FR2840802A1 - Implant cotyloidien pour prothese de hanche - Google Patents

Implant cotyloidien pour prothese de hanche Download PDF

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Publication number
FR2840802A1
FR2840802A1 FR0207269A FR0207269A FR2840802A1 FR 2840802 A1 FR2840802 A1 FR 2840802A1 FR 0207269 A FR0207269 A FR 0207269A FR 0207269 A FR0207269 A FR 0207269A FR 2840802 A1 FR2840802 A1 FR 2840802A1
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FR
France
Prior art keywords
cup
core
arrangements
fixed core
cavity
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
FR0207269A
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English (en)
Other versions
FR2840802B1 (fr
Inventor
Philippe Hernigou
Eric Barberichaux
Bertrand Bouxin
Franck Kieffer
Bernard Lacour
Denis Latune
Yves Marquet
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PROTHESIO
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PROTHESIO
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Publication date
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Priority to FR0207269A priority Critical patent/FR2840802B1/fr
Publication of FR2840802A1 publication Critical patent/FR2840802A1/fr
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Publication of FR2840802B1 publication Critical patent/FR2840802B1/fr
Anticipated expiration legal-status Critical
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—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
    • 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
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
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    • 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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    • 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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    • A61F2002/30329—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
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
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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
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    • A61F2002/305—Snap connection
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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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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/348—Additional features
    • A61F2002/3493—Spherical shell significantly greater than a hemisphere, e.g. extending over more than 200 degrees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • 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
    • A61F2002/4619—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 for extraction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0062—Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
    • 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
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • 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
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • 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
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Landscapes

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

Abstract

L'implant cotyloïdien pour prothèse de hanche comprenant un anneau ou cupule (1) recevant un noyau ou insert destiné à recevoir, avec capacité d'articulation, une tête fémorale,est remarquable en ce que :- la cupule (1) délimite une cavité hémisphérique entièrement lisse et polie (la) qui présente des agencements d'accouplement (1b) aptes à coopérer avec des agencements complémentaires (2a) que présente un noyau dit fixe (2), en vue de sa solidarisation;- les agencements d'accouplement (1b) de la cupule (1) permettent le montage, avec capacité de mobilité multidirectionnelle d'un noyau dit mobile (3);le rebord circulaire de la cupule (1) présente des agencements d'indexation angulaire coopérant avec des agencements complémentaires du noyau fixe (2).

Description

biocompatible. L'invention se rattache au secteur technique des implants
du type
cotylodien pour ['articulation de la hanche.
D'une maniere parfaitement connue pour l'homme du metier, un implant cotylodien comprend, pour l'essentiel, une cupule metallique de forme generale hemispherique destinee a recevoir un insert ou noyau cooperant avec une tete femorale d'un implant complementaire. La cupule metallique est impactee dans la cavite cotylodienne de l'os iliaque en etant maintenue par differents moyens, en combinaison ou non avec du ciment orthopedique. La fixation de la cupule peut egalement etre assuree par un effet connu sous le nom de << press-fit >>. Le noyau, qui peut etre en polyethylene, en ceramique, en metal, ou une combinaison quelconque de ces materiaux, est montee dans la cavite interne hemispherique de la cupule, soit d'une maniere fixe, soit d'une maniere mobile avec capacite de deplacement multidirectionnel, cela en fonction du type d'arthroplastie a traiter. I1 est bien evident que le montage fixe ou mobile du noyau, par rapport a la cupule, necessite de disposer, non senlement de noyaux de types differents, mais egalement des cupules de types differents. Or, il arrive kes souvent, apres impaction de la cupule dans la cavite cotylodienne de l'os iliaque, que le choix initial par l'operateur d'un noyau fixe ou d'un noyau mobile, doit eke modifie. Aukement dit, si, au depart, le chirurgien a selectionne une cupule pour un montage fixe du noyau, il ne pourra pas, en cours d'intervention, monter un noyau mobile, sauf a proceder a ['ablation
de la cupule.
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De plus, selon l'age du patient, le chirurgien peut sonhaiter disposer d'inserts fixes ou mobiles offrant une surface de frottement en ceramique, afin de reduire les frottements et augmenter ainsi la duree de vie de la prothese. L ' invention s ' est fixee pour but de remedier a ces inconvenients, de
maniere simple, sure, efficace et rationnelle.
Le probleme que se propose de resoudre ['invention est de proposer a I'operateur la possibilite de selectionner un noyau fixe ou un noyau mobile avec une cupule identique dans l'un ou l'autre cast Pour resoudre un tel probleme, il a ete con$u et mis au point un implant cotylodien dans lequel: - la cupule delimite une cavite hemispherique entierement lisse et poke qui presente des agencements d'accouplement apses a cooperer avec des agencements complementaires que presente un noyau dit fixe, en vue de sa solidarisation; - les agencements d'accouplement de la cupule permettent le montage, avec capacite de mobilite multidirectionnelle d'un noyau dit mobile; - le rebord circulaire de la cupule presente des agencements d'indexation angulaire cooperant avec des agencements complementaires du noyau fixe. Pour resoudre le probleme pose d' assurer l ' accouplement du noyau fixe dans la cupule, les agencements d'accouplement de la cupule vent constitues par une zone retentive resultant de ['intersection d'une portee T
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conique evasee formee dans le prolongement de la forme demi-spherique de la cavite et d'une portee conique se refermant, lesdites portees etant de
longueur reduite.
Les agencements complementaires d'accouplement du noyau fixe, vent constitues par un bourrelet peripherique externe forme a ltextremite
superieure, parallelement au plan equatorial.
Pour resoudre le probleme pose d'indexer angulairement le noyau fixe par rapport a la cupule, les agencements d'indexation angulaire de la
O cupule vent constitues par au moins un ergot.
Les agencements complementaires d'indexation angulaire du noyau fixe vent constitues par au moins une empreinte en creux formee a partir du
bord circulaire externe d'une collerette d'appui que presente ledit noyau.
Pour resoudre le probleme pose d'obtenir une parfaite retentivite, dans le cadre d'un noyau mobile, ce dernier delimite une enveloppe hemispherique qui va au-dela d'une demi-sphere pour constituer une calotte debordante apres mise en place dans la cavite hemispherique de la cupule,
afin d'eviter la luxation de la tete femorale.
Pour resoudre le probleme pose d'obtenir une bonne tenue primaire et secondaire de la cupule dans le fond de la cavite cotylodienne de l'os iliaque, la cupule presente des asperites externes pour une impaction du type
<< press-fit >> dans la cavite cotylodienne de l'os iliaque.
Pour resoudre le probleme pose d'obtenir une parfaite stabilite de la cupule, notamment en cas de defection osseuse importante, la cupule peut ld
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presenter dans une variante, au niveau de son ouverture, au moins une paste de fixation cooperant avec l'ilion et deux orifices pour le montage de deux
plots orientes vers l'ischion et le pubis.
D'une maniere avantageuse, le ou les ergots d'indexation angulaire de la cupule cooperent avec des formes complementaires que presente un instrument qui s'expand dans la zone retentive en vue de la mise en place ou
de ['ablation de ladite cupule.
0 L'invention est exposee ci-apres plus en detail a ['aide des figures des dessins annexes dans lesquels: - la figure 1 est une vue en perspective d'une premiere forme de realisation de la cupule metallique; - la figure 2 est une vue en perspective du noyau fixe; - la figure 3 est une vue en perspective du noyau mobile; - la figure 4 est une vue en perspective d'une variante de realisation de la cupule illustree figure 1; - la figure 5 est une vue en coupe longitudinale de la cupule; - la figure 6 est une vue en coupe longitudinale de la cupule, apres mise en place du noyau fixe; - la figure 7 est une vue en coupe longitudinale de la cupule apres mise en place du noyau mobile; - la figure 8 est une vue de dessus correspondent a la figure 6; - la figure 9 est une vue de dessus correspondent a la figure 7; - la figure 10 est une vue partielle en perspective et en coupe montrant la prehension de la cupule selon ['invention, avec une piece de conception specifique, en vue de sa mise en place ou de son ablation;
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- la figure 11 est une vue en coupe d'un noyau fixe presentant une couche interne en ceramique massive; - la figure 12 est une vue en coupe d'un noyau mobile presentant une
couche interne en ceramique massive.
Selon une caracteristique a la base de ['invention, la cupule (1) (figure 1 ou 4) est agencee pour recevoir, soit un noyau fixe (2), soit un
noyau mobile (3).
0 La cupule (1) delimite une cavite interne hemispherique (la), entierement lisse, qui presente des agencements d'accouplement (lb) apses a cooperer avec des agencements complementaires (2a) que presente le noyau fixe (2), lesdits agencements (lb) ne s'opposant pas au montage avec
capacite de deplacement multidirectionnel, du noyau mobile (3).
Les agencements (lb) d'accouplement de la cavite interne de la cupule (1), constituent une zone retentive. Cette zone, est constituee par ['intersection d'une portee conique (lbl) formee dans le prolongement de la forme demi-spherique de la cavite (la), et d'une portee conique (lb2) orientee d'une maniere inverse a la portee tronconique (lb l), c' est-adire se refermant en direction de l'extremite ouverte de la cupule (1). Comme le montre la figure 5 notamment, les portees (lbl) et (lb2) vent de longueur reduite. D'une maniere complementaire a la zone retentive (lb), le noyau fixe (2) presente un bourrelet peripherique externe (2a) forme, a son extremite superieure, parallelement au plan equatorial. Ces agencements
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d'accouplement complementaires (lb) (2a) assurant la fixation du noyau (2) dans la cavite hemispherique interne (la) de la cupule (1), par effet de clipage. Dans le cas d'un noyau fixe, il est important de ['indexer angulairement par rapport a la cupule metallique. Dans ce but, le bord
circulaire superieur (lc) de la cupule presente au moins un ergot (lcl).
Dans une forme de realisation preferee, la cupule (1) presente trots ergots (lcl) decales angulairement d'environ 45 . Chaque ergot (lcl) a une forme sensiblement semi-circulaire. Ces ergots (lcl) vent destines a cooperer avec des empreintes complementaires (2bl) formees a partir du rebord externe
d'une collerette d'appui (2b) que presente l'extremite ouverte du noyau (2).
A noter que cette collerette (2b) est raccordee a la cavite hemispherique (2c) du noyau fixe (2) destine a recevoir la tete femorale, par une portee
tronconique evasee (2d).
Comme indique, les agencements d'accouplement de la cupule (1), constitues par la zone retentive (lb), ne s'opposent pas au montage, avec capacite de deplacement multidirectionnel, du noyau mobile (3). Ce noyau mobile (3) est retentif afin d'empecher la luxation de la tete femorale. Dans ce but, le noyau mobile (3) delimite une enveloppe hemispherique qui va au-dela d'une demi-sphere, pour constituer une calotte debordante apres
mise en place, dans la cavite hemispherique (la) de la cupule (1) (figure 7).
Compte tenu des caracteristiques sus-indiquees de la cupule (1), il apparat que cette derriere peut recevoir, a volonte, soit un noyau fixe (2),
soit un noyau mobile (3).
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La cupule (1) presente un << press-fit >> peripherique afin d'etre congruent avec une operation de fraisage au pole du cotyle prothetique avec un serrage d'1 mm au niveau du plan equatorial. La cupule (1) presente en outre des macro-structures (l d) formees peripheriquement au niveau de sa
partie superieure.
La cupule (1) peut etre en inox et entierement revetue d'une couche HAC d'hydroxy apathite () de 100 microns par exemple. La cavite interne 0 (la) est entierement lisse en etant soumise, par exemple, a une operation de polissage. A partir de la conception de base de]a cupule (1), cette derriere presente essentiellement deux formes de realisation en fonction de l'etat de la cavite cotylodienne prothesee. Dans la forme de realisation de la figure
1, la cupule (1) est formee par une simple calotte hemispherique.
Selon la forme de realisation illustree figure 4, la cupule (1) presente une paste (le) orientee en direction de l'ilion. L'extremite libre de la paste (le) presente un trou (lel) pour ['engagement d'une vis a corticale. Dans cette forme de realisation, la cavite interne de la cupule peut egalement presenter deux orifices (if) permettant le passage de deux plots (4) orientes
vers l'ischion et le pubis.
Le noyau fixe (2) et le noyau mobile (3) peuvent etre tout en polyethylene ou bien presenter une couche externe en polyethylene et une couche interne (6) en ceramique massive afin de diminuer les frottements
(figures 11 et 12).
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D'une maniere avantageuse, les ergots (lcl) et la zone retentive (lb) de la cupule peuvent cooperer avec des formes complementaires que presente la tete (S) d'un instrument (fgure 10), afin de permettre la mise en place ou ['ablation de la cupule (1) dans la cavite cotylodienne de l'os iliaque. Par exemple, la tete de prehension de l' instrument (S) presente, d'une part, des empreintes (Sa) cooperant avec les ergots (lcl) et, d'autre part, une zone d'appui (Sb) cooperant avec le fond de la cavite hemispherique (la), avec capacite d'expansion. La tete (S) est assujettie a un manche de prehension et de mancouvre (Sc). Apres expansion, la partie (Sb) vient cooperer fermement avec la zone retentive (lb) du cotyle et
assure la tenue solide sur ['instrument (S).
Les avantages ressortent bien de la description, en particulier on
souligne et on rappelle la possibilite de monter, dans la meme cupule, soit
un noyau fixe, soit un noyau mobile, et un instrument de prehension fiable.
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Claims (1)

REVENDICATIONS -1- Implant cotylodien pour prothese de hanche comprenant un anneau ou cupule (1) recevant un noyau ou insert destine a recevoir, avec capacite d'articulation, une tete femorale, caracterise en ce que: - la cupule (1) delimite une cavite hemispherique entierement lisse et poke (la) qui presente des agencements d'accouplement (lb) apses a cooperer avec des agencements complementaires (2a) que presente un noyau dit fixe (2), en vue de sa solidarisation; - les agencements d'accouplement (lb) de la cupule (1) permettent le montage, avec capacite de mobilite multidirectionnelle d'un noyau dit mobile (3); - le rebord circulaire de la cupule ( 1) presente des agencements d'indexation angulaire cooperant avec des agencements complementaires du noyau fixe (2). -2- Implant cotylodien selon la revendication 1, caracterise en ce que les agencements d'accouplement de la cupule (1) vent constitues par une zone retentive (lb) resultant de ['intersection d'une portee conique evasee (lbl) formee dans le prolongement de la forme demi-spherique de la cavite (la), et d'une portee conique (lb2) se refermant, lesdites portees (lbl-lb2) etant de longueur reduite. -3- Implant cotylodien selon la revendication 1, caracterise en ce que les agencements complementaires d'accouplement du noyau fixe (2), vent 2340802 constitues par un bourrelet peripherique externe (2a) forme a l'extremite superieure parallelement au plan equatorial. -4- Implant cotyloidien selon la revendication 1, caracterise en ce que les agencements d'indexation angulaire de la cupule (1) vent constitues par au moins un ergot (lal). -5- Implant cotylodien selon la revendication 1, caracterise en ce que les agencements complementaires d'indexation angulaire du noyau fixe (2) vent lo constitues par au moins une empreinte en creux (2bl) formee a partir du bord circulaire externe d'une collerette d'appui (2b) que presente ledit noyau (2) -6- Implant cotylodien selon la revendication 1, caracterise en ce que le noyau mobile (3) delimite une enveloppe hemispherique qui va au-dela d'une demi-sphere pour constituer une calotte debordante apres mise en place dans la cavite hemispherique de la cupule (1) afin d'eviter la luxation de la tete femorale. -7- Implant selon les revendications 3, 4, S ou 6, caracterise en ce que le noyau f xe (2) ou mobile (3) presente une couche interieure (6) en ceramique massive. -8- Implant cotyloidien selon la revendication 1, caracterise en ce que la cupule (1) presente des asperites externes pour une impaction du type << press-fit >> dans la cavite cotylodienne de l'os iliaque.
1 1 2340802
-9- Implant cotylodien selon la revendication 1, caracterise en ce que la cupule (1) presente, au niveau de son ouverture, au moins une paste de fixation (ld) cooperant avec l'ilion et deux orifces pour le montage de deux
plots orientes vers l'ischion et le pubis.
-10- Implant cotylodien selon la revendication 4, caracterise en ce que le ou les ergots d'indexation angulaire (lal) et la zone retentive (lb) de la cupule, cooperent avec des formes complementaires que presente un instrument (S)
en vue de la mise en place ou de ['ablation de ladite cupule.
FR0207269A 2002-06-13 2002-06-13 Implant cotyloidien pour prothese de hanche Expired - Lifetime FR2840802B1 (fr)

Priority Applications (1)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2938751A1 (fr) * 2008-11-25 2010-05-28 Othesio Implants Implant cotyloidien pour prothese de hanche
EP3243486A1 (fr) * 2016-05-09 2017-11-15 Alessandro Melozzi Tête prothétique universelle pour prothèse de hanche

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE8530793U1 (de) * 1985-10-28 1986-09-25 Mecron Medizinische Produkte Gmbh, 1000 Berlin Schraubpfanne, Pfanneneinsatz und Eindrehwerkzeug
EP0245527A1 (fr) * 1986-04-15 1987-11-19 GebràœDer Sulzer Aktiengesellschaft Endoprothèse acétabulaire
FR2638963A1 (fr) * 1988-11-14 1990-05-18 Tornier Sa Cotyles artificiels a ergots pour prothese totale de la hanche
FR2689000A1 (fr) * 1992-03-27 1993-10-01 Rech Fabrications Et Cupule ancrée pour prothèse totale de hanche.
EP0648478A2 (fr) * 1993-10-18 1995-04-19 Bristol-Myers Squibb Company Coque acétabulaire non sphérique pour remplacement total de la hanche
WO1997042913A1 (fr) * 1996-05-14 1997-11-20 Bruno Balay Implant cotyloidien fixe sans ciment
FR2770769A1 (fr) * 1997-11-07 1999-05-14 Orthotechnique Composant acetabulaire
US6063123A (en) * 1998-07-22 2000-05-16 Sulzer Orthopedics Inc. Acetabular insert extractor and method for use
WO2001070141A1 (fr) * 1998-09-24 2001-09-27 Ortho - I.D. Sarl Calotte d'ancrage acetabulaire
WO2002000140A2 (fr) * 2000-06-28 2002-01-03 University College London Remplacement de surfaces d'appui pour prothese de la hanche

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE8530793U1 (de) * 1985-10-28 1986-09-25 Mecron Medizinische Produkte Gmbh, 1000 Berlin Schraubpfanne, Pfanneneinsatz und Eindrehwerkzeug
EP0245527A1 (fr) * 1986-04-15 1987-11-19 GebràœDer Sulzer Aktiengesellschaft Endoprothèse acétabulaire
FR2638963A1 (fr) * 1988-11-14 1990-05-18 Tornier Sa Cotyles artificiels a ergots pour prothese totale de la hanche
FR2689000A1 (fr) * 1992-03-27 1993-10-01 Rech Fabrications Et Cupule ancrée pour prothèse totale de hanche.
EP0648478A2 (fr) * 1993-10-18 1995-04-19 Bristol-Myers Squibb Company Coque acétabulaire non sphérique pour remplacement total de la hanche
WO1997042913A1 (fr) * 1996-05-14 1997-11-20 Bruno Balay Implant cotyloidien fixe sans ciment
FR2770769A1 (fr) * 1997-11-07 1999-05-14 Orthotechnique Composant acetabulaire
US6063123A (en) * 1998-07-22 2000-05-16 Sulzer Orthopedics Inc. Acetabular insert extractor and method for use
WO2001070141A1 (fr) * 1998-09-24 2001-09-27 Ortho - I.D. Sarl Calotte d'ancrage acetabulaire
WO2002000140A2 (fr) * 2000-06-28 2002-01-03 University College London Remplacement de surfaces d'appui pour prothese de la hanche

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2938751A1 (fr) * 2008-11-25 2010-05-28 Othesio Implants Implant cotyloidien pour prothese de hanche
EP3243486A1 (fr) * 2016-05-09 2017-11-15 Alessandro Melozzi Tête prothétique universelle pour prothèse de hanche

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