FR2852229A1 - Shoulder prosthesis, has brachial shin bone made of head and cupula that are equipped with connecting unit complementary with plate that cooperates with glenosphere connected with scapular part of articulation - Google Patents

Shoulder prosthesis, has brachial shin bone made of head and cupula that are equipped with connecting unit complementary with plate that cooperates with glenosphere connected with scapular part of articulation Download PDF

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Publication number
FR2852229A1
FR2852229A1 FR0302928A FR0302928A FR2852229A1 FR 2852229 A1 FR2852229 A1 FR 2852229A1 FR 0302928 A FR0302928 A FR 0302928A FR 0302928 A FR0302928 A FR 0302928A FR 2852229 A1 FR2852229 A1 FR 2852229A1
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France
Prior art keywords
plate
humeral
characterized
head
shoulder
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Granted
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FR0302928A
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French (fr)
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FR2852229B1 (en
Inventor
Denis Katz
Philippe Valenti
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IMPLANTS IND
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IMPLANTS IND
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4081Glenoid components, e.g. cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331Connections 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
    • A61F2002/30332Conically- or frustoconically-shaped protrusion and recess
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305Snap connection
    • AHUMAN NECESSITIES
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    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30607Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30728Collars; Bone edge protectors
    • A61F2002/30729Separate collars
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special external or bone-contacting surfaces, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4014Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4018Heads or epiphyseal parts of humerus
    • A61F2002/4022Heads or epiphyseal parts of humerus having a concave shape, e.g. hemispherical cups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4014Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4051Connections of heads directly to shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4059Humeral shafts
    • A61F2002/4062Proximal or metaphyseal parts of shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/40Joints for shoulders
    • A61F2/4081Glenoid components, e.g. cups
    • A61F2002/4085Glenoid components, e.g. cups having a convex shape, e.g. hemispherical heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033Connections 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0062Kits of prosthetic parts to be assembled in various combinations for forming different prostheses

Abstract

The prosthesis has a brachial shin bone (2) made of a humeral head and a cupula (6) that are equipped with a connecting unit that is complementary with a plate (3). The plate cooperates with a glenosphere (15) connected with a scapular part of the shoulder articulation. An intermediary head is equipped with the plate, and cooperates with the cupula in support on the scapular part of the articulation. The plate also cooperates with a coil connected to the scapular part of the articulation.

Description

i i

La présente invention concerne une prothèse totale d'épaule. The present invention relates to a total shoulder prosthesis.

Dans le domaine des prothèses totales d'épaule, on distingue deux principes de prothèses. In the area of ​​total shoulder arthroplasty, there are two principles of prostheses.

Il s'agit, d'une part, des prothèses dites anatomiques qui 5 comprennent une tige humérale sur laquelle est fixée une tête humérale, cette tête venant en appui contre une glène fixée ou scellée dans la partie scapulaire de l'articulation à reconstruire. This is on the one hand, of said anatomic prostheses which comprise a humeral stem 5 on which is fixed a humeral head, said head bearing against a fixed glenoid or sealed in the shoulder part of the joint to be reconstructed. Ce type de prothèse est particulièrement adapté dans le cas de coiffe intacte. This type of prosthesis is particularly suitable in the case of intact cap.

Dans le cas de coiffe rompue ou irréparable, il peut être mise en 10 Oeuvre des prothèses dites inversées dans lesquelles la tige humérale reçoit un insert dont la face extérieure est concave. In the case cap broken or irreparable, it can be put into 10 Organization of the prostheses known in which the reverse humeral stem receives an insert whose outer face is concave. Une glènosphère fixée sur la partie scapulaire de l'articulation à reconstruire vient en appui contre cet insert pour recréer l'articulation de l'épaule. A glenoid sphere fixed on the shoulder portion of the hinge to reconstruct abuts against said insert to recreate the shoulder joint.

Le praticien doit donc avoir à sa disposition plusieurs types de 15 prothèses en fonction des situations pathologiques auxquelles il est confronté; The practitioner must have available several types of prostheses 15 depending pathological situations it faces; il doit également avoir à sa disposition les ancillaires de pose correspondant à chaque type de prothèse. it must also have at its disposal the ancillary installation for each type of prosthesis. Dans la pratique, cela complique son travail puisque cela l'oblige à gérer plusieurs types de prothèses ainsi que les ancillaires de pose correspondantes. In practice, this complicates their work since it requires him to manage several types of prostheses and ancillary corresponding installation.

2() Sur un autre plan, un problème posé par les prothèses d'épaule actuelles réside dans le fait que, lorsqu'une rupture secondaire de la coiffe survient avec un descellement glénoïdien, il faut extraire la totalité de la prothèse. 2 () On another level, a problem posed by the present shoulder prosthesis lies in the fact that when secondary cuff tear occurs with a glenoid loosening, it is necessary to extract all of the prosthesis.

Ceci s'avère extrêmement traumatisant et l'extraction de la tige 25 humérale peut sérieusement endommager le canal médullaire de l'humérus. This is extremely traumatic to and extraction of the humeral stem 25 can seriously damage the medullary canal of the humerus.

Un but de l'invention est donc de proposer une prothèse complète d'épaule qui puisse répondre à plusieurs situations pathologiques auxquelles un praticien peut être confronté. An object of the invention is therefore to provide a complete shoulder prosthesis which can meet several pathological situations that a practitioner may face.

La prothèse totale d'articulation d'épaule comprend selon 30 l'invention une tige humérale, pouvant être ancrée dans le canal médullaire d'un humérus, comprenant dans sa partie métaphysaire une platine munie de moyens de liaison permettant de solidariser la tige humérale à un élément du groupe constitué par: - une tête humérale hémisphérique, munie de moyens de liaison 35 complémentaires de ceux de la platine, pouvant coopérer avec une glène reliée à la partie scapulaire, et - une cupule munie de moyens de liaison complémentaires de ceux de la platine pouvant coopérer avec une glènosphère reliée avec la partie scapulaire, et - une tête intermédiaire, munie de moyens de liaison 5 complémentaires de ceux de la platine, pouvant coopérer avec une cupule humérale en appui sur la partie scapulaire. Total shoulder prosthesis hinge 30 comprises according to the invention a humeral stem, which can be anchored in the medullary canal of a humerus, comprising in its metaphyseal part a plate provided with connecting means for securing the humeral stem one of the group consisting of: - a hemispherical humeral head, provided with 35 complementary connecting means from those of the platinum, which can cooperate with a coil connected to the shoulder part, and - a cup provided with complementary binding means of those of the plate being engageable with a glenoid sphere connected with the shoulder portion, and - an intermediate head provided with connection means 5 complementary to those of the platinum, which can cooperate with a humeral cup resting on the shoulder part.

La prothèse selon l'invention permet de répondre à des situations pathologiques variées. The prosthesis according to the invention can meet various pathological situations. Notamment elle peut être mise en oeuvre: - dans le cas d'omarthrose avec coiffe de bonne qualité, la prothèse 10 est configurée en prothèse anatomique, - dans le cas d'omarthrose excentrée avec coiffe irréparable, dans ce cas la prothèse est configurée en prothèse inversée, - dans le cas de descellement d'implant glénoïdien ou de glène usée avec support osseux déficient, il n'est plus nécessaire de retirer la tige 15 humérale puisque celle-ci peut recevoir une cupule de glènosphère, grâce à l'alésage tronconique dont sa partie métaphysaire est munie. In particular it may be carried out: - in the case of glenohumeral osteoarthritis with good cover, the prosthesis 10 is configured anatomical prosthesis, - in the case of eccentric glenohumeral osteoarthritis with irreparable cap, in this case the prosthesis is configured reverse prosthesis, - in the case of loosening of the glenoid implant or worn glenoid with bone support deficient, it is no longer necessary to remove the humeral stem 15 since the latter can receive a glenoid sphere cup through the bore frustoconical with its metaphyseal part is provided.

En outre, la même ancillaire de pose peut être utilisée pour la mise en place de la tige humérale que le praticien pose une prothèse anatomique ou une prothèse inversée. In addition, the same ancillary fitting may be used for the establishment of the humeral stem the practitioner pose an anatomical prosthesis or a reverse prosthesis.

2() Selon des aspects avantageux de l'invention, la prothèse totale d'épaule incorpore une ou plusieurs des caractéristiques suivantes: - la partie métaphysaire de la platine présente un alésage tronconique débouchant de la platine dans lequel peut s'engager un pion conique dont est pourvue: - la tête humérale hémisphérique, - la cupule, - la tête intermédiaire, - l'embase est fixée par impaction et par vissage à la partie scapulaire pouvant recevoir, par clipsage, la glène ou la glènosphère, - la glène est scellée dans la partie scapulaire et comprend au moins un plot impacté dans celle-ci, - l'insert de glènosphère et la tête humérale présentent, sur leurs faces en regard de la platine, un lamage de profondeur égale à l'épaisseur de celle-ci, - la platine est orientée selon un angle de 450 par rapport à l'axe de la tige humérale, l'embase présente un aileron postérieur présentant un perçage pour le passage d'une vis de fixation, - la tige humérale 2 () According to advantageous aspects of the invention, the total shoulder prosthesis incorporates one or more of the following features: - the metaphyseal portion of the plate has a frusto-conical bore of the plate into which can engage a conical pin which is provided: - the hemispherical humeral head, - the cup, - the intermediate head, - the base is fixed by impaction and by screwing to the shoulder portion can receive, by clipping, the glenoid or glenoid sphere, - the glenoid is sealed in the shoulder portion and includes at least one stud impacted therein, - the glenoid sphere insert and humeral head have on their opposing faces of the plate, a counterbore depth equal to the thickness of celle- latter, - the plate is oriented at an angle 450 relative to the axis of the humeral stem, the base has a posterior fin having a bore for passage of a fastening screw, - the humeral stem présente, dans sa partie métaphysaire, un aileron postérieur. has in its metaphyseal portion, a rear spoiler.

Pour sa bonne compréhension, l'invention est décrite en référence au dessin annexé représentant, à titre d'exemple non limitatif, une forme de réalisation d'une prothèse selon celle-ci. For a good understanding, the invention is described with reference to the accompanying drawing representing, by way of nonlimiting example, an embodiment of a prosthesis according thereto.

Figure 1 représente, en perspective éclatée, une prothèse dans une configuration inversée, 1 Figure 2 représente, en perspective éclatée, une prothèse en configuration anatomique, Figures 3 et 4 représentent, en coupe partielle, les prothèses des figures 1 et 2, Figure 5 représente, en perspective éclatée, une prothèse incluant 15 une tête intermédiaire. Figure 1 is an exploded perspective view of a prosthesis in an inverted configuration, 1 Figure 2 is an exploded perspective view of a prosthesis in an anatomical configuration, Figures 3 and 4 show, in partial section, the prosthesis of Figures 1 and 2, Figure 5 is an exploded perspective view of a prosthesis 15 including an intermediate head.

Comme on peut le voir sur les figures, la prothèse totale d'épaule selon l'invention présente une tige humérale 2 destinée à être ancrée dans le canal médullaire d'un humérus. As can be seen in the figures, the total shoulder prosthesis according to the invention a humeral shaft 2 intended to be anchored in the medullary canal of a humerus. Cette tige humérale 2 présente, dans sa partie métaphysaire une platine 3 orientée selon un angle sensiblement de 450 par 20 rapport à l'axe longitudinal de celle-ci. The humeral stem 2 has, in its metaphyseal part a 3-plate oriented at an angle substantially of 450 by 20 relative to the longitudinal axis thereof. On note que la tige humérale présente un aileron postérieur 9. Un alésage tronconique 4 débouche dans la surface de cette platine. It is noted that the humeral rod has a rear spoiler 9. A tapered bore 4 opens into the surface of this plate. Cet alésage 4 peut recevoir au choix du praticien mettant en oeuvre cette prothèse, soit une cupule 6 de glènosphère comme le montre la figure 1, soit une tête humérale 7 comme le montre la figure 2. This bore 4 can accommodate the choice of the practitioner using said prosthesis, a cup 6 glenoid sphere as shown in Figure 1, a humeral head 7 as shown in Figure 2.

Si l'on se réfère tout d'abord à la figure 2, on peut voir que celle-ci représente une prothèse dans une configuration dite anatomique. If Referring firstly to Figure 2 it can be seen that there is shown a prosthesis in a known anatomic configuration. En effet, dans cette configuration, la prothèse présente une tige humérale 2 qui reçoit une tête humérale 7 hémisphérique. Indeed, in this configuration, the prosthesis has a humeral stem 2 which receives a hemispherical humeral head 7. La tête humérale 7 hémisphérique présente, sur sa face en regard de la platine, un pion conique 8 qui s'engage 30 dans l'alésage tronconique 4 ménagé dans la platine. The hemispherical humeral head 7 has, on its side facing the plate, a conical peg 8 which engages in the tapered bore 30 formed in the plate 4.

Sur la représentation de la figure 2, on peut voir que, en ce qui concerne la partie scapulaire de cette prothèse, il est prévu une embase 10 en titane, cette embase 10 étant solidarisée sur l'os scapulaire par des vis traversant un aileron postérieur 12. Ces vis ne sont pas représentées sur la 35 figure. In the illustration of Figure 2, it is seen that, as regards the shoulder part of the prosthesis, there is provided a base 10 made of titanium, the base 10 being fixed on the scapular bone by screws passing through a rear spoiler 12. These screws are not shown in Figure 35. Une glène 11 en polyéthylène est clipsée sur l'embase 10. La glène 11 présente une surface concave coopérant avec la tête humérale 7 hémisphérique de façon à recréer une articulation d'épaule. A glenoid 11 in polyethylene is clipped onto the base 10. The coil 11 has a concave surface cooperating with the hemispherical humeral head 7 so as to recreate a shoulder joint.

A la figure 1, la prothèse présente une cupule 6 de glènosphère qui présente, sur sa face en regard de la platine, un pion conique 13 s'engageant 5 dans l'alésage conique 4 réalisé dans la partie métaphysaire de la tige 2 et débouchant dans la platine 3. Pour la fixation à la partie scapulaire, la prothèse présente une embase 10 similaire à celle représentée sur la figure 1, cette embase recevant une glènosphère 15, c'est-à-dire une pièce présentant une calotte hémisphérique destinée à coopérer avec la cupule 6 de glènosphère qui 1 0 présente, lui, une partie concave. In Figure 1, the prosthesis has a cup 6 which glenoid sphere has on its side facing the plate, a conical pin 13 engaging 5 in the conical bore 4 formed in the metaphyseal portion of the rod 2 and opening in the plate 3. for the fixing to the shoulder portion, the prosthesis has a base 10 similar to that shown in Figure 1, this base receiving a glenoid sphere 15, that is to say a part having a hemispherical dome intended to cooperate with the cup 6 which glenoid sphere 1 0 present, it a concave part.

Comme on peut le voir sur les représentations en coupe des figures 4 et 5, la tête humérale 7 et la cupule 6 de glènosphère présentent sur leurs faces en regard de la platine, un lamage d'une profondeur égale à l'épaisseur de celle-ci. As can be seen in cross-sectional representations of Figures 4 and 5, the humeral head 7 and the cup 6 glenosphere have on their opposing faces of the plate, a counterbore to a depth equal to the thickness of celle- this.

Dans la pratique, l'intérêt majeur de cette prothèse est que, d'une part, le chirurgien pratiquant une intervention sur une épaule a, à sa disposition, une prothèse pouvant être, selon la pathologie, configurée en prothèse anatomique ou en prothèse inversée. In practice, the major advantage of this prosthesis is that, firstly, the surgeon performing an operation on a shoulder at its disposal, a prosthesis can be, according to the pathology, or anatomical prosthesis configured in reverse prosthesis .

D'autre part, l'avantage tout à fait significatif de cette prothèse est 2<) que, dans le cas o celle-ci est implantée, tout d'abord en tant que prothèse d'épaule anatomique, et que par la suite il survient une rupture secondaire de la coiffe avec un descellement glénoïdien, il est alors possible de retirer la tête humérale prothétique, tout en laissant la tige humérale in situ. On the other hand, the very significant advantage of this prosthesis is 2 <) that, in the case where it is implanted, first as an anatomical shoulder prosthesis, and thereafter it occurs a secondary rupture of the rotator with a glenoid loosening, it is then possible to remove the prosthetic humeral head, while leaving the humeral rod in situ. La tige humérale 2 peut être alors réutilisée pour recevoir la cupule 6 de glènosphère, cette 25 cupule 6 de glènosphère coopérant avec une glènosphère 15 fixée sur la partie scapulaire. The humeral stem 2 can then be reused for receiving the cup 6 glenosphere, this cup 25 6 glenosphere cooperating with a glenoid sphere 15 secured to the shoulder portion. La fixation de ce glènosphère pouvant être réalisée grâce à une embase telle qu'elle est représentée à la figure 1. Fixing this glenoid sphere can be achieved through a base as is shown in Figure 1.

Bien que cela ne soit pas représenté sur les figures, il peut être tout à fait envisagé de prévoir une glène à fond convexe et à quatre plots 3() permettant sa fixation dans la partie scapulaire par impaction et cimentation. Although this is not shown in the figures, it may be quite possible to provide a glenoid with a convex bottom and four pads 3 () for fixing it into the shoulder part by impaction and cementing.

La figure 5 représente une variante de réalisation de l'invention dans laquelle la tige humérale reçoit, dans son alésage conique 4, un pion 17 également conique dépassant d'une tête intermédiaire 18 sphérique. 5 shows an alternative embodiment of the invention wherein the humeral shaft receives, in its conical bore 4, a likewise conical pin 17 protruding from an intermediate spherical head 18. La tête intermédiaire 18 sphérique coopère alors avec une cupule humérale 19. 5 comprenant une cupule en polyéthylène 20 engagée dans une calotte 21 d'appui métallique, une bague 22 solidarisant la tête intermédiaire dans la cupule humérale. The intermediate spherical head 18 then cooperates with a humeral cup 19. 5 comprising a polyethylene cup 20 engaged in a cap 21 of metal support, a ring 22 solidarisant the intermediate head in the humeral cup. Dans ce mode de réalisation, la calotte d'appui 21 vient en appui dans la cavité glénoldale de la scapula. In this embodiment, the bearing cap 21 abuts in the glénoldale cavity of the scapula.

Ainsi, comme cela a été décrit, la prothèse selon l'invention présente de nombreux avantages et notamment répond à des situations pathologiques variées. Thus, as described, the prosthesis according to the invention has many advantages including responding to various pathological situations. Notamment elle peut être mise en oeuvre: - dans le cas d'omarthrose avec coiffe de bonne qualité, la prothèse est configurée en prothèse anatomique, - dans le cas d'omarthrose excentrée avec coiffe irréparable, dans ce cas la prothèse est configurée en prothèse inversée. In particular it may be carried out: - in the case of glenohumeral osteoarthritis with good cover, the prosthesis is configured anatomical prosthesis, - in the case of eccentric glenohumeral osteoarthritis with irreparable cap, in this case the prosthesis is configured prosthesis reversed.

I() - dans le cas de descellement d'implant glénoïdien ou de glène usée avec support osseux déficient, il n'est plus nécessaire de retirer la tige humérale puisque celle-ci peut recevoir une cupule de glènosphère, grâce à l'alésage tronconique dont sa partie métaphysaire est munie. I () - in the case of loosening of the glenoid implant or worn glenoid with bone support deficient, it is no longer necessary to remove the humeral stem since it may receive a glenoid sphere cup through the frustoconical bore including its metaphyseal part is provided.

Comme il va de soi, l'invention n'est limitée à la forme de i 5 réalisation décrite ci-dessus à titre d'exemple non limitatif. It goes without saying that the invention is not limited to the form of i 5 embodiment described above by way of non-limiting example. Ainsi bien que ce ne soit pas représenté sur le dessin, la glène peut présenter plusieurs plots pour son impaction et son scellement dans la partie scapulaire de l'articulation. So although this is not shown in the drawing, the coil may have several studs for its impaction and sealing in the shoulder part of the joint. De plus, le pion dont est munie la tête humérale hémisphérique pourrait être décentré par rapport à l'axe de rotation de celle-ci. In addition, the pawn which is equipped hemispherical humeral head could be offset from the axis of rotation thereof.

Claims (8)

REVENDICATIONS
1. Prothèse totale d'articulation d'épaule caractérisée en ce qu'elle comprend une tige humérale (2), pouvant être ancrée dans le canal médullaire d'un humérus, comprenant dans sa partie métaphysaire une platine (3) munie 5 de moyens de liaison permettant de solidariser la tige humérale(2) à un élément du groupe constitué par: - une tête humérale (7) hémisphérique, munie de moyens de liaison complémentaires de ceux de la platine (3), pouvant coopérer avec une glène (11) reliée à la partie scapulaire de l'articulation, et - une cupule (6) munie de moyens de liaison complémentaires de ceux de la platine (3) pouvant coopérer avec une glènosphère (15) reliée avec la partie scapulaire de l'articulation, et - une tête intermédiaire (18), munie de moyens de liaison complémentaires de ceux de la platine, pouvant coopérer avec une cupule 15 humérale (19) en appui sur la partie scapulaire de l'articulation. 1. Total shoulder joint prosthesis characterized in that it comprises a humeral rod (2) which can be anchored in the medullary canal of a humerus, comprising in its metaphyseal part a plate (3) provided with means 5 connecting to secure the humeral rod (2) to an element of the group consisting of: - a humeral head (7) hemispherical, provided with complementary binding means of those of the plate (3) which can cooperate with a glenoid cavity (11 ) connected to the shoulder portion of the joint, and - a cup (6) provided with complementary binding means of those of the plate (3) engageable with a glenoid sphere (15) connected with the shoulder part of the articulation, and - an intermediate head (18), provided with complementary connecting means from those of the platinum, which can cooperate with a humeral cup 15 (19) bearing on the shoulder part of the joint.
2. Prothèse totale d'épaule selon la revendication 1, caractérisée en ce que la partie métaphysaire de la platine (3) présente un alésage tronconique (4) débouchant de la platine dans lequel peut s'engager un pion conique (8, 13, 17) dont est pourvue: - la tête humérale (7) hémisphérique, - la cupule (13), - la tête intermédiaire (18). 2. Total shoulder prosthesis according to claim 1, characterized in that the metaphyseal part of the plate (3) has a frustoconical bore (4) opening of the plate into which can engage a conical pin (8, 13, 17) which is provided: - the humeral head (7) hemispherical, - the cup (13), - the intermediate head (18).
3. Prothèse totale d'épaule selon la revendication 1 ou la revendication 2, caractérisée en ce qu'elle comprend en outre une embase (10) 25 fixée par impaction et par vissage à la partie scapulaire, pouvant recevoir, par clipsage, la glène (11) ou la glènosphère (15). 3. Total shoulder prosthesis according to claim 1 or claim 2, characterized in that it further comprises a base (10) 25 fixed by impaction and by screwing to the shoulder part, which can receive, by clipping, the glenoid (11) or the glenoid sphere (15).
4. Prothèse totale d'épaule selon la revendication 1 ou la revendication 2, caractérisée en ce que la glène (11) est scellée dans la partie scapulaire (10) et comprend au moins un plot impacté dans celle-ci. 4. Total shoulder prosthesis according to claim 1 or claim 2, characterized in that the coil (11) is sealed in the shoulder portion (10) and comprises at least one stud impacted therein.
5. Prothèse totale d'épaule selon l'une des revendications 1 à 3, caractérisée en ce que la cupule (6) et la tête humérale (7) présentent sur leurs faces en regard de la platine (3), un lamage de profondeur égale à l'épaisseur de celle-ci. 5. Total shoulder prosthesis according to one of claims 1 to 3, characterized in that the cup (6) and the humeral head (7) have on their opposite faces of the plate (3), a deep counterbore equal to the thickness thereof.
6. Prothèse totale d'épaule selon l'une des revendications 1 à 5, 35 caractérisée en ce que la platine (3) est orientée selon un angle de 450 par rapport à l'axe de la tige humérale (2). 6. Total shoulder prosthesis according to one of claims 1 to 5, 35 characterized in that the plate (3) is oriented at an angle 450 relative to the axis of the humeral rod (2).
-.1 2852229 -.1 2852229
7. Prothèse totale d'épaule selon l'une des revendications 2 à 6 caractérisée en ce que l'embase (10) présente un aileron (12) postérieur présentant un perçage pour le passage d'une vis de fixation. 7. Total shoulder prosthesis according to one of claims 2 to 6 characterized in that the base (10) has a fin (12) having a posterior bore for the passage of a fastening screw.
8. Prothèse totale d'épaule selon l'une des revendications 1 à 7 5 caractérisée en ce que la tige humérale (2) présente dans sa partie métaphysaire un aileron postérieur (9). 8. Total shoulder prosthesis according to one of claims 1 to 7 5, characterized in that the humeral rod (2) has in its metaphyseal part a posterior fin (9).
FR0302928A 2003-03-10 2003-03-10 Total prosthesis of shoulder. Active FR2852229B1 (en)

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FR0302928A FR2852229B1 (en) 2003-03-10 2003-03-10 Total prosthesis of shoulder.
PCT/FR2004/000573 WO2004080331A2 (en) 2003-03-10 2004-03-10 Total shoulder prosthesis kit
EP20040718983 EP1603494A2 (en) 2003-03-10 2004-03-10 Total shoulder prosthesis kit

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WO2004080331A3 (en) 2004-10-21
EP1603494A2 (en) 2005-12-14
WO2004080331A2 (en) 2004-09-23

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