FR2676917A1 - Ankle prosthesis - Google Patents

Ankle prosthesis Download PDF

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Publication number
FR2676917A1
FR2676917A1 FR9106626A FR9106626A FR2676917A1 FR 2676917 A1 FR2676917 A1 FR 2676917A1 FR 9106626 A FR9106626 A FR 9106626A FR 9106626 A FR9106626 A FR 9106626A FR 2676917 A1 FR2676917 A1 FR 2676917A1
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FR
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Patent type
Prior art keywords
component
characterized
ankle prosthesis
prosthesis according
tibial
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.)
Granted
Application number
FR9106626A
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French (fr)
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FR2676917B1 (en )
Inventor
Docteur Mendolia Georges
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OMCI SA
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OMCI SA
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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
    • 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
    • A61F2/42Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14Surgical saws ; Accessories therefor
    • A61B17/15Guides therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy prostheses
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30138Convex polygonal shapes
    • A61F2002/30153Convex polygonal shapes rectangular
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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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    • 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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    • A61F2002/30199Three-dimensional shapes
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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
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • A61F2002/30398Sliding
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30767Special 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
    • A61F2002/30841Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • 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
    • A61F2/30767Special 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
    • A61F2002/30878Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • 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
    • A61F2/30767Special 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
    • A61F2002/30878Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891Plurality of protrusions
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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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    • A61F2/4202Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4205Tibial components
    • 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
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    • A61F2/02Prostheses implantable into the body
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    • A61F2/4202Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4207Talar components
    • 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
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    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • 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
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

The ankle prosthesis according to the invention comprises a tibial component (T), an astragalar component (A) and an intermediate component (I). The latter is joined to the tibial component (T) in such a way that it has a freedom of translation, with respect to the latter, only in the anteroposterior direction. It is joined to the astragalar component (A) by means of a hollow surface at its base which is congruent with the upper convex surface of the astragalar component (A). These surfaces have circular curvatures in the sagittal plane and in the lateral plane, in such a way as to permit flexion-extension movements and valgus and varus movements. <IMAGE>

Description

PROTHESE DE CHEVILLE PROSTHETIC ANKLE
La présente invention concerne une prothèse de cheville consistant en un dispositif destiné à être implanté à la place de l'interligne articulaire de la cheville en vue du remplacement de cette interligne physiologique. The present invention relates to an ankle prosthesis comprising a device intended to be implanted instead of the joint space of the anchor in order to replace this physiological spaced.

Une telle prothèse est généralement utilisée lorsque le cartilage articulaire de l'articulation est abîmé ou pathologique. Such a prosthesis is typically used when the articular cartilage of the joint is damaged or diseased.

La plupart des prothèses de cheville connues sont à deux composants, l'un destiné à être implanté dans la base du tibia et l'autre dans l'astragale. Most known ankle prostheses are two components, one to be implanted in the base of the tibia and the other in the talus. Ces deux composants sont engagés mutuellement par l'intermédiaire de surfaces congruentes dont le profil est circulaire pour permettre des mouvements de flexion-extension par glissement. These two components are interengaged by means of congruent surfaces whose profile is circular to allow for flexion-extension by sliding movements.

On connaît également par les brevets US n0 4 309 778 et 4 470 158 des prothèses de cheville ayant un composant intermédiaire supplémentaire, interposé entre le composant tibial et le composant astragalien. Also known from US Patents 4,309,778 and n0 4,470,158 ankle prostheses having an additional intermediate component interposed between the tibial component and the talar component. Dans la prothèse décrite dans le premier brevet, le dessous du composant tibial est plan tandis que la surface supérieure du composant astragalien est convexe dans le sens sagittal, et a une section transversale en V évasé. In the prosthesis disclosed in the first patent, the underside of the tibial component is planar while the upper surface of the talar component is convex in the sagittal direction, and a cross-sectional V flared. Le dessous du composant intermédiaire est congruent avec cette surface, tandis que sa face supérieure est plane, comme la face inférieure du composant tibial. The underside of the intermediate component is congruent with that surface, while its upper surface is planar, such as the underside of the tibial component. Ainsi, en plus des mouvements de flexion-extension généralement seuls possibles avec les prothèses à deux composants, cette prothèse offre une certaine mobilité en translation dans les sens antéro-postérieur et transversal. Thus, in addition to generally only possible flexion-extension movements with prostheses bicomponent, this prosthesis provides some mobility in translation in the anteroposterior and transverse directions.

Dans le brevet US n0 4 470 158 au nom de Pappas et al., le composant intermédiaire est fixé au composant tibial, n'ayant par rapport à lui qu'une liberté en rotation autour d'un axe sensiblement vertical. In U.S. Patent N0 4470158 in the name of Pappas et al., The intermediate component is attached to the tibial component, having in relation to it a freedom of rotation about a substantially vertical axis. La surface inférieure du composant intermédiaire a un profil circulaire et est congruente avec la surface supérieure du composant astragalien. The lower surface of the intermediate component has a circular profile and is congruent with the upper surface of the talar component. En plus des mouvements de flexion-extension, cette prothèse permet donc des mouvements de rotation interne et externe. In addition to flexion-extension movements, this prosthesis allows the inner and outer rotational movements.

Malgré leur mobilité accrue, ces deux prothèses à trois composants, comme l'ensemble des prothèses à deux composants, n'offrent pas entière satisfaction à l'usage et connaissent un taux de descellement important. Despite their increased mobility, both three component prostheses, like all prostheses two components do not offer complete satisfaction to use and experiencing significant loosening rates.

L'invention consiste en une nouvelle prothèse de cheville à trois composants conçue notamment en vue de pallier cet inconvénient relatif au descellement, et d'en faciliter la pose. The invention consists of a novel ankle prosthesis with three components designed especially to overcome this drawback relating to loosening, and easier installation.

Cette prothèse comprenant un composant tibial destiné à être implanté dans la base du tibia, un composant astragalien destiné à être implanté dans l'astragale, et un élément intermédiaire, est caractérisée en ce que ce dernier s'assemble d'une part avec le composant tibial de manière à n'avoir par rapport à lui qu'une liberté de mouvement en translation antéro-postérieure, et s'assemble d'autre part avec le composant astragalien par congruence d'une surface de contact en creux à sa base avec la surface supérieure convexe du composant astragalien, lesquelles surfaces sont à courbures circulaires dans le sens sagittal et dans le sens latéral, de manière à permettre des mouvements de flexion-extension et des mouvements de valgus et de varus. This prosthesis comprising a tibial component intended to be implanted in the base of the tibia, talus component intended to be implanted in the talus, and an intermediate element, is characterized in that it is assembled on the one hand with the component tibial so as to have with respect to it a freedom of movement in anterior-posterior translation, and assembles the other hand with the talar component congruence with a recessed contact surface at its base with the convex upper surface of the talar component, which surfaces are circular curvatures in the sagittal direction and in the lateral direction, so as to allow movements of flexion-extension movements and valgus and varus.

L'invention sera mieux comprise à l'aide des explications qui vont suivre et des dessins annexés, dans lesquels The invention will be better understood using the following explanations and the accompanying drawings, wherein
les Figs. Figs. la, lb et lc sont des vues en perspective représentant respectivement le composant tibial, le composant intermédiaire et le composant astragalien d'une prothèse de cheville selon l'invention, la, lb and lc are perspective views respectively showing the tibial component, the intermediate component and the talar component of an ankle prosthesis according to the invention,
la Fig. Fig. 2 est une coupe selon la ligne Il-Il de la 2 is a section according to II-II line of the
Fig. Fig. 3 des trois composants assemblés, et 3 of the three assembled components, and
la Fig. Fig. 3 est une coupe selon la ligne III-III de la Fig. 3 is a section along line III-III of Fig. 2. 2.

Le composant tibial T, Fig. The tibial component T, Fig. la, est constitué par une plaque 10 de forme rectangulaire, bordée par deux ailes latérales 11 dirigées vers le bas de manière à former une coulisse dans le sens antéro-postérieur. la, consists of a plate 10 of rectangular shape, bordered by two lateral wings 11 directed downwardly so as to form a slide in the anteroposterior direction. Sur la face supérieure plane de la plaque 11, sont rapportés des moyens d'ancrage dans le tibia, soit ici deux plots d'ancrage 12 disposés symétriquement de chaque côté On the plane upper face of the plate 11 are brought from the means for anchoring in the tibia, either within two anchoring pins 12 arranged symmetrically on either side
La coulisse formée par le composant tibial T est prévue pour recevoir la partie supérieure du composant intermédiaire I, laquelle est un bloc parallélépipédique 20 de section carrée et de hauteur h au moins égale à celle des ailes 11 du composant tibial T.Le bloc 20 est prolongé vers le bas par une partie 21 dont la section diminue et évolue vers une forme arrondie à sa base, laquelle présente une surface inférieure concave à courbures circulaires respectivement dans le sens antéro-postérieur et dans le sens transversal. The wings formed by the tibial component T is provided for receiving the upper portion of the intermediate component I, which is a parallelepiped block 20 of square cross section and height h at least equal to that of the wings 11 of the tibial component T.The block 20 is extended downwards by a portion 21 whose section decreases and transitions into a rounded shape at its base, which has a concave lower surface with circular curvatures respectively in the anteroposterior direction and in the transverse direction.

Cette surface est congruente avec la surface supérieure du composant astragalien A, Fig. This surface is congruent with the upper surface of the talar component A, Fig. lc, dont les courbures dans le sens antéro-postérieur et dans le sens latéral sont respectivement illustrées par les lignes Cl et C2. lc, the bends in the anteroposterior direction and in the lateral direction are respectively illustrated by the lines Cl and C2. Le composant astragalien A reproduisant ainsi la poulie astragalienne est un dôme 30 dont la surface inférieure est plane. The talar component A thereby reproducing the talar pulley is a dome 30 whose lower surface is planar. Ses moyens d'ancrage consistent ici en un seul plot 31. Its anchoring means consist here in one stud 31.

En règle générale, il est prévu de fabriquer le composant tibial T et le composant astragalien A en un alliage métallique biocompatible, par exemple à base de titane, et le composant intermédiaire I en un matériau souple tel que matière plastique. Generally, it is expected to manufacture the tibial component and the talar component T A of a biocompatible metal alloy, eg titanium, and the intermediate component I in a flexible material such as plastic.

La prothèse constituée de ces trois éléments, par le libre coulissement du composant intermédiaire dans le composant tibial, permet d'éviter pour une part importante les sollicitations mécaniques antéropostérieures qui sont les principales causes de descellement. The prosthesis consists of these three elements, the free sliding of the intermediate component into the tibial component, prevents to a large extent the anteroposterior mechanical stresses which are the leading causes of loosening. Par l'interface composant astragaliencomposant intermédiaire, elle est apte à reproduire l'essentiel des mouvements physiologiques de la cheville, à savoir les mouvements de flexion-extension et les mouvements de valgus et de varus. Via astragaliencomposant component interface, it is capable of reproducing the essential physiological movements of the ankle, ie flexion-extension movements and movements of valgus and varus.

Comme le montrent les dessins, les plots d'ancrage 12 du composant tibial T sont inclinés de bas en haut et d'avant en arrière, tandis que le plot 31 du composant astragalien A est incliné de haut en bas et d'avant en arrière, pour faciliter l'ancrage de ces composants dans le tibia et l'astragale. As shown in the drawings, the anchoring pins 12 of the tibial component T are inclined from bottom to top and front to back, while the stud 31 of the talar component A is inclined from top to bottom and from front to back to facilitate the anchoring of these components in the tibia and the talus. Cette disposition, conjuguée au fait que le composant tibial T et le composant astragalien A ont leur surface destinée à venir en contact avec l'os qui est plane, procure l'avantage de n'obliger à réséquer que très peu d'os, par une coupe tibiale horizontale sans fenêtre antérieure et une coupe astragalienne également horizontale. This arrangement, combined with the fact that the tibial component and the talar component T A have their surface for contacting the bone which is flat, has the advantage of not requiring to be resected very little bone, by a horizontal tibial cut without previous window and also horizontal talar cut.

Le matériel prévu pour la mise en place de la prothèse comprend un guide de coupe tibial, un guide de coupe astragalien et un guide de forage. Equipment intended for the introduction of the prosthesis comprises a tibial cutting guide, a talar cutting guide and a drill guide. Le guide de coupe tibial se fixe au moyen de deux broches et permet de réaliser à l'aide d'un viseur la coupe tibiale strictement horizontale. The tibial cutting guide is fixed with two pins and allows for using a viewfinder strictly horizontal tibial cut. De même, le guide de coupe astragalien permet de réaliser une coupe astragalienne horizontale, ainsi que d'en ajuster le niveau, en fonction de l'importance de l'os que l'on désire réséquer. Similarly, the talar cutting guide enables a horizontal talar cut, as well as adjust the level, depending on the importance of the bone that is to be resected. Le guide de forage est mis en place dans l'espace résultant des deux coupes. The drill guide is set up in the space resulting from the two cuts. Il permet de réaliser les trous pour l'ancrage des plots tibiaux et astragalien. It allows the holes for anchoring the tibial and talar pads.

La mise en place de la prothèse est également facilitée du fait que pour l'implantation des composants tibial et astragalien, on dispose de l'espace réservé au composant intermédiaire, lequel n'est placé qu'en fin d'intervention. The establishment of the prosthesis is also facilitated by the fact that for the implantation of the tibial component and talus, it has the space for the intermediate component, which is placed at the end of intervention.

Selon une autre caractéristique importante de l'invention, pour un composant tibial et un composant astragalien donnés, on prévoit un jeu de plusieurs composants intermédiaires I se différenciant les uns des autres par leur hauteur, afin de permettre de reprendre de façon précise les ligaments latéraux de la cheville. According to another important feature of the invention, for a tibial component and a talus component given, there is provided a set of several intermediate components I differing from one another in their height, in order to allow to take accurately the lateral ligaments the ankle.

Dans le cas du composant I représenté dans les dessins, les différences seront établies au niveau de la hauteur h de la partie supérieure 20. In the case of I component shown in the drawings, the differences will be established at the height h of the top portion 20.

La prothèse de l'invention est prévue en plusieurs tailles, par exemple petite, moyenne et grande. The prosthesis of the invention is provided in several sizes, eg small, medium and large. En outre, il est également prévu des composants d'essai pour adapter la prothèse définitive et pour choisir l'élément intermédiaire correspondant à la meilleure tension des ligaments latéraux de la cheville. In addition, there is also provided of the test components to adjust the final prosthesis and to select the corresponding intermediate element at the highest voltage of the lateral ligaments of the ankle.

Claims (8)

    REVENDICATIONS
  1. 1) Prothèse de cheville comprenant un composant tibial (T) destiné à être implanté dans la base du tibia, un composant astragalien (A) destiné à être implanté dans l'astragale, et un composant intermédiaire (I), caractérisée en ce que celui-ci s'assemble d'une part avec le composant tibial (T) de manière à n'avoir par rapport à lui qu'une liberté de mouvement en translation antéro-postérieure, et s'assemble d'autre part avec le composant astragalien (A) par congruence d'une surface de contact en creux à sa base avec la surface supérieure convexe dudit composant astragalien, lesquelles surfaces sont à courbures circulaires dans le sens sagittal et dans le sens latéral, de manière à permettre des mouvements de flexion-extension et des mouvement de valgus et de varus. 1) The ankle prosthesis comprising a tibial component (T) intended to be implanted in the base of the tibia, a talar component (A) to be implanted in the talus, and an intermediate component (I), characterized in that -ci assembles one hand with the tibial component (T) so as to have with respect to it a freedom of movement in anterior-posterior translation, and assembles the other hand with the talar component (a) in congruence with a recessed contact surface at its base with the convex upper surface of said talar component, which surfaces are circular curvatures in the sagittal direction and in the lateral direction, so as to allow movements of flexion extension and motion valgus and varus.
  2. 2) Prothèse de cheville selon la revendication 1, caractérisée en ce que le composant tibial (T) comprend une plaque rectangulaire (10) avec des ailes latérales (11) dirigées vers le bas, de manière à former une coulisse pour le composant intermédiaire (I). 2) Ankle prosthesis according to Claim 1, characterized in that the tibial component (T) comprises a rectangular plate (10) with lateral wings (11) directed downwards, so as to form a coulisse for the intermediate component ( I).
  3. 3) Prothèse de cheville selon la revendication 2, caractérisée en ce que le composant intermédiaire (I) comprend une partie supérieure (20) de forme parallélépipédique à section carrée et de hauteur (h) supérieure à celle des ailes (11), prolongée par une partie inférieure dont la section diminue jusqu'à sa base dans laquelle est ménagée ladite surface en creux destinée au contact avec le composant astragalien (A). 3) Ankle prosthesis according to Claim 2, characterized in that the intermediate component (I) comprises an upper portion (20) of parallelepipedic shape with a square section and a height (h) greater than that of the wings (11) extended by a lower portion whose cross-section decreases to its base wherein is formed said recessed surface for contact with the talar component (a).
  4. 4) Prothèse de cheville selon l'une des revendications 1 à 3, caractérisée en ce qu'il est prévu un jeu de composants intermédiaires (I) de hauteurs différentes, afin de permettre de choisir celui qui correspond à la meilleure tension des ligaments latéraux. 4) Ankle prosthesis according to one of claims 1 to 3, characterized in that there is provided a set of intermediate components (I) of different heights in order to allow to choose one that corresponds to the best voltage collateral ligament .
  5. 5) Prothèse de cheville selon l'une des revendications 1 à 4, caractérisée en ce que le composant astragalien (A) comprend un dôme (30) dont la base est plane. 5) Ankle prosthesis according to one of claims 1 to 4, characterized in that the talus component (A) comprises a dome (30) whose base is flat.
  6. 6) Prothèse de cheville selon l'une des revendications 1 à 4, caractérisée en ce que les moyens d'ancrage des composants tibial (T) et astragalien (A) sont des plots (12, 31) inclinés d'avant en arrière à partir de leur extrémité de jonction auxdits composants. 6) Ankle prosthesis according to one of claims 1 to 4, characterized in that the means for anchoring the tibial component (T) and the talus (A) are studs (12, 31) inclined from front to back from their junction of said end components.
  7. 7) Prothèse de cheville selon la revendication 6, caractérisée en ce que le composant tibial comprend deux plots d'ancrage latéraux disposés symétriquement. 7) Ankle prosthesis according to Claim 6, characterized in that the tibial component comprises two lateral anchoring pins arranged symmetrically.
  8. 8) Prothèse de cheville selon l'une des revendications 1 à 5, caractérisée en ce qu'elle est prévue en plusieurs tailles. 8) Ankle prosthesis according to one of claims 1 to 5, characterized in that it is provided in several sizes.
FR9106626A 1991-05-29 1991-05-29 Ankle prosthesis. Expired - Fee Related FR2676917B1 (en)

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FR2715557A1 (en) * 1994-01-28 1995-08-04 Lepine Groupe Three part prosthetic ankle joint
FR2730157A1 (en) * 1995-02-08 1996-08-09 Bouvet Jean Claude Joint construction for ankle replacement prosthesis
FR2808994A1 (en) * 2000-05-22 2001-11-23 Transysteme Sarl Prosthesis for e.g. ankle is made of two parts with protruding elements forced within a hole in the bone and a smooth opposite face cooperating with an intermediate part
WO2003075802A1 (en) * 2002-03-08 2003-09-18 Waldemar Link Gmbh & Co. Kg Ankle-joint endoprosthesis
WO2004084773A1 (en) * 2003-03-21 2004-10-07 Feiwell Lawrence M D Sphere-on-sphere ankle prosthesis
WO2005030098A1 (en) * 2003-08-27 2005-04-07 Waldemar Link Gmbh & Co. Kg Ankle-joint endoprosthesis
WO2005041823A1 (en) * 2003-10-02 2005-05-12 Concepts In Medicine Iii, Llc Ankle joint prosthesis
EP1563807A1 (en) * 2004-02-13 2005-08-17 Buechel-Pappas Trust Ankle prosthesis including tibial component having peripheral wall for preventing the formation of bone cysts
EP1731115A1 (en) * 2005-06-08 2006-12-13 Implantcast GmbH Cement-free tibial component for an ankle replacement prosthesis and an ankle prosthesis comprising such a component
WO2006136940A2 (en) * 2005-06-24 2006-12-28 Malan De Villiers Ankle prosthesis
EP1850800A2 (en) * 2005-02-22 2007-11-07 ArthroSurface, Inc. Articular surface implant
US7915046B2 (en) 2004-06-30 2011-03-29 Depuy Products, Inc. System and method for determining the operating state of orthopaedic admixtures
US7935118B2 (en) 2002-06-21 2011-05-03 Depuy Products, Inc. Prosthesis removal cutting guide, cutting tool and method
WO2012061453A1 (en) 2010-11-02 2012-05-10 Perler Adam D Prosthetic device with multi-axis dual bearing assembly and methods for resection
US8491596B2 (en) 2002-06-21 2013-07-23 Depuy Products, Inc. Method for removal of bone
US9579210B2 (en) 2014-11-07 2017-02-28 Wright Medical Technology, Inc. Talar dome fixation stem
US9662126B2 (en) 2009-04-17 2017-05-30 Arthrosurface Incorporated Glenoid resurfacing system and method
EP2124832B2 (en) 2006-12-23 2017-07-19 Corin Limited Improvements in and relating to an ankle prosthesis
US9861492B2 (en) 2014-03-07 2018-01-09 Arthrosurface Incorporated Anchor for an implant assembly
US9931211B2 (en) 2003-02-24 2018-04-03 Arthrosurface Incorporated Trochlear resurfacing system and method
US10045788B2 (en) 2006-12-11 2018-08-14 Arthrosurface Incorporated Retrograde resection apparatus and method
US10076343B2 (en) 2002-12-03 2018-09-18 Arthrosurface Incorporated System for articular surface replacement

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US7678151B2 (en) 2000-05-01 2010-03-16 Ek Steven W System and method for joint resurface repair
US7713305B2 (en) 2000-05-01 2010-05-11 Arthrosurface, Inc. Articular surface implant
US6520964B2 (en) 2000-05-01 2003-02-18 Std Manufacturing, Inc. System and method for joint resurface repair
US7951163B2 (en) 2003-11-20 2011-05-31 Arthrosurface, Inc. Retrograde excision system and apparatus
US7901408B2 (en) 2002-12-03 2011-03-08 Arthrosurface, Inc. System and method for retrograde procedure
US7163541B2 (en) 2002-12-03 2007-01-16 Arthrosurface Incorporated Tibial resurfacing system
US7828853B2 (en) 2004-11-22 2010-11-09 Arthrosurface, Inc. Articular surface implant and delivery system
JP2007512108A (en) 2003-11-20 2007-05-17 アースロサーフィス・インコーポレーテッド Degeneracy specific delivery of surface re-forming device
EP2262448A4 (en) 2008-03-03 2014-03-26 Arthrosurface Inc Bone resurfacing system and method
WO2010121246A1 (en) 2009-04-17 2010-10-21 Arthrosurface Incorporated Glenoid resurfacing system and method
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FR2715557A1 (en) * 1994-01-28 1995-08-04 Lepine Groupe Three part prosthetic ankle joint
FR2730157A1 (en) * 1995-02-08 1996-08-09 Bouvet Jean Claude Joint construction for ankle replacement prosthesis
WO2001089427A1 (en) * 2000-05-22 2001-11-29 S.A Transysteme Articulation prosthesis
FR2808994A1 (en) * 2000-05-22 2001-11-23 Transysteme Sarl Prosthesis for e.g. ankle is made of two parts with protruding elements forced within a hole in the bone and a smooth opposite face cooperating with an intermediate part
KR100764974B1 (en) * 2002-03-08 2007-10-08 발데마르 링크 게엠베하 운트 코.카게 Ankle-joint endoprosthesis
WO2003075802A1 (en) * 2002-03-08 2003-09-18 Waldemar Link Gmbh & Co. Kg Ankle-joint endoprosthesis
US6852130B2 (en) 2002-03-08 2005-02-08 Waldemar Link Gmbh & Co. Kg Ankle-joint endoprosthesis
US8491596B2 (en) 2002-06-21 2013-07-23 Depuy Products, Inc. Method for removal of bone
US7935118B2 (en) 2002-06-21 2011-05-03 Depuy Products, Inc. Prosthesis removal cutting guide, cutting tool and method
US10076343B2 (en) 2002-12-03 2018-09-18 Arthrosurface Incorporated System for articular surface replacement
US9931211B2 (en) 2003-02-24 2018-04-03 Arthrosurface Incorporated Trochlear resurfacing system and method
WO2004084773A1 (en) * 2003-03-21 2004-10-07 Feiwell Lawrence M D Sphere-on-sphere ankle prosthesis
US9681958B2 (en) 2003-08-27 2017-06-20 Stryker European Holdings I, Llc Ankle-joint endoprosthesis
US8591595B2 (en) 2003-08-27 2013-11-26 Link America, Inc. Ankle-joint endoprosthesis
WO2005030098A1 (en) * 2003-08-27 2005-04-07 Waldemar Link Gmbh & Co. Kg Ankle-joint endoprosthesis
WO2005041823A1 (en) * 2003-10-02 2005-05-12 Concepts In Medicine Iii, Llc Ankle joint prosthesis
EP1563807A1 (en) * 2004-02-13 2005-08-17 Buechel-Pappas Trust Ankle prosthesis including tibial component having peripheral wall for preventing the formation of bone cysts
US7485147B2 (en) 2004-02-13 2009-02-03 Pappas Michael J Ankle prosthesis including tibial component having peripheral wall for preventing the formation of bone cysts
US7915046B2 (en) 2004-06-30 2011-03-29 Depuy Products, Inc. System and method for determining the operating state of orthopaedic admixtures
EP1850800A4 (en) * 2005-02-22 2010-01-06 Arthrosurface Inc Articular surface implant
EP1850800A2 (en) * 2005-02-22 2007-11-07 ArthroSurface, Inc. Articular surface implant
EP1731115A1 (en) * 2005-06-08 2006-12-13 Implantcast GmbH Cement-free tibial component for an ankle replacement prosthesis and an ankle prosthesis comprising such a component
WO2006136940A2 (en) * 2005-06-24 2006-12-28 Malan De Villiers Ankle prosthesis
WO2006136940A3 (en) * 2005-06-24 2007-06-07 Villiers Malan De Ankle prosthesis
US10045788B2 (en) 2006-12-11 2018-08-14 Arthrosurface Incorporated Retrograde resection apparatus and method
EP2124832B2 (en) 2006-12-23 2017-07-19 Corin Limited Improvements in and relating to an ankle prosthesis
US9662126B2 (en) 2009-04-17 2017-05-30 Arthrosurface Incorporated Glenoid resurfacing system and method
EP2635239A1 (en) * 2010-11-02 2013-09-11 Adam D. Perler Prosthetic device with multi-axis dual bearing assembly and methods for resection
EP2635239A4 (en) * 2010-11-02 2014-09-24 Adam D Perler Prosthetic device with multi-axis dual bearing assembly and methods for resection
WO2012061453A1 (en) 2010-11-02 2012-05-10 Perler Adam D Prosthetic device with multi-axis dual bearing assembly and methods for resection
US9931219B2 (en) 2014-03-07 2018-04-03 Arthrosurface Incorporated Implant and anchor assembly
US9861492B2 (en) 2014-03-07 2018-01-09 Arthrosurface Incorporated Anchor for an implant assembly
US9962265B2 (en) 2014-03-07 2018-05-08 Arthrosurface Incorporated System and method for repairing articular surfaces
JP2016536102A (en) * 2014-09-12 2016-11-24 ライト メディカル テクノロジー インコーポレイテッドWright Medical Technology, Inc. Talus vault prosthesis
US9579210B2 (en) 2014-11-07 2017-02-28 Wright Medical Technology, Inc. Talar dome fixation stem

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