KR102453209B1 - Hip joint device and method - Google Patents

Abstract

A medical device for implantation in a hip joint of a patient is provided. The medical device includes first and second pieces and a release member capable of retaining the first piece attached to the second piece in a first state and releasing the first piece from the second piece in a second state. The release member is adapted to change from the first state to the second state when a predetermined deformation force is applied to the release member.

Description

HIP JOINT DEVICE AND METHOD

FIELD OF THE INVENTION The present invention relates generally to hip prosthesis.

Osteoarthritis of the hip is a syndrome in which low-grade inflammation causes pain in the hip joints, caused by abnormal wear of the cartilage that acts as a cushion within the hip joint. Abnormal wear of this cartilage also results in a decrease in joint synovial fluid called synovial fluid. Hip osteoarthritis, a more or less severe form, has been estimated to affect 80% of all people over the age of 65.

Current treatments for hip osteoarthritis include NSAID drugs, local injections of hyaluronic acid or glucocorticoids to help lubricate the hip joint, and replacement of a portion of the hip joint with an artificial organ through hip surgery. do.

Partial replacement of the hip joint is one of the most common surgeries in the world to date, performed on hundreds of thousands of patients each year. The most common method involves placing a metal prosthesis in the femur and placing a plastic bowl in the acetabulum. This operation is performed through an incision in the hip and upper thigh and through the Fascia Lata and lateral muscles of the thigh. In order to access the joint, the supporting fibrous capsule attached to the femur and the long bone must be penetrated, making it difficult to obtain a fully functional joint after surgery. The femur is then cut at the neck with an osteotomy saw and an artificial prosthesis is placed on the femur with or without bone cement. The acetabulum is slightly dilated using an acetabular reamer, and a plastic bowl is placed using screws or bone cement.

Complications after hip surgery include dislocation of the hip joint and loosening of the prosthesis in fixation in the femur. Loosening and/or displacement of this prosthesis may be induced by abnormal deformation forces applied to the hip joint, for example from a patient's fall or rapid hip movement. A fully immobilized hip prosthesis with no potential to displace will increase the risk of loosening the prosthesis from immobilization at the femur, as the entire strain will then be applied to the femur.

A hip prosthesis that can reduce complications after hip surgery would therefore be desirable.

A medical device for implanting a patient's hip joint is provided. The medical device includes a first piece capable of being secured to a pelvic bone. The first piece includes a convex contact surface that may be partially disposed within a concave contact surface. The medical device further includes a second piece capable of being secured to the femur. The second piece includes a concave contact surface that, when implanted, partially surrounds the convex contact surface of the first piece. The medical device further includes a release member that retains the first piece attached to the second piece in the first state and releases the first piece from the second piece in the second state. The release member may change from a first state to a second state when a predetermined deformation force is applied to the release member. Structures with release members reduce the risk of damage to any structure of the human body and/or between the human body and artificial parts.

According to one embodiment of the medical device, the convex contact surface of the first and/or second piece is at least partially spherical.

According to another embodiment, the concave contact surface of the second piece is at least partially spherical.

According to an embodiment, the first piece may include a ball-shaped piece, and the second piece may include a bowl-shaped piece. The ball-shaped piece may be placed in a bowl-shaped piece to replace a functional hip joint. The ball-shaped piece may be secured using the release member within the bowl-shaped piece.

A release member according to any embodiment of the present disclosure may non-invasively change from a first state to a second state and from a second state to a first state when a predetermined deformation force is applied to the release member.

At least one of the first and second pieces includes two or more portions capable of contacting each other when the medical device is implanted in a patient.

According to another embodiment, the first or the second pieces may be introduced through a hole in the patient's pelvic bone. One of the two or more pieces may be mechanically secured to each other after the two or more pieces are introduced into the hip joint through a hole in the patient's pelvic bone.

The orifice of the pelvic bone may have a cross-sectional area of less than 530 mm ² , less than 380 mm ² , less than 250 mm ² , less than 180 mm ² , or less than 110 mm ² .

According to one embodiment, the second piece of medical device comprises a release member according to any embodiment herein. The release member may comprise an elastic part, which may for example comprise an elastic material, a spring or an elastic band. The elastic band may at least partially surround the ball-shaped piece.

According to another embodiment of the medical device, the release member comprises one or more of a bendable portion, a flexible portion, a compressible portion, a movable portion, or a movable portion.

According to another embodiment, the release member comprises a magnet capable of retaining the first piece to the second piece.

According to another embodiment, the release member comprises a rupture device capable of failing at a predetermined deformation force. The tearing device may include, for example, a tearing band and/or a tearing pin.

The release member may, according to one embodiment, comprise multiple holding members, which may further slide relative to the first piece or roll relative to the first piece. According to an embodiment, the rotatable holding member includes a ball-shaped holding member.

The first piece of the medical device according to an embodiment of the present disclosure may include two or more parts that may be in contact with each other when the medical device is implanted in a patient. One of the two or more parts may be mechanically secured to the second of the two or more parts after the two or more parts are introduced into the hip joint through a hole in the patient's pelvic bone.

According to one embodiment, the first piece may include a flexible portion or an elastic portion that allows the medical device to be inserted into the pelvic bone through a hole, wherein the elastic portion compresses the first piece in one or more directions. make it possible

According to another embodiment, the first piece includes a first area and a second area. The first region includes a first material that can be made elastic, and the second region includes a second material that can be made elastic. The first material may be more resilient than the second material.

According to an embodiment of the medical device, the second piece includes two or more parts that can be brought into contact with each other when the medical device is implanted in a patient. One of the two or more portions may be mechanically secured to the second of the two or more portions after the two or more portions are introduced into the hip joint through a hole in the patient's pelvic bone.

The medical device, according to another embodiment, may include a compensating member for compensating a predetermined deformation force required for the release member to change from the first state to the second state. The compensating member may be a compensating screw.

A method of installing a medical device according to any embodiment herein is further provided. The method includes the following steps. : exposing the hip joint according to a surgical or arthroscopic procedure, fixing a first piece of the medical device to the pelvic bone, fixing a second piece of the medical device to the femur; placing a first piece in connection with the second piece, and holding the first piece to a second piece using the release member.

According to one embodiment, holding the first piece to the second piece using the release member comprises holding the first piece to the second piece using an elastic member. According to another embodiment, holding the first piece to the second piece using the elastic member comprises holding the first piece to the second piece using an elastic band.

According to one embodiment, retaining the first piece to the second piece using the release member may include retaining the first piece to the second piece using the tear member. The tearing member may be a tearing band.

According to another embodiment, holding the first piece to the second piece comprises holding the first piece to the second piece using a spring loaded member.

A medical device for implanting a patient's hip joint is further provided. The medical device includes first and second pieces and a release capable of retaining the first piece attached to the second piece in a first state and releasing the first piece from the second piece in a second state. include absence. The release member is such that, when a predetermined deformation force is applied to the release member, it can be changed from the first state to the second state.

According to an embodiment, the first piece includes a ball-shaped piece, which may replace the surface of the femur at least in the hip joint.

According to one embodiment, the second piece comprises a bowl-shaped piece, which may replace the surface of the acetabulum at least in the hip joint.

According to another embodiment, the first piece comprises a ball-shaped piece and the second piece comprises a bowl-shaped piece, and the ball-shaped piece is disposed in a bowl-shaped piece to replace a functional hip joint. can be, thereby creating a totally artificial hip joint. The ball-shaped piece may be secured within the bowl-shaped piece using a release member.

The release member according to any embodiment is capable of non-invasively changing from a first state to a second state and from a second state to a first state when a predetermined deformation force is applied to the release member. Thus, if displaced, the hip joint can be reinstated without the need for a surgical procedure.

One or more of the first and second pieces may include two or more portions that are brought into contact with each other when the medical device is implanted in a patient.

The first and/or the second piece may be introduced through a hole in the patient's pelvic bone.

According to an embodiment, the two or more pieces may be mechanically fixed to each other after the two or more pieces are introduced into the hip joint through a hole in the patient's pelvic bone.

absence of release

According to one embodiment the first piece of the medical device comprises the release member, which may be a ball-shaped piece of the medical device comprising the release member. According to another embodiment, the second piece of the medical device comprises the release member, which may be a bowl-shaped piece of the medical device comprising the release member.

According to another embodiment, the release member comprises an elastic part, which may further comprise an elastic material.

According to another embodiment, the release member comprises a bendable and/or a flexible and/or compressible portion. It is further contemplated that the release member comprises a movable portion or a movable portion.

In embodiments in which the medical device comprises an elastic member, the elastic member may include a spring and/or an elastic band, at least in part capable of encircling the ball-shaped piece, whereby the ball is contained within the bowl-shaped piece. A piece of shape can be maintained. The elastic band may further be disposed between the ball-shaped piece and the bowl-shaped piece.

According to another embodiment, the release member comprises a magnet capable of retaining the first piece to the second piece.

According to another embodiment, the release member comprises a rupture device capable of failing at a predetermined strain for releasing the first piece from the second piece. The tearing device may include a tearing band, which may at least partially enclose the ball-shaped piece. The rupture band, according to an embodiment, may be disposed between the ball-shaped piece and the bowl-shaped piece, and may include a rupture pin.

The release member may include multiple holding members, or the holding members or holding members may be slidable relative to the first piece and/or may rotate relative to the first piece. The holding member may include a ball-shaped holding member.

1st piece

According to one embodiment, the first piece includes two or more parts that can contact each other when the medical device is implanted in a patient.

The first piece may, according to some embodiments, be introduced through a hole in the patient's pelvic bone.

According to one embodiment, one of the two or more parts is such that the two or more parts are mechanically secured to the second of the two or more parts after the two or more parts are introduced into the hip joint through an orifice in the patient's pelvic bone.

The first piece may include a flexible and/or resilient portion that allows the medical device to be inserted through a hole in the pelvic bone. The elastic part may compress the first piece in one or more directions.

The first piece may include a first region and a second region, wherein the first region may include a first material to be made elastic, and the second region may include a second material to be made elastic. and the first material may be made more resilient than the second material.

2nd piece

According to one embodiment, the second piece comprises two or more parts that can be brought into contact with each other when the medical device is implanted in a patient. The second piece may be introduced through a hole in the patient's pelvic bone.

According to another embodiment, one of the two or more parts may be configured to be mechanically secured to a second one of the two or more parts after the two or more parts are introduced into the hip joint through a hole in the patient's pelvic bone. there will be

According to another embodiment, the medical device comprises a three-dimensionally curved hip joint surface comprising at least an inner surface and an outer surface. The inner surface comprises six different points: a first point, a second point, a third point, a fourth point, a fifth point, and a sixth point, all points along the long axis of the inner surface. placed in different positions. A first straight line, named from the first point to the second point, is parallel to a second straight line from the third point to the fourth point, which in turn is a second straight line from the fifth point to the sixth point 3 parallel to a straight line. Moreover, the first and third straight lines are shorter than the second straight line, and the second straight line is located between the first and the third straight lines.

The medical device may further include a compensating member for compensating for a predetermined deformation force required for the release member to change from the first state to the second state. The compensating member may be a compensating screw.

A normal hip joint has an axial distribution to the head of the femur, wherein the femur has a substantially globular arrangement with a maximum diameter substantially perpendicular to the central axis of the prolongation of the axial distribution of the colum femur. , with the Columb femur. The femoral head is disposed in the bowl-shaped acetabulum to form a hip joint. The bowl-shaped acetabulum has an opening and a second axial distribution with a central axis from the center of the bottom of the acetabulum bowl and along the center of the bowl towards the opening and the femur, wherein the acetabulum has a second axial distribution of the acetabulum has a maximum diameter substantially perpendicular to the center axis of The extension of the central axis of the axial distribution is the same as the central axis of the second axial distribution when the femur is symmetrically centered in the acetabulum bowl. The medical device comprises two artificial hip surfaces, wherein the first piece, on an opposite side of the columboid femur, is capable of replacing the articular surface of the femur and replacing the artificial femoral surface; and and an artificial femoral surface that, when mounted on an acetabulum, can be placed within the acetabulum bowl or a prosthetic substitute thereof. The prosthetic femoral surface, when mounted in a functional position at a joint on the femur, moves away from the acetabulum bowl towards the columbar femur, and on at least a portion of the femur beyond the maximum diameter of the femur. a first beyond portion of the surface, which may enter and/or cover the bone of the at least one first transcendental portion is adapted to have a closest perpendicular distance to the central axis that is less than the distance between the central axis and the distal edge of the maximum diameter of the femur, and thus is in the functional position on the femur When mounted, it can and creates a more stable position of the surface of the artificial femoral head. The transcendental portion includes at least a portion of the release member.

A normal hip joint has a columbic femur with an axial distribution that spans the femur, wherein the femur has a substantially globular arrangement with a maximum diameter substantially perpendicular to the central axis of extension of the axial distribution of the columbic femur. The femoral head is disposed in the bowl-shaped acetabulum to form a hip joint. The bowl-shaped acetabulum has an opening and a second axial distribution having a central axis along the center of the bowl from the center of the bottom of the acetabulum bowl and towards the opening and the femur. wherein the acetabulum has a maximum diameter substantially perpendicular to a central axis of the second axial distribution of the acetabulum, and an extension of the central axis of the axial distribution is such that when the femur is in a centrally symmetrical position within the acetabulum bowl, The second axis is the same as the central axis of the distribution. The medical device includes two artificial hip surfaces, the artificial hip surface capable of and replacing at least a portion of the articular surface of the acetabulum, and disposed on the femur or an artificial replacement thereof when mounted in a hip joint. which may be, including an artificial acetabulum surface. The prosthetic acetabulum surface, when mounted on the femur or prosthesis thereof, is at least a portion of the femur or prosthesis thereof beyond the largest diameter of the acetabulum, away from the acetabulum bowl towards the columbium, in a functional position at the hip joint. a first beyond portion of the surface, capable of covering the at least one first transcendental portion is adapted to have a nearest vertical distance to the central axis less than the distance between the central axis and the outer edge of the largest diameter of the artificial acetabulum surface, and thus on the femur or its prosthetic replacement When mounted, in a functional position of the hip joint, it can and creates a more stable position of the artificial acetabulum surface. The first transcendental portion includes the release member.

The release member may, according to certain embodiments, be configured to be resilient and/or bendable and/or flexible and/or compressible and/or flexible to enable releasing of the first piece from the second piece. or a movable portion and/or a movable portion.

A method of installing a medical device according to certain embodiments is further provided, the method comprising the following steps. : exposing the hip joint through a surgical or arthroscopic procedure, fixing the first piece of the medical device to the femur, fixing the second piece of the medical device to the pelvic bone, the first placing one piece in connection with the second piece, and retaining the first piece to the second piece using the release member.

According to an embodiment, holding the first piece to the second piece comprises holding the first piece to the second piece using an elastic member.

According to one embodiment, retaining the first piece to the second piece comprises retaining the first piece to the second piece using a rupture member.

According to one embodiment, retaining the first piece to the second piece comprises retaining the first piece to the second piece using a spring loaded member.

According to one embodiment, holding the first piece to the second piece comprises holding the first piece to the second piece using an elastic band.

According to one embodiment, retaining the first piece to the second piece comprises retaining the first piece to the second piece using a rupture band.

It should be noted that any embodiment or part, feature, method, related system, part of the system, or related drawings described herein or any embodiment may be combined in any way.

BRIEF DESCRIPTION OF THE DRAWINGS The invention is explained in detail below with reference to the accompanying drawings by way of example.

1 shows a cross-section of the hip joint,
2 shows the first stage of a traditional hip surgery;
3 shows the step of separating the femur from the hip capsule;
4 shows incisions made in a laparoscopic/arthroscopic method;
5 shows instruments used in laparoscopy/arthroscopy;
6 shows the steps of creating a hole in a patient's pelvic bone;
7 shows details of laparoscopic surgery;
8 shows a cross-section of a patient when laparoscopic surgery is performed;
9 shows a cross-section of the hip joint in a first state when a medical device is provided;
10 shows a cross-section of the hip joint in a second state when a medical device is provided;
11 shows a cross-section of the hip joint in a first state when a medical device is provided;
12 shows a cross-section of the hip joint in a second state when a medical device is provided;
13 shows a cross-section of the medical device;
FIG. 14 shows, in a first state, an alternative embodiment of the medical device shown in FIG. 11 ;
15 shows, in a second state, an alternative embodiment of the medical device shown in FIG. 11 ;
16 is a cross-sectional view of a hip joint in a first state when a medical device according to another embodiment is provided;
17 is a cross-sectional view of a hip joint in a second state when a medical device according to another embodiment is provided;
18A shows a cross-section of the hip joint in a first state when a medical device comprising an elastic or rupture band is provided;
Figure 18b shows a cross-section of the medical device of Figure 18a in a first state,
19A shows a cross-section of the hip joint in a second state when a medical device comprising an elastic or rupture band is provided;
19B shows a cross-section of the medical device of FIG. 19A in a second state;
20 is a cross-sectional view of a hip joint in a first state when a medical device according to another embodiment is provided;
21 is a cross-sectional view of a hip joint in a second state when a medical device according to another embodiment is provided;
22 shows a cross-section of the hip joint in a first state when a medical device comprising a rupture band is provided;
23 shows a cross-section of the hip joint in a second state when a medical device comprising a rupture band is provided;
24 is a cross-sectional view of a hip joint in a first state when a medical device according to another embodiment is provided;
25 is a cross-sectional view of a hip joint in a second state when a medical device according to another embodiment is provided;
Fig. 26 shows a cross-section of the hip joint in a first state when the medical device according to an embodiment is provided, wherein the artificial acetabulum surface comprises elastic elements;
Fig. 27 shows a cross-section of the hip joint in a second state when the medical device according to an embodiment is provided, wherein the artificial acetabulum surface comprises elastic elements;
Fig. 28 shows an alternative embodiment of the medical device shown in Fig. 26;
Fig. 29 shows a cross-section of the hip joint in a first state when a medical device capable of holding the femur 5, or an artificial substitute thereof, in the artificial acetabulum by means of magnetic force is provided;
30 shows a cross-section of the hip joint in a second state, in the case of medical provision capable of retaining the femur 5, or an artificial substitute thereof, in the artificial acetabulum by means of magnetic force;
31 schematically shows an artificial acetabulum or an artificial femoral head;
32 shows a cross-section of an artificial acetabulum or artificial femur;
33 shows the principle of an alternative embodiment;
34 shows the principle of an alternative embodiment;
35 shows the principle of an alternative embodiment;
36A shows one embodiment of a locking/releasing member;
36B shows a cross-section of the hip joint in one embodiment when the locking/unlocking member locks the prosthetic femur to the prosthetic acetabulum;
36C shows a cross-section of the hip joint in one embodiment when the lock/release member releases the prosthetic femur from the prosthetic acetabulum;
36D shows another embodiment of the locking/unlocking member;
36E is a cross-sectional view of the hip joint in one embodiment when the locking/unlocking member according to the embodiment of FIG. 36D locks the artificial femur to the artificial acetabulum;
FIG. 36F shows a cross-section of the hip joint in one embodiment when the locking/release member according to the embodiment of FIG. 36D releases the artificial femur from the artificial acetabulum;
36G shows another embodiment of a locking/unlocking member;
36H shows another embodiment of the locking/unlocking member;
36i shows a cross-section of the hip joint when the artificial hip joint is assembled;
36j shows a cross-section of the hip joint when the artificial hip joint is assembled;
36K shows a cross-section of the hip joint when the artificial hip joint is assembled;
36M shows a cross-section of the hip joint when the hip joint is in the released state.

Elasticity should be understood as the ability of materials to deform in an elastic manner.

Elastic deformation is when a material deforms under stress (eg, an external force), but returns to its original shape when the stress is removed. A more elastic material is to be understood as a material with less elastic modules. The modulus of the elasticity of an object is defined as the slope of its stress-strain force curve in the elastic deformation section. The elastic modulus is calculated as stress/strain force, where stress is the force causing the deformation divided by the area over which the force is applied; And strain is the rate of change due to stress.

Stiffness should be understood as the resistance of an elastic body to deformation by an applied force.

Functional hip movement should be understood as movement of the hip that corresponds at least in part to the natural movement of the hip joint. In some cases, the natural motion of the hip joint may be somewhat limited or altered after hip surgery, where a hip joint with artificial surfaces makes the functional hip motion somewhat different from the functional motion of the natural hip joint.

The functional position of an implantable medical device or artificial organ is a position in which the hip joint can perform functional hip joint motion. The final position should be understood as a functional position at which the medical device does not require any further position change.

A biocompatible material should be understood as a material with a low level of immune response. Biocompatible materials are often also referred to as biomaterials. Analogous are biocompatible metals, and are biocompatible metals with a low immune response, such as titanium or tantalum. The biocompatible metal may also be a biocompatible alloy comprising one or more biocompatible metals.

Form fitting is to be understood as an element having a part or section, said part or section being capable of causing said element to be mechanically connected to one or more other elements by means of said part or section. do. A form-fitted structure is a structure of an element that can be made to form-fit.

The medical device according to some embodiments may include one or more materials selected from the group consisting of polytetrafluoroethylene (PTFE), perfluoroalkoxy (PFA), and fluorinated ethylene propylene (FEP). It is further contemplated that the material comprises an alloy of a metal, such as cobalt-chromium-molybdenum or titanium or stainless steel, or polyethylene, such as cross-linked polyethylene or gas-sterilized polyethylene. The use of a ceramic material, such as zirconium or zirconium dioxide ceramics or ceramics, on the contact surface or in the overall medical device is also contemplated. The portion of the medical device that is in contact with the human bone for fixing the medical device to the human bone may include a poorhouse structure, which may include a poorhouse structure for securing the medical device to the human bone in the medical device. It can be a porous micro- or nano-structure that can facilitate bone growth-in. The porous structure can be obtained by applying a hydroxy-apatite (HA) coating, or a rough open-pored titanium coating, which can be produced by air plasma spraying, and rough open-pored titanium coating. Combinations comprising a coating and an HA top layer are also contemplated. The parts in contact may contain a self lubricated material, such as a waxy polymer, such as PTFE, PFA, FEP, PE and UHMWPE, or a lubricant, preferably a biocompatible lubricant, such as a hyaluronic acid derivative ( infuse) can be made of powder metallurgical materials. It is also conceivable here that the material of the contacting parts or surfaces of the medical device may be lubricated continuously or intermittently. According to some embodiments, the parts or regions of the medical device include a combination of metallic materials and/or carbon fibers and/or boron, a combination of metal and plastic materials, a combination of metal and carbon-based materials, a combination of carbon and plastic based materials, a combination of flexible and rigid materials, a combination of elastic and less elastic materials, Corian or acrylic polymers.

In the following, detailed descriptions of preferred embodiments of the present invention will be provided. In the drawings, like reference numbers indicate the same or corresponding elements in several drawings. It should be understood that these drawings are for illustrative purposes only and are in no way intended to limit the protection scope of the present invention. Accordingly, any direction indication, such as "up" or "down", is only for the purpose of indicating the direction shown in the drawings. Also, any dimensions and the like appearing in the drawings are for illustrative purposes only.

1 shows a cross-section of a hip joint of a human patient. The hip joint includes a femoral head (5) located at the top of the columbine femur (6), which is a normal part of the femur (7), or an artificial replacement thereof. The femoral head 5 is connected to the acetabulum 8 which is a bowl-shaped part of the pelvic bone 9 . Both the femoral surface (10) and the acetabulum surface (11) are covered with articular cartilage (13) which acts as a cushion in the hip joint. In patients with hip osteoarthritis, this articular cartilage 13 is abnormally worn down by low grade inflammation. The hip joint is surrounded by a hip capsule 12 , which provides support for the joint and inhibits luxation. After conventional hip surgery, penetrating the hip capsule 12 , the capsule 12 is extremely weakened by the limited wound healing potential of its ligamentous tissue. By performing the hip joint surgery without damaging the hip capsule 12, the patient can fully recover and can apply the same amount of strain to the artificial joint as possible as in the case of the natural one.

FIG. 2 shows a side view of a traditional hip surgery in which an incision 112 is made in the femur 113 to allow the surgeon to reach the femur 7 on which the head 5 is disposed. The femur 7 is then extracted from the hip capsule 12 to expose the femur 5, which may be replaced or resurfaced during surgery.

3 shows the addition of an artificial femoral surface 45 on the femoral head 5 in a traditional surgery. However, according to other embodiments of the prior art, the entire columbine femur 6 is separated using an osteotomy saw, and then the part of the prosthesis including the femur is fixed to the femur using bone cement or mechanical fixation members. . A bowl-shaped cup is then placed in the acetabulum 8 so as to act as a contact surface against the new artificial femoral head 45 when the hip joint performs a functional hip movement in its functional position. According to the prior art, the artificial femoral surface and the artificial acetabulum surface are kept together by a hip capsule, which is extremely weakened when the capsule is pierced during surgery.

An alternative way of operating the hip joint will be described below.

4 shows a front view of a human patient body. Laparoscopic/arthroscopy of hip surgery, from the opposite side of the acetabulum, is performed according to the first embodiment, starting by making small incisions 14 in the abdominal wall of a human patient. The small incisions allow the surgeon to insert laproscopic trocars into the abdomen of a human patient. According to a first embodiment the incisions 14 go through the rectus abdominis muscle and the abdominal cavity into the abdomen of a human patient. According to a second preferred embodiment, the small incisions 15 are made through the rectus abdominis muscle and into the pelvic region below the abdominal cavity. According to a third embodiment, small incisions 16 are made directly between the iliac bone and the surrounding tissue, one incision 16 allowing the pelvic bone to be dissected with very little penetration of fascia and muscle tissue. According to a fourth embodiment the incision 17 is made in the inguinal channel. In all four embodiments, the surrounding tissue of the pelvic bone 9 is separated or penetrated in the area opposite the acetabulum 8 to allow the surgeon to reach the pelvic bone 9 .

It is self-evident that the methods described can be combined or modified to reach the same goal of dissecting the pelvic bone opposite the acetabulum.

After dissection of the pelvic bone 9 , a hole 18 is formed in the bone 9 , as shown in FIG. 6 . The hole (18) goes through the pelvic bone from the opposite side of the acetabulum (8) to the hip joint (19). Here, a medical device according to any of the embodiments may be adapted to be inserted through the hole 18 in the pelvic bone 9 . For this purpose, the medical device is introduced through an aperture 18 , and then mounted and first and second capable of being mechanically fixed to each other in situ for the formation of the mounted medical device. may include pieces. This is explained in more detail with reference to FIGS. 36H and 36I.

The medical device, or the first and second pieces of the medical device, is inserted into the pelvic bone 9 through a hole 18 having a cross-sectional area of less than 530 m2, or a hole 18 having a cross-sectional area less than 380 mm2. into the pelvic bone 9 through, or through a hole 18 with a cross-sectional area less than 250 mm2, into the pelvic bone 9, or through a hole 18 with a cross-sectional area less than 180 mm2, into the pelvic bone 9 , or into the pelvic bone 9 through a hole 18 having a cross-sectional area of less than 110 mm2. It may further be contemplated that a smaller aperture is a less invasive procedure, where the medical device requires that the medical device be mounted in two or more pieces. In some embodiments the medical device is mounted in several pieces that can be mechanically coupled to a base piece.

FIG. 5 shows a front view of the body of a human patient, illustrating a laparoscopic method of operating the hip joint from the opposite side of the acetabulum 8 . The hip joint includes the acetabulum (8) and the femoral head (5). Small incisions 14 in the human patient's abdominal wall allow for insertion of laparoscopic trocars 33a,b,c into the patient's body. One or more cameras 34 , surgical instruments 35 capable of forming a hole in the pelvic bone, or prostheses or parts of prostheses thereafter are then introduced, placed, connected, attached, formed, or filled. Capable instruments 36 can be inserted into the body through the laparoscopic trocars 33a,b,c.

6 shows the formation of a hole 18 in the pelvic bone 9 from the ventral side of the acetabulum using a bone contacting organ 22 .

7 shows a close-up view of the insert 37 of the parts 38 of the prosthesis through the laparoscopic trocars 33a,b,c into the patient's body. The parts of the prosthesis may be parts of the prosthetic head 45 , the artificial acetabulum 65 or parts of the prosthesis or parts of bone material that can be used to close the hole 18 formed in the pelvic bone 9 .

8 is a side view of a human patient, in which the hip joint is shown in cross-section. The hip joint includes the femoral head 5 located at the top of the columbine femur 6 , which is the normal part of the femur bone 7 . The femoral head (5) is connected to the acetabulum (8), which is a bowl-shaped part of the pelvic bone (9). Laparoscopic trocars 33a,b,c introduce, deploy, one or more cameras 34, surgical instruments 35 that may form a configuration in pelvic bone 9, or prostheses or parts of prostheses. , connecting, attaching, forming or filling instruments 36 , used to reach the hip joint 39 .

9 shows an artificial bowl-shaped acetabulum cup 65 placed on the pelvic bone 9 . The artificial bowl-shaped acetabulum cup 65 is, in the first state, an artificial bowl-shaped acetabulum cup ( 65) include release members 801 that can be maintained in position at the hip joint. In the second state, the release member 801 is capable of releasing the femur 5, or an artificial replacement thereof, from the artificial bowl-shaped acetabulum cup 65 disposed on the pelvic bone 9 . The release member 801 may change from a first state to a second state when a predetermined deformation force is applied to the release member 801 . Said deformation force is preferably caused by an abnormal movement of the hip joint, for example a patient's fall. According to the embodiment shown in FIG. 9 , the release member 801 comprises an elastic portion comprising an elastic material, which in the illustrated embodiment is the entire release member 801 . The release member may non-invasively change from the first state to the second state and from the second state to the first state when a predetermined deforming force is applied to the release member 801 .

FIG. 10 shows a cross-section of the hip joint when the release member 801 is in a second state, wherein the release member 801 places the femur 5, or a prosthetic replacement thereof, on the pelvic bone 9. It can be released from the bowl-shaped acetabulum cup (65). The release member 801 was changed from the first state to the second state because a predetermined deformation force was applied to the release members 801 .

11 shows an artificial bowl-shaped acetabulum surface 65 comprising release members 801 including holding members 802a,b slidable relative to the femur 5, or a prosthetic substitute thereof. An embodiment according to a medical device is shown. The holding members are, in the first state, an artificial bowl-shaped acetabulum cup 65 disposed on the pelvic bone 9 for the femur 5, which is a ball-shaped part attached to the columbia femur 6, or an artificial substitute thereof. ) to maintain the hip joint position. In the second state, the release member 801 is capable of releasing the femur 5, or a prosthetic replacement thereof, from the artificial bowl-shaped acetabulum cup 65 disposed on the pelvic bone 9 . The holding members 802a,b are spring-loaded, being loaded between the holding members 802a,b and the compensating member in which the spring 803a,b is the compensating screw 804a,b. The force applied to the holding members 802a,b from the spring 803a,b may retain the femur 5, or its prosthetic replacement, within the prosthetic acetabulum 65 in normal, functional hip movements, but is preferred. When a certain strain force is applied to the release member, preferably as a result of abnormal movement of the hip joint, for example, a patient's falling, the femoral head 5, or its prosthetic replacement, is removed from the prosthetic acetabulum 65. can be turned off The compensating screws 804a,b allow pre-determination of a deformation force that may cause the holding members 802a,b to change from the first state to the second state.

12 shows the release members in a second state when a predetermined deformation force is exceeded, preferably as a result of a fall of the patient, preferably caused by an abnormal movement of the hip joint. The holding members 802a,b are retracted into the sleeves 806 of the artificial acetabulum surface 65, thereby compressing the springs 803a,b. Retraction of the holding members 802a,b causes the femur 5, or its prosthetic replacement, to be displaced/dislocated from their position on the artificial acetabulum surface 65, which causes a large strain on the hip joint and the femur (7). When added to, reduces the risk of fracture of the patient's femur (7) or pelvic bone (9). The holding members 802a,b can non-invasively change from a first state to a second state and from a second state to a first state when a predetermined deformation force is applied to the holding members 802a,b. have.

13 shows a holding positioned within sleeves 806 that holds the femoral head 5, or an artificial replacement thereof, in a position within the artificial acetabulum 65 and is distributed evenly along the cross-section of the artificial acetabulum 65 . The members 802 and the artificial acetabulum 65 are shown.

14 shows an alternative embodiment of the principle shown in FIGS. 11-13 , wherein the holding members 802a , b are in contact with the femur 5 , or a prosthetic replacement thereof, and the femur 5 . , or its prosthesis, and capable of sliding the femur 5, or its prosthesis, into the prosthetic acetabulum 65, with springs 803a,b supported by corrective screws 804a,b and ball-shaped members 805a,b, retainable by holding members 802a,b, which exert a force on the femur 5, or its prosthetic substitute, through the contact of.

Fig. 15 shows the release members in a second state when a predetermined strain is exceeded, preferably as a result of a fall of the patient, preferably caused by an abnormal movement of the hip joint. Holding members 802a,b comprising ball-shaped members 805a,b are withdrawn into sleeves 806 of artificial acetabulum surface 65, thereby compressing springs 803a,b. Retraction of the holding members 802a,b causes the femur 5, or prosthetic replacement thereof, to be displaced/dislocated from its position on the artificial acetabulum surface 65, which results in a large deforming force at the hip joint of the femur 7 When added to, reduces the risk of fracture of the patient's femur (7) or pelvic bone (9). The holding members 802a,b can non-invasively change from the first state to the second state and from the second state to the first state when a predetermined deformation force is applied to the holding members 802a,b. And, this may allow the femoral head 5, or an artificial replacement thereof, to be replaced in the artificial acetabulum 65 without a surgical procedure.

16 shows a medical device in an embodiment wherein the release members 801 include a rupture device 807 , 808 , 809 capable of failing at a predetermined strain force. According to this embodiment, the rupture device is attached to the basal portion 809a ,b through a weakened section 808a ,b and a basal portion 809a ,b fixed to the artificial acetabulum 65 . A portion 807a,b, wherein in said region, when a predetermined strain is applied to the tearing device in contact with the femoral head 5, or its prosthetic substitute, the tearing portion 807a,b transforms into the base portion 809a,b ), detached from, is a bursting pin 807, 808, 809 comprising

FIG. 17 shows the medical device according to the embodiment of FIG. 16 where the rupturing device has failed due to excess of a predetermined strain on the rupture device. According to one embodiment, (not shown) the tearing parts 807a,b protect the tearing parts 807a,b close to the base part 809a,b even after loss of function of the tearing device. (Security wire) is retained at the base.

18A shows a medical device according to an embodiment in which the prosthetic orifice 65 includes a circular sleeve 806 , which is provided with an elastic or rupture band 810 . The elastic or rupture band 810 may at least partially encircle the ball-shaped femur 5, or a prosthetic replacement thereof. When a predetermined strain is applied to the elastic or rupture band 810, the circular opening that roundly surrounds the femur 5, or prosthesis thereof, expands and the femur 5, or prosthesis thereof, becomes elastic. It is released from the artificial acetabulum (65) held by the band (810). In embodiments in which the medical device includes a rupture band 810 that holds the femur 5, or a prosthetic replacement thereof, to the prosthetic acetabulum 65, the weakened region 811 of the band 810 becomes dysfunctional and thus The circular opening roundly surrounding the femur 5 , or prosthesis thereof, is inflated and the femur 5 , or prosthesis thereof, is released from the prosthetic acetabulum 65 . In embodiments where the band 810 is an elastic band 810, it is contemplated that the band 810 comprises a portion or region of elastic, or that the entire band 810 is made of an elastic material.

18B shows a cross-section of a medical device in which an elastic or rupture band 810 holding the femur 5, or a prosthetic replacement thereof, is disposed in a circular sleeve 806 within the prosthetic orifice 65. An opening or weakening zone 811 is provided perpendicular to the circumference of the band 810 .

19A shows the medical device in a second state when, after a predetermined strain is applied to the elastic or rupture band 810, the femur 5, or its prosthetic replacement, is released from connection with the acetabulum. As shown in FIG. 19B , the gap or weakened portion is inflated, thereby allowing the femur, or prosthesis thereof, (5) to pass through the opening defined by the elastic or rupture band (810). The medical device may non-invasively change from a first state to a second state and from a second state to a first state when a predetermined strain is applied to the band 810 , which may include the femur 5 , or its A prosthetic prosthesis may be replaced in the prosthetic acetabulum 65 without a surgical procedure.

20 shows that the release member 801 has the femur 5, or prosthesis thereof, at the greatest cross-sectional distance from the prosthetic bulb 65 to the femur 5, or prosthesis thereof. According to an embodiment comprising an elastic wing of an artificial acetabulum 65 assisted by an elastic or rupture band 810 enclosing the medical device by enclosing beyond (beyond) the point of A medical device is shown. The elastic or rupture band 810 is held in the artificial acetabulum 65 by a band 810 disposed in a groove along the circumference of the artificial acetabulum 65 . However, the groove may be assisted or replaced by an adhesive or mechanical fastening element.

21 shows the medical device in the case of the second state, wherein the release member 801 releases the femur 5, or a prosthesis thereof, from the prosthetic acetabulum 65 . In embodiments where the band 810 is an elastic band 810, it is inflated, thereby expanding the aperture, through which the femur 5, or a prosthetic replacement thereof, can pass. In embodiments where the band 810 is a rupture band, the band 810 becomes dysfunctional such that the femur 5, or a prosthetic replacement thereof, is subjected to a pre-defined strain on the femur 5, or its prosthesis. Only the release member 801 capable of releasing the prosthetic is held in position. The medical device is capable of non-invasively changing from a first state to a second state and from a second state to a first state when a predetermined strain is applied to the band 810 and/or the release member 801; , which allows the femoral head 5, or an artificial replacement thereof, to be replaced in the artificial acetabulum 65 without a surgical procedure.

22 is a view of the hip joint according to an embodiment in which the femur 5, or a prosthetic replacement thereof, and the columboid femur 6 are replaced with bone cement, or a portion 818 of an artificial prosthesis secured to the femur 7 without it, FIG. A cross section is shown. The portion 818 of the prosthesis includes a cavity 816 , wherein a rupture band 813 includes a fixation portion 814 of the artificial femoral head 812 , and a cavity 816 of the artificial acetabulum 65 . fixed to the apex 815 , including an artificial femoral head 812 with The cavity 816 may allow the artificial femoral head 812 to perform normal functional hip movement within the artificial acetabulum 65 . The rupture band 813 is configured such that the artificial femoral head 812 is maintained in the artificial acetabulum 65 in the first state, and when a predetermined deformation force is applied to the rupture band 813 , the artificial femoral head 812 is artificial. It can be released from the acetabulum.

FIG. 23 shows an embodiment of the medical device according to FIG. 22 in a second state, wherein the rupture band 813 is dysfunctional whereby the femoral head 812 is released from the prosthetic acetabulum 65 . The rupture band 813 may be secured to the anchoring portion 814 of the artificial femoral head 812 , and/or the anchoring portion 815 of the artificial acetabulum 65 using: one or more screws, one or more screws. Pins, form fittings, welding, adhesives, pins, wire, balls mounted in a bowl, male mounted into the female compartment of another part A key, band, or other mechanical connecting member introduced into a lock as a section of a section, sections of said sections. The loss of function of the rupture band 813 preferably results as a result of abnormal movement of the hip joint, for example, a fall of the patient.

24 shows a portion 818 of the prosthesis, wherein the portion 818 of the prosthesis is secured to the femur 7 and, in the 1 state, the fixation portion 814 of the prosthetic head 812 . , and a cavity 816 that allows the hip joint to perform functional hip joint movements while being held in the artificial acetabulum using an elastic band 817 secured to the fixing portion 815 of the artificial acetabulum 65 . two 812 , and a release member 801 according to the embodiment shown in FIGS. 9 and 10 . The combination of the release member 801 and the elastic band 817 retains the portion 818 of the prosthesis in the prosthesis 65 in a first state, and retains the portion 818 of the prosthesis in the acetabulum 65 in a second state. It can be released from (65). According to another embodiment (not shown) a portion of the prosthesis alone may be held in the prosthesis 65 using an elastic band 817 and of course the remainder of the hip capsule and the affected muscle. can be supported by

FIG. 25 shows an embodiment of the medical upper according to FIG. 24 in a second state, wherein the elastic band 817 is stretched such that the portion 818 of the prosthesis is released from the prosthetic acetabulum 65 . The elastic band 817 may be secured to the anchorage 814 of the artificial femoral head 812, and/or the anchorage 815 of the artificial acetabulum 65 using: one or more screws, one or more pins. , form fitting, welding, adhesive, pin, wire, ball mounted in a bowl, male compartment mounted into the female compartment of another part A key, band, or other mechanical connecting member introduced into the lock as a portion of the section of the section. The loss of function of the rupture band 813 preferably occurs as a result of abnormal movement of the hip joint, eg, a fall of the patient. The elastic band 817 preferably comprises an elastic portion or region, which is made of an elastic material, such as an elastic polymeric material, such as: a copolymer material, such as polystyrene, poly(ethylene-butylene) or polystyrene. It can be an entire elastic band 817 . The material is a polyurethane elastomeric material, polyamide elastomeric materials and polyester elastomeric materials, ethylene and one or more vinyl monomers such as, for example, vinyl acetates, unsaturated aliphatic monocarboxylic acid , and elastic copolymers of esters of such monocarboxylic acids are also conceivable. The elastic band 817 may include a barrier coating that cannot be penetrated by somatic cells. Preferably, the barrier coating comprises a Parylene ^™ coating, or a coating of a biocompatible metal, such as gold, silver or titanium. According to other embodiments the elastic band comprises a spring type member, a combination of metal and plastic materials, a combination of metal and carbon based material or a combination of carbon and plastic based material.

26 shows a cross-section of the hip joint in an embodiment wherein the medical device comprises a portion 819 of an artificial prosthesis capable of being secured to a femur 7 . The portion of the prosthesis includes a prosthetic head, which may include resilient elements 820 that act as a release member to hold the prosthetic head within an artificial acetabulum 65 secured to the pelvic bone. The elastic elements 820 of the artificial femur are preferably made of an elastic material, which may be, for example, an elastomeric polymer material or an elastic metallic material. It is contemplated for the elastic material to include an outer layer in contact with the prosthetic acetabulum 65 that may resist abrasion from contact with the prosthetic acetabulum surface. The elastic element may be compressed when a predetermined strain is applied to the hip joint and thereby is applied on the elastic elements 820 . The artificial femoral head is released from the artificial acetabulum 65 when the elastic elements 820 are compressed.

Fig. 27 shows the medical device according to the embodiment shown in Fig. 26 in a second state, wherein the elastic element 820 has been compressed as a predetermined strain is applied to the medical device. The medical device is thereby placed into the second state, wherein the artificial femoral head is released from the artificial acetabulum 65 in which it was held.

FIG. 28 shows an embodiment of a medical device in which elastic elements 820 are further assisted by a spring 821 in contact with two elastic elements 820 , said spring 821 having a predetermined deforming force. It is compressed along the elastic members 820 when added to the portion 819 of the prosthesis comprising the femoral head.

29A shows, in a first state, retaining the femur 5, or a prosthesis thereof, in the artificial acetabulum 65, and in a second state, retaining the femur 5, or a prosthesis thereof, from the prosthetic acetabulum 65 A cross-section of the hip joint is shown in the case of a releasing medical device. The medical device can be changed from being in a first state to being in a second state at a predetermined deforming force affecting the medical device by connection with the pelvic bone 9 and femur 7, which is the patient's femur. (7) and/or reduce the risk of fracture of the pelvic bone (9). The medical device comprises magnets 823 or magnetic material 823 disposed on the prosthesis 65, and magnets 822 or magnetic material 822 disposed on the femur 5 or its prosthesis. do. According to one embodiment the magnet 823 is disposed on the artificial acetabulum to have a south pole towards the femur 5, or a prosthesis thereof, and the magnet 822 to have a north pole toward the artificial acetabulum 65. 5), or its artificial substitute. However, one of ordinary skill in the art will readily understand that only one needs to be magnetic, while the other needs only to contain a magnetic material. Any combination of north and south pole ends and magnet/magnetic material is therefore contemplated. The magnetic force described is to hold the femoral head (5), or its prosthetic replacement, in the acetabulum in normal use, enable the hip joint to perform functional hip joint movements, and, when a predetermined strain force is exceeded, the femoral head (5) 5), or an artificial replacement thereof, may be released from the artificial acetabulum (65).

29B shows the medical device according to the embodiment of FIG. 29A in a second state, wherein the femur 5, or an artificial replacement thereof, is released from the artificial acetabulum 65 as a result of the predetermined level of deformation force being exceeded.

30A shows a medical device according to another embodiment in a first state, wherein the medical device comprises a portion 818 of an artificial prosthesis secured to a femur 7 . A portion 818 of the prosthesis may be separated along a separation line 860 disposed in the region of the columbar femur. A proximal portion of the prosthetic portion is placed in the prosthetic acetabulum 65 and is clasped there to allow a stable fixation of the prosthetic portion 818 to the pelvic bone 9 . The portion of the prosthesis is made separable such that the portion of the prosthesis comprises two portions 861 and 862 , wherein a first portion 861 can be disposed in the artificial acetabulum 65 , and A second portion 862 may be secured to the femur 7. The first 861 and second 862 portions may be secured by a break pin 863 disposed in a hole in the portion 818 of the prosthesis. A brake pin 863 here holds the first piece 861 attached to the second piece 862 in a first state, and in a second state, the first piece 861 is a release member capable of breaking so as to disengage it from the second piece 862. The break pin 863 is breakable, whereby when a predetermined strain is applied to the release member, the first state is changed to the second state.

FIG. 30B shows according to the embodiment of FIG. 30A where the break pin 863 is disengaged and thereby the first piece 861 is released from the second piece 862 and changed from the first state to the second state. A medical device is shown.

30C and 30D show a malfunctioning brake pin (shown in FIG. 30D ) by removing the pieces of the malfunctioning brake pin 863 (shown in FIG. 30C ) and replacing it with a new brake pin 863 (shown in FIG. 30D ). 863) is shown. Positioning the dividing line 860 in the region of the columbine femur and not in the region of fixation to the femur 5 or pelvic bone 9 means that the portion 818 of the prosthesis is separated from the femur 5 and pelvic bone 9. It is possible to release the first part 861 from the second part 862 when a force exceeding a predetermined value is exceeded while maintaining the fixation of the prosthesis, so that the hip joint of the prosthesis can be displaced without damaging the fixations have.

31 schematically shows how the artificial acetabulum advances beyond the maximum diameter of the femur 5, or its artificial substitute. That is, the cross-sectional distance of the maximum opening 52 is less than the maximum cross-sectional distance of the femur 5 or its prosthesis.

32 illustrates a medical device according to an embodiment wherein the second piece includes an inner surface 906 and an outer surface 907 . The inner surface 906 includes a first point 908a, a second point 909a, a third point 908b, a fourth point 909b, a fifth point 908c, and a sixth point 909c. and all points are located at different locations along the long axis of the inner surface. The first straight line 910a is parallel to the second straight line 910b from the first point 908a to the second 909a and from the third point 908b to the fourth point 909b, which further It is parallel to the third straight line 910c from the fifth point 908c to the sixth point 909c. The first 910a and third 910c straight lines are shorter than the second straight line, and the second straight line is located between the first and third straight lines. .

32C shows, in the medical device, passing beyond a point having the maximum cross-sectional distance of the femur 5, or prosthetic prosthesis thereof, rounding the medical device by wrapping the femur 5, or prosthetic prosthesis thereof. It shows a medical device according to an embodiment wherein the release member 801, assisted by an enclosing elastic or rupture band 810, comprises an elastic wing of the medical device. An elastic or rupture band 810 is positioned and held on the medical device by a band 810 positioned in a groove along the circumference of the medical device. However, the groove may be assisted or replaced by an adhesive or mechanical fastening element.

32D shows the medical device in a second state, wherein the release member 801 releases the femur 5 or its prosthetic replacement from the medical device. In embodiments where the band 810 is an elastic band 810, it may be inflated, thereby expanding the orifice and through which the femur 5, or prosthetic replacement thereof, may pass. In embodiments in which band 810 is a rupture band, the band 810 loses function such that the femur 5, or prosthetic replacement thereof, is subjected to a pre-defined strain on the femur 5, or It is held in position solely by a release member 801 that is part of an extending portion capable of releasing its prosthesis replacement. The medical device is capable of non-invasively changing from a first state to a second state and from a second state to a first state when a predetermined strain is applied to the band 810 and/or release member 801, which Allows the femoral head (5), or its prosthetic replacement, to be replaced in the medical device without a surgical procedure.

Opposite Example

A reverse embodiment will be described below, and the scope of the reverse embodiment is not limited to the specific version below, rather, all of the above-described embodiments can be used for the reverse embodiment.

33 shows a hip joint cross-section when an artificial femoral head surface 112 is secured to a surgically modified femur comprising a concave artificial acetabular surface 110 disposed within a surgically modified femur. do. 33, an elongated member 206 is used as a guiding rod to guide and center the prosthetic acetabulum surface in the hip joint, and the prosthetic femoral surface. The convex hip surface 112 holds the prosthesis in a first state, releases the prosthesis in a second state, and releases that can be changed from the first state to the second state when a predetermined strain force is exceeded. Secured with member 801 . The release member is secured to the surgically deformed femur using screws 121 . The surface of the locking element 117 and the concave hip surface 117 may be disposed in connection with the convex hip surface and may be made of a friction reducing material, such as PTFE or a self-lubricating powder material. However, it is also conceivable that the connection surfaces are lubricated using an implantable lubrication system capable of lubricating the medical device after the medical device has been implanted in a human patient, which is a conceivable solution in all the embodiments described above. . According to the illustrated embodiment, the elongated member 206 is inserted through the femur, but according to other embodiments, not shown, is disposed within the hip joint from the side of the elongated member acetabulum.

34 shows the placement of a portion 118 of the prosthesis that can occupy the hole 18 created in the pelvic bone 9 . The part 118 of the prosthesis includes support members 119 which are brought into contact with the pelvic bone 9 and are capable of supporting to load a load imposed on the medical device from the weight of a human patient. 34 further shows the fastening of a nut 120 to an attachment rod 113 , which is further guided by an elongated member 206 which acts as a guide rod.

Fig. 35 shows a cross-section of the hip joint when all the elements of the medical device are fixed in or around the region of the hip joint. The part 113 of the prosthesis adapted to occupy the hole 18 in the pelvic bone 9 is here fixed with screws 121 , but these screws 121 are between the part of the prosthesis and the pelvic bone 9 . may be assisted or replaced by an adhesive that can be applied between the surfaces of The elongated member 206 acting as a guide rod was withdrawn through the incision in the femur.

The elastic or flexible portion, piece or region of any of the embodiments herein may comprise an elastic polymeric material, such as: a copolymer material, such as polystyrene, poly(ethylene-butylene) or polystyrene. In addition, the material may contain polyurethane elastomeric materials, polyamide elastomeric materials and polyester elastomeric materials, ethylene and one or more vinyl monomers, such as, for example, vinyl acetates, unsaturated aliphatic monocarboxylic acids, and elastic copolymers of esters of such monocarboxylic acids. The elastic band 1361 may include a barrier coating that cannot be penetrated by somatic cells. Preferably, the barrier coating comprises a Parylene ^™ coating, or a coating of a biocompatible metal, such as gold, silver or titanium. According to other embodiments, the elastic band comprises a spring-type member, a combination of metal and plastic materials, a combination of metal and carbon-based material, or a combination of carbon and plastic-based material.

The artificial acetabulum, according to certain embodiments, may be introduced into another part as one or more zones of one or more screws, one or more pins, one or more parts, the parts may be slidable to the other part, form fitting , welding, adhesive, pin, spelling, a ball mounted in a bowl which is the zones of the parts, the old body of one part mounted in the arm zone of another part, a key, band or other machine introduced into the lock that is the zones of the parts It may include one or more portions capable of being secured to the pelvic bone using a flexible connecting member.

FIG. 36A shows an embodiment of a locking/unlocking member 116 , wherein the locking/unlocking member 116 is in contact with a first piece, an artificial convex hip surface (112 in FIG. 36B ) and slides the hip surface. and a surface (1353) capable of locking, in a first state, the locking member (116) locks the artificial femur (112) to the artificial acetabulum surface (1340 in FIG. 36B), and in a second state, , the artificial femoral head 112 may be released from the artificial acetabulum 1340 . The locking/unlocking member 116 may be changed from the first state to the second state when a predetermined amount of deformation force is applied on the locking/unlocking member 116 . The locking/unlocking member 116 according to the embodiment shown in FIG. 36A includes four holding members, which are here elastic portions 1351 , and the locking/unlocking member 116 uses the elasticity of the elastic portions 1351 . It can be changed from the first state to the second state. The locking member 116 may be secured to the femur 7 using screws that fit into the holes 1352 . According to another embodiment (not shown) the holding members 1351 include one or more holding members rotatable relative to the first piece, which is an artificial convex hip surface 112 .

36B shows a cross-section of the hip joint when the two-state locking/unlocking member 116 locks the artificial femur 112 to the artificial acetabulum 1340 . The two-state locking/unlocking member 116 is secured to the femur 7 using screws 121 , shown here in a first state, wherein the locking/unlocking member 116 is a prosthetic femur 112 . Lock the artificial acetabulum (1340).

FIG. 36C shows a cross-section of the hip joint according to the embodiment of FIG. 36B , but with the two-state lock/unlock member 116 in a second state, wherein the lock/unlock member 116 is the prosthetic head 112 . release from the artificial acetabulum surface 1340 . The structure with this locking/unlocking member 116 reduces the risk of strain forces being added to the artificial joint impairing anchoring points, ie, contact with bone; This further allows the artificial joint to be relocated non-invasively in case of dislocation.

FIG. 36D shows an alternative embodiment of a two-state (two-state) locking/unlocking member 116 , wherein the two-state locking/unlocking member 116 additionally includes a prosthetic head 112 when implanted. ) includes an elastic band 1361 that can surround the round. The elastic band 1361 may be an elastic polymer band, such as a polyurethane or silicone band.

36E shows a cross-section of the hip joint when the two-state lock/unlock member 116 is implanted and in a first state. The two-state locking/unlocking member 116 is secured to the femur 7 using screws 121 .

36F shows an implantable device comprising a two-state locking/unlocking member 116 in a second state, ie, wherein the locking/unlocking member 116 circumscribes the prosthetic head 112 . Through the elastic band 1361 is stretched so that the artificial femoral head 112 can escape from the artificial acetabulum 1340, it is possible to release the artificial femoral head 112. The structure with the locking/unlocking member 116 reduces the risk of strain forces added to the artificial joint impairing anchoring points, ie, contact with the bone; It also allows the artificial joint to be repositioned non-invasively in case of dislocation.

The locking/unlocking member 116 described with reference to FIGS. 36A-36F is depicted in the embodiments with a large aperture in the pelvic bone 9 occupied by the portion 118 of the prosthesis, but allows for a less invasive procedure. For this purpose, it is equally conceivable that the two-state locking/unlocking member 116 is used in embodiments having a small hole in the pelvic bone 9 , furthermore, all embodiments disclosing the above medical device include the hip capsule. It is contemplated that it may also be installed during a piercing traditional open hip surgical procedure. In this case the two-state lock/unlock member 116 may be part of a full prosthesis, such as the prosthesis disclosed with reference to FIGS. 22-28 .

36G shows an embodiment of a locking/unlocking member 116 , wherein the locking/unlocking member 116 moves from a first state to a second state to release the artificial femoral head 112 from the artificial acetabulum 1340 . and a spring 1371 that creates the necessary elasticity for the furnace change. The locking/unlocking member 116 may change from the first state to the second state when a predetermined amount of deformation force is applied to the locking/unlocking member 116 . According to the embodiment shown in FIG. 36G , the medical device further comprises a compensating screw coupled with a spring 1371 for correction of resilience and thereby the capacity of the deformation force required to change the lock/unlock member from the first state to the second state. (1372).

36H shows an implementation of a locking/unlocking member, including four rupture pins 1373 that can fail at a given strain force to allow the locking/unlocking 116 members to change from a first to a second state. An example is shown. The pins, according to this embodiment, are made of a brittle material, which can be applied to specific patients. In other embodiments (not shown), the rupture pins 1373 are rupture bands similar to elastic bands but capable of failure under a given strain, or such as a centrally disposed rupture band as described with reference to FIG. 23 . can be replaced with

FIG. 36I shows a cross-section of a hip joint where a femoral head 1375a,b comprising two portions 1375a and 1375b may be interconnected to form an interconnected prosthetic head. Each of the two artificial portions 1375a , 1375b further includes a fixing portion 1374a , 1374b that can be fixed in the acetabulum 8 . The artificial femoral head, after interconnection, may be placed in an artificial concave acetabulum 1340 disposed at the base of the femur 7 to form a functional hip joint in an inverse embodiment.

FIG. 36J shows a cross-section of the hip joint when the interconnected artificial femoral head 1375 is placed in the acetabulum 8 and secured using a fixture 1374 . The locking/unlocking member 116 is positioned on the artificial femur 1375 using a spring 1371 upon which the artificial femur 1375 is positioned to create a resilient force such that the locking/unlocking members tighten the artificial femur 1375 . is placed on

FIG. 36K shows a cross-section of the hip joint when the bi-state locking/unlocking member 116 locks the interconnected femoral head 1375 within the prosthetic acetabulum 1340 . The two-state locking/unlocking member 116 is secured to the femur 7 using screws 121 , wherein the locking/unlocking member 116 attaches the prosthetic head 112 to the prosthetic acetabulum 1340 . It is shown in the locked first state.

FIG. 36M shows a cross-section of the hip joint according to the embodiment of FIG. 36K , but with the bi-state locking/unlocking member 116 in a second state, wherein the locking/unlocking member 116 requires a femoral head 112 . Release from the artificial acetabulum surface (1340) by a spring (1371) that forms an elastic. The structure with the locking/unlocking member 116 reduces the risk of strain forces being added on the artificial joint damaging the anchoring points, ie the points of contact with the bone; This further allows the artificial joint to be repositioned non-invasively in case of dislocation.

It should be noted that any embodiment or part of an embodiment, of course, any method or part of a method may be combined in any way. All embodiments herein are to be understood as part of a general description, and therefore any combination of ways is possible in a general sense.

Claims (10)

A medical device for implantation in a patient's hip joint, comprising:
a prosthetic head (caput femur);
The artificial organ femoral head,
- an at least partially spherical part functioning as an artificial femoral head,
- an at least partially concave portion that functions as an artificial acetabulum, and
- a release member configured to confine said at least partially spherical portion within said artificial acetabulum;
wherein the release member is configured to release the at least partially spherical portion from the prosthetic acetabulum when a deforming force exceeding a predetermined threshold is applied on the hip joint, thereby releasing the prosthetic femur. for medical devices. According to claim 1,
and the release member magnetically confines the at least partially spherical portion within the artificial acetabulum. 3. The method of claim 2,
wherein the release member comprises at least one magnet. 4. The method of claim 3,
wherein the release member comprises a plurality of magnets. 5. The method according to any one of claims 2 to 4,
and the release member forms a portion of one of the at least partially spherical portion and the at least partially concave portion. 5. The method of claim 4,
wherein the plurality of magnets are integrated into one of the at least partially spherical portion and the at least partially concave portion. 7. The method of claim 6,
wherein the other of the at least partially spherical portion and the at least partially concave portion not comprising the plurality of magnets comprises a metallic material interacting with the plurality of magnets. . 5. The method of claim 4,
wherein the plurality of magnets are integrated into both the at least partially spherical portion and the at least partially concave portion. 9. The method of claim 8,
wherein the plurality of magnets located in the at least partially concave portion have a south pole towards the center of the hip joint, and the plurality of magnets located in the at least partially spherical portion have a north pole towards the center of the hip joint. for medical devices. 5. The method according to any one of claims 1 to 4,
wherein the at least partially spherical portion is configured to be secured to a pelvic bone of a patient, and wherein the prosthetic acetabulum is configured to be secured to the femur to construct an inverted hip joint. .

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