ITMI982599A1 - Cotile da revisione per impiego nel trattamento di patologie dll'anca - Google Patents
Cotile da revisione per impiego nel trattamento di patologie dll'anca Download PDFInfo
- Publication number
- ITMI982599A1 ITMI982599A1 IT1998MI002599A ITMI982599A ITMI982599A1 IT MI982599 A1 ITMI982599 A1 IT MI982599A1 IT 1998MI002599 A IT1998MI002599 A IT 1998MI002599A IT MI982599 A ITMI982599 A IT MI982599A IT MI982599 A1 ITMI982599 A1 IT MI982599A1
- Authority
- IT
- Italy
- Prior art keywords
- revision
- cup according
- shell
- insert
- edge
- Prior art date
Links
- XGWFJBFNAQHLEF-UHFFFAOYSA-N 9-anthroic acid Chemical compound C1=CC=C2C(C(=O)O)=C(C=CC=C3)C3=CC2=C1 XGWFJBFNAQHLEF-UHFFFAOYSA-N 0.000 title 1
- 210000000988 bone and bone Anatomy 0.000 claims description 10
- 210000001624 hip Anatomy 0.000 claims description 9
- 230000007170 pathology Effects 0.000 claims description 9
- 210000004197 pelvis Anatomy 0.000 claims description 8
- 239000004698 Polyethylene Substances 0.000 claims description 6
- 238000004873 anchoring Methods 0.000 claims description 6
- -1 polyethylene Polymers 0.000 claims description 6
- 229920000573 polyethylene Polymers 0.000 claims description 6
- 239000000919 ceramic Substances 0.000 claims description 5
- 238000003780 insertion Methods 0.000 claims description 3
- 230000037431 insertion Effects 0.000 claims description 3
- 239000007769 metal material Substances 0.000 claims description 3
- 210000000689 upper leg Anatomy 0.000 claims description 2
- 125000000913 palmityl group Chemical group [H]C([*])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])[H] 0.000 claims 2
- 230000005012 migration Effects 0.000 description 5
- 238000013508 migration Methods 0.000 description 5
- 239000007943 implant Substances 0.000 description 4
- 239000000463 material Substances 0.000 description 4
- 210000000588 acetabulum Anatomy 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 239000002184 metal Substances 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 238000011882 arthroplasty Methods 0.000 description 1
- 239000004568 cement Substances 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000002860 competitive effect Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
Classifications
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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Landscapes
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Description
DESCRIZIONE
Il presente trovato riguarda un cotile da revisione per il trattamento di patologie dell'anca. Più particolarmente, il trovato riguarda un cotile da revisione di forma migliorata ed avente una funzionalità resa ot-
Come è noto, nelle diverse patologie dell’anca spesso si è costretti ad impiegare artroprotesi. Queste sono generalmente costituite da uno stelo che viene posizionato nel canale femorale, da un cotile che viene posizionato nella cavità acetabolare del bacino, e da una testina sferica che viene posizionata sulla sommità dello stelo e che va ad articolarsi entro la superficie interna del cotile protesico permettendo così il ripristino funzionale dell'articolazione dell'anca.
I cotili sono generalmente di forma emisferica e sono realizz materiali diversi.
Si possono distinguere due tipi di cotili: cementati e non c me tati I primi sono realizzati in polietilene con la superficie ester provvista di scanalature per l'ancoraggio del cemento. I secondi sono invece realizzati in due componenti: un guscio esterno in materiale metallico che va a contatto con l'osso, ed un componente interno, o inserto, che può essere in polietilene o in ceramica, il quale si accoppia stabilmente al guscio metallico da un lato e dall'altro è munito di una cavità emisferica al cui interno va ad articolarsi la testina protesica sopra citata.
Nel tempo l'impianto protesico nel suo complesso o in parte può mobilizzarsi rendendo necessario un intervento chirurgico di revisione. La situazione ossea sia del femore che dell'acetabolo può risultare notevolmente modificata rispetto a quella originale, spesso con gravi distruzioni, rendendo necessario l'utilizzo di steli e/o cotili speciali detti per questo da revisione-Per quanto riguarda la revisione cotiloidea, i prodotti attualmente in commercio, pur basandosi su concetti diversi, sono difficili da impiantare e generalmente risultano eccessivamente verticalizzati.
Si comincia a parlare di verticalizzazione del cotile quando, una volta impiantato, il suo piano equatoriale forma con il piano orizzontale un angolo superiore a 45 gradi.
Il cotile di primo impianto, sia cementato che non, quando si mobilizza, per effetto del carico diretto verticalmente, subisce una migrazione in direzione verticale mediale. In pratica, come illustrato nella figura 1, la direzione di migrazione del cotile di primo impianto, globalmente indicato dal numero di riferimento 1, rappresentata dalla tangente al profilo esterno nelle diverse posizioni assunte dal cotile stesso durante la sua migrazione è inclinata di un generico angolo a misurato rispetto alla direzione a 45 gradi, diverso da zero.
Pertanto l'impronta lasciata dal cotile nel bacino ha una superficie ottenuta da un'emisfera il cui centro trasli di un valore indicato nella figura 1 dal numero di riferimento 2, nella direzione che forma un angolo a con il piano a 45*. Un cotile da revisione ottenuto come interpolazione delle superfici generate da una semisfera il cui centro trasli di un vaiore in figura indicato con 2 sul piano equatoriale, e montato nella sede acetabolare in modo che la sua superficie esterna sia in completo appoggio alla superficie ossea, risulterebbe inevitabilmente verticalizzato sul piano frontale e cioè ruotato di un angolo a rispetto all'inclinazione ideale di 45 gradi.
Nella figura 1 la porzione tratteggiata indica lo spostamento che subisce il cotile alloggiato nella sede acetabolare del bacino 3. Quindi, il cotile da revisione che viene successivamente reimpiantato nella sede acetabolare deve avere la forma che è ottenuta dalla porzione in linea spessa unita alla porzione in linea tratteggiata illustrata nella figura 1.
Quanto sopra descritto comporta in sostanza una riduzione della copertura della testa della protesi dal valore A indicato nella figura 2, al valore B con i due seguenti svantaggi:
maggiori probabilità di lussazioni ed elevate pressioni di contatto che possono provocare deformazioni dei materiali a contatto e/o incremento dell'usura dei materiali stessi nel movimento relativo durante la deambulazione -Compito precipuo del presente trovato è quindi quello di realizzare un cotile da revisione per il trattamento di patologie dell'anca che abbia una forma particolare atta a tenere conto del cambiamento di forma della sede acetabolare e quindi a mantenere una superficie di contatto con l'osso che sia sempre disposta secondo l'inclinazione ideale.
Nell'ambito di questo compito, uno scopo del presente trovato è quello di realizzare un cotile da revisione per il trattamento di patologie dell'anca. in cui sia realizzata un'opportuna sede per alloggiare un inserto nel quale si articola la testina protesica.
Un altro scopo del presente trovato è quello di realizzare un cotile da revisione per il trattamento di patologie dell'anca, che sia dotato di mezzi di fissaggio per il suo ancoraggio stabile all'osso.
Ancora un altro scopo del presente trovato è quello di realizzare un cotile da revisione per il trattamento di patologie dell anca che sia adatto ad alloggiare sia inserti in ceramica che in polietilene.
Non ultimo scopo del presente trovato e quello di realizzare un cotile da revisione per il trattamento di patologie dell'anca, che sia di elevata affidabilità, di relativamente facile realizzazione ed a costi competitivi.
Questo compito, nonché questi ed altri scopi che meglio appariranno in seguito sono raggiunti da un cotile da revisione, per il trattamento di patologie dell'anca, caratterizzato dal fatto di comprendere un guscio avente una superficie esterna sostanzialmente semisferica e schiacciata in corrispondenza del suo polo, una porzione di bordo essendo sporgente rispetto al piano diametrale della superficie semisferica, almeno per un tratto parziale di detto piano diametrale, un inserto essendo alloggiabile in detto guscio.
Ulteriori caratteristiche e vantaggi del trovato risulteranno maggiormente dalla descrizione di sue forme di realizzazione preferite, illustrate a titolo indicativo e non limitativo negli uniti disegni, in cui:
la figura 1 è una vista schematica illustrante la migrazione che subisce un cotile impiantato nella sede acetabolare, in seguito alla deambulazione;
la figura 2 è una vista schematica illustrante l’effetto dell'impiego di un cotile da revisione di tipo noto;
la figura 3 è una vista schematica illustrante un cotile da revisione secondo il presente trovato;
la figura 4 è una vista illustrante una seconda forma di realizzazione del cotile secondo il presente trovato;
il presente trovato all’osso del bacino;
la figura 6 illustra una terza forma di realizzazione del cotile secondo il presente trovato;
la figura 7 è una vista in pianta del cotile realizzato secondo il presente trovato;
la figura 8 è una vista laterale, parzialmente in sezione, del cotile secondo il presente trovato; e
la figura 9 è una vista del cotile secondo il presente trovato quando visto dalla parte opposta rispetto alla sede di inserimento della testina protesica.
Con riferimento alle sopra citate figure, il cotile da revisione secondo il presente trovato, globalmente indicato dal numero di riferimento 10 ed illustrato nelle figure da 3 a 9, è costituito da una calotta emisferica {o guscio) sostanzialmente schiacciata in corrispondenza del polo, ottenuta dal raccordo di superfici generate da una semisfera di diametro D e di centro O la quale durante il movimento di traslazione che subisce una volta inserita nell’acetabolo (la cavità del bacino in cui normalmente si posiziona il cotile), si sposta di una quantità indicata dal numero di riferimento 2 lungo il proprio piano diametrale indicato dal numero di riferimento 4.
Il cotile sostanzialmente emisferico cosi realizzato è inoltre provvisto di una porzione sostanzialmente triangolare 5 i cui lati formano un angolo al vertice a rispetto al piano diametrale 4 in modo da evitare la verticalizzazione del cotile da revisione 10.
La porzione sostanzialmente triangolare 5 costituisce un bordo o collare che è definito in pratica dall'intersezione del piano indicato dal numero di riferimento 6 con il piano diametrale 4.
Il piano 6 rappresenta l'inclinazione ideale di circa 45 gradi rispetto ad una retta ideale intersecante orizzontalmente il bacino il cui cotile è sottoposto ad intervento da revisione.
All'interno il cotile da revisione 10 presenta una sede 12 atta ad alloggiare un inserto 13 entro il quale si articola la testina protesica, non illustrata.
Tale inserto 13, che può essere in polietilene o in ceramica, può essere dotato, in una seconda forma di realizzazione del cotile secondo il presente trovato, di un bordo antilussante 14, che forma un angolo β con il piano 6, tale da compensare migrazioni del cotile formanti un angolo α+<β >con la direzione a 45 gradi, come illustrato nella figura 4.
Sulla superficie esterna del guscio emisferico costituente il cotile da revisione 10 sono inoltre previsti fori 16 per il passaggio di viti di fissaggio 17 atte a fissare saldamente il cotile 10 all'osso.
Sono altresì previsti, in corrispondenza della base del cotile 10, fori filettati per l'innesto a vite di mezzi per la presa esterna sull'ala iliaca, quali la piastrina 18, e per la presa nel forame otturatorio, quali il gancio 19.
La superficie esterna del cotile 10 presenta una certa rugosità, vantaggiosamente per favorire un ancoraggio secondario all'osso 3, l'ancoraggio primario essendo dato dalla piastrina 18 e dal perno 19.
La figura 6 illustra una terza forma di realizzazione del cotile da revisione secondo il presente trovato, in cui l'inserimento nella sede definita dall'inserto 12 di elementi troncoconici 20 aventi differenti angoli di inclinazione, consente di variare l'angolo formato tra il piano 6 del cotile 10 ed il piano 21 dell'inserto.
Come illustrato nella figura 8, l'inserto 12 presenta una pluralità di sporgenze 25 atte ad impegnarsi in corrispondenti sedi 26 definite lungo il perimetro del guscio esterno metallico che costituisce il cotile 10.
Il diametro D del cotile 10 può variare da un minimo di 40 mm ad un massimo di 70 mm; la dimensione indicata dal numero di riferimento 2 può variare da un minimo di 4 mm ad un massimo di 20 mm e l'angolo a varia da un minimo di 10 gradi ad un massimo di 45 gradi.
Vantaggiosamente il cotile da revisione secondo il trovato è realizzato in materiale metallico mentre l'inserto può essere realizzato sia in polietilene che in ceramica.
Si è in pratica constatato come il cotile da revisione secondo il presente trovato assolva pienamente il compito prefissato in quanto consente di evitare la verticalizzazione rispetto al piano orizzontale, ossia evitare che il piano diametrale del cotile formi un angolo superiore a 45 gradi rispetto al suddetto piano orizzontale.
Il cotile così concepito è suscettibile di numerose modifiche e va-rianti, tutte rientranti nell’ambito del concetto inventivo; inoltre tutti i dettagli potranno essere sostituiti da altri elementi tecnicamente equivalenti.
In pratica, i materiali impiegati, purché compatibili con l'uso specifico, nonché le dimensioni, potranno essere qualsiasi secondo le esigen-ze e lo stato della tecnica.
Claims (15)
- RIVENDICAZIONI 1. Cetile da revisione, per il trattamento di patologie dell'anca, caratterizzato dal fatto di comprendere un guscio avente una superficie esterna sostanzialmente semisferica e schiacciata in corrispondenza del suo polo, una porzione di bordo essendo,sporgente rispetto al piano diametrale della superficie semisferica, almeno per un tratto parziale di detto piano diametrale, un inserto essendo alloggiabile in detto guscio.
- 2. Cotile da revisione secondo la rivendicazione 1, caratterizzato dal fatto che detta superficie esterna è generata dal raccordo di una prima semisfera di una seconda semisfera avente il centro traslato rispetto a detta prima semisfera, detto centro essendo disposto sull'asse diametrale di detta prima semisfera.
- 3. Cotile da revisione secondo la rivendicazione 1, caratterizzato dal fatto che detta porzione di bordo è definita da un ulteriore porzione di detta prima semisfera.
- 4. Cotile da revisione secondo la rivendicazione 1, caratterizzato dal fatto che il bordo inferiore di detta porzione di bordo forma un angolo con detto piano diametrale.
- 5. Cotile da revisione secondo la rivendicazione 4, caratterizzato dal fatto che detto angolo è compreso tra 10 e 45 gradi.
- 6. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto che detto inserto è alloggiato ruotato entro detto guscio in modo tale che una porzione di detto inserto fuoriesce rispetto a detta porzione di bordo, formando un angolo con essa.
- 7. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto che detto inserto prevede una sede di alloggiamento per la testa del femore.
- 8. Cetile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto di prevedere elementi troncoconici inseriti nella sede definita da detto inserto e differentemente angolati in modo da variare l'angolo formato tra il bordo inferiore di detta porzione di bordo ed il piano definito dal bordo inferiore di detto inserto.
- 9. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto che la superficie esterna di detto guscio è rugosa.
- 10. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto che la superficie esterna di detto guscio è dotata di una pluralità di fori filettati per l'inserimento di viti di fissaggio del guscio all'osso del bacino.
- 11. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto di prevedere mezzi di ancoraggio fissati in corrispondenza del bordo di detto guscio, per l'ancoraggio di detto guscio all'osso del bacino.
- 12. Cotile da revisione secondo una o più delle rivendicazioni prece-denti, caratterizzato dal fatto che detto inserto prevede una pluralità di sporgenze atte ad impegnarsi in sedi corrispondenti definite in corrispon-denza del bordo di detto guscio.
- 13. Cotile da revisione secondo una o più delle precedenti rivendica-zioni, caratterizzato dal fatto che detto guscio è realizzato in materiale metallico.
- 14. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzato dal fatto che detto inserto è realizzato in ceramica o in polietilene.
- 15. Cotile da revisione secondo una o più delle rivendicazioni precedenti, caratterizzata dal fatto di comprendere una o più delle caratteristiche descritte e/o illustrate.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IT1998MI002599A IT1303805B1 (it) | 1998-12-01 | 1998-12-01 | Cotile da revisione per impiego nel trattamento di patologiedell'anca. |
FR9915048A FR2786390B1 (fr) | 1998-12-01 | 1999-11-30 | Cotyle de correction pour emploi dans le traitement de pathologies de la hanche |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IT1998MI002599A IT1303805B1 (it) | 1998-12-01 | 1998-12-01 | Cotile da revisione per impiego nel trattamento di patologiedell'anca. |
Publications (2)
Publication Number | Publication Date |
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ITMI982599A1 true ITMI982599A1 (it) | 2000-06-01 |
IT1303805B1 IT1303805B1 (it) | 2001-02-23 |
Family
ID=11381167
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
IT1998MI002599A IT1303805B1 (it) | 1998-12-01 | 1998-12-01 | Cotile da revisione per impiego nel trattamento di patologiedell'anca. |
Country Status (2)
Country | Link |
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FR (1) | FR2786390B1 (it) |
IT (1) | IT1303805B1 (it) |
Families Citing this family (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE20105862U1 (de) * | 2001-04-04 | 2001-06-21 | Eska Implants Gmbh & Co | Beckenpfanne eines künstlichen Hüftgelenkes |
FR2831424B3 (fr) * | 2001-10-26 | 2003-10-17 | Medical Solution | Implant cotyloidien avec patte de fixation rapportee |
FR2833478B1 (fr) * | 2001-12-13 | 2004-08-13 | Science Medecine Sa | Implant cotyloidien de reprise et dispositif de fraisage du site osseux destine a recevoir cet implant |
ITUD20020037A1 (it) * | 2002-02-14 | 2003-08-14 | Lima Lto Spa | Protesi acetabolare dell'anca |
GB2406056B (en) | 2003-09-17 | 2007-07-11 | Corin Ltd | Prosthetic cup |
FR2883722B1 (fr) * | 2005-03-31 | 2007-06-22 | Evolutis Sa | Implant cotyloidien |
US20070142922A1 (en) * | 2005-12-21 | 2007-06-21 | Lewis Paul P P | Modular hip cup assembly, fastener assembly & fastener |
DE202006000650U1 (de) * | 2006-01-16 | 2006-03-23 | Dot Gmbh | Modulare Revisionspfanne für die Hüftgelenkendoprothetik und Verankerungszapfen hierzu |
DE102007031666A1 (de) * | 2006-08-04 | 2008-02-14 | Ceramtec Ag Innovative Ceramic Engineering | Asymmetrische Gestaltung von Pfannen und/oder Pfanneneinsätzen zur Manipulation und Unterdrückung der Eigenfrequenzen |
WO2008128282A1 (en) * | 2007-04-20 | 2008-10-30 | Portland Orthopaedics Limited | Acetabular prosthesis assembly with offset insert |
US7682399B2 (en) * | 2007-06-06 | 2010-03-23 | Howmedica Osteonics Corp. | Acetabular shell |
US8211184B2 (en) | 2009-04-20 | 2012-07-03 | Michael D. Ries | Acetabular cup |
US9023112B2 (en) * | 2011-02-24 | 2015-05-05 | Depuy (Ireland) | Maintaining proper mechanics THA |
EP3050539A1 (de) * | 2015-01-27 | 2016-08-03 | AQ Implants GmbH | Revisionsendoprothese |
EP3954332B1 (en) * | 2020-08-13 | 2023-07-26 | Alessandro Melozzi | Acetabular cup assembly for hip prosthesis |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5176711A (en) * | 1991-03-06 | 1993-01-05 | Grimes James B | Acetabular revision system |
US5192329A (en) * | 1991-03-07 | 1993-03-09 | Joint Medical Products Corporation | Oblong acetabular cup |
US5507824A (en) * | 1993-02-23 | 1996-04-16 | Lennox; Dennis W. | Adjustable prosthetic socket component, for articulating anatomical joints |
DE4442559C2 (de) * | 1993-12-09 | 1998-07-09 | Eska Implants Gmbh & Co | Gelenkpfanne für ein künstliches Hüftgelenk |
DE29517637U1 (de) * | 1995-11-07 | 1996-01-04 | Aesculap AG & Co. KG, 78532 Tuttlingen | Endoprothetische Hüftgelenkpfanne |
DE19701778C2 (de) * | 1996-11-21 | 1999-03-11 | Plus Endoprothetik Ag | Gelenkpfanne für eine Hüftgelenkendoprothese |
FR2758255B1 (fr) * | 1997-01-16 | 1999-07-16 | Groupe Lepine | Implant cotyloidien "de reprise" |
US5928288A (en) * | 1998-05-13 | 1999-07-27 | Johnson & Johnson Professional, Inc. | Variable fit oblong acetabular prosthesis |
-
1998
- 1998-12-01 IT IT1998MI002599A patent/IT1303805B1/it active
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- 1999-11-30 FR FR9915048A patent/FR2786390B1/fr not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
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FR2786390B1 (fr) | 2003-05-09 |
FR2786390A1 (fr) | 2000-06-02 |
IT1303805B1 (it) | 2001-02-23 |
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