JP2002143191A - 近位心出し装置を備える人工大腿骨幹 - Google Patents

近位心出し装置を備える人工大腿骨幹

Info

Publication number
JP2002143191A
JP2002143191A JP2001269617A JP2001269617A JP2002143191A JP 2002143191 A JP2002143191 A JP 2002143191A JP 2001269617 A JP2001269617 A JP 2001269617A JP 2001269617 A JP2001269617 A JP 2001269617A JP 2002143191 A JP2002143191 A JP 2002143191A
Authority
JP
Japan
Prior art keywords
artificial
femoral shaft
stem
centering
artificial femoral
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
JP2001269617A
Other languages
English (en)
Other versions
JP4266543B2 (ja
Inventor
Lorenzo Spotorno
スポトルノ ロレンゾ
Werner Guettinger
ギュッティンゲル ヴェルナー
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Zimmer GmbH
Original Assignee
Zimmer GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Zimmer GmbH filed Critical Zimmer GmbH
Publication of JP2002143191A publication Critical patent/JP2002143191A/ja
Application granted granted Critical
Publication of JP4266543B2 publication Critical patent/JP4266543B2/ja
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Classifications

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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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    • 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
    • A61F2002/365—Connections of heads to necks
    • 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
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • 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
    • A61F2310/00353—Bone cement, e.g. polymethylmethacrylate or PMMA

Landscapes

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

Abstract

(57)【要約】 【課題】 人工大腿骨幹の心出し装置を軸方向位置が人
工幹の直径変動と無関係で、選択的に使用できるように
すること。 【解決手段】 この人工大腿骨幹（１）は、セメント付
けでき、且つ人工頸部（２）、幹（３）およびこの幹
（３）と共に骨小腔（５）の中に挿入できる近位心出し
装置（４）を含む。この幹（３）がつばなし幹であり、
この心出し装置（４）が中位からこの幹にセメント付け
した領域で押被せられ、および少なくともこの中位領域
に、この近位の方に拡がり且つウエブ（７）を介してク
ランプ装置（８）に結合した心出し楔（６）を有し、こ
のクランプ装置（８）がこの人工頸部（２）のセメント
のない領域に配置してあり且つこれらのウエブ（７）を
遮断したとき除去可能であるので、精度よく機械加工し
た頸部（２）が基準となり、この幹（３）の半径方向お
よび軸方向共に精度のよい位置決めが可能である。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】この発明は、セメント付けで
き且つ人工頸部、幹およびこの幹と共に骨小腔の中に挿
入できる近位心出し装置を含む人工大腿骨幹に関する。
【０００２】
【従来の技術】セメント付けでき且つその上に近位心出
しスリーブを遠位から押被せられる人工幹は、特許出願
ＥＰ−Ａ−０９６２１０７に記載してある。これらのス
リーブは、この人工幹をまだ流動可能な骨セメントで満
たした骨窩に挿入する最後の段階でそれをこの近位領域
で心出しする。つばなし幹では、この種のスリーブのこ
の幹軸に沿う正確な位置は、この近位領域でのこの幹の
円錐角、並びにこのスリーブおよびこの幹の直径公差に
依る。人工幹は、屡々それらの外形を鍛造品によって受
け、それは製造手順として幹直径に関して大きなばらつ
きを有する。できることならこの遠位端からこの幹軸に
関して正しい回転角位置に押被せた、スリーブの位置
は、不十分な円錐角によって生ずる軸方向の偏差の増加
のために比較的大きく変動する。もし、この幹直径に対
する比較的粗い鍛造公差も存在するならば、このスリー
ブのこの幹に関する軸方向位置は、管状骨の切除面に対
する挿入深さの高さ基準として無条件にはもう使えない
程に変動する。
【０００３】
【発明が解決しようとする課題】この発明の目的は、軸
方向位置が人工幹の直径変動と無関係な、選択的に使用
できる心出し装置を創ることである。
【０００４】
【課題を解決するための手段】この目的は、独立請求項
１の記載の構成で達成される。すなわち、この幹がつば
なし幹であり；この心出し装置が中位からこの幹にセメ
ント付けした領域で押被せられ、および少なくともこの
中位領域に、この近位の方に拡がり且つウエブを介して
クランプ装置に結合した心出し楔を有し、このクランプ
装置がこの人工頸部のセメントのない領域に配置してあ
り且つこれらのウエブを遮断したとき除去可能とした構
成である。
【０００５】
【発明の効果】この装置は、通常、例えばボール頭を固
定するために正確に機械加工され、また挿入深さの基準
とすることもでき、幹の頸部領域に関して正確に配置さ
れるという利点を有する。更なる利点は、この心出し装
置がセメン付けする領域でこの幹を完全には囲まず、余
剰骨セメントの上昇を可能にすることにある。更なる利
点は、この心出し楔がこの幹に縦方向に接触している領
域を短くでき、且つ通常負荷の加圧領域に限定され、一
方残りの領域では、まだ液体の骨セメントが均質な、隙
間のない嚢窩を形成できることにある。
【０００６】
【発明の実施の形態】従属請求項２ないし１０に記載の
構成は、この発明の更なる具体例を言及している。よっ
てこのクランプ装置のセメント付け後の除去は、もし、
これらのウエブがこれらのウエブの切断または切離しを
容易にする弱点部を有すれば容易になる。この種の弱点
部は、このクランプ装置の除去後残留物が突出しないよ
うに、この心出し装置への移行部にあるのが都合がよ
い。もし、この心出し楔それ自体が骨セメント、例えば
ＰＭＭＡ（ポリメタクリル酸メチル）から成るならば、
それを後者によって濡らされる場所でこの液体骨セメン
トと組合わせることができる。
【０００７】心出し装置を射出成形機で処理できるプラ
スチックで製造すれば経済的である。この人工頸部のノ
ックアウト穴または固着円錐は、この心出し装置の固着
用基準面として適当である。この切除面での幹の沈み込
みを制限し且つ後に除去できる突当には、この心出し装
置の除去可能部に固着する支持面を設けることができ
る。
【０００８】
【実施例】以下に実施例を参照してこの発明を説明す
る。
【０００９】セメント付けでき且つ中位から幹にセメン
ト付けした領域で押被せられる、つばなし人工大腿骨幹
用近位心出し装置を添付の図面に示す。この心出し装置
は、少なくともこの中位領域に、この近位の方に拡がり
且つウエブを介してクランプ装置に結合した心出し楔を
有し、このクランプ装置がこの人工頸部のセメントのな
い領域に配置してあり且つこれらのウエブを遮断したと
き除去可能である。以下の例で、同じ参照記号は、同じ
機能に使ってある。
【００１０】図１および図２で、心出し装置４が、中位
から押被せることができ且つ近位の方へ拡がるＣ形心出
し楔６、およびウエブ７を介してそれに結合したクラン
プ装置８から成る。中央に一つ、後方に一つおよび前方
に一つの三つのウエブ７がＣ形リング部１４と共に安定
した三脚を形成する。このリング部１４は、クランプ装
置８のようにこの人工頸部２を１８０°以上に亘って囲
み、弾性的に開くことができ、それでこの人工頸部２を
あるバイアス応力下で取囲む。このリング部１４は、中
央に内方に突出する突起１１を有し、それをこの人工頸
部２のノックアウト穴１０に固着できる。ウエブ７は、
この人工幹が出来るだけ少ししか見えないように不明瞭
にするために比較的薄くしてある。それらは、この心出
し楔６への移行部に弱点部９を形成し、それはメスによ
るか、またはウエブ７の後ろに破壊用の尖った物で係合
することによって容易に断ち切ることができる。
【００１１】図１に従って、この心出し装置４を付けた
人工大腿骨幹１は、骨セメント１７で満たした大腿骨１
８の骨小腔５に挿入できる。この大腿骨１８は、切除面
１６を有し、そこまでこの幹３と、この幹に接触してい
る心出し楔６をその上縁に関して沈め、骨セメント１７
を追出してこの骨小腔５の外部で払い落す。この人工頸
部が円錐１３で終り、それも同様にリング部１４用当接
面として使える。
【００１２】図３、図４および図５による更なる実施例
では、この円錐１３を、三つのウエブ７を介してこの心
出し楔に結合した、弾性のあるスリットキャップ１２に
よって完全に囲んである。この心出し装置４をこの人工
幹１上に近中位から押被せて、このキャップ１２を弾性
的に開かせ、この円錐１３を越えて突出する内方突出隆
起２０によってこの円錐面１３上にしっかりとクランプ
する。
【００１３】図３によれば、この心出し楔６が中位から
前部および後部の方へ伸び、且つ各場合にその前端およ
び後端でウエブ７によって中央に保持され、このウエブ
の断面がキャップ１２の方向に拡大する。このキャップ
１２は、縦方向に切込み１９を備え、それがこのジャケ
ット表面を弾性的に開かせ且つこの円錐１３上にしっか
りとクランプする。この人工頸部２の適当な穴での支持
は、中央ウエブ７の突起１１で行うことができる。この
キャップ１２は、大腿骨球に付ける直前にしか外さない
ので、円錐１３の表面を保護するという利点も有する。
それで、このキャップ１２を予め取付けた心出し装置
は、同時に円錐１３の保護装置としても使える。
【００１４】図５で、支持面１５で切除面上に支持する
ことができ且つこの様にして深さ突当てを形成できる二
つの外方に突出するアーム２２が中央ウエブ７に取付け
てある。この更なる実施例は、図４を参照して説明した
通りである。
【００１５】図６で、心出し楔６がその内側に遠位から
近位まで伸びる凹み２１を備える。これで、この心出し
楔６もその内側を液体骨セメントによって濡らすことが
でき且つ幹３との組合せを作ることができる。
【図面の簡単な説明】
【図１】骨セメントで満たした大腿骨の骨小腔の中に入
る心出し装置を備える幹を概略的に示す。
【図２】図１の心出し装置の概略的拡大図である。
【図３】幹に付ける心出し装置の更なる実施例の概略図
である。
【図４】図３の心出し装置の概略的拡大図である。
【図５】支持面を切除面のための突当てとして付加的に
設けた、図３の心出し装置を概略的に示す。
【図６】この幹の方の側を液体骨セメントによって大き
く濡らすことができる心出し楔の概略拡大断面を示す。
【符号の説明】
１ 人工大腿骨幹 ２ 人工頸部 ３ 幹 ４ 心出し装置 ５ 骨小腔 ６ 心出し楔 ７ ウエブ ８ クランプ装置 ９ 弱点部 １０ ノックアウト穴 １１ 突起 １２ 弾性キャップ １３ 円錐 １４ 弾性リング部 １５ 支持面 １６ 切除面 ２１ 凹み
───────────────────────────────────────────────────── フロントページの続き Ｆターム(参考） 4C097 AA05 BB01 BB09 CC01 CC05 CC13 SC01

Claims (10)

    【特許請求の範囲】
  1. 【請求項１】 セメント付けでき且つ人工頸部（２）、
    幹（３）およびこの幹（３）と共に骨小腔（５）の中に
    挿入できる近位心出し装置（４）を含む人工大腿骨幹
    （１）に於いて、この幹（３）がつばなし幹であるこ
    と；この心出し装置（４）が中位からこの幹にセメント
    付けした領域で押被せられ、および少なくともこの中位
    領域に、この近位の方に拡がり且つウエブ（７）を介し
    てクランプ装置（８）に結合した心出し楔（６）を有
    し、このクランプ装置（８）がこの人工頸部（２）のセ
    メントのない領域に配置してあり且つこれらのウエブ
    （７）を遮断したとき除去可能であることを特徴とする
    人工大腿骨幹。
  2. 【請求項２】 請求項１による人工大腿骨幹に於いて、
    これらのウエブ（７）が弱点部（９）を有し、それがこ
    の幹（３）と心出し楔（６）のセメント付け後のこれら
    のウエブ（７）の切断または切離しを可能にすることを
    特徴とする人工大腿骨幹。
  3. 【請求項３】 請求項１または請求項２の何れか一つに
    よる人工大腿骨幹に於いて、この心出し楔（６）が、例
    えばＰＭＭＡの、骨セメントから成ることを特徴とする
    人工大腿骨幹。
  4. 【請求項４】 請求項１ないし請求項３の何れか一つに
    よる人工大腿骨幹に於いて、この心出し装置（４）がプ
    ラスチックで射出成形部品として作ってあることを特徴
    とする人工大腿骨幹。
  5. 【請求項５】 請求項１ないし請求項４の何れか一つに
    よる人工大腿骨幹に於いて、この人工頸部（２）がノッ
    クアウト穴（１０）を有し、およびこの心出し装置
    （４）をこのノックアウト穴（１０）の中の突起（１
    １）で支持することを特徴とする人工大腿骨幹。
  6. 【請求項６】 請求項１ないし請求項５の何れか一つに
    よる人工大腿骨幹に於いて、このクランプ装置（８）が
    この人工頸部（２）の円錐（１３）上に支持した弾性キ
    ャップ（１２）から成ることを特徴とする人工大腿骨
    幹。
  7. 【請求項７】 請求項１ないし請求項５の何れか一つに
    よる人工大腿骨幹に於いて、このクランプ装置（８）が
    この人工頸部（２）上に支持した弾性リング部（１４）
    から成ることを特徴とする人工大腿骨幹。
  8. 【請求項８】 請求項２ないし請求項７の何れか一つに
    よる人工大腿骨幹に於いて、これらの弱点部（９）がこ
    の心出し楔（６）と近位方向に直接接することを特徴と
    する人工大腿骨幹。
  9. 【請求項９】 請求項２ないし請求項８の何れか一つに
    よる人工大腿骨幹に於いて、この心出し装置（４）の除
    去可能部が、この幹（３）のこの切除面（１６）に関す
    る沈み込みを制限できるように、支持面（１５）を有す
    ることを特徴とする人工大腿骨幹。
  10. 【請求項１０】 請求項２ないし請求項９の何れか一つ
    による人工大腿骨幹に於いて、この心出し楔（６）は、
    液体骨セメントがこの心出し楔（６）とこの幹（３）の
    間に流入できるように、この幹の方向に凹み（２１）を
    有することを特徴とする人工大腿骨幹。
JP2001269617A 2000-10-30 2001-09-06 近位心出し装置を備える人工大腿骨幹 Expired - Fee Related JP4266543B2 (ja)

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EP00811012 2000-10-30
EP00811012.4 2000-10-30

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JP4266543B2 JP4266543B2 (ja) 2009-05-20

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ES (1) ES2238409T3 (ja)

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US20020052661A1 (en) 2002-05-02
JP4266543B2 (ja) 2009-05-20
EP1201205A1 (de) 2002-05-02
US6669734B2 (en) 2003-12-30
ATE294546T1 (de) 2005-05-15
DE50106092D1 (de) 2005-06-09
EP1201205B1 (de) 2005-05-04
ES2238409T3 (es) 2005-09-01

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