NO323673B1 - Protese for lange knokler og underlagt et modulsystem - Google Patents
Protese for lange knokler og underlagt et modulsystem Download PDFInfo
- Publication number
- NO323673B1 NO323673B1 NO20032630A NO20032630A NO323673B1 NO 323673 B1 NO323673 B1 NO 323673B1 NO 20032630 A NO20032630 A NO 20032630A NO 20032630 A NO20032630 A NO 20032630A NO 323673 B1 NO323673 B1 NO 323673B1
- Authority
- NO
- Norway
- Prior art keywords
- component
- bone
- prosthesis
- cone
- shaft
- Prior art date
Links
- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 36
- 241001465754 Metazoa Species 0.000 claims abstract description 5
- 210000000689 upper leg Anatomy 0.000 claims description 14
- 210000002436 femur neck Anatomy 0.000 claims description 5
- 230000008468 bone growth Effects 0.000 claims description 4
- 239000000463 material Substances 0.000 claims description 3
- 229910052588 hydroxylapatite Inorganic materials 0.000 claims description 2
- 238000002513 implantation Methods 0.000 claims description 2
- XYJRXVWERLGGKC-UHFFFAOYSA-D pentacalcium;hydroxide;triphosphate Chemical compound [OH-].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[Ca+2].[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O.[O-]P([O-])([O-])=O XYJRXVWERLGGKC-UHFFFAOYSA-D 0.000 claims description 2
- 238000004381 surface treatment Methods 0.000 claims description 2
- 210000001519 tissue Anatomy 0.000 claims description 2
- 239000011248 coating agent Substances 0.000 claims 1
- 238000000576 coating method Methods 0.000 claims 1
- 230000000638 stimulation Effects 0.000 claims 1
- 210000004872 soft tissue Anatomy 0.000 description 3
- 238000010276 construction Methods 0.000 description 2
- 210000005069 ears Anatomy 0.000 description 2
- 210000002435 tendon Anatomy 0.000 description 2
- 206010005949 Bone cancer Diseases 0.000 description 1
- 208000018084 Bone neoplasm Diseases 0.000 description 1
- 229910000684 Cobalt-chrome Inorganic materials 0.000 description 1
- 229910001069 Ti alloy Inorganic materials 0.000 description 1
- 239000002639 bone cement Substances 0.000 description 1
- 239000000919 ceramic Substances 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 239000010952 cobalt-chrome Substances 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 210000002414 leg Anatomy 0.000 description 1
- 210000003041 ligament Anatomy 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 210000001694 thigh bone Anatomy 0.000 description 1
Classifications
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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
- A61F2/30721—Accessories
- A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
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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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- A61F2/00—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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- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
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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
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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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
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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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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06166—Sutures
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- 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
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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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- A61F2/00—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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- A61F2/00—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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- A61F2/00—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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- A61F2/00—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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- A61F2/00—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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- A61F2/00—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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- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
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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
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- 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
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0081—Prosthesis for animals
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0084—Means for distinguishing between left-sided and right-sided devices; Sets comprising both left-sided and right-sided prosthetic parts
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00179—Ceramics or ceramic-like structures
-
- 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
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Public Health (AREA)
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- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
- Paper (AREA)
- Cyclones (AREA)
- Quick-Acting Or Multi-Walled Pipe Joints (AREA)
- Tents Or Canopies (AREA)
- Diaphragms For Electromechanical Transducers (AREA)
- Valve Housings (AREA)
- Crystals, And After-Treatments Of Crystals (AREA)
- Signal Processing For Digital Recording And Reproducing (AREA)
Description
Massivt modulsystem
Denne oppfinnelse gjelder proteser for delvis eller total erstatning av lange knokler i mennesker eller dyr.
I det tilfelle hvor lemmer er meget skadet eller store benmengder må fjernes kirurgisk, så som i tilfelle med behandling av benkreft, vil det være et behov for proteser som kan erstatte en stor del av den naturlige bensubstans i knokkelen og som kan monteres av kirurgen for å møte et stort omfang av situasjoner. Oppfinnelsen tilbyr et modulsystem for effektiv oppbygging av skreddersydde proteser for å møte mange slike kirurgiske behov. Typiske behov kan for eksempel være å erstatte den proksimale eller distale femor (på låret) eller kanskje en total erstatning av femor (lårbensknokkelen).
Fra den kjente teknikk skal det vises til følgende patenter:
US 4 834 758, US 6 127 596 Al, US 5 658 349 Al, US 4 578 081 Al, DE 3 336 005 Al, EP 290 735 Al, GB 2 225 722 Al, US 6 146 424 Al og US 6 048 356 Al.
I et aspekt ved oppfinnelsen er det fremskaffet en protese for hel eller delvis erstatning av en lang knokkel i mennesker eller dyr, hvilken protese omfatter en endekomponent for proksimal eller distal implantering, en akselkomponent sammenføyd med endekomponenten, og en tapp for innfesting i den resekterte knokkel som skal erstattes, hvor akselkomponenten er forbundet med endekomponenten ved hjelp av konusforbindelser med en konusformet hanndel hhv. en konusformet hunndel, hvor hanndelene i enden har et fremspring med utstrekning i hanndelens lengderetning, men sideforskjøvet fra dennes sentrale lengdeakse, for inngrep i en tilsvarende utsparing i hunndelen, slik at komponentene som sammenføyes i sin respektive konusforbindelse får riktig innbyrdes vinkelstilling, kjennetegnet ved at tappen likeledes er sammenføyd med akselkomponenten i en konusforbindelse, og at det i en eller flere av konusforbindelsene er avsatt et tverrhull for tilgang med et demonteringsverktøy på tvers inn til området ved enden av hanndelen.
I et særlig aspekt av oppfinnelsen er det således skaffet tilveie eri protese for delvis eller total erstatning av lange knokler i mennesker eller dyr, hvilken protese omfatter en proksimal eller distal endekomponent som utgjør en komponent i en protesesammenføyning, en aksel sammenføyd med den distale eller proksimale ende, og en tapp for inngrep i en resektert knokkel, hvor akselen, tappen og den distale eller proksimale endekomponent er forbundet ved hjelp av hann- eller hunndel konuser, idet hver hanndel konus omfatter en projeksjon som strekker seg langsetter protesen, men er forskjøvet fra dennes lengdeakse og er innrettet for inngrep i en tilsvarende utsparing i hunndel konusen, hvor et tverrhull er anordnet for tverrtilgang til området ved enden av hanndel konusen ved hjelp av et demonteringsverktøy, og hvor denne projeksjon opprettholder tilstøtende komponenter i ønsket vinkelmessig forhold.
Oppfinnelsen omfatter også andre trekk som innbefatter en krage som kan være montert til akselen eller en forlengelse av denne og er dimensjonert for å ligge an mot den resekterte flate av knokkelen, i hvilken protesen skal innpasses, og hvor kragen har en del som er innrettet for å føres konisk mot den resekterte flate og med en overflatebehandling for å stimulere benvekst over kragens konusformede overflate.
Når det gjelder proteser for erstatning av den proksimale femor omfatter den fortrinnsvis en trokantererstatningskomponent som er sammenstilt med en aksel og en tapp og er utformet for tilnærmet å tilsvare en anatomisk trokanter og omfatter en femoral hals for opptak av en femoral kule og en generelt plan flate motsatt den femorale hals for forbindelse med resterende benmasse eller mykt vev.
Detaljerte trekk ved oppfinnelsens protese vil fremgå av tegningene, hvor:
fig. 1 viser et oppriss av sammenmonterte komponenter for en protese for den proksimale femor,
fig. 2 viser et oppriss av en tilsvarende protese for den distale femor,
fig. 3 viser forskjellige trokantererstatningskomponenter i samsvar med oppfinnelsen,
fig. 4 viser forskjellige illustrasjoner av en modulaksel for bruk i oppfinnelsen, fig. 5 viser to snitt av en femoral tapp for bruk i oppfinnelsen,
fig. 6 viser et oppriss og et tverrsnitt av en krage for bruk i en protese ifølge oppfinnelsen, og
fig. 7 viser oppriss og forskjellige snitt av en modulutvidelsestapp for bruk i oppfinnelsen.
Det vises først til fig. 1, og denne tegning viser skjematisk en sammenstilt protese for den proksimale femor og omfattende en trokanterkomponent 1 med en femoral hals 2 som er konusformet for opptak av en femoral kule på konvensjonell måte. Trokanterkomponenten 1 er vist i nærmere detalj i snittene på fig. 3, og det fremgår at den grovt tilsvarer den anatomiske form av en trokanter og har en generell plan flate 3 for feste til eventuell restbenmasse eller til mykt vev. Trokanterkomponenten 1 har en intern hunndel konus som best fremgår av fig. 3 og er sammenstilt med en hanndel konus som er anordnet på en aksel 5. Detaljkonstruksjonen av akselen 5 fremgår av fig. 4, og det ses at akselen 5 har en hanndel konus 33 i sin ene ende for inngrep i hunndel konusen i trokanterkomponenten 1 og i sin andre ende en hunndel konus 7 for inngrep med den ene ende av en tapp 8 (vist i nærmere detalj på fig. 5).
Tappen 8 er innpasset i en resektert femor 9, enten ved presspasning eller ved bruk av bensement. En krage 10 omslutter den distale ende av akselen 5, og dette er vist i nærmere detalj på fig. 6. Kragen 10 har en distal nedre ende 11 som blir liggende an mot kanseliusbenet som danner flaten for den resekterte femor 9. Kragens 10 dimensjoner velges slik at dens endeflate avsluttes i flukt med den eksterne dimensjon av knokkelen, femor 9. Kragen 10 er utformet på sin eksterne overflate med stifter eller med et benvekststimulerende materiale så som hydroksyapatit. Disse midler stimulerer til at kanseliusbenmassen kan gro over overflaten på kragen 10 og hjelpe til å låse protesen bedre fast til den resekterte benmasse i femor 9.
Det ofte mulig når man fjerner skadet benmasse eller femor og holde tilbake restdelen 12 av trokanter. Dette reststykket av benet kan ha ligamenter eller annet mykt vev festet til det, og det er ønskelig å bruke dette til å hjelpe til ved stabiliseringen av trokantererstatningskomponenten. Restbenmassen 12 kan festes til trokanterkomponenten ved å klemme fast en plate 13 til platen 3 på denne komponent.
Fig. 2 viser en oversikt over en sammenstilt distal protese som omfatter en kondylar hodekomponent 21 som danner en del av kneleddet som er forbundet med en aksel S på analog måte til den måte trokanterkomponenten 1 er forbundet med akselen S på, vist på fig. 1. Tilsvarende er akselen 5 forbundet med tappen 8 på tilsvarende måte som det som er beskrevet i forbindelse med fig. I, og kragen 10 er ført over den avskrådde nedre del av elementet som utgjør akselen 5, akkurat som beskrevet ovenfor i forbindelse med fig. 1 og har en distal avskrådd eller konusformet del 11 som ligger an mot den resekterte flate av femor 9. På tilsvarende måte stimulerer dette benveksten over kragens 10 overflate.
Detaljer av trokanterkomponenten 1 er vist i oversiktene på fig. 3. Det fremgår at den flate overflate 3 av komponenten 1 er utformet i et mønster med stifter 30. Dette mønster med stifter er anordnet for å sikre en fast forbindelse med eventuelt gjenværende ben 12 (se fig. 1) og tjener til ytterligere stabilisering av protesen. Det fremgår at trokanterkomponenten har en hunndel konus som avsluttes internt med en forskjøvet utsparing 31. Denne utsparing 31 er formet for inngrep med et fremspring 32 som er anordnet på akselens 5 hanndel konus 33 (se fig. 4). Trokanterkomponenten. er utrustet med et tverrhull 34 som et demonteringsverktøy kan føres inn i for å tvinge trokanterkomponenten og akselen fra hverandre der et skille er påkrevd. Det fremgår av fig. 4 at akselen S også har en hunndel konus 7 og er utformet med en tilsvarende utsparing 35 som utsparingen 31 i trokanterkomponenten. Akselen 5 omfatter også et tverrhull 36 som et demonteringsverktøy kan føres inn i for tvinge fra hverandre akselen og den tapp som danner en komponent som er utformet for å passe inn i konusen 7.
Vi viser videre til fig. 3 hvor det fremgår at trokanterkomponenten også har hull 36. Disse hull er ment for sutur av denne komponent til mykere vev så som sener, i det tilfelle at man ikke har noe restbenmasse som senene er festet til, som kunne være klemt fast til den stiftforsynte flate 3.
Trokanterkomponenten er ment å kunne brukes som en standardkomponent i et modulsystem, selv om man likevel bør ha en høyre- og en venstreversjon. Det kan også være alternative trokanterkomponenter hvor forskyvningsgraden av den femorale hals avviker for å passe en bestemt pasient.
Slik det fremgår av fig. 4 leveres den femorale aksel, selv om den er standardisert når det gjelder konusdelene, i lengder på 15 mm intervall. Akselen har også hakk 37 som er ment å passe til tilsvarende ører 38 i ett med kragen 10. Slik det fremgår av fig. 8 har kragen 10 en innvendig konus 36 for å passe på en tilsvarende konus 40 på den ene ende av akselen 5. Inngrepet av kragen på akselen 5 og dessuten av ørene 38 i hakkene 37 gjør det mulig for kragen å bli festet sikkert på akselen. Fra fig. 6 fremgår at kragen 10 er leverbar i en rekke diametere Dl og D2. Fig. 5 viser forskjellige visninger av akselkomponenten 8. Det fremgår av tverrsnittet at akselen selv er utformet med skinner for inngrep i kortikale ben og kan være rett eller krum for å passe til eventuell krumning i benkanalen. Den proksimale ende av akselen har en konus 42 som tilsvarer den innvendige konus 7 i akselkomponenten. Akselen har også et fremspring 43 som tilsvarer utsparingen 35 i akselkomponenten. Akselkomponenten 5 omfatter et tverrhull 36 for demonteringsformål, idet et verktøy som føres inn i dette hull vil kunne brukes til å presse fra hverandre akselen og tappen ved å presse mot deres motstående flater. Det fremgår av fig. 5 at tappen er tilgjengelig i flere diametere og lengder og kan være buet eller rett for å passe til forskjellige kirurgiske problemer som kan møtes ved innpassing av en slik protese. Fig. 7 viser en modulær forlengelsesaksel 50 som gjør det mulig å lage en total sammenstilling som vist på fig. 1 og 2 i utvidet versjon. En slik modul er at forlengelsesakselen 50 har sin respektive hanndel- og hunndelkonus i motsatt ende, og dette tilsvarer henholdsvis konusen 7 på den modulære aksel og konusen 42 på den modulære tapp. Naturligvis kan forlengelsesakselen 50 brukes sammen med en standardaksel eller alene for å forbinde trokantorkomponenten 1 eller det kondulære element 21 med tappene 8.
Selv om dette ikke er vist i detalj kan protesen vist på fig.l og 2 brukes i kombinasjon ved å utelate akslene 8 og kragene 10, for å danne en komplett femoral erstatningsprotese. Også analogt utformede komponenter kan brukes til å erstatte et annet langt ben, så som knokkelen numerus.
Som beskrevet ovenfor kan komponentene i protesen lett demonteres ved å bruke et demonteringsverktøy som føres inn i tverrveggene i komponentene ved hver konusformet sammenføyning, enten etter en forsøkssammenstilling eller i en revisjonsopera-sjon.
Materialet som fortrinnsvis brukes er en titanlegering tvers igjennom, med unntak av de femorale hoder hvor koboltkrom eller keramiske hoder fortrinnsvis brukes.
Claims (6)
1. Protese for hel eller delvis erstatning av en lang knokkel i mennesker eller dyr, hvilken protese omfatter en endekomponent (1,2) for proksimal eller distal implantering, en akselkomponent (5) sammenføyd med endekomponenten (1, 2), og en tapp (8) for innfesting i den resekterte knokkel som skal erstattes, hvor akselkomponenten (5) er forbundet med endekomponenten (1, 2) ved hjelp av konusforbindelser med en konusformet hanndel (33, 42) hhv. en konusformet hunndel (4, 7), hvor hanndelene (33, 42) i enden har et fremspring (32 hhv. 43) med utstrekning i hanndelens lengderetning, men sideforskjøvet fra dennes sentrale lengdeakse, for inngrep i en tilsvarende utsparing (31, 35) i hunndelen (4, 7), slik at komponentene som sammenføyes i sin respektive konusforbindelse får riktig innbyrdes vinkelstilling,karakterisert vedat tappen (8) likeledes er sammenføyd med akselkomponenten (5) i en konusforbindelse, og at det i en eller flere av konusforbindelsene er avsatt et tverrhull (34, 36) for tilgang med et demonteringsverktøy på tvers inn til området ved enden av hanndelen (33,42).
2. Protese ifølge krav 1,karakterisert veden krage (10) montert på akselkomponenten (5) eller på en akselforlengelse (50) for denne og dimensjonert for å ligge an mot knokkelens resekterte endeflate der protesen passes inn, og hvor kragen (10) har en del (11) som avsmalner konisk mot denne endeflate og overflatebehandlet for stimulering av benvekst over denne del (11) av kragen (10).
3. Protese ifølge krav 2,karakterisert vedat kragen (10) har sin overflatebehandling i form av utstående stifter eller et belegg av hydroksyapatitt eller et annet benvekststimulerende materiale.
4. Protese ifølge ett av de foregående krav, og utformet for å erstatte den proksimale femor,karakterisert vedat endekomponenten (1,2) utgjør en trokantererstatningskomponent med en tapp (8) eller en akselkomponent (5) for sammenføyning med den resekterte knokkel.
5. Protese ifølge krav 4,karakterisert vedat trokantererstatningskomponenten er utformet for tilnærmet å tilsvare en anatomisk trokanter og omfatter en endekomponent (2) i form av en femoral hals egnet for innpasning i en femoral kule, og en generelt plan flate (13) motsatt halsen, for sammenføyning med restbenmasse eller mykere vev.
6. Protese ifølge krav 5,karakterisert vedat den generelt plane flate (13) har utstikkende stifter for inngrep med slik restbenmasse.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB0030643A GB2370041C (en) | 2000-12-15 | 2000-12-15 | A modular system for formation of a prosthesis |
PCT/GB2001/005456 WO2002047585A1 (en) | 2000-12-15 | 2001-12-07 | Massive modular system |
Publications (3)
Publication Number | Publication Date |
---|---|
NO20032630D0 NO20032630D0 (no) | 2003-06-11 |
NO20032630L NO20032630L (no) | 2003-08-06 |
NO323673B1 true NO323673B1 (no) | 2007-06-25 |
Family
ID=9905174
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
NO20032630A NO323673B1 (no) | 2000-12-15 | 2003-06-11 | Protese for lange knokler og underlagt et modulsystem |
Country Status (25)
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US (5) | US7044976B2 (no) |
EP (1) | EP1353614B1 (no) |
JP (1) | JP4098623B2 (no) |
KR (1) | KR100781021B1 (no) |
CN (1) | CN1236737C (no) |
AT (1) | ATE310473T1 (no) |
AU (2) | AU1620102A (no) |
BG (1) | BG64688B1 (no) |
BR (1) | BR0116213A (no) |
CA (1) | CA2431401C (no) |
CZ (1) | CZ300291B6 (no) |
DE (1) | DE60115289T2 (no) |
DK (1) | DK1353614T3 (no) |
ES (1) | ES2252151T3 (no) |
GB (1) | GB2370041C (no) |
HU (1) | HUP0302640A3 (no) |
IL (1) | IL156428A0 (no) |
MX (1) | MXPA03005235A (no) |
NO (1) | NO323673B1 (no) |
NZ (1) | NZ526476A (no) |
PL (1) | PL201358B1 (no) |
RU (1) | RU2269979C2 (no) |
WO (1) | WO2002047585A1 (no) |
YU (1) | YU48003A (no) |
ZA (1) | ZA200304428B (no) |
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US7867282B2 (en) | 2004-12-17 | 2011-01-11 | Depuy Products, Inc. | Modular implant system and method with diaphyseal implant and adapter |
WO2006065879A2 (en) * | 2004-12-17 | 2006-06-22 | Depuy Products, Inc. | Modular implant system and method with diaphyseal implant |
WO2007031575A1 (de) * | 2005-09-16 | 2007-03-22 | Zimmer Gmbh | Einsatz und schale einer gelenkkugelaufnahme |
EP1787603A1 (de) * | 2005-11-18 | 2007-05-23 | Zimmer GmbH | Basisplattform für ein künstliches Gelenk |
CA2637060C (en) * | 2006-01-20 | 2014-09-16 | Zimmer Gmbh | Humeral component |
JP5285227B2 (ja) * | 2007-02-26 | 2013-09-11 | 京セラメディカル株式会社 | 生体用補綴体 |
US8177849B2 (en) | 2007-05-07 | 2012-05-15 | Zimmer, Inc. | Methods and apparatuses for attaching tissue to orthopaedic implants |
US8556912B2 (en) | 2007-10-30 | 2013-10-15 | DePuy Synthes Products, LLC | Taper disengagement tool |
US8052755B2 (en) * | 2008-05-09 | 2011-11-08 | Remi Sciences, Inc. | Ulnar head prosthesis system |
US7875082B2 (en) * | 2008-05-09 | 2011-01-25 | Remi Sciences, Inc. | Ulnar head prosthesis system |
US8715356B2 (en) * | 2010-04-13 | 2014-05-06 | Biomet Manufacturing, Llc | Prosthetic having a modular soft tissue fixation mechanism |
EP2394606A1 (de) * | 2010-06-11 | 2011-12-14 | WALDEMAR LINK GmbH & Co. KG | Prothese zum teilweisen Ersatz eines Röhrenknochens |
US8533921B2 (en) | 2010-06-15 | 2013-09-17 | DePuy Synthes Products, LLC | Spiral assembly tool |
US9095452B2 (en) | 2010-09-01 | 2015-08-04 | DePuy Synthes Products, Inc. | Disassembly tool |
EP2856976A1 (en) | 2011-04-06 | 2015-04-08 | DePuy Synthes Products, LLC | Instrument assembly for implanting a revision hip prosthesis |
EP2689749B1 (de) * | 2012-07-26 | 2016-06-08 | WALDEMAR LINK GmbH & Co. KG | Aufsteckmodul für eine Langschaftprothese |
WO2014022506A1 (en) * | 2012-08-01 | 2014-02-06 | Exactech, Inc. | Prosthetic devices to improve joint mechanics in arthroplasty |
US9050150B2 (en) | 2012-08-20 | 2015-06-09 | Zimmer, Inc. | Trochanter attachment device |
US8979940B2 (en) * | 2012-12-14 | 2015-03-17 | Biomet Manufacturing, Llc | Modular attachment mechanism in prosthetic implants |
US9681960B2 (en) | 2014-05-16 | 2017-06-20 | Howmedica Osteonics Corp. | Guides for fracture system |
US10575968B2 (en) | 2014-05-16 | 2020-03-03 | Howmedica Osteonics Corp. | Guides for fracture system |
US9597203B2 (en) | 2015-03-25 | 2017-03-21 | Tornier, Inc. | Modular humeral implant |
US10537658B2 (en) | 2017-03-28 | 2020-01-21 | DePuy Synthes Products, Inc. | Orthopedic implant having a crystalline gallium-containing hydroxyapatite coating and methods for making the same |
US10537661B2 (en) | 2017-03-28 | 2020-01-21 | DePuy Synthes Products, Inc. | Orthopedic implant having a crystalline calcium phosphate coating and methods for making the same |
EP3412251B1 (en) | 2017-06-08 | 2021-12-15 | MAKO Surgical Corp. | Robotic bone preparation for increasing implant contact surface area |
US10610365B2 (en) | 2017-12-23 | 2020-04-07 | Onkos Surgical, Inc. | Implant with ability to capture extravasating fixation medium |
US11684398B2 (en) | 2019-01-29 | 2023-06-27 | Howmedica Osteonics Corp. | Press fit stem |
DE102020205229A1 (de) * | 2020-04-24 | 2021-10-28 | Aesculap Ag | Knochenimplantat |
USD958091S1 (en) * | 2020-05-29 | 2022-07-19 | John E. Klein | Gripped wire connector with square bumps |
CN112603600B (zh) * | 2020-12-04 | 2022-01-18 | 北京力达康科技有限公司 | 一种股骨假体及其设计方法 |
US20220316504A1 (en) * | 2021-04-01 | 2022-10-06 | Wright Medical Technology, Inc. | Coupling systems and methods |
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-
2000
- 2000-12-15 GB GB0030643A patent/GB2370041C/en not_active Expired - Lifetime
-
2001
- 2001-12-07 WO PCT/GB2001/005456 patent/WO2002047585A1/en active IP Right Grant
- 2001-12-07 US US10/450,559 patent/US7044976B2/en not_active Expired - Lifetime
- 2001-12-07 ES ES01270290T patent/ES2252151T3/es not_active Expired - Lifetime
- 2001-12-07 EP EP01270290A patent/EP1353614B1/en not_active Expired - Lifetime
- 2001-12-07 MX MXPA03005235A patent/MXPA03005235A/es active IP Right Grant
- 2001-12-07 CN CNB018206069A patent/CN1236737C/zh not_active Expired - Fee Related
- 2001-12-07 AU AU1620102A patent/AU1620102A/xx active Pending
- 2001-12-07 AU AU2002216201A patent/AU2002216201C1/en not_active Ceased
- 2001-12-07 CA CA002431401A patent/CA2431401C/en not_active Expired - Fee Related
- 2001-12-07 DE DE60115289T patent/DE60115289T2/de not_active Expired - Lifetime
- 2001-12-07 HU HU0302640A patent/HUP0302640A3/hu unknown
- 2001-12-07 DK DK01270290T patent/DK1353614T3/da active
- 2001-12-07 AT AT01270290T patent/ATE310473T1/de not_active IP Right Cessation
- 2001-12-07 NZ NZ526476A patent/NZ526476A/en not_active IP Right Cessation
- 2001-12-07 KR KR1020037007985A patent/KR100781021B1/ko active IP Right Grant
- 2001-12-07 JP JP2002549163A patent/JP4098623B2/ja not_active Expired - Fee Related
- 2001-12-07 BR BR0116213-6A patent/BR0116213A/pt not_active Application Discontinuation
- 2001-12-07 YU YU48003A patent/YU48003A/sh unknown
- 2001-12-07 CZ CZ20031654A patent/CZ300291B6/cs not_active IP Right Cessation
- 2001-12-07 RU RU2003121397/14A patent/RU2269979C2/ru not_active IP Right Cessation
- 2001-12-07 PL PL363378A patent/PL201358B1/pl unknown
- 2001-12-07 IL IL15642801A patent/IL156428A0/xx active IP Right Grant
-
2003
- 2003-06-06 ZA ZA200304428A patent/ZA200304428B/xx unknown
- 2003-06-11 NO NO20032630A patent/NO323673B1/no unknown
- 2003-06-13 BG BG107907A patent/BG64688B1/bg unknown
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2006
- 2006-05-15 US US11/433,953 patent/US7662189B2/en not_active Expired - Lifetime
- 2006-10-14 US US29/267,493 patent/USD581536S1/en not_active Expired - Lifetime
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2007
- 2007-10-31 US US11/981,394 patent/US8021433B2/en not_active Expired - Lifetime
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2011
- 2011-08-18 US US13/212,589 patent/US9463090B2/en active Active
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