FR2685193A1 - Hip prosthesis with extractable femoral head and extraction tool - Google Patents

Hip prosthesis with extractable femoral head and extraction tool Download PDF

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Publication number
FR2685193A1
FR2685193A1 FR9115938A FR9115938A FR2685193A1 FR 2685193 A1 FR2685193 A1 FR 2685193A1 FR 9115938 A FR9115938 A FR 9115938A FR 9115938 A FR9115938 A FR 9115938A FR 2685193 A1 FR2685193 A1 FR 2685193A1
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France
Prior art keywords
femoral
recess
femoral head
intended
housing
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Granted
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FR9115938A
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French (fr)
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FR2685193B1 (en
Inventor
De Leobardy Loup
Lajoie Daniel
Tardivon Alain
Segrestaa Daniel
Aucouturier Paul
Saunier Jean-Pierre
Lacroix Guy
Huitema Jean-Pierre
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MEDIC INSTR
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MEDIC INSTR
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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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The 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
    • A61F2002/30329—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
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3654—Connections of heads directly to shafts
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2002/3678—Geometrical features
    • A61F2002/3686—Geometrical features bent
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4641—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for disconnecting
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4681—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by applying mechanical shocks, e.g. by hammering
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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

Landscapes

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

Abstract

Femoral head constituting a part of a hip prosthesis, of spherical type and provided with a frustoconical recess intended to receive the free end of a femoral stem (12), itself intended to be introduced, especially in the medullary cavity (canal) of the femur (14), the free end of which stem is frustoconical so as to be able to interlock with the frustoconical recess of the femoral head, characterised in that it comprises, at its base, at least one hollow housing intended to receive the end of an impact extractor. The invention also relates to the corresponding impact tool.

Description

La présente invention a pour objet une tête fémorale extractible pour prothèse de hanche.The present invention relates to an extractable femoral head for hip prosthesis.

Dans le domaine chirurgical, la pose de prothèse de hanche est devenue courante. I1 s'agit de remplacer l'articulation de l'extrémité du fémur avec l'os iliaque, par une articulation mécanique.In the surgical field, the fitting of hip prostheses has become common. I1 is to replace the joint of the end of the femur with the iliac bone, by a mechanical joint.

Cette articulation comprend une partie réceptrice dite cotyle qui est une pièce munie d'un logement hémisphérique généralement une pièce en polyéthylène, ce logement étant destiné à coopérer avec la tette fémorale de la prothèse qui n'est autre qu'une sphère parfaitement calibrée aux dimension; du logement du cotyle, cette toute sphérique étant fixée à une pièce de liaison dite tige fémorale qui est introduite en force dans le canal médullaire du fémur préalablement tronqué.This articulation comprises a receiving part called the acetabulum which is a part provided with a hemispherical housing generally a polyethylene part, this housing being intended to cooperate with the femoral tette of the prosthesis which is none other than a sphere perfectly calibrated to the dimensions ; of the socket of the acetabulum, this all spherical being fixed to a connecting piece called the femoral rod which is forcefully introduced into the medullary canal of the previously truncated femur.

La partie maie de la prothèse, a savoir la tête fémorale et la pièce de liaison sont réalisées en deux éléments.The main part of the prosthesis, namely the femoral head and the connecting piece are made in two elements.

La pièce de liaison est introduite en force dans le canal médullaire du fémur. La sphère est tronquée et munie d'un évidement de forme complémentaire a celle de l'extrémité de la pièce de liaison, de façon à coopérer avec elle. Les formes de l'évide- ment et de l'extrémité de la pièce de liaison sont généralement tronconiques et la précision d'usinage permet un blocage mécanique efficace de la sphère sur l'extrémité de la tige de liaison par emmanchement à force.The connecting piece is forced into the medullary canal of the femur. The sphere is truncated and provided with a recess of a shape complementary to that of the end of the connecting piece, so as to cooperate with it. The shapes of the recess and the end of the connecting piece are generally frustoconical and the machining precision allows effective mechanical locking of the sphere on the end of the connecting rod by force fitting.

On sait par ailleurs que le cotyle est une pièce fragile qui peut s'user, se détériorer ou qui peut nécessiter des repositionnements par rapport a l'os iliaque, et les chirurgiens sont amenés à les remplacer, éventuellement pour changer également le diamètre de l'articulation.We also know that the acetabulum is a fragile part which can wear out, deteriorate or which may require repositioning relative to the iliac bone, and surgeons are led to replace them, possibly also to change the diameter of the 'joint.

Dans ce cas, la nouvelle intervention nécessite le remplacement du cotyle d'une part, et d'autre part de la toute fémorale elle-mBme. Le remplacement du cotyle est une opération bien connue qui n'intéresse pas directement l'invention.In this case, the new intervention requires the replacement of the acetabulum on the one hand, and on the other hand of the whole femoral itself. The replacement of the acetabulum is a well known operation which does not directly interest the invention.

Par contre, le changement de la toute fémorale pose un problème car ltemboutement mécanique de cette sphère sur la pièce de liaison est très efficace et il est souvent nécessaire de changer l'ensemble sphère et pièce de liaison. Ce remplacement est regrettable car il engendre un traumatisme de l'os et par conséquent du patient, or la pièce de liaison pourrait subsister et recevoir une nouvelle tête fémorale.By cons, the change of the entire femoral poses a problem because the mechanical drawing of this sphere on the connecting piece is very effective and it is often necessary to change the whole sphere and connecting piece. This replacement is regrettable because it causes trauma to the bone and therefore the patient, or the connecting piece could remain and receive a new femoral head.

Lors du démontage, le chirurgien est amené à retirer à l'aide d'un outil à choc la tête fémorale de la pièce de liaison. 11 arrive malheureusement très souvent que, malgré l'adresse du praticien, l'outil à choc endommage l'extrémité de la pièce de liaison devant recevoir la sphère. La moindre dégradation de l'état de surface de l'extrémité de cette pièce de liaison nécessite l'extraction également de cette pièce de liaison car il n'est plus possible d'introduire une nouvelle tête fémorale, comptetenu de la précision d'usinage et de l'état de surface des pièces.During disassembly, the surgeon is led to remove the femoral head from the connecting piece using an impact tool. Unfortunately, it very often happens that, despite the address of the practitioner, the impact tool damages the end of the connecting piece which is to receive the sphere. The slightest deterioration in the surface condition of the end of this connecting piece also requires the extraction of this connecting piece because it is no longer possible to introduce a new femoral head, taking into account the machining precision. and the surface condition of the parts.

Par ailleurs, on sait depuis longtemps qu'un choc violent en un point précis permet un déblocage brusque d'une pièce emboîtée sur une autre sans que cette dernière ne subisse un quelconque déplacement. Furthermore, it has been known for a long time that a violent shock at a precise point allows an abrupt release of a piece fitted onto another without the latter undergoing any displacement.

ussi, s la présente invention propose une tête fémorale extractible, destinée a store montée sur une pièce de liaison d'une prothèse de hanche notamment, qui pallie les inconvénients des testes fémorales de l'art antérieur et qui permet notamment une extraction aisée, qui évite toute détérioration de l'extrémité de la pièce de liaison, qui est d'un prix de revient peu élevé, qui est réalisable sur des pièces existantes par une reprise d'usinage qui évite toute modification des éléments de la prothèse autres que la tête fémorale ellemême et qui ne perturbe pas le fonctionnement de la prothèse en place après l'intervention. ussi, s the present invention provides an extractable femoral head, intended for a blind mounted on a connecting piece of a hip prosthesis in particular, which overcomes the drawbacks of the femoral tests of the prior art and which allows in particular an easy extraction, which avoids any deterioration of the end of the connecting part, which is of a low cost price, which can be achieved on existing parts by a resumption of machining which avoids any modification of the elements of the prosthesis other than the head femoral itself and which does not disturb the functioning of the prosthesis in place after the intervention.

cet effet, la toute fémorale, selon l'invention, constituant une partie d'une prothèse de hanche est sphérique et munie d'un évidement tronconique destiné à recevoir l'extrémité libre d'une tige fémorale, destinée à être introduite dans le canal médullaire d'un fémur, cette extrémité libre étant tronconique de façon à pouvoir coopérer par emboitement avec l'évidement de la toute fémorale, et elle se caractérise en ce qu'elle comprend à sa base au moins un logement en creux, destiné à recevoir l'extrémité d'un extracteur à choc. this effect, the entire femoral, according to the invention, constituting a part of a hip prosthesis is spherical and provided with a frustoconical recess intended to receive the free end of a femoral rod, intended to be introduced into the canal medullary of a femur, this free end being frustoconical so as to be able to cooperate by interlocking with the recess of the entire femoral, and it is characterized in that it comprises at its base at least one hollow housing, intended to receive the end of a shock extractor.

Selon une caractéristique particulière de l'invention, le logement en creux est disposé sur la périphérie sphérique extérieure de ladite toute fémorale.According to a particular characteristic of the invention, the hollow housing is disposed on the outer spherical periphery of said whole femoral.

Plus particulièrement, le logement en creux est réalisé dans l'épaisseur de la partie de sphère comprise entre la périphérie et l'évidement.More particularly, the hollow housing is produced in the thickness of the part of the sphere lying between the periphery and the recess.

Selon une caractéristique particulière de l'invention, la sphère constituant la tîte comprend une partie chanfreinée à sa base, en périphérie de l'évidement et le logement est porté par cette partie chanfreinée.According to a particular characteristic of the invention, the sphere constituting the top comprises a chamfered part at its base, at the periphery of the recess and the housing is carried by this chamfered part.

Selon un autre mode de réalisation particulier, ladite toute comprend quatre logements, régulière- ment répartis sur toute la périphérie, dont les dimensions sont de 3 mm pour la profondeur, 2 mm pour la hauteur et 2 mm pour la largeur.According to another particular embodiment, said whole comprises four housings, regularly distributed over the entire periphery, the dimensions of which are 3 mm for the depth, 2 mm for the height and 2 mm for the width.

Selon un mode de réalisation, le fond du logement est parallèle à la paroi de l'évidement intérieur de la toute, de façon que l'épaisseur entre le logement et l'évidement soit constante.According to one embodiment, the bottom of the housing is parallel to the wall of the interior recess of the whole, so that the thickness between the housing and the recess is constant.

La présente invention a également pour objet un outil d'impaction prévu pour coopérer avec le logement en creux de façon à permettre l'extraction de la tête fémorale par rapport à la tige fémorale.The present invention also relates to an impact tool intended to cooperate with the recessed housing so as to allow the extraction of the femoral head relative to the femoral stem.

La présente invention est décrite selon un mode de réalisation particulier, en regard des dessins annexés sur lesquels - la figure I représente une partie de prothèse de hanche, à savoir la tette fémorale et la tige fémorale, vue en élévation latérale, - la figure 2 représente une vue en coupe suivant la ligne 2-2 de la figure 1, - la figure 3 représente une vue de détail de la toute fémorale, munie de ses logements en creux, et - la figure 4 représente une vue de l'outil d'impaction.The present invention is described according to a particular embodiment, with reference to the appended drawings in which - Figure I represents a part of hip prosthesis, namely the femoral pad and the femoral stem, viewed in side elevation, - Figure 2 shows a sectional view along line 2-2 of Figure 1, - Figure 3 shows a detail view of the entire femoral, provided with its recesses, and - Figure 4 shows a view of the tool d impaction.

La figure 1 représente une partie de la prothèse de hanche qui comprend une toute fémorale 10 et une tige fémorale 12. L'ensemble est implanté dans un fémur 14 représenté en trait discontinu sur cette figure t
La teste fémorale 10 est représentée en détail sur la figure 2 ainsi qu'une partie de la tige fémorale 12.FIG. 1 represents a part of the hip prosthesis which includes a femoral whole 10 and a femoral stem 12. The assembly is implanted in a femur 14 shown in broken lines in this figure t
The femoral test 10 is shown in detail in FIG. 2 as well as part of the femoral stem 12.

La teste fémorale 10 est une sphère dont les matériaux peuvent être variés. Ils présentent une biocompacibilité certaine avec les tissus humains ainsi que des propriétés mécaniques et chimiques très strictes. La majorité de ces testes fémorales est métallique, notamment en titane. La tête fémo- rale comprend un évidement intérieur 16 réalisé par usinage mécanique. Cet évidement est très légèrement tronconique et la conicité est de quelques degrés. De plus, cet évidement est non débouchant et la profondeur est supérieure au rayon de la sphère. Cette sphère est par ailleurs tronquée dans sa partie basse 18 et un chanfrein 20 assure la liaison entre la partie sphérique proprement dite 22 et cette partie basse 18 ou embase.The femoral test 10 is a sphere of which the materials can be varied. They have a certain biocompatibility with human tissues as well as very strict mechanical and chemical properties. The majority of these femoral tests are metallic, in particular titanium. The femoral head comprises an internal recess 16 produced by mechanical machining. This recess is very slightly frustoconical and the taper is a few degrees. In addition, this recess is not opening and the depth is greater than the radius of the sphere. This sphere is also truncated in its lower part 18 and a chamfer 20 provides the connection between the spherical part proper 22 and this lower part 18 or base.

La tige fémorale 12 a une forme particulière conférée par la nature même du lieu d'implantation et cette tige fémorale se termine à son extrémité supérieure 24 par un doigt 26 en saillie de forme tronconique, la conicité et la longueur étant adaptées pour que la toute fémorale vienne se bloquer par rapport a la tige fémorale grâce aux portées coniques de l'évidement et la conicité du doigt 26.The femoral stem 12 has a particular shape conferred by the very nature of the place of implantation and this femoral stem terminates at its upper end 24 by a projecting finger 26 of frustoconical shape, the conicity and the length being adapted so that the whole femoral blocking with respect to the femoral stem thanks to the conical surfaces of the recess and the taper of the finger 26.

Sur la figure 3, on a représenté une vue partielle et agrandie de la tête fémorale 10 et plus particulièrement de son embase 18, de sa partie chanfreinée 20 et d'une partie de la surface sphérique 22, y compris l'évidement 16. Cette toute fémorale selon l'invention est modifiée par rapport à la tête fémorale de la figure 2 en ce qu'elle comprend au moins un logement en creux 28 ménagé dans la partie chanfreinée 20 de ladite teste fémorale. Ce logement en creux 28 est orienté de telle façon que le fond 30 du logement est sensiblement parallèle à la paroi de l'évidement de façon à conserver une épaisseur de matière constante entre le fond du trou et l'évidement. Quant à la partie supérieure de ce logement en creux elle est sensiblement horizontale. Ceci conduits sur des ttes fémorales existantes, à des dimensions de l'ordre de 3 mm de profondeur, 2 mm de hauteur et 2 mm de largeur.In Figure 3, there is shown a partial and enlarged view of the femoral head 10 and more particularly of its base 18, its chamfered part 20 and part of the spherical surface 22, including the recess 16. This any femoral according to the invention is modified with respect to the femoral head of FIG. 2 in that it comprises at least one hollow housing 28 formed in the chamfered part 20 of said femoral test. This recessed housing 28 is oriented such that the bottom 30 of the housing is substantially parallel to the wall of the recess so as to keep a constant thickness of material between the bottom of the hole and the recess. As for the upper part of this hollow housing, it is substantially horizontal. This leads to existing femoral heads, with dimensions of the order of 3 mm in depth, 2 mm in height and 2 mm in width.

Dans le mode de réalisation représenté, il est prévu trois logements en creux à l20. In the embodiment shown, three recesses are provided at 120.

Sur la figure 4, on a représenté un outil d'impaction 32 comportant un corps 34, une partie 36 formant enclume et une pointe 38 à son autre extrémité dont le profil est destiné à coopérer avec le logement en creux 28. À cet effet, la pointe 38 comprend une partie en saillie 40 destinée à coopérer avec le logement en creux 28 et une partie en creux 42 destinée à coopérer avec le chanfrein et une partie de la zone sphérique 22 de la teste fémorale.FIG. 4 shows an impact tool 32 comprising a body 34, a part 36 forming an anvil and a point 38 at its other end, the profile of which is intended to cooperate with the recessed housing 28. For this purpose, the tip 38 comprises a projecting part 40 intended to cooperate with the recessed housing 28 and a recessed part 42 intended to cooperate with the chamfer and a part of the spherical zone 22 of the femoral test.

Le fonctionnement et l'utilisation de l'ensemble outil et teste fémorale sont décrits ci-après - le praticien met en place la tête fémorale suivant une méthode bien connue et la tête fémorale selon l'invention ne requiert aucune manipulation particulière. En effet, la répartition des logements en creux 28 est suffisante pour que le praticien puisse toujours disposer d'un logement dans la zone de travail.The operation and use of the tool and femoral test assembly are described below - the practitioner sets up the femoral head according to a well-known method and the femoral head according to the invention does not require any particular manipulation. In fact, the distribution of the hollow recesses 28 is sufficient so that the practitioner can always have a housing in the working area.

Lorsque la tête fémorale doit être retirée, le praticien accède à la tête fémorale par les méthodes chirurgicales connues, puis il utilise l'outil d'impaction 32 en disposant la partie en saillie 40 dans le logement en creux 28 tandis que la partie en creux 42 coopère partiellement avec la tête fémorale de façon à éviter tout glissement et à assurer un bon positionnement de l'outil d'impaction. Le praticien choque la partie 36 formant enclume de l'outil d'impaction à l'aide d'un moyen approprié. Ce choc est transmis suivant l'axe longitudinal 44 de l'outil d'impaction et l'on constate que cet axe 44 permet d'exercer un effort sur la sphère qui tend à éjecter cette dernière de la tige fémorale sur laquelle elle est emboltée. When the femoral head must be removed, the practitioner accesses the femoral head by known surgical methods, then he uses the impaction tool 32 by placing the projecting part 40 in the hollow housing 28 while the hollow part 42 partially cooperates with the femoral head so as to avoid any sliding and to ensure proper positioning of the impaction tool. The practitioner shocks the anvil part 36 of the impact tool using an appropriate means. This shock is transmitted along the longitudinal axis 44 of the impaction tool and it can be seen that this axis 44 makes it possible to exert a force on the sphere which tends to eject the latter from the femoral stem on which it is embossed. .

L'outil permet ainsi une extraction sans risque d'endommagement du doigt qui constitue l'extrémité supérieure de la tige fémorale Ce doigt est donc prêt a recevoir une nouvelle teste fémorale sans nécessiter le retrait de la tige fémorale du fémur ou elle est installée. The tool thus allows extraction without risk of damage to the finger which constitutes the upper end of the femoral stem. This finger is therefore ready to receive a new femoral test without requiring the removal of the femoral stem from the femur where it is installed.

Claims (8)

REVENDICÀTIONS 1. Teste fémorale constituant une partie d'une prothèse de hanche, de type sphérique et munie d'un évidement tronconique (16) destiné à recevoir l'extrémité libre d'une tige fémorale (12), elle-mBme destinée a Strie introduite notamment dans le canal médullaire d'un fémur (14), tige dont l'extrémité libre (26) est tronconique de façon à pouvoir coopérer par embottement avec l'évidement tronconique de la tête fémorale, carac térisée en ce qu'elle comprend à sa base (18) au moins un logement (28) en creux destiné à recevoir l'extrémité (40) d'un extracteur à choc (32). 1. Femoral test constituting a part of a hip prosthesis, of spherical type and provided with a frustoconical recess (16) intended to receive the free end of a femoral stem (12), itself intended for introduced streak in particular in the medullary canal of a femur (14), rod whose free end (26) is frustoconical so as to be able to cooperate by embedding with the frustoconical recess of the femoral head, charac terized in that it comprises its base (18) at least one recess (28) hollow intended to receive the end (40) of an impact extractor (32). 2. Teste fémorale selon la revendication 1, caractérisée en ce que le logement (28) en creux est disposé sur la partie sphérique (22) extérieure de ladite tette fémorale. 2. Femoral test according to claim 1, characterized in that the recess (28) is arranged on the spherical part (22) outside of said femoral tette. 3. Teste fémorale selon la revendication 1 ou 2, caractérisée en ce que le logement (28) en creux est réalisé dans l'épaisseur e de la partie de sphère comprise entre la périphérie (22) et l'évi- dement (16). 3. Femoral test according to claim 1 or 2, characterized in that the recess (28) is made in the thickness e of the sphere part between the periphery (22) and the recess (16) . 4. Tête fémorale selon l'une quelconque des revendications précédentes, caractérisée en ce qu'elle comprend une partie chanfreinée (20) à sa base, en périphérie de l'évidement et en ce que le logement est porté par cette partie chanfreinée. 4. Femoral head according to any one of the preceding claims, characterized in that it comprises a chamfered part (20) at its base, at the periphery of the recess and in that the housing is carried by this chamfered part. 5. Teste fémorale selon l'une quelconque des rrevendications précédentes, caractérisée en ce qu'elle comprend quatre logements (28) en creux régulièrement répartis sur toute la périphérie dont les dimensions sont de 3 mm pour la profondeur, 2 mm pour la hauteur et 2 mm pour la largeur.  5. Femoral test according to any one of the preceding claims, characterized in that it comprises four recesses (28) hollow regularly distributed over the entire periphery whose dimensions are 3 mm for the depth, 2 mm for the height and 2 mm for the width. 6. Tête fémorale selon l'une quelconque des revendications précédentes, caractérisée en ce que le fond (30) du logement (28) est parallèle à la paroi de l'évidement intérieur de la toute de façon que l'épaisseur e entre le logement (28) et l'évi- dement (16) soit constante. 6. femoral head according to any one of the preceding claims, characterized in that the bottom (30) of the housing (28) is parallel to the wall of the interior recess in such a way that the thickness e between the housing (28) and the recess (16) is constant. 7. Outil d'impaction pour l'extraction d'une tête fémorale selon l'une quelconque des revendications 1 à 6, caractérisé en ce qu'il comprend une partie (36) formant enclume, l'autre extrémité (38) étant munie d'une pointe (44) de forme complémentaire à celle du logement (28) en creux. 7. Impaction tool for the extraction of a femoral head according to any one of claims 1 to 6, characterized in that it comprises a part (36) forming an anvil, the other end (38) being provided a point (44) of shape complementary to that of the recess (28). 8. Outil selon la revendication 7, caractérisé en ce que la pointe (44) comprend une partie supplémentaire (42) destinée à coopérer avec la partie chanfreinée (20) et avec une portion de la partie sphérique (22) de la tête fémorale (10).  8. Tool according to claim 7, characterized in that the tip (44) comprises an additional part (42) intended to cooperate with the chamfered part (20) and with a portion of the spherical part (22) of the femoral head ( 10).
FR9115938A 1991-12-20 1991-12-20 HIP PROSTHESIS WITH EXTRACTIBLE FEMALE HEAD AND EXTRACTION TOOL. Expired - Fee Related FR2685193B1 (en)

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2287209A1 (en) * 1975-10-13 1976-05-07 English Thomas SURGICAL PROSTHESIS
DE3306171A1 (en) * 1982-05-28 1983-12-08 Gebrüder Sulzer AG, 8401 Winterthur Ball head for a hip prosthesis
FR2606628A1 (en) * 1986-11-13 1988-05-20 Bataille Jacques Hip joint prostheses in a plurality of parts
EP0373078A1 (en) * 1988-12-07 1990-06-13 Fabrique D'implants Et D'instruments Chirurgicaux Societe A Responsabilite Limitee Femoral head positioning apparatus
EP0428303A1 (en) * 1989-11-03 1991-05-22 Wright Medical Technology, Inc. Modular hip joint prosthesis with adjustable anteversion
FR2660855A1 (en) * 1990-04-13 1991-10-18 Orthocogit Hip prosthesis
WO1991018559A1 (en) * 1990-06-06 1991-12-12 Ronald Sekel Hip prosthesis

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2287209A1 (en) * 1975-10-13 1976-05-07 English Thomas SURGICAL PROSTHESIS
DE3306171A1 (en) * 1982-05-28 1983-12-08 Gebrüder Sulzer AG, 8401 Winterthur Ball head for a hip prosthesis
FR2606628A1 (en) * 1986-11-13 1988-05-20 Bataille Jacques Hip joint prostheses in a plurality of parts
EP0373078A1 (en) * 1988-12-07 1990-06-13 Fabrique D'implants Et D'instruments Chirurgicaux Societe A Responsabilite Limitee Femoral head positioning apparatus
EP0428303A1 (en) * 1989-11-03 1991-05-22 Wright Medical Technology, Inc. Modular hip joint prosthesis with adjustable anteversion
FR2660855A1 (en) * 1990-04-13 1991-10-18 Orthocogit Hip prosthesis
WO1991018559A1 (en) * 1990-06-06 1991-12-12 Ronald Sekel Hip prosthesis

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