ITVI20060280A1 - DIMA, TOOL AND EQUIPMENT FOR THE IMPLEMENTATION OF PROSTHESIS PLANTS - Google Patents

Description

DESCRIPTION

of the patent for industrial invention entitled <"> TEMPLATE, TOOL AND EQUIPMENT FOR THE REALIZATION OF PROSTHETIC IMPLANTS <"> of

COMEG TECNOLOGIE S .R.L. VI A Manzoni, 27 - 36040 Grisignano di Zocco (VI)

Designated inventors: GON EL I A Giandomenico and PERETTO Marco

The present invention relates to orthopedic surgery.

In particular, the present invention relates to equipment to be used in orthopedic surgery, preferably for prosthetic implant operations.

More in detail, the present invention relates to a template or guide, a tool and equipment to be used during surgical interventions for the realization of prosthesis implants in orthopedic surgery such as for example hip prostheses and more in general of joints.

As known, the orthopedic surgery technique and in particular the operative technique for the realization of the hip prosthesis, provides for the realization on the patient's hip of a housing aito to receive a part of the prosthesis, also called definitive colile, on the which is housed the head of a second part of the prosthesis which is fixed to the limb.

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More specifically, floating is carried out by the surgeon with the aid of burs of various shapes using an operating equipment, also called an operating kit or set, comprising a set of tools.

These tools are used, as will be seen better below, during the various phases of the operation and substantially include, in the case of a hip prosthesis kit, a series of templates of various sizes, called a tic he coti l i trial head, trial head adapter and trial head. Each trial template or cup comprises a shaped body that reproduces the shape of the lodge to be made on the patient's bone. More particularly, in the case of a hip prosthesis, each trial crown has a body having a substantially hemispherical shape with a different radius.

Such equipments are reusable and the materials chosen for their realization must have characteristics such as to allow their sterilization.

More precisely, in order to allow the reuse of the equipment and the particular of the aforesaid tools, they must be made of materials that allow their sterilization in an autoclave, as well as such as to withstand the longest possible extension to the aforementioned sterilization cycles. lization ensuring that their dimensional characteristics and their shape remain unchanged.

The known technique provides that each monthly or template or test pack is made of stainless steel or aluminum using automatic machines with chip removal. Each template after the aforementioned processes is also treated with anodic oxidation in the case of aluminum construction.

To satisfy the need for lightness and to provide the surgeon with the possibility of inspecting the walls and the shape of the housing, as will be better described below, each template or trial cup is also provided with through openings called windows. .

As far as the test head is concerned, it too is made with the aid of chip removal machines using extruded plastic bar materials.

Said trial head comprising a substantially spherical body provided with a hole suitable for receiving a maneuvering rod or part of the definitive prosthesis to be implanted in the act.

According to the known operating technique and as previously said, the application of a prosthesis requires the surgeon to make a housing on the region of the patient's bone where the prosthesis is to be implanted.

More particularly, the surgeon realizes this housing in various successive phases, alternating operations for removing it with operations to check the shape and dimensions of the housing he is making.

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As previously mentioned, the bone removal operations are carried out using drills, also called acetabular drills made entirely of steel, while the verification and control operations are carried out using the aforementioned templates.

More specifically, the surgeon checks the shape of the housing made using the trial cup which has the shape and size of the part of the final prosthesis to be implanted and therefore of the ideal housing that he must make for obtain the best anchorage of the part of the prosthesis to be implanted.

It should in fact be considered that for the success of the prosthesis implantation operation and for its duration in time it is essential to ensure the greatest possible stability to the implantation of the prosthesis to be implanted on the patient. This stability depends fundamentally on the shape of the housing and more precisely on the precision with which the surgeon is able to make this housing.

For the best stability it is in fact necessary that the housing has a shape substantially conjugated to the crowns or definitive template of the prosthesis to be implanted.

To verify this, the surgeon uses openings present on the dome of the aforementioned template or trial cup.

More particularly, through the aforementioned openings, he verifies any discrepancies and decides the operations from

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undertake.

More in detail, this check is carried out by inserting the template into the housing and trying to verify, through the openings, whether the external surface of the 5 test collector adheres to the wall of the housing and / or whether it is further milling is required.

The surgeon repeats these operations several times until he reaches a place that he deems suitable for receiving the collet of the definitive prosthesis.

ut Finally, the surgeon evaluates the stability and functionality of the joint obtainable with the definitive implant before inserting and blocking the definitive l necks to the bone.

To do this, he once again places the trial neck in the housing without locking it and places the adapter first and then the trial head inside it 15, inserting the defined prosthesis or the rasp or the test head into the hole. trial neck. Finally, by acting on the rod, the doctor moves the head inside its seat, simulating / verifying the stability and mobility that the definitive replacement will have after the intervention.

20 It should also be noted that each colile has first connection means suitable for coupling to second connection means belonging to the adapter.

Once the desired stability has been obtained, the surgeon proceeds to implant the definitive prosthesis by placing and then fixing 25 the definitive cetyl in the housing made.

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A first drawback of the equipment to be used during the surgical interventions for the realization of the described prosthesis implants of the known type and in particular of the templates and tools (drills, etc.) of the known type, is constituted by the fact that they are they wear out and have a limited duration both because of the necessary sterilization operations to which they must be subjected for their use, and because of their use. In fact, due to the sterilization cycles and the numerous uses, some details of the cups or test templates of known type tend to degrade until it is necessary to replace them.

Another drawback is constituted by the fact that the known equipment comprises a considerable number of templates of various sizes which, being chosen by the surgeon during the operation, must in any case be subjected each time, before their use, to the aforementioned sterilization. A further drawback is constituted by the fact that special and expensive machines are required to sterilize such equipment, which therefore affect the operating costs of the hospitals. It should be added that to carry out this operation the equipment must be placed in special and expensive baskets suitable for being placed in an autoclave. Another drawback is constituted by the fact that the sterilization of the equipment and in particular of the trial cups, of the trial heads and of the tools, while being

performed by the operators before and after each intervention, they can be performed in an unsuitable way with the consequent known risks of infection for the patient.

A further drawback is constituted by the fact that the aforesaid openings also do not allow homogeneous compaction of the bone tissue which identifies the surface of the housing made, useful before applying the definitive prosthesis and can introduce an error in the surgeon's evaluation.

Another drawback is the high cost of the various parts of the equipment. Such costs are substantially linked both to the type of material used for their manufacture and to the production process used to manufacture them, which requires the necessary use of expensive, high-precision chip removal machine tools.

A further drawback is constituted by the fact that these equipments have a considerable bulk and after being sterilized they must be kept in suitable places. In consideration of the situation described above, it would be desirable to have a template, a tool and equipment to be used during surgical interventions for the realization of prosthesis implants preferably for joints that would allow to overcome or at least limit the drawbacks of the known state of the art.

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It would therefore be desirable to have a template, a tool and equipment to be used during surgical interventions for the realization of prosthetic implants that would allow to overcome the drawbacks encountered in the templates, in the tool and in the equipment to be used during the surgical interventions for the realization of prosthesis implants described above.

In particular, a first object of the invention is to produce a template, a tool and an equipment to be used during the surgical interventions for the realization of prosthesis implants that can be made without the use of chip removal machines or at least by reducing the number of chip removal operations.

It is another object to provide a tool and equipment which allows the surgeon to check in particular the milling work performed on it in an easier and more effective way. the bone, as well as the evaluation of the goodness of the re-implantation that is being carried out,

It is a further object to produce a template, a tool and a less expensive equipment than the known one and ready for use.

The aforementioned purposes are achieved by a template to be used during surgical interventions for the realization of prosthesis implants in accordance with the contents of the

primary claim.

The said aims are also achieved by a tool to be used during surgical interventions for the realization of prosthesis implants in accordance with the content of the corresponding dependent claim.

The said aims are also achieved by an equipment to be used during surgical interventions for the realization of prosthesis implants in accordance with the content of the corresponding independent claim.

Innovative and advantageous embodiments are the subject of the respective dependent claims.

The said aims and advantages will be better highlighted during the description of some preferred embodiments of the invention, given by way of non-limiting example, with reference to the attached drawing tables where:

Figure 1 represents a schematic sectional view of a hip prosthesis implanted in a patient;

Figure 2 shows an exploded side view of the prosthesis of Figure 1;

- figure 3 represents a perspective and exploded view of an apparatus of the invention;

- figure 4 represents one of the parts of the equipment of figure 3 packed in a sterile container;

- figure 5 represents an axonometric view of a

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executive variant of uria of but of the invention;

figure 6 represents a schematic perspective view of a phase of a surgical intervention;

figure 7 represents a side view and partially sectioned of a subsequent phase of a surgical intervention;

- Figures 8 and 9 each represent a front view of one of but arranged in a housing obtained in the patient's bone during as many verification phases carried out by the surgeon in an operation of an implant of a hip prosthesis of the type of Figure 1;

- Figures 10 and 1 1 each represent a partially sectional view of some phases of an operation of implantation of a hip prosthesis of the type of figure I:

Figure 12 represents a perspective view of another example of a template for implants for knee prostheses made according to the invention;

- figures 13 and 14 represent respectively a front view and a side view of the template of figure 1 2;

- Figures 1 5 and 1 6 each represent a perspective view of another example of a template of the invention;

Figure 1 7 represents a plan view of an example of a tool of the invention;

Figure 1 8 represents a sectional view along the plane

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A-A of the tool of figure 1 7 with an enlarged detail;

- Figure 19 represents a perspective view of an example of another tool according to the invention;

- Figure 20 represents a perspective view of an example of a further tool according to the invention:

Figure 2 1 represents a perspective view of an example of another tool or instrument according to the invention. By way of introduction, it is pointed out that the corresponding elements of the individual embodiments are identified by means of the same numerical references.

The position indications mentioned in the individual executive examples are to be transferred to the new position in the event of a change in position.

While some particular embodiments of the present invention will be set out in the following description relating to the figures, it is clear that the present invention is not limited to such particular embodiments, but rather, the particular embodiments described below clarify several aspects of the present invention, the purpose and scope of which are defined by the claims.

With reference to the attached figures, a first illustrative embodiment of some templates, tools and equipment to be used during the interventions will be described below.

surgical procedures for making implants of prostheses, preferably of joints, according to the present invention.

In particular, equipment, tools and templates used to make, for example, a hip prosthesis implant shown of the type shown in detail in figures 1 and 2 will be described. The hip prosthesis shown comprises a cup definitive C which is fixed on the O bone of the hip, an adapter f> for a head T and a part P which is implanted in the bone S of the limb,

It is clear, however, that the solution proposed in the present invention is applicable to all tools, templates and equipment that can be used to perform any surgery and in particular implant prosthesis preferably of joints, as will be better described below.

Figure 3 shows a non-limiting example of some parts of an equipment to be used during surgical interventions for the realization of hip prosthesis implants indicated as a whole with the number 500.

It comprises a template 1, also object of the invention, also called a trial cup and an adapter element 2 suitable for coupling to the template 1 and for receiving a trial head 3 for prosthesis and / or for rasp,

In the preferred embodiment shown the template 1

comprises a main body 4 or dome having a shape substantially of a portion of a sphere.

More generally, the main body 4 has the shape of the housing that the surgeon must make in the patient's bone to place the part of the prosthesis to be implanted, in this case constituted by the note C.

It is therefore clear that the main body may have different shapes depending precisely on the shape of the parts of the implant that the surgeon must implant,

-According to the invention, the main body 4 is made of non-metallic and preferably plastic or synthetic material. More particularly, the plastic material is of the type suitable for use in the medical field, ie it is such as not to give rise to irritation or problems to the tissues with which it is capable of coming into contact. Fixed it is also preferably resistant to lipids and preferably suitable for high sterilization with rays or gases. However, it is clear that the body 4 can be made of equivalent material.

According to a preferred embodiment, the material also satisfies the requirements set by the current regulations such as for example EDA, ISO 10993-1 and USP Class VE Again according to a preferred embodiment of the invention, the main body 4 is made with a molding process and in particular with injection molding.

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This advantageously allows to considerably reduce the manufacturing costs of the template 1 as well as to produce, again according to the invention, a template 1 of the template 1. type called disposable or disposable. In fact, it has been verified that the molding techniques allow to produce templates having the dimensional characteristics and the desired tolerances as well as repeatable, with typical realization times of the molding processes and therefore with significantly lower costs than the templates of the known type. It has also been verified that the cost of manufacturing the proposed template is at least comparable and generally lower than the cost of sterilizing tools and equipment of the known type.

It should also be noted that advantageously the tool or template of the invention can be advantageously sterilized and packaged in a sterile container.

Always according to a preferred embodiment, in fact, the template 1 is made with the molding techniques described above and subsequently subjected first to a sterilization treatment and then packaged in a controlled atmosphere environment by means of an envelope which guarantees its sterility. The template I is therefore presented, as schematically represented in figure 4, enclosed in a wrapping or sterile container, which can be opened by the surgeon at the moment of its use and comprising for example a bag of synthetic material.

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This advantageously leads to avoiding the sterilization process to which the template should be subjected before its use.

Similarly, the other parts of the equipment 500 or in the example shown the adapter element 2 and the test head 3. comprise bodies and parts made of the same materials.

More particularly as regards the adapter element 2, it comprises a shaped element provided with second connection means 7 suitable for coupling to first connection means 6 belonging to the template 1.

These means 6, 7 allow the application of the adapter 2 which stabilizes and locks on several points made along the circumference of the test template 1. This allows you to adjust the internal diameter of the template to suit the diameter of the 3-click test head you plan to use. As far as the test head 3 is concerned, it comprises a substantially weak head body 8.

Also the adapter element 2 and the test head 3 are also preferably obtained with injection molding processes and preferably packaged in sterile containers. This advantageously allows to obtain also for these parts 2 and 3 of the size 500 the same advantages described for the template 1.

A further embodiment of the template

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of the invention indicated as a whole with the number 100 in Figure 5, differs from the previous one in that the main body 41 has at least one opening 42, These openings 42 allow the surgeon to inspect directly and visually at least a part of the housing made on the patient's bone when the template is placed therein.

A further embodiment of the invention differs from the previous one in that the body of the template is made of a transparent plastic material.

More particularly, according to this embodiment, the template is made of a transparent material and more particularly the main body is made, at least in part, of a plastic material comprising a polycarbonate. in other embodiments such plastic material may comprise for example ABS, PC. PM MA. PA, POM. PPSU, PC. PP, eco

This advantageously allows and as will be better described hereinafter, to facilitate some verification operations that the surgeon carries out during the operation. More specifically, the transparency of the template allows the surgeon to have an advantageous direct visual control of the l <'> to the housing he is making on the patient's bone. In more detail, this allows the surgeon to check the characteristics of the housing made in an easier and more immediate way and to better appreciate any corrective interventions to be

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implement.

It should also be noted that advantageously the plastic material such as for example the PC polycarbonate has, once extracted from the mold used during the realization of the template, a good transparency and does not require further particular treatments. It also has a good dimensional stability and is suitable for subjecting to sterilization treatments, for example by rays and or by gas, as well as having good compatibility with organic tissues. Other embodiments may provide that only one or more parts of the main body are transparent and in particular those of more interest to the surgeon. Λ in this regard, it should be noted that the transparency of the material used and the presence of liquids inside the housing allow the surgeon a better view of the work as the plastic material creates a sort of lens effect.

in fact, the transparent disposable template or coti advantageously allows the surgeon to precisely identify the non-contact areas by exploiting the entire surface of the piece because it is totally transparent.

This solution also makes it possible to produce templates without the previously described openings while maintaining the disposable feature and to allow a visual inspection of the surgeon. Again advantageously, this template being free

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of openings, allows the surgeon to achieve optimal compaction of the bone tissue, while guaranteeing the surgeon the possibility of visually inspecting the housing created,

In fact, it is clear that the template, not being provided with inspection openings, allows to carry out a better and more homogeneous compacting operation of the bone tissue, compared to that obtainable with the templates of the known type, which, as will be better described in then, it is made by compressing the template itself placed in the housing against the patient's ditch.

Furthermore, the good resistance of the material used and the absence of openings make it suitable for compacting the surface before inserting the final cup. Figures 12 to 16 represent some other examples of templates of the invention.

More specifically, figures 12, 13 and 14 represent as many views of another example of a template for knee prosthesis implants, indicated as a whole with the number 300. made according to [<^> invention, also called a positioner.

Figures 1 5 and 1 6 show as many views of another example of a template for knee prosthesis implants, indicated as a whole with the number 400 made according to the invention and also called a cutting mask.

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This template has through openings indicated with 405, used to guide cutting tools consisting for example of saws, used by the surgeon to make resections on the patient's bone. It should also be noted that in this embodiment the ma 400 has a main body 401 in plastic and in correspondence with the openings 405. of the inserts 402 are the most resistant material to mechanical wear.

In the example shown, the inserts 402 are preferably metallic and have been co-molded during the manufacturing step of the body 401. It should be noted that always according to finding. the use of a transparent plastic material to make the main body 401 allows the surgeon to observe the area in which he is operating.

Similarly to what is described above and in accordance with the invention, the tools used during the operation can also be made as described above.

More particularly, all at least some of the parts of the equipment used for surgical intervention are of the disposable type and comprise bodies and parts made of the same materials, preferably including ABS, PC, PMMA, PA 'PGM, PPSU, ΡΒ. PP. etc. Therefore, these tools can also be advantageously obtained with processes comprising injection molding operations and preferably packaged in sterile containers. This advantageously allows to obtain also for such tools

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the same advantages described for template 1.

Figures 1 7 and I H represent an example of embodiment of a tool of the invention indicated as a whole with the number 6U0 and in particular represent an acetabular bur comprising a substantially hemispherical body 601 made of plastic material and a series of inserts 602 preferably made in metal material, better visible in the enlarged detail of figure 18, which identify the cutting profile,

In the example representing the metal inserts 602 were co-molded during the construction phase of the hemispherical body. It should be noted that the use of a transparent plastic material allows for example the use of a micro camera or optical fiber that placed in proximity of the rotating tool and more precisely of the body, permits a vision of the treated bone.

Figure 19 represents a plan view of another example of a tool according to the invention, indicated as a whole with the number 700 and more particularly of a tool for hip prosthesis used to act during surgery on the test templates.

Figure 20 represents a plan view of an example of another tool according to the invention, indicated as a whole with the number 800 and more particularly of a retractor tool which can preferably be used during

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hip replacement surgery. Also in this case the tool body is made of plastic material and may possibly also have metal or other material inserts in the areas where particular characteristics are required, for example of a mechanical type.

Figure 21 represents a perspective view of an example of another tool according to the invention, indicated as a whole with the number 900 and more particularly of a retractor tool or instrument which can be preferably used during surgery for knee prostheses. Also in this case, the body of the tool and its gears 901 are made completely or at least partially in plastic material. The tool may also possibly also have metal or other material inserts in the areas where particular characteristics are required, for example of a mechanical type.

Operationally, the use of the proposed equipment provides that the surgeon, once he has chosen the prosthesis of the most suitable size for the morphological characteristics of the patient, chooses the corresponding template from those available to him, without removing it from its sterile package.

The surgeon then proceeds to create the housing in various successive stages, alternating bone removal operations with operations to check the shape and size of the housing that is being created.

J

The operations to remove the bone are carried out using drills, as shown schematically in figure 6, for example of the type previously described and represented in figure 1 7, while the verification and control operations are carried out using the aforementioned templates. More specifically, the surgeon, in order to check the shape of the housing made, proceeds to extract the selected test template from the sterile package and to position it in the seat made.

More precisely, the surgeon to verify this, if he is using a template of the type represented in figure 5, uses the openings 42 present on the dome of the template 100 itself while, if he is using a template of the type shown in figure 3 made of transparent material, it exploits the transparency of its body 2,

In this regard, it should also be noted that the surgeon, using a transparent template, can more easily check and identify the contact / non-contact areas between the surface of the template and the surface of the housing. thanks to the liquids present inside the housing. In fact, these liquids give rise in the body of the template, when floating is not well made, to the areas or zones of di fferent colors, shown in particular in figure 8, which identify precisely the areas of non-contact between the surface of the template. itself and the surface

housing. Vice versa. when floating has a profile substantially conjugated to that of the template, the template assumes a substantially uniform "color <"> as schematically represented in figure 9. This phenomenon helps the surgeon in the necessary verification operations on the basis of which he decides the operations to be undertaken,

The surgeon repeats the operations several times until he reaches a housing which he believes is suitable for receiving the colile of the definitive prosthesis.

Finally, the surgeon, before inserting and locking the final cup C to the bone, assesses the stability and functionality of the joint that can be obtained with definitive regression.

To do this, he once again places the trial dune or cup in the housing without locking it and places inside it first the adapter 2 which anchors itself to the template I thanks to the connection means 6, 7 and then the head. test 3 inserting the prosthesis, the rasp or the test neck into the hole as shown for example in figures 10 and M, It is clear that even in this case the surgeon must first extract the adapter and test head

Finally, by acting on the prosthesis or on the rasp or on the test neck, the doctor moves the head 11 <"> inside its seat, simulating / verifying the stability and mobility of the implant.

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definitive will present after the intervention, as shown in figure I,

Once the desired stability has been obtained, the surgeon proceeds to implant the definitive prosthesis by placing and then fixing the definitive colile in the housing made, as shown in figure 1.

From what has been said it is clear how the proposed solution allows to solve the aforementioned drawbacks.

In particular, the proposed solution advantageously makes it possible to produce one of a tool and more generally parts of equipment to be used during surgery, partially and / or entirely in disposable and preferably transparent plastic material. This allows the surgeon to check more easily and immediately, for example, the characteristics of the housing made and to better appreciate any corrective interventions to be implemented.

Still advantageously, the proposed solution allows to realize a template, a tool and a disposable equipment which does not require sterilization in an autoclave and which allows to reduce the volume of the instruments both in the operating room.

Moreover, thanks to the pre-operative study, they can be identified with the aid of radiographs, etc. the measures of the templates that are considered most suitable for the patient. By doing so the

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surgeon can bring in the operating room only the two or three templates of the size he deems suitable, thus gaining space. Still advantageously, the proposed solution allows for making templates, tools and more generally parts of equipment or complete equipment to be used during surgery, with considerably lower manufacturing costs than known equipment. This allows the creation of templates, tools and more generally parts of complete, disposable equipment and equipment that are subjected to sterilization directly in the manufacturing phase and packaged in special containers that guarantee their sterility. carry out the necessary sterilization operations with the known types of equipment and tools and then equip themselves with such sterilization equipment.

Although the invention has been described with reference to the attached drawing tables, it may undergo modifications during the manufacturing phase, all falling within the same inventive concept expressed by the claims reported below and therefore protected by the present patent. It also points out that where the features mentioned in the claims reported below are followed by reference signs, they are to be understood as useful for improving the readability of the claim itself and not

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what limitations in the interpretation of the same.

Without departing from the scope of the invention, it is possible for a technician to make the improvements suggested by natural technical evolution to the template and to the operating equipment for making prosthetic implants.

It should also be emphasized that all the details can be replaced by other technically equivalent elements and that the materials used; provided that they are compatible with the contingent use, as well as the dimensions of the various elements, they may be any according to requirements.

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Claims (7)

CLAIMS 1) Template (1, 100, 300, 400) for surgical interventions preferably to be used during interventions for the realization of joint prostheses, comprising a main body (4, 401) having a shape substantially equal to a part of the prosthesis to be planted characterized by the fact that said main body (4. 401) is made of non-metal material. 2) Template (I, 100, 300, 400) for preferred surgical interventions to be used during interventions for the realization of joint prostheses, characterized by the fact that said template (1, 100, 300, 400) is of the or no u s o. 3) Template according to claim 2, characterized in that it comprises a main body having a shape substantially equal to a part of the prosthesis to be planted. said main body (4. 40 1) comprising at least a part made of non-metallic material. 4) Template according to claim 1) or 3) characterized by the fact that said non-metallic material comprises a plastic material. 5) Template according to claim 4, characterized in that said material comprises ABS and / or PC and / or - 27 PMMA and / or PA and / or PQM and / or PPSU and / or PE and / or PP. 6) Template according to claim 1) or 4) or 5) characterized in that it is made with a process that includes at least one injection molding operation. 7) Template according to any one of the preceding claims, characterized in that it has inserts made of different materials, preferably metal, 8) Template according to claims 6) and 7) characterized by the fact that said inserts are co-molded with said main body. 9) Template according to any one of the preceding claims, characterized in that it has at least one transparent part. 10) Template according to any one of the preceding claims characterized in that it has at least one inspection opening. 1 1) Template according to any one of the preceding claims characterized in that it is contained in a sterile container. 12) Tools (600, 700, 800, 900) to be used during operations for the construction of prosthesis implants, preferably joint prostheses, characterized in that they are of the disposable type. 1 3) Tool according to claim 12) characterized - 2K by the fact that it comprises at least a part made of non-metallic material. 14. Tool according to claim 13, characterized in that said non-metallic material comprises a plastic material. 15) Tool according to claim 14) characterized by the fact that said material comprises ABS, PC and / or PMMA and / or ΡΛ and / or POM and / or PPSU and / or PE and / or PP. 16) Tool according to claim 13) or 14) characterized in that it is made with a process which includes at least one injection molding operation. 17) Tools according to any one of claims 12 to 16) characterized by the fact of presenting inserts in different materials, preferably metal-1 8) tool according to claims 16) and 17) characterized by the fact that said inserts are molded with a main body of said tool. 19) Utensils according to any one of claims 12) to 18) characterized in that they are contained in a sterile container. 20) Tool according to any one of claims 12) to 1 9) characterized in that it has at least one transparent part. 21) Equipment (500) to be used during the interventions for the realization of prosthesis implants preferably of articulation prostheses comprising at least one template characterized in that said template is made according to any one of claims 1) to 1 1). s5 22) Equipment to be used during interventions for the realization of prosthesis implants preferably of articulation prostheses comprising at least one tool (600, 700, 800, 900) characterized in that said tool is made according to any one of the claims to be 12) to 20). 23) Equipment according to claim 22, characterized in that it further comprises a template, said template being made according to any one of claims I) to 1 I). 15 24) Equipment according to claim 22) characterized in that it further comprises a template or trial cup (1, 100, 300, 400) and / or a bur (600) and / or a cutting jig (700) and / or a positioner (700. 800) and / or a retractor (900). 0 25) Equipment according to claim 2 1) or 22) or 23) or 24) characterized by the fact that all the parts of said equipment are contained in one or more containers