JPH1170132A - 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
JPH1170132A
JPH1170132A JP10182488A JP18248898A JPH1170132A JP H1170132 A JPH1170132 A JP H1170132A JP 10182488 A JP10182488 A JP 10182488A JP 18248898 A JP18248898 A JP 18248898A JP H1170132 A JPH1170132 A JP H1170132A
Authority
JP
Japan
Prior art keywords
shaft
proximal
distal
trial
distal end
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.)
Granted
Application number
JP10182488A
Other languages
English (en)
Other versions
JP3443003B2 (ja
Inventor
Gloria Ro
ロ グロリア
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Johnson and Johnson Professional Inc
Original Assignee
Johnson and Johnson Professional Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Johnson and Johnson Professional Inc filed Critical Johnson and Johnson Professional Inc
Publication of JPH1170132A publication Critical patent/JPH1170132A/ja
Application granted granted Critical
Publication of JP3443003B2 publication Critical patent/JP3443003B2/ja
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • 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
    • A61F2/4684—Trial or dummy prostheses
    • 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
    • A61F2/46—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
    • 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
    • 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
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    • 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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    • A61F2/02—Prostheses implantable into the body
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    • A61F2/32—Joints for the hip
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    • A61F2/367—Proximal or metaphyseal parts of shafts
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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
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    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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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    • 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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    • A61F2002/30001—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
    • A61F2002/30331—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
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • 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
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    • 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
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Landscapes

  • Health & Medical Sciences (AREA)
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  • 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)
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Abstract

(57)【要約】 【課題】 股関節形成に使用される人工大腿骨要素の必
要寸法を決定するための距軸用トライアル（仮要素）に
関する。 【解決手段】 距トライアルは近位端および遠位端を有
する軸、および本体を含む。本体は軸の近位端近くで軸
と係合しかつ軸に対して慴動自在である。所望より係止
機構が軸に対する本体の移動を阻止する。本体の一部を
囲繞するカラーが軸から半径方向外側へ延在する。本体
と軸はカラーと軸の遠位端間の所定点において距トライ
アルの直径が、本体部が軸の遠位端へ移動するに伴って
増大しかつ本体部が軸の遠位端から離れるに伴って縮小
する形態になっている。軸の近位端はフォーク付き器具
により係合する切欠き部を含む。湾曲遠位軸部がその軸
の遠位端へ固定できる。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】本発明は人工大腿要素のトラ
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。
【０００２】
【従来の技術】本願は１９９７年３月２６日出願の米国
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。
【０００３】既知処置において、大腿要素のトライアル
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。
【０００４】他の方法は、トライアルヘッドおよびネッ
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。
【０００５】他の既知トライアルは、カラーが適切なネ
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。
【０００６】既知トライアルの他の欠点に加えて、種々
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。
【０００７】
【発明が解決しようとする課題】従って、本発明は、便
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。
【０００８】
【課題を解決するための手段】課題を達成するための本
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、前記近位軸部の近位端と遠
位端間で前記近位軸部に対して慴動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。
【０００９】本発明による他の形態の距トライアルは、
近位端および遠位端を有する近位軸部、および近位端お
よび遠位端を有する遠位軸部から成り、前記遠位軸部の
近位端は第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配向において前記近位
軸部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２方向へ湾曲させる構成であることを特徴とす
る。この形態の距トライアルにおいて、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。
【００１０】好適形態において、本発明の距トライアル
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。
【００１１】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
孔を形成しているのが好ましい。更に、前記遠位軸部は
湾曲していてよい。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配向において前記近位軸部と係合自在であっ
て前記遠位軸部を前記近位軸部に対して第２方向へ湾曲
させ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。
【００１２】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。本発
明は更に股置換装置を提供し、この股置換装置は、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、前記近位軸部と慴動自在に係合する本
体部、前記本体部よりも幅広くかつ両側に各々形成され
た一対の切欠き部を含む垂直フランジ、および複数の遠
位軸部から成り、前記本体部は前記近位軸部の近位端と
遠位端間で所定間隔慴動し、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。
【００１３】前記距トライアルにおいて、軸部に対する
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。
【００１４】
【発明の実施の形態】本発明の更に完全な理解および本
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。
【００１５】ガイドまたはトラックが本体部１２および
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。
【００１６】更に、係止機構が軸部１０に対する本体部
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。
【００１７】再度、図１および２を参照すると、カラー
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。
【００１８】図７および８へ戻ると、距トライアルの使
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。
【００１９】上記図面から理解されるように、カラー４
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。
【００２０】距トライアルは、通常、骨髄管内へ非常に
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。
【００２１】図１０は骨髄管へ距トライアルを挿入する
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。
【００２２】トライアル、特に、長い股軸用のトライア
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。
【００２３】図示形態において、近位軸部７８は図１か
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。
【００２４】遠位軸部８０が直状または近位軸部７８と
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く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。
【００２５】続いて図１２を参照すると、遠位軸部８０
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。
【００２６】長孔８６および小身８４は近位軸部７８お
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。
【００２７】図１３は図１２のトライアルの組立状態を
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。
【００２８】以上、本発明は例示形態を参照して説明さ
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。
【図面の簡単な説明】
【図１】本体部および軸部を示す本発明によるトライア
ルの分解図である。
【図２】図１のトライアルの軸部の斜視図である。
【図３】図１の本体部の上面図である。
【図４】係合位置の係止機構を示すトライアルの断面図
である。
【図５】離脱位置の係止機構を示すトライアルの断面図
である。
【図６】組立形態の図１のトライアルの側面図である。
【図７】本体部の第１高さで大腿骨へ挿入された本発明
によるトライアルの側面図である。
【図８】本体部の第２高さで大腿骨へ挿入された本発明
によるトライアルの側面図である。
【図９】挿入−抜去器具の斜視図である。
【図１０】大腿骨へトライアルを挿入するためにトライ
アルに係合した図９の器具を示す斜視図である。
【図１１】抜去位置の挿入−抜去器具を示す側面図であ
る。
【図１２】モジュール型軸部を有するトライアルの１形
態の分解図である。
【図１３】組立状態の図１２のトライアルの斜視図であ
る。
【図１４】第１軸部と第２軸部管との間の連結を示す部
分図である。
【符号の説明】
１０…軸部 １２…本体部 １４…ピン ２０…近位端 ２２…遠位端 ２６…遠位端 １８…押しボタン ２８…トラック ３２…切欠き部 ４６…カラー ５０，５２…大腿骨 ５４，５６…骨髄管 ６２，６４…切欠き部 ６６…器具 ６８…分岐 ７８…近位軸部 ８０…遠位軸部 ８２…連結要素 ８４…小身 ８６…長孔

Claims (13)

    【特許請求の範囲】
  1. 【請求項１】 近位端および遠位端を有する近位軸部、 前記近位軸部の近位端と遠位端間で前記近位軸部に対し
    て慴動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遠位軸部、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、から成
    ることを特徴とする距トライアル。
  2. 【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。
  3. 【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。
  4. 【請求項４】 前記遠位軸部は湾曲している、請求項１
    の距トライアル。
  5. 【請求項５】 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
    配向において前記近位軸部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２方向へ湾曲させる構成
    である、請求項４の距トライアル。
  6. 【請求項６】 前記第１方向は前記第２方向と反対方向
    である、請求項５の距トライアル。
  7. 【請求項７】 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である、請求
    項２の距トライアル。
  8. 【請求項８】 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７の距トライアル。
  9. 【請求項９】 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７の距トライアル。
  10. 【請求項１０】 近位端および遠位端を有する近位軸
    部、および近位端および遠位端を有する遠位軸部から成
    り、前記遠位軸部の近位端は第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
    向において前記近位軸部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２方向へ湾曲させる構成で
    ある、ことを特徴とする距トライアル。
  11. 【請求項１１】 前記第１方向は前記第２方向と反対方
    向である、請求項１０の距トライアル。
  12. 【請求項１２】 前記近位軸部の遠位端を前記遠位軸部
    の近位端へ結合する連結要素を更に含む、請求項１０の
    距トライアル。
  13. 【請求項１３】 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、前記近位軸部と
    慴動自在に係合する本体部、前記本体部は前記近位軸部
    の近位端と遠位端間で所定間隔慴動する、 前記本体部よりも幅広く、かつ両側に各々形成された一
    対の切欠き部を含む垂直フランジ、および複数の遠位軸
    部、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、から成ることを特徴とする股置換装置。
JP18248898A 1997-03-26 1998-06-29 距トライアルおよび股置換装置 Expired - Lifetime JP3443003B2 (ja)

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 true JPH1170132A (ja) 1999-03-16
JP3443003B2 JP3443003B2 (ja) 2003-09-02

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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

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US (3) US5860982A (ja)
EP (3) EP0867161B1 (ja)
JP (3) JPH11342A (ja)
BR (1) BR9900317A (ja)
DE (1) DE69936478T2 (ja)
ES (1) ES2289800T3 (ja)

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Also Published As

Publication number Publication date
EP0931524B1 (en) 2007-07-11
US6193759B1 (en) 2001-02-27
BR9900317A (pt) 2000-01-18
JPH11253469A (ja) 1999-09-21
EP0931524A3 (en) 1999-11-17
EP0887053A2 (en) 1998-12-30
EP0931524A2 (en) 1999-07-28
US5888208A (en) 1999-03-30
ES2289800T3 (es) 2008-02-01
EP0867161A1 (en) 1998-09-30
US5860982A (en) 1999-01-19
EP0867161B1 (en) 2003-05-21
EP0887053A3 (en) 1999-11-17
JP4233663B2 (ja) 2009-03-04
EP0887053B1 (en) 2003-05-14
DE69936478D1 (de) 2007-08-23
JP3443003B2 (ja) 2003-09-02
JPH11342A (ja) 1999-01-06
DE69936478T2 (de) 2008-03-13

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