FR2896985A1 - Above-knee prosthesis e.g. hip prosthesis, for femur, has femoral stem inserted in medullary cavity of femur and deflected with respect to socket to laterally expand socket against femur to block prosthesis - Google Patents

Above-knee prosthesis e.g. hip prosthesis, for femur, has femoral stem inserted in medullary cavity of femur and deflected with respect to socket to laterally expand socket against femur to block prosthesis Download PDF

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Publication number
FR2896985A1
FR2896985A1 FR0600977A FR0600977A FR2896985A1 FR 2896985 A1 FR2896985 A1 FR 2896985A1 FR 0600977 A FR0600977 A FR 0600977A FR 0600977 A FR0600977 A FR 0600977A FR 2896985 A1 FR2896985 A1 FR 2896985A1
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FR
France
Prior art keywords
femur
prosthesis
sheath
stem
prosthesis according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
FR0600977A
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French (fr)
Inventor
Marc Siguier
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Individual
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Individual
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Application filed by Individual filed Critical Individual
Priority to FR0600977A priority Critical patent/FR2896985A1/en
Publication of FR2896985A1 publication Critical patent/FR2896985A1/en
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • 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
    • A61F2/32—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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • 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
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    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
    • 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
    • A61F2002/30579—Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
    • 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
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • 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
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • A61F2002/30738—Sleeves
    • 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
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    • 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
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    • 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
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    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
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    • A—HUMAN NECESSITIES
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    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
    • A—HUMAN NECESSITIES
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    • 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
    • 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
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    • 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
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    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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    • 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

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

Abstract

The prosthesis has a femoral stem (1) inserted in a medullary cavity of a femur, and a socket (4) with a lateral groove. The socket has dimension, in rest position, lower than the dimension of a part of the stem corresponding to a metaphyseal part (6) of the femur to insert the stem in the socket till the part (6). The stem and the socket are housed in the cavity by axial penetration of the stem towards the bottom of the cavity of the femur. The stem is deflected with respect to the socket to laterally expand the socket against the femur to block the prosthesis.

Description

10 La présente invention concerne une prothèse fémorale. Elle s'appliqueThe present invention relates to a femoral prosthesis. It applies

plus particulièrement, mais non exclusivement, à la pose sans ciment d'une prothèse de hanche.  more particularly, but not exclusively, to the cementless installation of a hip prosthesis.

De façon générale, l'altération de l'articulation de la hanche a plusieurs 15 causes telles que l'usure du cartilage, de l'arthrose, une maladie rhumatismale, une nécrose...  In general, alteration of the hip joint has several causes such as cartilage wear, osteoarthritis, rheumatic disease, necrosis ...

Cette altération peut entraîner des douleurs d'intensité croissante, de localisation diverse et un enraidissement. Une prothèse de hanche est un remède à cette altération.  This alteration can lead to pain of increasing intensity, various localization and stiffness. A hip prosthesis is a cure for this alteration.

L'articulation de la hanche est composée de deux parties : le cotyle, partie articulaire du bassin et l'extrémité supérieure du fémur, la tête et le col. 25 Ce sont ces parties qui sont remplacées lors de la pose d'une prothèse de hanche respectivement d'une part par une cupule présentant extérieurement une surface globalement hémisphérique et intérieurement un logement concave et, d'autre part, par une bille fémorale et une tige.  The hip joint is composed of two parts: the acetabulum, articular part of the pelvis and the upper end of the femur, the head and the cervix. 25 It is these parts that are replaced during the installation of a hip prosthesis respectively on the one hand by a cup having externally a globally hemispherical surface and internally a concave housing and, on the other hand, by a femoral ball and a rod.

30 Il existe deux grandes techniques de fixation de telles prothèses : au moyen d'un ciment chirurgical tel qu'un polymère acrylique, par impact axial, enfoncement à frottement dur et stabilisation par pression de maintien puis repousse osseuse secondaire, la zone de contact entre l'os et la prothèse étant traités à cet effet. 1 20 Préalablement à la mise en place d'une prothèse dans un fémur, le chirurgien doit préparer le canal médullaire de ce fémur de façon à lui donner une forme complémentaire de celle de la prothèse.  There are two main techniques for fixing such prostheses: by means of a surgical cement such as an acrylic polymer, by axial impact, hard-rubbing depression and stabilization by holding pressure and then secondary bone regrowth, the contact zone between the bone and the prosthesis being treated for this purpose. Before placing a prosthesis in a femur, the surgeon must prepare the medullary canal of this femur so as to give it a shape complementary to that of the prosthesis.

Ensuite, la tige fémorale est introduite dans le canal médullaire du fémur et le maintien est assuré par impact axial vers le fond de la cavité et frottement dur. Cependant, la cohésion entre la tige fémorale et le fémur peut s'avérer 10 insuffisante.  Then, the femoral stem is introduced into the medullary canal of the femur and the maintenance is ensured by axial impact towards the bottom of the cavity and hard friction. However, the cohesion between the femoral stem and the femur may be insufficient.

L'invention a pour objet de résoudre ces inconvénients en proposant une prothèse qui permet d'exercer une pression de maintien à la fois axiale et latérale sans perte osseuse supplémentaire. 15 A cet effet, elle propose une prothèse fémorale comportant deux parties : une tige fémorale s'insérant dans le canal médullaire du fémur et surmonté d'un col prothétique et d'une tête sphérique fémorale, un fourreau comportant une fente latérale, fourreau dont les 20 dimensions en position repos, c'est-à-dire sans exercer de force en vue d'augmenter ou diminuer la fente, sont sensiblement inférieures aux dimensions de la partie de la tige correspondant à la partie métaphysaire du fémur de façon à insérer la tige dans le fourreau jusqu'à la partie métaphysaire, 25 l'ensemble tige/fourreau étant logé dans le canal médullaire par pénétration axiale de la tige vers le fond du canal médullaire du fémur, le fourreau est stoppé au niveau de la partie métaphysaire et un enfoncement supplémentaire de la tige par rapport au fourreau entraîne une expansion latérale du fourreau contre le fémur afin de bloquer la prothèse. 30 La section de la tige présente une forme sensiblement oblongue dont les dimensions vont en diminuant vers l'extrémité de la tige. -3- Selon une variante, le fourreau pourra comporter une partie repoussée délimitant une concavité qui, lors de l'expansion latérale, se déplie pour devenir convexe et se placer dans la continuité de forme du fourreau et entrer ainsi en contact avec l'os. La face extérieure de la tige pourra comporter des crans.  The object of the invention is to overcome these disadvantages by proposing a prosthesis which makes it possible to exert an axial and lateral holding pressure without additional bone loss. To this end, it proposes a femoral prosthesis comprising two parts: a femoral stem inserted in the medullary canal of the femur and surmounted by a prosthetic neck and a femoral spherical head, a sheath having a lateral slit, a sheath of which the dimensions in the rest position, that is to say without exerting force in order to increase or decrease the slit, are substantially smaller than the dimensions of the part of the stem corresponding to the metaphyseal part of the femur so as to insert the stem in the sheath to the metaphyseal part, the rod / sheath assembly being housed in the medullary canal by axial penetration of the rod towards the bottom of the medullary canal of the femur, the sheath is stopped at the metaphyseal part and further depression of the shaft relative to the sheath results in lateral expansion of the sheath against the femur to block the prosthesis. The section of the stem has a substantially oblong shape, the dimensions of which diminish towards the end of the stem. According to one variant, the sheath may comprise a repulsed part delimiting a concavity which, during the lateral expansion, unfolds to become convex and is placed in the continuity of shape of the sheath and thus come into contact with the bone. . The outer face of the rod may comprise notches.

La face intérieure du fourreau pourra comporter des crans complémentaires ou non de crans situés sur la face extérieure de ladite tige. 10 Les matériaux utilisés pour la tige fémorale et le fourreau pourront être identiques ou différents. La tige fémorale pourra être essentiellement métallique ou non. Le fourreau fendu pourra être essentiellement métallique ou non. 15 Les métaux utilisés pourront être par exemple de l'acier inoxydable, du titane.  The inner face of the sleeve may comprise complementary notches or not notches located on the outer face of said rod. The materials used for the femoral stem and the sheath may be the same or different. The femoral stem may be essentially metallic or not. The split sheath may be essentially metallic or not. The metals used may be, for example, stainless steel or titanium.

La prothèse selon l'invention pourra être au moins partiellement recouverte d'un matériau adapté tel que de l'hydroxyapatite et/ou présenter un état de 20 surface permettant une construction par repousse osseuse (ostéoinduction).  The prosthesis according to the invention may be at least partially covered with a suitable material such as hydroxyapatite and / or have a surface state allowing a construction by bone regrowth (osteoinduction).

Des modes d'exécution de l'invention seront décrits ci-après, à titre d'exemples non limitatifs, avec référence aux dessins annexés dans lesquels :  Embodiments of the invention will be described below, by way of non-limiting examples, with reference to the accompanying drawings in which:

La figure 1 est une vue dans le plan frontale d'une prothèse selon l'invention ;  Figure 1 is a view in the front plane of a prosthesis according to the invention;

La figure 2 est une coupe transversale de la figurel ;  Figure 2 is a cross section of the figurel;

La figure 3 est une coupe transversale d'une deuxième prothèse selon l'invention. 25 30 -4- L'exemple de prothèse P illustré sur les figures 1 et 2 comprend deux parties une tige fémorale 1 en acier inoxydable s'insérant dans le canal médullaire du fémur et surmonté d'un col prothétique 2 et d'une tête sphérique fémorale 3, un fourreau 4 en acier inoxydable comportant une fente latérale 5, fourreau dont les dimensions en position repos, c'est-à-dire sans exercer de force en vue d'augmenter ou diminuer la fente, sont sensiblement inférieures aux dimensions de la partie de la tige 1 correspondant à la partie métaphysaire 6 du fémur de façon à insérer la tige dans le fourreau jusqu'à la partie métaphysaire.  Figure 3 is a cross section of a second prosthesis according to the invention. The prosthesis example P illustrated in FIGS. 1 and 2 comprises two parts a stainless steel femoral stem 1 inserted in the medullary canal of the femur and surmounted by a prosthetic neck 2 and a head. spherical femoral 3, a sleeve 4 of stainless steel having a lateral slot 5, sleeve whose dimensions in the rest position, that is to say without exerting force to increase or decrease the slot, are substantially smaller than the dimensions part of the stem 1 corresponding to the metaphyseal part 6 of the femur so as to insert the rod in the sheath to the metaphyseal part.

Le fourreau 4 présente une section sensiblement oblongue, son extrémité supérieure située vers le haut de la tige présente une ouverture avec une découpe en biais 7 par rapport l'axe longitudinal du fourreau 4 et son extrémité inférieure située vers le bas de la tige présente une ouverture 8 avec une découpe perpendiculaire à l'axe longitudinal du fourreau 4. La fente 5 est située à un des deux rétrécissements dudit fourreau 4. Il est à noter que les découpes supérieure et inférieure pourront être de tout 20 autre forme adaptée.  The sheath 4 has a substantially oblong section, its upper end located towards the top of the rod has an opening with an oblique cutout 7 with respect to the longitudinal axis of the sheath 4 and its lower end located towards the bottom of the rod has a opening 8 with a cut perpendicular to the longitudinal axis of the sleeve 4. The slot 5 is located at one of the two narrowing of said sleeve 4. It should be noted that the upper and lower cutouts may be of any other suitable form.

La tige 1 sur laquelle est montée sans forcer le fourreau 4 est insérée dans le canal médullaire du fémur.  The rod 1 on which is mounted without forcing the sleeve 4 is inserted into the medullary canal of the femur.

25 L'impact de la tige 1 selon la flèche A dans le canal médullaire entraîne un coulissement entre la tige et le fourreau et ainsi une expansion latérale du fourreau 4 selon les flèches B par ouverture de la fente 5.  The impact of the stem 1 along the arrow A in the medullary canal causes a sliding between the rod and the sheath and thus a lateral expansion of the sheath 4 according to the arrows B by opening the slot 5.

La figure 3 illustre un fourreau 9 comportant à l'opposé d'une fente 10 une 30 partie repoussée 11 délimitant une concavité.  FIG. 3 illustrates a sheath 9 comprising, opposite a slot 10, a pushed-out portion 11 delimiting a concavity.

Ainsi, lors de l'impact de la tige 1, outre l'expansion latérale déjà décrite dans l'exemple précédent, la partie repoussée 11 se déplie pour devenir convexe -5- et se placer dans la continuité de forme du fourreau selon les pointillés 12 et vient au contact de l'os en exerçant une pression selon les flèches C et D.  Thus, during the impact of the rod 1, in addition to the lateral expansion already described in the previous example, the repelled portion 11 unfolds to become convex -5- and to be in the continuity of shape of the sleeve according to the dotted line 12 and comes into contact with the bone by exerting a pressure according to the arrows C and D.

L'invention ne se limite pas aux exemples précédemment décrits.  The invention is not limited to the examples described above.

En effet, des modifications diverses peuvent être envisagées sans pour autant sortir du cadre de l'invention.  Indeed, various modifications can be envisaged without departing from the scope of the invention.

Claims (9)

Revendicationsclaims 1. Prothèse fémorale, caractérisée en ce qu'elle comporte deux parties : une tige fémorale (1) s'insérant dans le canal médullaire du fémur et surmonté d'un col prothétique (2) et d'une tête sphérique fémorale (3), un fourreau (4) comportant une fente latérale (5), fourreau dont les dimensions en position repos, c'est-à-dire sans exercer de force en vue d'augmenter ou diminuer la fente, sont sensiblement inférieures aux dimensions de la partie de la tige (1) correspondant à la partie métaphysaire (6) du fémur de façon à insérer la tige dans le fourreau jusqu'à la partie métaphysaire, l'ensemble tige (1) /fourreau (4) étant logé dans le canal médullaire par pénétration axiale de la tige (1) vers le fond du canal médullaire du fémur, le fourreau (4) est stoppé au niveau de la partie métaphysaire (6) et un enfoncement supplémentaire de la tige (1) par rapport au fourreau (4) entraîne une expansion latérale (B, C) du fourreau (4) contre le fémur afin de bloquer la prothèse.  1. Femoral prosthesis, characterized in that it comprises two parts: a femoral stem (1) fitting into the medullary canal of the femur and surmounted by a prosthetic neck (2) and a femoral spherical head (3) , a sheath (4) having a lateral slot (5), sleeve whose dimensions in the rest position, that is to say without exerting force to increase or decrease the slot, are substantially smaller than the dimensions of the part of the stem (1) corresponding to the metaphyseal part (6) of the femur so as to insert the rod in the sleeve to the metaphyseal part, the rod assembly (1) / sleeve (4) being housed in the channel medullary by axial penetration of the stem (1) towards the bottom of the medullary canal of the femur, the sheath (4) is stopped at the metaphyseal part (6) and an additional depression of the stem (1) relative to the sheath ( 4) causes a lateral expansion (B, C) of the sheath (4) against the femur in order to block the prosthesis. 2. Prothèse selon la revendication 1, caractérisée en ce que le fourreau (4) comporte une partie repoussée (11) délimitant une concavité qui, lors de l'expansion latérale, se déplie pour devenir convexe et se placer dans la continuité de forme du fourreau et entrer ainsi en contact avec l'os.  2. Prosthesis according to claim 1, characterized in that the sheath (4) comprises a recessed portion (11) defining a concavity which, during the lateral expansion, unfolds to become convex and place itself in the continuity of shape of the sheath and thus come in contact with the bone. 3. Prothèse selon la revendication 1, caractérisée en ce que la face extérieure de la tige comporte des crans.  3. Prosthesis according to claim 1, characterized in that the outer face of the rod comprises notches. 4. Prothèse selon la revendication 1, 30 caractérisée en ce que la face intérieure du fourreau comporte des crans, complémentaires ou non, de crans situés sur la face extérieure de ladite tige.  4. Prosthesis according to claim 1, characterized in that the inner face of the sleeve comprises notches, complementary or not, notches located on the outer face of said rod. 5. Prothèse selon la revendication 1, caractérisée en ce que la tige fémorale (1) et le fourreau (4) sont métalliques. 6  5. Prosthesis according to claim 1, characterized in that the femoral stem (1) and the sheath (4) are metallic. 6 6. Prothèse selon la revendication 1, caractérisée en ce que la tige fémorale (1) et/ou le fourreau (4) sont métalliques.  6. Prosthesis according to claim 1, characterized in that the femoral stem (1) and / or the sheath (4) are metallic. 7. Prothèse selon la revendication 1, caractérisée en ce que la tige fémorale (1) et/ou le fourreau (4) ne sont pas métalliques. 10  7. Prosthesis according to claim 1, characterized in that the femoral stem (1) and / or the sheath (4) are not metallic. 10 8. Prothèse selon la revendication 1, caractérisée en ce qu'elle est au moins partiellement recouverte d'un matériau adapté permettant une construction par repousse osseuse (ostéoinduction). 15  8. Prosthesis according to claim 1, characterized in that it is at least partially covered with a suitable material for a construction by bone regrowth (osteoinduction). 15 9. Prothèse selon la revendication 1, caractérisée en ce qu'elle est présente un état de surface permettant une construction par repousse osseuse (ostéoinduction).5  9. Prosthesis according to claim 1, characterized in that it is present a surface state allowing a construction by bone regrowth (osteoinduction).
FR0600977A 2006-02-03 2006-02-03 Above-knee prosthesis e.g. hip prosthesis, for femur, has femoral stem inserted in medullary cavity of femur and deflected with respect to socket to laterally expand socket against femur to block prosthesis Pending FR2896985A1 (en)

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FR0600977A FR2896985A1 (en) 2006-02-03 2006-02-03 Above-knee prosthesis e.g. hip prosthesis, for femur, has femoral stem inserted in medullary cavity of femur and deflected with respect to socket to laterally expand socket against femur to block prosthesis

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FR0600977A FR2896985A1 (en) 2006-02-03 2006-02-03 Above-knee prosthesis e.g. hip prosthesis, for femur, has femoral stem inserted in medullary cavity of femur and deflected with respect to socket to laterally expand socket against femur to block prosthesis

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2883519A1 (en) * 2013-12-10 2015-06-17 Krankenhaus Buchholz und Winsen gemeinnützige GmbH Prosthesis for the upper humerus
CN115645119A (en) * 2022-12-12 2023-01-31 兰州西脉记忆合金股份有限公司 Hip joint prosthesis memory alloy femoral stem component system and using method thereof

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EP0273871A1 (en) * 1986-12-02 1988-07-06 G. CREMASCOLI S.p.A. A femoral neck hip prosthesis
FR2703583A1 (en) * 1993-04-07 1994-10-14 Medinov Sa Femoral implant for hip prosthesis
US5766262A (en) * 1996-03-29 1998-06-16 Mikhail; W. E. Michael Femoral prosthesis with spacer
EP0985387A1 (en) * 1998-09-10 2000-03-15 Plus Endoprothetik Ag Kit for implanting a cementable endoprosthesis
EP1043000A1 (en) * 1999-04-09 2000-10-11 Plus Endoprothetik Ag Positioning element for a part of an endoprosthese and part of an endoprosthese with one or more of positioning elements
WO2002034171A2 (en) * 2000-10-25 2002-05-02 Sdgi Holdings, Inc. Laterally expanding intervertebral fusion device
FR2867381A1 (en) * 2004-03-10 2005-09-16 Buttet Michel De Femoral stem for hip prosthesis, has metaphyseal part receiving attachments for bone replacement in fixed manner, where each attachment constitutes horizontal support on cut bone realized at variable height based on fracture features

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Publication number Priority date Publication date Assignee Title
EP0257222A1 (en) * 1986-08-09 1988-03-02 S + G Implants Gmbh Shank for a joint prosthesis
EP0273871A1 (en) * 1986-12-02 1988-07-06 G. CREMASCOLI S.p.A. A femoral neck hip prosthesis
FR2703583A1 (en) * 1993-04-07 1994-10-14 Medinov Sa Femoral implant for hip prosthesis
US5766262A (en) * 1996-03-29 1998-06-16 Mikhail; W. E. Michael Femoral prosthesis with spacer
EP0985387A1 (en) * 1998-09-10 2000-03-15 Plus Endoprothetik Ag Kit for implanting a cementable endoprosthesis
EP1043000A1 (en) * 1999-04-09 2000-10-11 Plus Endoprothetik Ag Positioning element for a part of an endoprosthese and part of an endoprosthese with one or more of positioning elements
WO2002034171A2 (en) * 2000-10-25 2002-05-02 Sdgi Holdings, Inc. Laterally expanding intervertebral fusion device
FR2867381A1 (en) * 2004-03-10 2005-09-16 Buttet Michel De Femoral stem for hip prosthesis, has metaphyseal part receiving attachments for bone replacement in fixed manner, where each attachment constitutes horizontal support on cut bone realized at variable height based on fracture features

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2883519A1 (en) * 2013-12-10 2015-06-17 Krankenhaus Buchholz und Winsen gemeinnützige GmbH Prosthesis for the upper humerus
CN115645119A (en) * 2022-12-12 2023-01-31 兰州西脉记忆合金股份有限公司 Hip joint prosthesis memory alloy femoral stem component system and using method thereof

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