JP3443003B2 - 距トライアルおよび股置換装置 - Google Patents
距トライアルおよび股置換装置Info
- Publication number
- JP3443003B2 JP3443003B2 JP18248898A JP18248898A JP3443003B2 JP 3443003 B2 JP3443003 B2 JP 3443003B2 JP 18248898 A JP18248898 A JP 18248898A JP 18248898 A JP18248898 A JP 18248898A JP 3443003 B2 JP3443003 B2 JP 3443003B2
- Authority
- JP
- Japan
- Prior art keywords
- proximal
- distal
- shank
- shaft
- trial
- 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.)
- Expired - Lifetime
Links
Classifications
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- A61F2/4684—Trial or dummy prostheses
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- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
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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
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/3055—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/30708—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
- 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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
- A61F2002/3071—Identification means; Administration of patients
-
- 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
- A61F2/32—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
- A61F2002/3625—Necks
- A61F2002/3627—Necks with lateral apertures, holes or openings
-
- 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
- A61F2/32—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
- A61F2002/3625—Necks
- A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/3672—Intermediate parts of shafts
- A61F2002/3674—Connections of proximal parts to distal 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
- 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
- A61F2/3662—Femoral shafts
- A61F2002/3678—Geometrical features
- A61F2002/3686—Geometrical features bent
-
- 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
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4619—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof for extraction
-
- 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
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
- A61F2002/4628—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
-
- 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
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
- A61F2002/4638—Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
-
- 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
- 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
- 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
- A61F2250/0085—Identification means; Administration of patients
Landscapes
- Health & Medical Sciences (AREA)
- Transplantation (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Physical Education & Sports Medicine (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
イアル(trial)の必要寸法を決定するためのトラ
イアル等の股関節形成に使用する装置、更に具体的には
大腿距軸(calcar stem)に関する。
特許出願第08/824,336号の一部係属出願であ
る。股置換または股関節形成術の好結果は、一部で、特
定寸法に合わせて形成されかつぴったりと適合するよう
に位置決めされて自然の健康な股関節の幾何学的かつ機
能的特徴を再現する人工関節要素の選択によって得られ
る。典型例として、その要素選択方法は関節画像の術前
分析を必要とする。しかしながら、画像分析に有効な補
佐は人工関節の永久的固定前の股関節形成段階における
1以上の過度的要素の関係骨への一時的固定であること
が発見されている。この過度的要素は外科医にとって測
定を確実にしかつ数回にわたる異なる要素の寸法および
形態を試験または『試行』("try-out")するために永久
的人工関節の特定断面(特徴)を模倣するために使用さ
れる。従って、かかる過度的要素は『トライアル』とし
て知られている。
は次の方法で使用される。大腿骨の近位端部が切除され
かつ大腿骨の骨髄管が切削される。ブローチ(broa
ch)が大腿骨の切除された近位端部へ挿入され、大腿
骨軸を受けるべく寸法取りされかつ付形された骨内にキ
ャビティを形成する。しかしながら、ブローチを除去す
る前に、完全な大腿軸を模造するためにトライアルネッ
ク(首部)またはトラニオン(筒耳部)およびトライア
ルヘッド(頭部)がブローチへ固定される。通常、長さ
および幾何学的形状を変化させた数個のネックおよびヘ
ッドトライアルが試験的に連続的にブローチへ結合され
て、適切なネック長および全体的大腿軸長が決定され
る。これらの長さが一旦決定されると、トライアルネッ
クおよびヘッドはブローチから除去され、かつブローチ
が大腿骨から除去される。続いて、適切長の大腿軸がブ
ローチにより当分野に既知の方法によって決定されたキ
ャビティへ挿入するために選択される。
クに加えて、軸部を有するトライアルを使用するために
ブローチを骨髄管から除去することを必要とする。例え
ば、米国特許第5,100407号は、適切なトライア
ルの形成に適合するように混在させた、一群の種々の寸
法のネックおよび本体部および一群の異なる長さのトラ
イアル軸部を含む装置を開示している。しかしながら、
本体部に対する連続的組立および分解によるトライアル
軸部の反復的除去および連続的挿入は処置時間を長引か
せかつ費用を消耗させる。
ック長および軸長が探知されるまでトライアルの長手に
沿って連続的点で固定されなければならない軸を含む。
このタイプのトライアルは、カラーが軸からの係合およ
び離脱を繰り返すために、軸移動に起因して不正確な測
定を誘導するので望ましくない。更に、カラーが軸の遠
位端方向へ移動するので、次第に小さくなった軸が骨髄
管内に設置され、それによりトライアルは次第に不安定
になり、結果的に精確測定を得るのが極めて困難であ
る。
の組合体から数回にわたり選択しかつ適合させなければ
ならない複数パーツから成るトライアル装置は煩瑣、不
必要に煩雑かつ貴重な時間の浪費であると考えられる。
利かつ容易な使用法により極めて精確な測定を可能にす
る一体化された組立体を提供することにより、従来トラ
イアルの欠点を解消することを課題とする。本発明のト
ライアルは反復的組立および分解を必要とせず、かつト
ライアルの高さと関係なく探査されたキャビティに非常
に近似した幾何学を独創的に提供する。
発明の距トライアルは、好適形態において、近位端およ
び遠位端を有する近位軸部、前記近位軸部が本体部に対
して実質的外方に設置されるように前記近位軸部に対し
て長手方向に摺動して調節自在に前記近位軸部と係合す
る本体部、ならびに近位端および遠位端を有する湾曲し
た遠位軸部から成り、前記遠位軸部の近位端は前記近位
軸部の遠位端と係合自在であることを特徴とする。
近位端および遠位端を有する近位軸部、前記近位軸部の
遠位端に対して外方へ取付自在の近位端、および遠位端
を有する連結要素、ならびに近位端および遠位端を有す
る遠位軸部を有し、前記遠位軸部の近位端は第1配向に
おいて前記連結要素の遠位端と係合自在であって前記遠
位軸部を前記近位軸部に対して第1方向へ湾曲させ、か
つ前記遠位軸部は第2配向において前記連結要素の遠位
端と係合自在であって前記近位軸部に対して第2方向へ
湾曲する構成であることを特徴とする。上記形態の距ト
ライアルにおいて、前記遠位軸部は湾曲していて近位軸
部に対して可逆的固定が可能であり、それにより左右大
腿骨のいずれの処置にも適した長い軸トライアルを提供
する。このトライアルは慴動自在の本体部を含んでよ
く、それによりトライアルの高さ調整を可能にする。
は第1および第2端部を有する連結要素を更に含み、前
記連結要素は前記遠位軸部の近位端と前記近位軸部の遠
位端間に挿入自在であり、前記連結要素は第1端部で前
記近位軸部の遠位端へ解放自在に固定でき、かつ第2端
部で前記遠位軸部の近位端へ解放自在に固定できる構成
である。
かつ前記近位軸部の遠位端は前記小身を受けるための長
孔を形成しているのが好ましい。更に、前記遠位軸部は
第1配向において前記近位軸部と係合自在であって前記
近位軸部に対して第1方向へ湾曲し、かつ前記遠位軸部
は第2配向において前記近位軸部と係合自在であって前
記近位軸部に対して第2方向へ湾曲する構成であってよ
い。前記第1方向は前記第2方向と反対方向である。好
適形態において、前記連結要素はねじ孔を含み、かつ前
記近位軸部の遠位端および前記遠位軸部の近位端はねじ
切りされていて前記連結要素の孔へ挿入自在の構成であ
るのが好ましい。前記連結要素の外面部は表面凹凸模様
が付されていてよい。前記連結要素の外面部は複数の隆
起と陥没を含む構成であってよい。
置換装置は、近位端および遠位端を有する近位軸部を含
む人工大腿骨移植片用トライアル、前記近位軸部に対し
て長手方向へ摺動して調節自在に前記近位軸部に係合す
る本体部、近位軸部から半径方向に延在しかつ前記本体
部の一部を囲繞きる孔を有するカラー、および複数の遠
位軸部を有し、前記遠位軸部は前記近位軸部の遠位端へ
固定自在であることを特徴とする。本発明による他の形
態の股関置換装置は、近位端および遠位端を有する近位
軸部を含む人工大腿骨移植片トライアル、前記近位軸部
に対して長手方向へ摺動して調節自在に前記近位軸部と
係合する本体部、および複数の遠位軸部を有し、前記近
位軸部は近位端に前記本体部よりも幅広い面を有し、前
記幅広い面は両側に各々が形成された一対の切欠き部を
含み、かつ前記遠位軸部は前記近位軸部の遠位端へ固定
自在であることを特徴とする。
本体部の移動を阻止するために係止機構が設けられてよ
い。同様に、前記軸部から半径方向外側へ延在して前記
本体部の一部を囲繞するカラーが設けられてよい。この
場合、前記本体部と軸部は、前記カラーと前記軸部の遠
位端間の所定点における距トライアルの直径が前記本体
部が前記軸部の遠位端へ移動するに伴って増大し、かつ
前記本体部が前記軸部の遠位端から離れる方向へ移動す
るに伴って縮小する形態であってよい。更に、前記軸部
はフォーク付き器具と係合自在の切欠き部等の係合構造
を近位端の両側に有する構成であってよい。
発明に付随する利点および特徴について理解を容易にす
るために添付図面を参照して本発明の実施形態を説明す
る。図1を参照すると、本発明によるトライアルは軸部
10、本体部12、ピン14、ばね16、および押しボ
タン18を示すために分解図で示されている。軸部10
は近位端20および遠位端22を有し、かつ本体部12
はトラニオン(筒耳部)24および遠位端26を有す
る。本体部12は軸部10の近位端20近くで軸部10
と係合自在であり、軸部10に対して軸部10の近位端
と遠位端間で所定間隔慴動自在である。
軸部10の両方またはいずれか一方へ連結されて軸部1
0に対する本体部12の運動を案内する。例えば、図2
に示されたように、軸部10は軸部10の第1面30か
ら突出しかつ軸部10の近位端20および遠位端22間
で所定間隔延在するトラック28を含む。図1に示され
たように、本体部12はトラック28を受けるための切
欠き部32を含む。ただし、他の形態において、本体部
12は軸部10内で凹所をなすトラックと係合自在の隆
起部を含む。この形態と関係なく、本体部12および軸
部10の補足的ガイド/トラック/切欠き部は所定通路
に沿った本体部12の運動、例えば長手方向移動、を制
限し、かつ捩れまたは横変位等の望ましくない運動を阻
止する。
12の運動を阻止するために設けられてよい。図1およ
び3に示されたように、本体部12は切欠き部32を横
切りかつ押しボタン18の細長部を受けることのできる
通路34を含んでよい。押しボタン18は、押しボタン
18の一部が軸部10のトラック28の一部と接触、係
合する第1位置から押しボタン18がトラック28から
離脱する第2位置へ通路34内で移動自在である。図4
に示されたように、押しボタン18はばね16により第
1位置へ付勢される。図5は第2位置の押しボタン18
を示す。押しボタン18は押しボタン18の本体部12
への挿入深さを制限するために本体部12と係合する拡
大頭部36を含む。押しボタン18は、また、ピン14
およびトラック28の一部を受ける切欠き部38を含
む。図2に明瞭に示されたように、トラック28は第1
および第2横溝40および42を含む。本体部12およ
び軸部10を相互に対して慴動させるときに、切欠き部
38は溝40,42に達するまでトラック28上または
トラック28に沿って上昇し、その後に、押しボタン1
8の端部44が溝40,42へ付勢される。端部44は
ばね16の付勢力を克服するに足る充分な力によって押
しボタン18を本体部12へ押すことにより溝40,4
2から解放される。
46は軸部10から半径方向外側へ延在する。カラー4
6は図6に示されたように、本体部12の一部を囲繞
し、かつ図7および8に示されたように、切除された骨
面上に設置できる寸法である。カラー46と軸部10の
遠位端22とは一定間隔をおいている。カラー46は本
体部12の形状に適合する曲率を有する孔48を形成
し、かつそこへ本体部12を受ける。
用がそれぞれの切除大腿骨50および52との関係で示
されている。大腿骨に距トライアルを受ける準備がされ
ると、距トライアルの遠位端22は骨髄管54,56へ
挿入される。図7および8から理解されるように、カラ
ー46から軸部10の遠位端22までの全長が骨髄管5
4,56へ挿入される。これは骨髄管54,56が置換
股軸を収容できる深さおよび幅まで切削されたことを外
科医に確証する。そこで、外科医は頭部36高さ、また
は本体部12へ固定された頭部60上の参照点とカラー
46間の間隔を調整して人工股軸長を決定するために必
要に応じて軸部10に対して本体部12を慴動させる。
図7において、本体部12は軸部10に対して頭部高さ
45mmに位置決めされ、他方、図8において頭部高さ
は55mmである。次に、距トライアルを骨髄管54,
56から除去し、かつ決定された長を有する人工股軸が
股軸群から選択される。選択された股軸は骨髄管54,
56へ固定される。
6下の距トライアルの近位部は、大腿骨内への距トライ
アルの密着を確実にするために、その軸の中間部もしく
はその遠位端22よりも広い。距トライアルは、実際の
置換軸よりも僅かに大きく切削された(置換軸を包囲す
る骨セメントのための空間をつくる)骨髄管を充填する
ために、カラー46下の近位部における実際の置換軸よ
りも僅かに大きい。更に、軸部10および本体部12
は、カラー46と軸部10の遠位端間の所定点で距トラ
イアルの直径が、本体部12の軸部10の遠位端22方
向への移動に伴って増大し、かつ本体部12の軸部10
の遠位端22からの移動に伴って縮小するように形成さ
れる。従って、切除が行われるか否かと関係なく、距ト
ライアルの寸法および形状はブローチ(探査)された骨
髄管の寸法および形状に対応する。
滑めらかに着座するので、本発明による距トライアル
は、更に、距トライアルの骨髄管への挿入および骨髄管
からの抜去時に使用できる特徴を有する。例えば、図2
を参照すると、軸部10の近位端20は軸部10上の一
対の反対向きの切欠き部62および64等の器具係合構
造を含む。図10に示された器具66は、2つの切欠き
部62および64にそれぞれ係合する第1および第2フ
ォーク部もしくはフォーク状に分かれた分岐68および
70を含む。2つの分岐間の空間はその器具の本体部1
2への滑合を可能にするために本体部12の形状に対応
する。これは器具の本体部12および軸部10との軸方
向整列を確実にする。各分岐68および70はそれぞれ
角度を付けた端部もしくは歯72および74を含んでよ
い。ハンドル76は器具66を牽引または押圧すために
容易に把持できる構造を有しかつマレットストライキン
グ(槌打ち)に好適な面を提供する。切欠き部62,6
4はセルクラージュケーブルの配向に使用される置換軸
の切欠きに類似するので、同一器具66がトライアルお
よび置換軸の両者の挿入および抜去に使用できる。
ために距トライアルに対して位置決めされた器具66を
示し、ここでは歯72,74は切欠き部62、64と係
合せず、本体部12の両側のカラー46上に直接当接し
ている。図11は骨髄管から距トライアルを抜去するた
めに距トライアルに対して位置決めされた器具66を示
し、ここでは歯72,74は切欠き部62,64と係合
する。フォーク付き器具は、このようにして、その挿入
および抜去時に均一分布力を軸部10に付与する。
ルに関する他の問題は、長いトライアルが大腿骨の曲率
もしくは湾曲を考慮しなければならないことである。従
って、本発明は、更に、遠位軸部の形態に依存して、ト
ライアル軸を長くでき、かつ適切な大腿骨移植に必要な
曲率を有するモジュール軸を提供する。例えば、図12
は近位軸部78、遠位軸部80、および連結要素82を
有するトライアルの1形態の分解図である。近位軸部7
8は本体部12の係合に関するまたは器具66に関する
上述の特徴の1以上を有するものであってよい。選択的
に、近位軸部78は上述の特徴を含まず、当分野に既知
のトライアルの特徴を有するものであってよい。
ら11に図示された軸部10と略同一長さを有し、従っ
て、連結要素82または遠位軸部80を含むことなく、
上述のごとく使用できる。ただし、遠位軸部80が近位
軸部78へ結合されたときに、そのトライアルの全長は
伝統的単一ピースの長軸トライアルの全長に相当する。
他の実施形態において、近位軸部78は軸部10よりも
長くまたは短く、かつ従って、遠位軸部80は図12に
図示された軸部よりも長いかまたは短い。
同軸であってよいが、図示形態において、遠位軸部80
は湾曲または角状部を含み、遠位軸部80のある部分ま
たは全部が近位軸部78と同軸にならない。この曲率ま
たは角度は遠位軸部80の形状により、かつ/または所
定角度でその軸部を結合することにより付与されてよ
い。集合的に、この軸の曲率または角度は『湾曲』と呼
ぶ。
は選択的に近位軸部78と転換設置可能であり、それに
よりそのトライアルを第1またはその反対の第2方向へ
湾曲させる。そのようにして、トライアルは付加的部品
を必要とすることなく左右いずれの大腿骨にも使用でき
る。図示形態において、可逆性を促進する構造は近位軸
部78に形成された長孔86内に受けることのできる小
身84を遠位軸部80上に含む。小身84および長孔8
6は遠位軸部80および近位軸部78を精確配向で確実
に合致させ、かつその配向が不本意に変化しないように
する。例えば、遠位軸部80と近位軸部78を、円筒要
素を円筒ボアへ摩擦嵌めにより、または螺合により簡単
に結合する場合、精確な配向は得られない。
よび遠位軸部80のそれぞれの小径部88および90上
に位置決めできる。小径部88および90はねじ切りさ
れかつ連結要素82のねじ孔92内に受けることができ
るものであってよい。連結要素82は、連結要素82を
手によりまたは器具と共に握ることができかつ上記軸部
の一方または両方に対する回転を可能にして両軸部間の
螺合を可能にする細長い交互隆起94と陥没96から成
る等の表面組織部を含んでよい。このようにして、連結
要素82は近位軸部78と遠位軸部80とを係止させ
る。ただし、両軸部を精確な配向で結合し、かつ分離連
結要素を伴うことなく保持できる他の形態が意図されて
いる。
示す。この場合、連結要素82は連結要素82を結合し
た両軸部の最大径に近似の最大径を有する。図14は近
位軸部78と遠位軸部80間の連結の一部を示す部分図
であり、小身84と長孔86の係合を明瞭に表してい
る。図示小身84と長孔86は優れた転換自在の連結を
可能にするが、両軸部を結合する他の構造が意図されて
おり、特定図示連結は本発明の制限例ではない。
れたが、本発明の精神および範囲を逸脱することなく種
々の他の変更、省略、付加が形態および細部について可
能である。
ルの分解図である。
である。
である。
によるトライアルの側面図である。
によるトライアルの側面図である。
アルに係合した図9の器具を示す斜視図である。
る。
態の分解図である。
る。
分図である。
Claims (10)
- 【請求項1】 近位端および遠位端を有する近位軸部、 前記近位軸部が本体部に対して実質的外方に設置される
ように前記近位軸部に対して長手方向に摺動して調節自
在に前記近位軸部と係合する本体部、および近位端およ
び遠位端を有する湾曲した遠位軸部を有し、 前記遠位軸部の近位端は前記近位軸部の遠位端と係合自
在である、ことを特徴とする距トライアル。 - 【請求項2】 第1および第2端部を有する連結要素を
更に含み、前記連結要素は前記遠位軸部の近位端と前記
近位軸部の遠位端間に挿入自在であり、前記連結要素は
第1端部で前記近位軸部の遠位端へ解放自在に固定で
き、かつ第2端部で前記遠位軸部の近位端へ解放自在に
固定できる、請求項1の距トライアル。 - 【請求項3】 前記遠位軸部はその近位端に小身を含
み、かつ前記近位軸部の遠位端は前記小身を受けるため
の長孔を形成している、請求項1の距トライアル。 - 【請求項4】 前記遠位軸部は第1配向において前記近
位軸部と係合自在であって前記近位軸部に対して第1方
向へ湾曲し、かつ前記遠位軸部は第2配向において前記
近位軸部と係合自在であって前記近位軸部に対して第2
方向へ湾曲する構成である、請求項1の距トライアル。 - 【請求項5】 前記第1方向は前記第2方向と反対方向
である、請求項4の距トライアル。 - 【請求項6】 前記連結要素はねじ孔を含み、かつ前記
近位軸部の遠位端および前記遠位軸部の近位端はねじ切
りされていて前記連結要素のねじ孔へ挿入自在である、
請求項2の距トライアル。 - 【請求項7】 前記連結要素の外面部は表面凹凸模様が
付されている、請求項6の距トライアル。 - 【請求項8】 前記連結要素の外面部は複数の隆起と陥
没を含む、請求項6の距トライアル。 - 【請求項9】 近位端および遠位端を有する近位軸部を
含む人工大腿骨移植片トライアル、 前記近位軸部に対して長手方向へ摺動して調節自在に前
記近位軸部と係合する本体部、および複数の遠位軸部を
有し、 前記近位軸部は近位端に前記本体部よりも幅広い面を有
し、前記幅広い面は前記近位軸部上で軸を横切る方向に
おいて前記本体部の両側に対応する前記幅広い面の両側
縁部に各々が形成された一対の切欠き部を含み、かつ前
記遠位軸部は前記近位軸部の遠位端へ固定自在である、
ことを特徴とする股置換装置。 - 【請求項10】 近位端および遠位端を有する近位軸部
を含む人工大腿骨移植片用トライアル、 前記近位軸部に対し長手方向へ慴動して調節自在に前記
近位軸部と係合する本体部、 前記近位軸部から半径方向に延在しかつ前記本体部の一
部を囲繞する孔を有するカラー、および複数の遠位軸部
を有し、 前記遠位軸部は前記近位軸部の遠位端へ固定自在であ
る、ことを特徴とする股置換装置。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/824,336 US5860982A (en) | 1997-03-26 | 1997-03-26 | Cemented calcar replacement varying height trial |
US08/884,588 US5888208A (en) | 1997-03-26 | 1997-06-27 | Modular hip trial for long stems |
US08/884588 | 1997-06-27 | ||
US09/008,866 US6193759B1 (en) | 1997-03-26 | 1998-01-20 | Modular long stem hip trial |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2002337146A Division JP4249471B2 (ja) | 1997-06-27 | 2002-11-20 | 距トライアルの軸部 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH1170132A JPH1170132A (ja) | 1999-03-16 |
JP3443003B2 true JP3443003B2 (ja) | 2003-09-02 |
Family
ID=27358727
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP10095219A Pending JPH11342A (ja) | 1997-03-26 | 1998-03-25 | カルカートライアルおよびそれを用いた股関節置換システム |
JP18248898A Expired - Lifetime JP3443003B2 (ja) | 1997-03-26 | 1998-06-29 | 距トライアルおよび股置換装置 |
JP01120699A Expired - Lifetime JP4233663B2 (ja) | 1997-03-26 | 1999-01-19 | モジュール式長ステム股関節トライアル |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP10095219A Pending JPH11342A (ja) | 1997-03-26 | 1998-03-25 | カルカートライアルおよびそれを用いた股関節置換システム |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP01120699A Expired - Lifetime JP4233663B2 (ja) | 1997-03-26 | 1999-01-19 | モジュール式長ステム股関節トライアル |
Country Status (6)
Country | Link |
---|---|
US (3) | US5860982A (ja) |
EP (3) | EP0867161B1 (ja) |
JP (3) | JPH11342A (ja) |
BR (1) | BR9900317A (ja) |
DE (1) | DE69936478T2 (ja) |
ES (1) | ES2289800T3 (ja) |
Families Citing this family (111)
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US10195056B2 (en) | 2015-10-19 | 2019-02-05 | Depuy Ireland Unlimited Company | Method for preparing a patient's tibia to receive an implant |
US10537445B2 (en) | 2015-10-19 | 2020-01-21 | Depuy Ireland Unlimited Company | Surgical instruments for preparing a patient's tibia to receive an implant |
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-
1997
- 1997-03-26 US US08/824,336 patent/US5860982A/en not_active Expired - Lifetime
- 1997-06-27 US US08/884,588 patent/US5888208A/en not_active Expired - Lifetime
-
1998
- 1998-01-20 US US09/008,866 patent/US6193759B1/en not_active Expired - Lifetime
- 1998-03-25 JP JP10095219A patent/JPH11342A/ja active Pending
- 1998-03-25 EP EP98302238A patent/EP0867161B1/en not_active Expired - Lifetime
- 1998-06-26 EP EP98305075A patent/EP0887053B1/en not_active Expired - Lifetime
- 1998-06-29 JP JP18248898A patent/JP3443003B2/ja not_active Expired - Lifetime
-
1999
- 1999-01-19 EP EP99300324A patent/EP0931524B1/en not_active Expired - Lifetime
- 1999-01-19 BR BR9900317-1A patent/BR9900317A/pt not_active Application Discontinuation
- 1999-01-19 DE DE69936478T patent/DE69936478T2/de not_active Expired - Lifetime
- 1999-01-19 ES ES99300324T patent/ES2289800T3/es not_active Expired - Lifetime
- 1999-01-19 JP JP01120699A patent/JP4233663B2/ja not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP0887053B1 (en) | 2003-05-14 |
JPH1170132A (ja) | 1999-03-16 |
DE69936478T2 (de) | 2008-03-13 |
US5888208A (en) | 1999-03-30 |
EP0931524A3 (en) | 1999-11-17 |
EP0931524A2 (en) | 1999-07-28 |
BR9900317A (pt) | 2000-01-18 |
EP0867161A1 (en) | 1998-09-30 |
EP0887053A2 (en) | 1998-12-30 |
ES2289800T3 (es) | 2008-02-01 |
EP0887053A3 (en) | 1999-11-17 |
JP4233663B2 (ja) | 2009-03-04 |
EP0867161B1 (en) | 2003-05-21 |
EP0931524B1 (en) | 2007-07-11 |
JPH11253469A (ja) | 1999-09-21 |
JPH11342A (ja) | 1999-01-06 |
DE69936478D1 (de) | 2007-08-23 |
US5860982A (en) | 1999-01-19 |
US6193759B1 (en) | 2001-02-27 |
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