JP4060521B2 - 関節体内人工器官 - Google Patents

関節体内人工器官 Download PDF

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Publication number
JP4060521B2
JP4060521B2 JP2000287179A JP2000287179A JP4060521B2 JP 4060521 B2 JP4060521 B2 JP 4060521B2 JP 2000287179 A JP2000287179 A JP 2000287179A JP 2000287179 A JP2000287179 A JP 2000287179A JP 4060521 B2 JP4060521 B2 JP 4060521B2
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Prior art keywords
conical
stub
connection
joint
edge
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JP2000287179A
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JP2001104348A (ja
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アルノルト・ケラー
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Waldemar Link GmbH and Co KG
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Waldemar Link GmbH and Co KG
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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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3836—Special connection between upper and lower leg, e.g. constrained
    • A61F2/384—Special connection between upper and lower leg, e.g. constrained hinged, i.e. with transverse axle restricting the movement
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
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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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/3011—Cross-sections or two-dimensional shapes
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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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    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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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
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    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
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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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    • 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
    • A61F2002/30561—Special structural features of bone or joint prostheses not otherwise provided for breakable or frangible
    • 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
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    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
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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
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    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0071—Additional features; Implant or prostheses properties not otherwise provided for breakable or frangible

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (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

【０００１】
【発明の属する技術分野】
本発明は、アンカー固定部分、及び、関節部分とアンカー固定部分との間での円錐接続を備える関節体内人工器官に関する。
【０００２】
【従来の技術】
関節機能をシミュレートするために役立つコンポーネントに加えて、関節体内人工器官は、それらを骨にアンカー固定するための部分を持っている。異なるアンカー固定部分が１つの人工器官に利用可能な状態におかれているならば、各場合に選ばれた、アンカー固定部分は接続デバイスによって関連する関節コンポーネントに接続される。この目的のために、円錐接続は、円錐スタブからなるとともに同様の小さな円錐角度（例えば、５度）で設計され、それらが衝撃の影響下でともに連結されるやいなや、一般に、互いに十分に堅固に固着する円錐スリーブからなるということがそれ自身証明されている。もし相当大きな力が接続を分離する方向に作用することを引き起こすことがなければ、さらなる固定手段は必要ではない。例えば、股関節ヘッドを、関連するステム部分(米国A-５,３３６,２６８)に固定する場合、このことが当てはまる。実質的な解放力を考慮に入れなければならない場合、円錐接続は固定ネジを備える(EP-A ４７４０１５)。例えば、グラブねじは円錐スタブに含むことができ、ねじの円錐形の先端がねじ留めされて、偏心しながら、円錐スリーブの穴と係合する(EP-A ４７４０１５における図３)。
【０００３】
このことによって徐々に進む破壊に導かれるので、円錐表面間の相対的な回転を防止するために、円錐接続が反回転配置体を備えていることも知られている(米国A ５,４０５,４０３)。
【０００４】
固定ネジは、結合部分の軸方向への直動運動を防ぐだけでなく、回転運動を防ぐ。したがって、固定ネジは、伝統的に反回転配置体の機能も実行する。
【０００５】
【課題、課題解決の手段及びその作用・効果】
本発明は、固定ネジが、円錐形の先端を介して、偏心した穴と相互作用するならば、固定ネジを反回転配置体と組み合わせることにより相当な利点を達成することができるということに基づいている。先行技術のように、そのような固定ネジが反回転配置体なしで使用される場合、固定ネジの円錐形の先端が組立中に円錐接続のより太い端部に最も近いところにある穴のエッジのポイントと正確に相互作用することを保証することは可能ではない。実際に、それは、単に、固定ネジによって正確な反回転が得られるということである。しかしながら、接触ポイントが、相互作用のこの理想点の側にわずかに位置する場合、ミクロの回転動作は可能である。しかしながら、本発明に係るコンビネーションは、円錐形の先端と固定ネジと関連する穴との間での接触ポイントが固定されていることを保証する。これは上記の微視的動作を防止するだけでなく、固定ネジが摩耗し、ねじれて、それと相互作用する穴のエッジに対する相対的動作の結果として、その固定機能を完全にあるいは部分的に失うこと防止する。
【０００６】
固定ネジが、予め決められた破壊点を備えている場合に、このことは特に重要である(EP-A ９１５６８６であるWO ９８０４２１５)。このように、反回転配置体は、固定ネジが所望の方法でその機能を発揮することができるという効果を有する。
【０００７】
この反回転配置体を提供するために、突起及びくぼみが、２つの結合部分上に好ましくは形成され、軸と平行な側面を介して互いに相互作用する。例えば、少なくとも１つのスタブは、円錐スリーブの端から軸と平行に突出することができるとともに、円錐スタブのベースに設けられた、対応するように形作られた溝に係合することができる。反対に、円錐スリーブのエッジが、円錐スタブ上に設けられた横方向のピンが係合する少なくとも１つの刻み付けを備えることも可能である。
【０００８】
【発明の実施の形態】
本発明は、以下に、好ましい実施形態を示す図面に関して、より詳細に説明される。
【０００９】
図１に図示される膝人工器官は、大腿部のコンポーネント１及び脛骨のコンポーネント２を有している。大腿部のコンポーネントは、ステム３に接続されており、それは大腿骨のキャビティにアンカー固定されることになっている。それは円錐接続４によって大腿部のコンポーネント１に接続される。脛骨のコンポーネント２は、同様に、アンカー固定部分(不図示)に接続されることになっており、この目的のために、円錐接続の部分として円錐スタブ５を有している。
【００１０】
円錐接続は、円錐スタブ５からなるとともに、同一の円錐の表面７を介して大きな表面のエリア上で相互接触状態にある円錐スリーブ６からなる。これらの表面の円錐角度(完全に対向する包囲線間の角度)は、例えば、５度のオーダーである。それは、例えば衝撃による力で一緒に連結される接続部分５及び６が、相当な力によって再び分離され、さらに、相当な摩擦抵抗に抗して互いに回転することができるように寸法構成される。ある場合には、それらが移植でともに十分に強く連結されていないならば、あるいはそれらが使用している間に異常に高い解放力によって緩められたならば、接続の強さが疑われるかもしれない。したがって、この実施例において、接続スタブ５は、その六角形ヘッドが円錐スリーブ６の一方の側にある穴９によってアクセス可能であり、その円錐形の先端１０が、円錐スリーブ６の他方の側にある穴１２のエッジ１と相互作用するグラブねじ８を備える。
【００１１】
ねじ８が回転力によってロードしないために、あるいは、ねじ８が無い場合に接続の回転固定を保証するために、本発明に係る反回転配置体が設けられている。それは、円錐スリーブ６のエッジ上にある軸と平行な２つのスタブ１３と、円錐スタブ５が突出するカラー１５内にある対応する溝１４とからなる。スタブ１３及び溝１４は、それぞれの場合において、１対の平行な側面１６及び１７によって画定されており、それぞれ、溝１４の幅は、スタブ１３の幅より、全く大きくないかあるいは、ほとんど大きくない。
【００１２】
大略互いに対向する位置にある２つの反回転配置体１３，１４が、好ましくは設けられている。
【００１３】
ねじ接続の穴９，１２は、互いに同じ高さにない。したがって、ねじ先端１０が穴１２と正確に相互作用する回転の画定された位置にあるスタブ５上に円錐スリーブ６が適用されることは保証されなければならない。回転のこの画定された位置が発生するように設けられている反回転配置体又は配置体によってこのことは保証される。１つの反回転配置体１３，１４だけが使用されるならば、あるいは２つの反回転配置体が互いに極めて正確に対向する位置に位置決めされていないならば、これは必ずそうである。
【００１４】
アンカー固定部分は骨ステムである必要がない。それは、２つの関節によって囲まれた骨セクションの全ての人工器官の場合には、別の関節のコンポーネントに１つの関節のコンポーネントを接続する棒であってもよい。
【図面の簡単な説明】
【図１】 本発明に係る膝人工器官の側面図を示す。
【図２】 円錐接続の側面図を示す。
【図３】 円錐接続の断面図を示す。
【符号の説明】
１ コンポーネント
２ コンポーネント
３ ステム
５ 円錐スタブ（接続部分）
６ 円錐スリーブ（接続部分）
８ グラブねじ
９ 穴
１０ 先端
１２ 穴
１３ スタブ
１４ 溝

Claims (4)

  1. アンカー固定部分及び、円錐スリーブと円錐スタブとを備える円錐接続を備えて、
    該円錐接続は、関節部分とアンカー固定部分との間で形成され、
    該円錐接続は、固定ネジに対して偏心している穴のエッジと相互作用するように構成された円錐形先端を有する固定ネジを備える関節体内人工器官であって、
    該円錐接続は、前記固定ネジに加えて、円錐スタブが円錐スリーブに対して回転しないように固定するための回転防止手段を有し、
    前記回転防止手段は、一方の部分にある突起と他方の部分にあるくぼみとによって形成され、突起及びくぼみが、軸と平行な側面を介して相互作用することを特徴とする関節体内人工器官。
  2. 前記突起は、円錐スリーブのエッジから突出するスタブであり、
    前記くぼみは、円錐スタブのベースに設けられた対応する溝であることを特徴とする、請求項１記載の関節体内人工器官。
  3. 前記くぼみは、円錐スリーブのエッジに形成された刻み付けであり、
    前記突起は、円錐スタブ上に設けられた対応する横方向のピンであることを特徴とする、請求項１記載の関節体内人工器官。
  4. 前記固定ネジは、予め決められた破壊点を備えることを特徴とする、請求項１乃至３のいずれか一つに記載の関節体内人工器官。
JP2000287179A 1999-09-24 2000-09-21 関節体内人工器官 Expired - Lifetime JP4060521B2 (ja)

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AU5948500A (en) 2001-03-29

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