FR2699400A1 - Artificial shoulder prosthesis - Google Patents

Artificial shoulder prosthesis Download PDF

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Publication number
FR2699400A1
FR2699400A1 FR9215742A FR9215742A FR2699400A1 FR 2699400 A1 FR2699400 A1 FR 2699400A1 FR 9215742 A FR9215742 A FR 9215742A FR 9215742 A FR9215742 A FR 9215742A FR 2699400 A1 FR2699400 A1 FR 2699400A1
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FR
France
Prior art keywords
rod according
epiphyseal
elements
diaphyseal
arrangements
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
FR9215742A
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French (fr)
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FR2699400B1 (en
Inventor
Dr Delfosse
Dr Capon
Y Dr Bouchon
Dr Voydeville
Dr Boutens
Seriat-Gautier
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Medinov SA
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Medinov SA
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Priority to FR9215742A priority Critical patent/FR2699400B1/en
Publication of FR2699400A1 publication Critical patent/FR2699400A1/en
Application granted granted Critical
Publication of FR2699400B1 publication Critical patent/FR2699400B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime 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
    • A61F2/40—Joints for shoulders
    • 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
    • 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
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • A61F2002/30357—Stepped cylinders, i.e. having discrete diameter changes
    • 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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30767—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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30797—Blind bores, e.g. of circular cross-section internally-threaded
    • 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
    • A61F2/30767—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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2/30767—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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30899—Protrusions pierced with apertures
    • A61F2002/30902—Protrusions pierced with apertures laterally or radially
    • 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
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4018—Heads or epiphyseal parts of humerus
    • A61F2002/4022—Heads or epiphyseal parts of humerus having a concave shape, e.g. hemispherical cups
    • 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
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4029—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
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4044—Connections of necks 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
    • A61F2/40—Joints for shoulders
    • A61F2/4059—Humeral shafts
    • A61F2002/4062—Proximal or metaphyseal parts of 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
    • A61F2/40—Joints for shoulders
    • A61F2/4059—Humeral shafts
    • A61F2002/4077—Distal or diaphyseal parts of 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
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A61F2002/4085—Glenoid components, e.g. cups having a convex shape, e.g. hemispherical heads
    • 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
    • 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

Landscapes

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

Abstract

The artificial shoulder prosthesis is made from two separate components a shank (1) for implanting in the diaphysis of the humerus, and an epiphysial component (2) which can engage directly or indirectly with the scapular glene. The two components have matching surfaces which can be fixed together, e.g. female and male truncated cones (1a,2a) or threaded conical or cylindrical surfaces.The two components can incorporate a mechanism for locking them together, and both can be made in a variety of different sizes.

Description

Tige humérale Dour prothèse d'épaula
L'invention concerne le secteur technique des implants orthopédiques, notamment des prothèses d'épaule.Dour humeral stem shoulder prosthesis
The invention relates to the technical sector of orthopedic implants, in particular shoulder prostheses.

On connait différentes formes de réalisation de prothèses, conformées pour traiter les épaules détruites. Certaines prothèses sont plus particulièrement adaptées pour traiter les cas de rupture de coiffe des rotateurs susceptibles de détruire complètement la stabilité de l'épaule. There are known different embodiments of prostheses, shaped to treat destroyed shoulders. Certain prostheses are more particularly suitable for treating cases of rotator cuff rupture which may completely destroy the stability of the shoulder.

D'autres prothèses permettent de traiter les fractures comminutives de la tête humérale, ou les omarthroses avec destruction de la glène.Other prostheses are used to treat comminuted fractures of the humeral head, or osteoarthritis with destruction of the glenoid.

On a également proposé un ensemble prothétique composé d'éléments modulaires interchangeables permettant de traiter la plupart des traumatismes de l'articulation de l'épaule. Cet ensemble est défini dans la demande de brevet FR 8913366 dont le demandeur est également titulaire. Pour l'essentiel, cet ensemble modulaire comprend, en combinaison, un élément apte à être implanté dans''l8 fût huméral et dont la tête est conformée pour recevoir, d'une manière rapportée, des éléments interchangeables dont les formes et profils sont adaptés pour coopérer, soit directement avec la cavité glénoïde de l'épaule, soit avec des éléments complémentaires conformés pour être implantés dans une partie de ladite épaule, en fonction de la nature de la fracture ou autre à traiter. We have also proposed a prosthetic assembly composed of interchangeable modular elements making it possible to treat most of the traumas of the shoulder joint. This set is defined in patent application FR 8913366 of which the applicant is also the holder. Essentially, this modular assembly includes, in combination, an element capable of being implanted in''l8 humeral shaft and whose head is shaped to receive, in a reported manner, interchangeable elements whose shapes and profiles are adapted to cooperate, either directly with the glenoid cavity of the shoulder, or with complementary elements shaped to be implanted in a part of said shoulder, depending on the nature of the fracture or other to be treated.

Cet ensemble modulaire permet de réparer les articulations d'épaules, quels que soient les traumatismes. Par contre, très souvent, le praticien se trouve soit avec des humérus présentant des résections osseuses, soit avec des humérus plus ou moins tordus résultant de consolidations post-traumatiques. This modular set allows to repair the shoulder joints, whatever the trauma. On the other hand, very often, the practitioner is either with humerus presenting bone resections, or with more or less twisted humerus resulting from post-traumatic consolidations.

Ces humérus non anatomiques posent certains problèmes de congruence entre l'implant prothétique et l'os. These non-anatomical humerus pose certain problems of congruence between the prosthetic implant and the bone.

L'invention s'est fixée pour but de remédier à ces inconvénients, de manière simple, sûre efficace et rationnelle. The object of the invention is to remedy these drawbacks in a simple, safe, efficient and rational manner.

Le problème que se propose de résoudre l'invention est de créer une tige humérale de conception modulaire. The problem which the invention proposes to solve is to create a humeral rod of modular design.

Pour résoudre un tel problème, la tige comprend deux éléments distincts, à savoir un élément apte à être implanté dans la diaphyse de l'humérus et un élément épiphysaire apte à coopérer directement ou par l'intermédiaire d'organes rapportés, avec la glène scapulaire, lesdits éléments présentant des agencements complémentaires pour assurer leur fixation de manière démontable. To solve such a problem, the rod comprises two distinct elements, namely an element capable of being implanted in the diaphysis of the humerus and an epiphyseal element capable of cooperating directly or by means of attached organs, with the scapular glenoid , said elements having complementary arrangements to ensure their fixing in a removable manner.

Pour résoudre le problème posé d'assurer la fixation, de manière démontable entre les éléments épiphysairè et métaphysaire, les
lltr; agencements complémentaires de fixation sont constitués par un système de portées tronconiques.To solve the problem posed of securing, removably between the epiphyseal and metaphyseal elements, the
lltr; complementary fixing arrangements are constituted by a system of frustoconical bearing surfaces.

L'élément épiphysaire présente une portée tronconique mâle coopérant avec une portée tronconique femelle formée en bout de l'élément diaphysaire. Les éléments diaphysaire et épiphysaire présentent des moyens d'indexation et de blocage angulaire. The epiphyseal element has a male frustoconical bearing cooperating with a female frustoconical bearing formed at the end of the diaphyseal element. The diaphyseal and epiphyseal elements have means of indexing and angular blocking.

Dans une forme de réalisation, les agencements complémentaires de fixation sont constitués par un système de portée filetée et taraudée.  In one embodiment, the complementary fixing arrangements consist of a threaded and tapped bearing system.

L'élément épiphysaire présente une portée filetée mâle, formée coaxialement en bout d'une portée cylindrique et coopérant respectivement avec un alésage taraudé et un chambrage cylindrique formé en bout de l'élément diaphysaire. The epiphyseal element has a male threaded surface, formed coaxially at the end of a cylindrical surface and cooperating respectively with a threaded bore and a cylindrical recess formed at the end of the diaphyseal element.

Pour résoudre le problème posé de tenir compte de l'anatomie de l'épaule, l'élément épiphysaire présente une tête formée angulairement par rapport à un corps recevant les agencements de fixation. To solve the problem of taking into account the anatomy of the shoulder, the epiphyseal element has a head formed angularly with respect to a body receiving the fixing arrangements.

Pour résoudre le problème posé de traiter différents cas pathologiques et de tenir compte des différences de tailles susceptibles d'exister entre l'épiphyse et la diaphyse chaque élément est réalisé en plusieurs tailles, pour constituer plusieurs ensembles modulaires. To solve the problem posed of treating different pathological cases and taking into account the differences in sizes likely to exist between the epiphysis and the diaphysis each element is produced in several sizes, to constitute several modular sets.

En outre, l'un des éléments d'un ensemble est conformé pour être fixé sur un élément d'un autre ensemble. In addition, one of the elements of one set is shaped to be fixed on an element of another set.

L'invention est exposée, ci-après plus;en détail à l'aide des dessins annexés, dans lesquels:
La figure 1 est une vue en perspective avant montage, de la tige humérale selon l'invention.The invention is set out below in more detail with the aid of the appended drawings, in which:
Figure 1 is a perspective view before assembly, of the humeral rod according to the invention.

La figure 2 est une vue en coupe longitudinale de la tige selon la forme de réalisation illustrée figure 1. FIG. 2 is a view in longitudinal section of the rod according to the embodiment illustrated in FIG. 1.

La figure 3 montre par des vues éclatées, un ensemble modulaire selon l'invention. Figure 3 shows in exploded views, a modular assembly according to the invention.

Comme le montre la figure 1, la tige comprend deux éléments distincts (1) et (2). L'élément (1) est conformé pour être implanté dans la diaphyse de l'humérus. A cet égard, cet élément (1) présente tous types d'agencements etlou de profils pour permettre son ancrage dans le canal médulaire avec l'apport ou non d'un ciment. As shown in Figure 1, the rod comprises two separate elements (1) and (2). The element (1) is shaped to be implanted in the diaphysis of the humerus. In this regard, this element (1) has all types of arrangements and / or profiles to allow its anchoring in the medular canal with the addition or not of a cement.

L'élément (2) est conformé pour coopérer directement par l'intermédiaire d'organes rapportés, avec une tête humérale. Cet élément (2) constitue l'élément épiphysaire. The element (2) is shaped to cooperate directly by means of attached members, with a humeral head. This element (2) constitutes the epiphyseal element.

Selon une caractéristique à la base de l'invention, les éléments (1) et (2) présentent des agencements complémentaires pour assurer leur fixation de manière démontable. A cet égard, différentes solutions peuvent être envisagées. According to a characteristic at the base of the invention, the elements (1) and (2) have complementary arrangements to ensure their fixing in a removable manner. In this regard, different solutions can be envisaged.

Par exemple, les agencements sont constitués par un système de portées tronconiques (la) (2a). L'élément épiphysaire (2) présente une portée tronconique mâle (2a) coopérant avec une portée tronconique femelle (la) formée en bout de l'élément diaphysaire (1) (figures 1 et 2). For example, the arrangements are constituted by a system of frustoconical bearing surfaces (la) (2a). The epiphyseal element (2) has a male frustoconical bearing (2a) cooperating with a female frustoconical bearing (la) formed at the end of the diaphyseal element (1) (Figures 1 and 2).

Avantageusement, les éléments (1 ) et (2) présentent des moyens d'indexation et de blocage angulaire. De tels moyens' ne sont pas décrits
UCT; en détail, car ils ne font pas partie de l'objet spécifique de l'invention et peuvent présenter différentes formes d'exécution.Advantageously, the elements (1) and (2) have means of indexing and angular blocking. Such means are not described
UCT; in detail, since they do not form part of the specific object of the invention and can have different embodiments.

Dans l'exemple illustré figure 3, les agencements sont constitués par un système de portées filetée et taraudée. L'élément épiphysaire (2) présente une portée filetée mâle (2b) formée coaxialement en bout d'une portée cylindrique (2c). La portée filetée (2b) coopère avec un alésage taraudé (lob) formé coaxialement à Lin chambrage cylindrique (lc) établi en bout de la partie proximale de l'élément diaphysaire (1). Le chambrage (lc) reçoit la portée cylindrique (2c).  In the example illustrated in FIG. 3, the arrangements consist of a system of threaded and tapped spans. The epiphyseal element (2) has a male threaded surface (2b) formed coaxially at the end of a cylindrical surface (2c). The threaded seat (2b) cooperates with a threaded bore (lob) formed coaxially with a cylindrical recess (lc) established at the end of the proximal part of the diaphyseal element (1). The recess (lc) receives the cylindrical bearing (2c).

On prévoit également une solution mixte combinant les deux réalisations précédentes, à savoir une portée mâle tronconique filetée et une portée femelle tronconique taraudée. A mixed solution is also provided combining the two previous embodiments, namely a tapered tapered male bearing and a tapered tapered female bearing.

L'élément épiphysaire (2) présente une tête (2d) formée angulairement par rapport à un corps (2e). Les agencements de fixation entre les éléments (1) et (2) sont formés en bout du corps (2e). The epiphyseal element (2) has a head (2d) formed angularly relative to a body (2e). The fixing arrangements between the elements (1) and (2) are formed at the end of the body (2e).

Compte-tenu du caractère modulaire de la tige, et afin de s'adapter parfaitement à l'anatomie, une étude morphométrique a permis de retenir les tailles suivantes:
- pour la tête épiphysaire (2): # trois tailles d'épiphyse : une taille légèrement inférieure à 36 mm environ, une taille égale à 36 mm environ, et une taille égale à 42 mm environ.Given the modular nature of the rod, and in order to adapt perfectly to the anatomy, a morphometric study made it possible to select the following sizes:
- for the epiphyseal head (2): # three epiphysis sizes: one size slightly less than approximately 36 mm, one size equal to approximately 36 mm, and one size equal to approximately 42 mm.

# trois tailles de partie proximale qui correspondent respectivement aux tailles de l'épiphyse, à savoir une taille égale à 36 mm environ, une taille calée entre le modèle 36 mm et le modèle de 42 mm environ et une taille égale à 42 mm environ.  # three sizes of proximal part which correspond respectively to the sizes of the epiphysis, namely a size equal to approximately 36 mm, a size wedged between the model 36 mm and the model of approximately 42 mm and a size equal to approximately 42 mm.

- pour l'élément diaphysaire (1): # trois tailles sont prévues: une taille pour le modèle de 36 mm, une taille intermédiaire entre 36 mm et 42 mm et une taille pour le modèle de 42 mm. - for the diaphyseal element (1): # three sizes are provided: one size for the 36 mm model, an intermediate size between 36 mm and 42 mm and one size for the 42 mm model.

# deux longueurs de tige sont prévues pour chaque taille : un modèle standard pour le modèle de 36 mm, un modèle de rattrapage, c'est-à-dire de longueur plus importante pour le modèle de 36 mm.# two rod lengths are provided for each size: a standard model for the 36 mm model, a retrofit model, that is to say a longer one for the 36 mm model.

On renvoie à la figure 3 qui montre différents ensembles modulaires selon l'invention et les possibilités d'interchangeabilité entre les éléments (1) et (2). Bien évidemment, les valeurs numériques données ci-dessus le sont à titre indicatifs et constituent des exemples de réalisation préférés qui ne doivent pas être considérés comme limitatifs. Reference is made to FIG. 3 which shows different modular assemblies according to the invention and the possibilities of interchangeability between the elements (1) and (2). Obviously, the numerical values given above are for information only and constitute preferred embodiments which should not be considered as limiting.

On rappelle que l'élément épiphysaire (2) peut recevoir de manière démontable, des éléments interchangeables dont les formes et profils sont adaptés pour coopérer soit directement avec une partie de l'épaule, soit avec des éléments complémentaires conformés pour être implantés dans une partie de ladite épaule. Le choix de ces éléments est fonction de la nature de la pathologie à traiter. It is recalled that the epiphyseal element (2) can receive in a removable manner, interchangeable elements whose shapes and profiles are adapted to cooperate either directly with a part of the shoulder, or with complementary elements shaped to be implanted in a part of said shoulder. The choice of these elements depends on the nature of the pathology to be treated.

Ces dispositions ne sont pas décrites en détail car elles ressortent de l'enseignement de la demande de brevet précitée, FR 8913366. On rappelle simplement que ces éléments interchangeables comprennent une sphère humérale ou une cupule sphérique. These provisions are not described in detail because they emerge from the teaching of the aforementioned patent application, FR 8913366. It is simply recalled that these interchangeable elements comprise a humeral sphere or a spherical cup.

A noter que les agencements de solidarisation entre les deux éléments (1) et (2) sont dans l'axe de la tige, évitant ainsi toute erreur de positionnement. Le choix des éléments (1) et (2) est effectué en peropératoire au moyen de pièces d'essais, avant la' mise en place des
IlfT; implants définitifs.Note that the fastening arrangements between the two elements (1) and (2) are in the axis of the rod, thus avoiding any positioning error. The choice of elements (1) and (2) is made intraoperatively by means of test pieces, before the 'installation of
IlfT; final implants.

De même, le modèle de l'élément diaphysaire de grande longueur peut être utilisé pour des reconstructions humérales en utilisant des rondelles d'os pour reconstituer le fût huméral. Likewise, the long diaphyseal element model can be used for humeral reconstructions using bone washers to reconstruct the humeral shaft.

Les avantages ressortent bien de la description, en particulier on souligne et on rappelle le complément de modularité obtenu au niveau de la tige humérale par sa conception en deux parties amovibles permettant au praticien de choisir les éléments constitutifs de la tige, en fonction du cas pathologique à traiter.  The advantages emerge clearly from the description, in particular it underlines and recalls the additional modularity obtained at the level of the humeral rod by its design in two removable parts allowing the practitioner to choose the constituent elements of the rod, according to the pathological case. treat.

Claims (10)

REVENDICATIONS -1- Tige humérale pour prothèse d'épaule, caractérisée en ce qu'elle comprend deux éléments distincts, à savoir, un élément (1) apte à être implanté dans la diaphyse de l'humérus et un élément épiphysaire (2) apte à coopérer directement ou par l'intermédiaire d'organes rapportés, avec la glène scapulaire, lesdits éléments (1) (2) présentant des agencements complémentaires pour assurer leur fixation de manière démontable.-1- Humeral rod for shoulder prosthesis, characterized in that it comprises two distinct elements, namely, an element (1) capable of being implanted in the diaphysis of the humerus and an epiphyseal element (2) capable of cooperate directly or through attached members, with the scapular glenoid, said elements (1) (2) having complementary arrangements to ensure their fixing in a removable manner. -2- Tige selon la revendication 1, caractérisée en ce que les agencements complémentaires de fixation sont constitués par un système de portées tronconiques (1 a) (2a).-2- Rod according to claim 1, characterized in that the complementary fastening arrangements are constituted by a system of frustoconical bearing surfaces (1 a) (2a). -3- Tige selon la revendication 2, caractérisée en ce que l'élément épiphysaire (2) présente une portée tronconique mâle (2a) coopérant avec une portée tronconique femelle (la) formée en bout de l'élément diaphysaire (1).-3- Rod according to claim 2, characterized in that the epiphyseal element (2) has a male frustoconical bearing (2a) cooperating with a female frustoconical bearing (la) formed at the end of the diaphyseal element (1). -4- Tige selon la revendication 1, caractériséewën ce que l'élément épiphysaire (2) présente une portée tronconique mâle filetée coopérant avec une portée tronconique femelle taraudée formée en bout de l'élément diaphysaire (1).-4- Rod according to claim 1, characterizedwën that the epiphyseal element (2) has a tapered male tapered bearing cooperating with a tapered female tapered bearing formed at the end of the diaphyseal element (1). -5- Tige selon la revendication 1, caractérisée en ce que les agencements complémentaires de fixation sont constitués par un système de portées filetée (2b) et taraudée (lob). -5- Rod according to claim 1, characterized in that the complementary fixing arrangements are constituted by a system of threaded (2b) and tapped (lob) bearing surfaces. -6- Tige selon la revendication 5, caractérisée en ce que l'élément épiphysaire (2) présente une portée filetée mâle (2b), formée coaxialement en bout d'une portée cylindrique (2c) et coopérant respectivement avec un alésage taraudé (1 b) et un chambrage cylindrique (1 c) formé en bout de la partie proximale de l'élément diaphysaire (1).-6- Rod according to claim 5, characterized in that the epiphyseal element (2) has a male threaded surface (2b), formed coaxially at the end of a cylindrical surface (2c) and cooperating respectively with a threaded bore (1 b) and a cylindrical recess (1 c) formed at the end of the proximal part of the diaphyseal element (1). -7- Tige selon l'une quelconque des revendications 2 et 3, caractérisée en ce que les éléments diaphysaire (1) et épiphysaire (2) présentent des moyens d'indexation et de blocage angulaire. -7- Rod according to any one of claims 2 and 3, characterized in that the diaphyseal (1) and epiphyseal (2) elements have means of indexing and angular blocking. -8- Tige selon la revendication 1, caractérisée en ce que l'élément épiphysaire (2) présente une tête (2d) formée angulairement par rapport à un corps (2e) recevant les agencements de fixation.-8- Rod according to claim 1, characterized in that the epiphyseal element (2) has a head (2d) formed angularly relative to a body (2e) receiving the fixing arrangements. -9- Tige selon la revendication 1, caractérisée en ce que chaque élément (1) (2) est réalisé en plusieurs tailles, pour constituer plusieurs ensembles modulaires.-9- Rod according to claim 1, characterized in that each element (1) (2) is produced in several sizes, to constitute several modular assemblies. -10- Tige selon la revendication 9, caractérisée en ce que l'un des éléments (1) d'un ensemble est conformé pour être fixé sur un élément (2) d'un autre ensemble. -10- Rod according to claim 9, characterized in that one of the elements (1) of one set is shaped to be fixed on an element (2) of another set.
FR9215742A 1992-12-18 1992-12-18 Humeral stem for shoulder prosthesis. Expired - Lifetime FR2699400B1 (en)

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