FR2890853A1 - Prosthetic implant for the shoulder with a support element having a support and sliding surface able to cooperate with the joint head of the implant and the anatomical socket of the shoulder blade - Google Patents

Prosthetic implant for the shoulder with a support element having a support and sliding surface able to cooperate with the joint head of the implant and the anatomical socket of the shoulder blade Download PDF

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Publication number
FR2890853A1
FR2890853A1 FR0509826A FR0509826A FR2890853A1 FR 2890853 A1 FR2890853 A1 FR 2890853A1 FR 0509826 A FR0509826 A FR 0509826A FR 0509826 A FR0509826 A FR 0509826A FR 2890853 A1 FR2890853 A1 FR 2890853A1
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FR
France
Prior art keywords
glenoid
head
implant
support
implant according
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Granted
Application number
FR0509826A
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French (fr)
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FR2890853B1 (en
Inventor
Michel Colombier
Emmanuel Baulot
Nicolas Yvaldo
Mario Caniggia
Philippe Collin
Hugues Charles
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Emmanuel Baulot Fr
Hugues Charles Fr
Mario Caniggia It
Pierre Trouilloud Fr
Richard Nyffeler Ch
Aston Medical SAS
Original Assignee
ASTON MEDICAL Ltd
ASTON MEDICAL Ltd
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Priority to FR0509826A priority Critical patent/FR2890853B1/en
Publication of FR2890853A1 publication Critical patent/FR2890853A1/en
Application granted granted Critical
Publication of FR2890853B1 publication Critical patent/FR2890853B1/en
Expired - Fee Related 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
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30168—L-shaped
    • 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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30561—Special structural features of bone or joint prostheses not otherwise provided for breakable or frangible
    • 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • 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
    • A61F2002/30878—Special external or bone-contacting surface, 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
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/3096—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques trimmed or cut to a customised size
    • 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
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A61F2002/4085—Glenoid components, e.g. cups having a convex shape, e.g. hemispherical heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0043—L-shaped

Abstract

A glenoidal prosthetic implant for the shoulder joint comprises a hemispherical convex joint head (1) cooperating with a support and sliding surface that has a humeral implant fixed in the humeral diaphysis. The head has some fixing arrangements with an independent support element (4) able to be fixed at the level of the anatomical socket. The support element has, going beyond a support and fixing surface (4a) with the anatomical socket and from its lower edge, a ledge (4b) constituting a portion of a sphere able to cooperate with the head, along the same diameter, and with the pillar of the shoulder blade.

Description

L'invention se rattache au secteur technique des implants orthopédiques,The invention relates to the technical sector of orthopedic implants,

notamment des prothèses d'épaules.  including shoulder prostheses.

D'une manière parfaitement connue pour un homme du métier, une prothèse d'épaule comprend, pour l'essentiel, un implant huméral et un implant glénoïdien. L'implant huméral est destiné à être fixé au niveau de la diaphyse humérale, tandis que l'implant glénoïdien est destiné à être fixé au niveau de la glène de l'omoplate.  In a manner well known to those skilled in the art, a shoulder prosthesis essentially comprises a humeral implant and a glenoid implant. The humeral implant is intended to be fixed at the level of the humeral diaphysis, while the glenoid implant is intended to be fixed at the level of the glene of the scapula.

A partir de cette conception de base, l'implant huméral peut présenter une tête d'articulation très sensiblement hémisphérique coopérant avec une cupule ou plateau fixé au niveau de la glène anatomique. Ou bien, inversement, l'implant glénoïdien présente une tête d'articulation sensiblement hémisphérique coopérant avec une cupule ou plateau de forme complémentaire que présente l'implant huméral dans la variante d'articulation inversée.  From this basic design, the humeral implant may have a very substantially hemispherical hinge head cooperating with a cup or tray fixed at the level of the anatomical glenoid. Or conversely, the glenoid implant has a substantially hemispherical articulation head cooperating with a cup or plate of complementary shape that the humeral implant presents in the inverted joint variant.

L'invention concerne plus particulièrement un ensemble prothétique dont la tête d'articulation est rendue solidaire de la glène anatomique. Selon ce principe d'articulation inversée, on obtient une meilleure congruence humérus glène.  The invention more particularly relates to a prosthetic assembly whose articulation head is made integral with the anatomical glenoid. According to this principle of inverted articulation, we obtain a better congruence humerus glene.

Différentes solutions ont été proposées pour réaliser ce type d'articulation inversée. On peut citer, par exemple, l'enseignement du brevet FR 2.618.065.  Different solutions have been proposed to achieve this type of reverse articulation. There may be mentioned, for example, the teaching of patent FR 2,618,065.

Une solution avantageuse ressort également de l'enseignement du brevet EP 1.064.890. Selon l'enseignement de ce brevet, le centre de rotation de la tête d'articulation est décalé vers le bas par rapport au plan médian et au centre de la glène anatomique pour rabaisser, d'une manière correspondante, ladite tête d'articulation qui présente, du côté du pilier externe de l'omoplate, un prolongement apte à augmenter l'amplitude de rotation en adduction. Cette augmentation de l'amplitude de rotation en adduction résulte d'un décalage vers le haut du point d'application des efforts, augmentant par conséquent le bras de levier entre le point d'application du deltoïde qui crée le mouvement abducteur et ledit point, et en dégageant l'acromion.  An advantageous solution also emerges from the teaching of EP 1,064,890. According to the teaching of this patent, the center of rotation of the hinge head is offset downwardly with respect to the median plane and the center of the anatomic glenoid to lower, in a corresponding manner, said hinge head which presents, on the side of the outer pillar of the scapula, an extension capable of increasing the amplitude of rotation in adduction. This increase in the amplitude of rotation in adduction results from an upward shift of the point of application of the forces, consequently increasing the lever arm between the point of application of the deltoid which creates the abductor movement and the said point, and clearing the acromion.

Le prolongement que présente la tête d'articulation, est raccordé perpendiculairement à la surface d'appui de ladite tête, en faisant office de moyen d'anti-rotation et d'anti-élévation en coopérant avec la coupe osseuse du pilier de l'omoplate.  The extension that presents the hinge head is connected perpendicular to the bearing surface of said head, acting as a means of anti-rotation and anti-elevation by cooperating with the bone cutting of the pillar of the scapula.

Dans le cas d'une fixation sans ciment notamment, la tête d'articulation glénoïdienne coopère avec un élément support indépendant présentant des agencements de fixation dans la glène anatomique. Quelle que soit la forme de réalisation du support, des difficultés apparaissent pour la mise en place de la tête d'articulation sur ledit support compte tenu notamment du prolongement, ou débord inférieur, que présente la tête d'articulation glénoïdienne.  In the case of a fixation without cement in particular, the glenoid joint head cooperates with an independent support member having fixing arrangements in the anatomical glenoid. Whatever the embodiment of the support, difficulties arise for the establishment of the hinge head on said support taking into account in particular the extension or lower edge, that has the glenoid joint head.

A partir de cette conception de base, d'un ensemble prothétique d'articulation de l'épaule tel que défini par l'enseignement du brevet EP 1.064.890 précité, le problème que se propose de résoudre l'invention est non seulement d'éviter les chocs, mais de faciliter la mise en place par le chirurgien de la tête d'articulation glénoïdienne.  From this basic design, a prosthetic joint assembly of the shoulder as defined by the teaching of the patent EP 1.064.890 mentioned above, the problem that proposes to solve the invention is not only to avoid shocks, but facilitate the establishment by the surgeon of the glenoid joint head.

Pour résoudre un tel problème, il a été conçu et mis au point un implant prothétique glénoïdien du type de ceux comprenant, d'une manière connue, une tête d'articulation convexe du type hémisphérique pour coopérer avec une surface d'appui et de glissement que présente un implant huméral fixé dans la diaphyse humérale, ladite tête présentant des agencements de fixation avec un élément support indépendant apte à être fixé au niveau de la glène anatomique.  To solve such a problem, it has been designed and developed a glenoid prosthetic implant of the type of those comprising, in a known manner, a hemispherical type convex hinge head to cooperate with a bearing and sliding surface. that has a humeral implant fixed in the humeral shaft, said head having fixing arrangements with an independent support member adapted to be fixed at the level of the anatomical glenoid.

Selon l'invention, compte tenu du problème posé à résoudre, ledit élément support présente en débordement d'une face d'appui et de fixation avec la glène anatomique, et à partir de son bord inférieur, un rebord apte à coopérer avec le pilier de l'omoplate.  According to the invention, in view of the problem to be solved, said support member has an overflow of a bearing face and attachment with the anatomical glenoid, and from its lower edge, a flange adapted to cooperate with the pillar scapula.

Pour résoudre le problème posé d'assurer la fixation de l'élément support au niveau de la glène anatomique, l'élément support présente un plot d'ancrage coopérant avec la glène anatomique. L'élément support peut également présenter des trous pour le passage de vis à corticale fixées dans la glène anatomique.  To solve the problem of ensuring the attachment of the support member at the anatomical glenoid, the support element has an anchor cooperating with the anatomic glenoid. The support member may also have holes for the passage of cortical screws fixed in the anatomical glenoid.

Pour résoudre le problème posé d'assurer la fixation de la tête d'articulation sur l'élément support glénoïdien, la tête présente des agencements, constitués par des formes complémentaires de clipage sous un effet de pression. Ou bien, selon une autre forme de réalisation, les agencements sont constitués par une vis traversant la tête d'articulation et coopérant avec le plot d'ancrage de l'élément support glénoïdien.  To solve the problem of ensuring the attachment of the hinge head on the glenoid support element, the head has arrangements, consisting of complementary forms of clipping under a pressure effect. Or, according to another embodiment, the arrangements consist of a screw passing through the articulation head and cooperating with the anchor pad of the glenoid support element.

Suivant une autre caractéristique, les bords antérieur et postérieur du support sont rectilignes, les bords supérieur et inférieur étant arrondis.  According to another characteristic, the front and rear edges of the support are rectilinear, the upper and lower edges being rounded.

Selon une autre caractéristique, la surface d'appui du support coopérant avec la glène anatomique est plate, ou de forme convexe pour correspondre au profil de la glène anatomique.  According to another feature, the bearing surface of the support cooperating with the anatomical glenoid is flat, or of convex shape to correspond to the profile of the anatomical glenoid.

L'invention est exposée ci-après plus en détail à l'aide des figures des dessins annexés dans lesquels: la figure 1 est une vue en perspective avant montage des principaux éléments de l'implant glénoïdien selon l'invention, la perspective étant représentée en vue de dessus; la figure 2 est une vue semblable à la figure 1, la perspective étant représentée en vue de dessous; la figure 3 est une vue en perspective après assemblage des différents éléments constitutifs de l'implant cotyloïdien, la perspective étant considérée vue de dessus; la figure 4 est une vue correspondant à la figure 3, la perspective étant considérée vue de dessous; la figure 5 est une vue à caractère schématique montrant la fixation de l'implant prothétique glénoïdien, au niveau de la glène anatomique, et la coopération de la tête d'articulation avec une surface d'appui et de glissement que présente un implant huméral, fixé dans la diaphyse humérale.  The invention is described below in more detail with the help of the figures of the accompanying drawings, in which: FIG. 1 is a perspective view before mounting of the main elements of the glenoid implant according to the invention, the perspective being represented in top view; Figure 2 is a view similar to Figure 1, the perspective being shown in a view from below; Figure 3 is a perspective view after assembly of the various components of the cotyloid implant, the perspective being viewed from above; Figure 4 is a view corresponding to Figure 3, the perspective being viewed from below; FIG. 5 is a schematic view showing the fixation of the glenoid prosthetic implant, at the level of the anatomical glenoid, and the cooperation of the articulating head with a bearing and sliding surface that a humeral implant has, fixed in the humeral diaphysis.

la figure 6 est une vue en perspective d'une autre forme de réalisation de l'élément support correspondant à un autre mode de fixation.  Figure 6 is a perspective view of another embodiment of the support member corresponding to another mode of attachment.

Selon l'invention, l'implant prothétique glénoïdien est du type de ceux comprenant, d'une manière connue, une tête d'articulation hémisphérique (1) apte à coopérer avec une surface d'appui et de glissement (2) que présente un implant huméral (3) fixé dans la diaphyse humérale (figure 5).  According to the invention, the glenoid prosthetic implant is of the type comprising, in a known manner, a hemispherical hinge head (1) adapted to cooperate with a bearing and sliding surface (2) that a Humeral implant (3) fixed in the humeral diaphysis (Figure 5).

La tête d'articulation glénoïdienne (1) présente des agencements de fixation avec un élément support indépendant (4) apte à être fixé au niveau de la glène anatomique.  The glenoid joint head (1) has fixing arrangements with an independent support element (4) capable of being fixed at the level of the anatomical glenoid.

Selon l'invention, l'élément support (4) présente, en débordement d'une face d'appui (4a), à partir de son bord inférieur, un rebord (4b) apte à coopérer avec le pilier de l'omoplate. Le rebord (4b) est formé dans un plan sensiblement perpendiculaire à celui défini par la face d'appui (4a) de l'élément support (4). Ce rebord ou déport (4b) coopère, comme indiqué, avec la coupe osseuse dans le pilier de l'omoplate et avec la tête d'articulation glénoïdienne (1) afin d'accompagner le mouvement coude au corps. Autrement dit, le rebord (4b) délimite une portion de sphère prolongeant la tête sphérique d'articulation (1).  According to the invention, the support member (4) has, in overflow of a bearing face (4a), from its lower edge, a flange (4b) adapted to cooperate with the abutment of the scapula. The flange (4b) is formed in a plane substantially perpendicular to that defined by the bearing face (4a) of the support member (4). This rim or offset (4b) cooperates, as indicated, with the bone section in the abutment of the scapula and with the glenoid joint head (1) to accompany the elbow movement to the body. In other words, the flange (4b) defines a portion of sphere extending the spherical articulation head (1).

Les bords antérieur et postérieur (4c) et (4d) de l'élément support (4), sont rectilignes et parallèles, tandis que les bords supérieur et inférieur (4e) et (4f), sont arrondis d'une manière correspondante à l'embase de la tête hémisphérique d'articulation glénoïdienne (1). On rappelle que le prolongement (4b), formé à partir du bord inférieur (4f), est constitué par une partie de sphère identique au diamètre de la sphère (1) constituée par la tête d'articulation glénoïdienne.  The front and rear edges (4c) and (4d) of the support member (4) are rectilinear and parallel, while the upper and lower edges (4e) and (4f) are rounded correspondingly to the base of the hemispherical glenoid joint head (1). Recall that the extension (4b) formed from the lower edge (4f) is constituted by a sphere portion identical to the diameter of the sphere (1) constituted by the glenoid joint head.

La face d'appui (4a) de l'élément support (4) destinée à coopérer avec la glène anatomique, peut être plane ou présenter un rayon de courbure convexe afin de correspondre au profil anatomique de la glène et permettre son orientation dans l'espace selon des critères biomécaniques définis par une assistance informatique opératoire.  The bearing surface (4a) of the support element (4) intended to cooperate with the anatomical glenoid may be flat or have a convex radius of curvature so as to correspond to the anatomical profile of the glenoid and allow it to be oriented in the space according to biomechanical criteria defined by an operative computer assistance.

L'élément support (4) comprend sensiblement dans sa partie médiane un plot d'ancrage (5) formé perpendiculairement à la face d'appui (4a). Le plot d'ancrage (5) est engagé dans la masse spongieuse de la glène, en faisant notamment office de quille de stabilité. A noter que le plot (5) peut être constitué de plusieurs tronçons sécables (5a) coupés à la pince pendant l'intervention afin de s'adapter à la profondeur du col de la glène ou simplement à la qualité osseuse de cette glène. On pourra, si besoin, en cas d'os durs, ne pas utiliser de quille par une section au ras de la face d'appui.  The support element (4) substantially comprises in its middle part an anchor pad (5) formed perpendicularly to the bearing face (4a). The anchoring stud (5) is engaged in the spongy mass of the glenoid, notably acting as a stability keel. Note that the stud (5) may consist of several breakable sections (5a) cut with the clamp during the procedure to adapt to the depth of the neck of the glenoid or simply the bone quality of this glenoid. We can, if necessary, in case of hard bones, do not use a keel by a section flush with the face of support.

La fixation de l'élément support (4) est avantageusement complétée par des vis (6) et (7) et (8) disposées obliquement dans des trous (4g) -(4h) et (41) formés dans l'épaisseur de l'élément support (4). Les vis (7) et (8) sont vissées au niveau col de la glène, la vis (6) est orientée dans le pilier de la caracoïde.  The fixing of the support element (4) is advantageously completed by screws (6) and (7) and (8) arranged obliquely in holes (4g) - (4h) and (41) formed in the thickness of the support element (4). The screws (7) and (8) are screwed at the neck of the glenoid, the screw (6) is oriented in the pillar of the caracoid.

La fixation de la tête d'articulation glénoïdienne (1) sur l'élément support (4) peut s'effectuer par des agencements sous forme d'un cône autobloquant (4i) doublé d'un filetage (4j). Ou bien, selon une forme de réalisation illustrée, la fixation peut notamment être assurée par une vis (9) fixée à la place du plot d'ancrage (5) dans des cas de reprise (figure 6).  The fixing of the glenoid articulation head (1) on the support element (4) can be effected by arrangements in the form of a self-locking cone (4i) lined with a thread (4j). Or, according to an illustrated embodiment, the attachment may in particular be provided by a screw (9) fixed in place of the anchor pad (5) in cases of recovery (Figure 6).

Avantageusement, dans le prolongement du plot d'ancrage (5), l'élément support (4) avec le cône autobloquant (4i), dans lequel peut être engagée la vis optionnelle (9), est apte à coopérer avec un alésage complémentaire (la) que présente une portée (lb) formée à l'intérieur du corps hémisphérique de la tête d'articulation (1).  Advantageously, in the extension of the anchor pad (5), the support element (4) with the self-locking cone (4i), into which the optional screw (9) can be engaged, is adapted to cooperate with a complementary bore ( la) that has a bearing (Ib) formed inside the hemispherical body of the hinge head (1).

Les avantages ressortent bien de la description.  The advantages are apparent from the description.

Claims (9)

REVENDICATIONS -1- Implant prothétique glénoïdien pour l'articulation de l'épaule comprenant une tête d'articulation convexe du type hémisphérique (1) pour coopérer avec une surface d'appui et de glissement que présente un implant huméral fixé dans la diaphyse humérale, ladite tête (1) présentant des agencements de fixation avec un élément support indépendant (4) apte à être fixé au niveau de la glène anatomique, caractérisé en ce que ledit élément support (4) présente, en débordement d'une face d'appui et de fixation (4a) avec la glène anatomique et à partir de son bord inférieur, un rebord (4b) constituant une portion de sphère apte à coopérer, d'une part, avec ladite tête (1) selon un même diamètre et, d'autre part, avec le pilier de l'omoplate.  -1- Glenoid prosthetic implant for the shoulder joint comprising a convex hinge head of the hemispherical type (1) for cooperating with a bearing and sliding surface that has a humeral implant fixed in the humeral shaft, said head (1) having fixing arrangements with an independent support member (4) adapted to be fixed at the level of the anatomical glenoid, characterized in that said support member (4) has, in overflow of a bearing face and fixation (4a) with the anatomical glenoid and from its lower edge, a flange (4b) constituting a portion of sphere adapted to cooperate, on the one hand, with said head (1) of the same diameter and, d ' on the other hand, with the pillar of the scapula. -2- Implant selon la revendication 1, caractérisé en ce que l'élément support (4) présente un plot d'ancrage (5) coopérant avec la glène anatomique.  -2- Implant according to claim 1, characterized in that the support member (4) has an anchor pad (5) cooperating with the anatomical glenoid. -3- Implant selon la revendication 1, caractérisé en ce que le plot d'ancrage (5) est sécable afin d'optimiser sa longueur au terrain osseux.  -3- Implant according to claim 1, characterized in that the anchor pad (5) is breakable to optimize its length to the bone. -4- Implant selon la revendication 1, caractérisé en ce que l'élément support (4) présente des trous (4g), (4h), (41) pour le passage de vis à corticale (6), (7) et (8) fixées dans la glène anatomique.  Implant according to claim 1, characterized in that the support element (4) has holes (4g), (4h), (41) for the passage of cortex screws (6), (7) and ( 8) fixed in the anatomical glenoid. -5- Implant selon la revendication 1, caractérisé en ce que la tête d'articulation (1) présente des agencements de fixation avec l'élément support glénoïdien (4).  Implant according to claim 1, characterized in that the articulation head (1) has fastening arrangements with the glenoid support element (4). -6- Implant selon la revendication 5, caractérisé en ce que les agencements sont constitués par des formes complémentaires composés d'un cône autobloquant (4i) et d'un filetage (4j) qui assure la compression et le blocage sur le cône (4i).  -6- Implant according to claim 5, characterized in that the arrangements are constituted by complementary shapes consisting of a self-locking cone (4i) and a thread (4j) which provides compression and blocking on the cone (4i ). -7- Implant selon la revendication 1, caractérisé en ce que les agencements sont constitués par une vis (9) traversant la tête d'articulation (1) et coopérant avec le trou de l'élément support glénoïdien (4) quand il est utilisé sans plot.  -7- Implant according to claim 1, characterized in that the arrangements consist of a screw (9) passing through the hinge head (1) and cooperating with the hole of the glenoid support element (4) when it is used without plot. -8- Implant selon la revendication 1, caractérisé en ce que les bords antérieur et postérieur du support (4) sont rectilignes, les bords supérieur et inférieur étant arrondis, le bord inférieur présentant une partie de sphère correspondant à celle de la tête (1) qu'il reçoit.  Implant according to claim 1, characterized in that the anterior and posterior edges of the support (4) are rectilinear, the upper and lower edges being rounded, the lower edge having a portion of sphere corresponding to that of the head (1). ) that he receives. -9- Implant selon la revendication 1, caractérisé en ce que la face d'appui (4a) du support (4) coopérant avec la glène anatomique est convexe afin d'épouser la forme concave de la glène anatomique et de pouvoir l'orienter dans l'espace selon des critères bio mécaniques.  -9- Implant according to claim 1, characterized in that the bearing surface (4a) of the support (4) cooperating with the anatomical glenoid is convex so as to follow the concave shape of the anatomic glenoid and to guide it in space according to bio mechanical criteria.
FR0509826A 2005-09-22 2005-09-22 PROTHETIC IMPLANT FOR THE ARTICULATION OF THE SHOULDER Expired - Fee Related FR2890853B1 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2960418A1 (en) * 2010-05-31 2011-12-02 Evolutis Glenoid assembly for shoulder prosthesis, has base plate provided with part for receiving anchoring rod and articulation element, where base plate is provided with another part with fixation arrangements in coracoid process
GB2492810A (en) * 2011-07-13 2013-01-16 Upper Limb Innovations Ltd Prosthesis head and base with offset attachment means
WO2013162999A1 (en) * 2012-04-23 2013-10-31 Zimmer, Inc. Glenoid implant

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2618065A1 (en) * 1987-07-15 1989-01-20 Bourgogne Universite TOTAL PROSTHESIS OF THE SHOULDER
FR2652498A1 (en) * 1989-10-04 1991-04-05 Medinov Modular assembly for a shoulder prosthesis
EP1064890A1 (en) * 1999-06-28 2001-01-03 Aston Medical Limited Prosthetic assembly for a shoulder joint
US20030158605A1 (en) * 2002-02-15 2003-08-21 Alain Tornier Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2618065A1 (en) * 1987-07-15 1989-01-20 Bourgogne Universite TOTAL PROSTHESIS OF THE SHOULDER
FR2652498A1 (en) * 1989-10-04 1991-04-05 Medinov Modular assembly for a shoulder prosthesis
EP1064890A1 (en) * 1999-06-28 2001-01-03 Aston Medical Limited Prosthetic assembly for a shoulder joint
US20030158605A1 (en) * 2002-02-15 2003-08-21 Alain Tornier Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2960418A1 (en) * 2010-05-31 2011-12-02 Evolutis Glenoid assembly for shoulder prosthesis, has base plate provided with part for receiving anchoring rod and articulation element, where base plate is provided with another part with fixation arrangements in coracoid process
GB2492810A (en) * 2011-07-13 2013-01-16 Upper Limb Innovations Ltd Prosthesis head and base with offset attachment means
WO2013162999A1 (en) * 2012-04-23 2013-10-31 Zimmer, Inc. Glenoid implant
US9066806B2 (en) 2012-04-23 2015-06-30 Zimmer, Inc. Glenoid implant
US9592128B2 (en) 2012-04-23 2017-03-14 Zimmer, Inc. Glenoid implant

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