FR2842725A1 - Range of prosthesis femoral hip implants each have slit through distal portion emerging in distal end, with slit proximal end emerging in transverse hole in same direction as slit, and hole diameter being variable between implants - Google Patents

Range of prosthesis femoral hip implants each have slit through distal portion emerging in distal end, with slit proximal end emerging in transverse hole in same direction as slit, and hole diameter being variable between implants Download PDF

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Publication number
FR2842725A1
FR2842725A1 FR0209544A FR0209544A FR2842725A1 FR 2842725 A1 FR2842725 A1 FR 2842725A1 FR 0209544 A FR0209544 A FR 0209544A FR 0209544 A FR0209544 A FR 0209544A FR 2842725 A1 FR2842725 A1 FR 2842725A1
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France
Prior art keywords
implant
implants
slit
range
hole
Prior art date
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Granted
Application number
FR0209544A
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French (fr)
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FR2842725B1 (en
Inventor
Jean Louis Dore
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Individual
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Individual
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Priority to FR0209544A priority Critical patent/FR2842725B1/en
Publication of FR2842725A1 publication Critical patent/FR2842725A1/en
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Publication of FR2842725B1 publication Critical patent/FR2842725B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7208—Flexible pins, e.g. ENDER pins
    • 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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
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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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
    • 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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    • A61F2/00—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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30014—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
    • 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
    • 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
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30327—The prosthesis having different structural features at different locations within the same prosthesis differing in diameter
    • 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
    • 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
    • A61F2002/30331—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
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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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Abstract

Implants, of different sizes to adapt femur of different sizes, each have a slit (12) made through their distal portion emerging in their distal end. The slit proximal end emerges in a transverse hole (13) made through the implant in the same direction as the slit. The diameter of the hole is variable from one implant to another and is such that the portions (15) of the implant laterally delimiting the hole which connect to the rest of the implant the distal parts (16) individualized by the slit have the same width from one size of implant to another.

Description

GAMME D'IMPLANTS FEMORAUX DERANGE OF FEMALE IMPLANTS

PROTHESE DE HANCHE,HIP PROSTHESIS,

NOTAMMENT DE REPRISEIN PARTICULAR

La présente invention se rapporte à une gamme d'implants fémoraux de prothèse de hanche, notamment de reprise, et à chaque implant faisant partie de cette gamme.  The present invention relates to a range of femoral implants for hip prosthesis, in particular of recovery, and to each implant belonging to this range.

Une gamme d'implants fémoraux de prothèse de hanche comprend des implants de différentes tailles, adaptés aux différentes tailles de fémur se rencontrant dans une population de patients.  A range of femoral hip prosthesis implants includes implants of different sizes, adapted to the different sizes of femur encountered in a patient population.

Chaque implant d'une gamme comprend généralement une tige médullaire effilée, destinée à être engagée dans le canal médullaire du fémur dment réséqué, et une tête sphérique, portée par un col, destinée à coopérer avec un implant cotylodien. Cet implant fémoral peut être fixé à l'os au moyen d'un ciment polymérisable ou par croissance des cellules osseuses sur ou à l'intérieur d'un  Each implant in a range generally comprises a tapered medullary rod, intended to be engaged in the medullary canal of the resected femur, and a spherical head, carried by a neck, intended to cooperate with an acetabular implant. This femoral implant can be fixed to the bone by means of a polymerizable cement or by growth of bone cells on or inside a

revêtement ostéo-inducteur dont est pourvu l'implant.  osteo-inductive coating with which the implant is provided.

En cas de descellement d'un implant de première intention, ou lorsque l'os traité l'exige, il est utilisé des implants dits "de reprise". Un implant de ce type comprend une tige médullaire plus longue qu'un implant de première intention afin de 25 présenter une surface augmentée d'appui contre l'os, et peut faire l'objet d'un verrouillage, notamment au niveau distal, assurant l'immobilisation de l'implant par rapport à l'os. Ce verrouillage est réalisé au moyen d'une ou plusieurs vis transversales engagées au travers de trous aménagés dans l'os et dans ladite tige médullaire.  In the event of loosening of a first-line implant, or when the treated bone requires it, so-called "recovery" implants are used. An implant of this type comprises a medullary rod longer than a first-line implant in order to present an increased surface of support against the bone, and can be the subject of a locking, in particular at the distal level, ensuring immobilization of the implant relative to the bone. This locking is achieved by means of one or more transverse screws engaged through holes arranged in the bone and in said medullary rod.

Un implant fémoral comprend fréquemment une tige médullaire pleine au niveau de son extrémité distale qui, compte tenu de la courbure anatomique du fémur dans le plan sagittal, peut générer un contact ou une pression de l'extrémité distale de l'implant contre la corticale. Ce contact ou cette pression est à l'origine 35 de douleurs pour le patient et peut dans certains cas conduire à une détérioration  A femoral implant frequently includes a solid spinal cord at its distal end which, given the anatomical curvature of the femur in the sagittal plane, can generate contact or pressure of the distal end of the implant against the cortex. This contact or pressure causes pain for the patient and can in some cases lead to deterioration.

de l'os.bone.

Pour remédier à cet inconvénient, il a été envisagé d'aménager une fente dans la portion distale de l'implant, débouchant dans l'extrémité distale de celui-ci et 40 s'étendant sensiblement dans le plan frontal, entre la face externe et la face interne de l'implant. Cette fente est obtenue au moyen d'un usinage réalisé dans la portion distale des implants d'une même gamme d'implants.  To remedy this drawback, it has been envisaged to make a slot in the distal portion of the implant, opening into the distal end of the latter and 40 extending substantially in the frontal plane, between the external face and the internal face of the implant. This slot is obtained by means of machining carried out in the distal portion of the implants from the same range of implants.

Une telle fente permet de conférer une souplesse à l'implant au niveau de sa 45 portion distale, qui permet de mettre un implant en place dans l'os nonobstant la courbure anatomique de celui-ci dans le plan sagittal, en limitant l'alésage du  Such a slot makes it possible to confer flexibility on the implant at its distal portion, which makes it possible to place an implant in place in the bone notwithstanding the anatomical curvature of the latter in the sagittal plane, by limiting the bore of

canal médullaire de l'os, donc en préservant l'épaisseur de cet os et en limitant le risque de fracture.  bone marrow canal, thus preserving the thickness of this bone and limiting the risk of fracture.

Il s'avère toutefois que la souplesse d'un tel implant varie selon la taille de l'implant utilisé, ce qui n'est pas sans poser des problèmes pratiques, tant en ce qui concerne le choix de la taille de l'implant en fonction de l'os traité que les opérations de mise en place de cet implant.  However, it turns out that the flexibility of such an implant varies according to the size of the implant used, which is not without posing practical problems, both with regard to the choice of the size of the implant in function of the treated bone as the operations of placing this implant.

La présente invention a notamment pour but de solutionner ce problème.  The present invention aims in particular to solve this problem.

Par ailleurs, la mise en place d'une ou plusieurs vis transversales de verrouillage de l'implant est problématique avec les implants existants. En effet, une telle vis comprend un corps dont une partie marginale proximale est filetée et dont la partie principale est lisse et est destinée à être engagée dans un alésage 15 aménagé dans l'implant, le diamètre de cet alésage étant légèrement supérieur à celui de la vis; il apparaît que dans certains cas de corticales fines, la tête de la vis ne peut être amenée en appui contre la corticale, la vis se bloquant axialement avant que cette tête ne vienne dans cette position d'appui. Il en résulte que la tête de la vis fait plus ou moins saillie en deçà de la paroi de l'os, ce qui n'est pas  Furthermore, the placement of one or more transverse implant locking screws is problematic with existing implants. Indeed, such a screw comprises a body of which a proximal marginal part is threaded and whose main part is smooth and is intended to be engaged in a bore 15 arranged in the implant, the diameter of this bore being slightly greater than that of the opinion; it appears that in certain cases of thin cortices, the head of the screw cannot be brought to bear against the cortex, the screw locking axially before this head comes into this support position. As a result, the head of the screw projects more or less below the wall of the bone, which is not

souhaitable compte tenu des risques de lésions des tissus environnants.  desirable given the risk of damage to surrounding tissue.

L'invention a également pour but de solutionner ce problème.  The invention also aims to solve this problem.

La gamme d'implants qu'elle concerne comprend des implants de différentes 25 tailles, chaque implant présentant une tige médullaire destinée à être engagée dans le canal médullaire du fémur et une fente aménagée au travers de sa portion distale, débouchant dans son extrémité distale.  The range of implants which it relates to includes implants of different sizes, each implant having a medullary rod intended to be engaged in the medullary canal of the femur and a slot arranged through its distal portion, opening into its distal end.

Selon l'invention, l'extrémité proximale de la fente que comprend chaque implant 30 débouche dans un trou transversal aménagé au travers de l'implant, de même direction que la fente, le diamètre de ce trou étant variable d'un implant à l'autre de la gamme en fonction de la taille de ces implants, et étant tel que les portions de l'implant délimitant latéralement ce trou, qui relient au reste de l'implant les parties distales de l'implant individualisées par la fente, présentent sensiblement  According to the invention, the proximal end of the slot that each implant 30 comprises opens into a transverse hole arranged through the implant, in the same direction as the slot, the diameter of this hole being variable from implant to implant. '' other of the range depending on the size of these implants, and being such that the portions of the implant laterally delimiting this hole, which connect the distal parts of the implant individualized by the slot, to the rest of the implant sensibly

la même largeur, d'une taille d'implant à une autre.  the same width, from one implant size to another.

Lesdites portions de l'implant ont ainsi sensiblement la même largeur d'une taille d'implant à l'autre, et confèrent donc aux implants d'une gamme des caractéristiques d'élasticité au niveau de la fente distale de chaque implant qui 40 restent sensiblement constantes d'un implant à l'autre, quelle que soit la taille de l'implant. Les problèmes précités de variation de souplesse de la portion distale d'un implant à un autre dans une gamme existante sont ainsi éliminés, de même que, par conséquent, les problèmes de choix d'une taille d'implant et de pose de cet implant.  Said portions of the implant thus have substantially the same width from one implant size to another, and therefore give implants of a range of elasticity characteristics at the distal slot of each implant which remain substantially constant from one implant to another, regardless of the size of the implant. The aforementioned problems of variation in flexibility of the distal portion from one implant to another in an existing range are thus eliminated, as are, therefore, the problems of choosing an implant size and placing this implant. .

Le trou est de préférence circulaire mais pourrait avoir une section autre que circulaire.  The hole is preferably circular but could have a section other than circular.

Selon un autre aspect de l'invention, chaque implant comprend au moins un alésage le traversant de part en part, destiné à recevoir un organe de verrouillage de l'implant à l'os, et la gamme d'implants comprend au moins un organe de verrouillage propre à être engagé dans cet alésage.  According to another aspect of the invention, each implant comprises at least one bore passing right through it, intended to receive a member for locking the implant to the bone, and the range of implants comprises at least one member lock suitable for being engaged in this bore.

Au moins un alésage d'un implant de la gamme comprend alors au moins un lamage, aménagé au niveau d'un des orifices de cet alésage, coaxialement à celui-ci, et ledit organe de verrouillage présente une tête, une partie proximale filetée située en dessous de cette tête et un corps de diamètre légèrement inférieur au diamètre de l'alésage.  At least one bore of an implant of the range then comprises at least one counterbore, arranged at one of the orifices of this bore, coaxial therewith, and said locking member has a head, a threaded proximal part located below this head and a body with a diameter slightly smaller than the diameter of the bore.

En cas de corticale fine, ce lamage peut recevoir la portion excédentaire de ladite partie proximale filetée et permettre ainsi le vissage complet de l'organe de verrouillage, jusqu'à venue de la tête de cet organe en appui contre la corticale. Toute saillie néfaste de cette tête par rapport à cette corticale est ainsi éliminée.  In the case of a thin cortex, this countersink can receive the excess portion of said threaded proximal part and thus allow the complete screwing of the locking member, until the head of this member comes into abutment against the cortex. Any harmful projection of this head relative to this cortex is thus eliminated.

Chaque organe de verrouillage peut notamment être une vis.  Each locking member can in particular be a screw.

L'invention sera bien comprise, et d'autres caractéristiques et avantages de celle-ci apparaîtront, en référence au dessin schématique annexé, représentant, à titre d'exemple non limitatif, une forme de réalisation préférée d'un implant qu'elle  The invention will be clearly understood, and other characteristics and advantages thereof will appear, with reference to the appended schematic drawing, representing, by way of nonlimiting example, a preferred embodiment of an implant which it

concerne.concerned.

La figure 1 est une vue frontale de cet implant, avec coupe partielle, et d'un organe de verrouillage de cet implant à un fémur; La figure 2 est une vue sagittale de l'implant; Les figures 3 à 6 sont des vues de la partie distale d'implants de différentes tailles en ce qui concerne le diamètre de cette partie distale; La figure 7 est une vue frontale de l'implant et de l'organe de verrouillage après mise en place dans un fémur, ce dernier étant représenté en coupe longitudinale; La figure 8 est une vue partielle d'un implant selon la technique antérieure, d'une portion de la corticale d'un os recevant cet implant et d'une vis de verrouillage de cet implant à cet os, et  Figure 1 is a front view of this implant, partly in section, and of a member for locking this implant to a femur; Figure 2 is a sagittal view of the implant; Figures 3 to 6 are views of the distal part of implants of different sizes with regard to the diameter of this distal part; Figure 7 is a front view of the implant and the locking member after placement in a femur, the latter being shown in longitudinal section; FIG. 8 is a partial view of an implant according to the prior art, of a portion of the cortex of a bone receiving this implant and of a screw for locking this implant to this bone, and

La figure 9 est une vue similaire à la figure 8, dans le cas d'une corticale osseuse fine.  Figure 9 is a view similar to Figure 8, in the case of a thin bone cortex.

Les figures 1 et 2 représentent un implant fémoral 1 de prothèse de hanche et la figure 1 montre en outre une vis 2 de verrouillage de cet implant 1 à un fémur 3, visible sur la figure 7.  FIGS. 1 and 2 represent a femoral implant 1 of hip prosthesis and FIG. 1 further shows a screw 2 for locking this implant 1 to a femur 3, visible in FIG. 7.

L'implant 1 fait partie d'une gamme d'implants de différentes tailles, adaptés aux 45 différentes tailles de fémur 3 se rencontrant dans une population de patients. Il s'agit d'un implant dit "de reprise", comprenant une tige médullaire 4 plus longue que celle d'un implant de première intention afin de présenter une surface augmentée d'appui contre l'os.  Implant 1 is part of a range of implants of different sizes, adapted to the 45 different sizes of femur 3 encountered in a patient population. It is an implant called "recovery", comprising a medullary rod 4 longer than that of a first-line implant in order to present an increased surface of support against the bone.

L'implant 1 peut être fixé à l'os au moyen d'un ciment polymérisable ou par croissance des cellules osseuses sur ou à l'intérieur d'un revêtement ostéoinducteur dont il est pourvu.  The implant 1 can be fixed to the bone by means of a polymerizable cement or by growth of the bone cells on or inside an osteoinductive coating with which it is provided.

Dans l'exemple représenté, l'implant 1 comprend une pièce proximale 5 et une  In the example shown, the implant 1 comprises a proximal part 5 and a

pièce distale 6 assemblées l'une à l'autre au moyen d'un goujon 7.  distal part 6 assembled to one another by means of a stud 7.

La gamme comprend une série de pièces proximales 5 et distales 6 de différentes tailles, ces pièces 5, 6 comprenant des moyens d'assemblage identiques d'une 10 taille de pièce à une autre, pour permettre la constitution d'implants 1 de  The range includes a series of proximal 5 and distal parts 6 of different sizes, these parts 5, 6 comprising identical assembly means from one part size to another, to allow the creation of implants 1 of

différentes tailles.different sizes.

Chaque pièce proximale 5 présente un col 8 de forme conique à faible pente, pouvant recevoir une tête sphérique d'articulation, non représentée.  Each proximal part 5 has a neck 8 of conical shape with a slight slope, capable of receiving a spherical articulation head, not shown.

Elle comprend également un alésage longitudinal qui présente une forme conique au niveau distal et un épaulement 9 au niveau proximal.  It also includes a longitudinal bore which has a conical shape at the distal level and a shoulder 9 at the proximal level.

La pièce 5 comprend également, dans l'exemple représenté, une saillie interne 10  The part 5 also includes, in the example shown, an internal projection 10

d'appui contre l'os 3.support against the bone 3.

Chaque pièce distale 6 comprend un plot conique 11 à faible pente, propre à être reçu, avec possibilité de coincement, dans ladite portion conique de l'alésage de la pièce 5.  Each distal part 6 comprises a conical stud 11 with a slight slope, suitable for being received, with the possibility of jamming, in said conical portion of the bore of the part 5.

Ce plot 11 comprend un trou taraudé aménagé axialement à partir de sa face d'extrémité.  This stud 11 includes a threaded hole arranged axially from its end face.

Comme cela se comprend en référence aux figures 1 et 2, le goujon 7 peut être 30 engagé dans l'alésage de la pièce 5 puis être vissé dans le trou taraudé du plot  As can be understood with reference to FIGS. 1 and 2, the stud 7 can be engaged in the bore of the part 5 and then be screwed into the tapped hole of the stud

11, sa tête venant en appui contre l'épaulement 9.  11, its head pressing against the shoulder 9.

Chaque pièce distale 6 présente une partie diaphysaire 6a tendant à avoir un diamètre sensiblement constant, qui comprend une fente distale 12, un trou 13 et  Each distal part 6 has a diaphyseal part 6a tending to have a substantially constant diameter, which comprises a distal slot 12, a hole 13 and

un alésage 14.a bore 14.

La fente 12 est aménagée dans la partie diaphysaire 6a. Elle débouche dans l'extrémité distale de l'implant 1 et s'étend sensiblement dans le plan frontal de celui-ci, entre la face externe et la face interne de cet implant 1. L'extrémité  The slot 12 is arranged in the diaphyseal part 6a. It opens into the distal end of the implant 1 and extends substantially in the frontal plane thereof, between the external face and the internal face of this implant 1. The end

proximale de la fente 12 débouche dans le trou 13.  proximal of the slot 12 opens into the hole 13.

Ce dernier est de forme circulaire et est aménagé au travers de l'implant 1, selon une même direction externe-interne que celle dans laquelle s'étend la fente 12. Ainsi que cela apparaît sur les figures 3 à 6, le diamètre de ce trou 13 est variable 45 d'un implant 1 à l'autre de ladite gamme en fonction de la taille des pièces 6. Ce diamètre est tel que les portions 15 de l'implant 1 délimitant latéralement le trou 13, qui relient au reste de l'implant 1 les parties distales 16 de l'implant individualisées par la fente 12, présentent sensiblement la même largeur, d'une taille d'implant 1 à une autre.  The latter is circular in shape and is arranged through the implant 1, in the same external-internal direction as that in which the slot 12 extends. As can be seen in FIGS. 3 to 6, the diameter of this hole 13 is variable 45 from one implant 1 to another of said range as a function of the size of the parts 6. This diameter is such that the portions 15 of implant 1 laterally delimiting hole 13, which connect to the rest of the implant 1 the distal parts 16 of the implant individualized by the slot 12 have substantially the same width, from one size of implant 1 to another.

Les implants 1 d'une même gamme ont ainsi des caractéristiques d'élasticité au niveau de la fente 12 qui restent sensiblement constantes d'un implant à l'autre, quelle que soit la taille de l'implant.  The implants 1 of the same range thus have elasticity characteristics at the level of the slot 12 which remain substantially constant from one implant to another, whatever the size of the implant.

L'alésage 14 traverse l'implant 1 de part en part et cet implant 1 comprend deux lamages 17 coaxiaux à cet alésage 14, dont chacun est aménagé à partir d'un orifice de cet alésage 14.  The bore 14 passes through the implant 1 right through and this implant 1 comprises two counterbores 17 coaxial with this bore 14, each of which is arranged from an orifice in this bore 14.

La vis 2 présente une tête 18, une partie proximale filetée 19 située en dessous de cette tête 18 et un corps 20 de diamètre légèrement inférieur au diamètre de l'alésage 14.  The screw 2 has a head 18, a threaded proximal part 19 situated below this head 18 and a body 20 of diameter slightly smaller than the diameter of the bore 14.

Les lamages 17 ont des diamètres supérieurs à celui de la partie filetée 19 de la  The counterbores 17 have diameters greater than that of the threaded part 19 of the

vis 2 et des profondeurs supérieures à la longueur de cette partie 19.  screws 2 and depths greater than the length of this part 19.

Comme cela apparaît sur la figure 7, en cas de corticale fine, l'un des lamages 17 peut recevoir la portion excédentaire de la partie filetée 19 et permettre ainsi le vissage complet de la vis 2, jusqu'à venue de la tête 18 en appui contre la 20 corticale. Toute saillie néfaste de cette tête 18 par rapport à cette corticale est  As shown in FIG. 7, in the case of a thin cortex, one of the countersinks 17 can receive the excess portion of the threaded part 19 and thus allow the complete screwing of the screw 2, until the head 18 comes in. support against the cortex. Any harmful projection of this head 18 relative to this cortex is

ainsi éliminée.thus eliminated.

La figure 8 montre que, dans le cas d'une corticale 100 normalement épaisse, un implant classique 101 dépourvu de lamage 17 tel que précité peut effectivement 25 recevoir une vis 2 sans saillie de la tête 18 de cette vis 2 au-delà de la corticale 100, la partie 19 s'étendant dans la corticale 100. La figure 9 montre par contre qu'en cas de corticale 100 peu épaisse, la partie 19 vient buter contre l'implant 101 avant que la tête 18 soit au contact de la corticale 100. Il en résulte que la tête 18 fait plus ou moins saillie en deçà de la corticale 100, ce qui n'est pas  FIG. 8 shows that, in the case of a normally thick cortex 100, a conventional implant 101 without counterbore 17 as mentioned above can effectively receive a screw 2 without protrusion from the head 18 of this screw 2 beyond the cortex 100, the part 19 extending into the cortex 100. FIG. 9 shows on the other hand that in the case of a thin cortex 100, the part 19 abuts against the implant 101 before the head 18 is in contact with the cortex 100. As a result, the head 18 projects more or less below the cortex 100, which is not

souhaitable compte tenu des risques de lésions des tissus environnants.  desirable given the risk of damage to surrounding tissue.

Comme le montre notamment la figure 2, chaque implant 1 selon l'invention a une forme symétrique par rapport à son plan frontal médian; grâce aux deux lamages 17, cet implant 1 est adapté au traitement d'articulations droite ou gauche.  As shown in particular in FIG. 2, each implant 1 according to the invention has a shape symmetrical with respect to its median frontal plane; thanks to the two counterbores 17, this implant 1 is suitable for the treatment of right or left joints.

L'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais s'étend aux formes de réalisations couvertes par les revendications.  The invention is not limited to the embodiment described above by way of example but extends to the embodiments covered by the claims.

tt

Claims (5)

REVENDICATIONS 1. Gamme d'implants fémoraux (1) de prothèse de hanche, notamment de reprise, comprenant des implants (1) de différentes tailles, adaptés aux différentes tailles de fémur (3) se rencontrant dans une population de patients, chaque implant (1) présentant une tige médullaire (4) destinée à être engagée dans le canal médullaire du fémur (3) et une fente (12) aménagée au travers de sa portion distale (6a), débouchant dans son extrémité distale; gamme d'implants (1) caractérisée en ce que l'extrémité proximale de la fente (12) que comprend chaque implant (1) débouche dans un trou transversal (13) aménagé au travers de l'implant (1) , de même direction que la fente (12), le diamètre de ce trou (13) étant variable d'un implant (1) à l'autre de la gamme en fonction de la taille de ces implants (1), et étant tel que les portions (1-5y-de l'implant (1) délimitant latéralement ce trou (13), qui relient au reste de l'implant (1) les parties distales (16) de l'implant (1) individualisées par la fente (12), présentent sensiblement la même largeur, d'une taille d'implant (1) à une autre.  1. Range of femoral implants (1) for hip prosthesis, in particular revision, comprising implants (1) of different sizes, adapted to the different sizes of femur (3) found in a population of patients, each implant (1 ) having a medullary rod (4) intended to be engaged in the medullary canal of the femur (3) and a slot (12) arranged through its distal portion (6a), opening into its distal end; range of implants (1) characterized in that the proximal end of the slot (12) that each implant (1) comprises opens into a transverse hole (13) arranged through the implant (1), in the same direction as the slot (12), the diameter of this hole (13) being variable from one implant (1) to another in the range as a function of the size of these implants (1), and being such that the portions ( 1-5y-of the implant (1) laterally delimiting this hole (13), which connect to the rest of the implant (1) the distal parts (16) of the implant (1) individualized by the slot (12) , have substantially the same width, from one implant size (1) to another. 2. Gamme d'implants (1) selon la revendication 1, caractérisée en ce que le trou2. range of implants (1) according to claim 1, characterized in that the hole (13) que comprend chaque implant (1) est circulaire.  (13) that includes each implant (1) is circular. 3. Gamme d'implants (1) selon la revendication 1 ou la revendication 2, caractérisée en ce que chaque implant (1) comprend au moins un alésage (14) le traversant de part en part, destiné à recevoir un organe de verrouillage (2) de l'implant (1) à l'os, et en ce qu'elle comprend au moins un organe de  3. range of implants (1) according to claim 1 or claim 2, characterized in that each implant (1) comprises at least one bore (14) passing right through, intended to receive a locking member ( 2) from the implant (1) to the bone, and in that it comprises at least one organ for verrouillage (2) propre à être engagé dans cet alésage (14).  lock (2) suitable for being engaged in this bore (14). 4. Gamme d'implants (1) selon la revendication 3, caractérisée en ce qu'au moins un alésage (14) de chaque implant (1) qu'elle comprend présente au moins un lamage (17), aménagé au niveau d'un des orifices de cet alésage (14), coaxialement à celui-ci, et en ce que ledit organe de verrouillage (2) présente une tête (18), une partie proximale filetée (19) située en dessous de cette tête y (18) et un corps (20) de diamètre légèrement inférieur au diamètre de  4. range of implants (1) according to claim 3, characterized in that at least one bore (14) of each implant (1) which it comprises has at least one counterbore (17), arranged at one of the orifices of this bore (14), coaxial therewith, and in that said locking member (2) has a head (18), a threaded proximal part (19) located below this head y (18 ) and a body (20) of diameter slightly smaller than the diameter of l'alésage (14).the bore (14). 5. Gamme d'implants (1) selon la revendication 3 ou la revendication 4,  5. range of implants (1) according to claim 3 or claim 4, caractérisée en ce que chaque organe de verrouillage est une vis (2).  characterized in that each locking member is a screw (2).
FR0209544A 2002-07-26 2002-07-26 RANGE OF FEMALE IMPLANTS OF HIP PROSTHESIS, IN PARTICULAR REPRISE. Expired - Lifetime FR2842725B1 (en)

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Cited By (2)

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Publication number Priority date Publication date Assignee Title
FR2875397A1 (en) * 2004-09-23 2006-03-24 Genie Medical Sgm Sa Soc D Femoral rod for hip prosthesis, has diaphyseal part successively presenting on its entire length, two conical spans, and cylindrical span of different lengths to adapt and block part simultaneously in femoral isthmus
FR2941863A1 (en) * 2009-02-10 2010-08-13 Fournitures Hospitalieres Ind Prosthetic femoral stems for use during installation of hip prosthesis on patient, has forming part projected from femur, where positioning between part and hole is conceived so that distance between center and axis is identical to stems

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EP0970665A2 (en) * 1998-07-01 2000-01-12 Johnson & Johnson Medical Limited Prosthetic component
FR2799115A1 (en) * 1999-10-01 2001-04-06 Jean Claude Bouvet Modular shank for hip prosthesis comprises medullary pin with cylindrical surface for thrust member, stops and support
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Publication number Priority date Publication date Assignee Title
FR2483218A1 (en) * 1980-05-30 1981-12-04 Cuilleron J Artificial hip joint femoral stem - has lengthwise slot formed in femoral stem so as to make it elastically deformable to expand in medulla of femur
FR2549717A1 (en) * 1983-07-29 1985-02-01 Cuilleron J Femoral rod with flexible contacts for hip prosthesis
EP0359672A1 (en) * 1988-09-16 1990-03-21 Francis Henri Bréard Articulation prosthesis, in particular a hip prosthesis, with a self-damping property
EP0434604A1 (en) * 1989-12-15 1991-06-26 GebràœDer Sulzer Aktiengesellschaft Anchored shaft for a femoral prosthesis
US5360452A (en) * 1991-05-20 1994-11-01 Depuy Inc. Enhanced fixation system for a prosthetic implant
WO1993005728A2 (en) * 1991-09-19 1993-04-01 Waldemar Link Gmbh & Co. Endoprosthesis with a visco-elastic plastic prosthesis component
EP0543099A2 (en) * 1991-11-19 1993-05-26 Bristol-Myers Squibb Company Implant fixation stem
US5258035A (en) * 1992-05-29 1993-11-02 Intermedics Orthopedics, Inc. Femoral prosthesis with wedge having opposed tapers
FR2730628A1 (en) * 1995-01-27 1996-08-23 Amp Dev Adjustable two=part femoral implant prosthesis for hip replacement
DE19712758A1 (en) * 1997-03-27 1998-10-08 Eska Implants Gmbh & Co Vibration-proof conical clamp connection for bone implants
FR2766355A1 (en) * 1997-07-25 1999-01-29 Objectif Implants France Prosthesis medullary shank, e.g. femoral shank of hip prosthesis
EP0970665A2 (en) * 1998-07-01 2000-01-12 Johnson & Johnson Medical Limited Prosthetic component
FR2799115A1 (en) * 1999-10-01 2001-04-06 Jean Claude Bouvet Modular shank for hip prosthesis comprises medullary pin with cylindrical surface for thrust member, stops and support
EP1159937A1 (en) * 2000-05-29 2001-12-05 Spike Trading Lda A femoral prosthesis

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2875397A1 (en) * 2004-09-23 2006-03-24 Genie Medical Sgm Sa Soc D Femoral rod for hip prosthesis, has diaphyseal part successively presenting on its entire length, two conical spans, and cylindrical span of different lengths to adapt and block part simultaneously in femoral isthmus
FR2941863A1 (en) * 2009-02-10 2010-08-13 Fournitures Hospitalieres Ind Prosthetic femoral stems for use during installation of hip prosthesis on patient, has forming part projected from femur, where positioning between part and hole is conceived so that distance between center and axis is identical to stems

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