Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/38—Joints for elbows or knees
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/14—Surgical saws
  • A61B17/15—Guides therefor
  • A61B17/154—Guides therefor for preparing bone for knee prosthesis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
  • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
  • A61B17/1767—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee for the patella
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/14—Surgical saws
  • A61B17/15—Guides therefor
  • A61B17/154—Guides therefor for preparing bone for knee prosthesis
  • A61B17/155—Cutting femur
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/14—Surgical saws
  • A61B17/15—Guides therefor
  • A61B17/154—Guides therefor for preparing bone for knee prosthesis
  • A61B17/158—Cutting patella
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
  • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
• • 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
  • A61F2/38—Joints for elbows or knees
  • A61F2/3877—Patellae or trochleae

Definitions

• Femoro-patellar prosthesis and its positioning devices Femoro-patellar prosthesis and its positioning devices.
• the invention relates to a femoro-patellar prosthesis and its delivery devices.
• the object of the present invention is to remedy these drawbacks.
• This invention such as it is characterized, solves the problem of creating a prosthesis and its placement devices making it possible to perform, without any trial and error, on the femoral trochlea and on the ro tule, the bone resections adapted exactly to the shape and dimensions of the corresponding prostheses, by ensuring a rigorous positioning of the elements constituting the prosthesis and of this relative to the leg-ankle-head-femur alignment, in particular ensuring, on the trochlean surface, very precise sections strictly parallel to the posterior bi-condylar axis, of profile strictly parallel to the axis of the femur, and, on the patella, a precise and plane section corresponding exactly to the thickness of the medallion of the patellar prosthesis.
• the femoro-patellar prosthesis according to the invention consisting of a trochIean element with a curved semi-circular groove and a patellar element with a semi-spherical medallion of corresponding radius, intended to be fixed, respectively, on the lower femoral end , by nails and screws, and on the ball joint, by implantation stud, after execution of the corresponding resections, is characterized in that the curved semi-circular groove of the trochlear element is integral with a sole whose end comprises a fixing orifice and the other end of which is extended, in the median plane, by an inclined semi-cylindrical heel provided with a rod arranged parallel to the sole in the median plane thereof and oriented towards the fixing orifice , and in that the rotuiian element comprises, on the bearing face of its medallion, circular inlay recesses connected radially by grooves and, at the periphery of its contact pad plantation, inlay streaks connected transversely by
• the devices for placing the femoro-patellar prosthesis are characterized in that: 1)
• the devices for placing the trochlear element include: - a davit, mainly consisting of a plate at the base of lacquerIe are fixed euiII (2006) with spacing and adjustable lateral positioning, in the plane of symmetry of IaqueIle is made a bore communicating laterally by grooves with the front and rear sides era of the plate, in which the axis is mounted comprising, towards one of its ends, a drilling guide orifice, towards the other end another orifice provided with an alignment rod, and towards its middle, a cutting guide surmounted by a feeler arm; the drilling guide hole, the alignment rod and the feeler arm being located in the same plane, while the cutting guide is located in a perpendicular plane, - a milling template consisting of a fixing plate, provided fixing orifices, soIidaire of an inclined tubular milling guide, indented longitudinally in its part located under the fixing
• a milling cutter made up of a hollow cylindrical part, partially indented, comprising, at one of its ends, cutting teeth and, at the other end, a circular heel surmounted by a tail drive.
• the devices for fitting the rotuIary element include:
• a davit consisting mainly of two arms joined and held parallel to each other by means of an articulated crossover equipped with a spring permanently reminding one of the arms against a knurled nut mounted on a solid threaded graduated rod of the other arm;
• the said arms being provided, at one of their ends, respectively ment of a cylindrical square threaded and graduated, axially drilled, on which slides a cutting guide consisting of a split bell connected by a smooth ring, provided with a circular lip, with a knurled nut, made in two parts, comprising a groove intended to receive the lip of the ring of the bell, of a sliding sliding cup having in its center a pointed lug,
• a centering template consisting of a drilled cylindrical part, comprising a circular base provided with anchoring points,
• a drill bit for drilling the implantation hole of the nipple for fixing the rotatory element of the prosthesis consisting of a heel drill bit surmounted by a drive shank,
• the means for adjusting the spacing and positioning of the cookers of the trochlear davit is obtained by means of a dovetail groove made at the base of the plate, of pins of the same shape, located at the base of the spoons, and a threaded rod, with two opposite threads, fitted with a knob.
• the probe arm equipping the trochial cutting guide, has a square-shaped end, pierced in the middle, the base of which is situated in a plane perpendicular to the support axis coinciding with the upper face of the cutting guide.
• FIG. 1 shows a longitudinal sectional view of a lower end of the femur fitted with trochIean and patellar prostheses
• - Figure 2 shows a front view of a femur head fitted with the troch I éenne and ro tu prostheses link
• FIG. 3 represents a bottom view of the trochlear prosthesis
• FIG. 4 shows a perspective view of the piercing and cutting guide of the trochlea, in place on a lower end of the femur
• FIG. 5 shows a side view of the piercing and cutting guide of the trochlea in place on a lower end femur laugh
• FIG. 6 represents a partial bottom view of the guide for piercing and cutting the trochlea
• FIG. 7 shows a side view, in section, of a femur head provided with the milling template equipped with its wire, in place in the inter-condylar notch
• - Figure 8 shows a top view of a lower end of the femur provided with the milling template equipped with its trine in place in the inter-condylar notch
• FIG. 9 represents a side view in partial section of the guide for cutting and drilling the ball joint
• FIG. 10 represents a side view in partial section of the cutting and drilling guide of the IarotuIe in place on a ball joint before cutting and drilling,
• FIG. 11 represents a view in partial section of the cutting and drilling guide of the patella used for the implantation of the corresponding prosthesis
• FIG. 12 represents a bottom view of a prosthesis of large diameter patella
• FIG. 13 represents three views in elevation of a patella prosthesis
• FIG. 14 represents a bottom view of a small diameter ball prosthesis
• FIG. 15 represents a bottom view of a ball joint prosthesis of medium diameter
• FIG. 16 represents a bottom view of a large ball joint prosthesis
• FIG. 17 represents a sectional view of the patellar milling device in place on a ball joint
• FIG. 18 shows a partial sectional view of the drilling guide of the axis of the trochIée in place on the lower end of a femur at the time of the drilling operation.
• the femoro-patellar prosthesis consists of a trochleen element 10 comprising a curved semi-circular groove 11 forming a body with a sole 12, one of the ends of which has a fixing orifice 121 by a screw 2 and the other end of which is extended, in the median plane, by an ineIined semi-cylindrical pin 13 provided with a transverse rod 14 disposed parallel to the sole 12, in the median plane of the latter, and a patellar element 30 consisting of a medaiIIon 31 and an anchoring pad 32.
• the sole 12 rests on a flat surface, resulting from a bone resection carried out according to a cut in the plane X of profiI strictly parallel to the axis XX of the femur 40 and perpendicular to the posterior bi-condylar axis 22.
• the rod 14 enters an orifice 41 previously drilled in the intra-condylar space 42, parallel to the axis XX of the femur 40.
• the anterior cutting guide davit 50 consists of a plate 51 having, at its base, a dovetail groove 511 in which slides, under the action of a rod 52 with two opposite threads 521 and 522 and a knurled button 53, the heel in the shape of a tenon 541 of two cutters 542 and 543, intended to bear on the posterior condyIes 43 and 44, and, in its median plane, a bore 512, provided with grooves 513, in which is mounted, free in translation and in rotation, an axis 55 comprising, at its base, a transverse drilling guide orifice 551 for orifice 41, at its upper part, an orifice 552 intended to receive a removable guide rod 56, and, towards its middle, a cutting guide 57, materializing the cutting plane V, surmounted a feeler arm 58 provided with a finger 581 pierced with an orifice 582 into which a fixing nail 583 penetrates.
• the soldering of the forceps at the lower femoral end by means of the nail 583 therefore makes it possible to carry out the bone resection 45 by resting on the face upper 571 of the cutting guide 57.
• the milling template 60 consists of a plate 61 provided with fixing holes 611 by means of points 63, integral with an inclined cylindrical milling guide 62 comprising a longitudinal notch 621 in its part located under the plate 61 and, at its base, a stud forming a stop 622.
• the davit 80 for cutting the ball 8 consists of two arms 81 and 82, connected and held parallel to each other by means of an articulated cross 83 provided a return spring 831, ensuring the return of the upper arm 82 against a knurled nut 841 mounted on a threaded and graduated rod 840 connected to the lower arm 81.
• the upper arm 82 has, at one of its ends, a square cylindrical threaded graduated 821, comprising an axial bore 822, on IaqueIle slides the cutting guide consisting of a bell 85 having a lateral slot 851, allowing the passage of the upper arm 82, connected by a smooth ring 852 with lip 853 to a nut thumbwheel 86, made in two parts, comprising a groove 861 receiving the lip 853 from the ring 852 from the cutting guide bell 85.
• the lower arm 81 is provided, at its end situated under the bell 85, with a cutter removable health 87, comprising, in its center, a pointed lug 871 and, radially, fixing orifices 872 by means of nails 873 on the anterior face of the ball, before the forceps are placed thereon.
• a m ⁇ rdache 88 fits at the base of the bell 85 and makes it possible to exert an axial force on the medaiIlon 31 of the patellar element 30 of the prosthesis to facilitate its complete implantation, by exerting an effort of bringing the arms 81 together and 82 by means of the threaded rod 840 and the knurled nut 841.
• the drilling axiaI 822 of the bell holder bracket 821 allows the fixing of the forceps on the ball joint 8 by means of a nail 89.
• the patellar element 30 of the prosthesis although having an implantation pad 32 provided with identical ridges 321 and notches 322, differ as to the diameter of the medallion 31 and, for each diameter, according to the height H of the medallion. Furthermore, depending on the diameter, the circular inlay recesses 311 are 1 or 2 in number. These are connected radially by grooves 312.
• FIG. 17 represents the centering template 90 consisting of a cylindrical conduit 91 provided with a circular base 92 provided with anchoring points 93.
• the said template then introduce therein the drill bit 94 provided with a heel 941 and a tail 942 and then drive it in rotation until the heel comes into contact 941 against the upper end of the cylindrical duct 91.
• FIG. 18 represents the use of the intracondylar bit 59, comprising a semi-cylindrical ring 591 introduced into the drilling guide orifice 551 existing in the axis 55 of the cutting guide forceps 50.
• the incision opening the joint, and having dislocated the patella outward while keeping the knee in flexion consists mainly:
• the trochIean throat was put back very high so as to guide the patella in its complete positioning, taking into account that the arthroses are often very high patella which need to be guided at a distance markedly greater than the height of the trochlea. usual.
• the patellar cut is perfectly guided by the tick 85 of the patellar cut guide 80, since the latter makes it possible to firmly stabilize the patella 8 during cutting, hence obtaining a perfectly precise cut. plane.
• the thickness of the patellar resection is, in turn, determined very precisely taking into account, possibly, certain peculiarities, such as the thickness of the cement layer for example, given the presence of graduation on the '' Davit bell holder square, in order to avoid any excess thickness or under-thickness.

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Surgery (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Biomedical Technology (AREA)
• Veterinary Medicine (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Public Health (AREA)
• General Health & Medical Sciences (AREA)
• Engineering & Computer Science (AREA)
• Animal Behavior & Ethology (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Physical Education & Sports Medicine (AREA)
• Transplantation (AREA)
• Dentistry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Cardiology (AREA)
• Vascular Medicine (AREA)
• Prostheses (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

ID=9386019

Family Applications (1)

Country Status (3)

Cited By (20)

Families Citing this family (4)

Citations (5)

• 1989
  • 1989-09-29 FR FR8912874A patent/FR2652497A1/fr active Granted
• 1990
  • 1990-09-26 WO PCT/FR1990/000691 patent/WO1991004715A1/fr unknown
  • 1990-09-26 AU AU65183/90A patent/AU6518390A/en not_active Abandoned

Patent Citations (5)

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