JP4864966B2 - 関節置換術に用いるための器具 - Google Patents
関節置換術に用いるための器具 Download PDFInfo
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- JP4864966B2 JP4864966B2 JP2008514228A JP2008514228A JP4864966B2 JP 4864966 B2 JP4864966 B2 JP 4864966B2 JP 2008514228 A JP2008514228 A JP 2008514228A JP 2008514228 A JP2008514228 A JP 2008514228A JP 4864966 B2 JP4864966 B2 JP 4864966B2
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- 239000007943 implant Substances 0.000 claims description 74
- 210000000988 bone and bone Anatomy 0.000 claims description 60
- 238000001356 surgical procedure Methods 0.000 claims description 14
- 230000002093 peripheral effect Effects 0.000 claims description 5
- 210000000852 deltoid muscle Anatomy 0.000 description 12
- 210000002758 humerus Anatomy 0.000 description 10
- 238000000034 method Methods 0.000 description 8
- 239000000835 fiber Substances 0.000 description 7
- 238000003780 insertion Methods 0.000 description 7
- 230000037431 insertion Effects 0.000 description 7
- 210000003205 muscle Anatomy 0.000 description 7
- 238000002271 resection Methods 0.000 description 7
- 241001653121 Glenoides Species 0.000 description 5
- 239000000463 material Substances 0.000 description 5
- 238000013459 approach Methods 0.000 description 3
- 210000004095 humeral head Anatomy 0.000 description 3
- 239000007769 metal material Substances 0.000 description 3
- 210000000513 rotator cuff Anatomy 0.000 description 3
- 210000004872 soft tissue Anatomy 0.000 description 3
- 210000003041 ligament Anatomy 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 239000002861 polymer material Substances 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 210000000323 shoulder joint Anatomy 0.000 description 2
- 229910001220 stainless steel Inorganic materials 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- DHKHKXVYLBGOIT-UHFFFAOYSA-N 1,1-Diethoxyethane Chemical compound CCOC(C)OCC DHKHKXVYLBGOIT-UHFFFAOYSA-N 0.000 description 1
- 206010028331 Muscle rupture Diseases 0.000 description 1
- 239000004952 Polyamide Substances 0.000 description 1
- 239000011354 acetal resin Substances 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 210000000544 articulatio talocruralis Anatomy 0.000 description 1
- 239000003086 colorant Substances 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 210000003275 diaphysis Anatomy 0.000 description 1
- 210000002310 elbow joint Anatomy 0.000 description 1
- 210000001624 hip Anatomy 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 230000013011 mating Effects 0.000 description 1
- 238000000465 moulding Methods 0.000 description 1
- 230000005693 optoelectronics Effects 0.000 description 1
- 210000002976 pectoralis muscle Anatomy 0.000 description 1
- 229920002647 polyamide Polymers 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 229920000098 polyolefin Polymers 0.000 description 1
- 229920006324 polyoxymethylene Polymers 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 210000002435 tendon Anatomy 0.000 description 1
- 210000002303 tibia Anatomy 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 210000000689 upper leg Anatomy 0.000 description 1
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- Health & Medical Sciences (AREA)
- Transplantation (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Physical Education & Sports Medicine (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本発明は、長骨と他の骨との間の関節に関節プロテーゼを植え込む手術に用いられる器具に関する。
支持面に対する局所応力を最小限するために関節プロテーゼのコンポーネントの支持面の面積を最大にするのが望ましい。しかしながら、患者の骨の構造および構造間の空間により、植え込まれるコンポーネントの利用できる空間が制限されるため、使用できるコンポーネントのサイズが制限される。
本発明は、切除された骨の縁に対する骨の軸の位置に従って選択されるヘッド部の適切なサイズについてのゲージとなるように骨幹端部に取り付けできる、平坦なディスクを含む、関節プロテーゼのヘッド部の選択を助けるために用いることができるトライアルインプラントコンポーネントを提供する。
・切開部を形成するステップ
・骨頭を除去するために長骨を切除する平面の位置を設定するステップ
・長骨の骨頭を除去するために切除するステップ
・トライアルインプラントコンポーネントのステム部、そして最終的に関節プロテーゼのインプラントコンポーネントを受容できるように、切除された骨内に腔を形成するステップ
・トライアルインプラントコンポーネントのステム部を植え込むステップ
・ディスクをトライアルインプラントコンポーネントのステム部に取り付けて、切除された骨の縁に対する最終インプラントプロテーゼのコンポーネント縁の近接度を評価するステップ
・ディスクを、異なる構造(例えば、大きさや偏心度)を有する別のディスクに交換するステップ
・適切な横断方向の大きさ(インプラントが円形の場合は直径となる)を有するインプラントを選択するために、トライアルディスクを用いて切除された骨の適切な幅を決定するステップ
・適切な高さを有するインプラントを選択するために、切断ガイドを用いて切除された骨の骨頭の高さを決定するステップ
・トライアルヘッドコンポーネントを用いて関節運動の際の軟組織のバランスを評価するステップ
・三角筋繊維の方向に沿って三角筋に切開部を形成するステップ
・三角筋繊維に沿って三角筋を分離させるステップ
・関節上腕靭帯および烏口肩峰靭帯を除去し、2頭筋腱を解放するステップ
・切断ガイドを用いて上腕骨頭を切除するステップ
・ブローチ器具を用いて上腕骨に腔を形成するステップ
・腔内に挿入されたトライアルステムを用いてステムインプラントのサイズを決定するステップ
・トライアルヘッドを上腕骨のトライアルステムに係合させてヘッドインプラントのサイズを決定するステップ
・決定したサイズのステムインプラントおよびヘッドインプラント、およびこれらの任意の組合せを植え込むステップ
例として、添付の図面を参照しながら本発明の実施形態を説明する。
(1)長骨と他の骨との間の関節を置換するための外科手術に用いられるトライアルインプラントコンポーネントにおいて、
a.骨幹端部であって、前記長骨の切除面で腔内へと延び、前記骨幹端の領域において前記腔の内壁に接触するように、配置できる、骨幹端部と、
b.実質的に平坦な形状のディスクであって、切除された骨の縁に対する骨の軸の位置に従って選択されるヘッド部の適切なサイズについてのゲージとなるように、前記骨幹端部に取り付けできる、ディスクと、
を含む、トライアルインプラントコンポーネント。
(2)実施態様(1)に記載のトライアルインプラントコンポーネントにおいて、
前記ディスク部および前記骨幹端部は、互いに組み立てられうるモジュラーコンポーネントとして形成される、トライアルインプラントコンポーネント。
(3)実施態様(1)に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクおよび前記骨幹端部の一方が、差込み部を備えており、他方に、この差込み部を受容できるソケットが形成されている、トライアルインプラントコンポーネント。
(4)実施態様(3)に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクに形成された前記差込み部または前記ソケットは、前記ディスクの中心からずれて位置している、トライアルインプラントコンポーネント。
(5)実施態様(1)に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクは、貫通開口を有し、この開口を介して前記切除された骨を検査できる、トライアルインプラントコンポーネント。
前記ディスクは、外周リムを含み、このリムから複数のスポークが内側に向かって延びている、トライアルインプラントコンポーネント。
(7)実施態様(1)に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクは、ほぼ円形である、トライアルインプラントコンポーネント。
(8)関節置換術で長骨の骨頭の置換に用いられるキットにおいて、
実施態様(1)〜(7)のいずれか1つに記載のトライアルインプラントコンポーネントを含む、キット。
(9)実施態様(8)に記載のキットにおいて、
患者に植え込まれるようになっている、プロテーゼ、
をさらに含み、
前記プロテーゼは、ヘッドコンポーネントを備え、当該ヘッドコンポーネントは、ヘッドコンポーネント平面で切除された部分球の形態である外面を有する、
キット。
(10)長骨と他の骨との間の関節に関節プロテーゼを植え込む方法において、
a.実施態様(1)に記載のトライアルインプラントコンポーネントの前記骨幹端部を前記長骨に形成された腔内に植え込むステップと、
b.前記骨幹端部に前記トライアルインプラントコンポーネントの前記ディスクを取り付けて、切除された骨の縁に対する最終インプラントプロテーゼのコンポーネントの縁の近接度を評価するステップと、
を含む、方法。
a.三角筋繊維の方向に沿って三角筋に切開部を形成するステップと、
b.前記三角筋繊維に沿って前記三角筋を分離させるステップと、
c.関節上腕靭帯および烏口肩峰靭帯を除去し、2頭筋腱を解放するステップと、
d.上腕骨頭を切除するステップと、
e.ブローチ器具を用いて上腕骨に腔を形成するステップと、
f.前記上腕骨の腔内にプロテーゼコンポーネントを植え込むステップと、
を含む、方法。
Claims (8)
- 長骨と他の骨との間の関節を置換するための外科手術に用いられるトライアルインプラントコンポーネントにおいて、
骨幹端部であって、前記長骨の切除面で腔内へと延び、前記腔の内壁に接触するように、配置できる、骨幹端部と、
実質的に平坦な形状のディスクであって、前記骨幹端部が前記長骨の前記腔内に位置しているときに、切除された骨の縁に対する骨の軸の位置に従って選択されるヘッド部の適切なサイズについてのゲージとなるように、前記骨幹端部に取り付けできる、ディスクと、
を含み、
前記ディスクは、貫通開口を有し、この貫通開口を介して前記切除された骨を検査できる、トライアルインプラントコンポーネント。 - 請求項1に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクおよび前記骨幹端部は、互いに組み立てられうるモジュラーコンポーネントとして形成される、トライアルインプラントコンポーネント。 - 請求項1に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクおよび前記骨幹端部の一方が、差込み部を備えており、他方に、この差込み部を受容できるソケットが形成されている、トライアルインプラントコンポーネント。 - 請求項3に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクに形成された前記差込み部または前記ソケットは、前記ディスクの中心からずれて位置している、トライアルインプラントコンポーネント。 - 請求項1に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクは、外周リムを含み、このリムから複数のスポークが内側に向かって延びている、トライアルインプラントコンポーネント。 - 請求項1に記載のトライアルインプラントコンポーネントにおいて、
前記ディスクは、ほぼ円形である、トライアルインプラントコンポーネント。 - 関節置換術で長骨の骨頭の置換に用いられるキットにおいて、
請求項1〜6のいずれか1項に記載のトライアルインプラントコンポーネント、
を含む、キット。 - 請求項7に記載のキットにおいて、
患者に植え込まれるようになっている、プロテーゼ、
をさらに含み、
前記プロテーゼは、ヘッドコンポーネントを備え、当該ヘッドコンポーネントは、ヘッドコンポーネント平面で切除された部分球の形態である外面を有する、
キット。
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GB0511292.5 | 2005-06-03 | ||
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US (1) | US8231682B2 (ja) |
EP (1) | EP1885295B1 (ja) |
JP (1) | JP4864966B2 (ja) |
AU (1) | AU2006260591B2 (ja) |
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2006
- 2006-06-02 AU AU2006260591A patent/AU2006260591B2/en active Active
- 2006-06-02 JP JP2008514228A patent/JP4864966B2/ja active Active
- 2006-06-02 EP EP06779958.5A patent/EP1885295B1/en active Active
- 2006-06-02 WO PCT/IB2006/002187 patent/WO2006136954A1/en active Application Filing
- 2006-06-02 CA CA2610672A patent/CA2610672C/en not_active Expired - Fee Related
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US6228120B1 (en) * | 1998-01-09 | 2001-05-08 | Alain Leonard | Surgical equipment for implanting a total shoulder prosthesis, and total shoulder prosthesis constituting same |
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JP2007528280A (ja) * | 2004-03-11 | 2007-10-11 | マヨ ファウンデーション フォー メディカル エデュケーション アンド リサーチ | 骨置換のためのシステム |
Also Published As
Publication number | Publication date |
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JP2008541913A (ja) | 2008-11-27 |
US20090105837A1 (en) | 2009-04-23 |
CA2610672A1 (en) | 2006-12-28 |
US8231682B2 (en) | 2012-07-31 |
AU2006260591A1 (en) | 2006-12-28 |
AU2006260591B2 (en) | 2011-08-25 |
WO2006136954A1 (en) | 2006-12-28 |
EP1885295A1 (en) | 2008-02-13 |
EP1885295B1 (en) | 2013-12-11 |
CA2610672C (en) | 2013-09-17 |
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