FR2700947A1 - Prosthetic femoral implant for dysplastic hip - Google Patents

Prosthetic femoral implant for dysplastic hip Download PDF

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Publication number
FR2700947A1
FR2700947A1 FR9301378A FR9301378A FR2700947A1 FR 2700947 A1 FR2700947 A1 FR 2700947A1 FR 9301378 A FR9301378 A FR 9301378A FR 9301378 A FR9301378 A FR 9301378A FR 2700947 A1 FR2700947 A1 FR 2700947A1
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Prior art keywords
rod
neck
dysplastic
implant
pin
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Granted
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FR9301378A
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FR2700947B1 (en
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Noyer Daniel
Roussouly Pierre
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Noyer Daniel
Roussouly Pierre
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Priority to FR9301378A priority Critical patent/FR2700947B1/en
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Publication of FR2700947B1 publication Critical patent/FR2700947B1/en
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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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • 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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • 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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • 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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • A61F2/3676Distal or diaphyseal parts of shafts
    • 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30334Cone of elliptical or oval basis
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30339Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
    • 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
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. at discrete positions
    • 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
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30708Means for distinguishing between left-sided and right-sided devices, Sets comprising both left-sided and right-sided prosthetic parts
    • 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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611Heads or epiphyseal parts of femur
    • 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
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3609Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625Necks
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
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    • A61F2002/365Connections of heads to necks
    • AHUMAN NECESSITIES
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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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    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections 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
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    • A61F2250/0084Means for distinguishing between left-sided and right-sided devices; Sets comprising both left-sided and right-sided prosthetic parts

Abstract

This implant comprises, in combination: - a stem (3) suited to the specific dimensions of the medullary cavities of the dysplastic femurs; and - a cervical part (4) comprising an inclined neck (4b), which can be fitted onto the stem (3) in two stable positions located at 180 DEG from one another with, in one or the other of these positions, the side walls of the two parts (3, 4) lying in extension of one another. <IMAGE>

Description

IMPLANT FEMORAL DE PROTHESE POUR FEMORAL IMPLANT FOR PROSTHESIS
HANCHE DYSPLASIQUE HIP dysplastic
La présente invention concerne un implant fémoral de prothèse pour hanche dysplasique. The invention relates to a femoral implant prosthesis for hip dysplasia.

La mise en place d'une prothèse totale de hanche dans une hanche dysplasique pose, en ce qui concerne l'implant fémoral, des problèmes liés, d'une part, aux dimensions réduites du fémur, et en particulier du canal médullaire et, d'autre part, à l'antéversion ou à la rétroversion prononcée qu'il est nécessaire de donner au col de l'implant pour reproduire le fémur d'origine. The establishment of a total hip replacement in a dysplastic hip pose, regarding the femoral implant-related problems, firstly, the reduced size of the femur, and in particular the spinal canal and, Moreover, the anteversion or retroversion pronounced that it is necessary to give the implant neck to reproduce the original femur.

On connaît des implants de petite taille adaptés aux hanches dysplasiques, de type dit "Charnley ou Muller dysplasique". We know of small implants suitable for dysplastic hips, of the type called "Charnley Muller or dysplastic". La tige d'un tel implant est généralement droite afin de pouvoir pivoter autour de son axe dans le canal médullaire du fémur, pour permettre de régler l'ante ou la rétroversion du col du fémur. The stem of such an implant is generally straight so as to be pivotable about its axis in the medullary canal of the femur to allow for adjusting the ante or retroversion of the femoral neck. Ces implants présentent les inconvénients de n'être maintenus dans le canal médullaire du fémur qu'au moyen de leur ciment d'ancrage et d'avoir des appuis corticaux de faible surface. These implants have the disadvantages of being kept in the medullary canal of the femur by means of their anchoring cement and having cortical support of small area. Les contraintes répétées qu'ils subissent engendrent des risques importants de descellement, à relativement court terme. Repeated constraints they face involve significant risks of loosening, relatively short-term.

Pour remédier à ces inconvénients, une solution consiste à réaliser un implant sur mesure, dont les dimensions sont déterminées au moyen d'analyses radiographiques et d'une modélisation par traitement informatique. To overcome these disadvantages, one solution is to create a custom implant, whose dimensions are determined by radiographic analysis and modeling by computer processing. Ce procédé est toutefois complexe et coûteux à mettre en oeuvre. This method is however complex and expensive to implement. De plus, les dimensions de l'implant ainsi déterminées ne sont pas fidèles à cent pour cent et il existe un risque non négligeable que l'implant présente un défaut en longueur de la tige ou une erreur dans l'orientation du col par rapport à la diaphyse fémorale. In addition, the implant dimensions thus determined are not faithful to one hundred percent and there is a significant risk that the implant has a default length of the rod or an error in the orientation of the collar relative to femoral shaft.

La présente invention vise à remédier à ces inconvénients en fournissant un implant fémoral spécifiquement adapté aux fémurs dysplasiques, dont la tige soit maintenue en rotation dans le canal médullaire du fémur et dont le réglage de l'anté ou de la rétroversion du col soit possible de manière simple, facile et rapide, sans pour autant obliger à la fabrication de nombreuses pièces différentes adaptées aux différentes formes et dimensions possibles des articulations à reconstituer. The present invention aims to remedy these disadvantages by providing a femoral implant specifically adapted to dysplastic femurs, whose rod is rotatably held in the medullary canal of the femur and whose adjusting the ante or retroversion of the neck is possible to so simple, easy and fast, without obliging the manufacture of many different pieces adapted to the different possible shapes and dimensions of the joints to recover.

A cette fin, l'implant selon l'invention comprend, en combinaison To this end, the implant according to the invention comprises in combination
- une tige adaptée aux dimensions spécifiques des canaux médullaires des fémurs dysplasiques, c'est-à-dire suffisamment fine au niveau de son extrémité distale pour être engagée dans le canal médullaire du fémur, comprenant un évasement au niveau de sa partie métaphysaire et présentant une courbure antéro-postérieure prononcée ; - a rod adapted to the specific dimensions of the medullary canals of dysplastic femurs, that is to say sufficiently thin at its distal end to be engaged in the medullary canal of the femur, comprising an enlargement at its metaphyseal part and having an anteroposterior pronounced curvature; et and
- au moins une partie cervicale comprenant un col incliné, c'est-à-dire dont l'axe n'est pas contenu dans le plan médian longitudinal de l'implant, assemblable à la tige par engagement d'un pion faisant saillie de la face d'assemblage soit de la tige, soit de la partie cervicale, dans un puits de forme complémentaire débouchant dans la face d'assemblage, respectivement, soit de la partie cervicale, soit de la tige, le pion, le puits et les faces d'assemblage étant de forme symétrique par rapport aux plans médians longitudinal et transversal des faces d'assemblage et les dimensions de ces dernières étant identiques, de manière à ce que la partie cervicale puisse être emmanchée sur la tige selon deux positions stables situées à 1800 l'une de l'autre, avec, dans l'une ou l'autre de ces positions, la venue des parois latérales des deux pièces dans le prolongement les unes des autres. - at least one neck portion including an inclined neck, that is to say, the axis is not contained in the longitudinal median plane of the implant, assemblable to the rod by engagement of a peg projecting from the assembly face of either the rod or of the cervical segment, a complementarily shaped bore which opens into the assembly face, respectively, of the cervical part or of the rod, the pin, the wells and assembly faces being symmetrical shape with respect to the longitudinal and transverse median planes of the connecting surfaces and the dimensions of these latter being identical, so that the neck part can be fitted on the rod in two stable positions at 1800 from each other, with, in one or the other of these positions, the arrival of the side walls of the two parts in the extension of each other.

Grâce à sa forme adaptée à celle des fémurs dysplasiques, la tige peut être calée dans le canal médullaire du fémur, sans possibilité de pivotement selon son axe longitudinal. Thanks to its shape adapted to that of dysplastic femurs, the rod can be secured in the medullary canal of the femur, without the possibility of pivoting on its longitudinal axis. Son ciment d'ancrage n'est, par conséquent, que peu sollicité en torsion, ce qui limite de manière importante les risques de descellement. Its anchoring cement is therefore little solicited in torsion, which significantly reduces the risk of loosening.

La possibilité de montage de la partie cervicale à col incliné selon deux positions situées à 1800 l'une de l'autre permet, avec une seule et même partie cervicale, d'obtenir soit un col antéversé, soit un col rétroversé, par simple retournement de cette partie cervicale. The possibility of mounting the cervical collar according to two inclined positions located at 1800 from one another allows, with one and the same cervical part, to obtain either an anteverted neck, a neck retroverted by flipping this cervical portion.

Ainsi, l'invention permet de constituer, de manière simple, facile et rapide, une prothèse spécifiquement adaptée aux fémurs dysplasiques, avec seulement trois éléments de base, c'est-à-dire une tige pour le fémur droit, une tige pour le fémur gauche et la partie cervicale précitée. Thus, the invention allows to provide, in a simple, fast and easy, a prosthesis is tailored to dysplastic femurs with only three basic elements, that is to say a rod for the right femur, a stem for left femur and said cervical part. L'implant selon l'invention peut avantageusement être constitué à partir d'un jeu de différentes parties cervicales dont les cols présentent différentes inclinaisons. The implant according to the invention can advantageously be formed from a set of different parts including cervical collars have different inclinations. Ce jeu peut inclure une partie cervicale à col droit, employée lorsqu'il n'est pas nécessaire de réaliser une antéversion ou une rétroversion du col. This game may include a cervical collar part, used when it is not necessary to achieve anteversion or retroversion of the cervix.

Selon une forme de réalisation préférée de l'invention, le pion et le puits ont une forme tronconique à faible pente et une section transversale elliptique, le grand axe de l'ellipse étant contenu dans le plan médian longitudinal de la tige. According to a preferred embodiment of the invention, the peg and the wells have a truncated cone shape slightly inclined and an elliptical cross section, the major axis of the ellipse being contained in the longitudinal median plane of the rod.

La forme tronconique du pion et du puits assure une liaison axiale, par coincement conique, de la partie cervicale et de la tige, et la section transversale elliptique de ce pion et de ce puits assure une parfaite immobilisation en rotation de la partie cervicale par rapport à la tige. The frustoconical shape of the pin and the shaft provides an axial connection, by conical clamping, cervical portion and the stem, and the elliptical cross section of the pin and the well ensures perfect immobilization in rotation of the cervical portion relative to the stem.

Avantageusement, les parties diaphysaires et métaphysaires de l'implant sont galbées afin de s'adapter aux formes particulières des fémurs dysplasiques. Advantageously, the diaphyseal and metaphyseal portions of the implant are curved to adapt to the particular forms of dysplastic femurs.

De toute façon, l'invention sera bien comprise à l'aide de la description qui suit, en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de l'implant qu'elle concerne. Anyway, the invention will be better understood using the following description, with reference to the appended diagrammatic drawing representing, by way of nonlimiting example, a preferred embodiment of the implant to which it relates.

La figure 1 en est une vue de côté, en éclaté Figure 1 is a side view, exploded
la figure 2 en est une vue en coupe partielle selon la ligne Il-Il de la figure 3 ; Figure 2 is a partial sectional view along the line II-II of Figure 3;
la figure 3 en est une vue selon l'axe de sa partie cervicale ; Figure 3 is a view along the axis of the neck portion; et and
les figures 4 et 5 en sont des vues de face dans deux positions relatives différentes de deux de ses éléments constitutifs. Figures 4 and 5 are front views in two different relative positions of two of its components.

Les figures représentent sous différents angles un implant fémoral 2 pour prothèse de hanche dysplasique. The figures show different angles a femoral implant 2 for dysplastic hip prosthesis.

L'implant représenté est constitué à partir d'une tige 3, d'une partie cervicale 4 et d'une tête sphérique 5. The implant shown is constituted from a shank 3, a cervical portion 4 and a spherical head 5.

La tige 3 est adaptée aux dimensions spécifiques des canaux médullaires des fémurs dysplasiques, c'est-à-dire suffisamment fine au niveau de son extrémité distale 3a pour pouvoir être engagée dans le canal médullaire du fémur, comprenant un évasement au niveau de sa partie métaphysaire 3b et présentant une courbure antéro-postérieure prononcée. The rod 3 is adapted to the specific dimensions of the medullary canals of dysplastic femurs, that is to say sufficiently thin at its distal end 3a to be engaged in the medullary canal of the femur, comprising an enlargement at its part metaphyseal 3b and having an anteroposterior pronounced curvature.

Comme cela est visible sur les figures 4 et 5, sa partie distale 3a présente un galbe anatomique avec une faible pente dans le plan antéro-postérieur, assurant le bon coincement de la tige 3 dans le canal médullaire du fémur et deux chanfreins latéraux 6 évitant les appuis corticaux de son extrémité. As shown in Figures 4 and 5, the distal portion 3a has an anatomical curvature with a gentle slope in the antero-posterior plane, ensuring good clamping of the rod 3 into the medullary canal of the femur and two lateral chamfers 6 avoiding cortical support its end. Dans le plan latéral (figure 1), cette partie distale 3a présente une forme conique de faible pente, pour un bon guidage de l'implant lors de son introduction dans l'os. In the lateral plane (Figure 1), the distal portion 3a shows a conically shaped low slope, for good guidance of the implant during its introduction into the bone.

La partie métaphysaire 3b de la tige 3 est évasée pour procurer une bonne stabilité anti-rotatoire, tout en étant galbée pour s'adapter aux formes particulières des fémurs dysplasiques, et présente deux méplats latéraux 7 d'appui sur l'os. The metaphyseal portion 3b of the shaft 3 is flared to provide good anti-rotational stability while being curved to adapt to the particular forms dysplastic femurs and has two lateral flats 7 for bearing against the bone.

A l'extrémité de sa partie métaphysaire 3b, la tige 3 présente un pion 10 faisant saillie de sa face plane d'extrémité 11. Ce pion 10 est de forme tronconique à faible pente et de section transversale elliptique, le pion 10 et la face 11 étant de forme symétrique par rapport aux plans médians longitudinal et transversal de la face d'assemblage 11. At the end of the metaphyseal portion 3b, the rod 3 has a pin 10 protruding from its planar end face 11. This pin 10 is frustoconical in shape and slightly inclined elliptic cross section, the pin 10 and the face 11 being of symmetrical shape with respect to the longitudinal and transverse center planes of the assembly face 11.

La partie cervicale 4 présente une extrémité galbée 4a limitée, du côté opposé à la tête sphérique 5, par une face plane 12, perpendiculaire à l'axe de la partie cervicale 4 et de même dimension que la face d'extrémité 11 de la tige 3. Dans la face 12 est aménagé un puits tronconique de forme complémentaire à celle du pion 10, le puits et la face 12 étant également de forme symétrique par rapport aux plans longitudinal et transversal de la face 12. The cervical portion 4 has a curved end 4a limited, on the side opposite to the spherical head 5, by a plane face 12, perpendicular to the axis of the neck portion 4 and the same size as the end face 11 of the rod 3. in the face 12 is arranged a complementarily shaped conical wells to that of the pin 10, the well and the surface 12 also being of symmetrical shape with respect to longitudinal and transverse planes of the face 12.

La partie cervicale 4 comprend, du côté opposé à la face 12, un doigt tronconique à faible pente 4b, destiné à être engagé avec effet de coincement dans un puits tronconique complémentaire aménagé dans la tête fémorale 5. The cervical part 4 comprises, on the side opposite the face 12, a frustoconical finger low slope 4b to be engaged with a wedging effect in a complementary frusto-conical wells formed in the femoral head 5.

Ainsi que cela apparait sur les figures, la partie cervicale 4 est destinée à être emmanchée sur la tige 3 selon deux positions possibles, situées à 1800 l'une de l'autre, avec, dans l'une ou l'autre de ces positions, la venue des parois latérales des deux pièces dans le prolongement les unes des autres. As can be seen in the figures, the neck portion 4 is intended to be fitted on the shaft 3 in two possible positions, located at 1800 from each other, with, in one or the other of these positions , the arrival of the side walls of the two parts in the extension of each other.

Le col de la partie cervicale 4 que constitue le doigt 4b étant incliné, c'est-à-dire son axe n'étant pas contenu dans le plan médian longitudinal de la tige 3, la possibilité de montage de la partie cervicale 4 selon deux positions situées à 1800 l'une de l'autre permet, avec une seule et même partie cervicale 4, d'obtenir soit un col antéversé (figure 4), soit un col rétroversé (figure 5), par simple retournement de cette partie cervicale 4 sur l'extrémité de la tige 3. The neck of the neck portion 4 that constitutes the finger 4b is inclined, that is to say its axis is not contained in the longitudinal median plane of the rod 3, the mounting ability of the cervical part 4 in two positions at 1800 from one another allows, with one and the same cervical part 4, to obtain either an anteverted neck (4) or a retroverted neck (Figure 5), by simple reversal of this neck part 4 on the end of the rod 3.

Grâce à sa forme adaptée à celle des fémurs dysplasiques, la tige 3 peut être calée dans le canal médullaire du fémur, sans possibilité de pivotement selon son axe longitudinal. Thanks to its shape adapted to that of dysplastic femurs, the rod 3 can be wedged into the medullary canal of the femur, without the possibility of pivoting on its longitudinal axis. Son ciment d'ancrage n'est, par conséquent, que peu sollicité en torsion, ce qui limite de manière importante les risques de descellement. Its anchoring cement is therefore little solicited in torsion, which significantly reduces the risk of loosening.

La forme tronconique du pion 10 et du puits qui lui est complémentaire assure une liaison axiale, par coincement conique, de la partie cervicale 4 et de la tige 3, et la section transversale elliptique du pion 10 et de ce puits assure une parfaite immobilisation en rotation de la partie cervicale 4 par rapport à la tige 3. The frustoconical shape of the pin 10 and the shaft which is complementary thereto provides an axial connection, by conical clamping, cervical portion 4 and the rod 3, and the elliptical cross section of the pin 10 and this shaft ensures perfect immobilization rotation of the cervical part 4 relative to the rod 3.

Grâce à l'ensemble de ces caractéristiques, l'implant selon l'invention permet de constituer de manière simple, facile et rapide, une prothèse spécifiquement adaptée aux fémurs dysplasiques, avec seulement trois éléments de base, c'est-à-dire une tige 3 pour le fémur droit, une tige 3 pour le fémur gauche et une partie cervicale 4 à col incliné. With all these features, the implant according to the invention to form a simple, easy and fast, a prosthesis specifically tailored to dysplastic femurs, with only three basic elements, that is to say, a rod 3 to the right femur, a pin 3 for the left femur and a neck portion 4 with an inclined neck. L'implant 2 peut bien entendu être constitué à partir d'un jeu de différentes parties cervicales 4 dont les cols présentent différentes inclinaisons, ce jeu pouvant, en outre, inclure une partie cervicale à col droit, employée lorsqu'il n'est pas nécessaire de réaliser une antéversion ou une rétroversion du col. The implant 2 can of course be made from a set of different cervical parts 4 whose necks have different inclinations, this game may further include a cervical collar part, when not used necessary to achieve anteversion or retroversion of the cervix.

Claims (4)

REVENDICATIONS
1 - Implant fémoral de prothèse pour hanche dysplasique, caractérisé en ce qu'il comprend, en combinaison 1 - femoral implant prosthesis for dysplastic hip, characterized in that it comprises in combination
- une tige (3) adaptée aux dimensions spécifiques des canaux médullaires des fémurs dysplasiques, c'est-à-dire suffisamment fine au niveau de son extrémité distale (3a) pour être engagée dans le canal médullaire du fémur, comprenant un évasement au niveau de sa partie métaphysaire (3b) et présentant une courbure antéro-postérieure prononcée ; - a rod (3) adapted to the specific dimensions of the medullary canals of dysplastic femurs, that is to say sufficiently thin at its distal end (3a) to be engaged in the medullary canal of the femur, comprising a flare at of its metaphyseal part (3b) and having an anteroposterior pronounced curvature; et and
- au moins une partie cervicale (4) comprenant un col (4b) incliné, c'est-à-dire dont l'axe n'est pas contenu dans le plan médian longitudinal de l'implant (2), assemblable à la tige (3) par engagement d'un pion (10) faisant saillant de la face d'assemblage (11,12) soit de la tige (3), soit de la partie cervicale (4), dans un puits de forme complémentaire débouchant dans la face d'assemblage (11,12), respectivement, soit de la partie cervicale (4), soit de la tige (3), le pion (10), le puits et les faces d'assemblage (11,12) étant de forme symétrique par rapport aux plans médians longitudinal et transversal des faces d'assemblage (11,12) et les dimensions de ces dernières étant identiques, de manière à ce que la partie cervicale (4) puisse être emmanchée sur la tige (3) selon deux positions stables situées à 1800 l'une de l'autre, avec, dans l'une ou l'autre de ces positions, la venue des parois latérales des deux pièces (3,4) dans le prolongement les unes des autres - at least a neck portion (4) comprising a neck (4b) inclined, that is to say, the axis is not contained in the longitudinal median plane of the implant (2) assemblable to the rod (3) by engagement of a pin (10) being protruding from the assembly face (11,12) or the rod (3) or of the cervical portion (4) in a complementarily shaped opening into wells the assembly face (11,12), respectively, of the cervical portion (4) or the rod (3), the pin (10), the well and the assembly faces (11,12) being of symmetrical shape with respect to the longitudinal and transverse median planes of the assembly faces (11,12) and the dimensions of these latter being identical, so that the neck portion (4) can be fitted on the rod (3) according to two stable positions at 1800 from each other, with, in one or the other of these positions, the arrival of the side walls of the two parts (3,4) in the extension of each other . .
2 - Implant selon la revendication 1, caractérisé en ce qu'il est constitué à partir d'un jeu de différentes parties cervicales (4) présentant des cols de différentes inclinaisons, ce jeu pouvant également inclure une partie cervicale (4) à col droit. 2 - implant according to claim 1, characterized in that it is constituted from a set of different neck portions (4) having necked different inclinations, this game may also include a neck portion (4) with straight neck .
3 - Implant selon la revendication 1 ou la revendication 2, caractérisé en ce que le pion (10) et le puits ont une forme tronconique à faible pente et une section transversale elliptique, le grand axe de l'ellipse étant contenu dans le plan médian longitudinal de la tige (3). 3 - implant according to claim 1 or claim 2, characterized in that the pin (10) and the wells have a truncated cone shape slightly inclined and an elliptical cross section, the major axis of the ellipse being contained in the median plane the longitudinal rod (3).
4 - Implant selon l'une des revendications 1 à 3, caractérisé en ce que ses parties diaphysaires (3a) et métaphysaires (3b, 4a) sont galbées afin de s'adapter aux formes particulières des fémurs dysplasiques. 4 - An implant according to one of claims 1 to 3, characterized in that its parts diaphyseal (3a) and metaphyseal (3b, 4a) are curved in order to adapt to the particular forms dysplastic femurs.
FR9301378A 1993-02-03 1993-02-03 prosthetic femoral implant for hip dysplasia. Expired - Fee Related FR2700947B1 (en)

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FR2700947B1 FR2700947B1 (en) 1995-03-17

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Cited By (17)

* Cited by examiner, † Cited by third party
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US5645600A (en) * 1994-09-12 1997-07-08 Bimman; Lev A. High performance stem for arthroplasty
FR2753081A1 (en) * 1996-09-11 1998-03-13 Daniel Noyer femoral hip prosthesis Flanged antepulsee
FR2767471A1 (en) * 1997-08-25 1999-02-26 Serf Sa Femoral shank of hip prosthesis
WO2001070139A3 (en) * 2000-03-22 2002-05-23 Christopher M Angelucci Skeletal reconstruction cages
FR2832624A1 (en) * 2001-11-23 2003-05-30 Science Medecine Sa Femoral shank for hip prosthesis has metaphysis and diaphysis sections joined by couplings with right- and left-hand threads for corresponding hips
EP1336394A1 (en) * 2002-02-14 2003-08-20 LIMA Lto SpA Acetabular prosthesis of the hip
ITMI20101668A1 (en) * 2010-09-14 2012-03-15 Ala Ortho S R L Modular prosthetic device for hip joint replacement.
CN104622603A (en) * 2015-02-10 2015-05-20 北京市春立正达医疗器械股份有限公司 Combined type femoral stem
US9039775B2 (en) 2003-03-31 2015-05-26 DePuy Synthes Products, Inc. Spinal fixation plates
US9744049B2 (en) 2007-11-16 2017-08-29 DePuy Synthes Products, Inc. Low profile intervertebral implant
US9848992B2 (en) 2010-12-21 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9867718B2 (en) 2014-10-22 2018-01-16 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US10064740B2 (en) 2003-02-06 2018-09-04 DePuy Synthes Products, LLC Intervertebral implant
US10433976B2 (en) 2008-11-07 2019-10-08 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly
US10492922B2 (en) 2002-02-19 2019-12-03 DePuy Synthes Products, Inc. Intervertebral implant
US10512548B2 (en) 2006-02-27 2019-12-24 DePuy Synthes Products, Inc. Intervertebral implant with fixation geometry
US10531960B2 (en) 2016-07-08 2020-01-14 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly

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FR2647669A1 (en) * 1989-05-30 1990-12-07 Vialla Jean Marie Anatomical hip prosthesis
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Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5645600A (en) * 1994-09-12 1997-07-08 Bimman; Lev A. High performance stem for arthroplasty
FR2753081A1 (en) * 1996-09-11 1998-03-13 Daniel Noyer femoral hip prosthesis Flanged antepulsee
WO1998010720A1 (en) * 1996-09-11 1998-03-19 Daniel Noyer Femoral hip prosthesis with antepulsion-adapted seat
FR2767471A1 (en) * 1997-08-25 1999-02-26 Serf Sa Femoral shank of hip prosthesis
WO2001070139A3 (en) * 2000-03-22 2002-05-23 Christopher M Angelucci Skeletal reconstruction cages
FR2832624A1 (en) * 2001-11-23 2003-05-30 Science Medecine Sa Femoral shank for hip prosthesis has metaphysis and diaphysis sections joined by couplings with right- and left-hand threads for corresponding hips
EP1336394A1 (en) * 2002-02-14 2003-08-20 LIMA Lto SpA Acetabular prosthesis of the hip
US10492922B2 (en) 2002-02-19 2019-12-03 DePuy Synthes Products, Inc. Intervertebral implant
US10064740B2 (en) 2003-02-06 2018-09-04 DePuy Synthes Products, LLC Intervertebral implant
US9039775B2 (en) 2003-03-31 2015-05-26 DePuy Synthes Products, Inc. Spinal fixation plates
US9320549B2 (en) 2003-03-31 2016-04-26 DePuy Synthes Products, Inc. Spinal fixation plates
US10512548B2 (en) 2006-02-27 2019-12-24 DePuy Synthes Products, Inc. Intervertebral implant with fixation geometry
US10137003B2 (en) 2007-11-16 2018-11-27 DePuy Synthes Products, Inc. Low profile intervertebral implant
US9744049B2 (en) 2007-11-16 2017-08-29 DePuy Synthes Products, Inc. Low profile intervertebral implant
US10433976B2 (en) 2008-11-07 2019-10-08 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly
WO2012034771A1 (en) * 2010-09-14 2012-03-22 Ala Ortho S.R.L. Modular prosthetic device for hip joint replacement
ITMI20101668A1 (en) * 2010-09-14 2012-03-15 Ala Ortho S R L Modular prosthetic device for hip joint replacement.
US10507117B2 (en) 2010-12-21 2019-12-17 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9848992B2 (en) 2010-12-21 2017-12-26 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US10130492B2 (en) 2014-10-22 2018-11-20 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US9867718B2 (en) 2014-10-22 2018-01-16 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
US10010432B2 (en) 2014-10-22 2018-07-03 DePuy Synthes Products, Inc. Intervertebral implants, systems, and methods of use
CN104622603A (en) * 2015-02-10 2015-05-20 北京市春立正达医疗器械股份有限公司 Combined type femoral stem
US10531960B2 (en) 2016-07-08 2020-01-14 DePuy Synthes Products, Inc. Zero-profile interbody spacer and coupled plate assembly

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