GB2318296A - Femoral hip prosthesis to fit the medullary canal - Google Patents

Femoral hip prosthesis to fit the medullary canal Download PDF

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Publication number
GB2318296A
GB2318296A GB9621794A GB9621794A GB2318296A GB 2318296 A GB2318296 A GB 2318296A GB 9621794 A GB9621794 A GB 9621794A GB 9621794 A GB9621794 A GB 9621794A GB 2318296 A GB2318296 A GB 2318296A
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GB
United Kingdom
Prior art keywords
stem
artificial hip
proximal portion
hip according
zone
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.)
Granted
Application number
GB9621794A
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GB9621794D0 (en
GB2318296B (en
Inventor
Lee Taylor
Steffen Breusch
Jacques Bejui
Witte Gerard De
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Merck Biomaterial UK Ltd
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Merck Biomaterial UK Ltd
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Publication date
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Priority to GB9621794A priority Critical patent/GB2318296B/en
Publication of GB9621794D0 publication Critical patent/GB9621794D0/en
Publication of GB2318296A publication Critical patent/GB2318296A/en
Application granted granted Critical
Publication of GB2318296B publication Critical patent/GB2318296B/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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    • 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
    • A61F2/367—Proximal or metaphyseal parts of shafts
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30708—Means for distinguishing between left-sided and right-sided devices, Sets comprising both left-sided and right-sided prosthetic parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
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    • A61F2002/365—Connections of heads to necks
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/3678—Geometrical features
    • A61F2002/3698—Geometrical features twisted about the longitudinal axis of the shaft
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
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    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
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    • A61F2310/00179—Ceramics or ceramic-like structures

Abstract

A smooth one piece femoral stem 1 which has a substantially anatomical profile and a prosthetic neck 2. The stem 1 has a proximal zone 6 which has a degree of pre-stressing and a spiral rotation profile, thereby defining right and left femoral stems depending on the angle of pre-stressing. The distal portion of the stem 5 has a symmetry of revolution and a substantially circular cross-section allowing the stem to be inserted centrally into the medullary duct of the femur. This allows for a more uniform distribution of cement around the stem 1 which gives increased strength and limits the formation of microdelaminations.

Description

ARTIFICIAL HIP The invention relates to an improved artificial hip.
In a known way an artificial hip fundamentally comprises a femoral stem intended to be inserted and anchored in the medullary canal of the femur of the hip joint to be replaced, and a neck surmounted by a head forming an integral part of the stem and intended to operate in conjunction with frictional core usually made of polyethylene, and itself received in the cotyloidal cavity of the said hip, at the level of which there is initially placed a cotyle of a corresponding suitable shape.
One of the major problems encountered by practitioners within the field of placing such replacements, resides in the type of anchoring of the femoral stem in the medullary duct of the femur. In effect, different approaches have been taken in order to ensure effective fixing of the stem within the femur.
One of these consists in equipping the stem with an external threading, and inserting the latter by forcescrewing into the medullary duct of the femur, the threads biting into the internal cortical is of the femur. Apart from the disadvantages connected with the risks of potential unscrewing of the stem, there is likewise encountered an important difficulty arising from embrittlement of the cortical is under the action of the stresses exerted during the various efforts made by the patient, an embrittlement which will lead either to fracture of the bone, which is capable of causing serious damage, or a certain play of the stem within the medullary duct, which is reflected in considerable pain for the patient. There has also been observed pain inherent in the stress peaks at the level of the threads of the threaded portion of the stem.
Another approach consists in sealing the stem within the medullary ducts by means of an appropriate cement. However with this technique also micro-delaminations of the stem are observed notwithstanding the quality of the cements used or the surface coverings of the stem, these also causing pain and discomfort for the patient and in the long term ending in removal of the stem from the medullary duct of the femur.
The invention relates to an artificial hip of the type in which the stem is anchored by means of cement.
More specifically it relates to an artificial hip of the anatomical type, whose profile is such that it permits better anchorage of the stem within the medullary duct, particularly on the one hand by the special profile of the latter and on the other hand by undersizing the stem relative to the size of the replacement usually put in place.
This artificial hip comprises a femoral stem intended to be anchored in the femur to be fitted, and a prosthetic neck whose end carries a head intended to operate in conjunction with a frictional core, itself accommodated in the cotyloidal cavity of the hip joint concerned.
it is characterised: - in that the distal portion of the stem has a symmetry of revolution; -the proximal portion of the stem has a degree of prestressing; - in that the said proximal portion adopts a spirally rotated profile by partial rotation of the said portions on itself.
In other terms, the fact of associating a substantially anatomical profile with the stem, while at the same time giving it at its distal portion a symmetry of revolution of dimensions less than those of prostheses normally put in place, enables better anchorage of the latter within the femur, obtaining better centering of the stem within the medullary duct and as a corollary, enabling a larger quantity of cement to be used, which is more regularly distributed about the said stem and yet eliminating or in any case severely reducing the microdelaminations which are normally encountered with prostheses of this type.
In addition, in view of the spiral rotation and initial pre-stressing imparted to the stem, in this way there is defined a right femoral stem and a left femoral stem as a function of the site of implantation of the prosthesis being considered.
Advantageously, the radius of curvature of the internal face of the stem is in the vicinity of 1400 mm.
According to another feature of the invention, the cervico-diaphysary angle is 1330.
In addition, the spiral rotation of the proximal portion has an angle of 80 at the level of the epiphisary zone of the stem relative to the orientation of the said portion at the level of the metaphysodiaphysary zone.
In addition, the one-piece stem is made of stainless steel and is perfectly smooth and polished so that all risk of micro-abrasion between cement and the implant is avoided.
In addition, the stem has, upstream of the prosthetic neck, a narrowed portion in order to reduce any potential angular movements of the said stem.
The way in which the invention may be realised and the advantages which flow therefrom will become more apparent from the embodiment given by way of example which follows, and which is given as an indicative and non-limiting example with reference to the annexed Figures.
Figure 1 is a diagrammatic perspective view of the prosthesis according to the invention, seen from the rear.
Figure 2 is a partial perspective view of the lateral face.
Figure 3 is a view similar to Figure 1 but seen from the anterior face.
Figure 4 is a diagrammatic view from above showing in particular the spiral rotation of the stem and of the proximal portion of the stem.
Figure 5 is a diagrammatic perspective view of the prosthetic neck and of the upper end of the stem.
Figures 1 and 3 show diagrammatically in perspective the femoral stem (1) of the prosthesis according to the invention respectively in rear and front views. This stem (1) is extended at its proximal end by a prosthetic neck (2) intended to pass out of the femur to be fitted, and having support (3) in a truncated conical shape (morse taper) intended to accommodate by sleeving a sphere (not shown) upon which there is supported the cotyloidal cup or frictional core. This sphere is advantageously made of stainless steel or ceramics.
Even now it can be observed that the proximal zone (6) of this stem has a degree of pre-stressing directed to the left on Figure 1 and to the right in Figure 3, in order to impart to the latter its anatomical character in order to correspond to the pre-stressing of the femur.
Otherwise there is observed in Figures 1, 2 and 3 a fundamental characteristic of the invention according to which the distal portion (5) of the stem has a symmetry of revolution and particular, in that its transverse cross-section is substantially circular.
This feature allows the said stem to be inserted in a particularly centred manner within the medullary duct of the femur to be fitted and, as already stated, permits a more uniform distribution of the cement about the said stem in order to reinforce its sealing and particularly in order to eliminate microdelaminations.
As already stated, the stem according to the invention is undersized, in the sense that for a considered size of prosthesis, the size of the stem proper (1) is lower by one size, in order to permit positioning of a larger quantity of cement within the medullary duct during positioning of the prosthesis. In this way anchorage of the stem (1) within the femur is optimised without altering the mechanical strength of the implant, the material of which it consists being stainless steel.
According to another fundamental feature of the invention, and as can be particularly well seen in Figure 4, the proximal portion (6) of the stem (1) has a spiral rotation, i.e. rotation of the said stem on itself, this spiral rotation originating from the metaphysodiaphysary zone in order to extend as far as the epiphysary zone, and having at this level a maximum angle of spiral rotation of 80 relative to the orientation of the stem at the level of the metaphysodiaphysary zone.
In other terms orientation of the prosthetic neck (2) relative to the general orientation of the stem at the metaphysodiaphysary level likewise has an angle of 80, as the neck is of course aligned with the epiphysary end of the stem.
In effect, Figure 4 shows the annular variation of the large axis of the constituting ellipse of the transverse sections of the proximal portion (6) of the stem.
This double pre-stressing and spiral rotation movement imposed on the proximal portion of the stem imparts to the latter its anatomic character enabling limitation if not abolition of post-operative pain.
According to another feature of the invention, the neck has on either side at the level of its connecting zone with the proximal end of the stem, a narrowed portion (4) as can be seen in Figures 2, 3 and 5, more particularly intended to limit the potential angular movement of the said stem once it is in place.
According to another feature of the invention, the cervico-diaphysary angle is in the region of 1330, and the radius of curvature of the anterior zone is 1400 mm.
According to another feature of the invention the said stem, made in one-piece stainless steel, undergoes a smoothing and polishing treatment in order to have a perfectly homogeneous and smooth surface in order to avoid all risk of later micro-abrasion between the cement and the implant, and also to avoid all risk of delamination.

Claims (6)

1. Artificial joint comprising a femoral stem (1) intended to be anchored in the femur to be fitted, and a prosthetic neck (2) the end of which accommodates a head intended to operate in conjunction with a frictional core itself accommodated in the cotyloidal cavity of the joint of the hip concerned, characterised in that - the distal portion (5) of the stem (1) has a symmetry of revolution; - the proximal portion (6) of the stem has a degree of pre-stressing; - and in that the said proximal portion (6) adopts a spirally rotated profile by partial rotation of the said portion on itself.
2. Artificial hip according to claim 1, characterised in that the radius of curvature of the anterior face of the stem (1) is in the vicinity of one thousand four hundred (1, 400) mm.
3. Artificial hip according to one of claims 1 and 2, characterised in that the cervico-diaphysary angle of the stem (1) is 1330.
4. Artificial hip according to one of claims 1 to 3, characterised in that the end of the proximal portion (6) of the stem (1) forms an angle of 80 relative to the orientation of the said portion at the level of the metaphysodiaphysary zone.
5. Artificial hip according to one of claims 1 to 4, characterised in that the stem (1, 2) is one-piece in form, and in that it is made of stainless steel, and in that it is perfectly smooth and polished in order to eliminate any risk of micro-abrasion between the cement and the implant.
6. Artificial hip according to one of claims 1 to 5, characterised in that the stem (1) has, at the level of the zone of connection of the prosthetic neck (2) with the stem (1), a narrowed portion (4) in order to reduce the potential angular movements of the said stem.
Amendments to the claims have been filed as follows 1 Artificial joint comprising a femoral stem (1) intended to be anchored in the femur to be fitted, and a prosthetic neck (2) the end of which accommodates a head intended to operate in conjunction with a frictional core itself accommodated in the cotyloidal cavity of the joint of the hip concerned, characterised in that: - the distal portion (5) of the stem (1) has a symmetry of revolution; - the proximal portion (6) of the stem has a degree of pre-stressing; - and in that the said proximal portion (6) adopts a spirally rotated profile by partial rotation of the said portion on itself; and - the stem (1) has, at the level of the zone of connection of the prosthetic neck (2) with the stem (1), a narrowed portion (4) in order to reduce the potential angular movements of said stem.
2 Artificial hip according to claim 1, characterised in that the radius of curvature of the anterior face of the stem (1) is in the vicinity of one thousand four hundred (1,400) mm.
3 Artificial hip according to one of claims 1 and 2, characterised in that the cervico-diaphysary angle of the stem (1) is 133".
4 Artificial hip according to one of claims 1 to 3, characterised in that the end of the proximal portion (6) of the stem (1) forms an angle of 80 relative to the orientation of the said portion at the level of the metaphysodiaphysary zone.
5 Artificial hip according to one of claims 1 to 4, characterised in that the stem (1, 2) is one-piece in form, and in that it is made of stainless steel, and in that it is perfectly smooth and polished in order to eliminate any risk of micro abrasion between the cement and the implant.
GB9621794A 1996-10-18 1996-10-18 Improved artificial hip Expired - Fee Related GB2318296B (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2839641A1 (en) * 2002-05-17 2003-11-21 Jean Claude Cartillier Fe mural component of hip prosthesis has truncated conical tip on neck with oblong or rectangular cross-section

Citations (9)

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Publication number Priority date Publication date Assignee Title
EP0128036A1 (en) * 1983-06-06 1984-12-12 Pfizer Hospital Products Group, Inc. Femoral hip prosthesis
WO1987000033A1 (en) * 1985-07-10 1987-01-15 Orthomatrix, Inc. Femoral-joint prosthetic device
WO1987004916A1 (en) * 1986-02-19 1987-08-27 Harrington Arthritis Research Center Beam construction and method
US4938771A (en) * 1987-09-17 1990-07-03 Vilmos Vecsei Femoral portion of a hip joint prosthesis
WO1991018560A1 (en) * 1990-06-07 1991-12-12 Denis Godeau Hip prosthesis
EP0584892A2 (en) * 1987-11-03 1994-03-02 Orthopaedic Technology B.V. A method of shaping an endo-prosthesis, a femoral head prosthesis, an acetabulum prosthesis and a method of fixing a femoral head prosthesis in a bone
WO1994008534A1 (en) * 1992-10-12 1994-04-28 Klaus Draenert Pin of a femur component of a hip-joint endoprosthesis
EP0695540A1 (en) * 1994-08-02 1996-02-07 Merck Biomaterial France Hip prothesis
WO1996004868A1 (en) * 1994-08-12 1996-02-22 Advanced Technical Fabrication Hip prosthesis

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0128036A1 (en) * 1983-06-06 1984-12-12 Pfizer Hospital Products Group, Inc. Femoral hip prosthesis
WO1987000033A1 (en) * 1985-07-10 1987-01-15 Orthomatrix, Inc. Femoral-joint prosthetic device
WO1987004916A1 (en) * 1986-02-19 1987-08-27 Harrington Arthritis Research Center Beam construction and method
US4938771A (en) * 1987-09-17 1990-07-03 Vilmos Vecsei Femoral portion of a hip joint prosthesis
EP0584892A2 (en) * 1987-11-03 1994-03-02 Orthopaedic Technology B.V. A method of shaping an endo-prosthesis, a femoral head prosthesis, an acetabulum prosthesis and a method of fixing a femoral head prosthesis in a bone
WO1991018560A1 (en) * 1990-06-07 1991-12-12 Denis Godeau Hip prosthesis
WO1994008534A1 (en) * 1992-10-12 1994-04-28 Klaus Draenert Pin of a femur component of a hip-joint endoprosthesis
EP0695540A1 (en) * 1994-08-02 1996-02-07 Merck Biomaterial France Hip prothesis
WO1996004868A1 (en) * 1994-08-12 1996-02-22 Advanced Technical Fabrication Hip prosthesis

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2839641A1 (en) * 2002-05-17 2003-11-21 Jean Claude Cartillier Fe mural component of hip prosthesis has truncated conical tip on neck with oblong or rectangular cross-section

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GB2318296B (en) 2000-04-19

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