FR2825263A1 - Shoulder joint prosthesis has cap on humerus to engage socket with movement limiting stop surfaces - Google Patents
Shoulder joint prosthesis has cap on humerus to engage socket with movement limiting stop surfaces Download PDFInfo
- Publication number
- FR2825263A1 FR2825263A1 FR0107068A FR0107068A FR2825263A1 FR 2825263 A1 FR2825263 A1 FR 2825263A1 FR 0107068 A FR0107068 A FR 0107068A FR 0107068 A FR0107068 A FR 0107068A FR 2825263 A1 FR2825263 A1 FR 2825263A1
- Authority
- FR
- France
- Prior art keywords
- movable plate
- base
- glenoid prosthesis
- prosthesis according
- shoulder glenoid
- 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.)
- Pending
Links
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
- A61F2/40—Joints for shoulders
-
- 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
- A61F2/40—Joints for shoulders
- A61F2/4081—Glenoid components, e.g. 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
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- 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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- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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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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- 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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- 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
- A61F2002/30362—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 with possibility of relative movement between the protrusion and the recess
- A61F2002/30369—Limited lateral translation of the protrusion within a larger recess
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30316—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
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
- A61F2002/30397—Limited lateral translation of the rib within a larger groove
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/305—Snap connection
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- 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
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- A61F2/30—Joints
- 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
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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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- A61F2002/30001—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
- A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
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-
- 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
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0026—Angular shapes trapezoidal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0067—Three-dimensional shapes conical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00395—Coating or prosthesis-covering structure made of metals or of 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
Description
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PROTHESE DE GLENE D'EPAULE A PLATEAU MOBILE
La présente invention se rapporte à une prothèse d'épaule, et plus particulièrement à une prothèse de glène à plateau mobile susceptible d'être
fixée à la cavité glénoïdienne de l'omoplate et de recevoir la tête de l'humérus ou d'un implant huméral. SHOULDER GLENE PROSTHESIS WITH MOBILE TRAY
The present invention relates to a shoulder prosthesis, and more particularly to a glenoid prosthesis with a movable plate capable of being
attached to the glenoid cavity of the scapula and receiving the head of the humerus or humeral implant.
L'épaule humaine est un ensemble d'articulations qui unissent le membre supérieur au squelette thoracique. La partie essentielle de cet ensemble, l'articulation scapulo-humérale, relie la tête de l'humérus et la cavité glénoïde de l'omoplate. The human shoulder is a set of joints that unite the upper limb with the thoracic skeleton. The essential part of this set, the scapulo-humeral joint, connects the head of the humerus and the glenoid cavity of the scapula.
La présente invention s'intéresse plus particulièrement au prothèse de glène de cette articulation. The present invention relates more particularly to the glenoid prosthesis of this joint.
Généralement, une prothèse de glène comprend un élément glénoïdien monobloc en polyéthylène, ancré à l'aide d'un ciment dans un espace préalablement préparé par résection osseuse dans l'omoplate au niveau de la cavité glénoïdienne naturelle défectueuse. Generally, a glenoid prosthesis comprises a monobloc polyethylene glenoid element, anchored using a cement in a space previously prepared by bone resection in the scapula at the level of the defective natural glenoid cavity.
On connaît également d'après les documents EP-776.636, FR- 2.683. 142, FR-2.695. 313 et EP-963.742 des prothèses de glène en deux parties, comprenant une embase fixée à l'omoplate et une pièce de contact fixe par rapport à l'embase, possédant une surface de glissement apte à recevoir la tête de l'humérus. Also known from documents EP-776,636, FR-2,683. 142, FR-2.695. 313 and EP-963,742 two-part glenoid prostheses, comprising a base fixed to the scapula and a contact piece fixed relative to the base, having a sliding surface capable of receiving the head of the humerus.
Dans le cas du document EP-963.742, la pièce de contact peut se translater lors du montage par rapport à l'embase. Toutefois, une fois en place, cette pièce est immobilisée par rapport à l'embase grâce à une In the case of document EP-963,742, the contact piece can translate during assembly relative to the base. However, once in place, this part is immobilized relative to the base thanks to a
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protubérance bloquée dans un logement qui assure une liaison complète et fixe entre l'embase et la pièce de glissement. protrusion blocked in a housing which provides a complete and fixed connection between the base and the sliding part.
Par ailleurs, le fait de concevoir une glène monobloc ou en deux parties immobiles l'une par rapport à l'autre permet de respecter au mieux l'anatomie et la physionomie de cette articulation. Furthermore, the fact of designing a glenoid in one piece or in two immobile parts one in relation to the other makes it possible to respect the anatomy and physiognomy of this joint as well as possible.
La jonction os/prothèse étant une zone soumise à de fortes contraintes, le principal inconvénient de ces dispositifs réside dans la relative fragilité de leur ancrage, qui est accentuée notamment lorsque la prothèse n'est pas correctement implantée. Or, il est indispensable que cette jonction soit la plus solide possible afin de permettre le mouvement de l'articulation et d'éviter les descellements. The bone / prosthesis junction being a zone subjected to strong stresses, the main drawback of these devices lies in the relative fragility of their anchoring, which is accentuated in particular when the prosthesis is not correctly implanted. However, it is essential that this junction is as solid as possible in order to allow movement of the joint and to avoid loosening.
Aussi, de nombreux documents se focalisent sur les moyens d'ancrage et proposent de nombreuses solutions afin d'assurer la pérennité de la liaison entre la prothèse et l'os. Toutefois, malgré leur relative complexité, ces solutions ne donnent pas pleinement satisfaction en raison d'un pourcentage d'échec d'implantation relativement important, notamment lorsque l'implant n'est pas parfaitement placé. Also, many documents focus on the anchoring means and offer many solutions to ensure the sustainability of the connection between the prosthesis and the bone. However, despite their relative complexity, these solutions are not fully satisfactory due to a relatively large percentage of implantation failures, especially when the implant is not perfectly placed.
En effet, les efforts de cisaillement générés par la liaison gléno- humérale, c'est-à-dire l'action de la tête humérale sur l'implant glénoïdien, sont importants et tendent à déstabiliser l'implant glénoïdien dans le temps. In fact, the shear forces generated by the glenohumeral connection, that is to say the action of the humeral head on the glenoid implant, are significant and tend to destabilize the glenoid implant over time.
Aussi, pour réduire les efforts de cisaillement, les implants actuels présentent une surface d'appui avec un rayon de courbure nettement supérieur au rayon de courbure de la cavité glénoïdienne anatomique correspondant sensiblement au rayon de courbure de la tête de l'humérus. Also, to reduce shear forces, current implants have a bearing surface with a radius of curvature significantly greater than the radius of curvature of the anatomical glenoid cavity corresponding substantially to the radius of curvature of the head of the humerus.
Cependant, cette augmentation de rayon de courbure génère un contact quasi-ponctuel de la tête humérale sur la prothèse de glène en polyéthylène, entraînant une augmentation des contraintes de pression et de ce fait une usure accentuée dudit polyéthylène. However, this increase in the radius of curvature generates a quasi-punctual contact of the humeral head on the polyethylene glenoid prosthesis, resulting in an increase in pressure stresses and therefore increased wear of said polyethylene.
Un autre inconvénient des prothèses de glène existantes réside dans le fait qu'une erreur d'implantation de la prothèse est difficilement rattrapable ultérieurement, voire impossible, ce qui contribue à augmenter le taux d'échec. Another disadvantage of existing glenoid prostheses lies in the fact that an implantation error of the prosthesis is difficult to recover later, if not impossible, which contributes to increasing the failure rate.
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Aussi, la présente invention vise à pallier les inconvénients des prothèses de glène d'épaule existantes en proposant une nouvelle prothèse garantissant une implantation solide et fiable dans le temps et un fonctionnement de l'articulation de l'épaule correct et sans douleur, même en cas d'erreur d'implantation. Also, the present invention aims to overcome the drawbacks of existing shoulder glenoid prostheses by proposing a new prosthesis guaranteeing a solid and reliable implantation over time and a correct and painless shoulder joint operation, even in installation error.
A cet effet, l'invention a pour objet une prothèse de glène d'épaule comprenant une embase liée à l'os par des moyens d'ancrage et un plateau présentant une surface d'appui et de logement d'une tête d'humérus, caractérisée en ce qu'elle comporte des moyens de liaison entre ladite embase et ledit plateau susceptibles d'autoriser un mouvement relatif entre ces deux éléments une fois en place, notamment lors d'un mouvement de l'articulation. To this end, the subject of the invention is a shoulder glenoid prosthesis comprising a base linked to the bone by anchoring means and a plate having a support and housing surface for a humerus head. , characterized in that it comprises connecting means between said base and said plate capable of authorizing a relative movement between these two elements once in place, in particular during a movement of the joint.
De préférence, les moyens de liaison comprennent au niveau des surfaces en contact de l'embase et du plateau mobile des formes conjuguées qui permettent de maintenir plaquées lesdites surfaces l'une contre l'autre, tout en autorisant un glissement entre elles. Preferably, the connecting means comprise, at the surfaces in contact with the base and the movable plate, conjugated shapes which make it possible to keep said surfaces pressed against one another, while allowing sliding between them.
Avantageusement, les surfaces en contact de l'embase et du plateau mobile sont sensiblement sphériques. Advantageously, the surfaces in contact with the base and the movable plate are substantially spherical.
Selon un mode de réalisation, la surface de l'embase sur laquelle est susceptible de prendre appui le plateau mobile comprend à sa périphérie un rebord en saillie par rapport à ladite surface, définissant un logement susceptible de recevoir une partie du plateau mobile, un jeu étant prévu entre ledit rebord et la périphérie de la partie du plateau mobile de manière à autoriser un mouvement relatif entre le plateau et l'embase. According to one embodiment, the surface of the base on which the movable plate is capable of bearing comprises at its periphery a rim projecting from said surface, defining a housing capable of receiving a part of the movable plate, a clearance being provided between said flange and the periphery of the part of the movable plate so as to allow relative movement between the plate and the base.
En fonction de la disposition et de l'importance des jeux et de la forme du rebord, il est possible de maîtriser le degré de liberté du mouvement relatif et de définir une ou des directions de mouvement, ainsi que l'amplitude desdits mouvements. Depending on the arrangement and the importance of the clearances and the shape of the rim, it is possible to control the degree of freedom of the relative movement and to define one or more directions of movement, as well as the amplitude of said movements.
Selon une autre caractéristique de l'invention, les moyens de maintien en contact des surfaces d'appui de l'embase et du plateau mobile comportent au niveau du flanc de la partie du plateau mobile, une rainure dans laquelle est susceptible de se loger un retour, solidaire de l'extrémité libre du rebord, s'étendant sur la totalité de la périphérie dudit rebord, des moyens de According to another characteristic of the invention, the means for keeping the contact surfaces of the base and the movable plate in contact comprise, at the side of the part of the movable plate, a groove in which is capable of accommodating a return, integral with the free end of the rim, extending over the entire periphery of said rim, means for
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déformation au niveau de la partie du plateau mobile étant prévus pour permettre son introduction dans le logement. deformation at the part of the movable plate being provided to allow its introduction into the housing.
D'autres caractéristiques et avantages ressortiront de la description qui va suivre de l'invention, description donnée à titre d'exemple uniquement et en regard des dessins annexés sur lesquels : - la figure 1 est une vue en coupe dans un plan vertical d'une prothèse d'épaule selon l'invention, - la figure 2 est une vue en perspective d'une prothèse de glène à plateau mobile,
- la figure 3A est une vue en coupe se) on ! a direction)) !-))) de la figure 2 d'une première variante, - la figure 3B est une vue en coupe selon la direction II-III de la figure 2 d'une deuxième variante, - les figures 4A à 4E sont des vues schématiques de l'articulation d'épaule illustrant différentes combinaisons des surfaces de contact entre d'une part l'embase et le plateau mobile, et d'autre part, le plateau mobile et la tête de l'humérus, et - la figure 5 est une vue en coupe dans un plan horizontal d'une prothèse d'épaule illustrant une variante des moyens d'ancrage de la glène. Other characteristics and advantages will emerge from the description which follows of the invention, description given by way of example only and with reference to the appended drawings in which: - Figure 1 is a sectional view in a vertical plane of a shoulder prosthesis according to the invention, FIG. 2 is a perspective view of a glenoid prosthesis with a movable plate,
- Figure 3A is a sectional view se) on! a direction))! -))) of Figure 2 of a first variant, - Figure 3B is a sectional view along the direction II-III of Figure 2 of a second variant, - Figures 4A to 4E are schematic views of the shoulder joint illustrating different combinations of the contact surfaces between on the one hand the base and the mobile plate, and on the other hand, the mobile plate and the head of the humerus, and - Figure 5 is a sectional view in a horizontal plane of a shoulder prosthesis illustrating a variant of the means for anchoring the glenoid.
Sur la figure 1, on a représenté schématiquement une articulation d'épaule, notamment l'articulation scapulo-humérale 10, reliant la tête d'un humérus 12 et la cavité glénoïde de l'omoplate 14 correspondante. In Figure 1, there is shown schematically a shoulder joint, in particular the scapulohumeral joint 10, connecting the head of a humerus 12 and the glenoid cavity of the corresponding scapula 14.
A titre d'exemple, la tête de l'humérus 12 comprend une prothèse 16 telle que définie dans la demande de brevet WO 99/34756. Cette prothèse n'est pas plus détaillée car n'étant pas l'objet principal de l'invention. By way of example, the head of the humerus 12 comprises a prosthesis 16 as defined in patent application WO 99/34756. This prosthesis is not more detailed since it is not the main object of the invention.
En complément, l'omoplate 14 comprend une prothèse 18 de glène disposée dans un espace préalablement préparé par résection osseuse dans ladite omoplate, au niveau de la cavité glénoïdienne naturelle défectueuse. In addition, the scapula 14 includes a glenoid prosthesis 18 placed in a space previously prepared by bone resection in said scapula, at the level of the defective natural glenoid cavity.
L'étape de préparation préalable à l'implantation n'est également pas décrite en détail, car à la portée du praticien, la prothèse de l'invention ne nécessitant pas une préparation particulière. The preparation stage prior to implantation is also not described in detail, because within the reach of the practitioner, the prosthesis of the invention does not require any particular preparation.
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Selon l'invention, la prothèse de glène 18, représentée en détail sur la figure 2, comprend une embase 20 liée à l'os par des moyens d'ancrage 22 et un plateau mobile 24 présentant une surface 26 d'appui et de logement de la tête de l'humérus 12, ainsi que des moyens 28 de liaison entre ladite embase 20 et ledit plateau mobile 24 susceptibles d'autoriser un mouvement relatif entre ces deux éléments une fois en place, notamment lors d'un mouvement de l'articulation. According to the invention, the glenoid prosthesis 18, shown in detail in FIG. 2, comprises a base 20 linked to the bone by anchoring means 22 and a movable plate 24 having a support and support surface 26 of the head of the humerus 12, as well as means 28 of connection between said base 20 and said movable plate 24 capable of allowing a relative movement between these two elements once in place, in particular during a movement of the joint.
Ce mouvement relatif entre l'embase 20 et le plateau mobile 24 permet de réduire sensiblement, au niveau des moyens d'ancrage 22, les effets des efforts de cisaillement générés par le mouvement de la tête de l'humérus 12 sur la surface 26 d'appui et de logement. This relative movement between the base 20 and the movable plate 24 makes it possible to substantially reduce, at the level of the anchoring means 22, the effects of the shearing forces generated by the movement of the head of the humerus 12 on the surface 26 d support and housing.
Ainsi, lorsque le bras se lève comme illustré par la figure 1, la tête de l'humérus 12 génère au niveau de la surface 26 d'appui et de logement un effort de cisaillement qui tend à déplacer le plateau mobile par rapport à l'embase vers le haut, comme indiqué par la flèche 27, ce qui contribue à réduire fortement l'effet de ces efforts au niveau des moyens d'ancrage. Thus, when the arm rises as illustrated in FIG. 1, the head of the humerus 12 generates at the level of the support and housing surface 26 a shearing force which tends to move the movable plate relative to the base upwards, as indicated by arrow 27, which contributes to greatly reducing the effect of these forces at the anchoring means.
Ainsi, en sollicitant moins ces moyens d'ancrage 22, on améliore implicitement leur résistance dans le temps, ce qui contribue à améliorer la qualité de l'ancrage et à réduire le taux d'échec des implants. Thus, by making less use of these anchoring means 22, their resistance is implicitly improved over time, which contributes to improving the quality of the anchoring and reducing the failure rate of the implants.
La mobilité existante entre l'embase 20 et le plateau mobile 24 permet de diminuer le rayon de courbure de la surface 26 d'appui et de logement, et donc d'augmenter la surface de contact entre la tête de l'humérus et le plateau afin de diminuer les contraintes de compression au niveau de la zone de contact. The existing mobility between the base 20 and the movable plate 24 makes it possible to reduce the radius of curvature of the support and housing surface 26, and therefore to increase the contact surface between the head of the humerus and the plate in order to reduce the compression stresses at the level of the contact zone.
D'autre part, ce mouvement relatif permet également de compenser les éventuelles erreurs de positionnement de la prothèse, grâce à un auto positionnement du plateau mobile 24, plus particulièrement de la surface 26 d'appui et de logement par rapport à la tête de l'humérus, cette surface pouvant se déplacer par rapport à l'ancrage. On the other hand, this relative movement also makes it possible to compensate for any errors in positioning the prosthesis, by virtue of self-positioning of the movable plate 24, more particularly of the surface 26 of support and housing relative to the head of the humerus, this surface being able to move relative to the anchor.
Cet auto-positionnement du plateau mobile empêche, en cas d'erreur d'implantation, l'apparition d'un moment, produit par l'effort de la tête de This self-positioning of the movable plate prevents, in the event of an implantation error, the appearance of a moment, produced by the effort of the head.
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l'humérus 12 sur la prothèse de glène 14 lorsque ces derniers ne sont pas parfaitement alignés, qui est susceptible de détériorer rapidement l'ancrage. the humerus 12 on the glenoid prosthesis 14 when the latter are not perfectly aligned, which is liable to rapidly deteriorate the anchoring.
Selon un mode de réalisation, l'embase 20 comprend une première surface d'appui 30 en contact avec la glène anatomique, une seconde surface d'appui 32 sur laquelle est susceptible de prendre appui le plateau mobile 24 et une périphérie de préférence piriforme. Avantageusement, cette embase est métallique et la première surface d'appui 30, de préférence de forme convexe, est recouverte d'un matériel biocompatible poreux destiné à être ostéointégré. According to one embodiment, the base 20 comprises a first bearing surface 30 in contact with the anatomic glenoid, a second bearing surface 32 on which the movable plate 24 is capable of bearing and a periphery preferably piriform. Advantageously, this base is metallic and the first bearing surface 30, preferably of convex shape, is covered with a porous biocompatible material intended to be osseointegrated.
Le plateau mobile 24, de préférence en polyéthylène, comprend la surface 26 d'appui et de logement sur laquelle est susceptible de prendre appui la tête de l'humérus 12, une seconde surface 34 susceptible de prendre appui sur la surface 32 de l'embase et une périphérie de forme sensiblement identique à celle de l'embase. The movable plate 24, preferably made of polyethylene, comprises the surface 26 of support and housing on which the head of the humerus 12 is capable of bearing, a second surface 34 capable of bearing on the surface 32 of the base and a periphery substantially identical in shape to that of the base.
Sur les figures 4A à 4E, on a représenté de manière schématique différentes combinaisons de surfaces de contact entre d'une part l'embase 20 et le plateau mobile 24, et d'autre part, le plateau mobile 24 et la tête de l'humérus 12. In FIGS. 4A to 4E, various combinations of contact surfaces have been shown schematically between on the one hand the base 20 and the movable plate 24, and on the other hand, the movable plate 24 and the head of the humerus 12.
Sur la figure 4A, l'embase 20 et le plateau mobile 24 ont des surfaces de contact planes, le plateau mobile 24 a une surface de contact avec la tête de l'humérus concave. In FIG. 4A, the base 20 and the movable plate 24 have planar contact surfaces, the movable plate 24 has a contact surface with the head of the concave humerus.
Sur la figure 4B, l'embase 20 présente une surface de contact concave sensiblement sphérique avec le plateau mobile 24, et ce dernier présente également une surface de contact avec la tête de l'humérus 12 concave sensiblement sphérique. In FIG. 4B, the base 20 has a substantially spherical concave contact surface with the movable plate 24, and the latter also has a contact surface with the head of the substantially spherical concave humerus 12.
Sur la figure 4C, l'embase 20 présente une surface de contact concave sensiblement sphérique avec le plateau mobile 24, et ce dernier présente une surface de contact avec la tête de l'humérus 12 convexe sensiblement sphérique. In FIG. 4C, the base 20 has a substantially spherical concave contact surface with the movable plate 24, and the latter has a contact surface with the head of the substantially spherical convex humerus 12.
Sur la figure 4D, l'embase 20 présente une surface de contact convexe sensiblement sphérique avec le plateau mobile 24, et ce dernier présente une In FIG. 4D, the base 20 has a substantially spherical convex contact surface with the movable plate 24, and the latter has a
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surface de contact avec la tête de l'humérus 12 également convexe sensiblement sphérique. contact surface with the head of the humerus 12 also convex substantially spherical.
Sur la figure 4E, l'embase 20 présente une surface de contact avec le plateau mobile 24 convexe sensiblement sphérique, et ce dernier présente une surface de contact présente une surface de contact avec la tête de l'humérus 12 concave sensiblement sphérique. In FIG. 4E, the base 20 has a contact surface with the substantially spherical convex movable plate 24, and the latter has a contact surface has a contact surface with the head of the substantially spherical concave humerus 12.
Les solutions illustrées par les figures 4B à 4E sont particulièrement avantageuses car elles permettent de réduire sensiblement les sollicitations sur les moyens 22 d'ancrage. Selon ces modes de réalisation, la résultante des efforts du plateau mobile 24 sur l'embase 20 passe toujours par le centre de la surface de contact sphérique si bien que cette résultante ne produit aucun moment par rapport audit centre. Ainsi, on peut réduire sensiblement les sollicitations sur les moyens 22 d'ancrage en positionnant de manière adéquate le centre de la surface sphérique par rapport auxdits moyens 22. The solutions illustrated in FIGS. 4B to 4E are particularly advantageous because they make it possible to significantly reduce the stresses on the anchoring means 22. According to these embodiments, the result of the efforts of the movable plate 24 on the base 20 always passes through the center of the spherical contact surface so that this result does not produce any moment with respect to said center. Thus, the stresses on the anchoring means 22 can be reduced significantly by appropriately positioning the center of the spherical surface relative to said means 22.
Les moyens 28 de liaison comprennent au niveau des secondes surfaces d'appui 32,34 de l'embase et du plateau mobile des formes conjuguées qui permettent de maintenir plaquées ces deux surfaces l'une contre l'autre, tout en autorisant un glissement entre ces dernières. The connecting means 28 comprise at the second bearing surfaces 32, 34 of the base and the movable plate of conjugated shapes which make it possible to keep these two surfaces pressed against one another, while allowing sliding between these last.
Selon un mode de réalisation, la surface d'appui 32 de l'embase comprend à sa périphérie un rebord 36 en saillie par rapport à ladite surface
32 définissant un logement 38 susceptible de recevoir une partie 40 du plateau mobile 24, la seconde surface d'appui 34 du plateau mobile venant en appui contre la surface 32. According to one embodiment, the bearing surface 32 of the base comprises at its periphery a flange 36 projecting from said surface
32 defining a housing 38 capable of receiving a part 40 of the movable plate 24, the second bearing surface 34 of the movable plate bearing against the surface 32.
Un jeu est prévu entre le rebord 36 et la périphérie de la partie 40 du plateau mobile de manière à autoriser un mouvement relatif entre le plateau et l'embase. A clearance is provided between the rim 36 and the periphery of the part 40 of the movable plate so as to allow relative movement between the plate and the base.
En fonction de la disposition et de l'importance des jeux et de la forme du rebord 36, il est possible de maîtriser le degré de liberté du mouvement relatif et de définir une ou des directions de mouvement, ainsi que l'amplitude desdits mouvements. Depending on the arrangement and the importance of the games and the shape of the rim 36, it is possible to control the degree of freedom of the relative movement and to define one or more directions of movement, as well as the amplitude of said movements.
Ainsi, sur la figure 3A, le rebord 36 comprend deux portions parallèles selon la direction B-B, parfaitement ajustées à la partie 40 du plateau selon la Thus, in FIG. 3A, the rim 36 comprises two parallel portions in the direction B-B, perfectly adjusted to the part 40 of the plate according to the
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direction A-A et présente un jeu selon la direction B-B autorisant un mouvement de translation selon la direction B-B. direction A-A and has a clearance in direction B-B authorizing a translational movement in direction B-B.
Sur la figure 3B, il existe, quelle que soit la direction, un jeu entre le rebord 36 et la partie 40 si bien qu'un mouvement entre le plateau et l'embase est permis quelle que soit la direction. In FIG. 3B, there is, whatever the direction, a clearance between the rim 36 and the part 40 so that a movement between the plate and the base is permitted whatever the direction.
Des moyens de maintien en contact des secondes surfaces d'appui 32, 34 sont prévus et comportent au niveau de la partie 40 du plateau mobile, plus particulièrement au niveau de son flanc, une rainure 42 dans laquelle sont susceptibles de se loger un ou plusieurs ergots, ou un retour 44, solidaires de l'extrémité du rebord 36. Means for keeping the second bearing surfaces 32, 34 in contact are provided and comprise, at the part 40 of the movable plate, more particularly at its flank, a groove 42 in which one or more are likely to be housed lugs, or a return 44, integral with the end of the rim 36.
Comme illustré par les différentes figures, les moyens de maintien comportent un retour 44 qui s'étend sur la totalité de la périphérie du rebord 36, des moyens de déformation au niveau de la partie 40 du plateau étant prévus pour permettre son introduction dans le logement 38. Selon un mode de réalisation, ces moyens comportent une ou plusieurs rainures 46 au niveau de la seconde surface d'appui 34 du plateau, disposées à proximité de la périphérie délimitant une ou des zones 48 déformables. As illustrated by the different figures, the holding means comprise a return 44 which extends over the entire periphery of the rim 36, deformation means at the level of the part 40 of the plate being provided to allow its introduction into the housing 38. According to one embodiment, these means comprise one or more grooves 46 at the level of the second bearing surface 34 of the plate, arranged near the periphery delimiting one or more deformable zones 48.
Comme illustré par les différentes figures, et à titre d'exemple seulement, les moyens 22 d'ancrage comportent deux vis divergentes 50, disposées sensiblement dans l'alignement du pilier de l'omoplate et le pilier coracoïdien, engagées dans deux alésages 52, ménagées au niveau de l'embase 20, diamétralement opposées, assurant l'orientation angulaire divergente desdites vis. As illustrated by the various figures, and by way of example only, the anchoring means 22 comprise two divergent screws 50, arranged substantially in alignment with the pillar of the scapula and the coracoid pillar, engaged in two bores 52, formed at the base 20, diametrically opposite, ensuring the divergent angular orientation of said screws.
En complément, l'embase peut comprendre un plot 54 de positionnement, en saillie par rapport à la surface de l'embase orientée vers l'omoplate, de préférence de forme tronconique, et susceptible d'être engagé dans un logement conformé dans la glène anatomique. In addition, the base can include a positioning pad 54, projecting from the surface of the base oriented towards the scapula, preferably of frustoconical shape, and capable of being engaged in a housing formed in the glenoid. anatomical.
Sur la figure 5, on a représenté une autre variante des moyens d'ancrage comprenant au moins un élément incliné vers l'arrière du patient pour assurer un gain de place lors de la mise en place de la prothèse. In FIG. 5, another variant of the anchoring means is shown comprising at least one element inclined towards the rear of the patient in order to save space when the prosthesis is put in place.
Selon un mode de réalisation préféré, les moyens 22 comprennent des picots 56 obliques par rapport à la surface 30, orientés vers le dos du patient, According to a preferred embodiment, the means 22 comprise pins 56 oblique to the surface 30, oriented towards the back of the patient,
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de préférence recouverts d'un matériau métallique poreux pour permettre la fixation à l'os, ainsi qu'une patte 58 plaquée contre l'os, de préférence préparé par résection, et maintenue grâce à une vis 60. selon un agencement préféré, deux picots 56 sont prévus, la vis étant disposée selon une direction verticale entre les deux picots 56. preferably covered with a porous metallic material to allow fixation to the bone, as well as a tab 58 pressed against the bone, preferably prepared by resection, and held in place by a screw 60. according to a preferred arrangement, two pins 56 are provided, the screw being arranged in a vertical direction between the two pins 56.
Bien entendu, l'invention n'est évidemment pas limitée au mode décrit ci-dessus, mais en couvre au contraire toutes les variantes, notamment en ce qui concerne les moyens d'ancrage, les formes de l'embase et du plateau mobile, le degré de liberté et la direction des mouvements du plateau mobile par rapport à l'embase. Of course, the invention is obviously not limited to the mode described above, but on the contrary covers all the variants thereof, in particular as regards the anchoring means, the shapes of the base and the movable plate, the degree of freedom and the direction of movement of the movable plate relative to the base.
Claims (10)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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FR0107068A FR2825263A1 (en) | 2001-05-30 | 2001-05-30 | Shoulder joint prosthesis has cap on humerus to engage socket with movement limiting stop surfaces |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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FR0107068A FR2825263A1 (en) | 2001-05-30 | 2001-05-30 | Shoulder joint prosthesis has cap on humerus to engage socket with movement limiting stop surfaces |
Publications (1)
Publication Number | Publication Date |
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FR2825263A1 true FR2825263A1 (en) | 2002-12-06 |
Family
ID=8863765
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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FR0107068A Pending FR2825263A1 (en) | 2001-05-30 | 2001-05-30 | Shoulder joint prosthesis has cap on humerus to engage socket with movement limiting stop surfaces |
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FR (1) | FR2825263A1 (en) |
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EP1510190A1 (en) * | 2003-08-25 | 2005-03-02 | Tornier | Glenoid component of a shoulder prosthesis and total shoulder prosthesis comprising such a component |
EP1762201A1 (en) * | 2005-09-08 | 2007-03-14 | Biomet Manufacturing Corporation | Method and apparatus for a glenoid prosthesis |
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US20120041563A1 (en) * | 2003-08-11 | 2012-02-16 | Chudik Steven C | Resurfacing implant for a humeral head |
US20120089233A1 (en) * | 2008-12-29 | 2012-04-12 | Aston Medical Developments Limited | Glenoid implant |
US8231683B2 (en) | 2009-12-08 | 2012-07-31 | Depuy Products, Inc. | Shoulder prosthesis assembly having glenoid rim replacement structure |
US8241365B2 (en) | 2008-12-23 | 2012-08-14 | Depuy Products, Inc. | Shoulder prosthesis with vault-filling structure having bone-sparing configuration |
GB2492810A (en) * | 2011-07-13 | 2013-01-16 | Upper Limb Innovations Ltd | Prosthesis head and base with offset attachment means |
US8465548B2 (en) | 2010-11-24 | 2013-06-18 | DePuy Synthes Products, LLC | Modular glenoid prosthesis |
US8480750B2 (en) | 2010-11-24 | 2013-07-09 | DePuy Synthes Products, LLC | Modular glenoid prosthesis |
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US8690951B2 (en) | 2005-11-18 | 2014-04-08 | Zimmer, Gmbh | Base platform for an artificial joint |
US9149362B2 (en) | 2004-09-27 | 2015-10-06 | DePuy Synthes Products, Inc. | Instrument for preparing an implant support surface and associated method |
US9248022B2 (en) | 2012-03-27 | 2016-02-02 | DePuy Synthes Products, Inc. | Method of implanting a glenoid defect-filling component |
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US9775716B2 (en) | 2013-03-11 | 2017-10-03 | Catalyst Orthoscience Inc. | Glenoid arthroplasty |
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US10973646B2 (en) | 2013-03-11 | 2021-04-13 | Catalyst Orthoscience Inc. | Stabilized drill guide |
US11007063B2 (en) | 2013-03-11 | 2021-05-18 | Catalyst Orthoscience Inc. | Offset reamers |
US11007064B2 (en) | 2015-08-10 | 2021-05-18 | Catalyst Orthoscience Inc. | Arthroplasty prostheses with multi-axis fixation |
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EP4166115A1 (en) * | 2021-10-15 | 2023-04-19 | Howmedica Osteonics Corp. | Mobile bearing anatomic glenoid |
RU218258U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
US11779471B2 (en) | 2019-08-09 | 2023-10-10 | Howmedica Osteonics Corp. | Apparatuses and methods for implanting glenoid prostheses |
US11877933B2 (en) | 2011-02-01 | 2024-01-23 | Tornier Sas | Glenoid implant for a shoulder prosthesis, and surgical kit |
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RU218257U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
RU218260U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | SHOULDER ENDOPROSTHESIS |
RU218234U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
RU218235U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
RU218295U1 (en) * | 2022-10-17 | 2023-05-22 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis |
RU218258U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
RU218259U1 (en) * | 2022-10-17 | 2023-05-17 | Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский государственный технический университет имени Гагарина Ю.А." (СГТУ имени Гагарина Ю.А.) | Shoulder joint endoprosthesis with biocompatible coating |
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