FR2779342A1 - Replacement femoral hip implant - Google Patents

Replacement femoral hip implant Download PDF

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Publication number
FR2779342A1
FR2779342A1 FR9807000A FR9807000A FR2779342A1 FR 2779342 A1 FR2779342 A1 FR 2779342A1 FR 9807000 A FR9807000 A FR 9807000A FR 9807000 A FR9807000 A FR 9807000A FR 2779342 A1 FR2779342 A1 FR 2779342A1
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prosthesis
characterized
plane
passages
prosthesis according
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Granted
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FR9807000A
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French (fr)
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FR2779342B1 (en )
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Alain Dambreville
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Alain Dambreville
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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
    • A61F2/3662Femoral shafts
    • A61F2/367Proximal or metaphyseal 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
    • 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
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Threaded wires, pins or screws; Nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/863Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
    • 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
    • A61F2/30721Accessories
    • A61F2/30739Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
    • 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
    • A61F2/30721Accessories
    • A61F2/30749Fixation appliances for connecting prostheses to the body
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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
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
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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
    • A61F2/30Joints
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    • A61F2/36Femoral heads ; Femoral endoprostheses
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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
    • 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
    • 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
    • A61F2002/30667Features 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
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30784Plurality of holes
    • A61F2002/30785Plurality of holes parallel
    • 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
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes, grooves
    • A61F2002/30772Apertures or holes, e.g. of circular cross section
    • A61F2002/30784Plurality of holes
    • A61F2002/30789Plurality of holes perpendicular with respect to each other
    • 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
    • A61F2002/365Connections of heads to necks
    • 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
    • A61F2002/3678Geometrical features
    • A61F2002/368Geometrical features with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft
    • 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
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631Special 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
    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • 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
    • 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
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    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0084Means for distinguishing between left-sided and right-sided devices; Sets comprising both left-sided and right-sided prosthetic parts
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    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00017Iron- or Fe-based alloys, e.g. stainless steel
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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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00023Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
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    • A61F2310/00011Metals or alloys
    • A61F2310/00029Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium

Abstract

The body of the prosthesis extending into the femoral shaft (15), is thickened (10) in all planes. It is transfixed by passages (20,22,30,31) in the frontal and sagittal planes, to receive fixing screws (50).

Description

I I

La présente invention concerne une prothèse fémo- The invention relates to a prosthesis fémo-

rale de hanche, notamment prothèse de reprise, comprenant un corps dont le prolongement supérieur est muni d'un cône morse pour recevoir la tête prothétique fémorale et un prolongement inférieur pour venir dans le canal diaphysaire. hip rale, in particular prosthesis of recovery, comprising a body whose upper extension is provided with a Morse taper to receive the prosthetic femoral head and a lower extension to come into the diaphyseal channel. Il existe de nombreuses variantes de prothèses fémorales. There are many variations of femoral prostheses. Mais lorsqu'une prothèse fémorale de hanche est descellée, la difficulté opératoire dépend de la qualité de l'os restant après l'ablation de la prothèse éventuellement But when a hip femoral prosthesis is unsealed, operative difficulty depends on the quality of the remaining bone after removal of the prosthesis may

du ciment. cement.

Pour la prothèse de reprise il. For the prosthesis resume it. existe de nombreux are many

types de prothèses à fixation distale, c'est-à-dire des pro- types of prostheses for distal fixation, that is to say pro-

thèses qui se fixent au niveau de l'extrémité de la tige fé- theses that bind at the end of the rod Feb-

morale, dans la partie moyenne du fémur habituellement corporation, in the middle part of the femur usually

préservée car située sous l'ancienne prothèse alors que la partie supérieure du fémur est souvent détruite. preserved because beneath the old prosthesis while the upper part of the femur is often destroyed.

De telles prothèses se fixent par différents pro- Such prostheses are fixed by various pro-

cédés tels que le cimentage, le vissage ou l'impaction. disposed such as cementing, screwing or impaction. On utilise également le verrouillage par des vis transversales also used the locking by transverse screws

dites transfixantes, c'est-à-dire munies d'un filetage au ni- transfixing say, that is to say provided with a thread at ni

veau de la tête de vis et au niveau de l'extrémité libre de la vis, de façon à se visser transversalement de chaque côté pour une fixation diaphysaire calf of the screw head and at the free end of the screw, so as to be screwed transversely on each side to a fixing diaphyseal

Or une telle fixation a l'inconvénient de trans- However, such fixing has the disadvantage of trans-

mettre les contraintes directement à la diaphyse ce qui se traduit par des résultats fonctionnels très imparfaits et un risque d'amincissement des corticales supérieures du fémur put stress directly to the shaft resulting in very imperfect functional results and a risk of thinning of the upper femoral cortical

puisque celles-ci ne sont plus mises en charge. since they are no longer being supported.

Un autre inconvénient de telles prothèses à fixa- Another disadvantage of such prostheses fixings

tion diaphysaire est qu'un descellement sur cette prothèse longue se traduirait par une destruction osseuse non limitée à l'extrémité supérieure du fémur mais s'étendant également à tion diaphyseal is a loosening of the prosthesis long would result in an unlimited bone destruction at the upper end of the femur but also extending to

sa partie moyenne. its middle part. De telles destructions extensibles relè- Such expandable destruction relè-

vent du phénomène dit " d'escalade dans l'ostéolyse ". Wind phenomenon called "osteolysis in climbing."

On pourrait certes fixer la nouvelle prothèse à l'extrémité supérieure du fémur mais cela n'est possible dans certaines conditions que s'il n'y a pas destruction osseuse à One could certainly set the new prosthesis proximal femur but this is only possible under certain conditions if there is no bone destruction

ce niveau. this level. Cela correspond en quelque sorte à une interven- This corresponds in some way to interventions

tion pour la mise en place d'une prothèse de première inten- tion for the establishment of a first prosthesis inten-

tion et est seulement possible lorsque la destruction osseuse est modérée ou moyenne avec mise en place d'une prothèse courte. tion and is possible only when bone destruction is moderate with average establishment of a short prosthesis. Mais de telles prothèses qui se fixent dans la partie5 supérieure fémorale présentent l'inconvénient de risques d'instabilité, de fracture ou d'enfoncement de la prothèse. But such prostheses that attach the upper femoral partie5 the disadvantage risk of instability, fracture or penetration of the prosthesis.

La présente invention a pour but de remédier aux inconvénients des prothèses connues et se propose de dévelop- The present invention aims to remedy the drawbacks of known prostheses and intends to devel-

per une prothèse fémorale de reprise du type défini ci-dessus10 permettant une reconstitution osseuse efficace de l'extrémité supérieure du fémur. per a femoral prosthesis of recovery following dessus10 of the type defined for an effective bone reconstruction of the proximal femur.

A cet effet, l'invention concerne une prothèse fémorale de reprise caractérisée en ce que le corps prolongé To this end, the invention relates to a femoral prosthesis of recovery characterized in that the extended body

par une tige fémorale est formé par une partie métaphysaire15 épaisse dans tous les plans, et traversé par des passages si- tués dans le plan frontal et dans le plan sagittal, pour re- by a femoral stem is formed by a thick part métaphysaire15 in all planes, and traversed by passages if- killed in the frontal plane and in the sagittal plane, for re-

cevoir des vis épaisses. cevoir thick screws. Par la mise en place de vis épaisses, cette pro- For the implementation of thick screws, this pro-

thèse permet un verrouillage métaphysaire, c'est-à-dire un thesis provides a metaphyseal locking, that is to say a

verrouillage proximal favorisant l'accrochage entre la pro- proximal locking promoting attachment between pro-

thèse et les corticales et assurant la fixation proximale de thesis and cortical and ensuring the proximal attachment

la prothèse au fémur. the prosthesis to the femur.

Suivant une autre caractéristique avantageuse, les passages du plan frontal et ceux du plan sagittal sont à According to another advantageous characteristic, the passages in the frontal plane and the sagittal plane are those in

des niveaux différents. different levels.

Les passages décalés dans le plan frontal et dans le plan sagittal permettent la mise en place efficace de vis The passages are offset in the frontal plane and in the sagittal plane allow efficient implementation screws

de section importante, sans affaiblir la prothèse et la réa- significant section without weakening the prosthesis and the rea-

lisation d'une liaison efficace dans le plan sagittal et dans lisation of an effective link in the sagittal plane and in

le plan frontal, c'est-à-dire dans deux plans perpendiculai- the coronal plane, that is to say in two planes perpendiculai-

res. res.

Mécaniquement de telles liaisons sont particuliè- Mechanically such linkages are particu-

rement favorables et, médicalement, l'excellente liaison en- surely favorable and medically excellent bonding in-

tre la prothèse et le fémur favorise l'accrochage de la be the prosthesis and femur promotes the adhesion of the

prothèse sur l'os. prosthesis to the bone.

Suivant une autre caractéristique avantageuse, la partie métaphysaire épaisse comprend au moins deux passages dans le plan frontal et au moins trois passages dans le plan sagittal. According to another advantageous characteristic, the thick metaphyseal portion comprises at least two passages in the frontal plane and at least three passages in the sagittal plane. Dans la mesure o, à l'occasion de l'installation de la première prothèse, le fémur a été détruit, la courbe fémorale est modifiée et il peut accepter une prothèse droite de fabrication plus simple qu'une prothèse courbe et offrant Insofar, on the occasion of the installation of the first prosthesis, the femur was destroyed, the femoral curve is modified and can accept a simpler manufacturing prosthetic right curve and offering a prosthesis

l'avantage d'être utilisable à droite et à gauche. the advantage of being usable right and left.

Mais il existe également de nombreux cas o le fémur est peu affecté par la première prothèse et dans ce cas il est préférable d'utiliser une prothèse courbe dans le plan sagittal, convexe sur sa face antérieure, et convexe sur sa face postérieure. But there are also many cases where the femur is little affected by the first prosthesis and in this case it is better to use a prosthesis curve in the sagittal plane, convex on its front side and convex on its posterior surface. Bien que dans ce cas il faille réaliser une Although in this case it loophole achieve

prothèse pour le côté droit et une prothèse pour le côté gau- prosthesis for the right side and a prosthesis for the next gau-

che, de telles prothèses sont particulièrement intéressantes che, such prostheses are particularly interesting

à cause de leur adaptation à la forme du fémur. because of their adaptation to the shape of the femur.

Suivant une autre caractéristique, la prothèse est courbe dans le plan frontal avec un bord interne courbe et un bord externe courbe de façon à s'adapter d'une manière particulièrement étroite à la corticale interne du fémur et According to another feature, the prosthesis is curved in the coronal plane with a curved inner edge and an outer edge curved so as to adapt a particularly closely to the medial cortex of the femur and

d'assurer un appui pour la corticale externe. to provide support to the outer cortical.

La prothèse selon l'invention peut être réalisée en un alliage de titane, en acier inoxydable, en un alliage chrome-cobalt. The prosthesis of the invention may be made of a titanium alloy, stainless steel, a chromium-cobalt alloy. Outre les vis assurant le verrouillage proximal de la prothèse, celle-ci peut également être cimentée en plus; In addition to the screw ensuring the proximal locking of the prosthesis, the same may also be cemented in addition; dans ce cas il est avantageux que la surface de la prothèse soit lisse. in this case it is advantageous if the prosthesis the surface is smooth. La prothèse peut également être destinée The prosthesis may also be intended

à favoriser la réinsertion dans l'os et dans ce cas sa sur- to promote reintegration in the bone and in this case its over-

face est rugueuse et revêtue d'une substance bioactive. face is rough and coated with a bioactive substance.

La présente invention sera décrite ci-après de The present invention will be described below in

manière plus détaillée à l'aide des dessins annexés dans les- more detail with the accompanying drawings in

quels: what:

- la figure 1 montre une prothèse selon l'art an- - Figure 1 shows a prosthesis according to the art an-

térieur, implantée dans un fémur avec verrouillage distal, - la figure 2 montre une prothèse selon TER AL, implanted in a femur with distal locking, - Figure 2 shows a prosthesis according to

l'invention implantée dans un fémur, le plan du dessin cor- the invention implanted in a femur, the plane of the drawing corresponding

respondant au plan frontal de la prothèse, - la figure 3 est une vue de la prothèse de la figure 2 dans le plan sagittal, sponding to the frontal plane of the prosthesis, - Figure 3 is a view of the prosthesis of Figure 2 in the sagittal plane,

- la figure 4 montre une variante de prothèse se- - Figure 4 shows an embodiment of the prosthesis se-

lon l'invention, courbe dans le plan sagittal. lon the invention curve in the sagittal plane.

La figure 1 montre une prothèse de reprise 1, connue, mise en place dans un fémur 2. Cette prothèse 1, dite longue, c'est-à-dire dont la tige est très longue, pénètre profondément dans le fémur 2 pour être verrouillée par des Figure 1 shows a cover of prosthesis 1, known, inserted into a femur 2. This prosthesis 1, said long, that is to say the stem of which is very long, penetrates deeply into the femur 2 to be locked by

vis 3 dans la diaphyse restée saine. 3 screws in the shaft remained healthy.

La figure 2 est une vue analogue à celle de la Figure 2 is a view similar to that of

figure 1 montrant une prothèse selon l'invention. Figure 1 shows a prosthesis according to the invention. Cette pro- this pro-

thèse fémorale de hanche, de reprise, se compose d'un corps dont l'extrémité supérieure 11 comporte un prolongement 12 se terminant par un cône morse 13 destiné à recevoir la tête prothétique fémorale 14, c'est-à-dire la rotule, venant dans thesis femoral hip, recovery, consists of a body whose top end 11 has an extension 12 ending with a morse taper 13 for receiving the prosthetic femoral head 14, that is to say the patella, coming in

la cupule installée dans le bassin du sujet. the cup installed in the subject pool.

Le corps 10 se poursuit en partie inférieure par The body 10 continues at the bottom by

une tige fémorale 15. a femoral stem 15.

Selon l'invention, la partie métaphysaire 10 est épaisse dans le plan frontal, c'est-à-dire le plan de la According to the invention, the metaphyseal portion 10 is thick in the frontal plane, that is to say the plane of the

feuille du dessin de la figure 2 ainsi que dans le plan sa- sheet of the drawing of Figure 2 and in the plane sa-

gittal, c'est-à-dire un plan perpendiculaire au plan de la gittal, that is to say a plane perpendicular to the plane of the

feuille de dessin; drawing sheet; de façon générale, cette partie métaphy- in general, this part metaphysical

saire 10 est épaisse dans tous les plans comprenant le plan sary 10 is thick in all planes comprising the plane

frontal, le plan sagittal et les plans intermédiaires. frontal, sagittal plane and the intermediate planes.

La partie métaphysaire épaisse 10 est traversée par des passages 20, 21, 22 perpendiculaires au plan frontal, Thick metaphyseal portion 10 is traversed by passages 20, 21, 22 perpendicular to the frontal plane,

(c'est-à-dire contenus dans le plan sagittal) et par des pas- (That is to say contained in the sagittal plane) and by Pas

sages 30, 31 situés dans le plan frontal. wise 30, 31 located in the frontal plane. Ces passages ne se These passages do

croisent pas; not cross; ils sont situés à des niveaux différents. they are located at different levels. Se- se-

lon l'invention, on prévoit de façon avantageuse au moins deux passages et dans le présent exemple, vu la taille de la prothèse, trois passages 20, 21, 22 dans le plan sagittal et au moins deux passages 30, 31 dans le plan frontal mais le lon the invention there is provided advantageously at least two passages and in the present example, considering the size of the prosthesis, three passages 20, 21, 22 in the sagittal plane and at least two passages 30, 31 in the frontal plane but the

nombre de passages peut être plus important. number of passes may be more important.

Les passages 20-22 et 30-31 ont un diamètre rela- The 20-22 and 30-31 passages have a diameter rela-

tivement important pour recevoir des vis 50 de grand diamètre et de longueur appropriée. tively important to receive screws 50 of large diameter and of appropriate length. Ces vis 50, connues, ont une tête These 50 screws known, have a head

a, et sous celle-ci une partie filetée 50b puis un corps lisse 50c et enfin une extrémité filetée 50d. a, and below it a threaded portion 50b and a smooth body 50c and finally a threaded end 50d. Ces vis traver- These screws traver-

sent le passage réalisé dans la prothèse et se vissent de fa- çon " diamétrale " dans l'os, de part et d'autre de la prothèse. felt passage formed in the prosthesis and are screwed to fa- con "diameter" in the bone on either side of the prosthesis. La prothèse est courbe dans le plan frontal (fig. 2), c'est-à-dire qu'elle présente un côté intérieur 101 courbe de façon concave et un côté extérieur 102 courbe de The prosthesis is curved in the coronal plane (Fig. 2), that is to say it has an inner side 101 concavely curve and an outer side 102 of curve

façon convexe. convexly. Ce côté extérieur comporte également une par- The outside also has a par-

tie 103 formant un épaulement. tie 103 forming a shoulder.

La surface supérieure 104 de la partie métaphy- The upper surface 104 of the part metaphysical

saire épaisse est inclinée par rapport à l'axe de la pro- sary thick is inclined relative to the axis of the pro-

thèse, suivant un certain angle compris par exemple entre 30 thesis, at an angle of for example between 30

et 500. Bien que cela ne soit pas représenté, il est égale- 500. Although it is not shown, it is égale-

ment possible de réaliser, au niveau de l'extrémité supé- ment possible to realize, at the end of level SUPREME

rieure proche de la surface supérieure 104, une embase pour adapter des pièces complémentaires pour une orientation du higher close to the upper surface 104, a base to fit complementary parts to an orientation of the

col du fémur. femoral neck.

A la partie supérieure externe la prothèse com- At the upper part the external prosthesis com-

porte une ou quelques perforations 111 pour la réinsertion du carries one or a few perforations 111 for the reintegration of

grand trochanter 200. trochanter 200.

La figure 3 est une vue de la prothèse selon l'invention, mise en place, dans le plan sagittal. Figure 3 is a view of the prosthesis according to the invention, put in place, in the sagittal plane. Ce plan This plan

est perpendiculaire au plan de la figure 2. Cette figure mon- is perpendicular to the plane of Figure 2. This figure MON-

tre les trois passages 20, 21, 22 et les vis logées dans ces passages. be the three passages 20, 21, 22 and the screws housed in these passages. Dans le cas de la prothèse de la figure 3, on a une In the case of the prosthesis of Figure 3, there is a

prothèse droite, c'est-à-dire alignée sur son axe. prosthesis right, that is to say, aligned on its axis.

Par contre, dans le cas de la figure 4, qui mon- By cons, in the case of Figure 4, which MON-

tre également une vue de la prothèse dans son plan sagittal, on a une prothèse courbe. also be a view of the prosthesis in its sagittal plane, there is a prosthesis curve. Mais dans ce cas, comme la courbure est différente à droite et à gauche, on aura une prothèse pour la droite et une prothèse pour la gauche. But in this case, as the curvature is different in right and left, we will have a prosthesis for the right and a prosthetic for the left. Les éléments de cette prothèse étant analogues ou identiques à ceux de la The elements of this prosthesis being similar or identical to those of the

prothèse ci-dessus, ils portent les mêmes références complé- above prosthesis, they have the same references complementary

tées par le suffixe A. Les prothèses selon l'invention sont réalisées dans différentes matières telles que des alliages de titane, FOA by the suffix A. The prostheses according to the invention are carried out in different materials such as titanium alloys,

de l'acier inox ou du chrome-cobalt. of stainless steel or chromium-cobalt.

Si la prothèse, outre les vis, doit être cimentée dans le canal diaphysaire, elle a une surface lisse. If the prosthesis, further screws, must be cemented into the diaphyseal channel, it has a smooth surface. Dans le In the

cas contraire, si elle doit favoriser une réimplantation os- Otherwise, if it is to encourage relocation os

seuse, elle aura une surface rugueuse. Seuse, it will have a rough surface.

Il est particulièrement avantageux que la surface It is particularly advantageous that the surface

extérieure de la prothèse soit revêtue d'une substance bioac- outside of the prosthesis is coated with a substance bioac-

tive. tive.

Claims (5)

REVENDICATIONS
1 ) Prothèse fémorale de hanche, notamment prothèse de re- 1) femoral hip prosthesis, including prosthetic re-
prise, comprenant un corps dont le prolongement supérieur est outlet, comprising a body whose upper extension is
muni d'un cône morse pour recevoir la tête prothétique fémo- provided with a Morse taper for receiving the prosthetic head fémo-
raie et un prolongement inférieur pour venir dans le canal diaphysaire, caractérisée en ce que le corps prolongé par une tige fémorale (15) est formé par une partie métaphysaire épaisse (10) dans tous les plans, et traversé par des passages (20-22, 30, 31) situés dans le plan frontal et dans le plan sagittal, pour recevoir des vis épaisses.(50). ray and a lower extension to come into the diaphyseal channel, characterized in that the body extended by a femoral stem (15) is formed by a thick metaphyseal portion (10) in all planes, and traversed by passageways (20-22 , 30, 31) located in the frontal plane and in the sagittal plane, for receiving thick screws. (50). 2 ) Prothèse selon la revendication 1, caractérisée en ce que les passages du plan frontal (30, 31) et ceux (20-22) du plan 2) The prosthesis of claim 1, characterized in that the passages of the front plane (30, 31) and those (20-22) of the plane
sagittal sont à des niveaux différents. sagittal are at different levels.
3 ) Prothèse selon la revendication 1, caractérisée en ce que la partie métaphysaire épaisse (10) comprend au moins deux passages dans le plan frontal et au moins trois passages dans 3) The prosthesis of claim 1, characterized in that the thick metaphyseal portion (10) comprises at least two passages in the frontal plane and at least three passages in
le plan sagittal. the sagittal plane.
4 ) Prothèse selon la revendication 1, caractérisée en ce qu' 4) Prosthesis according to Claim 1, characterized in that
elle a une forme droite. it has a straight shape.
) Prothèse selon la revendication 1, caractérisée en ce que la prothèse est courbe dans le plan sagittal, avec une forme convexe sur sa face antérieure et une forme convexe sur sa ) Prosthesis according to claim 1, characterized in that the prosthesis is curved in the sagittal plane, with a convex shape on its anterior surface and a convex shape on its
face postérieure. posterior face.
6 ) Prothèse selon la revendication 1, caractérisée en ce qu' elle est courbe dans le plan frontal avec un bord interne et 6) A prosthesis according to Claim 1, characterized in that it is curved in the coronal plane with an inner edge and
un bord externe courbes (101, 102). a curved outer edge (101, 102).
x 7 ) Prothèse selon la revendication 1, caractérisée en ce qu' x 7) A prosthesis according to claim 1, characterized in that
elle est réalisée en un alliage de titane, en acier inoxyda- it is made of a titanium alloy, steel inoxyda-
ble ou en chrome cobalt. ble or cobalt chromium.
8 ) Prothèse selon la revendication 1, caractérisée en ce que 8) A prosthesis according to claim 1, characterized in that
la surface de la prothèse est lisse pour une implantation ci- the surface of the prosthesis is smooth for implantation below
mentée. mented. 9 ) Prothèse selon la revendication 1, caractérisée en ce que 9) The prosthesis according to claim 1, characterized in that
la surface de la prothèse est rugueuse pour une adhérence os- the surface of the prosthesis is roughened for adhesion os-
seuse secondaire sans ciment. Secondary Seuse without cement.
) Prothèse selon la revendication 1, caractérisée en ce que ) Prosthesis according to claim 1, characterized in that
la surface de la prothèse est revêtue d'une substance bioac- the surface of the prosthesis is coated with a substance bioac-
tive. tive.
FR9807000A 1998-06-04 1998-06-04 femoral hip prosthesis, in particular prosthesis of recovery Expired - Fee Related FR2779342B1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003034955A1 (en) * 2001-10-19 2003-05-01 Biomet Merck Gmbh Femoral prosthesis
FR2855395A1 (en) * 2003-05-27 2004-12-03 Faher Mohcine Femoral prosthesis for per-trochanteric fracture, has metaphyseal region with two perforations through which wires pass for longitudinal synthesis of large trochanter and/or small trochanter

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4895572A (en) * 1988-11-25 1990-01-23 Ira Chernoff Interlocking femoral prosthesis device
EP0465436A1 (en) * 1990-06-22 1992-01-08 G. Cremascoli S.R.L. Replacement hip prosthesis stem adapted to be locked at several locking positions
US5163961A (en) * 1991-04-17 1992-11-17 Harwin Steven F Compression-fit hip prosthesis and procedures for implantation thereof

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4895572A (en) * 1988-11-25 1990-01-23 Ira Chernoff Interlocking femoral prosthesis device
EP0465436A1 (en) * 1990-06-22 1992-01-08 G. Cremascoli S.R.L. Replacement hip prosthesis stem adapted to be locked at several locking positions
US5163961A (en) * 1991-04-17 1992-11-17 Harwin Steven F Compression-fit hip prosthesis and procedures for implantation thereof

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003034955A1 (en) * 2001-10-19 2003-05-01 Biomet Merck Gmbh Femoral prosthesis
FR2855395A1 (en) * 2003-05-27 2004-12-03 Faher Mohcine Femoral prosthesis for per-trochanteric fracture, has metaphyseal region with two perforations through which wires pass for longitudinal synthesis of large trochanter and/or small trochanter

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Publication number Publication date Type
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