WO1998042280A1 - Systeme de distribution de ciment - Google Patents

Systeme de distribution de ciment Download PDF

Info

Publication number
WO1998042280A1
WO1998042280A1 PCT/GB1998/000901 GB9800901W WO9842280A1 WO 1998042280 A1 WO1998042280 A1 WO 1998042280A1 GB 9800901 W GB9800901 W GB 9800901W WO 9842280 A1 WO9842280 A1 WO 9842280A1
Authority
WO
WIPO (PCT)
Prior art keywords
cement
delivery system
tube
tubular member
container
Prior art date
Application number
PCT/GB1998/000901
Other languages
English (en)
Inventor
Alan James Dextradeur
Kevin Cheah
Original Assignee
Johnson & Johnson Professional, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Johnson & Johnson Professional, Inc. filed Critical Johnson & Johnson Professional, Inc.
Priority to AU67411/98A priority Critical patent/AU6741198A/en
Publication of WO1998042280A1 publication Critical patent/WO1998042280A1/fr

Links

Classifications

    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
    • 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
    • A61F2/30721—Accessories
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
    • 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
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • 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
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • A61F2002/30726—Centering or guiding rods, e.g. for insertion of femoral shafts
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface

Definitions

  • the present invention relates to a cement delivery system for delivering cement into a bone cavity in particular during a joint replacement operation.
  • the technique of using impacted cancellous allografr and cement is used in femor replacements to address serious loss of bone stock at a femoral revision.
  • the basic operative technique involves packing the bone canal within the femur with cancellous allograft bone chips to form a "neo- medullary canal".
  • a medullary plug is usually located in the bone to seal the bone canal and a guide rod extends from the plug. Specially designed instruments can be passed over the guide rod to pack the graft and the guide rod maintains centralization witnin the canal.
  • cement is introduced into the canal in a retrograde fashion. After filling the canal cavity with cement, the femoral component is inserted.
  • Known cement delivery systems are in the form of cement guns.
  • a known cement gun is described in EP-A-0106960 in which a tube is connectable to a cement holding cylinder and a plunger is provided which fits inside the tube and forces out a small quantity of cement at high pressure.
  • Cement delivery systems such as that shown in EP-A-0106960 have the disadvantage of requiring the tube to be inserted into the bone cavity risking the damage to the wall of the cavity of impacted allograf-.
  • a cement delivery system comprising a container suitable for holding cement, a tubular member communicating with and ex-ending from the container, and means for forcing cement from the container into the tubular member, wherein the tubular member has locating means to locate the tubular member centrally over a guide rod.
  • the locating means is in the form of a plurality of projections projecting from the internal surface of the tubular member.
  • the projections extend along the length of the tubular member. Spaces may be provided between the projections providing a passage for cement through the tubular member.
  • the projections are in the form of three radial lobes which together define a central passageway for a guide rod.
  • the means for forcing the cement from the container may be in the form of a syringe.
  • the tubular member may have a tapered distal end for ease of location of the tubular member over a guide rod.
  • Figure 1 is a cross section of a cement delivery system in accordance with the present invention located within a canal of a femur;
  • Figure 2a is a cross section of a first embodiment of a tubular member of the cement delivery system of Figure 1;
  • Figure 2b is a cross section of a second embodiment of a tubular member of the cement delivery system of Figure 1.
  • a cement delivery system 1 has a container 2 for holding bone cement for example PMMA bone cement.
  • a syringe 6 is provided in the container 2 to force the cement from the container 2 into an elongate tube .
  • the tube 4 or spout or obturator has a tapered end 8 which defines an opening 22 in the distal end 24 of the tube 4.
  • the tube 4 has at least three projections in the form of radial lobes 20 extending from the internal surface 26 of the tube 4.
  • the lobes 20 extend the full length of the tube 4.
  • the lobes 20 can be moulded with the tube 4.
  • the lobes 20 define passages 18 between the lobes 20 through which the cement 3 can pass.
  • the size of the passages 18 and the lobes 20 can be varied to obtain a greater or lesser cement flow through the tube 4.
  • Figure 2a shows a tube 4 in which the lobes 20 are fairly large providing three narrow passages 18 for the cement 3 resulting in a small amount of cement flow.
  • Figure 2b shows a tube 4 in which the passages 18 are larger allowing a greater cement flow.
  • the lobes 20 also define a central passage 28 along the length of the tube 4.
  • the central passage 28 is suitable for locating a guide rod 10 within the tube 4.
  • a guide rod 10 is shown in broken lines of Figures 2a and 2b.
  • a bone for example a femur 14, has a central canal 30 which during a replacement operation is sealed by an intra- edullary plug 12.
  • the plug 12 has a guide rod 10 extending along the canal 30 of the femur 14.
  • Femoral revision can be carried out by packing the canal 30 with cancellous allograft bone chips to form a neo- edullary canal 16.
  • the guide rod 10 is used to guide instruments for packing the graft and maintaining centralization within the canal 30 of the femur 14.
  • cement 3 is introduced into the bone canal 30 by a cement delivery system 1.
  • the tapered end 3 of the tube 4 of the cement delivery system 1 is located over the guide rod 10 and the tube 4 is guided within the bone canal 30.
  • the tube 4 maintains its central position over the guide rod 10 as the guide rod 10 enters the central passage 23 within the tube 4 defined by the lobes 20.
  • cement 3 is forced into the tube 4.
  • the cement 3 is then guided by the lobes 20 through the passages 13.
  • the cement 3 exits from the distal end 24 of the tube 4 and flows into the bone canal 30.
  • the tube 4 can be withdrawn slowly along the guide rod 10 during the cement delivery process. Once the bone canal 30 is full of cement 3, the tube 4 is removed from the guide rod 10. The internal arrangement of the tube 4 prevents the tube from contacting the neo-medullary canal 16 of the bone canal 30.
  • the cement delivery system 1 may allow more complete filling of the bone canal 30 and reduces voids in the cement and allograft matrix.
  • the described embodiments have curved radial lobes 20 to centre the guide rod 10 within the tube 4.
  • the lobes 20 could equally be replaced by radial strips which could be connected by a secondary internal tube into which the guide rod -10 is locatable thereby forming a double walled sheath.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un système de distribution de ciment (1) équipé d'un contenant (2) pour porter le ciment (3). Ledit contenant (2) est muni d'une seringue (6) servant à pousser le ciment (3) du contenant (2) vers un tube (4). Ce tube (4), qui s'insère à l'intérieur d'un canal osseux (30), comporte un moyen central d'insertion qui permet de placer le tube (4) au-dessus d'une tige de guidage (10). Le moyen d'insertion du tube (4) se présente sous la forme d'un certain nombre de projections faisant saillie depuis une surface interne (26) du tube (4).
PCT/GB1998/000901 1997-03-26 1998-03-25 Systeme de distribution de ciment WO1998042280A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU67411/98A AU6741198A (en) 1997-03-26 1998-03-25 Cement delivery system

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB9706236.8A GB9706236D0 (en) 1997-03-26 1997-03-26 Cement delivery system
GB9706236.8 1997-03-26

Publications (1)

Publication Number Publication Date
WO1998042280A1 true WO1998042280A1 (fr) 1998-10-01

Family

ID=10809872

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1998/000901 WO1998042280A1 (fr) 1997-03-26 1998-03-25 Systeme de distribution de ciment

Country Status (3)

Country Link
AU (1) AU6741198A (fr)
GB (1) GB9706236D0 (fr)
WO (1) WO1998042280A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1095667A2 (fr) * 1999-11-01 2001-05-02 Dunsch-Herzberg, Renate Dispositif pour injecter du cement chirurgical dans le canal medullaire
WO2004071354A1 (fr) * 2003-02-12 2004-08-26 Australian Surgical Design And Manufacture Pty Limited Procede et dispositif d'implantation de chondrocytes arthroscopique
WO2009087421A2 (fr) 2008-01-09 2009-07-16 Oswestry Tissue Bank Ltd Composition de réparation osseuse, et procédé de production d'une telle composition
WO2017015371A1 (fr) * 2015-07-21 2017-01-26 Smith & Nephew, Inc. Instrumentation orthopédique

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0093560A2 (fr) * 1982-05-03 1983-11-09 Pfizer Hospital Products Group, Inc. Dispositif d'étanchéité pour la pressurisation du ciment dans le canal intramédullaire
US4919673A (en) * 1988-02-29 1990-04-24 Sulzer Brothers Limited Prosthesis for a femoral head
EP0379785A1 (fr) * 1989-01-25 1990-08-01 SMITH & NEPHEW RICHARDS, INC. Dispositif de centrage distal pour tige fémorale
FR2662931A1 (fr) * 1990-06-11 1991-12-13 Setiey Louis Element de prothese d'articulation scelle a un os.
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0093560A2 (fr) * 1982-05-03 1983-11-09 Pfizer Hospital Products Group, Inc. Dispositif d'étanchéité pour la pressurisation du ciment dans le canal intramédullaire
US4919673A (en) * 1988-02-29 1990-04-24 Sulzer Brothers Limited Prosthesis for a femoral head
EP0379785A1 (fr) * 1989-01-25 1990-08-01 SMITH & NEPHEW RICHARDS, INC. Dispositif de centrage distal pour tige fémorale
FR2662931A1 (fr) * 1990-06-11 1991-12-13 Setiey Louis Element de prothese d'articulation scelle a un os.
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1095667A2 (fr) * 1999-11-01 2001-05-02 Dunsch-Herzberg, Renate Dispositif pour injecter du cement chirurgical dans le canal medullaire
EP1095667A3 (fr) * 1999-11-01 2001-05-30 Dunsch-Herzberg, Renate Dispositif pour injecter du cement chirurgical dans le canal medullaire
WO2004071354A1 (fr) * 2003-02-12 2004-08-26 Australian Surgical Design And Manufacture Pty Limited Procede et dispositif d'implantation de chondrocytes arthroscopique
WO2009087421A2 (fr) 2008-01-09 2009-07-16 Oswestry Tissue Bank Ltd Composition de réparation osseuse, et procédé de production d'une telle composition
WO2009087421A3 (fr) * 2008-01-09 2010-03-25 Oswestry Tissue Bank Ltd Composition de réparation osseuse, et procédé de production d'une telle composition
WO2017015371A1 (fr) * 2015-07-21 2017-01-26 Smith & Nephew, Inc. Instrumentation orthopédique
CN107847234A (zh) * 2015-07-21 2018-03-27 史密夫和内修有限公司 整形外科器械
US10188404B2 (en) 2015-07-21 2019-01-29 Smith & Nephew, Inc. Orthopedic instrumentation
US10799249B2 (en) 2015-07-21 2020-10-13 Smith & Nephew, Inc. Orthopedic instrumentation

Also Published As

Publication number Publication date
GB9706236D0 (en) 1997-05-14
AU6741198A (en) 1998-10-20

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