JP2004515310A - 応用範囲の広いモジュールシステム - Google Patents

応用範囲の広いモジュールシステム Download PDF

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Publication number
JP2004515310A
JP2004515310A JP2002549163A JP2002549163A JP2004515310A JP 2004515310 A JP2004515310 A JP 2004515310A JP 2002549163 A JP2002549163 A JP 2002549163A JP 2002549163 A JP2002549163 A JP 2002549163A JP 2004515310 A JP2004515310 A JP 2004515310A
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JP
Japan
Prior art keywords
bone
artificial bone
shaft
collar
artificial
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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
JP2002549163A
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English (en)
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JP4098623B2 (ja
Inventor
ジェイ メスワニア
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Stanmore Implants Worldwide Ltd
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Stanmore Implants Worldwide Ltd
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Publication of JP2004515310A publication Critical patent/JP2004515310A/ja
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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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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    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
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    • 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
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    • 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
    • A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0081—Prosthesis for animals
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0084—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
    • 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
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • 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
    • A61F2310/00179—Ceramics or ceramic-like structures
    • 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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

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Abstract

人又は動物の長い骨を置き換えるための人口骨を構成するモジュールシステムを開示する。このシステムは、義関節の１つの部品を構成する転子（１）又は関節ヘッドのような中央部又は末端部品と、中央部又は末端部品に結合される軸（５）と、一部が切断された骨に係合される幹（８）を備えた人工骨を提供する。このシステムは、限られた範囲の部品から、特注の人工骨を組み立てることを可能にする。
【選択図】図１

Description

【０００１】
本発明は、人又は動物の体の長い骨の一部又は全体を置き換えるための人工骨に関する。
【０００２】
手足をひどく損傷したり、例えば骨肉腫の処置の場合のように大量の骨を外科的に除去しなければならない場合において、生まれつきの骨の大部分に置き換わり、かつ広範囲の状態に適合するように、外科医により組み立てが可能な人工骨が必要である。本発明は、これらの範囲の外科的要求に適合する特注の人工骨を効果的に構成するためのモジュールシステムを提供する。例えば、代表的な用途は、大腿骨の中央部又は末端を置き換え、場合によっては、大腿骨全体を置き換えることである。
【０００３】
本発明の一態様によれば、人又は動物における長い骨を部分的に又は全体的に置き換えるための人工骨が提供される。人工骨は、義関節（ｐｒｏｓｔｈｅｔｉｃ ｊｏｉｎｔ）の１つの部品を形成する中央部又は末端の部品と、その中央部又は末端の部品と結合された軸と、一部分が切除された骨に係合される幹とを備え、軸、幹（ｓｔｅｍ）及び中央部又は末端の部品は、雄及び雌テーパにより結合され、各雄テーパは、人工骨の長手方向に伸び、かつその軸からずれ、雌テーパの対応する凹部に係合する凸部を含み、横孔が分解工具により雄テーパの端部領域を横方向に突き抜けられるように設けられており、前記凸部が隣接する部品に対して所望する角度関係を維持している。
【０００４】
本発明は、軸又はその延長部に結合されたカラー（ｃｏｌｌａｒ）を含む他の特徴をさらに含む。そのカラーは、人工骨が嵌り合う骨の切断面に沿う寸法に形成されており、カラーは切断された面に向かってテーパに係合する部分及びそのカラーのテーパ状の面の上に骨が成長することを促進するように意図された表面処理を有する。
【０００５】
大腿骨の中央部を人工骨に置き換える場合、人工骨は、軸及び幹に結合された転子置換部品を含み、その転子置換部品は、解剖学的な転子に略対応した形状であり、大腿骨球部を受けるための大腿骨首、及び残りの骨又は軟組織に結合されるための大腿骨首とは反対側のおおむね平坦な面を含む。
【０００６】
本発明に係る人工骨の詳細な特徴を、図面を参照して説明する。はじめに図１を参照する。この図は、大腿骨首２を有する転子部品１を備えた組み立てられた大腿骨中央部の人口骨を図式的に示している。大腿骨首２は、従来の方法により、大腿骨球部を受け入れるために、テーパ状に形成されている。転子部品の詳細を図３に示す。転子部品は、大まかに解剖学的な形状に対応しており、残りの骨又は軟組織に結合されるように、おおむね平坦な面３を有していることが分かるであろう。転子部品１は、図３に最も良く示されているように、内側に雌テーパを有しており、軸５に備えられた雄テーパに結合される。軸５の詳細な構成は図４から明らかであり、軸５は、転子部品１の雌テーパに結合されるために、一端に設けられた雄テーパ３３及び幹８（図５にさらに詳細に示す）の一端に結合されるために、他端に設けられた雌テーパ７を有していることが分かるであろう。
【０００７】
幹８は、圧入により又は骨用の接着剤の使用により一部分が切断された大腿骨９に取り付けられる。軸５の末端部はカラー１０により囲まれている。カラー１０の詳細を図６に示す。カラー１０は、一部が切断された大腿骨９の表面を形成する海綿骨に境を接する下端部１１を有する。カラー１０の寸法は、カラー１０の端面が骨９の外側の寸法の全体にわたって終了する（ｔｅｒｍｉｎａｔｅｓ ｉｎ ｂｏａｒｄ ｏｆ）ように選択されている。カラー１０の外面には、点刻又は骨の成長を刺激するヒドロキシアパタイト（ｈｙｄｒｏｘｙａｐａｔｉｔｅ）のような材料が形成されている。これらの手段は、海綿骨がカラー１０の表面上に成長することを促進し、人工骨を一部が切断された残りの骨９とより強固に結合させる手助けをする。
【０００８】
損傷した骨又は腫瘍を除去し、転子の残りの部分１２をそのままにしておくこともしばしばあり得る。この骨の残り片は、それに付着した靱帯又はその他の軟組織を有しているであろうから、それを転子置き換え部品を安定させるために用いることが有用である。残りの骨１２は、プレート１３を転子部品の面３に押し付けることにより転子部品に取り付けることができる。
【０００９】
図２は、図１において転子部品１を軸５に結合した方法と同様の方法で軸５に結合された膝の関節の一部分を形成する関節ヘッド部品２１を供えた組み立てられた末端人工骨を示す。同様に、軸５は、図１との関係において前に述べた方法と同様の方法により、幹８に結合されている。カラー１０は、図１との関係においてすぐ上で述べたように、軸部材５のテーパ状の下方部分の上を滑り、また、大腿骨９の切断された面に境を接するテーパ状の末端部分１１を有する。同様にして、このことはカラー１０の表面上に骨が成長することを促進する。
【００１０】
転子部品１の詳細を図３に示す。転子部品１の平坦な面３には、所定パターンのスパイク３０が形成されている。このスパイクのパターンは、残りの骨１２（図１参照）との強固な結合を可能にし、人工骨をさらに安定させるように機能する。この転子部品は、軸からずれた凹部３１を有し、内側が行き止まりの雌テーパを有していることが分かるであろう。凹部３１は、軸５の雄テーパ３３に形成された凸部３２と係合する形状である。（図４参照）。転子部品には、分解が必要とされる部分である軸から転子部品を分離させるために、分解工具が挿入される横孔３４が設けられている。図４から分かるように、軸５は、また、雌テーパ７を有し、転子部品における凹部３１と同様の凹部３５を有するように形成されている。軸５は、また、軸とテーパ７に係合されるように設計された幹部品とを分離させるために分解工具を挿入することができる横孔３６を含む。
【００１１】
さらに図３を参照して、転子部品もまた孔３６を有することが分かるであろう。これらの孔３６は、残りの骨がない場合に腱のような軟組織に転子部品を縫い付けることを意図しており、この孔３６に腱が取り付けられ、腱がスパイクされた面３に押し付けられる。
【００１２】
転子部品は、左右両バージョンがあるけれども、モジュールシステムの標準部品として提供されることを意図されている。特定の患者に適するように、大腿骨首からのずれの度合いが異なった選択可能な複数の転子部品が用意されるであろう。
【００１３】
図４から分かるように、大腿骨の軸は、テーパに関しては標準化されているけれども、１５ｍｍ間隔で様々な長さのものが供給される。大腿骨の軸には、また、カラー１０と一体化された対応する耳（ｅａｒｓ）３８に結合するように意図された複数の切れ目３７が設けられている。図６から分かるように、カラー１０は、軸５の一端における対応するテーパ４０に係合するように形成された内部テーパ３９を有する。カラーを軸５に係合させ、また、耳３８を切れ目３７に係合させることにより、カラーを軸にしっかりと結合させることができる。図６から分かるように、カラーは、複数の直径Ｄ１及びＤ２部分が設けられている。
【００１４】
図５は、幹部品８の各部分を示す。断面図から分かるように、幹には、皮質骨に結合されるためのひだが形成されており、骨の筋における湾曲に適応するように真っ直ぐ又は曲がっていてもよい。軸の中央に近い端部は、軸部品の内側のテーパ７に対応するテーパを有している。軸は、また、軸部品の凹部３５に対応する凸部４３を含む。軸部品５は分解目的のための横孔３６を含み、その孔から挿入された工具を押し付けると、幹と軸の対応する端面で支えられた幹と軸とが分離される。図５から分かるように、幹は、人工骨の使用に際して遭遇する様々な外科的な問題に適用できるように、多数の直径と長さが用意されており、真っ直ぐであっても良いし、曲がっていてもよい。
【００１５】
図７は、図１及び図２に示した全体の組み立て体の延長を可能にする延長軸モジュールを示す。延長軸モジュール５０は、軸モジュールのテーパ７及び幹モジュールのテーパ４２にそれぞれ対応する雄テーパ及び雌テーパを両端に有している。もちろん、延長軸モジュール５０は、転子部品１又は関節ヘッド部品２１を幹８に結合するために、標準軸と共に又は単独で用いることができる。
【００１６】
詳細には示していないけれども、図１及び２に示す人工骨は、完全な大腿骨を置き換える人工骨を形成するために、軸８及びカラー１０を省略して結合することができる。また、同じように形成された部品を、上腕骨のような他の長い骨を置き換えるために用いることができる。
【００１７】
以上説明したように、人工骨の部品は、試しに組み立てた後や組み直し作業において、各部品のテーパ状の結合箇所の横孔に分解工具を挿入することにより簡単に分解することができる。
【００１８】
コバルトクロム又はセラミックのヘッドを用いることが好ましい大腿骨頭部を除いて、材料として全体的にチタン合金を用いることが好ましい。
【図面の簡単な説明】
【図１】大腿骨中央部の人工骨の結合された部品の側部立体図である。
【図２】本発明に係る大腿骨端部の人口骨の側部立体図である。
【図３】本発明に係る転子置換部品の各部分を示す図である。
【図４】本発明において用いられる軸モジュールの各部分を示す図である。
【図５】本発明において用いられる大腿骨幹の各部分を示す図である。
【図６】本発明に係る人工骨において用いられるカラーの各部分を示す図である。
【図７】本発明において用いられる延長軸モジュールの各部分を示す図である。

Claims (6)

  1. 人又は動物の体の長い骨の一部又は全体を置き換えるための人工骨であって、前記人工骨は、義関節の１つの部品を形成する中央部又は末端の部品と、その中央部又は末端の部品と結合された軸と、一部分が切除された骨に係合される幹とを備え、軸、幹及び中央部又は末端の部品は、雄及び雌テーパにより結合され、各雄テーパは、人工骨の長手方向に伸び、かつその軸からずれ、雌テーパの対応する凹部に係合する凸部を含み、横孔が分解工具により雄テーパの端部領域を横方向に突き抜けられるように設けられており、前記凸部が隣接する部品に対して所望する角度関係を維持していることを特徴とする人工骨。
  2. 軸又はその延長部に結合されたカラーを含み、そのカラーは、人工骨が嵌り合う骨の切断面に沿う寸法に形成されており、カラーは切断された面に向かってテーパに係合する部分及びそのカラーのテーパ状の面の上に骨が成長することを促進するように意図された表面処理を有することを特徴とする請求項１に記載の人工骨。
  3. カラーには、外向きに点刻された面が形成されており、又はヒドロキシアパタイト又は骨の成長を促進する他の材料がコーティングされていることを特徴とする請求項２に記載の人工骨。
  4. 大腿骨中央部を置き換える人工骨であって、人工骨は軸又は幹に結合された転子置換部品を含むことを特徴とする請求項１から３のいずれかに記載の人工骨。
  5. 転子置換部品は、解剖学的な転子に略対応した形状であり、大腿骨球部を受けるための大腿骨首、及び残りの骨又は軟組織に結合されるための大腿骨首とは反対側のおおむね平坦な面を含むことを特徴とする請求項４に記載の人工骨。
  6. 前記おおむね平坦な面は、残りの骨と噛み合うための点刻を有していることを特徴とする請求項５に記載の人工骨。
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GB0030643A GB2370041C (en) 2000-12-15 2000-12-15 A modular system for formation of a prosthesis
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