FR2720931A1 - Femoral shank for hip prosthesis - Google Patents

Femoral shank for hip prosthesis Download PDF

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Publication number
FR2720931A1
FR2720931A1 FR9407209A FR9407209A FR2720931A1 FR 2720931 A1 FR2720931 A1 FR 2720931A1 FR 9407209 A FR9407209 A FR 9407209A FR 9407209 A FR9407209 A FR 9407209A FR 2720931 A1 FR2720931 A1 FR 2720931A1
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France
Prior art keywords
bone
femoral stem
stem according
neck
rod
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Granted
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FR9407209A
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French (fr)
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FR2720931B1 (en
Inventor
Michel-Henri Fessy
Louis-Paul Fischer
Marc Maisonnier
Frederic Chauvin
Jean-Christophe Chatelet
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Individual
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Individual
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30205—Three-dimensional shapes conical
    • A61F2002/3021—Three-dimensional shapes conical frustoconical
    • 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
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30326—The prosthesis having different structural features at different locations within the same prosthesis differing in height or in length
    • 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
    • A61F2002/3082—Grooves
    • A61F2002/30827—Plurality of grooves
    • A61F2002/30828—Plurality of grooves parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2002/3678—Geometrical features
    • A61F2002/3698—Geometrical features twisted about the longitudinal axis of the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0037—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in height or in length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

The shank (1) is made with a regular lengthwise twist from the base of its metaphysis section (2a) to the base of its neck (3)l, passing through an angle of some 40 degrees. The diaphysis section of the shank is basically conical in shape with a small angle of taper, and has a cross-section smaller than that of the femur's medullary canal. The shank has a convex outer surface (5), with its portion with the greatest projection lying in line with an extension of the neck's axis. It is anchored in the femur by a synthetic cement. The outer surface of the shank can have lengthwise grooves for the adhesive, and the metaphysis section has a porous coating of calcium hydroxyapatite to promote bone growth.

Description

La présente invention concerne une tige fémorale de prothèse de hanche. The present invention relates to a femoral stem of a hip prosthesis.

Une tige fémorale présente classiquement une queue médullaire destinée à être engagée dans l'os, un col faisant saillie à l'extérieur de l'os lorsque la tige est mise en place et une tête sphérique engagée sur l'extrémité du col. La tête prothétique vient généralement coopérer avec une cavité sphérique correspondante que comprend une cupule cotyloïdienne fixée au bassin. A femoral stem conventionally has a medullary tail intended to be engaged in the bone, a neck protruding outside the bone when the stem is inserted and a spherical head engaged on the end of the neck. The prosthetic head generally comes to cooperate with a corresponding spherical cavity that includes an acetabular cup fixed to the pelvis.

Les tiges existantes présentent fréquemment une forme plus ou moins standardisée, qui ne correspond pas parfaitement à l'anatomie de la cavité médullaire au niveau de l'extrémité supérieure du fémur. The existing stems frequently have a more or less standardized shape, which does not correspond perfectly to the anatomy of the medullary cavity at the level of the upper end of the femur.

I1 en résulte une possibilité de micro-mouvements de la tige par rapport à l'os, pouvant générer des fissures dans le ciment de scellage de la tige à l'os ou, lorsque l'ancrage s'opère par repousse osseuse, compromettre cet ancrage et générer des douleurs. I1 results in a possibility of micro-movements of the rod relative to the bone, which can generate cracks in the cement sealing the rod to the bone or, when the anchoring takes place by bone regrowth, compromising this anchoring and generating pain.

En outre, une mauvaise adaptation de la forme de la tige à la cavité médullaire peut entraîner une mauvaise répartition des contraintes, pouvant conduire à des douleurs au niveau de l'extrémité distale de la tige, où s'exercent en priorité ces contraintes, et à une détérioration ou fragilisation de la partie proximale de l'os, non soumise à ces contraintes. In addition, a poor adaptation of the shape of the rod to the medullary cavity can lead to a poor distribution of the stresses, which can lead to pain at the distal end of the rod, where these stresses are exerted as a priority, and to a deterioration or weakening of the proximal part of the bone, not subject to these constraints.

Pour remédier à ces inconvénients, il est connu de concevoir une tige fémorale dite "à hélitorsion", c'est-à-dire présentant, au niveau de sa partie métaphysaire, un vrillage longitudinal de l'ordre de 10 à 15 degrés dans le sens de l'antéversion du col. To overcome these drawbacks, it is known to design a so-called "helitorion" femoral rod, that is to say having, at its metaphyseal part, a longitudinal twist of the order of 10 to 15 degrees in the sense of cervical anteversion.

Une telle hélitorsion améliore l'ancrage de la tige, sans toutefois que l'ancrage obtenu par les tiges existantes s'avère optimal. Such a helitorion improves the anchoring of the rod, without however the anchoring obtained by the existing rods being optimal.

La présente invention vise à remédier à cet inconvénient.  The present invention aims to remedy this drawback.

La tige fémorale qu'elle concerne est du type précité dite "à hélitorsion", et est caractérisée en ce que le vrillage longitudinal est régulier et s'étend depuis la base de la partie métaphysaire jusqu'au-delà de la base du col, l'angle que forment entre eux les axes médians des sections de la tige aux deux extrémités de la partie vrillée étant de l'ordre de 40 degrés. The femoral stem that it relates to is of the aforementioned type called "helitorion", and is characterized in that the longitudinal twist is regular and extends from the base of the metaphyseal part to beyond the base of the neck, the angle formed between them by the median axes of the sections of the rod at the two ends of the twisted part being of the order of 40 degrees.

La tige selon l'invention présente par conséquent un vrillage nettement plus marqué que les tiges existantes, et qui se poursuit jusqu'au-delà de la base du col. The rod according to the invention therefore has a markedly more marked twist than the existing rods, and which continues beyond the base of the neck.

La forme de la partie métaphysaire de cette tige s'avère parfaitement adaptée à l'anatomie de l'extrémité supérieure du fémur. La tige assure un complet remplissage de la cavité médullaire et présente une surface de contact importante entre l'implant et l'os cortico-spongieux métaphysaire, ce qui donne toute garantie de bonne transmission et répartition des contraintes exercées. The shape of the metaphyseal part of this rod is perfectly adapted to the anatomy of the upper end of the femur. The rod provides complete filling of the medullary cavity and has a large contact surface between the implant and the metaphyseal cortico-cancellous bone, which gives every guarantee of good transmission and distribution of the stresses exerted.

De plus et surtout, cette forme spécifique assure un blocage complet de la tige par rapport à l'os, dans toutes les directions de l'espace. Tout risque d'enfoncement excessif ou de rotation axiale de la tige par rapport à l'os est éliminé. In addition and above all, this specific shape ensures complete blocking of the rod relative to the bone, in all directions of space. Any risk of excessive sinking or axial rotation of the rod relative to the bone is eliminated.

L'antéversion du col obtenue par cette valeur d'hélitorsion s'avère parfaitement anatomique. The anteversion of the cervix obtained by this helitorion value proves to be perfectly anatomical.

Avantageusement, la partie diaphysaire de la tige présente une forme sensiblement conique de faible pente et une section inférieure à celle du canal médullaire de 1 ' os .  Advantageously, the diaphyseal part of the stem has a substantially conical shape with a slight slope and a section smaller than that of the medullary canal of the bone.

Cette partie diaphysaire se trouve ainsi à distance de la paroi corticale lorsque la tige est en place dans l'os. Elle ne joue aucun rôle de maintien de la tige par rapport à l'os, mais seulement un rôle de guidage de celle-ci lors de son introduction dans la cavité médullaire. L'adaptation rigoureuse de la partie métaphysaire de la tige à la forme anatomique de la cavité médullaire au niveau de l'extrémité supérieure du fémur permet de parfaitement maintenir la partie diaphysaire de la tige coaxialement par rapport à la diaphyse et, donc, d'éliminer tout risque de venue de cette partie diaphysaire en contact avec la paroi corticale. This diaphyseal part is thus at a distance from the cortical wall when the rod is in place in the bone. It plays no role in retaining the rod relative to the bone, but only a role in guiding the latter during its introduction into the medullary cavity. The rigorous adaptation of the metaphyseal part of the rod to the anatomical shape of the medullary cavity at the level of the upper end of the femur allows the diaphyseal part of the rod to be perfectly maintained coaxially with respect to the diaphysis and, therefore, eliminate any risk of this diaphyseal part coming into contact with the cortical wall.

Les douleurs dues à la venue en appui de l'extrémité distale de la tige contre la paroi corticale sont ainsi éliminées. The pain due to the abutment of the distal end of the rod against the cortical wall is thus eliminated.

En outre, la partie métaphysaire de la tige présente avantageusement une face extérieure convexe, dont la zone la plus saillante se trouve sensiblement dans le prolongement de l'axe du col. In addition, the metaphyseal part of the rod advantageously has a convex outer face, the most projecting zone of which is substantially in the extension of the axis of the neck.

Le positionnement géométrique de cette zone permet de recevoir directement l'essentiel des contraintes et de les transmettre dans les meilleures conditions à l'os métaphysaire. I1 en résulte une limitation des contraintes verticales d'enfoncement et une transmission harmonieuse de ces contraintes à l'os. The geometrical positioning of this zone makes it possible to receive most of the stresses directly and to transmit them under the best conditions to the metaphyseal bone. This results in a limitation of the vertical driving stresses and a harmonious transmission of these stresses to the bone.

La tige fémorale selon l'invention peut être prévue soit pour être ancrée au moyen de ciment synthétique, soit pour être ancrée par repousse osseuse. The femoral stem according to the invention can be provided either to be anchored by means of synthetic cement, or to be anchored by bone regrowth.

Dans le premier cas, la tige est lisse sur l'ensemble de sa surface, sauf dans son extrémité distale. In the first case, the stem is smooth over its entire surface, except at its distal end.

Elle peut avantageusement comprendre des rainures assurant, à titre complémentaire, sa prise d'appui dans le ciment de scellage. Une rainure rectiligne peut s'étendre sur toute la longueur de la tige et deux rainures latérales, parallèles à cette première rainure longitudinale, peuvent être prévues au niveau de la partie métaphysaire.It can advantageously include grooves ensuring, as a complement, its support in the sealing cement. A rectilinear groove can extend over the entire length of the rod and two lateral grooves, parallel to this first longitudinal groove, can be provided at the level of the metaphyseal part.

Dans le second cas, la partie métaphysaire de la tige reçoit un revêtement poreux d'hydroxyapatite de calcium, destiné à être envahi par l'os spongieux lors de sa repousse. In the second case, the metaphyseal part of the stem receives a porous coating of calcium hydroxyapatite, intended to be invaded by the cancellous bone during its regrowth.

Pour sa bonne compréhension, l'invention va être à nouveau décrite ci-après, en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de la tige fémorale qu'elle concerne. For a good understanding, the invention will be described again below, with reference to the appended diagrammatic drawing representing, by way of nonlimiting example, a preferred embodiment of the femoral stem which it concerns.

La figure 1 en est une vue de face ;
les figures 2 à 11 en sont des vues en coupe selon les lignes II-II à XI-XI de la figure 1
la figure 12 en est une vue latérale, coté extérieur et
la figure 13 en est une vue selon une variante.Figure 1 is a front view;
Figures 2 to 11 are sectional views along lines II-II to XI-XI of Figure 1
Figure 12 is a side view, exterior side and
Figure 13 is a view according to a variant.

Les figures représentent une tige fémorale 1 de prothèse de hanche. The figures represent a femoral stem 1 of hip prosthesis.

Cette tige 1 présente une queue médullaire 2, un col 3 faisant saillie à l'extérieur de l'os lorsque la tige 1 est mise en place et une tête sphérique (non représentée) engagée sur l'extrémité conique du col 3. This rod 1 has a medullary tail 2, a neck 3 protruding outside the bone when the rod 1 is put in place and a spherical head (not shown) engaged on the conical end of the neck 3.

Comme le montrent plus particulièrement les figures 2 à 11, la tige fémorale 1 présente un vrillage longitudinal, dit "à hélitorsion", s'étendant depuis la base de la partie métaphysaire 2a (figure 5) jusqu'au-delà de la base du col 3 (figure 11). En comparant les figures 2 à 11, il apparaît que cette hélitorsion est régulière et que l'angle que forment entre eux les axes médians des sections de la tige 1 aux deux extrémités de la partie vrillée est de l'ordre de 40 degrés. As shown more particularly in FIGS. 2 to 11, the femoral stem 1 has a longitudinal twist, called "helitoral", extending from the base of the metaphyseal part 2a (FIG. 5) to beyond the base of the col 3 (figure 11). By comparing FIGS. 2 to 11, it appears that this helitorion is regular and that the angle formed between them by the median axes of the sections of the rod 1 at the two ends of the twisted part is of the order of 40 degrees.

En outre, la partie métaphysaire 2a présente une face extérieure 5 convexe, dont la zone 5a la plus saillante se trouve sensiblement dans le prolongement de l'axe du col 3. La partie diaphysaire 2b présente une forme sensiblement conique de faible pente et une section inférieure à celle du canal médullaire de l'os (figures 2 à 4). In addition, the metaphyseal part 2a has a convex outer face 5, the most projecting zone 5a of which is substantially in the extension of the axis of the neck 3. The diaphyseal part 2b has a substantially conical shape of slight slope and a section lower than that of the bone marrow canal (Figures 2 to 4).

La partie métaphysaire 2a de cette tige 1 s'avère, grâce à cette forme spécifique, parfaitement adaptée à l'anatomie de la cavité médullaire de l'extrémité supérieure du fémur. Elle vient assurer un complet remplissage de cette cavité et présente une surface de contact importante avec l'os cortico-spongieux métaphysaire, ce qui donne toute garantie de bonne transmission et répartition des contraintes exercées par la tige 1 sur l'os. The metaphyseal part 2a of this rod 1 turns out, thanks to this specific shape, perfectly adapted to the anatomy of the medullary cavity of the upper end of the femur. It ensures complete filling of this cavity and has a large contact surface with the cortical-cancellous metaphyseal bone, which gives any guarantee of good transmission and distribution of the stresses exerted by the rod 1 on the bone.

De plus et surtout, elle assure un blocage complet de la tige 1 par rapport à l'os, dans toutes les directions de l'espace. Tout risque d'enfoncement excessif ou de rotation axiale de la tige par rapport à l'os est éliminé. In addition and above all, it ensures complete blocking of the rod 1 relative to the bone, in all directions of space. Any risk of excessive sinking or axial rotation of the rod relative to the bone is eliminated.

L'antéversion du col 3 obtenue par cette valeur d'hélitorsion élevée s'avère parfaitement anatomique. The anteversion of the cervix 3 obtained by this high helitorion value proves to be perfectly anatomical.

Le positionnement géométrique de la zone 5a permet à celle-ci de recevoir directement l'essentiel des contraintes et de les transmettre dans les meilleures conditions à l'os métaphysaire. I1 en résulte une limitation des contraintes verticales d'enfoncement, et une transmission harmonieuse de ces contraintes à l'os. The geometrical positioning of the zone 5a allows it to directly receive most of the stresses and to transmit them under the best conditions to the metaphyseal bone. This results in a limitation of the vertical driving stresses, and a harmonious transmission of these stresses to the bone.

La partie diaphysaire 2b se trouve, grâce à sa forme conique précitée, placée à distance de la paroi corticale lorsque la tige 1 est insérée dans la cavité médullaire de l'os. Elle ne joue aucun rôle de maintien de la tige 1 par rapport à l'os, mais seulement un rôle de guidage de celle-ci lors de cette insertion. La coïncidence rigoureuse de la forme de la partie métaphysaire 2a avec la forme de la cavité médullaire supérieure permet de parfaitement maintenir la partie diaphysaire 2b coaxialement par rapport à la corticale et, donc, d'éliminer tout risque de venue de cette partie diaphysaire 2b en contact avec l'os. The diaphyseal part 2b is, thanks to its aforementioned conical shape, placed at a distance from the cortical wall when the rod 1 is inserted into the medullary cavity of the bone. It plays no role in retaining the rod 1 relative to the bone, but only a role in guiding the latter during this insertion. The rigorous coincidence of the shape of the metaphyseal part 2a with the shape of the upper medullary cavity makes it possible to perfectly maintain the diaphyseal part 2b coaxially with respect to the cortex and, therefore, to eliminate any risk of coming of this diaphyseal part 2b in contact with the bone.

I1 en résulte qu'aucun appui de cette extrémité 2b contre la corticale ne peut se produire lors des micro-mouvements que la tige peut avoir par rapport à l'os. Les douleurs dues à une telle venue en appui sont ainsi éliminées. I1 follows that no support of this end 2b against the cortex can occur during micro-movements that the rod can have relative to the bone. The pain due to such support is eliminated.

La tige 1 représentée aux figures 1 à 12 est prévue pour être ancrée au moyen de ciment synthétique.  The rod 1 shown in Figures 1 to 12 is intended to be anchored by means of synthetic cement.

Elle est lisse sur l'ensemble de sa surface, sauf dans son extrémité distale. La tige représentée à la figure 13 comprend, selon une variante de réalisation de l'invention, une rainure rectiligne 6 s'étendant sur toute sa longueur et deux rainures latérales 7, parallèles à cette rainure longitudinale 6, s'étendant au niveau de sa partie métaphysaire. Ces rainures 6 et 7 assurent, à titre complémentaire, la prise d'appui de la tige dans le ciment de scellage. It is smooth over its entire surface, except at its distal end. The rod shown in Figure 13 comprises, according to an alternative embodiment of the invention, a rectilinear groove 6 extending over its entire length and two lateral grooves 7, parallel to this longitudinal groove 6, extending at its metaphyseal part. These grooves 6 and 7 provide, in addition, the support of the rod in the sealing cement.

Claims (7)

REVENDICATIONS 1 - Tige fémorale de prothèse de hanche, du type dite "à hélitorsion", c'est-à-dire présentant, au niveau de sa partie métaphysaire, un vrillage longitudinal dans le sens de l'antéversion du col, caractérisée en ce que ce vrillage longitudinal est régulier et s'étend depuis la base de la partie métaphysaire (2a) jusqu'au-delà de la base du col (3), l'angle que forment entre eux les axes médians des sections de la tige aux deux extrémités de la partie vrillée étant de l'ordre de 40 degrés. 1 - Femoral hip prosthesis stem, of the so-called "helitorion" type, that is to say having, at its metaphyseal part, a longitudinal twist in the direction of the anteversion of the cervix, characterized in that this longitudinal twist is regular and extends from the base of the metaphyseal part (2a) to beyond the base of the neck (3), the angle formed between them by the median axes of the sections of the stem at both ends of the twisted part being of the order of 40 degrees. 2 - Tige fémorale selon la revendication 1, caractérisée en ce que sa partie diaphysaire (2b) présente une forme sensiblement conique de faible pente et une section inférieure à celle du canal médullaire de l'os. 2 - Femoral stem according to claim 1, characterized in that its diaphyseal part (2b) has a substantially conical shape of slight slope and a section smaller than that of the medullary canal of the bone. 3 - Tige fémorale selon la revendication 1 ou la revendication 2, caractérisée en ce qu'elle comprend une face extérieure convexe (5), dont la zone (5a) la plus saillante se trouve sensiblement dans le prolongement de l'axe du col (3). 3 - Femoral stem according to claim 1 or claim 2, characterized in that it comprises a convex outer face (5), the most projecting zone (5a) of which is substantially in the extension of the axis of the neck ( 3). 4 - Tige fémorale selon l'une des revendications 1 à 3, caractérisée en ce qu'elle est prévue pour être ancrée au moyen de ciment synthétique, et en ce qu'elle est lisse sur l'ensemble de sa surface, sauf dans son extrémité distale (2b). 4 - Femoral stem according to one of claims 1 to 3, characterized in that it is intended to be anchored by means of synthetic cement, and in that it is smooth over the whole of its surface, except in its distal end (2b). 5 - Tige fémorale selon la revendication 4, caractérisée en ce qu'elle comprend des rainures (6,7) assurant sa prise d'appui dans le ciment de scellage. 5 - Femoral stem according to claim 4, characterized in that it comprises grooves (6,7) ensuring its support in the sealing cement. 6 - Tige fémorale selon la revendication 5, caractérisée en ce qu'elle comprend une rainure rectiligne (6) s'étendant sur toute sa longueur et deux rainures latérales (7), parallèles à cette première rainure (6), s'étendant au niveau de sa partie métaphysaire (2a). 6 - Femoral stem according to claim 5, characterized in that it comprises a rectilinear groove (6) extending over its entire length and two lateral grooves (7), parallel to this first groove (6), extending at level of its metaphyseal part (2a). 7 - Tige fémorale selon l'une des revendications 1 à 3, caractérisée en ce qu'elle est prévue pour être ancrée par repousse osseuse, et en ce que sa partie métaphysaire (2a) reçoit un revêtement poreux d'hydroxyapatite de calcium, destiné à être envahi par l'os spongieux.  7 - Femoral stem according to one of claims 1 to 3, characterized in that it is intended to be anchored by bone regrowth, and in that its metaphyseal part (2a) receives a porous coating of calcium hydroxyapatite, intended to be invaded by the cancellous bone.
FR9407209A 1994-06-08 1994-06-08 Femoral hip prosthesis stem. Expired - Lifetime FR2720931B1 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2125174A1 (en) * 1996-11-12 1999-02-16 Traiber S A Hip prosthesis
EP0962199A1 (en) * 1998-06-04 1999-12-08 Sulzer Orthopädie AG Shaft prosthesis
EP1013243A3 (en) * 1998-12-21 2002-10-16 Benoist Girard Sas Femoral component for use in replacement hip joint

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2618667A1 (en) * 1987-07-30 1989-02-03 Verola Jean Self-immobilising femoral rod for hip prosthesis
DE3829361A1 (en) * 1988-02-10 1989-08-24 Orthoplant Endoprothetik Cementable femoral part of a hip joint endoprosthesis
DE3913874C1 (en) * 1987-10-27 1990-05-23 Ulrich Dr.-Ing. 5600 Wuppertal De Witzel Hip joint prosthesis femur part - has shaft, whose cross-section is helically twisted from proximal to distal end
FR2660855A1 (en) * 1990-04-13 1991-10-18 Orthocogit Hip prosthesis
WO1991018560A1 (en) * 1990-06-07 1991-12-12 Denis Godeau Hip prosthesis
FR2676914A1 (en) * 1991-05-28 1992-12-04 Tec Implant Sarl Anatomical femoral prosthesis
EP0528284A1 (en) * 1991-08-19 1993-02-24 Intraplant AG Hip joint prosthesis
FR2683717A1 (en) * 1991-11-20 1993-05-21 Impact Est Femoral stem for total hip prosthesis

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2618667A1 (en) * 1987-07-30 1989-02-03 Verola Jean Self-immobilising femoral rod for hip prosthesis
DE3913874C1 (en) * 1987-10-27 1990-05-23 Ulrich Dr.-Ing. 5600 Wuppertal De Witzel Hip joint prosthesis femur part - has shaft, whose cross-section is helically twisted from proximal to distal end
DE3829361A1 (en) * 1988-02-10 1989-08-24 Orthoplant Endoprothetik Cementable femoral part of a hip joint endoprosthesis
FR2660855A1 (en) * 1990-04-13 1991-10-18 Orthocogit Hip prosthesis
WO1991018560A1 (en) * 1990-06-07 1991-12-12 Denis Godeau Hip prosthesis
FR2676914A1 (en) * 1991-05-28 1992-12-04 Tec Implant Sarl Anatomical femoral prosthesis
EP0528284A1 (en) * 1991-08-19 1993-02-24 Intraplant AG Hip joint prosthesis
FR2683717A1 (en) * 1991-11-20 1993-05-21 Impact Est Femoral stem for total hip prosthesis

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2125174A1 (en) * 1996-11-12 1999-02-16 Traiber S A Hip prosthesis
EP0962199A1 (en) * 1998-06-04 1999-12-08 Sulzer Orthopädie AG Shaft prosthesis
US6254640B1 (en) 1998-06-04 2001-07-03 Sulzer Orthopaedie Ag Shaft prosthesis and set
EP1013243A3 (en) * 1998-12-21 2002-10-16 Benoist Girard Sas Femoral component for use in replacement hip joint

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