FR2728157A1 - Hip joint prosthesis assembly - Google Patents

Hip joint prosthesis assembly Download PDF

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Publication number
FR2728157A1
FR2728157A1 FR9415536A FR9415536A FR2728157A1 FR 2728157 A1 FR2728157 A1 FR 2728157A1 FR 9415536 A FR9415536 A FR 9415536A FR 9415536 A FR9415536 A FR 9415536A FR 2728157 A1 FR2728157 A1 FR 2728157A1
Authority
FR
France
Prior art keywords
insert
cup
assembly
femoral
rigid
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
FR9415536A
Other languages
French (fr)
Other versions
FR2728157B1 (en
Inventor
Laurent Barba
Lavirotte Jean Yves Coillard
Gerard Gacon
Jean Jacques Lalain
Michel Laurencon
Christophe Levigne
Andre Ray
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ERAMI
Original Assignee
ERAMI
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Filing date
Publication date
Application filed by ERAMI filed Critical ERAMI
Priority to FR9415536A priority Critical patent/FR2728157B1/en
Publication of FR2728157A1 publication Critical patent/FR2728157A1/en
Application granted granted Critical
Publication of FR2728157B1 publication Critical patent/FR2728157B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related 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
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
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    • 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
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    • 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
    • A61F2002/30217—Three-dimensional shapes conical hollow cones, e.g. tubular-like cones
    • A—HUMAN NECESSITIES
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    • 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
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    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • 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
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    • A61F2/02—Prostheses implantable into the body
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    • 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
    • A61F2002/30474—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using an intermediate sleeve interposed between both prosthetic parts to be coupled
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special 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. Morse taper connections, at discrete positions, angular positions or continuous positions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • 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
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
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    • 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
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    • 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
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
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    • A61F2/02—Prostheses implantable into the body
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    • 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
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • 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
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0006—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting angular orientation
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

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 assembly comprises a cotyloid implant in the form of a rigid cup (1) and a rigid insert (2) designed to receive the spherical head (4) of a femoral implant. The head (4) is made from a rigid material and incorporates an element (5) of an elastically-deformable material to act as a shock absorber. The ring extends for the whole height of the bush, and is made, for example, from polyethylene. The base of the insert (2) is made to provide a reservoir for a physiological lubrication fluid, e.g. by means of an aperture (2b) linked to a channel (2c) in its inner wall. The insert can be fitted inside the cup in different angles.

Description

Ensemble prothétiaue de l'articulation cotvioldienne.  Prosthetic assembly of the Cotvioldian joint.

L'invention se rattache au secteur technique des implants chirurgicaux. The invention relates to the technical sector of surgical implants.

D'une manière parfaitement connue, ce type d'ensemble prothétique comprend une cupule ou anneau, de forme sensiblement hémisphérique pour être impacté dans la cavité cotyloîdienne de l'os illiaque. La cupule reçoit généralement un noyau ou insert, apte à recevoir la tête d'articulation sphérique de l'implant fémoral en tant que tel. In a perfectly known manner, this type of prosthetic assembly comprises a cup or ring, of substantially hemispherical shape to be impacted in the acetabular cavity of the iliac bone. The cup generally receives a core or insert, capable of receiving the spherical articulation head of the femoral implant as such.

Dans une première forme de réalisation, le noyau peut être en polyéthylène, la tête sphérique d'articulation de l'implant fémoral étant réalisée dans un matériau dur, par exemple en acier inoxydable, en céramique... Le noyau peut etre monté dans la cupule, avec une position angulaire fixe, ou bien avec capacité d'orientation angulaire. Le noyau en polyéthylène peut être impacté directement dans la cupule ou par l'intermédiaire d'un insert métallique. In a first embodiment, the core can be made of polyethylene, the spherical articulation head of the femoral implant being made of a hard material, for example stainless steel, ceramic, etc. The core can be mounted in the cup, with a fixed angular position, or with angular orientation capacity. The polyethylene core can be impacted directly in the cup or through a metal insert.

Dans une autre forme de réalisation, la tête sphérique d'articulation de l'élément fémoral, peut coopérer directement avec l'insert métallique ou en céramique, monté dans la cupule. Dans ce cas, il n'y a pas de polyéthylène. On a donc un contact métal - métal ou céramiquecéramique, ce qui permet de diminuer l'usure, en opposition à un contact métal - polyéthylène, ce dernier étant susceptible de s'user assez rapidement. Cependant, la suppression du polyéthylène empêche tout effet d'amortissement. In another embodiment, the spherical articulation head of the femoral element can cooperate directly with the metallic or ceramic insert, mounted in the cup. In this case, there is no polyethylene. There is therefore a metal-to-metal or ceramic-ceramic contact, which makes it possible to reduce wear, as opposed to a metal-to-polyethylene contact, the latter being liable to wear out fairly quickly. However, the removal of polyethylene prevents any dampening effect.

Pour tenter de remédier à ces inconvénients, on a proposé d'inserrer, dans la cupule, une couche en matériau déformable élastiquement., comme il ressort, par exemple, de l'enseignement des brevets FR 9300158 et FR 7412767. Cette couche en matériau déformable est inserrée entre deux couches en matériau dur. Cette solution n'est cependant pas satisfaisante, car elle augmente le volume de l'ensemble de l'implant cotyloîdien.  In an attempt to remedy these drawbacks, it has been proposed to insert, in the cup, a layer of elastically deformable material., As appears, for example, from the teaching of patents FR 9300158 and FR 7412767. This layer of material deformable is inserted between two layers of hard material. This solution is not satisfactory, however, because it increases the volume of the entire acetabular implant.

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, effective and rational manner.

Le problème que se propose de résoudre l'invention, est de réaliser un ensemble prothétique de l'articulation cotyloîdienne, en ayant un contact du type métal - métal ou céramique - céramique et, plus généralement, de deux matériaux de dureté élevée, tout en ayant la possibilité d'obtenir un effet d'amortissement. The problem which the invention proposes to solve is to produce a prosthetic assembly for the acetabular joint, by having a contact of the metal - metal or ceramic - ceramic type and, more generally, of two materials of high hardness, while having the possibility of obtaining a damping effect.

Pour résoudre un tel problème, il a été conçu et mis au point un ensemble prothétique comprenant un implant cotyloîdien constitué par une cupule rigide apte à recevoir, selon des orientations angulaires déterminées, un insert rigide adapté pour recevoir la tete d'articulation sphérique d'un implant fémoral, la tête fémorale d'articulation étant réalisée dans un matériau rigide et incorpore un élément en matériau déformable élastiquement pour faire office d'amortisseur. To solve such a problem, it was designed and developed a prosthetic assembly comprising a cotyloid implant constituted by a rigid cup capable of receiving, according to determined angular orientations, a rigid insert adapted to receive the spherical joint head of a femoral implant, the femoral articulation head being made of a rigid material and incorporates an element of elastically deformable material to act as a shock absorber.

Pour résoudre le problème posé de créer un effet d'amortissement, la tete comprend un embout dans un matériau rigide, sous forme d'un manchon apte à etre fixé sur la tige fémorale, ledit embout recevant une bague en matière déformable élastiquement, la tête fémorale sphérique en matèriau rigide étant emmanchée sur ladite bague. To solve the problem of creating a damping effect, the head comprises an end piece in a rigid material, in the form of a sleeve capable of being fixed on the femoral stem, said end piece receiving a ring of elastically deformable material, the head spherical femoral in rigid material being fitted on said ring.

La bague s'étend sur sensiblement la totalité de la hauteur de l'embout.  The ring extends over substantially the entire height of the endpiece.

Pour résoudre le problème posé d'assurer la liaison de la tête fémorale d'articulation avec la tige, L'embout présente un alésage débouchant de forme tronconique, apte à coopérer avec une portée complémentaire que présente la tige fémorale. To solve the problem posed of ensuring the connection of the femoral head of articulation with the rod, the endpiece has a bore opening in a frustoconical shape, able to cooperate with a complementary bearing which has the femoral rod.

Pour résoudre le problème posé de diminuer le frottement de la tête fémorale avec l'insert, le fond de l'insert est aménagé pour constituer une réserve de liquide physiologique de lubrification. To resolve the problem posed of reducing the friction of the femoral head with the insert, the bottom of the insert is arranged to constitute a reserve of physiological lubrication liquid.

Le fond de l'insert présente un trou faisant office de réservoir, en communication avec un canal formé dans l'épaisseur de la paroi interne dudit insert. The bottom of the insert has a hole acting as a reservoir, in communication with a channel formed in the thickness of the internal wall of said insert.

Selon une autre caractéristique, L'insert présente des agencements externes aptes à coopérer avec des agencements complémentaires de la cupule pour limiter son débattement angulaire. According to another characteristic, the insert has external arrangements able to cooperate with complementary arrangements of the cup to limit its angular movement.

Les agencements sont constitués par un bossage périphérique coopérant avec des empreintes en creux de l'insert. The arrangements consist of a peripheral boss cooperating with recesses of the insert.

Pour résoudre le problème posé de conférer à la cupule, une certaine élasticité, en vue de l'impaction de l'insert, la cupule est fendue depuis son bord périphérique jusqu'à sa zone polaire, pour permettre l'impaction par élasticité de l'insert. To solve the problem posed of giving the cup a certain elasticity, with a view to impaction of the insert, the cup is split from its peripheral edge to its polar zone, to allow the impaction by elasticity of the 'insert.

Pour résoudre le problème posé d'assurer la fixation de l'ensemble, dans le fond de la cavité cotyloïdienne, la cupule présente en débordement de sa périphérie, au moins un agencement pour la mise en place d'un plot tangent de fixation. To resolve the problem posed of securing the assembly, at the bottom of the acetabular cavity, the cup has, in overflow from its periphery, at least one arrangement for the establishment of a tangent fixing stud.

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 des principaux éléments constitutifs de l'ensemble prothétique selon l'invention.The invention is set out below in more detail using the appended drawings, in which:
Figure 1 is a perspective view before assembly of the main components of the prosthetic assembly according to the invention.

La figure 2 est une vue en coupe longitudinale de la tête fémorale d'articulation. Figure 2 is a longitudinal sectional view of the femoral joint head.

La figure 3 est une vue en coupe transversale considérée selon la ligne 2.2 de la figure 3. FIG. 3 is a cross-sectional view taken along line 2.2 of FIG. 3.

La figure 4 est une vue en coupe longitudinale de la cupule. Figure 4 is a longitudinal sectional view of the cup.

La figure 5 est une vue en coupe longitudinale de l'insert. Figure 5 is a longitudinal sectional view of the insert.

La figure 6 est une vue en plan de l'insert. Figure 6 is a plan view of the insert.

La figure 7 est une vue en coupe montrant des différents éléments constitutifs de l'ensemble prothétique. Figure 7 is a sectional view showing different components of the prosthetic assembly.

D'une manière connue, L'ensemble prothétique comprend un implant cotyloïdien et un implant fémoral. L'implant cotyloïdien est constitué par une cupule rigide (1) apte à recevoir, selon différentes orientations angulaires, un insert rigide (2). L'implant fémoral comprend une tige (3) dont le col (3a) reçoit une tête sphérique d'articulation (4) apte à coopérer avec l'insert (2). A noter que l'insert rigide (2) peut etre monté dans la cupule (1) sans possibilité d'orientation angulaire. In a known manner, the prosthetic assembly comprises an acetabular implant and a femoral implant. The acetabular implant is constituted by a rigid cup (1) capable of receiving, according to different angular orientations, a rigid insert (2). The femoral implant comprises a rod (3) whose neck (3a) receives a spherical articulation head (4) capable of cooperating with the insert (2). Note that the rigid insert (2) can be mounted in the cup (1) without the possibility of angular orientation.

Selon une caractéristique à la base de l'invention, la tête sphérique d'articulation (4) incorpore un élément (5), en matériau élastiquement déformable. Par exemple, comme le montrent les figures 2 et 3, la tête (4) comprend un embout (4a) réalisé dans un matériau rigide, et se présentant sous forme d'un manchon apte à être fixé sur le col (3a) de la tige fémorale (3). L'embout (4a) présente un alésage débouchant (4a1) de forme tronconique. According to a characteristic at the base of the invention, the spherical articulation head (4) incorporates an element (5), made of elastically deformable material. For example, as shown in Figures 2 and 3, the head (4) comprises a tip (4a) made of a rigid material, and in the form of a sleeve capable of being fixed on the neck (3a) of the femoral stem (3). The end piece (4a) has a through bore (4a1) of frustoconical shape.

L'embout (4a) reçoit l'élément (5) sous forme d'une bague en polyéthylène, sans pour cela exclure d'autre matière avec capacité de déformation élastique, tel que le silicone. La bague (5) s'étend sur sensiblement la totalité de la hauteur de l'embout (4a) et présente, à l'une de ses extrémités, un évidement circulaire (5a), apte à coopérer avec un bossage circulaire (4a2) formé à la base de l'embout (4a). Sur la bague (5), est emmanchée à force, ou autrement rendue solidaire, la tête sphérique en tant que telle (4) constituée par un corps (4b) en matériau rigide, notamment, en acier inoxydable, céramique... The end piece (4a) receives the element (5) in the form of a polyethylene ring, without excluding other material with elastic deformation capacity, such as silicone. The ring (5) extends over substantially the entire height of the endpiece (4a) and has, at one of its ends, a circular recess (5a), capable of cooperating with a circular boss (4a2) formed at the base of the nozzle (4a). On the ring (5), is press fitted, or otherwise made integral, the spherical head as such (4) constituted by a body (4b) of rigid material, in particular, stainless steel, ceramic ...

La bague amortissante (5), s'étendant sur sensiblement la totalité de la hauteur de l'embout (4a), travaille sur une distance importante, pour permettre un amortissement efficace, étant donné que la course d'amortissement est importante. The damping ring (5), extending over substantially the entire height of the end piece (4a), works over a significant distance, to allow effective damping, since the damping stroke is large.

L'insert rigide (2) est conformé pour être impacté à l'intérieur de la cupule (1), selon différentes positions angulaires limitées. Dans ce but, le bord périphérique externe de l'insert présente un bossage circulaire (2a) apte à coopérer avec une empreinte complémentaire (la), formée à partir du bord équatorial de l'ouverture de la cupule (1).  The rigid insert (2) is shaped to be impacted inside the cup (1), according to different limited angular positions. For this purpose, the outer peripheral edge of the insert has a circular boss (2a) capable of cooperating with a complementary imprint (la), formed from the equatorial edge of the opening of the cup (1).

De manière connue, pour permettre l'introduction de l'insert (2) dans la cupule (1), selon différentes orientations angulaires, la cupule (1) présente, à partir de son bord équatorial, une fente (lob) s'étendant jusqu'au niveau de sa zone polaire (il). Ces dispositions permettent de conférer à la cupule (1), une certaine élasticité, pour la mise en place de l'insert (2). In known manner, to allow the insertion of the insert (2) into the cup (1), according to different angular orientations, the cup (1) has, from its equatorial edge, a slot (lob) extending up to the level of its polar zone (il). These provisions allow to give the cup (1), a certain elasticity, for the establishment of the insert (2).

En fonction de l'angle d'antéversion souhaité, le chirurgien choisit l'orientation de l'insert (2) par rapport à la cupule (1). Ces dispositions ne sont pas décrites en détail car elles ne font pas partie de l'objet spécifique de l'invention et sont parfaitement connues par un homme du métier. Depending on the desired anteversion angle, the surgeon chooses the orientation of the insert (2) relative to the cup (1). These provisions are not described in detail since they do not form part of the specific object of the invention and are perfectly known to a person skilled in the art.

Compte-tenu de ces dispositions, I'articulation entre l'implant fémoral et l'implant cotyloldien, s'effectue par un contact entre deux matériaux rigides, constitués respectivement par le corps (4b) de la tête sphérique (4) et l'insert (2), supprimant ainsi tout phénomène d'usure. In view of these provisions, the articulation between the femoral implant and the acetabulum implant is effected by contact between two rigid materials, constituted respectively by the body (4b) of the spherical head (4) and the insert (2), thus eliminating any wear phenomenon.

L'effet amortisseur est réalisé par l'insertion de la bague (5) en polyéthylène ou autre matière déformable élastiquement, dans la tête fémorale (4).The damping effect is achieved by inserting the ring (5) made of polyethylene or other elastically deformable material, into the femoral head (4).

Afin de réduire le frottement au moment de l'articulation entre la tête fémorale (4) et l'insert (2), le fond de l'insert (2) présente une réserve (2b) apte à recevoir un liquide physiologique de lubrification. Cette réserve (2b) peut être constituée par un trou borgne en communication avec un canal profilé (2c) formé dans l'épaisseur de la paroi interne de l'insert (2). Avantageusement, le canal profilé (2c) est de forme divergente. In order to reduce friction at the time of articulation between the femoral head (4) and the insert (2), the bottom of the insert (2) has a reserve (2b) capable of receiving a physiological lubrication liquid. This reserve (2b) can be constituted by a blind hole in communication with a profiled channel (2c) formed in the thickness of the internal wall of the insert (2). Advantageously, the profiled channel (2c) is of divergent shape.

En ce qui concerne la fixation de la cupule (1) dans la cavité cotyloidienne de l'os illiaque, cette dernière peut s'effectuer par tout moyen connu et approprié. Avantageusement, la cupule (1) présente, à l'opposé de son ouverture, un bossage vertical (nid) apte à recevoir un plot tangent de fixation. As regards the fixation of the cup (1) in the acetabular cavity of the iliac bone, the latter can be carried out by any known and appropriate means. Advantageously, the cup (1) has, opposite its opening, a vertical boss (nest) capable of receiving a tangent fixing stud.

De même, cette cupule (1) peut présenter tous types de revêtements externes et autres agencements aptes à améliorer son ancrage. Similarly, this cup (1) can have all types of external coatings and other arrangements capable of improving its anchoring.

Les avantages ressortent bien de la description, en particulier on souligne et on rappelle
- la suppression de l'usure par un contact de deux matériaux rigides au niveau des surfaces d'articulation des implants fémoral et cotyloïdien,
- le phénomène d'amortissement transféré au niveau de la tête
fémorale,
- la capacité d'orientation angulaire de l'insert dans la cupule
pour régler l'antéversion,
- la possibilité de réaliser une réserve de liquide
physiologique de lubrification. The advantages are apparent from the description, in particular it is emphasized and recalled
- the elimination of wear by contact of two rigid materials at the articulation surfaces of the femoral and acetabular implants,
- the phenomenon of damping transferred to the level of the head
femoral,
- the angular orientation capacity of the insert in the cup
to adjust the anteversion,
- the possibility of making a reserve of liquid
physiological lubrication.

Claims (6)

REVENDICATIONS -1- Ensemble prothétique de l'articulation cotyloidienne comprenant un implant cotyloïdien constitué par une cupule rigide (1) apte à recevoir un insert rigide (2) adapté pour recevoir la tête d'articulation sphérique (4) d'un implant fémoral, caractérisé en ce que la tête fémorale d'articulation (4) est réalisée dans un matériau rigide et incorpore un élément (5) en matériau déformable élastiquement pour faire office d'amortisseur.-1- Prosthetic assembly of the acetabular joint comprising an acetabular implant constituted by a rigid cup (1) capable of receiving a rigid insert (2) adapted to receive the spherical articulation head (4) of a femoral implant, characterized in that the femoral articulation head (4) is made of a rigid material and incorporates an element (5) of elastically deformable material to act as a shock absorber. -2- Ensemble selon la revendication 1, caractérisé en ce que la tête (4) comprend un embout (4a) dans un matériau rigide, sous forme d'un manchon apte à être fixé sur la tige fémorale, ledit embout (4a) recevant une bague (5) en matière déformable élastiquement, la tête fémorale sphérique en matèriau rigide (4b) étant emmanchée sur ladite bague (5).-2- An assembly according to claim 1, characterized in that the head (4) comprises a tip (4a) in a rigid material, in the form of a sleeve capable of being fixed on the femoral stem, said tip (4a) receiving a ring (5) of elastically deformable material, the spherical femoral head of rigid material (4b) being fitted on said ring (5). -3- Ensemble selon la revendication 2, caractérisé en ce que la bague (5) s'étend sur sensiblement la totalité de la hauteur de l'embout (4a).-3- The assembly of claim 2, characterized in that the ring (5) extends over substantially the entire height of the nozzle (4a). -4- Ensemble selon la revendication 2, caractérisé en ce que l'embout (4a) présente un alésage débouchant (4a1) de forme tronconique apte à coopérer avec un col de forme complémentaire (3a), que présente la tige fémorale (3).-4- The assembly of claim 2, characterized in that the tip (4a) has a through bore (4a1) of frustoconical shape capable of cooperating with a neck of complementary shape (3a), that has the femoral stem (3) . -5- Ensemble selon la revendication 1, caractérisé en ce que le fond de l'insert (2) est aménagé pour constituer une réserve de liquide physiologique de lubrification.-5- The assembly of claim 1, characterized in that the bottom of the insert (2) is arranged to constitute a reserve of physiological lubrication liquid. -6- Ensemble selon la revendication 5, caractérisé en ce que le fond de l'insert (2) présente un trou faisant office de réservoir (2b), en communication avec un canal (2c) formé dans l'épaisseur de la paroi interne de l'implant -7- Ensemble selon la revendication 1, caractérisé en ce que l'insert (2) est monté à l'intérieur de la cupule (1) avec capacité d'orientations angulaires déterminées, ledit insert présentant des agencements externes (2a) aptes à coopérer avec des agencements complémentaires (la) de la cupule (1) pour limiter son débattement angulaire.-6- The assembly of claim 5, characterized in that the bottom of the insert (2) has a hole acting as a reservoir (2b), in communication with a channel (2c) formed in the thickness of the inner wall of the implant -7- assembly according to claim 1, characterized in that the insert (2) is mounted inside the cup (1) with capacity for determined angular orientations, said insert having external arrangements ( 2a) able to cooperate with complementary arrangements (la) of the cup (1) to limit its angular movement. -8- Ensemble selon la revendication 7, caractérisé en ce que les agencements sont constitués par un bossage périphérique coopérant avec des empreintes en creux de l'insert.-8- The assembly of claim 7, characterized in that the arrangements are constituted by a peripheral boss cooperating with recesses of the insert. -9- Ensemble selon la revendication 1, caractérisé en ce que la cupule (1) est fendue depuis son bord équatorial jusqu'à sa zone polaire, pour permettre l'impaction par élasticité de l'insert (2).-9- The assembly of claim 1, characterized in that the cup (1) is split from its equatorial edge to its polar region, to allow the impaction by elasticity of the insert (2). -10- Ensemble selon la revendication 1, caractérisé en ce que la cupule (1) présente en débordement de sa périphérie, au moins un agencement pour la mise en place d'un plot tangent de fixation. -10- An assembly according to claim 1, characterized in that the cup (1) has in excess of its periphery, at least one arrangement for the establishment of a tangent fixing stud.
FR9415536A 1994-12-16 1994-12-16 PROTHETIC ASSEMBLY OF THE COTYLOID JOINT Expired - Fee Related FR2728157B1 (en)

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FR2790662A1 (en) * 1999-03-11 2000-09-15 Michel Porte Prosthetic cup for hip replacement has metal shell with anchor pins formed of rods with angled tips
WO2001013823A3 (en) * 1999-08-23 2001-08-23 Emanuel Gautier Femur head-segment prosthesis and instrument for precise insertion of a segment prosthesis
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis

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FR2682588A1 (en) * 1991-10-22 1993-04-23 Lepine Groupe Acetabular implant
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FR2790662A1 (en) * 1999-03-11 2000-09-15 Michel Porte Prosthetic cup for hip replacement has metal shell with anchor pins formed of rods with angled tips
WO2001013823A3 (en) * 1999-08-23 2001-08-23 Emanuel Gautier Femur head-segment prosthesis and instrument for precise insertion of a segment prosthesis
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445903B2 (en) 2008-11-24 2016-09-20 Biomet Manufacturing, Llc Multi-bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445904B2 (en) 2009-07-14 2016-09-20 Biomet Manufacturing, Llc Multiple bearing acetabular prosthesis

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