FR2784890A1 - Cotyloidal implant for hip joint prosthesis has recesses in insert to receive fixing screw heads - Google Patents

Cotyloidal implant for hip joint prosthesis has recesses in insert to receive fixing screw heads Download PDF

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Publication number
FR2784890A1
FR2784890A1 FR9813345A FR9813345A FR2784890A1 FR 2784890 A1 FR2784890 A1 FR 2784890A1 FR 9813345 A FR9813345 A FR 9813345A FR 9813345 A FR9813345 A FR 9813345A FR 2784890 A1 FR2784890 A1 FR 2784890A1
Authority
FR
France
Prior art keywords
cup
insert
implant
recesses
holes
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
FR9813345A
Other languages
French (fr)
Other versions
FR2784890B1 (en
Inventor
Jean Yves Lazennec
Gerard Saillant
Claude Laville
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Individual
Original Assignee
Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to FR9813345A priority Critical patent/FR2784890B1/en
Publication of FR2784890A1 publication Critical patent/FR2784890A1/en
Application granted granted Critical
Publication of FR2784890B1 publication Critical patent/FR2784890B1/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
    • A61F2/34—Acetabular cups
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • 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
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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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
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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
    • A61F2002/30331—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
    • A61F2002/30378—Spherically-shaped protrusion and recess
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A61F2002/30449—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives the adhesive being cement
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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
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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
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
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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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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • 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
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    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30708—Means for distinguishing between left-sided and right-sided devices, Sets comprising both left-sided and right-sided prosthetic parts
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    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0084—Means for distinguishing between left-sided and right-sided devices; Sets comprising both left-sided and right-sided prosthetic parts
    • 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
    • A61F2310/00011—Metals or alloys

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 hip replacement implant has a cup (1) with an opening (7) formed at its base and having a thickness of between two and our millimetres. An insert (2) has cut outs (10) on its external face to be placed opposite the holes (8) in the cup to receive fixing screws (20). The depth of the cut outs is sufficient to allow them to receive the heads of the screws.

Description

La présente invention concerne un implant cotyloïdien de prothèse de hanche. The present invention relates to a cotyloid implant for a hip prosthesis.

Un tel implant comprend généralement une cupule métallique de forme hémisphérique, délimitant une cavité, et un insert en matériau favorisant le glissement, notamment en polyéthylène, destiné à tre engagé dans cette cavité. L'insert délimite lui-mme une cavité hémisphérique de réception de la tte prothétique d'une tige médullaire fixée à l'extrémité du fémur. Such an implant generally comprises a metallic cup of hemispherical shape, delimiting a cavity, and an insert made of a material promoting sliding, in particular made of polyethylene, intended to be engaged in this cavity. The insert itself delimits a hemispherical cavity for receiving the prosthetic head of a medullary rod fixed to the end of the femur.

Dans certains cas, I'os délimitant la cavité cotyloidienne est détérioré ou érodé, et n'offre par un soutien suffisamment à l'implant compte tenu des contraintes importantes et répétées subies par l'articulation prothétique. In certain cases, the bone delimiting the acetabular cavity is deteriorated or eroded, and does not offer sufficient support for the implant taking into account the significant and repeated stresses undergone by the prosthetic joint.

II est alors nécessaire de recourir à un implant de "reconstruction"de la cavité cotyloïdienne. Un tel implant comprend une cupule munie d'une ou de plusieurs pattes latérales percées de trous, pour permettre un ancrage de l'implant par vissage au niveau de zones d'os sain environnantes. Cette cupule peut également tre munie d'un crochet destiné à tre engagé dans le trou obturateur du bassin pour fournir à l'implant un point d'appui solide dans la direction verticale. It is then necessary to resort to an implant for "reconstruction" of the acetabular cavity. Such an implant comprises a cup provided with one or more lateral tabs pierced with holes, to allow the implant to be anchored by screwing at the level of surrounding healthy bone areas. This cup can also be provided with a hook intended to be engaged in the obturator hole of the pelvis to provide the implant with a solid fulcrum in the vertical direction.

Un implant de reconstruction existant présente généralement une cupule à paroi continue et relativement épaisse, pourvue d'un revtement ostéo-conducteur sur sa face destinée à venir en contact avec l'os. Cette cupule est dans certains cas percée de trous pour la mise en place de vis d'ancrage, ces vis assurant la fixation de la cupule à l'os le temps que la croissance des cellules osseuses s'opère à l'intérieur dudit revtement. An existing reconstruction implant generally has a cup with a continuous and relatively thick wall, provided with an osteoconductive coating on its face intended to come into contact with the bone. This cup is in certain cases pierced with holes for the installation of anchoring screws, these screws ensuring the fixing of the cup to the bone while the growth of the bone cells takes place inside said coating.

Ces implants conviennent pour des patients plutôt jeunes, c'est-à-dire dont les os sont de nature à permettre une telle fixation par croissance des cellules osseuses. Pour des patients plus âgés, ce type d'ancrage est moins opportun qu'une fixation par ciment ou est mme inenvisageable.  These implants are suitable for rather young patients, that is to say those whose bones are such as to allow such fixation by growth of bone cells. For older patients, this type of anchoring is less expedient than cement fixation or is even unthinkable.

L'épaisseur des cupules de ces implants a pour inconvénient de limiter les dimensions de l'insert, et donc la résistance de ce dernier à l'usure et au fluage. The thickness of the cups of these implants has the disadvantage of limiting the dimensions of the insert, and therefore the resistance of the latter to wear and creep.

Par ailleurs, les ttes des vis assurant la fixation de la cupule à l'os ont pour inconvénient de faire saillie dans certains cas à l'intérieur de la cavité délimitée par la cupule. Elles peuvent par conséquent constituer des obstacles à l'engagement de l'insert dans cette cavité et causer un mauvais appui de l'insert contre la paroi de la cupule, à l'origine d'un fluage de ce dernier. Ces ttes saillantes constituent de plus des surfaces ponctuelles de frottement qui peuvent générer une usure prématurée de l'insert, favorisant également l'apparition d'un fluage. Furthermore, the heads of the screws ensuring the fixing of the cup to the bone have the disadvantage of protruding in certain cases inside the cavity delimited by the cup. They can therefore constitute obstacles to the engagement of the insert in this cavity and cause poor support of the insert against the wall of the cup, causing a creep of the latter. These projecting heads also constitute punctual friction surfaces which can generate premature wear of the insert, also favoring the appearance of creep.

La présente invention vise à remédier à ces limites et inconvénients, en fournissant un implant cotyloïdien de reconstruction adapté à une fixation de l'insert au moyen d'un ciment synthétique de scellement et présentant des risques limités d'usure et de fluage de cet insert. The present invention aims to remedy these limits and drawbacks, by providing an acetabular reconstruction implant suitable for fixing the insert by means of a synthetic sealing cement and presenting limited risks of wear and creep of this insert. .

L'implant qu'elle concerne comprend, de manière connue en soi, une cupule munie d'une ou de plusieurs pattes latérales percées de trous, ces trous étant destinés à recevoir des vis d'ancrage de l'implant à l'os, et munie éventuellement d'un crochet destiné à tre engagé dans le trou obturateur du bassin, pour fournir b I'implant un point d'appui solide dans la direction verticale, cette cupule étant elle-mme percée de trous pour la mise en place de vis pour son ancrage à l'os et délimitant une cavité destinée à recevoir un insert en matériau favorisant le glissement, notamment en polyéthylène à très haut poids moléculaire, cet insert étant destiné à recevoir la tte prothétique d'une tige médu))airefixéeà l'extrémité supérieure du fémur. The implant which it concerns comprises, in a manner known per se, a cup provided with one or more lateral tabs pierced with holes, these holes being intended to receive screws for anchoring the implant to the bone, and optionally provided with a hook intended to be engaged in the obturator hole of the pelvis, to provide the implant with a solid fulcrum in the vertical direction, this cup itself being pierced with holes for the placement of screw for its anchoring to the bone and delimiting a cavity intended to receive an insert of material promoting sliding, in particular made of very high molecular weight polyethylene, this insert being intended to receive the prosthetic head of a meduated rod)) airefixéeà l upper extremity of the femur.

Selon l'invention,
-la cupule présente une large ouverture aménagée au niveau de son fond et a une faible épaisseur, de l'ordre de 2 à 4 mm, et
-I'insert présente des évidements aménagés dans sa face externe, destinés à venir en regard des trous que comprend la cupule pour la réception des vis précitées, la profondeur de ces évidements étant telle que ces évidements peuvent recevoir les ttes des vis faisant éventuellement saillie à l'intérieur de la cavité de la cupule.According to the invention,
the cup has a large opening arranged at its bottom and has a small thickness, of the order of 2 to 4 mm, and
-The insert has recesses arranged in its external face, intended to come opposite the holes that the cup includes for receiving the aforementioned screws, the depth of these recesses being such that these recesses can receive the heads of the screws possibly protruding inside the cup cavity.

La cupule constitue ainsi une surface d'appui solide de l'insert et peut tre parfaitement fixée à l'os, mme en cas de dégradation importante de celui-ci, grâce aux pattes, crochet et vis qu'elle comprend. The cup thus constitutes a solid bearing surface of the insert and can be perfectly fixed to the bone, even in the event of significant degradation of the latter, thanks to the lugs, hook and screw which it comprises.

Sa large ouverture permet une surface de contact importante du ciment avec l'os, qui permet d'assurer une parfaite fixation de l'insert à l'os au moyen de ce ciment. Its wide opening allows a large contact surface of the cement with the bone, which ensures perfect attachment of the insert to the bone by means of this cement.

L'épaisseur réduite de la cupule est rendue possible par la fixation avec ciment, qui supprime la nécessité d'un revtement ostéoconducteur. Cette épaisseur réduite permet d'utiliser un insert de dimensions relativement importantes et ayant par conséquent une paroi relativement épaisse. Cette épaisseur est à mme de permettre l'aménagement des évidements précités sans amoindrissement substantiel de la structure de l'insert, et donc sans risques d'usure et de fluage suite aux contraintes répétées subies par la prothèse. The reduced thickness of the cup is made possible by fixing with cement, which eliminates the need for an osteoconductive coating. This reduced thickness makes it possible to use an insert of relatively large dimensions and therefore having a relatively thick wall. This thickness is able to allow the arrangement of the aforementioned recesses without substantial reduction in the structure of the insert, and therefore without risk of wear and creep due to the repeated stresses undergone by the prosthesis.

Les évidements permettent, quant à eux, de loger les portions des ttes des vis d'ancrage pouvant faire saillie à l'intérieur de la cupule en cas d'angulations importantes de ces vis par rapport à cette cupule. The recesses allow, for their part, to accommodate the portions of the heads of the anchoring screws that can protrude inside the cup in the event of significant angulations of these screws relative to this cup.

Ces ttes ne constituent donc pas une gne à la mise en place de l'insert dans la cupule, de sorte que l'insert peut prendre parfaitement appui contre la surface interne de la cupule, et que toute surface ponctuelle de frottement est éliminée.These heads therefore do not constitute a hindrance to the installation of the insert in the cup, so that the insert can perfectly support against the internal surface of the cup, and that any point friction surface is eliminated.

Cette possibilité de logement des ttes des vis permet en outre l'utilisation de vis de dimensions relativement importantes, pour assurer une parfaite fixation de la cupule à l'os.  This possibility of housing the heads of the screws also allows the use of screws of relatively large dimensions, to ensure perfect fixing of the cup to the bone.

En outre, les parois de l'insert qui délimitent lesdits évidements constituent des surfaces supplémentaires d'appui de l'insert contre le ciment, qui permettent d'augmenter la résistance anti-rotation et anti-basculement de cet insert par rapport à la cupule. In addition, the walls of the insert which delimit said recesses constitute additional surfaces for pressing the insert against the cement, which make it possible to increase the anti-rotation and anti-tilting resistance of this insert relative to the cup. .

De préférence, l'insert comprend plusieurs autres évidements répartis sur l'ensemble de sa périphérie, qui communiquent largement entre eux et avec les évidements précités pour permettre le fluage du ciment sur l'ensemble de la périphérie de l'insert. Preferably, the insert comprises several other recesses distributed over the whole of its periphery, which communicate widely with each other and with the aforementioned recesses to allow the creep of the cement over the whole of the periphery of the insert.

Selon une forme de réalisation préférée de l'invention dans ce cas,
-la cupule comprend quatre trous pour la réception des vis d'ancrage précitées, amenagés à 90 les uns des autres, et
-I'insert présente deux rainures méridiennes qui se croisent à angle droit au niveau de son p6le et deux rainures circulaires parallèles au plan délimitant l'ouverture de sa cavité, I'une de ces deux rainures circulaires étant située près du bord d'ouverture de cette cavité tandis que
I'autre s'étend au-delà du bord délimitant l'ouverture aménagée dans le fond de la cupule et en deçà du pôle de l'insert. According to a preferred embodiment of the invention in this case,
the cup includes four holes for the reception of the above-mentioned anchoring screws, arranged at 90 from one another, and
-The insert has two meridian grooves which intersect at right angles to its pole and two circular grooves parallel to the plane delimiting the opening of its cavity, one of these two circular grooves being located near the opening edge of this cavity while
The other extends beyond the edge delimiting the opening in the bottom of the cup and below the pole of the insert.

Les parois délimitant latéralement ces différentes rainures constituent de nombreuses surfaces de calage anti-rotation et anti-basculement de linsert.  The walls delimiting laterally these different grooves constitute numerous anti-rotation and anti-tilt wedging surfaces of the insert.

Ces rainures délimitent, au niveau de la paroi de la cupule, des plots ayant de grandes dimensions, qui assurent un large appui de l'insert contre cette paroi, et, au niveau du pô ! e de l'insert, des plots de plus petites dimensions qui permettent un appui de cet insert contre l'os. La surface d'appui de l'insert contre la cupule et l'os reste par conséquent importante aux endroits où s'exercent les plus fortes sollicitations. These grooves delimit, at the level of the wall of the cup, studs having large dimensions, which ensure a broad support of the insert against this wall, and, at the level of the po! e of the insert, pads of smaller dimensions which allow a support of this insert against the bone. The bearing surface of the insert against the cup and the bone therefore remains significant at the places where the greatest stresses are exerted.

De préférence, chaque trou que comprend la cupule pour l'engagement d'une vis d'ancrage est délimité latéralement par une paroi concave en segment de sphère, et la paroi latérale de la tte de la vis présente une forme convexe en segment de sphère correspondante, permettant un large appui de la tte de la vis contre la paroi concave délimitant le trou, mme en cas d'angulation importante de la vis par rapport à l'os.  Preferably, each hole that the cup includes for engaging an anchor screw is delimited laterally by a concave wall in a segment of a sphere, and the side wall of the head of the screw has a convex shape in a segment of a sphere. corresponding, allowing wide support of the head of the screw against the concave wall delimiting the hole, even in the event of significant angulation of the screw relative to the bone.

Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de l'implant cotyloidien qu'elle concerne. For a good understanding, the invention is again described below with reference to the appended schematic drawing representing, by way of nonlimiting example, a preferred embodiment of the acetabular implant which it relates to.

Les figures 1 et 2 sont des vues en perspective respectivement de l'insert et de la cupule qu'il comprend ;
la figure 3 est une vue postérieure, en plan, de l'insert ;
la figure 4 est une vue de côté de l'implant après montage, en coupe longitudinale, et
la figure 5 est une vue à échelle agrandie d'une portion de la cupule et de l'insert, ainsi que de l'une des vis d'ancrage osseux de la cupule.Figures 1 and 2 are perspective views respectively of the insert and the cup it comprises;
Figure 3 is a rear plan view of the insert;
FIG. 4 is a side view of the implant after mounting, in longitudinal section, and
Figure 5 is an enlarged view of a portion of the cup and the insert, as well as one of the bone anchor screws of the cup.

Les figures 1 et 2 représentent la cupule 1 et l'insert 2 d'un implant cotyloidien de prothèse de hanche, cet implant permettant une "reconstruction"de la cavité cotyloïdienne à appareiller. Figures 1 and 2 show the cup 1 and the insert 2 of a cotyloid implant of hip prosthesis, this implant allowing a "reconstruction" of the cotyloid cavity to be fitted.

La cupule 1 est métallique, de forme hémisphérique et délimite une cavité 3 pour la réception de l'insert 2. The cup 1 is metallic, hemispherical in shape and delimits a cavity 3 for receiving the insert 2.

Elle est munie d'une patte latérale 4 présentant une partie terminale 4a en forme de palette, cette partie terminale étant percée de trous 5. Ces trous sont destinés à recevoir des vis (non représentées) pour permettre un ancrage de la cupule 1 au niveau de zones d'os sain environnant la cavité cotyloïdienne. It is provided with a lateral tab 4 having an end portion 4a in the form of a pallet, this end portion being pierced with holes 5. These holes are intended to receive screws (not shown) to allow anchoring of the cup 1 at the level areas of healthy bone surrounding the acetabulum.

La cupule 1 est également munie d'un crochet 6 destiné à tre engagé dans le trou obturateur du bassin. Ce crochet 6 fournit ainsi à la cupule 1 un point d'appui solide dans la direction verticale. The cup 1 is also provided with a hook 6 intended to be engaged in the obturator hole of the basin. This hook 6 thus provides the cup 1 a solid fulcrum in the vertical direction.

En outre, cette cupule 1 présente une large ouverture 7 aménagée au niveau de son fond et a une épaisseur de 3 mm. Elle comprend également quatre trous 8 pour la réception de vis (non représentées) permettant son ancrage à l'os. Ces trous 8 sont aménagés à 90 les uns des autres et leurs axes forment un angle de 45 avec I'axe longitudinal de la cupule 1, c'est-à-dire celui sur lequel sont placés les bases de la patte 4 et du crochet 6. In addition, this cup 1 has a wide opening 7 arranged at its bottom and has a thickness of 3 mm. It also includes four holes 8 for receiving screws (not shown) allowing it to be anchored to the bone. These holes 8 are arranged 90 from each other and their axes form an angle of 45 with the longitudinal axis of the cup 1, that is to say the one on which the bases of the tab 4 and of the hook are placed. 6.

II apparaît à la figure 5 que chaque trou 8 est délimité latéralement par une paroi concave 8a en segment de sphère, et que la paroi latérale 20a de la tte de la vis 20 destinée à tre reçue dans ce trou 8 présente une forme convexe en segment de sphère correspondante. It appears in FIG. 5 that each hole 8 is delimited laterally by a concave wall 8a in segment of a sphere, and that the side wall 20a of the head of the screw 20 intended to be received in this hole 8 has a convex shape in segment of corresponding sphere.

Cette forme permet une orientation facile de chaque vis 20 selon un large débattement et une surface d'appui importante de la tte de la vis 20 contre la paroi 8a, mme en cas d'angulation importante de cette vis.This shape allows easy orientation of each screw 20 according to a large clearance and a large bearing surface of the head of the screw 20 against the wall 8a, even in the event of significant angulation of this screw.

Un trou 9 est également aménagé en face du crochet 6, pour la mise en place d'une vis osseuse de verrouillage, si nécessaire. A hole 9 is also arranged in front of the hook 6, for the installation of a bone locking screw, if necessary.

Ce crochet 6 peut comprendre un trou 21 aménagé dans sa partie arrondie pour immobiliser la cupule 1 le temps que soit réalisée l'opération de fermeture de ce crochet 6 par déformation de ce dernier autour de la zone osseuse correspondante. This hook 6 may include a hole 21 arranged in its rounded part to immobilize the cup 1 while the closing operation of this hook 6 is carried out by deformation of the latter around the corresponding bone area.

L'insert 2 est en polyéthylène à très haut poids moléculaire et délimite lui-mme une cavité hémisphérique (non visible sur les figures) pour la réception de la tte prothétique d'une tige médullaire fixéeà l'extrémité du fémur. The insert 2 is made of very high molecular weight polyethylene and delimits itself a hemispherical cavity (not visible in the figures) for the reception of the prosthetic head of a medullary rod fixed at the end of the femur.

II est destiné b tre fixé b la cupule 1 et à I'os délimitant la cavité cotyloidienne au moyen d'un ciment synthétique polymérisable. It is intended to be fixed to the cup 1 and to the bone delimiting the acetabular cavity by means of a polymerizable synthetic cement.

Grâce à l'épaisseur réduite de la cupule 1, rendue possible par cette fixation par ciment, I'insert 2 a des dimensions relativement importantes et par conséquent une paroi relativement épaisse. Thanks to the reduced thickness of the cup 1, made possible by this fixing by cement, the insert 2 has relatively large dimensions and therefore a relatively thick wall.

II présente deux rainures méridiennes 10 et deux rainures circulaires 11 aménagées dans sa paroi, à partir de sa face extérieure.  It has two meridian grooves 10 and two circular grooves 11 arranged in its wall, from its outer face.

Ainsi que le montrent les figures 1 à 4, les deux rainures 10 se croisent à angle droit au niveau de son pâle. Les deux rainures 11 sont quant à elles parallèles au plan délimitant l'ouverture de la cavité 3 ; I'une d'elles est située près du rebord 13 délimitant l'ouverture de cette cavité 3 tandis que
I'autre s'étend au-delà du bord 7a délimitant l'ouverture 7 et s'interrompt en deçà du pô ! e de l'insert 2.As shown in Figures 1 to 4, the two grooves 10 intersect at right angles to its pale. The two grooves 11 are in turn parallel to the plane delimiting the opening of the cavity 3; One of them is located near the rim 13 delimiting the opening of this cavity 3 while
The other extends beyond the edge 7a delimiting the opening 7 and is interrupted below the po! e of insert 2.

Ces rainures 10, 11 délimitent, au niveau de la paroi de la cupule 1, des plots 15 ayant de grandes dimensions, et, au niveau du pote de l'insert 2, des plots 16 de plus petites dimensions. These grooves 10, 11 delimit, at the wall of the cup 1, studs 15 having large dimensions, and, at the level of the insert 2 insert, studs 16 of smaller dimensions.

Le rebord 13 présente quant à lui quatre encoches 17 diamétralement opposées, dont deux dont destinées à recevoir la patte 4 et le crochet 6 et les deux autres sont destinées à permettre la prise d'appui de l'instrument servant b l'introduction de l'insert 2 dans la cavité 3. The rim 13 has four diametrically opposite notches 17, two of which are intended to receive the tab 4 and the hook 6 and the other two are intended to allow the support for the instrument used for the introduction of the insert 2 in the cavity 3.

La figure 4 montre que l'insert 2 est destiné à tre placé dans la cupule 1 de telle sorte que ses rainures 10 soient positionnées en regard des trous 8. Les portions de ces rainures 10 situées en regard de ces trous 8 constituent alors des évidements suffisamment profonds pour recevoir les ttes des vis 20 faisant éventuellement saillie à l'intérieur de la cavité 3, ainsi que cela est visible sur la figure 5. FIG. 4 shows that the insert 2 is intended to be placed in the cup 1 so that its grooves 10 are positioned opposite the holes 8. The portions of these grooves 10 located opposite these holes 8 then constitute recesses deep enough to receive the heads of the screws 20 possibly protruding inside the cavity 3, as can be seen in FIG. 5.

Ces rainures 10 et les rainures 11 forment des évidements répartis sur l'ensemble de la périphérie de l'insert 2, qui communiquent largement entre eux pour permettre le fluage du ciment sur l'ensemble de la périphérie de cet insert. Les parois de ce dernier qui délimitent les rainures 10 et 11 constituent des surfaces supplémentaires d'appui de l'insert 2 contre le ciment, qui augmentent la résistance anti-rotation et anti-basculement de cet insert 2 par rapport à la cupule 1. These grooves 10 and the grooves 11 form recesses distributed over the whole of the periphery of the insert 2, which communicate widely with one another to allow the creep of the cement over the whole of the periphery of this insert. The walls of the latter which delimit the grooves 10 and 11 constitute additional bearing surfaces of the insert 2 against the cement, which increase the anti-rotation and anti-tilting resistance of this insert 2 relative to the cup 1.

Les plots 15 ont de grandes surfaces et assurent un large appui de l'insert 2 contre la paroi de la cupule 1, et les plots 16 permettent un appui de cet insert 2 contre l'os. La surface d'appui de l'insert 2 contre la cupule 1 et contre l'os reste par conséquent importante aux endroits où s'exercent les plus fortes sollicitations. The studs 15 have large surfaces and provide broad support for the insert 2 against the wall of the cup 1, and the studs 16 allow this insert 2 to rest against the bone. The bearing surface of the insert 2 against the cup 1 and against the bone therefore remains large at the places where the greatest stresses are exerted.

II va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle en embrasse, au contraire, toutes les variantes de réalisation. Ainsi, chaque patte 4 peut tre aménagée de manière à s'étendre parallèlement à l'axe longitudinal de la cupule, comme représenté au dessin, ou peut tre déportée latéralement par rapport à cet axe, d'environ 15 ; ce déport d'un côté ou de l'autre de cet axe permet de constituer des implants"droit"ou"gauche", utilisables en fonction des besoins.  It goes without saying that the invention is not limited to the embodiment described above by way of example but that it embraces, on the contrary, all the variant embodiments. Thus, each tab 4 can be arranged so as to extend parallel to the longitudinal axis of the cup, as shown in the drawing, or can be offset laterally with respect to this axis, by about 15; this offset on one side or the other of this axis makes it possible to form "right" or "left" implants, which can be used as required.

Claims (8)

REVENDICATIONS 1-Implant cotyloidien de prothèse de hanche, comprenant une cupule (1) munie d'une ou de plusieurs pattes latérales (4) percées de trous (5), ces trous (5) étant destinés à recevoir des vis d'ancrage de l'implant à l'os, et munie éventuellement d'un crochet (6) destiné h tre engagé dans le trou obturateur du bassin, pour fournir à l'implant un point d'appui solide dans la direction verticale, cette cupule (1) étant elle-mme percée de trous (8) pour la mise en place de vis (20) pour son ancrage à l'os et délimitant une cavité (3) destinée 6 recevoir un insert (2) en matériau favorisant le glissement, notamment en polyéthylène à très haut poids moléculaire, cet insert (2) étant destiné b recevoir la tte prothétique d'une tige médullaire fixée 6 l'extrémité supérieure du fémur, 1-Cotyloid implant of hip prosthesis, comprising a cup (1) provided with one or more lateral tabs (4) pierced with holes (5), these holes (5) being intended to receive anchoring screws of the implant to the bone, and optionally provided with a hook (6) intended to be engaged in the obturator hole of the pelvis, to provide the implant with a solid fulcrum in the vertical direction, this cup (1) being itself pierced with holes (8) for the installation of screws (20) for its anchoring to the bone and delimiting a cavity (3) intended to receive an insert (2) of material promoting sliding, in particular by very high molecular weight polyethylene, this insert (2) being intended to receive the prosthetic head of a medullary rod fixed to the upper end of the femur, implant caractérisé en ce que implant characterized in that -la cupule (1) présente une large ouverture (7) aménagée au niveau de son fond et a une faible épaisseur, de l'ordre de 2 à 4 mm, et the cup (1) has a wide opening (7) arranged at its bottom and has a small thickness, of the order of 2 to 4 mm, and -insert (2) présente des évidements (10) aménagés dans sa face externe, destinés b venir en regard des trous (8) que comprend la cupule (1) pour la réception des vis (20) précitées, la profondeur de ces évidements (10) étant telle que ces évidements (10) peuvent recevoir les ttes des vis (20) faisant éventuellement saillie à l'intérieur de la cavité (3) de la cupule (1). -insert (2) has recesses (10) arranged in its external face, intended to come opposite the holes (8) that the cup (1) includes for receiving the aforementioned screws (20), the depth of these recesses ( 10) being such that these recesses (10) can receive the heads of the screws (20) possibly protruding inside the cavity (3) of the cup (1). 2-Implant selon la revendication 1, caractérisé en ce que l'insert (2) comprend plusieurs autres évidements (11) répartis sur l'ensemble de sa périphérie, qui communiquent largement entre eux et avec les évidements (10). 2-Implant according to claim 1, characterized in that the insert (2) comprises several other recesses (11) distributed over the whole of its periphery, which communicate widely with each other and with the recesses (10). 3-Implant selon la revendication 2, caractérisé en ce que 3-Implant according to claim 2, characterized in that -la cupule (1) comprend quatre trous (8) pour la réception des vis d'ancrage (20) précitées, aménagés à 90 les uns des autres, et the cup (1) comprises four holes (8) for the reception of the above-mentioned anchoring screws (20), arranged 90 from one another, and -I'insert (2) présente deux rainures méridiennes (10) qui se croisent à angle droit au niveau de son pote et deux rainures circulaires (11) parallèles au plan délimitant l'ouverture de sa cavité (3), I'une de ces deux rainures circulaires (11) étant située près du bord d'ouverture de cette cavité (3) tandis que l'autre s'étend au-delà du bord (7a) délimitant l'ouverture (7) aménagée dans le fond de la cupule (1) et en deçà du pote de l'insert (2).  -The insert (2) has two meridian grooves (10) which intersect at right angles to the level of its bud and two circular grooves (11) parallel to the plane delimiting the opening of its cavity (3), one of these two circular grooves (11) being located near the opening edge of this cavity (3) while the other extends beyond the edge (7a) delimiting the opening (7) provided in the bottom of the cup (1) and below the insert insert (2). 4-Implant selon l'une des revendications 1 à 3, caractérisé en ce que chaque trou (8) que comprend la cupule (1) pour l'engagement d'une vis d'ancrage (20) est délimité latéralement par une paroi concave (8a) en segment de sphère, et en ce que la paroi latérale (20a) de la tte de la vis (20) présente une forme convexe en segment de sphère correspondante. 4-Implant according to one of claims 1 to 3, characterized in that each hole (8) that includes the cup (1) for the engagement of an anchor screw (20) is delimited laterally by a concave wall (8a) in segment of a sphere, and in that the lateral wall (20a) of the head of the screw (20) has a convex shape in segment of corresponding sphere. 5-Implant selon l'une des revendications 1 b 4, caractérisé en ce que la patte latérale (4) présente une partie terminale (4a) en forme de palette, cette partie terminale étant percée de trous (5). 5-Implant according to one of claims 1 b 4, characterized in that the lateral tab (4) has an end portion (4a) in the form of a pallet, this end portion being pierced with holes (5). 6-Implant selon l'une des revendications 1 à 5, caractérisé en ce que chaque patte (4) est déportée latéralement par rapport b I'axe longitudinal de la cupule (1), d'environ 15 , ce déport d'un côté ou de l'autre permettant de constituer des implants"droit"ou"gauche", utilisables en fonction des besoins. 6-Implant according to one of claims 1 to 5, characterized in that each tab (4) is offset laterally relative to the longitudinal axis of the cup (1), of about 15, this offset on one side or the other allowing to constitute implants "right" or "left", usable according to the needs. 7-Implant selon l'une des revendications 1 à 6, caractérisé en ce qu'il comprend un crochet (6) tel que précité, et en ce qu'un trou (9) est aménagé en face de ce crochet (6), pour la mise en place d'une vis osseuse de verrouillage. 7-Implant according to one of claims 1 to 6, characterized in that it comprises a hook (6) as mentioned above, and in that a hole (9) is arranged opposite this hook (6), for placing a locking bone screw. 8-Implant selon la revendication 7, caractérisé en ce que le crochet (6) peut comprendre un trou (21) aménagé dans sa partie arrondie pour immobiliser la cupule (1) le temps que soit réalisée l'opération de fermeture de ce crochet (6) par déformation de ce dernier autour de la zone osseuse correspondante.  8-Implant according to claim 7, characterized in that the hook (6) may include a hole (21) arranged in its rounded part to immobilize the cup (1) while the closing operation of this hook is carried out ( 6) by deformation of the latter around the corresponding bone area.
FR9813345A 1998-10-21 1998-10-21 COTYLOIDAL HIP PROSTHESIS IMPLANT Expired - Fee Related FR2784890B1 (en)

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2837092A1 (en) * 2002-03-18 2003-09-19 Rech S Et De Fabrication S E R Acetabulum implant for hip prosthesis comprises reinforcing member with wings connected by ring extended to enclose cotyloid cup
FR2851155A1 (en) * 2003-02-17 2004-08-20 Groupe Lepine Acetabular implant for prosthesis of hip, has hemispheric cup with crest where crest constitutes solid beam structure for making body of cup which forms angle of specific degrees with axis of revolution of cup
FR2900571A1 (en) * 2006-05-05 2007-11-09 Pierre Roussouly Acetabulum for hip prosthesis, has articulation part with insertion surface inserted in receiving surface of insertion cup, where surfaces are pivoted to adjust orientation of articulation part in cup
FR2916960A1 (en) * 2007-06-11 2008-12-12 Herve Arnould Hemispherical shaped metal cup for cotyloidal implant, has undercut provided at level of its free edge of equatorial zone to install impacting-gripping apparatus with extraction capacity, where undercut integrates groove with edge

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3310944A1 (en) * 1983-03-25 1984-10-11 Fritz Dr Erler Prosthetic socket
FR2595241A1 (en) * 1986-03-07 1987-09-11 Erato Hip prosthesis
FR2649005A1 (en) * 1989-07-03 1991-01-04 Fischer Louis Acetabular prosthesis made of plastic
FR2651995A1 (en) * 1989-09-15 1991-03-22 Aubaniac Jean Manuel Ring for acetabular implant
FR2689000A1 (en) * 1992-03-27 1993-10-01 Rech Fabrications Et Anchored cup for complete hip prosthesis - has outer metal shell and inner plastic one with antislip ridge on rim and engaging flat faces in polygonal shape

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3310944A1 (en) * 1983-03-25 1984-10-11 Fritz Dr Erler Prosthetic socket
FR2595241A1 (en) * 1986-03-07 1987-09-11 Erato Hip prosthesis
FR2649005A1 (en) * 1989-07-03 1991-01-04 Fischer Louis Acetabular prosthesis made of plastic
FR2651995A1 (en) * 1989-09-15 1991-03-22 Aubaniac Jean Manuel Ring for acetabular implant
FR2689000A1 (en) * 1992-03-27 1993-10-01 Rech Fabrications Et Anchored cup for complete hip prosthesis - has outer metal shell and inner plastic one with antislip ridge on rim and engaging flat faces in polygonal shape

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2837092A1 (en) * 2002-03-18 2003-09-19 Rech S Et De Fabrication S E R Acetabulum implant for hip prosthesis comprises reinforcing member with wings connected by ring extended to enclose cotyloid cup
FR2851155A1 (en) * 2003-02-17 2004-08-20 Groupe Lepine Acetabular implant for prosthesis of hip, has hemispheric cup with crest where crest constitutes solid beam structure for making body of cup which forms angle of specific degrees with axis of revolution of cup
FR2900571A1 (en) * 2006-05-05 2007-11-09 Pierre Roussouly Acetabulum for hip prosthesis, has articulation part with insertion surface inserted in receiving surface of insertion cup, where surfaces are pivoted to adjust orientation of articulation part in cup
FR2916960A1 (en) * 2007-06-11 2008-12-12 Herve Arnould Hemispherical shaped metal cup for cotyloidal implant, has undercut provided at level of its free edge of equatorial zone to install impacting-gripping apparatus with extraction capacity, where undercut integrates groove with edge

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