FR2628314A1 - Prothese d'articulation coxo-femorale - Google Patents

Prothese d'articulation coxo-femorale Download PDF

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Publication number
FR2628314A1
FR2628314A1 FR8803210A FR8803210A FR2628314A1 FR 2628314 A1 FR2628314 A1 FR 2628314A1 FR 8803210 A FR8803210 A FR 8803210A FR 8803210 A FR8803210 A FR 8803210A FR 2628314 A1 FR2628314 A1 FR 2628314A1
Authority
FR
France
Prior art keywords
cotyle
bone
alumina
piece
femoral
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Withdrawn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
FR8803210A
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English (en)
Inventor
Jacques Witvoet
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.)
Ceraver SA
Original Assignee
Les Laboratories Osteal Medical
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 Les Laboratories Osteal Medical filed Critical Les Laboratories Osteal Medical
Priority to FR8803210A priority Critical patent/FR2628314A1/fr
Publication of FR2628314A1 publication Critical patent/FR2628314A1/fr
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61F2/30—Joints
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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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    • A61F2/36—Femoral heads ; Femoral endoprostheses
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    • A61F2/367—Proximal or metaphyseal parts of shafts
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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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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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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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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
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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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3082—Grooves
    • A61F2002/30827—Plurality of grooves
    • A—HUMAN NECESSITIES
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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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    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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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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    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni 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
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203—Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide

Abstract

Prothèse d'articulation coxo-fémorale comportant une tête fémorale prothétique 2 en alumine et un cotyle prothétique 3 en alumine, caractérisé par le fait que ledit cotyle prothétique en alumine est lui-même fixé extérieurement par emmanchement conique dans un cotyle 5 en métal ou en alliage métallique présentant un taraudage 7 sur sa partie extérieure.

Description

Prothèse d'articulation coxo-fémorale
La présente invention concerne une prothèse d'articulation coxofémorale.
Ce type de prothèse comprend - un composant de frottement qui est constitué par une tête fémorale prothétique et un cotyle prothétique qui sera scellé à l'aide d'un ciment à base de méthacrylate de méthyle ou fixé sans ciment par divers systèmes de blocage mécanique, - un composant fémoral en un alliage métallique, soit du type acier inoxydable 316 L, soit en alliage cobalt-chrome et/ou en alliage de titane. Ce composant fémoral est fixé dans la diaphyse avec ou sans ciment.
Au niveau du composant de frottement, de nombreux couples de matériaux ont été testés, parfois implantés trop rapidement chez l'homme après des essais in-vitro insuffisants et ont du être abandonnés. Ce fut par exemple le cas des couples de matériaux cobalt-chrome-molybdène contre le polyméthacrylate de méthyle et du polytétrafluoroéthylène contre l'acier inox. Quant au couple constitué d'un cotyle en cobalt-chrome-molybdène et d'une tête fémorale en cobalt-chromemolybdène, utilisé assez fréquemment lors du démarrage de ce type d'arthroplasties, il présente une usure modérée ; toutefois ses débris d'usure sont mal tolérés et son couple de frottement élevé sollicite beaucoup trop les ancrages et amène des descellements assez fréquents.
Compte-tenu de ces inconvénients, il est aujourd'hui pratiquement abandonné.
Trois types de prothèses sont utilisés aujourd'hui
Le premier type comporte un cotyle en polyéthylène et une tête fémorale en acier du type 316 L ou une tête fémorale en cobalt-chrome-molybdène. Ce couple présente une usure assez importante qui peut être estimée, d'après certains auteurs, de l'ordre de 0,1 à 0,15 mm par an. Le couple de frottement relativement faible au début croit dans le temps, du fait de particules métalliques qui viennent stenchasser dans le polyéthylène, d'où cette augmentation de la friction.
Le second type comporte un cotyle en polyéthylène et une tête fémorale en alumine. L'alumine utilisée dans ce domaine depuis 1970 présente une parfaite biocompatibilité avec l'organisme du fait de sa résistance exceptionnelle à toutes formes de corrosion. Ses caractéristiques mécaniques adaptées, son excellente mouillabilité aux liquides de lubrification, sa haute résistance à l'usure, son couple de frottement faible et stable dans le temps, permettent d'envisager ce matériau comme particulièrement bien adapté comme matériau de frottement s'il répond, bien entendu, à certaines exigences : composition chimique, densité élevée, structure cristalline très fine.
La tête fémorale en alumine peut être associée à un cotyle prothétique en polyéthylène et on a pu constater, in-vitro et in-vivo, des usures et des couples de frottement plus faibles qu'avec le couple métal-polyéthylène.
Le troisième type comporte un cotyle en alumine et une tête fémorale en alumine. Dans ce cas, l'usure-et le couple de frottement restent à un niveau très faible et les résultats in-vitro et in-vivo sur ces deux critères, après plusieurs années de fonctionnement, apparaissent tout à fait satisfaisants. Toutefois, si un disfonctionnement mécanique intervient, par exemple un jeu trop important entre la tête et le cotyle, ou un descellement cotyloldien ou fémoral, le niveau d'usure peut être important ; on a pu relever dans certains cas cliniques des usures de 1 mm.
En outre on observe que, dans le cas d'un couple#alumine-alumine avec un cotyle fixé au méthacrylate de méthyle, les descellements cotyloldiens sont assez fréquents ; ceci s'explique par des différences importantes entre les modules d'élasticité de l'alumine, du ciment et de l'os sous-chondral. En effet l'alumine, matériau présentant une très haute dureté, possède un module d'élasticité de 380 000 MPa, à comparer, à celui de l'os sous-chondral qui est de l'ordre de 15 à 25 000 MPa et à celui du ciment qui est de l'ordre de 3000 MPa.
Pour éviter ces inconvénients, la présente invention a pour but de définir une articulation coxo-fémorale qui garde un composant de frottement comportant une tête fémorale en alumine et un cotyle prothétique en alumine, mais qui permet d'éviter les problèmes de descellements.
La présente invention a pour objet une prothèse d'articulation coxo-fémorale comportant une tête fémorale prothétique en alumine et un cotyle prothétique en alumine, caractérisée par le fait que ledit cotyle prothétique en alumine est lui-même fixé extérieurement par emmanchement conique dans un cotyle en métal ou en alliage métallique présentant un taraudage sur sa partie extérieure.
De préférence ledit alliage métallique est un alliage de titane comportant 90 % de titane, 6 % d'aluminium et 4 % de vanadium.
Selon un autre mode de réalisation le cotyle taraudé est réalisé en titane non allié, ce matériau présentant une bonne biotolérance.
La présente invention sera mieux comprise à l'aide de l'exemple donné ci-après à titre illustratif et non limitatif en regard du dessin annexé ' dans lequel - la figure 1 représente schématiquement en perspective en coupe une prothèse selon l'invention, - la figure ? représente en coupe partielle agrandie une prothèse selon l'invention.
On voit dans les deux figures une prothèse coxo-fémorale selon l'invention en quatre parties. Une tige fémorale 1 est destinée à être logée à sa partie inférieure dans un fémur. Une tête fémorale sphérique 2 est fixée par emmanchement conique sur l'extrémité proximale de la tige fémorale métallique. Cette tête en alumine coopère avec un cotyle prothétique ou pièce acétabulaire 3, en alumine frittée présentant une surface 4 hémisphérique concave. Cette surface ainsi que la surface extérieure de la tête fémorale 2 présentent des tolérances géométriques très précises; elles sont rectifiées et polies pour obtenir un indice de rugosité de l'ordre de 0,01 t Ra. Ces états de surface permettent un bon fonctionnement sur le plan de l'usure et de la friction.
Selon l'invention, le cotyle prothétique en alumine 3 coopère par emmanchement conique au niveau de sa face 6 avec un cotyle prothétique 5, ou pièce acétabulaire, en métal ou alliage métallique. Ce cotyle 5 présente sur sa face externe un taraudage 7 avec des rainures transversales 8 ; de préférence il s'agit d'un filetage avec une forme de filet qui assure un autotaraudage aisé dans l'os iliaque, avec une surface de contact importante entre l'os et l'implant ; ceci assure une meilleure répartition et une meilleure transmission des contraintes et une stabilité immédiate de l'ancrage. La mise en oeuvre d'un ciment utilisé classiquement n'est pas nécessaire dans ce cas. Dans un premier temps le cotyle 5 sera maintenu dans l'os par le blocage mécanique, puis ensuite par envahissement osseux dans ses rainures.
De préférence il est réalisé en titane, avec éventuellement un revêtement d'oxyde de titane.
Tous les matériaux utilisés dans ce type de prothèse supportent les conditions requises pour différents types de stérilisation tels que, autoclave, chaleur sèche, oxyde d'éthylène, rayonnements gamma.
Bien entendu l'invention n'est pas limitée au mode de réalisation qui vient d'être décrit. On pourra sans sortir du cadre de l'invention, remplacer tout moyen par un moyen équivalent.

Claims (4)

REVENDICATIONS
1/ Prothèse d'articulation coxo-fémorale comportant une tête fémorale prothétique en alumine et un cotyle prothétique en alumine, caractérisé par le fait que ledit cotyle prothétique en alumine est lui-même fixé extérieurement par emmanchement conique dans un cotyle en métal ou en alliage métallique présentant un taraudage sur sa partie extérieure.
2/ Prothèse d'articulation selon la revendication 1, caractérisée par le fait que le taraudage dudit cotyle en métal présente des rainures transversales à ses filets.
3/ Prothèse d'articulation selon la revendication 1, caractérisée par le fait que ledit alliage métallique est un alliage de titane comportant 90 % de titane, 6 % d'aluminium et 4 % de vanadium.
4/ Prothèse d'articulation selon la revendication 1, caractérisée par le fait que le cotyle taraudé est réalisé en titane non allié, ce matériau présentant une bonne biotolérance.
FR8803210A 1988-03-11 1988-03-11 Prothese d'articulation coxo-femorale Withdrawn FR2628314A1 (fr)

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FR8803210A FR2628314A1 (fr) 1988-03-11 1988-03-11 Prothese d'articulation coxo-femorale

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Application Number Priority Date Filing Date Title
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FR2628314A1 true FR2628314A1 (fr) 1989-09-15

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996013231A1 (fr) * 1994-10-28 1996-05-09 Astra Aktiebolag Ensemble cupule acetabulaire-revêtement
US5871547A (en) * 1996-03-01 1999-02-16 Saint-Gobain/Norton Industrial Ceramics Corp. Hip joint prosthesis having a zirconia head and a ceramic cup
EP1025814A1 (fr) * 1999-02-04 2000-08-09 Norton Desmarquest Fine Ceramics Prothèse fémorale céramique/céramique de petit diamètre.
US6896703B2 (en) * 2001-01-26 2005-05-24 Mathys Medizinaltechnik Ag Expandable socket
FR2868691A1 (fr) 2004-04-08 2005-10-14 Langlais Frantz Prothese totale du genou a charniere rotatoire immobilisable et liberable
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8679187B2 (en) 2006-03-20 2014-03-25 Smith & Nephew, Inc. Acetabular cup assembly for multiple bearing materials

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2242065A1 (fr) * 1973-08-31 1975-03-28 Oscobal Ag
FR2419717A1 (fr) * 1978-03-17 1979-10-12 Medizinska Akad Prothese totale de hanche
EP0225838A2 (fr) * 1985-12-05 1987-06-16 TECHMEDICA Inc. Dispositif pour prothèse osseuse

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2242065A1 (fr) * 1973-08-31 1975-03-28 Oscobal Ag
FR2419717A1 (fr) * 1978-03-17 1979-10-12 Medizinska Akad Prothese totale de hanche
EP0225838A2 (fr) * 1985-12-05 1987-06-16 TECHMEDICA Inc. Dispositif pour prothèse osseuse

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996013231A1 (fr) * 1994-10-28 1996-05-09 Astra Aktiebolag Ensemble cupule acetabulaire-revêtement
US5997579A (en) * 1994-10-28 1999-12-07 Astra Aktiebolag Liner
US5871547A (en) * 1996-03-01 1999-02-16 Saint-Gobain/Norton Industrial Ceramics Corp. Hip joint prosthesis having a zirconia head and a ceramic cup
EP1025814A1 (fr) * 1999-02-04 2000-08-09 Norton Desmarquest Fine Ceramics Prothèse fémorale céramique/céramique de petit diamètre.
FR2789295A1 (fr) * 1999-02-04 2000-08-11 Norton Desmarquest Fine Cerami Prothese femorale ceramique/ceramique de petit diametre
US6896703B2 (en) * 2001-01-26 2005-05-24 Mathys Medizinaltechnik Ag Expandable socket
FR2868691A1 (fr) 2004-04-08 2005-10-14 Langlais Frantz Prothese totale du genou a charniere rotatoire immobilisable et liberable
US8679187B2 (en) 2006-03-20 2014-03-25 Smith & Nephew, Inc. Acetabular cup assembly for multiple bearing materials
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445903B2 (en) 2008-11-24 2016-09-20 Biomet Manufacturing, Llc Multi-bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445904B2 (en) 2009-07-14 2016-09-20 Biomet Manufacturing, Llc Multiple bearing acetabular prosthesis

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