NO319549B1 - Skulderproteseanordning - Google Patents
Skulderproteseanordning Download PDFInfo
- Publication number
- NO319549B1 NO319549B1 NO20023063A NO20023063A NO319549B1 NO 319549 B1 NO319549 B1 NO 319549B1 NO 20023063 A NO20023063 A NO 20023063A NO 20023063 A NO20023063 A NO 20023063A NO 319549 B1 NO319549 B1 NO 319549B1
- Authority
- NO
- Norway
- Prior art keywords
- screw
- joint
- sleeve
- threads
- axial
- Prior art date
Links
- 238000003780 insertion Methods 0.000 claims description 7
- 230000037431 insertion Effects 0.000 claims description 7
- 210000000784 arm bone Anatomy 0.000 claims 1
- 210000003205 muscle Anatomy 0.000 description 5
- 230000000295 complement effect Effects 0.000 description 4
- 210000002758 humerus Anatomy 0.000 description 4
- 239000007943 implant Substances 0.000 description 4
- 230000006378 damage Effects 0.000 description 2
- 210000000852 deltoid muscle Anatomy 0.000 description 2
- 238000009434 installation Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 206010003246 arthritis Diseases 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 230000001747 exhibiting effect Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 201000003068 rheumatic fever Diseases 0.000 description 1
- 210000000513 rotator cuff Anatomy 0.000 description 1
- 210000000323 shoulder joint Anatomy 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
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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
- A61F2/40—Joints for shoulders
- A61F2/4081—Glenoid components, e.g. 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
-
- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2/4059—Humeral shafts
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2002/30138—Convex polygonal shapes
- A61F2002/30143—Convex polygonal shapes hexagonal
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30224—Three-dimensional shapes cylindrical
- A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/3037—Translation along the common longitudinal axis, e.g. piston
- A61F2002/30372—Translation along the common longitudinal axis, e.g. piston with additional means for limiting said translation
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- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
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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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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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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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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30514—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking washer
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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- A—HUMAN NECESSITIES
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- A61F2/02—Prostheses implantable into the body
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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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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- A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
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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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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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- 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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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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Description
Foreliggende oppfinnelse angår en skulderproteseanordning omfattende et leddelement dannet av en plate utstyrt med en rørformet, midtre hylse med en aksial boring med gjenger i en dei av lengden, og organer for fastgjøring i en leddskål i skulderen, og en leddkule beregnet til å dekke leddelementet og som er utstyrt med en aksial skrue som kan skrus inn i hylsen, idet leddkulen oppviser en leddflate beregnet til å samvirke med en leddskål på en protese på overarmsbenet.
En protese av denne typen er for eksempel kjent fra FR A1 2 652 498, i navnet
MEDINOV.
Det er kjent at dreietildekningen er dannet av settet av skuldermuskler, som omfatter deltårnuskelen, supraspinata, infraspinata, infraskapulærmuskelen og den lille runde muskelen. Når det oppstår en alvorlig brist i tildekningen, gjenstår bare deltamuskelen, som er utilstrekkelig til å muliggjøre at svingning av skulderen fungerer korrekt, hvilket gjør det nødvendig å anbringe en skulderprotese.
Det er kjent proteser der leddelementet er festet til leddet på skulderbladet med flere skruer og holder en leddkule med konveks leddflate, hvilken er skrudd mot omkretsen av leddelementet.
Det er påvist at leddkulen etter en viss brukstid har en tendens til å skrus løs. Dette medfører en svingning av leddkulen under leddelementet, med ødeleggelse av gjengene. Slike skader forårsaket på protesen kan tvinge kirurgen til å fjerne hele protesen og erstatte denne.
For å løse dette problemet har det vært foreslått å rugjøre leddflatene på leddkulen og leddelementet. Dette har vist seg å være utilstrekkelig.
Det har også vært foreslått, knyttet til skruen på halvkulen, et arrangement av koniske, komplementære hann- og hunnlager, dannet henholdsvis på leddelementet og på leddkulen. Disse to koniske lager kan beveges fra eller mot hverandre som en funksjon av drivretningen for skruen, for å sperre eller oppheve sperringen av systemet som omfatter leddkulen og leddelementet. En skulderprotese anordnet på denne måten er beskrevet i FR-A1 2 737 107 i navnet MEDINOV. Denne protesen er tilfredsstillende. Imidlertid kan hodet på skruene trenge fullstendig gjennom leddelementet ved slutten av tilskru ingen, når kirurgen ikke bedømmer dette korrekt, ettersom det ikke er anordnet særskilte midler for sperring. I et slikt tilfelle er leddelementet ikke lenger fastgjort til leddet.
Et annet problem ligger i adkomsten til leddelementet for kirurgen, hvilket danner et problem med korrekt anbringelse av leddkulen på leddelementet. Pasienten er i en halvt sittende stilling under det kirurgiske inngrepet, slik at kirurgen må føre leddelementet inn fra siden, til bunnen av en stags "brønn" avgrenset av vevet og skuldermusklene. Adkomsten til leddelementet er trang og forholdsvis vanskelig, med dårlig synlighet som ikke gjør det mulig å bestemme hvorvidt skruen på leddelementet befinner seg nøyaktig langs aksen til hylsen på leddelementet.
Dette medfører at kirurgens anbringelse av leddkulen kan bli feilaktig, på den måten at den aksiale skruen på leddkulen ikke befinner seg nøyaktig langs aksen til det tilsvarende hullet i leddelementet. I dette tilfellet starter tilskruingen når gjengene på skruen på leddkulen og gjengene i det midtre hullet i leddelementet er ført feilaktig sammen. Når kirurgen blir klar over denne feilaktige innføringen, har gjengene allerede blitt tilstrekkelig skadet til at det er nødvendig å skifte ut hele proteseanordningen. Ikke bare to proteser må derved benyttes, hvilket i betydelig grad øker de materielle omkostninger, men tiden for det operative inngrepet fordobles.
Et formål med oppfinnelsen er å komme frem til en skulderleddprotese utformet slik at disse ulemper unngås.
I henhold til oppfinnelsen kjennetegnes skulderprotesanordningen ved at skruen er tilknyttet midler for styring som samvirker med en jevn, sylindrisk sone ved innløpet til boringen i hylsen, for å styre leddkulen i forhold til leddelementet og muliggjøre aksial innføring av skruen i boringen uten å skade gjengene i boringen.
I henhold til en utførelse av oppfinnelsen omfatter midlene for styring en stav innrettet til å kunne forskyves i hylsen, og skruen på leddkulen oppviser en aksial, langsgående og gjennomgående kanal som muliggjør innføring av staven i kanalen, slik at staven sikrer styring av leddkulen når skruen forskyves på staven for innføring i den rørformede hylsen.
Den midlertidige innføringen av staven i den midtre hylsen i leddelementet muliggjør at det sikres fullstendig styring av leddkulen langs aksen til den midtre hylsen på leddelementet. Skruen på leddkulen kan derved skrus korrekt inn i hylsen på leddelementet uten fare for å skade gjengene, og faren for at det må benyttes en annen protese er tilnærmet totalt eliminert.
Organene for å fastgjøre leddelementet i leddet kan være skruer, idet det er anordnet midler for at skruene skal komme til anlegg i leddelementet ved slutten av tilskruingen.
Disse midler for anlegg kan være en krave utformet rundt hodet til i det minste en skrue, ragende radialt i forhold til gjenger på skruehodet, idet en ringformet anleggsskulder er dannet rundt kanten til et gjenget hull for innføring av skruen i leddelementet.
Midlene for anlegg kan omfatte i det minste et skruehode som oppviser en konveks ytte rf I a te beregnet til å komme til anlegg mot et komplementært, konkavt sete dannet i veggen til et hull for innføring av skruen i leddelementet.
Disse tiltak hindrer enhver fare for at skruene drives gjennom leddelementet ved slutten av tilskruingen, og medfører således en sikker fastgjøring av leddelementet til leddet.
Andre trekk og fordeler med oppfinnelsen vil fremgå av den følgende beskrivelse, med henvisning til de medfølgende tegninger, som viser et ikke-begrensende eksempel på en utførelsesform.
Figur 1 er et oppriss i et plan sett forfra, i minsket målestokk, av en skulderprotese
som omfatter et leddimplantat i henhold til oppfinnelsen.
Figur 2 er et aksialsnitt i forstørret målestokk av skulderprotesen i figur 1, etter linjen 2
- 2 i figur 4.
Figur 3 er et snitt gjennom skulderprotesen etter linjen 3 - 3 i figur 4.
Figur 4 er en projeksjon ovenfra av leddelementet til skulderprotesen i figur 1-3. Figur 5 er et aksialsnitt gjennom skulderprotesen etter linjen 3 - 3 i figur 4, og viser begynnelsen på bevegelsen for innføring av den aksiale skruen i leddkulen i den midtre hylsen til leddelementet. Figur 6 viser analogt med figur 5 bevegelsen for anbringelse av leddkulen på
leddelementet ved hjelp av en styrestav.
Figur 7 er et delvist aksialsnitt i forstørret målestokk i forhold tii figur 5, av den frie
enden av den aksiale skruen på leddkulen.
Skulderprotesen vist i figur 1 omfatter et skulderimplantat 1 og et overarmsben-implantat 2, fastgjort til henholdsvis partiet 3 på et skulderblad 4 og i margkanalen 5 i et overarmsben 6.
Leddimplantatet 1 omfatter et leddelement 7 dannet av en plate 13 (figur 2 - 6) som er utstyrt med flere festeskruer 8 i partiet 3, av hvilke 2 er synlige i figur 1, samt en leddkule 9 beregnet til å dekke leddelementet 7.
Leddkulen 9 har en leddflate 11, som er konveks i denne utførelsen, beregnet til å samvirke med en komplementær flate på en skål 12 på overarmsprotesen 2. I denne utførelsen omfatter skålen 12 en konkav flate som samvirker med den konvekse flaten 11.
Platen 13 er fortrinnsvis konisk, med en akse X - X, og er utstyrt med en midtre hylse 14, fortrinnsvis i ett med platen 13. Den midtre hylsen 14 rager ut fra platen 13 og omfatter sirkulære ribber 15 for fastgjøring av leddelementet 7 i benmaterialet. Hylsen 14 er rørformet og har en aksial boring 16 som har gjenger 17 i en del av sin lengde. Disse gjenger 17 går over i en boring 49 som danner en jevn sone.
Gjennom platen 13 er det fire hull for gjennomføring av festeskruer for leddelementet 7. To av disse hullene 18 er diametralt motsatt og har gjenger 19. Aksene er divergerende og symmetriske på hver side av aksen X - X. To andre hull 21 som er diametralt motsatt er i vinkelavstander fra hullene 18 som fortrinnsvis er lik 90°. Hullene 21, som ikke er gjenget, avgrenses av vegger 22 som danner konkave anleggsseter for konvekse flater 23 som avgrenser hodene 24 på festeskruene 25 for leddelementet 7 i partiet 3 (figur 3).
Setene 22 er slik orientert at skruene 25 når de er satt på plass befinner seg divergerende i forhold til den midtre hylsen 14 og symmetrisk i forhold til denne. Utsparinger 26, for eksempel sekskantede, er dannet i hodene 24 for å muliggjøre tilskruing av skruene 25 ved hjelp av et ikke vist verktøy.
Hullene 19 kan motta divergerende skruer 27 som hver danner et hode 28 og en gjenget stamme 29. Hodet 28 omfatter gjenger 31 som kan skrus inn i gjengene 19, og en endekrave 32 utformet rundt hodet 28. Kraven 32 rager radialt i forhold til gjengene 31 og kan danne anlegg mot en ringformet skulder 33, dannet rundt kanten av hullet 18 for innføring av skruen 27.
Kraven 32 danner et middel for anlegg av skruen 27 i partiet 3 ved slutten av tilskruingen, og stanser innskruingen av skruen 27 ved at kraven 32 kommer til anlegg mot en tilhørende skulder 33. De konkave setene 22 danner likeledes anlegg for skruene 25 i leddelementet 7 ved slutten av innskruingen i partiet 3, når innskruingen av skruene 25 er tilstrekkelig til at flatene 23 på hodene er i kontakt med setene 22.
Denne foranstaltningen hindrer at skruene 25 og 27 skrus gjennom leddelementet 7 ved slutten av tilskruingen.
Leddkulen 9 er dannet av en hovedsakelig halvkuleformet del, med en sfærisk
overflate 11 som er komplementær med leddflaten på skålen 12. I leddkulen 9 er det dannet en konisk utsparing rundt aksen X - X, dimensjonert slik at platen 13 kan innføres. Leddkulen 9, som er rotasjonssymmetrisk om aksen X - X, dekker således leddelementet 7.
Leddkulen 9 er utstyrt med en aksial skrue 35 som kan rotere fritt i forhold til
leddkulen 9. Hylsen 36 for skruen 35 oppviser langs en del av sin lengde gjenger 10, og kan skrus inn i gjengene 17 i hylsen 14. Skruen 35 har et hode 37 som kan innføres i et hulrom 38 rundt aksen X - X og som munner ut på kuppelflaten 11 i en aksial åpning 39. Den sistnevnte muliggjør innføring av enden til et skruverktøy for skruen 35 som kan
innføres i en tilsvarende profilert utsparing 41.
Etter innføring av hodet 37 i utsparingen 38 holdes skruen 35 på plass av en gjenget skive 42 som er anordnet i en gjenget utsparing 43 som er koaksial med utsparingen 38 og aksen X - X.
I skruen 35 er det dannet en aksial, langsgående kanal 45 som munner ut ved endene av skruen, ved en ende i utsparingen 41 og i åpningen 39. Dessuten omfatter proteseanordningen midler for styring av leddkulen 9, innrettet til å forenkle anbringelsen på leddelementet 7. I den viste utførelsesformen omfatter disse midler for styring en stav 46, som fortrinnsvis oppviser en viss fleksibilitet, innrettet til å kunne forskyves, først inn i den aksiale kanalen 16 i hylsen 14 og deretter inn i den langsgående kanalen 45 i skruen 35 (figur 6). Diameteren til staven 46, som fortrinnsvis er metallisk, er fortrinnsvis litt mindre enn diameteren til kanalen 45 i skruen 35.
Skruen 35 omfatter en jevn, fri ende 48 som ytterst er avfaset for å forenkle innføring i enden av den rørformede hylsen 14. Midlene for styring av skruen 35 omfatter en sylindrisk, jevn sone dannet i innløpet til hylsen 14, etterfulgt av gjenger 17. Den avfasede enden 51 omfatter fortrinnsvis en ringformet flate 52 med rettlinjet lengdesnitt (konisk flate) og som etterfølges mot den frie enden 51 av en ringformet, avrundet flate 53, fortrinnsvis dannet av en sfærisk avrunding. På motsatt side av denne går det koniske partiet 52 over i en jevn sone 50, etterfulgt av gjenger 10.
Staven 46 benyttes av kirurgen på følgende måte.
Leddelementet 7 fastgjøres først i partiet 3 ved slag mot hylsen 14 og innskruing av skruene 25, 27. Deretter innfører kirurgen enden av staven 46 i kanalen 16 i hylsen 14. Ved bruk av en skrutrekker med kanyle bringer kirurgen deretter leddkulen 9 til innløpet av "brønnen" dannet i vevet og musklene i skulderen, med bunnen dannet av leddelementet 7, og enden av staven 46 innføres i den aksiale kanalen 45. Kirurgen forskyver deretter leddkulen 9 på staven 46 inntil den frie enden 48 på skruen 35 er ført inn i det jevne innløpet 49 (fig. 6). Den avfasede og avrundede enden 51 forenkler innføringen av skruen 35 i hylsen 14, uten å skade gjengene 17, på grunn av den jevne sonen 49 eller gjengene 10, på grunn av den jevne sonen 50. Når skruen 35 befinner seg langs aksen X - X til hylsen 14, skrur kirurgen skruen 35 inntil leddkulen 9 kommer til anlegg mot leddelementet 7 (fig. 3 og 4), og fjerner deretter skrutrekkeren og staven.
Anordningen av avrundingen 53 på det koniske partiet 52, det jevne partiet 50 og det jevne innløpet 49 i hylsen 14 kan benyttes for å sikre korrekt styring av skruen inn i hylsen 14, enten i kombinasjon med en styrestav 46 (fig. 5 og 6) eller uten denne. I såfall kan skruen 35 styres av den langsgående kanalen 16 eller den kan være jevn. Kombinasjonen av kanalen 16, staven 46, enden 48 med det jevne partiet 50 og innløpspartiet 49 i hylsen 14 sikrer den beste styringen av leddkulen 9 til korrekt stilling langs aksen X - X til leddelementet 7.
Med andre ord er de forskjellige, følgende varianter mulig:
- Skruen 35 kan ha en kanyle og oppvise den aksiale kanalen 16 og benyttes sammen med styrestaven 46, uten forskyvning mellom gjengene på skruen 35 og gjengene i hylsen 14; i såfall forløper gjengene 10 omtrent til den frie enden av skruen 35, og det jevne partiet 49 er erstattet av gjenger 17. - Skruen 35 er uten kanyle, og oppviser ikke noen aksial kanal 16, men gjengene 10 og gjengene 17 er innbyrdes forsatt slik som vist på tegningene, dvs. at et jevnt parti 50 er dannet på skruen 35 og et jevnt innløpsparti 49 er dannet i hylsen 14. - Skruen 35 har kanyle og dessuten er gjengene 10 og gjengene 17 innbyrdes forsatt, dvs. at det jevne partiet 50 og enden 51 er dannet på enden 48 på skruen, mens et jevnt parti 49 er dannet i innløpet til kanalen 16 i hylsen 14.
Enden 48 på skruen 35 kan også være annerledes profilert, f.eks. med en enkel, konisk avfasning slik som 52, eller bare med en endeavrunding med tilstrekkelig dimensjon.
Indikasjonene for leddprotesen 1 som er beskrevet er hovedsakelig følgende: traumer, leddbetennelse mellom overarmsbenet og skulderbladet, reumatisk leddbetennelse. Generelt er skulderprotesen i henhold til oppfinnelsen til bruk ved sykdommer i leddtildekningen.
Claims (5)
1. Skulderproteseanordning omfattende et leddelement (7) dannet av en plate (13) utstyrt med en rørformet, midtre hylse (14) med en aksial boring (16) med gjenger (17) i en del av lengden, og organer (25, 27) for fastgjøring i en leddskål (3) i skulderen, og en leddkule (9) beregnet til å dekke leddelementet og som er utstyrt med en aksial skrue (35) som kan skrus inn i hylsen, idet leddkulen oppviser en leddflate (11) beregnet til å samvirke med en leddskål (12) på en protese (2) på overarmsbenet, karakterisert ved at skruen (35) er tilknyttet midler (46, 50) for styring som samvirker med en jevn, sylindrisk sone (49) ved innløpet til boringen (16) i hylsen, for å styre leddkulen (9) i forhold til leddelementet og muliggjøre aksial innføring av skruen (35) i boringen (16) uten å skade gjengene (17) i boringen.
2. Proteseanordning som angitt i krav 1,
karakterisert ved at midlene for styring omfatter en stav (46) innrettet til å kunne forskyves i hylsen (14), og at skruen (35) i leddkulen (9) oppviser en aksial, langsgående og gjennomgående kanal (45) og muliggjør innføring av staven (46) i kanalen, slik at staven sikrer styring av leddkulen (9) når skruen forskyves på staven inntil skruen er innført i hylsen.
3. Proteseanordning som angitt i krav 2,
karakterisert ved at den aksiale kanalen (45) i skruen (35) ved en ende munner ut i en utsparing (41) dannet i et hode (37) på skruen og innrettet til samvirke med et skruverktøy som har kanyle.
4. Proteseanordning som angitt i ett av kravene 1 - 3,
karakterisert ved at midlene for styring omfatter en jevn, fri ende (48) på skruen (35) i leddkulen (9), og et jevnt parti (49) dannet i innløpet til hylsen, etterfulgt av gjenger (17).
5. Proteseanordning som angitt i krav 4,
karakterisert ved at den frie enden (48) har en avfasning (51) som avgrenser en ringformet, konisk flate (52) etterfulgt av en ringformet, avrundet flate (53), fortrinnsvis sfærisk.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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FR9916420A FR2802799B1 (fr) | 1999-12-23 | 1999-12-23 | Ensemble de prothese d'epaule |
PCT/FR2000/003539 WO2001047442A1 (fr) | 1999-12-23 | 2000-12-14 | Ensemble de prothese d'epaule |
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Publication Number | Publication Date |
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NO20023063D0 NO20023063D0 (no) | 2002-06-24 |
NO20023063L NO20023063L (no) | 2002-06-24 |
NO319549B1 true NO319549B1 (no) | 2005-08-29 |
Family
ID=9553783
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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NO20023063A NO319549B1 (no) | 1999-12-23 | 2002-06-24 | Skulderproteseanordning |
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US (3) | US6953478B2 (no) |
JP (1) | JP4464026B2 (no) |
AU (1) | AU780176B2 (no) |
FR (1) | FR2802799B1 (no) |
GB (1) | GB2375052B (no) |
NO (1) | NO319549B1 (no) |
SE (1) | SE526618C2 (no) |
WO (1) | WO2001047442A1 (no) |
ZA (1) | ZA200205014B (no) |
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-
1999
- 1999-12-23 FR FR9916420A patent/FR2802799B1/fr not_active Expired - Lifetime
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2000
- 2000-12-14 AU AU25262/01A patent/AU780176B2/en not_active Expired
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- 2000-12-14 JP JP2001548038A patent/JP4464026B2/ja not_active Expired - Fee Related
- 2000-12-14 WO PCT/FR2000/003539 patent/WO2001047442A1/fr active IP Right Grant
- 2000-12-14 GB GB0216015A patent/GB2375052B/en not_active Expired - Lifetime
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2002
- 2002-06-17 SE SE0201836A patent/SE526618C2/sv not_active IP Right Cessation
- 2002-06-21 ZA ZA200205014A patent/ZA200205014B/en unknown
- 2002-06-24 NO NO20023063A patent/NO319549B1/no not_active IP Right Cessation
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2005
- 2005-07-19 US US11/183,826 patent/US7611539B2/en not_active Expired - Fee Related
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2009
- 2009-10-07 US US12/574,808 patent/US8361157B2/en not_active Expired - Lifetime
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JP2003518408A (ja) | 2003-06-10 |
SE0201836D0 (sv) | 2002-06-17 |
GB2375052B (en) | 2004-03-24 |
US8361157B2 (en) | 2013-01-29 |
US20050256583A1 (en) | 2005-11-17 |
GB0216015D0 (en) | 2002-08-21 |
NO20023063D0 (no) | 2002-06-24 |
ZA200205014B (en) | 2003-03-18 |
JP4464026B2 (ja) | 2010-05-19 |
GB2375052A (en) | 2002-11-06 |
WO2001047442A1 (fr) | 2001-07-05 |
US20100023068A1 (en) | 2010-01-28 |
NO20023063L (no) | 2002-06-24 |
AU2526201A (en) | 2001-07-09 |
US20030114933A1 (en) | 2003-06-19 |
US6953478B2 (en) | 2005-10-11 |
US7611539B2 (en) | 2009-11-03 |
SE526618C2 (sv) | 2005-10-18 |
FR2802799A1 (fr) | 2001-06-29 |
AU780176B2 (en) | 2005-03-03 |
SE0201836L (sv) | 2002-06-17 |
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