FR2843294A1 - Insert to be engaged in hip prosthesis cotyloid cup comprises hemispherical shell and hemispherical core able to pivot inside shell and receive femoral rod hemispherical head - Google Patents

Insert to be engaged in hip prosthesis cotyloid cup comprises hemispherical shell and hemispherical core able to pivot inside shell and receive femoral rod hemispherical head Download PDF

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Publication number
FR2843294A1
FR2843294A1 FR0209990A FR0209990A FR2843294A1 FR 2843294 A1 FR2843294 A1 FR 2843294A1 FR 0209990 A FR0209990 A FR 0209990A FR 0209990 A FR0209990 A FR 0209990A FR 2843294 A1 FR2843294 A1 FR 2843294A1
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France
Prior art keywords
shell
cup
hemispherical
insert
core
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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
FR0209990A
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French (fr)
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FR2843294B1 (en
Inventor
Jean Christophe Chatelet
Louis Setiey
Jean Claude Cartillier
Bruno Balay
Claude Charlet
Michel Henri Fessy
Alain Machenaud
Jean Marc Semay
Jean Pierre Vidalain
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Individual
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Individual
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • 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
    • 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
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • 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
    • A61F2002/30316—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
    • 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
    • A61F2002/30316—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
    • A61F2002/30337—Inverted concave conical connections, e.g. for opposing disconnection
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30378—Spherically-shaped protrusion and recess
    • 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
    • A61F2002/3208—Bipolar or multipolar joints, e.g. having a femoral head articulating within an intermediate acetabular shell whilst said shell articulates within the natural acetabular socket or within an artificial outer shell
    • 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
    • A61F2002/3233—Joints for the hip having anti-luxation means for preventing complete dislocation of the femoral head from the acetabular cup
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/3445—Acetabular cups having a number of shells different from two
    • A61F2002/3448—Multiple cups made of three or more concentric shells fitted or nested into one another
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • 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
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
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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
    • 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

Abstract

The insert which is to be engaged in a cotyloid cavity delimited by a metal hip prosthesis cup (3) comprises a hemispherical shell (4) which is to be fixed in a given angular position. A hemispherical core (5) can pivot inside the shell and receive a spherical head (20) of a femoral rod (24). An Independent claim is included for a hip implant comprising the insert.

Description

i La présente invention se rapporte notamment à un insert destiné à êtrei The present invention relates in particular to an insert intended to be

engagé dans une cupule cotyloidienne pour prothèse totale  engaged in an acetabular cup for total prosthesis

de hanche, cette cupule étant fixée à l'os du bassin sans ciment.  hip, this cup being fixed to the bone of the pelvis without cement.

Un implant cotylodien comprend classiquement une cupule de 5 forme hémisphérique, destinée à la cavité cotylodienne, et un insert constitué par un élément monobloc engagé dans cette cupule. La cupule est destinée à être fixée dans le bassin, et l'insert délimite une cavité  A cotylodian implant conventionally comprises a cup of hemispherical shape, intended for the cotylodian cavity, and an insert constituted by a monobloc element engaged in this cup. The cup is intended to be fixed in the pelvis, and the insert delimits a cavity

sphérique destinée à recevoir la tête sphérique d'une tige fémorale.  spherical intended to receive the spherical head of a femoral stem.

La cupule est généralement en matériau métallique, notamment 10 en titane, et I'insert est en matériau favorisant le glissement de la tête fémorale, notamment en polyéthylène à haute densité, en céramique ou en métal. La face de la cupule au contact du bassin peut également être revêtue d'une couche de composition très proche de la fraction minérale de l'os humain de façon à favoriser la fixation osseuse de la cupule. Cette 15 couche peut consister par exemple en de l'hydroxyapatite de calcium  The cup is generally made of metallic material, in particular of titanium, and the insert is of material promoting the sliding of the femoral head, in particular of high density polyethylene, ceramic or metal. The face of the cup in contact with the pelvis can also be coated with a layer of composition very close to the mineral fraction of human bone so as to promote bone fixation of the cup. This layer can consist for example of calcium hydroxyapatite

déposé par torche à plasma.deposited by plasma torch.

Un implant standard fait appel à un insert monobloc qui est  A standard implant uses a monobloc insert which is

maintenu au contact de la cupule dans une position angulaire donnée par engagement tronconique. Dans ce cas là, seule la tête sphérique de la tige 20 fémorale est mobile à l'intérieur de la cavité sphérique définie par l'insert.  maintained in contact with the cup in an angular position given by frustoconical engagement. In this case, only the spherical head of the femoral rod is movable inside the spherical cavity defined by the insert.

La stabilité n'est alors assurée qu'en phase active sous l'effet des muscles fessiers, I'implant ne jouant qu'un rôle accessoire. Cela suppose donc un positionnement exact dans l'espace du couple prothétique, une bonne tension des muscles fessiers et un respect des amplitudes articulaires. 25 Néanmoins, il a été constaté qu'un tel implant n'est pas satisfaisant lorsqu'un patient portant cette prothèse est sujet à des luxations récidivantes. En effet, il se crée alors une véritable instabilité prothétique  Stability is then only ensured in the active phase under the effect of the gluteal muscles, the implant playing only an accessory role. This therefore supposes an exact positioning in space of the prosthetic couple, a good tension of the gluteal muscles and a respect of the articular amplitudes. However, it has been found that such an implant is not satisfactory when a patient wearing this prosthesis is subject to recurrent dislocations. Indeed, it creates a real prosthetic instability

conduisant bien souvent à une ré intervention chirurgicale.  often leading to re surgery.

Afin de pallier ce problème, il a déjà été proposé des implants 30 cotylodiens à double mobilité. Plus précisément, un tel implant comprend un insert monobloc, qui n'est plus fixé dans la cavité cotyloidienne de la cupule dans une position angulaire donnée, mais qui est au contraire mobile dans cette cavité. L'insert monobloc est en polyéthylène et la cupule présente une face interne spécialement usinée de façon à pouvoir 35 accueillir l'insert mobile. Cette solution est particulièrement intéressante lorsqu'il s'agit d'une première intervention chirurgicale. En revanche, pour pouvoir l'appliquer dans le cas d'une ré intervention chirurgicale, le chirurgien doit préalablement ôter la cupule constitutive de l'implant standard. Or, cette dernière peut être parfaitement ostéointégrée, et la  To overcome this problem, dual mobility cotylodial implants have already been proposed. More specifically, such an implant comprises a monobloc insert, which is no longer fixed in the acetabular cavity of the cup in a given angular position, but which is on the contrary mobile in this cavity. The monobloc insert is made of polyethylene and the cup has an internal surface specially machined so as to be able to accommodate the mobile insert. This solution is particularly interesting when it is a first surgical intervention. On the other hand, to be able to apply it in the case of a re-surgical intervention, the surgeon must previously remove the cup constituting the standard implant. However, the latter can be perfectly osseointegrated, and the

désolidarisation n'est pas toujours souhaitable ou envisageable.  decoupling is not always desirable or possible.

La présente invention a pour objet de résoudre le problème précédemment évoqué, et concerne à cet effet un insert destiné à être engagé dans une cavité cotylodienne délimitée par une cupule pour prothèse totale de hanche, cette cupule étant en métal, de forme générale hémisphérique et étant fixée sans ciment, caractérisée en ce qu'il 10 comprend: i) une coque de forme sensiblement hémisphérique réalisée dans un matériau compatible avec celui de la cupule et destinée à être fixée dans une position angulaire donnée, ii) un noyau mobile de forme sensiblement hémisphérique apte à 15 pivoter à l'intérieur de la coque et à recevoir une tête sensiblement  The object of the present invention is to solve the problem mentioned above, and for this purpose relates to an insert intended to be engaged in an acetabular cavity delimited by a cup for total hip prosthesis, this cup being made of metal, of generally hemispherical shape and being fixed without cement, characterized in that it comprises: i) a shell of substantially hemispherical shape made of a material compatible with that of the cup and intended to be fixed in a given angular position, ii) a mobile core of substantially shape hemispherical able to pivot inside the shell and to receive a head substantially

sphérique d'une tige fémorale.spherical of a femoral stem.

Ainsi, le fait d'utiliser un insert modulaire comprenant, d'une part, une coque fixe réalisée dans un matériau compatible avec celui de la cupule, et d'autre part, un noyau mobile dans la coque, permet d'obtenir, 20 après ré intervention chirurgicale, un implant cotylodien à double mobilité sur la base d'une cupule parfaitement ostéointégrée utilisée préalablement  Thus, the fact of using a modular insert comprising, on the one hand, a fixed shell made of a material compatible with that of the cup, and on the other hand, a movable core in the shell, makes it possible to obtain, after re-surgical intervention, an acetabular implant with dual mobility on the basis of a perfectly osteointegrated cup used beforehand

dans le cadre d'un implant standard.  as part of a standard implant.

Avantageusement, la coque est fixée dans la cavité  Advantageously, the shell is fixed in the cavity

cotylo'dienne par engagement tronconique dans la cupule.  acetabulum by tapered engagement in the cup.

Préférentiellement, la coque est réalisée dans un matériau métallique, par exemple un alliage chrome cobalt. Un tel matériau est parfaitement compatible avec la cupule qui peut être par exemple en titane  Preferably, the shell is made of a metallic material, for example a cobalt chrome alloy. Such a material is perfectly compatible with the cup which may for example be made of titanium

de nuance TA 6V.TA 6V grade.

Avantageusement encore, le noyau mobile est réalisé dans un 30 matériau choisi dans le groupe de matériau auquel appartient le polyéthylène. La présente invention se rapporte à l'utilisation d'une coque de  Advantageously also, the movable core is made of a material chosen from the group of materials to which the polyethylene belongs. The present invention relates to the use of a shell of

forme sensiblement hémisphérique réalisée dans un matériau compatible avec celui d'une cupule cotylodienne en métal pour former un insert selon 35 la présente invention.  substantially hemispherical shape made of a material compatible with that of a metal acetabulum to form an insert according to the present invention.

La présente invention se rapporte également à un implant cotylodien pour prothèse de hanche, caractérisé en ce qu'il comprend une cupule métallique de forme générale hémisphérique, fixée sans ciment, et  The present invention also relates to an acetabulum implant for hip prosthesis, characterized in that it comprises a metal cup of generally hemispherical shape, fixed without cement, and

coopérant avec un insert selon la présente invention.  cooperating with an insert according to the present invention.

L'invention sera mieux comprise à l'aide de la description  The invention will be better understood using the description

détaillée qui est exposée ci-dessous en regard du dessin annexé dans lequel: La figure 1 est une vue en perspective éclatée d'un implant  detailed which is set out below with reference to the appended drawing in which: FIG. 1 is an exploded perspective view of an implant

selon la présente invention.according to the present invention.

La figure 2 est une vue en coupe transversale d'un implant  Figure 2 is a cross-sectional view of an implant

cotylodien selon l'invention implanté dans le bassin d'un patient.  acetabulum according to the invention implanted in the pelvis of a patient.

Les figures 1 et 2 représentent un implant 1 cotyloidien de  Figures 1 and 2 show an acetabular implant 1 of

prothèse de hanche selon l'invention fixé dans le bassin 2 d'un patient.  hip prosthesis according to the invention fixed in the pelvis 2 of a patient.

Plus précisément, I'implant 1 est constitué par une cupule 3 en titane de 15 nuance TA 6V par exemple, et par un insert qui se décompose, d'une part, en une coque 4 en chrome cobalt compatible avec le titane de la cupule 3, et d'autre part, en un noyau 5 en matériau favorisant le glissement, notamment en polyéthylène à haute densité. Le noyau 5 est alors apte à  More specifically, the implant 1 is constituted by a titanium cup 3 of grade 15 TA 6V for example, and by an insert which decomposes, on the one hand, into a shell 4 of cobalt chromium compatible with the titanium of the cup 3, and on the other hand, into a core 5 of material promoting sliding, in particular of high density polyethylene. The core 5 is then able to

recevoir une tête 20 sphérique correspondante d'une tige fémorale 24.  receiving a corresponding spherical head 20 of a femoral stem 24.

Il est à noter que la cupule 3 a été intégrée lors d'une  It should be noted that the cup 3 was integrated during a

précédente opération chirurgicale et qu'elle peut donc être tout à fait conforme à une cupule d'un implant standard tel que défini précédemment.  previous surgical operation and that it can therefore be entirely in accordance with a cup of a standard implant as defined above.

La cupule 3 présente une forme générale hémisphérique et délimite une cavité 6 dans laquelle est engagé l'insert. Cette cupule 3 est 25 munie d'une face intérieure qui présente, du côté fond de la cavité cotyloidienne 6, une partie 7 de forme parfaitement hémisphérique et, du côté de l'ouverture de cette cavité cotylodienne 6, une partie 8 de forme légèrement tronconique dont la plus faible section circulaire est située vers l'intérieur de ladite cavité 6. Ces deux parties 7, 8 sont séparées par un 30 épaulement conique 9 dont la plus faible section est située du côté de  The cup 3 has a general hemispherical shape and delimits a cavity 6 in which the insert is engaged. This cup 3 is provided with an inner face which has, on the bottom side of the acetabular cavity 6, a part 7 of perfectly hemispherical shape and, on the opening side of this acetabular cavity 6, a part 8 of slightly shaped frustoconical, the smallest circular section of which is situated towards the interior of said cavity 6. These two parts 7, 8 are separated by a conical shoulder 9, the smallest section of which is situated on the side of

l'ouverture de la cavité intérieure 6.  the opening of the interior cavity 6.

La cupule 3 peut posséder également une structure extérieure en écailles (non représentée) et être revêtue d'une couche d'hydroxyapatite  The cup 3 may also have an external structure in scales (not shown) and be coated with a layer of hydroxyapatite

de calcium afin de favoriser l'ostéo-intégration dans la cavité du bassin 2.  calcium to promote osteointegration in the pelvic cavity 2.

La cupule 3 peut présenter une épaisseur de l'ordre de 5 mm, un diamètre externe légèrement supérieur à celui de la cavité cotylodienne  The cup 3 may have a thickness of the order of 5 mm, an external diameter slightly greater than that of the acetabulum

et être ancrée par impaction dans celle-ci.  and be anchored by impaction in it.

La coque 4 possède une face extérieure de forme générale 5 complémentaire à la face intérieure de la cupule 3, et est donc maintenue fixement par engagement tronconique dans la cavité cotyloidienne 6 de la cupule 3. La coque 4 présente une face intérieure parfaitement sphérique et polie délimitant une cavité 21 apte à recevoir le noyau 5. La coque 4  The shell 4 has an outer face of general shape 5 complementary to the inner face of the cup 3, and is therefore fixedly held by frustoconical engagement in the acetabular cavity 6 of the cup 3. The shell 4 has an inner face that is perfectly spherical and polished delimiting a cavity 21 able to receive the core 5. The shell 4

possède une épaisseur minimale de l'ordre de 2 ou 3 millimètres.  has a minimum thickness of around 2 or 3 millimeters.

Le noyau mobile 5, de forme générale hémisphérique, présente une cavité sphérique 22 et est engagé dans la cavité 21 de la coque 4. Ce noyau 5 n'est pas fixé dans la coque 4, mais est destiné à être pris en sandwich entre, d'une part, ladite coque 4, et d'autre part, la tête 20 sphérique correspondante insérée dans la cavité sphérique 22 du noyau 5. 15 Il en découle alors que le noyau 5 est mobile en rotation par rapport à la  The movable core 5, of generally hemispherical shape, has a spherical cavity 22 and is engaged in the cavity 21 of the shell 4. This core 5 is not fixed in the shell 4, but is intended to be sandwiched between, on the one hand, said shell 4, and on the other hand, the corresponding spherical head 20 inserted in the spherical cavity 22 of the core 5. It follows that the core 5 is movable in rotation relative to the

coque 4 mais également par rapport à la tête 20 sphérique.  shell 4 but also relative to the spherical head 20.

De plus, de façon à réduire encore le risque de luxation, le noyau 5 est avantageusement réalisé de facçon à ce que sa cavité sphérique 22 possède, du côté de l'ouverture, un diamètre légèrement 20 inférieur au plus grand diamètre de la tête 20 sphérique, cette dernière  In addition, in order to further reduce the risk of dislocation, the core 5 is advantageously made in such a way that its spherical cavity 22 has, on the side of the opening, a diameter slightly less than the largest diameter of the head 20 spherical, the latter

pouvant cependant être engagée en force dans ladite cavité 22.  can however be engaged in force in said cavity 22.

Bien que l'invention ait été décrite en liaison avec des exemples particuliers de réalisation, il est bien évident qu'elle n'y est nullement limitée et qu'elle comprend tous les équivalents techniques des moyens 25 décrits ainsi que leurs combinaisons si celles-ci entrent dans le cadre de l'invention.  Although the invention has been described in connection with particular exemplary embodiments, it is obvious that it is in no way limited thereto and that it includes all the technical equivalents of the means described as well as their combinations if these these are within the scope of the invention.

Claims (7)

REVENDICATIONS 1.- Insert destiné à être engagé dans une cavité 5 cotylodienne (6) délimitée par une cupule (3) pour prothèse totale de hanche, cette cupule étant en métal, de forme générale hémisphérique et étant fixée sans ciment, caractérisée en ce qu'il comprend: i) une coque (4) de forme sensiblement hémisphérique réalisée dans un matériau compatible avec celui de la cupule et destinée à être 10 fixée dans une position angulaire donnée, ii) un noyau (5) mobile de forme sensiblement hémisphérique apte à pivoter à l'intérieur de la coque et à recevoir une tête (20)  1.- Insert intended to be engaged in an acetabular cavity (6) delimited by a cup (3) for total hip prosthesis, this cup being made of metal, of generally hemispherical shape and being fixed without cement, characterized in that it comprises: i) a shell (4) of substantially hemispherical shape made of a material compatible with that of the cup and intended to be fixed in a given angular position, ii) a movable core (5) of substantially hemispherical shape capable of pivot inside the shell and receive a head (20) sensiblement sphérique d'une tige fémorale (24).  substantially spherical of a femoral stem (24). 2.- Insert selon la revendication 1, caractérisé en ce que la 15 coque (4) est fixée dans la cavité cotyloidienne (6) par engagement  2.- insert according to claim 1, characterized in that the shell (4) is fixed in the acetabular cavity (6) by engagement tronconique dans la cupule (3).frustoconical in the cup (3). 3.- Insert selon l'une quelconque des revendications 1 ou 2,  3.- insert according to any one of claims 1 or 2, caractérisé en ce que la coque (4) est réalisée dans un matériau métallique.  characterized in that the shell (4) is made of a metallic material. 4.- Insert selon la revendication 3, caractérisé en ce que la 20 coque (4) est réalisée dans un alliage chrome cobalt.  4.- Insert according to claim 3, characterized in that the shell (4) is made of a cobalt chrome alloy. 5.- Insert selon l'une quelconque des revendications 1 à 4,  5.- insert according to any one of claims 1 to 4, caractérisé en ce que le noyau (5) est réalisé dans un matériau choisi dans  characterized in that the core (5) is made of a material chosen from le groupe de matériaux auquel appartient le polyéthylène.  the group of materials to which the polyethylene belongs. 6.- Utilisation d'une coque (4) de forme sensiblement 25 hémisphérique réalisée dans un matériau compatible avec celui d'une cupule (3) cotylodienne en métal pour former un insert selon l'une  6.- Use of a shell (4) of substantially hemispherical shape made of a material compatible with that of a cup (3) acetabular cup made of metal to form an insert according to one quelconque des revendications 1 à 5.  any of claims 1 to 5. 7.- Implant (1) cotylodien pour prothèse de hanche, caractérisé en ce qu'il comprend une cupule (3) métallique de forme générale 30 hémisphérique, fixée sans ciment, et coopérant avec un insert selon l'une  7.- Implant (1) acetabulum for hip prosthesis, characterized in that it comprises a metal cup (3) of generally hemispherical shape, fixed without cement, and cooperating with an insert according to one quelconque des revendications 1 à 5.  any of claims 1 to 5.
FR0209990A 2002-08-06 2002-08-06 INSERT WITH DOUBLE MOBILITY AND IMPLANT COMPRISING SUCH AN INSERT Expired - Fee Related FR2843294B1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2016179229A (en) * 2011-02-24 2016-10-13 デピュイ・（アイルランド）Ｄｅｐｕｙ （Ｉｒｅｌａｎｄ） Maintaining proper mechanical structures of tha
EP3243486A1 (en) 2016-05-09 2017-11-15 Alessandro Melozzi Universal prosthetic head for hip prosthesis

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EP0461019A1 (en) * 1990-06-06 1991-12-11 Jean-Claude Bouvet Prosthesis ball joint
EP0591594A1 (en) * 1992-10-07 1994-04-13 Oscobal Ag Acetabular cup supporting ring
FR2705883A1 (en) * 1993-06-04 1994-12-09 Revest Michel Prosthesis with ball bearing race for hip or other joint replacement
FR2719465A1 (en) * 1994-05-04 1995-11-10 Medinov Sa Implant for cotyloid cavity
FR2793137A1 (en) * 1999-05-07 2000-11-10 Tornier Sa Cotyloid implant for total hip prosthesis incorporates metal adapter between cup and insert
WO2001076511A1 (en) * 2000-04-06 2001-10-18 Societe D'etudes, De Recherches Et De Fabrication S.E.R.F. Cotyloid insert for total hip prosthesis
EP1195149A2 (en) * 1998-05-22 2002-04-10 Howmedica Osteonics Corp. Acetabular cup assembly with selected bearing
WO2002058597A2 (en) * 2001-01-25 2002-08-01 Smith & Nephew, Inc. Containment system for constraining a prosthetic component

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Publication number Priority date Publication date Assignee Title
EP0461019A1 (en) * 1990-06-06 1991-12-11 Jean-Claude Bouvet Prosthesis ball joint
EP0591594A1 (en) * 1992-10-07 1994-04-13 Oscobal Ag Acetabular cup supporting ring
FR2705883A1 (en) * 1993-06-04 1994-12-09 Revest Michel Prosthesis with ball bearing race for hip or other joint replacement
FR2719465A1 (en) * 1994-05-04 1995-11-10 Medinov Sa Implant for cotyloid cavity
EP1195149A2 (en) * 1998-05-22 2002-04-10 Howmedica Osteonics Corp. Acetabular cup assembly with selected bearing
FR2793137A1 (en) * 1999-05-07 2000-11-10 Tornier Sa Cotyloid implant for total hip prosthesis incorporates metal adapter between cup and insert
WO2001076511A1 (en) * 2000-04-06 2001-10-18 Societe D'etudes, De Recherches Et De Fabrication S.E.R.F. Cotyloid insert for total hip prosthesis
WO2002058597A2 (en) * 2001-01-25 2002-08-01 Smith & Nephew, Inc. Containment system for constraining a prosthetic component

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2016179229A (en) * 2011-02-24 2016-10-13 デピュイ・（アイルランド）Ｄｅｐｕｙ （Ｉｒｅｌａｎｄ） Maintaining proper mechanical structures of tha
US10064729B2 (en) 2011-02-24 2018-09-04 Depuy Ireland Unlimited Company Methods for maintaining proper mechanics THA
EP3243486A1 (en) 2016-05-09 2017-11-15 Alessandro Melozzi Universal prosthetic head for hip prosthesis

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