KR20240015055A - 제거 가능한 테이퍼형 중앙 포스트를 갖는 연동형 역고관절 보철물 - Google Patents

제거 가능한 테이퍼형 중앙 포스트를 갖는 연동형 역고관절 보철물 Download PDF

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Publication number
KR20240015055A
KR20240015055A KR1020237026826A KR20237026826A KR20240015055A KR 20240015055 A KR20240015055 A KR 20240015055A KR 1020237026826 A KR1020237026826 A KR 1020237026826A KR 20237026826 A KR20237026826 A KR 20237026826A KR 20240015055 A KR20240015055 A KR 20240015055A
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KR
South Korea
Prior art keywords
cup
hip prosthesis
acetabular
prosthesis system
reverse hip
Prior art date
Application number
KR1020237026826A
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English (en)
Inventor
자퍼 테르마니니
Original Assignee
자퍼 테르마니니
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Application filed by 자퍼 테르마니니 filed Critical 자퍼 테르마니니
Publication of KR20240015055A publication Critical patent/KR20240015055A/ko

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • 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
    • A61F2/32—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
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/46—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
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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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    • A61F2/4603—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
    • A61F2/4609—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 acetabular cups
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    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
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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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    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/348—Additional features
    • A61F2002/3483—Additional features having a convex shape, e.g. hemispherical heads
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • A61F2002/3615—Heads or epiphyseal parts of femur having a concave shape, e.g. hemispherical cups
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • 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
    • A61F2002/4681—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by applying mechanical shocks, e.g. by hammering

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Abstract

비구강에 임플란트되는 비구 컵의 중앙부에 개구를 갖는 비구 컵을 포함하는 연동형 역 고관절 보철물이 제공된다. 상기 개구는 적어도 개구의 직경과 동일한 거리만큼 컵의 오목부 내로 돌출하는 원형 연장 벽을 갖는다. 컵이 내측으로 연장하여, 비구 볼의 수형 모스 테이퍼 포스트를 수용하기에 적합한 암형 모스 테이퍼가 제공된다. 비구 컵을 이식한 후, 외과의는 (종래의 임플란트에서와 같이) 중앙 못의 간섭 없이, 여러 개의 나사를 사용하여 컵을 비구 뼈에 쉽게 고정할 수 있다. 이어서, 대퇴 볼이 중앙 모스 테이퍼를 통해 컵에 부착된다.

Description

제거 가능한 테이퍼형 중앙 포스트를 갖는 연동형 역 고관절 보철물
본 발명은 고관절 보철물에 관한 것으로, 보다 상세하게는 복수의 고정 비구 나사(acetabular screw)의 삽입을 용이하게 하기 위해 제거 가능한 중앙 모스 테이퍼형 중앙 못(Morse tapered central peg)을 갖는 비구 구성요소를 구비한 연동형 역 고관절 보철물(interlocking reverse hip prosthesis)에 관한 것이다.
여러 고관절 임플란트가 수년 동안 일반적으로 사용되어 왔다는 것을 알 수 있지만, 중앙 포스트(central post)에 간섭하지 않으면서 여러 각도에서 복수의 고정 나사의 삽입을 용이하게 하는 설계에 대한 필요성이 있다.
본 발명은 비구 볼과 중앙 포스트가 일체형으로 구성된 신규의 연동형 역 고관절 보철물을 제공한다. 상기 포스트는 비구 컵의 중앙 정점 원형 개구에 동심원으로 견고하게 부착되고 모스 테이퍼(Morse taper)를 통해 고정된다. 상기 비구 컵은 골반 뼈에 외과의가 만든 비구 소켓에 임플란트되고 끼워넣어지며(impacted), 상기 비구 컵의 하나 이상의 개구를 통해 하나 이상의 연동형 나사로 단단히 고정된다. 일부 실시예에서, 이들 연동형 나사는 생체적합성의 재흡수성 스터드(biocompatible resorbable stud)로 대체된다. 그 후, 중앙 포스트는 중앙 정점 개구에 삽입되고 모스 테이퍼를 통해 단단히 끼워넣어져 제 위치에 유지된다. 그런 다음, 적절한 크기의 리머(reamer)를 사용하여 외과의에 의해 준비되어 속이 비워진 대퇴 골수관(femoral medullary canal)에 대퇴부 구성 요소를 삽입하여 끼워넣는다. 한편, 적절한 각도로 나사를 삽입하는 데 방해가 될 수 있는 중앙 포스트를 제거하면 복수 개의 연동형 나사를 쉽게 삽입할 수 있다. 보행 중에, 관절 대퇴골 컵 가장자리 또는 립(lip)은 비구 볼과 비구 컵 사이에 위치한 연동 공간 내로 동심원 형태로 적합하여 미끄러져 들어갈 것이다. 당업자에게 자명한 바와 같이, 본 발명의 기하학적 구성은 대퇴골 컵이 비구 컵과 비구 볼 사이의 잠금 공간에 구속되기 때문에 운동 범위가 증가할 때 대퇴 컵이 탈구되는 것을 매우 어렵게 한다.
또한, 두 구성요소의 관절면이 항상 100% 완전히 접촉하기 때문에, 이는 중량 분포를 개선하고 접촉 표면의 마모를 줄이며 관절내에 방출되는 마모 입자의 수를 감소시킬 것은 명백하다. 후자는 관절의 적절한 기능에 매우 해롭고 종종 임플란트 구성 요소의 골 용해(osteolysis) 및 풀림을 유발한다. 본 발명의 새로운 특징은 중앙 포스트가 제거 가능하여 연동형 고정 나사의 삽입에 기계적으로 충돌하거나 간섭하지 않는다는 것이다. 그 결과 단독으로 또는 조합하여 고려할 때 종래의 고관절 보철물에 의해 예상되지 않고, 명백해지지 않고, 제안되지 않고 또는 암시조차 되지 않는 새로운 역 고관절 임플란트가 얻어진다.
본 발명의 다양한 다른 목적, 특징 및 이점은, 동일한 참조 부호가 여러 도면에 걸쳐 동일하거나 유사한 요소를 나타내는 첨부 도면과 관련하여 고려될 때 충분히 이해될 것이다.
도 1은 중앙 모스 테이퍼형 개구를 갖는 연동형 역 고관절 비구 컵의 단면도이다.
도 2는 중앙 포스트가 모스 테이퍼형 개구에 삽입된 연동형 역 고관절 비구 컵의 단면도이다.
도 3은 모노블럭 비구 볼과 테이퍼 중앙 포스트의 사시도이다.
도 4는 조립된 연동형 역 고관절 임플란트의 단면도이다.
도 5는 비구 컵 임팩터의 단면도이다.
유사한 참조 문자가 여러 도면에 걸쳐 유사한 요소를 나타내는 도면을 설명적으로 살펴보면, 첨부된 도면은 매끄러운 오목면과 볼록한 비관절면(non-articulating surface)을 갖는 반구형 비구 컵(4)을 포함하는 연동형 역 고관절 보철물을 나타내고 있다. 볼록한 비관절면은 복수의 요철과 미세 공극을 갖는 다공성 표면을 제공하여, 뼈 내부성장을 가능케 한다. 또한, 비구 컵(4)은 하나 이상의 연동형 나사(미도시)를 사용할 목적으로 상이한 위치에 하나 이상의 구멍(2)을 제공한다. 비구 컵(4)의 오목한 반구형 표면은 비구 컵의 오목한 공간 내부로 확장된 중앙 암형 테이퍼 개구(1)를 제공한다. 상기 개구는 수형의 테이퍼진 중앙 포스트(6)를 적합하게 수용하도록 테이퍼져 있다. 비구 볼(5)은 모노블록으로서 중앙 포스트에 견고하게 부착되거나 모스 테이퍼를 이용하여 견고하게 부착될 수 있다.
일 실시예에서, 비구 컵은 적어도 2개의 리세스(3)를 제공하는데, 이들 리세스는 비구 컵의 원주 에지 근처에서 컵의 적도 에지에 가깝게 직경방향으로 대향하여 위치되고, 수술의가 준비한 비구 골반강 내로 컵을 끼워넣기 위한 핸드헬드 임팩터를 고정하는데 사용된다.
다른 실시예에서, 일체형 비구는 고정 핀을 수용하기 위한 3개 이상의 리세스를 제공할 수 있다. 또한, 상기 리세스는 정사각형 또는 타원형의 형상을 가질 수 있다.
도 4는 중앙 개구(1) 내로 끼워넣어진 비구 볼과 중앙 포스트(6)를 구비한 비구 컵을 도시한다. 대퇴 금속 컵(9)은 테이퍼형 스템(10)과, 비구 볼(5)과 안락하게 접촉하는 폴리에틸렌 라이닝(8)을 구비한다.
일 실시예에서, 대퇴골 컵의 관절면은 다양한 두께이지만 4mm 이상인 고분자량 폴리에틸렌을 함유한다. 다른 실시예에서, 상기 라이닝은 도자기, 세라믹 또는 금속 합금일 수 있다. 상이한 사이징 요구를 충족시키기 위한 설계의 변화는 당업자에게 명백할 것이다.
도 4를 참조하면, 금속 대퇴골 컵(8)과 그 폴리에틸렌 라이닝(9)이 비구 볼(5)에 관절식으로 접합하면, 대퇴골 컵의 가장자리가 반구형 연동형 공간(7) 내외로 이동하고, 대퇴골 컵의 관절면은 전체 운동 범위에 걸쳐 비구 볼과 동일한 접촉 면적을 유지한다. 즉, 전체 운동 범위에 걸쳐 대퇴 컵의 관절 접촉 면적이 100% 유지된다.
비구 컵 핸드헬드 임팩터를 자세히 도시하는 도 5를 참조한다. 핸드헬드 임팩터는 절두체 형태의 절두형 반구체(12)와 핸들헬드 임팩터의 원주를 넘어 연장되는 립을 구비하며, 이에 따라 비구 컵의 경사진 림 위에 놓인다. 반구체의 원위 표면은 중앙의 모스 테이퍼형 개구(6)와 접촉하지 않는다. 상향 연장되는 중앙 샤프트(11)는 끼워넣기 위해 근위 단부에 핸들을 구비하고, 원위 단부는 폴리에틸렌 임팩터(12)의 본체에 견고하게 내장된다. 중앙 샤프트(11) 둘레에 위치한 금속 슬리브(19)가 콘(18) 형태의 원위 단부를 구비한다. 상기 슬리브는 슬리브(19)와 중앙 샤프트(11) 사이의 공간에 위치된 스프링(17)을 통해 원위 방향으로 슬라이딩식으로 밀린다. 임팩터에 단단히 부착된 비구 컵을 유지하기 위해, 2개의 고정 핀이 직경방향으로 대향하여 채널(20) 내에 위치되며, 스프링(16)을 통해 안쪽으로 밀려 후퇴된 상태로 남아 있다. 슬리브(19)가 스프링(17)을 통해 아래로 밀리면, 원위 콘(18)은 고정 핀(14)을 비구 컵 리세스(3) 내로 밀어, 비구 컵을 끼워넣는 과정 중에 핸드헬드 임팩터에 고정한다.
본 발명의 다른 실시예에서, 비구 컵은 고관절 교정 수술에 사용하기 위해 특별히 설계된 다수의 고정 나사를 삽입하기 위한 다수의 구멍을 갖는다.
교정은 기존 임플란트를 제거하는 수술 절차이다. 이 경우, 가장 자주 필요로 하는 것은 비구 컵의 제거이며, 높은 수준의 이환율(morbidity)이 연관된다. 이전에 임플란트된 비구 컵의 제거는 특히 컵에 뼈 내부성장을 위한 금속 비드가 구비되어 있는 경우 외과적으로 매우 어려울 수 있다. 이러한 경우, 제거시 의원성(iatrogenic) 골 손실이 발생하여 다른 기존 비구 컵을 삽입하는 데 어려움이 있다.
본 발명의 중요한 특징은 교정 수술 동안과 같이, 중앙 포스트가 여러 나사를 상이한 각도에서 배치하는 것을 방해하지 않으면서, 비구 컵을 제 위치에 배치하고 끼워넣을 수 있다는 점이다. 비구 컵 삽입에 이어서, 중앙 포스트와 비구 볼은 중앙 모스 테이퍼 내로 적절하게 끼워넣어진다. 상기한 바와 같이, 비구 뼈의 품질이 고정 나사의 수와 위치를 결정하는 고관절 교정 수술 중에 여러 개의 나사를 사용하면 상당한 이점이 있다. 중앙 포스트가 있으면, 노출이 제한되고 고정 나사를 배치하는 데 방해가 된다.
따라서, 본 발명의 목적은 고관절 교정 수술 동안, 또는 골반 뼈의 재건이 필요한 복잡한 골절 사례와 같이, 다수의 고정 나사의 삽입을 허용하는 제거 가능한 중앙 포스트를 금속성 비구 컵이 제공하는 새롭고 개선된 연동형 역 고관절 보철물 시스템을 제공하는 것이다.
상기 설명과 관련하여, 크기, 재료, 형상, 형태, 기능, 작동 방식, 조립 및 사용의 변화를 포함하는 본 발명의 일부에 대한 최적의 치수 관계는, 당업자에게 바로 자명한 것이며, 도면에 도시되고 명세서에 설명된 것과 균등 관계에 있는 모든 것은 본 발명에 의해 포괄되는 것으로 의도된다. 따라서 전술한 내용은 단지 본 발명의 원리를 설명하기 위한 것으로 간주된다. 또한, 당업자는 많은 수정 및 변경을 용이하게 할 것이므로, 본 발명을 도시되고 설명된 정확한 구성 및 동작으로 제한하는 것은 바람직하지 않으며, 따라서 모든 적절한 수정 및 균등물은 본 발명의 범위에 속하게 될 수 있다.

Claims (13)

  1. 골반 뼈의 비구 소켓에 부착하기 위한 볼록 비관절면 및 상기 볼록 비관절면의 반대측에 위치되고, 중앙 개구를 갖는 오목면을 갖는 단일형 비구 컵;
    못에 견고히 부착되는 비구 볼;
    대퇴 임플란트의 근위 단부에 견고히 부착되는 대퇴 컵; 및
    상기 비구 컵을 준비된 비구 골강(bony cavity)에 삽입하기 위한 핸드헬드 임팩터
    를 포함하는 역 고관절 보철물 시스템.
  2. 제1항에 있어서, 상기 비구 컵의 오목면은 반구형이고 중앙 정점 개구를 갖는 것인, 역 고관절 보철물 시스템.
  3. 제2항에 있어서, 상기 중앙 개구는 암형 모스 테이퍼를 제공하도록 테이퍼진, 역 고관절 보철물 시스템.
  4. 제2항에 있어서, 모스 테이퍼를 갖는 상기 중앙 개구는 상기 중앙 개구의 베이스의 직경의 1.5배를 초과하지 않는 높이의 원형 벽을 갖는 것인, 역 고관절 보철물 시스템.
  5. 제1항에 있어서, 상기 중앙 개구의 외벽은 상기 비구 컵의 내벽과 매끄럽게 연속하도록 상기 베이스를 향해 벌어지는 것인, 역 고관절 보철물 시스템.
  6. 제1항에 있어서, 상기 비구 컵의 볼록면이 반구형이고, 상기 컵의 오목면도 반구형인, 역 고관절 보철물 시스템.
  7. 제5항에 있어서, 상기 단일형 비구 컵은 고정 핀을 수용하기 위한 적어도 2개 이상의 리세스를 제공하는 것인, 역 고관절 보철물 시스템.
  8. 제7항에 있어서, 상기 직경방향으로 대향하는 리세스는 상기 컵의 적도 에지 가까이에 위치되는 것인, 역 고관절 보철물 시스템.
  9. 제7항에 있어서, 상기 직경방향으로 대향하는 리세스는 원형, 장방형(oblong) 또는 다각형 형상인, 역 고관절 보철물 시스템.
  10. 제1항에 있어서, 상기 핸드헬드 임팩터는 금속 실린더; 근위 단부에 핸들을 제공하는 중앙 금속 코어; 상기 금속 실린더를 원위로 편향시키기 위해 상기 중앙 금속 코어에 장착된 스프링; 및 끼워넣기 동안 중앙 모스 연장부와의 접촉을 방지하기 위한 폴리에틸렌 절두체를 포함하며, 상기 폴리에틸렌 절두체는 적어도 2개 이상의 직경 방향으로 스프링이 장착된 고정 핀을 갖는 것인, 역 고관절 보철물 시스템.
  11. 제10항에 있어서, 상기 금속 실린더의 원위 단부는 상기 고정 핀을 상기 비구 컵의 직경방향으로 대향하는 적도 리세스 내로 외측으로 연장시키는 캠 작용을 제공하기 위해 테이퍼져 있는 것인, 역 고관절 보철물 시스템.
  12. 제10항에 있어서, 상기 고정 핀은 직경방향으로 대향하는 원통형 채널 내에 위치되고, 스프링을 통해 내측으로 밀리는 것인, 역 고관절 보철물 시스템.
  13. 제1항에 있어서, 핸드헬드 임팩터 장치는 금속, 금속 합금, 또는 복합 재료로 제작되는 것인, 역 고관절 보철물 시스템.
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