FR2834630A1 - Cotyloid cup for head of artificial hip joint femoral implant is made from two hemispherical shells, one partly flexible and other rigid - Google Patents

Cotyloid cup for head of artificial hip joint femoral implant is made from two hemispherical shells, one partly flexible and other rigid Download PDF

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Publication number
FR2834630A1
FR2834630A1 FR0200553A FR0200553A FR2834630A1 FR 2834630 A1 FR2834630 A1 FR 2834630A1 FR 0200553 A FR0200553 A FR 0200553A FR 0200553 A FR0200553 A FR 0200553A FR 2834630 A1 FR2834630 A1 FR 2834630A1
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FR
France
Prior art keywords
shell
intended
rod
cup
bulge
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
FR0200553A
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French (fr)
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FR2834630B1 (en
Inventor
Jean Louis Herve
Claude Henry Perron
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IMPLANT REDUCTION EURL
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IMPLANT REDUCTION EURL
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Priority to FR0200553A priority Critical patent/FR2834630B1/en
Publication of FR2834630A1 publication Critical patent/FR2834630A1/en
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Publication of FR2834630B1 publication Critical patent/FR2834630B1/en
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Classifications

    • 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
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    • A61F2/34—Acetabular cups
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
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    • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
    • A61B17/1666—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the acetabulum
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    • A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4629—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof connected to the endoprosthesis or implant via a threaded connection
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Dentistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

The cup, designed to be implanted in a cotyloid cavity to receive the head (25) of a femoral implant (27) of an artificial hip joint, comprises a first hemispherical shell (3) with a bulge (9) in its outer surface, connected to the tip of the shell by an elastically deformable zone that allows the bulge to be fitted into a circular recess (11) made in the wall of the cavity, and a second rigid shell (5) that is fixed inside the first shell and prevents any deformation of the latter. The two shells have shaped surfaces that engage with one another in an intermediate position before final fitting, and the first shell's bulge hase surface grooves and/or teeth that promote adhesion with the annular recess.

Description

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CUPULE POUR IMPLANT COTYLOÏDIEN
La présente invention concerne une cupule destinée à recevoir un implant cotyloïdien d'une prothèse fémorale et concerne plus particulièrement des moyens de fixation de cette cupule à l'intérieur de la cavité cotyloïdienne. COTYLOID IMPLANT CUP
The present invention relates to a cup intended to receive an acetabular implant of a femoral prosthesis and relates more particularly to means for fixing this cup inside the acetabular cavity.

On sait qu'une prothèse totale de hanche se compose essentiellement d'une pièce fémorale et d'une pièce cotyloïdienne. La pièce fémorale est constituée d'une tige qui prend place dans la diaphyse fémorale et qui se termine à son extrémité externe par une tête sphérique. La pièce cotyloïdienne est généralement constituée d'une cupule métallique qui est fixée dans la cavité cotyloidienne et à l'intérieur de laquelle est disposé un insert en matière de synthèse, notamment en polyéthylène, qui est creusé d'une cavité semi-sphérique de façon à recevoir, à pivotement, la tête de la pièce fémorale.  We know that a total hip prosthesis essentially consists of a femoral part and an acetabular part. The femoral part consists of a rod which takes place in the femoral diaphysis and which ends at its external end by a spherical head. The acetabular part generally consists of a metal cup which is fixed in the acetabular cavity and inside which is placed an insert made of synthetic material, in particular polyethylene, which is hollowed out of a semi-spherical cavity to receive, pivotally, the head of the femoral piece.

La fixation de la cupule métallique à l'intérieur de la cavité cotyloïdienne peut s'effectuer de différentes façons, et notamment par des moyens de scellement à l'aide de ciments appropriés, par vissage, ou simplement par un montage à force dans la cavité. Afin de faciliter cette fixation et empêcher le glissement de la cupule dans la cavité, les parois externes de celle-ci sont la plupart du temps pourvues de divers types de rainures et de crantages divers destinés à prévenir tout glissement.  The fixing of the metal cup inside the acetabular cavity can be carried out in different ways, and in particular by means of sealing with suitable cements, by screwing, or simply by force fitting in the cavity . In order to facilitate this fixing and to prevent the cup from sliding in the cavity, the external walls of the latter are usually provided with various types of grooves and various notches intended to prevent any sliding.

La plupart du temps cependant ces moyens de fixation se révèlent insuffisants, et parfois douloureux pour le patient en raison d'une instabilité de la cupule générant de micromouvements.  Most of the time, however, these means of fixation prove to be insufficient, and sometimes painful for the patient due to instability of the cup, generating micromovements.

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La présente invention a pour but de remédier à ces inconvénients en proposant un moyen de fixation d'une cupule dans la cavité cotyloïdienne qui soit à la fois simple, facile à mettre en oeuvre, et qui assure une fixation efficace sur le plan mécanique.  The object of the present invention is to remedy these drawbacks by proposing a means of fixing a cup in the acetabular cavity which is both simple, easy to implement, and which ensures effective fixing from the mechanical point of view.

La présente invention a ainsi pour objet une cupule destinée à être implantée dans la cavité cotyloïdienne et destinée à la réception de la tête sphérique d'un implant fémoral, caractérisée en ce qu'elle est constituée : - d'une première coquille hémisphérique destinée à être appliquée dans la cavité cotyloïdienne, comportant sur son bord externe périphérique un renflement, ce bord externe étant relié au sommet de la coquille par une zone déformable élastiquement, de façon à permettre un encastrement, au moins partiel, du renflement périphérique dans une gorge circulaire correspondante creusée dans la cavité cotyloïdienne, - d'une seconde coquille rigide indéformable destinée à se fixer dans la première, de façon à bloquer toute déformation ultérieure de celle-ci.  The present invention thus relates to a cup intended to be implanted in the acetabular cavity and intended for the reception of the spherical head of a femoral implant, characterized in that it consists of: - a first hemispherical shell intended for be applied in the acetabular cavity, comprising on its peripheral external edge a bulge, this external edge being connected to the top of the shell by an elastically deformable zone, so as to allow an at least partial embedding of the peripheral bulge in a circular groove corresponding hollowed out in the acetabular cavity, - a second rigid non-deformable shell intended to be fixed in the first, so as to block any subsequent deformation thereof.

Préférentiellement, les deux coquilles posséderont des moyens permettant de les solidariser l'une de l'autre dans une position intermédiaire de la seconde coquille, telle que la mise en place définitive de celle-ci dans la première soit obtenue par un déplacement suivant l'axe de révolution de ces deux coquilles.  Preferably, the two shells will have means making it possible to secure them to one another in an intermediate position of the second shell, such that the final positioning of the latter in the first is obtained by displacement according to the axis of revolution of these two shells.

De façon avantageuse, le renflement périphérique de la première coquille sera pourvu, en surface, de rainures et/ou de crans aptes à favoriser son adhérence avec la gorge circulaire dans laquelle il est logé.  Advantageously, the peripheral bulge of the first shell will be provided, on the surface, with grooves and / or notches capable of promoting its adhesion with the circular groove in which it is housed.

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De façon à favoriser et contrôler l'élasticité de sa zone déformable élastiquement, la première coquille pourra comporter des fentes radiales.  In order to promote and control the elasticity of its elastically deformable zone, the first shell may have radial slots.

La présente invention a également pour objet un outil de mise en place d'une cupule, caractérisé en ce qu'il comprend une tige dont une extrémité comporte des moyens de fixation amovibles sur la première coquille, qui traverse la seconde coquille, et qui assure le guidage d'un manchon monté à déplacement longitudinal sur celle-ci, et qui se termine par des moyens aptes à venir en appui sur la base de la seconde coquille lorsque celle-ci est en position de fixation intermédiaire dans la première, et à la repousser en position de fixation définitive dans la première coquille lorsque l'on déplace les moyens d'appui en direction du fond de la première coquille.  The present invention also relates to a tool for placing a cup, characterized in that it comprises a rod, one end of which comprises removable fixing means on the first shell, which passes through the second shell, and which ensures guiding a sleeve mounted in longitudinal displacement thereon, and which ends with means capable of coming to bear on the base of the second shell when the latter is in intermediate fixing position in the first, and at push it back into the final fixing position in the first shell when the support means are moved towards the bottom of the first shell.

Le manchon pourra être vissé sur la tige et se terminer par un plateau qui viendra en appui sur la base de la seconde coquille, de façon à la repousser vers la position de fixation lorsque l'on visse/dévisse le manchon sur la tige. La tige sera préférablement fixée par vissage sur la première coquille.  The sleeve can be screwed onto the rod and end with a plate which will come to bear on the base of the second shell, so as to push it back towards the fixing position when the sleeve is screwed / unscrewed on the rod. The rod will preferably be fixed by screwing on the first shell.

La présente invention a également pour objet un outil de fraisage rotatif d'une gorge circulaire dans une cavité cotyloïdienne, caractérisé en ce qu'il comporte une tige dont une extrémité, ou extrémité active, comporte un guide de positionnement destiné à venir en appui sur la paroi de la cavité cotyloïdienne, et au moins deux lames d'usinage mobiles dans des logements radiaux sensiblement perpendiculaires à la tige et qui sont aptes à occuper deux positions, à savoir une position rétractée, ou position de repos, sous l'action de moyens élastiques de rappel, et une position sortie, ou  The present invention also relates to a rotary milling tool for a circular groove in an acetabular cavity, characterized in that it comprises a rod of which one end, or active end, comprises a positioning guide intended to come to bear on the wall of the acetabular cavity, and at least two movable machining blades in radial housings substantially perpendicular to the rod and which are able to occupy two positions, namely a retracted position, or rest position, under the action of elastic return means, and an extended position, or

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position d'usinage, dans laquelle elles sont extraites partiellement de leurs logements respectifs sous l'action de la force centrifuge provoquée par la rotation de l'outil.  machining position, in which they are partially extracted from their respective housings under the action of centrifugal force caused by the rotation of the tool.

On décrira ci-après, à titre d'exemple non limitatif, une forme d'exécution de la présente invention, en référence aux dessins annexés sur lesquels :
Les figures 1 et 2 sont des vues en coupe suivant l'axe de révolution de la cupule, respectivement dans les positions de prépositionnement et de positionnement définitif des deux coquilles constituant celle-ci. An embodiment of the present invention will be described below, by way of non-limiting example, with reference to the appended drawings in which:
Figures 1 and 2 are sectional views along the axis of revolution of the cup, respectively in the positions of prepositioning and final positioning of the two shells constituting it.

La figure 3 est une vue en perspective avec coupe partielle de la cupule en position de prépositionnement telle que représentée sur la figure 1.  FIG. 3 is a perspective view with partial section of the cup in the prepositioning position as shown in FIG. 1.

La figure 4 est une vue en perspective à plus petite échelle de la coquille interne de la cupule.  Figure 4 is a perspective view on a smaller scale of the inner shell of the cup.

La figure 5 est une vue en coupe axiale d'une cupule suivant l'invention dont les deux coquilles sont en position de prépositionnement, et qui sont saisies par un outil de positionnement de cette cupule.  FIG. 5 is a view in axial section of a cup according to the invention, the two shells of which are in the prepositioning position, and which are gripped by a tool for positioning this cup.

La figure 6 est une vue partielle représentant la cupule et l'outil de positionnement de la figure 5, une fois les deux coquilles de la cupule mises en position définitive.  Figure 6 is a partial view showing the cup and the positioning tool of Figure 5, once the two shells of the cup placed in the final position.

La figure 7 est une vue en coupe axiale d'un outil de fraisage rotatif permettant de creuser, dans la cavité cotyloidienne, une rainure circulaire destinée à recevoir le renflement périphérique prévu sur la coquille interne de la cupule.  Figure 7 is an axial sectional view of a rotary milling tool for digging, in the acetabulum, a circular groove for receiving the peripheral bulge provided on the inner shell of the cup.

Les figures 8 et 9 sont des vues en coupe transversale de l'outil de fraisage représenté sur la figure 7 suivant la ligne VII-VII de celle-ci, respectivement en position de repos et en position d'usinage.  Figures 8 and 9 are cross-sectional views of the milling tool shown in Figure 7 along line VII-VII thereof, respectively in the rest position and in the machining position.

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On a représenté sur les figures 1 à 4 une cupule 1 suivant l'invention qui est essentiellement constituée d'une coquille interne 3 et d'une coquille externe 5 qui ont l'une et l'autre une forme sphérique. La coquille interne 3 est destinée à prendre place dans une cavité cotyloïdienne 7 qui, à cet effet, ainsi qu'il en est habituellement dans l'état antérieur de la technique, aura subi un usinage destiné à parfaire sa forme sphérique.  There is shown in Figures 1 to 4 a cup 1 according to the invention which consists essentially of an inner shell 3 and an outer shell 5 which both have a spherical shape. The internal shell 3 is intended to take place in an acetabular cavity 7 which, for this purpose, as is usually the case in the prior art, will have been machined to perfect its spherical shape.

La base de la coquille interne 3 comporte sur sa périphérie un renflement 9. Ce renflement est destiné à prendre place dans une gorge circulaire 11 créée à cet effet dans la cavité cotyloïdienne 7 au moyen d'un outil dont la forme et la fonction seront décrites en détails plus loin.  The base of the inner shell 3 has on its periphery a bulge 9. This bulge is intended to take place in a circular groove 11 created for this purpose in the acetabular cavity 7 by means of a tool whose shape and function will be described in detail later.

Afin d'améliorer l'adhérence du renflement 9 dans la gorge 11, celui-ci est pourvu sur l'ensemble de sa périphérie d'une sorte de crantage. La zone 3a reliant le renflement 9 au sommet de la coquille interne 3 est de plus faible épaisseur que le reste de la coquille de façon à conférer à cette zone une certaine élasticité. Afin d'améliorer cette élasticité la coquille interne 3 est pourvue de quatre fentes radiales 13 qui s'étendent de cette zone jusqu'à la périphérie de la coquille 3. In order to improve the adhesion of the bulge 9 in the groove 11, the latter is provided over its entire periphery with a sort of notch. The zone 3a connecting the bulge 9 to the top of the internal shell 3 is thinner than the rest of the shell so as to give this zone a certain elasticity. In order to improve this elasticity, the internal shell 3 is provided with four radial slots 13 which extend from this zone to the periphery of the shell 3.

La coquille externe 5 possède, ainsi que représenté sur la figure 2, un profil externe qui reproduit le profil interne de la coquille 3, de façon qu'elle puisse prendre place à l'intérieur de celle-ci et s'y adapter. La coquille externe 5, à l'inverse de la coquille interne 3, est indéformable, de façon que, lorsqu'elle a pris position à l'intérieur de la coquille interne 3, elle empêche toute déformation ultérieure de celle-ci.  The external shell 5 has, as shown in FIG. 2, an external profile which reproduces the internal profile of the shell 3, so that it can take place inside it and adapt to it. The outer shell 5, unlike the inner shell 3, is non-deformable, so that, when it has taken position inside the inner shell 3, it prevents any subsequent deformation thereof.

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Afin d'assurer le maintien de la coquille externe 5 dans la coquille interne 3, les deux coquilles sont pourvues de moyens d'encliquetage qui sont constitués, dans le mode de mise en oeuvre représenté sur les dessins des figures 1 à 4, par une cavité circulaire 15 réalisée dans la coquille interne 3 et par une protubérance de forme complémentaire 17 réalisée sur la face externe de la coquille externe 5.  In order to maintain the outer shell 5 in the inner shell 3, the two shells are provided with latching means which are, in the embodiment shown in the drawings of Figures 1 to 4, by a circular cavity 15 produced in the internal shell 3 and by a protrusion of complementary shape 17 produced on the external face of the external shell 5.

Dans un mode de mise en oeuvre, spécifique du présent mode de mise en oeuvre de la réalisation représentée, la coquille externe 5 possède une rainure circulaire périphérique 19 destinée à recevoir une fine languette circulaire 21 réalisée à la base de la coquille interne 3, de façon que cette languette 21 puisse s'encliqueter dans la rainure périphérique 19.  In one embodiment, specific to the present embodiment of the embodiment shown, the outer shell 5 has a peripheral circular groove 19 intended to receive a thin circular tongue 21 produced at the base of the inner shell 3, of so that this tongue 21 can snap into the peripheral groove 19.

Une telle forme de mise en oeuvre est particulièrement intéressante en ce qu'elle permet de réaliser un prépositionnement de la coquille externe 5'à l'intérieur de la coquille interne 3, de façon à constituer un sous-ensemble, si bien que le praticien n'aura pas, au cours de son intervention, à manipuler deux éléments séparés mais un sousensemble unique. Ce sous-ensemble peut d'ailleurs avoir fait l'objet d'une stérilisation.  Such a form of implementation is particularly advantageous in that it allows a prepositioning of the outer shell 5 ′ inside the inner shell 3, so as to constitute a sub-assembly, so that the practitioner will not have, during his intervention, to handle two separate elements but a single subset. This sub-assembly may also have been sterilized.

Dans ces conditions, on comprend que la mise en place de la cupule 1 constituée des deux coquilles interne 3 et externe 5 est particulièrement facile à réaliser. Dans une première étape on présentera la cupule 1 à l'entrée de la cavité cotyloïdienne 7, et, en exerçant un léger effort F suivant la direction de l'axe de révolution yy'de la cupule 1, on provoquera une déformation de la zone 3a de la coquille interne 3 permettant au renflement 9 de prendre place dans la gorge 11. On sera alors dans la position de prépositionnement  Under these conditions, it is understood that the establishment of the cup 1 consisting of the two inner shells 3 and outer 5 is particularly easy to perform. In a first step, the cup 1 will be presented at the entrance to the acetabular cavity 7, and, by exerting a slight force F in the direction of the axis of revolution yy 'of the cup 1, the zone will be deformed. 3a of the internal shell 3 allowing the bulge 9 to take place in the groove 11. We will then be in the prepositioning position

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représentée sur la figure 1. Il suffira ensuite, dans une seconde étape, d'exercer de nouveau un effort F sur la coquille externe 5 pour que celle-ci prenne place à l'intérieur de la coquille interne 3 et soit maintenue dans cette position par les moyens d'encliquetage.  represented in FIG. 1. It will then suffice, in a second step, to again exert a force F on the external shell 5 so that the latter takes place inside the internal shell 3 and is maintained in this position by latching means.

Il restera ensuite au praticien à mettre en place, ainsi que représenté sur la figure 2, un insert 23 dans la coquille externe 5, qui recevra lui-même la tête 25 d'une pièce fémorale 27.  The practitioner will then have to put in place, as shown in FIG. 2, an insert 23 in the external shell 5, which will itself receive the head 25 of a femoral part 27.

La mise en place de la cupule à l'intérieur de la cavité cotyloïdienne 7 est grandement facilitée par l'utilisation d'un outil de positionnement 29 notamment du type de celui représenté sur les figures 5 et 6.  The placement of the cup inside the acetabular cavity 7 is greatly facilitated by the use of a positioning tool 29 in particular of the type shown in FIGS. 5 and 6.

Sur ces dernières cet outil 29 est essentiellement constitué d'un fourreau 30 à l'intérieur duquel est montée à vissage une tige filetée 32. Cette tige 32 se termine, à l'une de ses extrémités par une partie filetée 34, qui est destinée à venir se visser dans un trou fileté 35 réalisé au sommet de la coquille interne 3 et qui, par un bossage 36 vient en appui sur le sommet interne de la coquille. La coquille externe 5 sera pourvue d'un orifice 37 de plus grand diamètre permettant de laisser le passage à la tige 32.  On the latter this tool 29 essentially consists of a sheath 30 inside which is screwed a threaded rod 32. This rod 32 ends, at one of its ends by a threaded part 34, which is intended to be screwed into a threaded hole 35 made at the top of the internal shell 3 and which, by a boss 36 comes to bear on the internal top of the shell. The outer shell 5 will be provided with a hole 37 of larger diameter allowing the passage to the rod 32.

La tige 32 se termine à son autre extrémité par des moyens de maintien 38. Le fourreau 30 comporte à l'une de ses extrémités quatre tiges de commande radiales 42, et à son autre extrémité un plateau 44.  The rod 32 ends at its other end by holding means 38. The sheath 30 has at one of its ends four radial control rods 42, and at its other end a plate 44.

Dans ces conditions, l'outil 29 est mis en oeuvre ainsi que décrit ci-après. Les coquilles interne 3 et externe 5 étant assemblées de façon à former un sous-ensemble, c'est-àdire que la languette périphérique 21 sera encliquetée dans la rainure périphérique 19, le praticien vissera la partie  Under these conditions, the tool 29 is used as described below. The inner 3 and outer 5 shells being assembled so as to form a sub-assembly, that is to say that the peripheral tongue 21 will be snapped into the peripheral groove 19, the practitioner will screw the part

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filetée 34 de la tige 32 dans le filetage 35, si bien que la coquille interne 3 sera solidarisée de cette tige.  threaded 34 of the rod 32 in the thread 35, so that the internal shell 3 will be secured to this rod.

Le praticien utilisera alors l'outil 29 pour assurer un positionnement facile de la cupule 1 à l'intérieur de la cavité cotyloïdienne 7 et, par une pression déformera la partie souple 3a de la coquille interne 3 de façon que le renflement 9 prenne place dans la gorge circulaire 11.  The practitioner will then use the tool 29 to ensure easy positioning of the cup 1 inside the acetabular cavity 7 and, by pressure, will deform the flexible part 3a of the internal shell 3 so that the bulge 9 takes place in the circular groove 11.

Ensuite, le praticien vissera le fourreau 30 sur la tige filetée 32 en s'aidant pour ce faire des tiges de commande 42, jusqu'à ce que le plateau 44 vienne en contact avec la base de la coquille externe 5. Ensuite, toute rotation supplémentaire du fourreau 30 sur la tige filetée 32 aura pour effet de repousser la coquille externe 5 à l'intérieur de la coquille interne 3 jusqu'à assurer l'encliquetage, et donc le verrouillage des deux coquilles. Il restera ensuite au praticien à dévisser la tige filetée 32 afin de libérer l'outil 29. Then, the practitioner will screw the sheath 30 onto the threaded rod 32 with the help of the control rods 42, until the plate 44 comes into contact with the base of the outer shell 5. Then, any rotation additional sheath 30 on the threaded rod 32 will have the effect of pushing the outer shell 5 inside the inner shell 3 until it clicks, and therefore the locking of the two shells. The practitioner will then have to unscrew the threaded rod 32 in order to release the tool 29.

Suivant l'invention la réalisation de la gorge périphérique 11 peut avantageusement être réalisée au moyen d'un outil de fraisage rotatif, par exemple du type de celui représenté sur les figures 7 à 9.  According to the invention, the production of the peripheral groove 11 can advantageously be carried out by means of a rotary milling tool, for example of the type shown in FIGS. 7 to 9.

Cet outil de fraisage 50 est essentiellement constitué d'une tige 52 terminée, à l'une de ses extrémités, par des moyens d'entraînement en rotation et à son autre extrémité par un guide sphérique 54 destiné à prendre appui sur la face interne de la cavité cotyloïdienne 7 et qui comporte trois lames d'usinage 56 qui sont disposées à 1200 les unes des autres, dans le présent mode de mise en oeuvre, et qui sont mobiles à l'intérieur de chemins de guidage radiaux 58, si bien qu'elles sont aptes à occuper deux positions, à savoir une position de repos, ainsi que représenté sur la figure 8,  This milling tool 50 essentially consists of a rod 52 terminated, at one of its ends, by rotation drive means and at its other end by a spherical guide 54 intended to bear on the internal face of the acetabular cavity 7 and which comprises three machining blades 56 which are arranged at 1200 from one another, in the present embodiment, and which are movable inside radial guide tracks 58, so that '' they are capable of occupying two positions, namely a rest position, as shown in FIG. 8,

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dans laquelle elles sont maintenues par des moyens de rappel élastiques 60, et une position dans laquelle elles sont sorties sous l'effet de la force centrifuge qui s'exerce sur elles lors de la rotation de l'outil. Les lames d'usinage 56 comportent des butées 62 destinées à limiter leur course, ainsi que représenté sur la figure 9. in which they are held by elastic return means 60, and a position in which they are exited under the effect of the centrifugal force which is exerted on them during the rotation of the tool. The machining blades 56 have stops 62 intended to limit their travel, as shown in FIG. 9.

Claims (8)

REVENDICATIONS 1.-Cupule destinée à être implantée dans la cavité cotyloïdienne (7) et destinée à la réception de la tête sphérique (25) d'un implant fémoral (27), caractérisée en ce qu'elle est constituée : - d'une première coquille hémisphérique (3) destinée à être appliquée dans la cavité cotyloïdienne (7), comportant sur son bord externe périphérique un renflement (9), ce bord externe étant relié au sommet de la coquille (3) par une zone (3a) déformable élastiquement, de façon à permettre un encastrement, au moins partiel, du renflement périphérique (9) dans une gorge circulaire (11) correspondante creusée dans la cavité cotyloïdienne (7), d'une seconde coquille (5) rigide indéformable destinée à se fixer dans la première, de façon à bloquer toute déformation ultérieure de celle-ci.  CLAIMS 1.-Cup intended to be implanted in the acetabular cavity (7) and intended for the reception of the spherical head (25) of a femoral implant (27), characterized in that it consists of: - a first hemispherical shell (3) intended to be applied in the acetabular cavity (7), comprising on its peripheral external edge a bulge (9), this external edge being connected to the top of the shell (3) by a deformable zone (3a) elastically, so as to allow at least partial embedding of the peripheral bulge (9) in a corresponding circular groove (11) hollowed out in the acetabular cavity (7), of a second rigid non-deformable shell (5) intended to be fixed in the first, so as to block any subsequent deformation thereof. 2.-Cupule suivant la revendication 1 caractérisée en ce que les deux coquilles (3,5) possèdent des moyens (19,21) permettant de les solidariser l'une de l'autre dans une position intermédiaire de la seconde coquille (5), telle que la mise en place définitive de celle-ci dans la première soit obtenue par un déplacement suivant l'axe de révolution (yy') de ces deux coquilles (3,5).  2.-Cup according to claim 1 characterized in that the two shells (3,5) have means (19,21) for securing them to one another in an intermediate position of the second shell (5) , such that the final positioning of the latter in the first is obtained by a displacement along the axis of revolution (yy ') of these two shells (3,5). 3.-Cupule suivant l'une des revendications 1 ou 2 caractérisée en ce que le renflement périphérique (9) de la première coquille (3) est pourvu, en surface, de rainures et/ou de crans aptes à favoriser son adhérence avec la gorge circulaire (11) dans laquelle il est logé.  3.-Cup according to one of claims 1 or 2 characterized in that the peripheral bulge (9) of the first shell (3) is provided, on the surface, with grooves and / or notches capable of promoting its adhesion with the circular groove (11) in which it is housed. 4.-Cupule suivant l'une des revendications précédentes caractérisée en ce que la première coquille (3) comporte des  4.-Cup according to one of the preceding claims characterized in that the first shell (3) comprises <Desc/Clms Page number 11><Desc / Clms Page number 11> fentes radiales (13) destinées à favoriser et contrôler l'élasticité de sa zone (3a) déformable élastiquement.  radial slots (13) intended to promote and control the elasticity of its elastically deformable zone (3a). 5.-Outil de mise en place d'une cupule suivant l'une quelconque des revendications précédentes, caractérisé en ce qu'il comprend une tige (32) dont une extrémité comporte des moyens de fixation (34) amovibles sur la première coquille (3), qui traverse la seconde coquille (5), et qui assure le guidage d'un manchon (30) monté à déplacement longitudinal sur celle-ci, et qui se termine par des moyens (44) aptes à venir 1 en appui sur la base de la seconde coquille (5) lorsque celle- ci est en position de fixation intermédiaire dans la première, et à la repousser en position de fixation définitive dans la première coquille (3) lorsque l'on déplace les moyens d'appui (44) en direction du fond de la première coquille (3).  5. Tool for fitting a cup according to any one of the preceding claims, characterized in that it comprises a rod (32), one end of which comprises fixing means (34) removable on the first shell ( 3), which passes through the second shell (5), and which guides a sleeve (30) mounted in longitudinal displacement thereon, and which ends with means (44) capable of coming to bear on the base of the second shell (5) when the latter is in the intermediate fixing position in the first, and to push it back into the final fixing position in the first shell (3) when the support means are moved ( 44) towards the bottom of the first shell (3). 6.-Outil suivant la revendication 5 caractérisé en ce que le manchon (30) est vissé sur la tige (32) et se termine par un plateau (44) qui vient en appui sur la base de la seconde coquille (5), de façon à la repousser vers la position de fixation lorsque l'on visse/dévisse le manchon (30) sur la tige (32).  6. Tool according to claim 5 characterized in that the sleeve (30) is screwed onto the rod (32) and ends with a plate (44) which comes to bear on the base of the second shell (5), so as to push it back towards the fixing position when the sleeve (30) is screwed / unscrewed on the rod (32). 7.-Outil suivant l'une des revendications 5 ou 6 caractérisé en ce que la tige (32) est fixée par vissage sur la première coquille (3).  7. Tool according to one of claims 5 or 6 characterized in that the rod (32) is fixed by screwing on the first shell (3). 8.-Outil de fraisage rotatif d'une gorge circulaire (11) dans une cavité cotyloïdienne (7) destinée à recevoir une cupule suivant l'une des revendications 1 à 4, caractérisé en ce qu'il comporte une tige (52) dont une extrémité, ou extrémité active, comporte un guide de positionnement (54) destiné à venir en appui sur la paroi de la cavité cotyloïdienne (7) et au moins deux lames d'usinage (56) mobiles dans des logements radiaux (58) sensiblement  8. Rotary milling tool of a circular groove (11) in an acetabular cavity (7) intended to receive a cup according to one of claims 1 to 4, characterized in that it comprises a rod (52) of which one end, or active end, comprises a positioning guide (54) intended to come to bear on the wall of the acetabular cavity (7) and at least two machining blades (56) movable in radial housings (58) substantially <Desc/Clms Page number 12><Desc / Clms Page number 12> perpendiculaires à la tige (52) et qui sont aptes à occuper deux positions, à savoir une position rétractée, ou position de repos, sous l'action de moyens élastiques de rappel (60), et une position sortie, ou position d'usinage, dans laquelle elles sont extraites partiellement de leurs logements respectifs (58) sous l'action de la force centrifuge provoquée par la rotation de l'outil. perpendicular to the rod (52) and which are able to occupy two positions, namely a retracted position, or rest position, under the action of elastic return means (60), and an extended position, or machining position , in which they are partially extracted from their respective housings (58) under the action of the centrifugal force caused by the rotation of the tool.
FR0200553A 2002-01-17 2002-01-17 COTYLOIDIAN IMPLANT CUP Expired - Fee Related FR2834630B1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007016329A1 (en) 2005-07-28 2007-02-08 Alexandria Research Technologies, Llc Apparatus and method for placing an implant in vivo
FR2892014A1 (en) * 2005-10-19 2007-04-20 Implant Reduction Eurl Entpr U Cup for cotyloid implant of femoral prosthesis has threaded axial aperture to receive threaded projection on insert

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EP0083708A1 (en) * 1982-01-08 1983-07-20 GebràœDer Sulzer Aktiengesellschaft Acetabular cup to be anchored in the pelvis without cement
EP0169978A1 (en) * 1984-07-16 1986-02-05 GebràœDer Sulzer Aktiengesellschaft Endoprosthesis with an interior and exterior part for a hip joint cup
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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007016329A1 (en) 2005-07-28 2007-02-08 Alexandria Research Technologies, Llc Apparatus and method for placing an implant in vivo
EP1912580A1 (en) * 2005-07-28 2008-04-23 Alexandria Research Technologies, LLC Apparatus and method for placing an implant in vivo
EP1912580A4 (en) * 2005-07-28 2011-06-29 Alexandria Res Technologies Llc Apparatus and method for placing an implant in vivo
US8128631B2 (en) 2005-07-28 2012-03-06 Alexandria Research Technologies, Inc. Apparatus and method for placing an implant in vivo
CN101232850B (en) * 2005-07-28 2012-12-12 亚历山大研究科学有限责任公司 Apparatus and method for placing an implant in vivo
FR2892014A1 (en) * 2005-10-19 2007-04-20 Implant Reduction Eurl Entpr U Cup for cotyloid implant of femoral prosthesis has threaded axial aperture to receive threaded projection on insert
EP1982675A1 (en) * 2005-10-19 2008-10-22 Implant reduction Cup for cotyloidal implant.

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