has a recess (17) coaxial with the threaded bore (15).
  12. 12.- Prothèse selon l'une quelconque des revendications 8 à 11, caractérisée en ce que les moyens permettant le réglage de la position angulaire relative de la tête sphérique (7) de l'élément huméral (2) et de sa tige d'ancrage (9) comprennent, d'une part, une rangée circulaire de trous cylindriques (18) ménagée concentriquement au bos sa#ge tronconique (13), dans la face d'appui (9a) de l'extrémité supérieure de la tige d'ancrage (9) et d'autre part, au moins un ergot cylindrique (19) de même diamètre que les trous précités (18), prévu en saillie sur la partie de la face d'appui (8a) de 1'embase (8) de la tête sphérique (7) entourant le puits tronconique (12) et apte à être engagé dans l'un choisi des trous (18) de la rangée circulaire précitée. 12. A prosthesis according to any one of claims 8 to 11, characterized in that the means for adjusting the relative angular position of the spherical head (7) of the humeral element (2) and its rod anchor (9) comprise, on the one hand, a circular array of cylindrical holes (18) concentrically provided at its bos # frustoconical ge (13) in the bearing face (9a) of the upper end of the rod anchor (9) and secondly, at least one cylindrical lug (19) of the same diameter as said holes (18) protrusively provided on the portion of the bearing surface (8a) of 1'embase ( 8) of the spherical head (7) surrounding the tapered shaft (12) and adapted to be engaged in a selected one of holes (18) of said circular array.
  13. 13.- Prothèse selon l'une quelconque des revendications précédentes, caractérisée en ce que la tête sphérique (7) de l'élément huméral (2) est en une matière rigide inaltérable et bio-compatible, la face interne concave (3b) de l'élément glénoldien (3) étant en une matière relativement souple et présentant un faible coefficient de frottement par rapport à la matière constitutive de la tête sphérique (7) de l'élément huméral (2). 13. A prosthesis according to any one of the preceding claims, characterized in that the spherical head (7) of the humeral element (2) is of a rigid material and unalterable biocompatible, the concave inner face (3b) glénoldien the element (3) being relatively flexible and having a low friction coefficient with respect to the constituent material of the ball head material (7) of the humeral element (2).
  14. 14.- Prothèse selon la revendication 13, caractérisée en ce que la tête sphérique (7) de l'élément huméral (2) est en acier inoxydable et la face interne (3b) de l'élément glénoldien est constituée par une partie (27b) en matière plastique telle qu'un polyamide ou un polyéthy lène. 14. A prosthesis according to claim 13, characterized in that the spherical head (7) of the humeral element (2) is of stainless steel and the inner face (3b) of the glénoldien element is constituted by a portion (27b ) of plastic material such as polyamide or polyethylene film lene.
FR8505198A 1985-03-28 1985-03-28 Glenohumeral prosthesis Withdrawn FR2579454A1 (en)

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FR2619502A1 (en) * 1987-08-19 1989-02-24 Matco Cranial or total shoulder prosthesis
EP0329854A1 (en) * 1988-02-02 1989-08-30 David M. Dines Modular shoulder prothesis
US4919670A (en) * 1988-02-03 1990-04-24 Intermedics Orthopedics, Inc. Modular humeral prosthesis
FR2645735A1 (en) * 1989-04-14 1990-10-19 Diebold Patrice Metatarsophalangeal joint prosthesis for the first shaft of the foot
US4986833A (en) * 1989-05-05 1991-01-22 Worland Richard L Glenoid component for an artificial shoulder joint
FR2673100A1 (en) * 1991-02-27 1992-08-28 Herzberg Guillaume Wrist joint prosthesis
US5282865A (en) * 1992-06-22 1994-02-01 Osteonics Corp. Humeral shoulder prosthesis
EP0581667A1 (en) * 1992-07-29 1994-02-02 Science Et Medecine Sa Screw-in glene prosthesis
FR2699400A1 (en) * 1992-12-18 1994-06-24 Medinov Sa Artificial shoulder prosthesis
EP0664108A2 (en) * 1994-01-24 1995-07-26 ESKA Implants GmbH Shoulder endoprosthesis
FR2743492A1 (en) * 1996-01-15 1997-07-18 Landanger Landos humeral head prostheses of set
WO1998004216A1 (en) * 1996-07-26 1998-02-05 Fleega Basim A Complete endoprosthesis for the shoulder
FR2773060A1 (en) * 1997-12-31 1999-07-02 Merck Biomaterial France Wrist joint prosthesis used for treating severe arthritis
FR2776506A1 (en) * 1998-03-25 1999-10-01 Depuy France Shoulder prosthesis glenoid member and ancillary components
US5961555A (en) 1998-03-17 1999-10-05 Huebner; Randall J. Modular shoulder prosthesis
EP1013246A1 (en) * 1998-12-22 2000-06-28 Sulzer Orthopedics Ltd. Glenoid prosthesis and modular system with glenoid prostheses
EP1136046A2 (en) * 2000-03-17 2001-09-26 Depuy Orthopaedics, Inc. Cementless glenoid component
US6364910B1 (en) 2001-07-11 2002-04-02 Biomet, Inc. Method and apparatus for use of a glenoid component
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EP2135576A1 (en) * 2008-06-20 2009-12-23 Tornier Method for modelling a glenoidal surface of a scapula, device for implanting a glenoidal component of a shoulder prosthesis, and method for manufacturing such a component
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FR2619502A1 (en) * 1987-08-19 1989-02-24 Matco Cranial or total shoulder prosthesis
EP0329854A1 (en) * 1988-02-02 1989-08-30 David M. Dines Modular shoulder prothesis
US4865605A (en) * 1988-02-02 1989-09-12 Dines David M Modular shoulder prosthesis
US4919670A (en) * 1988-02-03 1990-04-24 Intermedics Orthopedics, Inc. Modular humeral prosthesis
FR2645735A1 (en) * 1989-04-14 1990-10-19 Diebold Patrice Metatarsophalangeal joint prosthesis for the first shaft of the foot
US4986833A (en) * 1989-05-05 1991-01-22 Worland Richard L Glenoid component for an artificial shoulder joint
FR2673100A1 (en) * 1991-02-27 1992-08-28 Herzberg Guillaume Wrist joint prosthesis
US5282865A (en) * 1992-06-22 1994-02-01 Osteonics Corp. Humeral shoulder prosthesis
EP0581667A1 (en) * 1992-07-29 1994-02-02 Science Et Medecine Sa Screw-in glene prosthesis
FR2694186A1 (en) * 1992-07-29 1994-02-04 Science Medecine Glenoid prosthesis screwed and establishment process.
FR2699400A1 (en) * 1992-12-18 1994-06-24 Medinov Sa Artificial shoulder prosthesis
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EP0664108A3 (en) * 1994-01-24 1996-03-27 Squibb Bristol Myers Co Shoulder endoprosthesis.
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US6673115B2 (en) 1997-09-09 2004-01-06 Stryker Technologies Corporation Anatomic glenoid shoulder prosthesis together with methods and tools for implanting same
US6379386B1 (en) * 1997-09-09 2002-04-30 Stryker Technologies Corporation Anatomic glenoid shoulder prosthesis together with methods and tools for implanting same
FR2773060A1 (en) * 1997-12-31 1999-07-02 Merck Biomaterial France Wrist joint prosthesis used for treating severe arthritis
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US6494913B1 (en) 1998-03-17 2002-12-17 Acumed, Inc. Shoulder prosthesis
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FR2776506A1 (en) * 1998-03-25 1999-10-01 Depuy France Shoulder prosthesis glenoid member and ancillary components
EP1013246A1 (en) * 1998-12-22 2000-06-28 Sulzer Orthopedics Ltd. Glenoid prosthesis and modular system with glenoid prostheses
US6406495B1 (en) 1998-12-22 2002-06-18 Sulzer Orthopedics Ltd. Glenoid prosthesis and a modular system with glenoid prostheses
EP1136046A3 (en) * 2000-03-17 2001-10-04 Depuy Orthopaedics, Inc. Cementless glenoid component
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FR2826256A1 (en) * 2001-06-21 2002-12-27 Depuy France Prosthetics for shoulder traumatic
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