JP2006500188A - 人工器官用の機械的に取り付けられたエラストマーのカバー - Google Patents
人工器官用の機械的に取り付けられたエラストマーのカバー Download PDFInfo
- Publication number
- JP2006500188A JP2006500188A JP2004568907A JP2004568907A JP2006500188A JP 2006500188 A JP2006500188 A JP 2006500188A JP 2004568907 A JP2004568907 A JP 2004568907A JP 2004568907 A JP2004568907 A JP 2004568907A JP 2006500188 A JP2006500188 A JP 2006500188A
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- Japan
- Prior art keywords
- graft
- elastomeric cover
- graft body
- orthopedic
- assembly
- 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.)
- Pending
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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
- A61F2/40—Joints for shoulders
- A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
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- 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
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
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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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Landscapes
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Abstract
【解決手段】移植片本体と、この移植片本体に機械的ファスナにより接続されているエラストマーのカバーとを含んでいる、整形外科用人工器官移植片アッセンブリ。
Description
本発明は、概括的には、エラストマー製の接触面を備えた移植可能な人工器官及び同人工器官の製作法に、更に厳密には、エラストマーのカバーを機械的に取り付けた人工器官に関する。
本出願は、35USC第119条により、2002年9月20日出願の米国仮特許出願第60/411,932号、2002年11月15日出願の米国仮特許出願第60/426,345号、及び2003年4月14日出願の米国仮特許出願第60/462,327号に関して優先権を主張し、上記出願を参考文献として本願に援用する。
外科処置では、関節又は関節の一部を置き換えるために移植可能な人工器官を使用することがある。例えば、関節形成術においては、人工のボールを使って肩関節の上腕頭を置換することがある。人工器官としては、代表的にはエラストマーの殻で金属ボールを覆って形成された柔らかくクッション性のあるボール(又は「頭部」)があり、このボールが肩関節の元からの関節運動面と置き換えられる。
柔らかくクッション性のある頭部に不具合が生じると、エラストマーの殻がその下の硬いボールから外れたり、エラストマーの殻が裂けたりして、人工器官全体に支障が生じることになる。
エラストマーの殻は、接着剤かセメントで、又はエラストマーを現場で硬化させることによって、硬いボール(場合によっては多孔質である)に結合させるのが一般的である。利用可能な接着剤及びセメントには、エラストマーの殻又は硬質ボールの期待有効寿命よりも早い時期に不具合が生じて、移植片を取り出し、移植片の有効寿命を短縮する結果になることが多い。硬いボール上で現場硬化させても同じ結果になる。
エラストマーの殻を硬いボールに接着しても、硬いボールに接着している状態でエラストマーの殻に裂けが生じる結果になる。裂ける原因は、接着すると、エラストマーの殻のどの部分も硬いボールの表面に対して平行運動ができなくなってしまうことにある。その結果、エラストマーの殻に不均等に圧力が加わり、裂けが生じていたずらに移植片の有効寿命を縮めることになる。
米国仮特許出願第60/411,932号
米国仮特許出願第60/426,345号
米国仮特許出願第60/462,327号
第1の全体的態様では、整形外科用人工器官移植片アッセンブリは、移植片本体と、この移植片本体に機械的ファスナで結合されたエラストマーのカバーを含んでいる。
各種実施形態は、以下の特徴の内の1つ又はそれ以上を含んでいる。機械的ファスナには、移植片本体と前記エラストマーのカバーの間の目違い接合が含まれる。この目違い接合では、移植片の外表面に少なくとも1つの窪みが形成され、エラストマーのカバーの内表面に少なくとも1つの突起が形成されて、この少なくとも1つの突起が前記少なくとも1つの窪みに入ることになる。この少なくとも1つの窪みでは、少なくとも部分環状溝が移植片本体の外表面に形成される。
各種実施形態は、以下の特徴の内の1つ又はそれ以上を含んでいる。機械的ファスナには、移植片本体と前記エラストマーのカバーの間の目違い接合が含まれる。この目違い接合では、移植片の外表面に少なくとも1つの窪みが形成され、エラストマーのカバーの内表面に少なくとも1つの突起が形成されて、この少なくとも1つの突起が前記少なくとも1つの窪みに入ることになる。この少なくとも1つの窪みでは、少なくとも部分環状溝が移植片本体の外表面に形成される。
この他の利点は、以下の説明及び添付図面から明らかになるであろう。ここに示す実施形態は、単独で使用してもよいし、任意に組み合わせて集合的に使用してもよい。これらの実施形態は、網羅的列挙として理解されるべきではなく、むしろ本発明を説明するための例示的性格を有している。
これより、添付図面を参照しながら、ほんの一例として、本発明について説明する。特に図面について詳しく言うと、ここに示す詳細事項は一例に過ぎず、本発明を例示的に論じることだけを目的としている点を強調しておく。
以下に詳しく説明するが、エラストマーのカバーは、移植片本体上に配置され機械的ファスナにより所定の位置に固定される。
図1に示すように、整形外科用人工器官移植片アッセンブリ10は、外面23を有する任意の剛性の移植片本体22と、機械的ファスナで移植片本体22に接合されているエラストマーのカバー20を含んでいる。エラストマーのカバー20は、移植片本体22と、これと相補的な関節面40の間の接触応力を下げる働きがある。移植片本体22は、ボール状の形状であり、球窩関節として使用することができる。ここで「ボール」とは、「ソケット」(即ち凹状に湾曲した輪郭を有する3次元形状の一部)内で関節運動可能な凸状に湾曲した輪郭を有する3次元物体の少なくとも一部を指し、球体の様なものであるが、これに限定されるわけではない。ボールは、半径rを有し、半径の寸法は、ボールの使用部位及び/又は患者の寸法によって変わる。例えば、成人患者の肩関節に使用されるボールの半径は、同じ成人患者の股関節に使用されるボールよりも大きい。小児では、所定関節の値rは成人よりも小さくする必要がある。更に、ボールに使用される球体の部分も、その使用部位により変わる。例えば、股関節では全球体の220度から280度分が使用され、肩関節では全球体の20度から90度分が使用される。
図1に示すように、整形外科用人工器官移植片アッセンブリ10は、外面23を有する任意の剛性の移植片本体22と、機械的ファスナで移植片本体22に接合されているエラストマーのカバー20を含んでいる。エラストマーのカバー20は、移植片本体22と、これと相補的な関節面40の間の接触応力を下げる働きがある。移植片本体22は、ボール状の形状であり、球窩関節として使用することができる。ここで「ボール」とは、「ソケット」(即ち凹状に湾曲した輪郭を有する3次元形状の一部)内で関節運動可能な凸状に湾曲した輪郭を有する3次元物体の少なくとも一部を指し、球体の様なものであるが、これに限定されるわけではない。ボールは、半径rを有し、半径の寸法は、ボールの使用部位及び/又は患者の寸法によって変わる。例えば、成人患者の肩関節に使用されるボールの半径は、同じ成人患者の股関節に使用されるボールよりも大きい。小児では、所定関節の値rは成人よりも小さくする必要がある。更に、ボールに使用される球体の部分も、その使用部位により変わる。例えば、股関節では全球体の220度から280度分が使用され、肩関節では全球体の20度から90度分が使用される。
エラストマーのカバー20の材料硬度は、ショアA硬度で約60から65の間にあればよい。より厳密には、材料の硬度は、ショアA硬度で約60以上、同約65以上、同約70以上、同約75以上、同約80以上、同約85以上、同約90以上、又は同約95以上であってもよい。材料の硬度は、ショアA硬度で約105未満、同約95未満、同約90未満、同約85未満、同約80未満、同約75未満、同約70未満、又は同約65未満でもよい。エラストマーのカバー20は、弾性率が約10から約150MPaの間にあればよい。より具体的には、材料は弾性率が、約10Mpa以上、約30Mpa以上、約50Mpa以上、約70Mpa以上、約90Mpa以上、約110Mpa以上、約130Mpa以上であってもよく、弾性率が約150Mpa未満、約130Mpa未満、約110Mpa未満、約90Mpa未満、約70Mpa未満、約50Mpa未満、又は約30Mpa未満でもよい。エラストマーのカバー20の外側表面は、滑らかな面であってもよいし、滑らかではなく、概ね滑らかな面に変更を加えて使用時の潤滑品質を改善し、例えば溝や僅かに粗い肌理などを設けてもよい。表面に浅い溝を刻めば、表面に滑液を保持するための通路を設けることにより潤滑を円滑にすることができる。
移植片本体22は、下端部29が少なくとも部分的にはリッジ33に取り囲まれており、このリッジ33により、相補的な関節面40内での関節運動時に、エラストマーのカバー20が外表面23から外れるのが防止される。
更に図1に示すように、エラストマーのカバー20を移植片本体22に留める機械的ファスナは、移植片本体22とエラストマーのカバー20の間の目違い接合である。目違い接合は、外表面23上の少なくとも1つの窪み36と、エラストマーのカバー20の内表面19上の少なくとも1つの突起38を含んでいる。1つ又は複数の突起38は、1つ又は複数の窪み36にぴったり填り込んで、相補的な関節面40内での関節運動時に、カバー20を移植片本体22の湾曲面23に対して機械的に固定できるように設計、製作、配置されている。この少なくとも1つの窪み36は、外表面23を巡る環状溝又は部分環状溝として形成してもよい。代わりに又は追加的に、エラストマーのカバー20の内表面19に1つ又は複数の窪み36を設け、移植片本体22の湾曲面23に1つ又は複数の突起38を設けてもよい。
次に図1Aに示すように、移植片アッセンブリ10の流体シール構造44では、窪み36から歯(例えば、少なくとも部分的には環状の形状)が突き出して、突起38を押圧しシールを形成している。流体シール構造44は、エラストマーのカバー20と移植片本体22の間に流体が入り込むのを防いでいる。
次に図2Aと図2Bに示すように、整形外科用人工器官移植片アッセンブリ30は、半径方向内向きで少なくとも部分的には環状形状の溝37が形成されたリップ35を含んでいるエラストマーのカバー20を備えている。エラストマーのカバー20は、移植片本体22の外表面23を覆うように装着され、機械的ファスナで移植片本体22に留められており、この機械的ファスナとしては、保持要素例えば保持リング24などが挙げられるが、これに限定されるわけではない。(保持要素は、リング形状以外の形状、例えば矩形でもよいが、これに限定されるわけではない。保持要素及び保持リングという用語は、ここでは同義的に使用し、リングという語で保持要素の形状を限定しているわけではないと理解頂きたい。)保持リング24は、限定するわけではないが、スクリュー、リベット、ボルトなどの様な1つ又は複数のファスナ25で、非関節運動面(底面)34に固定される。追加的に又は代わりに、保持リング24は、溶接、接着、又は他の結合法で、非関節運動面(底面)34に固定してもよい。非関節運動面(底面)34は平らな面である。保持リング24には、少なくとも部分的には環状の溝37に嵌合する少なくとも部分的には環状のリッジ27を設けてもよい。(代わりに、溝37を移植片本体22に形成してもよい。)
関節の関節運動時、エラストマーのカバー20は、相補的な関節面40に対して関節運動(移動)する。保持リング24をリップ35及び移植片本体22に取り付けることにより、相補的関節面40内での関節運動時に、エラストマーのカバー20が移植片本体22から外れるのを防いでいる。
関節の関節運動時、エラストマーのカバー20は、相補的な関節面40に対して関節運動(移動)する。保持リング24をリップ35及び移植片本体22に取り付けることにより、相補的関節面40内での関節運動時に、エラストマーのカバー20が移植片本体22から外れるのを防いでいる。
保持リング24は、どの様な材料で製作してもよく、移植片本体22と同じ材料で製作してもよいし違う材料で製作してもよい。通常は、移植片本体22は、セラミック又は金属材料で製作されるが、他の材料を使ってもよい。保持リング24は、硬度(又は他の特性)が移植片本体22又はエラストマーのカバー20と同程度、又はそれより下又は上の材料で製作してもよい。
保持リング24は、周囲の組織(例えば、ソケット壁面)との摩擦の結果、又は圧力がエラストマーのカバー20の特定の点に加わったときに、エラストマーのカバー20と移植片本体22の間で、少しの局所的な相対平行移動又は回動ができるようにしている。僅かな局所的相対移動によって、エラストマーのカバー20が裂ける可能性を減らすことができる。
次に図3では、移植片アッセンブリ50は、外(図面では上)表面53を有する任意の剛性の移植片本体52と、移植片本体52に機械的に接合可能なエラストマーのカバー54を含んでいる。移植片本体52は、1つ又は複数の取付部材58が内表面(底面)60から突き出ているプレート部56を含んでいる。取付部材58は、例えば、他の人工器官要素又は骨構造に装着するための丸いペグの形態であってもよい。取付部材58は、代わりに又は追加的に、ねじ付ファスナ、ねじ付インサート、スパイクなどであってもよい。
プレート部56の外表面53は、エラストマーのカバー54を移植片本体52に留めるための1つ又は複数のファスナ62を有している。ファスナ62は、プレート部56と概ね(必ずしも平行である必要はないが)平行で、少なくとも部分的には環状形状のスペーサリング66によりプレート部56から離間されている、少なくとも部分的には環状のリップ64を有している。エラストマーのカバー54は、リップ64とプレート部56の間の間隙にぴったりと嵌ってエラストマーのカバー54を移植片本体52に機械的に固定する、内側に向いたリップ68を有している。
少なくとも部分的には環状形状のリップ64と、プレート部56と、少なくとも部分的には環状形状のスペーサリング66は、一体に形成してもよい。随意的にではあるが、少なくとも部分的には環状形状のリップ64と、プレート部56と、少なくとも部分的には環状形状のスペーサリング66は、別個の部分として形成し、エラストマーのカバー54に、個々のプレート部56の間の間隙にぴったり嵌る隔壁70を設けてもよい。
随意的に、移植片アッセンブリ50は、エラストマーのカバー54の内側に内芯72を有しており、この芯部はエラストマーのカバー54を移植片本体52に機械的に取り付けることによって所定の位置に保持されている。内芯72は、エラストマーのカバー54と異なる性質の材料で製作してもよいし、同じ性質の材料で製作してもよい。例えば、内芯72は、エラストマーのカバー54よりコンプライアンスがあり弾性的な材料で形成してもよく、そうすれば移植片アッセンブリ50とのコンプライアンスを高めることができる。
次に図4では、移植片アッセンブリ80は、外(図面では上)表面83を有する任意の剛性の移植片本体82と、移植片本体82と機械的に接合可能なエラストマーのカバー84を含んでいる。移植片本体82は、全体的にボールのような形状であり、球窩関節として使用することができる。
機械的ファスナは、エラストマーのカバー84を移植片本体82に留めるねじ付ファスナ(ねじ付接合ともいう)である。ねじ付接合は、移植片本体82の首部89に相補的に形成されたねじ88と噛み合うねじ付リング86を含んでいる。ねじ付リング86には雌ねじ87が設けられ、一方、相補的に形成されたねじ88は雄ねじである。代わりに、ねじ付リング86に雄ねじを設け、相補的に形成されたねじ88を雌ねじとしてもよい。
図1に示したものと同様に、エラストマーのカバー84は、1つ又は複数の突起85を有し、この突起が、エラストマーのカバー84を巡る少なくとも部分的には環状形状のリングとして形成されている。ねじ付リング86は、突起部85に当たるように締められ、エラストマーのカバー84を移植片本体82に固定する。ねじ付リング86は、突起85に当接する面取り部90を有している。図1Aに示したものと同様に、移植片本体82から突き出て、突起85を押圧してシールを形成する(例えば、少なくとも部分的には環状形状の)歯の様な流体シール構造92が設けられている。流体シール構造92は、エラストマーのカバー84と移植片本体82の間に流体が入り込むのを防ぐ働きをする。
他の実施形態
以上、本発明の実施形態を数多く説明してきた。しかしながら、様々な変更を加えることができるものと理解頂きたい。従って、この他の実施形態も、特許請求の範囲に定める範囲に含まれる。
以上、本発明の実施形態を数多く説明してきた。しかしながら、様々な変更を加えることができるものと理解頂きたい。従って、この他の実施形態も、特許請求の範囲に定める範囲に含まれる。
Claims (20)
- 移植片本体と、
該移植片本体に機械的ファスナで接続されたエラストマーのカバーと、を備えている、整形外科用人工器官移植片アッセンブリ。 - 前記機械的ファスナは、目違い接合を備えている、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記目違い接合は、前記移植片本体の外表面に形成された少なくとも1つの窪みと、前記エラストマーのカバーの内表面に形成された少なくとも1つの突起とを備えており、前記少なくとも1つの突起が前記少なくとも1つの窪みに入り込む、請求項2に記載の整形外科用人工器官移植片アッセンブリ。
- 前記少なくとも1つの窪みは、前記移植片本体の前記外表面の環状溝を含んでいる、請求項3に記載の整形外科用人工器官移植片アッセンブリ。
- 前記移植片本体はボール形状であり、前記エラストマーのカバーは前記ボール形状の移植片本体の少なくとも一部を覆っており、前記ボール形状の移植片本体は、前記エラストマーのカバーが前記移植片本体の外表面から外れるのを防ぐように作られた、前記移植片本体の一部を取り巻くリッジを含んでいる、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記移植片本体はボール形状であって、前記エラストマーのカバーの内表面に接触する歯を含んでおり、前記エラストマーのカバーは、前記ボール形状の移植片本体の少なくとも一部を覆っており、前記歯と前記エラストマーのカバーの前記内表面との間の接触により、前記エラストマーのカバーと前記移植片本体の間に流体が滲み込むのを防ぐ液密シールが形成される、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記機械的ファスナは、前記移植片本体と前記エラストマーのカバーの間の目違い接合を備えており、前記歯は、前記目違い接合の溝部分から突き出している、請求項6に記載の整形外科用人工器官移植片アッセンブリ。
- 前記機械的ファスナは、前記エラストマーのカバーを前記移植片本体上の所定の位置に保持するための保持リングを備えている、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記保持リングは、機械的ファスナで前記移植片本体の非関節運動面に固定されている、請求項8に記載の整形外科用人工器官移植片アッセンブリ。
- 前記保持リングには、前記エラストマーのカバーと前記移植片本体の少なくとも一方に形成された少なくとも部分的には環状形状の溝に嵌合する少なくとも部分的には環状形状のリッジが設けられている、請求項8に記載の整形外科用人工器官移植片アッセンブリ。
- 前記保持リングは、前記エラストマーのカバーと前記移植片本体の間の局所的な相対運動を許容する、請求項8に記載の整形外科用人工器官移植片アッセンブリ。
- 前記移植片本体は、その内表面から突き出る少なくとも1つの取付部材を有するプレート部と、前記エラストマーのカバーを前記移植片本体に固定するための、その外表面上の少なくとも1つのファスナとを、備えている、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記少なくとも1つのファスナは、少なくとも部分的には環状形状のスペーサリングによって前記プレート部から離間している少なくとも部分的には環状形状のリップを含んでおり、前記エラストマーのカバーは、前記少なくとも部分的には環状形状のリップと前記プレート部の間の間隙に嵌る内側に向いたリップを備えている、請求項12に記載の整形外科用人工器官移植片アッセンブリ。
- 前記少なくとも部分的には環状形状のリップと、前記プレート部と、前記少なくとも部分的には環状形状のスペーサリングとは、一体に形成されている、請求項13に記載の整形外科用人工器官移植片アッセンブリ。
- 前記少なくとも部分的には環状形状のリップと、前記プレート部と、前記少なくとも部分的には環状形状のスペーサリングとは、別々の部品として形成され、前記エラストマーのカバーは、前記別々の部品の間の間隙に嵌合する隔壁を備えている、請求項13に記載の整形外科用人工器官移植片アッセンブリ。
- 前記エラストマーのカバーの内側に配置された内芯を更に備えている、請求項12に記載の整形外科用人工器官移植片アッセンブリ。
- 前記内芯は、前記エラストマーのカバーとは異なる性質の材料で製作されている、請求項16に記載の整形外科用人工器官移植片アッセンブリ。
- 前記内芯は、前記エラストマーのカバーの材料よりもコンプライアンスと弾性のある材料で製作されている、請求項17に記載の整形外科用人工器官移植片アッセンブリ。
- 前記機械的ファスナは、前記エラストマーのカバーを前記移植片本体に留めるねじ付ファスナを含んでいる、請求項1に記載の整形外科用人工器官移植片アッセンブリ。
- 前記ねじ付ファスナは、前記移植片本体上の相補的に形成されたねじと噛み合うねじ付リングを備えている、請求項19に記載の整形外科用人工器官移植片アッセンブリ。
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EP (1) | EP1542624A2 (ja) |
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FR2765100B1 (fr) * | 1997-06-30 | 1999-07-30 | Implant Reduction Eurl | Prothese articulaire retentive |
US6368354B2 (en) * | 1999-10-07 | 2002-04-09 | Exactech, Inc. | Acetabular bearing assembly for total hip joints |
EP1166724A1 (de) * | 2000-06-21 | 2002-01-02 | Sulzer Orthopedics Ltd. | Gelenkteil einer Interimsprothese sowie Interimsprothese |
-
2003
- 2003-09-17 JP JP2004568907A patent/JP2006500188A/ja active Pending
- 2003-09-17 EP EP03797498A patent/EP1542624A2/en not_active Withdrawn
- 2003-09-17 WO PCT/IL2003/000748 patent/WO2004026170A2/en not_active Application Discontinuation
- 2003-09-17 US US10/663,768 patent/US20040059429A1/en not_active Abandoned
- 2003-09-17 AU AU2003263567A patent/AU2003263567A1/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
US20040059429A1 (en) | 2004-03-25 |
WO2004026170A3 (en) | 2004-06-10 |
AU2003263567A8 (en) | 2004-04-08 |
EP1542624A2 (en) | 2005-06-22 |
WO2004026170A2 (en) | 2004-04-01 |
AU2003263567A1 (en) | 2004-04-08 |
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