WO2001010356A2 - Procede et appareil permettant de distribuer du ciment a des os et/ou de positionner des composants - Google Patents

Procede et appareil permettant de distribuer du ciment a des os et/ou de positionner des composants Download PDF

Info

Publication number
WO2001010356A2
WO2001010356A2 PCT/GB2000/003089 GB0003089W WO0110356A2 WO 2001010356 A2 WO2001010356 A2 WO 2001010356A2 GB 0003089 W GB0003089 W GB 0003089W WO 0110356 A2 WO0110356 A2 WO 0110356A2
Authority
WO
WIPO (PCT)
Prior art keywords
component
cement
seal
tool
cavity
Prior art date
Application number
PCT/GB2000/003089
Other languages
English (en)
Other versions
WO2001010356A3 (fr
Inventor
Nicolaas Jacobus Joseph Verdonschot
Hans Rudolf Kriek
Maria Margaretha Martina Willems
Bernardus Johannes Elisabeth Maria Janssen
Wilhelmus Servatius Johannes Van De Wijdeven
Original Assignee
Novarticulate Holdings Limited
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 Novarticulate Holdings Limited filed Critical Novarticulate Holdings Limited
Priority to AU64590/00A priority Critical patent/AU6459000A/en
Publication of WO2001010356A2 publication Critical patent/WO2001010356A2/fr
Publication of WO2001010356A3 publication Critical patent/WO2001010356A3/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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated screw
    • 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
    • A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • 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
    • 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
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
    • 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
    • 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
    • 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
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • 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
    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30682—Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
    • A61F2002/30685—Means for reducing or preventing the generation of wear particulates
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30787—Plurality of holes inclined obliquely with respect to each other
    • 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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30807—Plurality of blind bores
    • A61F2002/30808—Plurality of blind bores parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/3412—Acetabular cups with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • 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
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4632—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using computer-controlled surgery, e.g. robotic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4653—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using cooling means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4685—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor by means of vacuum
    • 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
    • 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
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical

Definitions

  • This invention relates to cement delivery and, more particularly, to a method and apparatus for delivering cement and the like to bones in the human and animal body. It also relates to positioning components to be cemented in place . It is a well known to cement various types of prostheses or components to or in bones in the human and animal body. Likewise, treatment of bones that have been broken or are diseased may involve cementing bone together or filling a cavity in the bone. This invention is particularly applicable to the delivery of cement or the like to cavities or bores in bones (whether natural or artificial) and to the fixation of prostheses or components in such cavities or bores where desirable . Problems with conventional techniques for cement delivery can be understood by considering the replacement of worn out, damaged or diseased joints in human and animal bodies with artificial joint prostheses.
  • Such prostheses may comprise, for example, a replacement joint articulation, such as a metal ball and socket or other pivotal connection.
  • the joint prosthesis may replace only part of the joint.
  • the ball of a ball and socket joint may be replaced with a joint prosthesis comprising an artificial replacement ball designed to sit in the original socket of a natural joint or the socket of a ball and socket joint may be replaced with a joint prosthesis comprising an artificial socket designed to fit the original ball.
  • the joint prosthesis or parts of the joint prosthesis need to be anchored in or located on bone adjacent or near to the joint.
  • Joint prostheses therefore generally further comprise means for anchoring the replacement articulation, joint surface or joint part in a bone.
  • a joint prosthesis for replacing a ball and socket joint such as the human shoulder or hip, often has a replacement articulation comprising a ball and socket.
  • the replacement ball may be located on, or formed integrally with, anchoring means comprising a pin arranged to be inserted in the medullary canal of a bone, such as the femur or humerus, after the natural ball has been removed.
  • anchoring means comprising a pin arranged to be inserted in the medullary canal of a bone, such as the femur or humerus, after the natural ball has been removed.
  • a replacement socket may be carried in anchoring means comprising a cup which is arranged to fit in the bone surrounding the socket, such as the acetabulum or scapula, or carried on anchoring means comprising a pin which is inserted into an artificial bore in the acetabulum or scapula.
  • Prosthesis components such as these anchoring means are usually cemented into the bone in their respective positions. This is generally achieved by applying cement to the area, cavity or both in which the anchoring means is to be fixed, then positioning the prosthesis component into the cement and holding it in position until the cement sets.
  • cementing process in this type of procedure gives rise to a number of problems.
  • cement by its nature cement must set after a given time in its desired location, and this unavoidably puts a time constraint on the procedure between delivery of the cement the time after which the cement sets.
  • many cements are formed by mixing together two constituents to form a composition which sets after a given length of time due, for example, to a chemical reaction such as polymerisation (although cements may be made in other ways and have other constituents such as antibiotic ingredients to prevent infections, Hydroxyl Apatite or heavy elements to aid X-ray imaging for example) .
  • the cement should preferably be pressurised in order to force the cement into any cavities and recesses in the region which the cement is intended to fill and to help expel body fluids from that region.
  • it can be very difficult to pressurise the cement and, at the same time, position the prosthesis component correctly.
  • the cement may not be properly pressurised and body fluids may not be properly expelled on pressurisation or may re-enter the area or cavity as the component is being positioned.
  • body fluids can weaken the cement fixation and the mounting of the component in the bone .
  • apparatus for positioning and cementing a component of or for a prosthesis comprising means for positioning the component in or adjacent a bone cavity, cement delivery means for providing cement under pressure to a cavity space next to the component whilst the component is in its desired position, and a seal carried by the cement delivery means and arranged to confine the cement in such space until it has set.
  • a further aspect of the invention provides a method of cementing a component of or for a prosthesis into or adjacent a bone cavity, comprising locating the component in a desired position, providing a seal, and providing cement under pressure into a cavity space next to the component and confined by the seal .
  • the provision of cement comprises the provision of cement using a cement delivery means and the provision of a seal comprises locating over a cavity a seal carried by the cement delivery means and preferably the method also comprises removing the seal when the cement has set .
  • a component for a prosthesis such as an anchoring means, or a joint prosthesis component itself, is positioned in or adjacent a bone cavity before the cement is delivered.
  • This enables correct positioning to be achieved without any undue time constraint caused by the cement setting time.
  • cement pressurisation may be carried out with the component in its intended final position, and the pressure can be maintained by the seal until the cement sets. More reliable pressurisation can therefore be achieved and there is less chance of body fluid remaining in the cavity space in which the cement is intended to be located and interfering with fixation of the cement to the surrounding bone .
  • the method and apparatus of the invention are therefore more convenient to use and potentially provide more reliable fixation than the prior art.
  • the invention is applicable to a wide range of components for placement in the human or animal body, including components for prostheses, e.g. joint replacement prostheses, such as separate anchoring parts or articulating prosthetic parts themselves.
  • the bone cavity into which the component is cemented will vary depending on the component or prosthesis concerned, and may be formed in or comprise a naturally occurring cavity such as a bone canal, recess, indentation or socket, or it may be a cavity which is drilled or reamed by a surgeon especially for location of a prosthesis component.
  • the invention is described below in relation to the anchoring of a cup component in the acetabular socket for an artificial hip prosthesis but, it will be recognised, has wider application.
  • the invention may find particular utility in minimally invasive joint replacement procedures, such as that described in W098/34567.
  • minimally invasive procedures it is desirable to insert or locate joint prostheses, or components of such joint prostheses, through an incision distal from the joint, and in the example described in 098/34567, through a bore in a bone.
  • access to the location in which the component is to be positioned is restricted, and it is difficult to supply cement and to position the prosthetic component correctly in the time it takes for the cement to set. There is therefore an increased risk of mis-location.
  • a preferred embodiment of the apparatus therefore comprises a tool provided with carrying means on which the component for the prosthesis is releasably mounted.
  • the component may therefore be positioned by manipulating the tool and held in position thereby until the cement has set, whereupon the component is released from the carrying means.
  • the component may be guided and manipulated from a position remote from where the component is to be mounted in a body.
  • the invention provides a placement tool for positioning a component of or for a prosthesis, the tool comprising means for detachably mounting the component to a distal end of the tool such that the component is fixed to the tool and can be carried and manipulated thereby, and means for delivering cement for cementing the component on or in a bone within the body whilst the component is still mounted to the tool and positioned thereby.
  • the tool preferably also comprises a seal as well as cement delivery means so that it provides the triple function of locating the prosthetic component in its desired position, providing a seal adjacent the component, and supplying cement to the cavity space surrounding the component and confined by the seal.
  • the tool may include an elongate, preferably tubular portion, provided at its distal end with the carrying means for the prosthetic component.
  • the tool may be manipulated manually by a surgeon, or its guidance may be partly or entirely automated. It may be provided with suitable means, such as an endoscope, for providing the surgeon with an image of the site of the prosthesis to assist guidance and location. This may be particularly important in minimally invasive procedures where the surgeon's view of the site is obscured. Similarly, the tool may be provided with temperature and pressure transducers to either aid automation or to assist a surgeon in noting the pressure being applied on the tool or the temperature of the cement as it sets. This is particularly useful where a surgical procedure is carried out robotically as the temperature and pressure transducers may provide feedback for a computer automation system.
  • the cement delivery means may comprise a tube, carried by or extending through the tool, through which cement can be provided.
  • cement may also be provided from a location distal from the position at which the component is to be mounted.
  • Suitable means such as a piston/cylinder device, may be provided to force cement under pressure, through the tube, and into the bone cavity space around the component and confined by the seal .
  • the cement may be supplied to the space surrounding the prosthetic component via a suitable aperture in the seal, which aperture would communicate with the cement delivery tube of the tool.
  • the cement is preferably supplied via one or more apertures in the component itself.
  • an uninterrupted and unapertured seal may extend around the prosthetic component, with the cement being introduced into the space around the component and confined by the seal, through the component .
  • a further aspect of the invention provides a cup- shaped component of or for a prosthesis, which component is intended to be cemented in position, and which includes one or more apertures which are arranged such that cement may be supplied to a space surrounding and/or underlying the component in use.
  • a further aspect of the invention provides a method of cementing a cup- shaped component of or for a prosthesis, in which cement is provided to a space surrounding and/or underlying the component via one or more apertures in the component.
  • the tool for positioning a cup-shaped component of or for a prosthesis includes a mating part engageable with the component, with a means for releasably locking the component thereto.
  • the mating part preferably includes one or more cement delivery orifices, which in the preferred embodiments just discussed, communicate with the aperture (s) in the cup component, so that, in use, cement can be supplied, via the aperture (s) to the space beneath and/or surrounding the cup-shaped component whilst it is locked to, and thereby correctly positioned by, the tool.
  • the locking means can be released and the positioning tool removed, leaving the component in place.
  • a preferred form of locking means may comprise retractable locking elements carried by the mating part, which cooperate between the mating part and the cup component .
  • This aspect of the invention finds particular utility in cementing joint prosthesis, or anchoring means therefor, in sockets of ball and socket joints of the human or animal body, such as the acetabulum or scapula of the human hip and shoulder joints using, for example, a joint prosthesis such as that described in W098/34567.
  • a joint prosthesis for replacing the socket of a ball and socket joint, the joint prosthesis having a generally cup- shaped anchoring means which has one or more apertures through which cement may be provided.
  • the anchoring means can be located in, for example, a natural socket, or an artificial bore in a socket, and cement can be then provided to the socket or bore through the aperture (s) in the anchoring means.
  • the anchoring means may be integral with the joint prosthesis and, if the joint prosthesis comprises, for example, an artificial socket, the aperture (s) may extend through the artificial socket as well as the anchoring means. However, this may mean that a replacement or natural ball rests in the socket over the aperture (s) and this may cause undesirable wear or deterioration of the ball .
  • the aperture (s) are located at a location in the socket that supports the least load from a corresponding ball in use.
  • the aperture (s) are often located close to the rim of the socket and, as a ball that rests in the socket in use exerts most of its load through the base or centre of the socket, the pressure on the socket over the aperture (s) is reduced and consequently wear and deterioration of the joint prosthesis is reduced.
  • the anchoring means is detachably mounted to the articulation component of the prosthesis and comprises further means for mounting or receiving such component.
  • the articulation component may be an artificial socket and the receiving means may be a cup for receiving the artificial socket.
  • the cement aperture (s) of the anchoring means need not extend into the articulation component since this can be mounted in place after the anchoring means has been cemented in position.
  • the articulation component may be mounted to the anchoring means of the prosthesis by a tapering fit or by corresponding internal and external screw threads on the articulation component and the anchoring means .
  • the component of or for a prosthesis according to any of the above aspects of the invention may be provided with one or more protrusions which engage the bone and which help maintain the desired position during cement delivery. This is additional to the positioning function achieved by the preferred tool of the invention discussed above.
  • the seal provided in accordance with the above aspects may take any convenient form suitable for confining the cement in the space surrounding and/or underlying the prosthetic component.
  • the seal may be of a generally annular or doughnut shape extending around the cement delivery tool such that the seal cooperates in use with the bone surrounding the site for the prosthesis. Cement may then be forced under pressure through the tool into the space adjacent the prosthesis component and confined by the seal, preferably via one or more apertures in the component as discussed.
  • the seal may be an annular rubber or plastics ring, an umbrella type device or an iris or diaphragm arrangement.
  • the seal comprises an inflatable balloon. This has the advantage of providing an improved sealing action against the bone, and may also provide enhanced pressurisation of the cement when inflated.
  • the balloon is deflated and confined in close proximity to or within the outer periphery of an elongate part of the tool when the tool is initially manipulated to position the prosthetic component in the body.
  • the seal is inflated, for example by a suitable medium, such as saline, via a further conduit in the tool, to provide a seal against the surrounding tissue. Cement may then be forced into the space confined by the seal in a manner as described above.
  • the deflated balloon is radially confined whilst the tool is being manipulated in the body. This may be achieved, for example, by retaining means such as an expandable mesh or umbrella device.
  • the retaining means comprises a plurality of pins which are initially fixed and extend approximately parallel to the axis of the tool, over the seal.
  • the pins are releasable at their distal ends, and are pivotal in relation to the tool at their proximal ends so that they can be pushed outwardly when the seal is inflated into its sealing condition.
  • the retaining means or the pins also function to provide additional support behind the seal when it has been fully inflated.
  • a delivery device for delivering fluid to a cavity in a bone, the device comprising an elongate supply means having a generally ring or doughnut shaped seal which is carried within the radial dimensions of the supply means as the supply means is inserted, in use, through an orifice into a position for delivering fluid and is expandable outside - li the radial dimensions of the supply means to seal the cavity whilst fluid is supplied in use from the supply means to the cavity.
  • inflatable balloon type seals One problem that may occur with inflatable balloon type seals is that, as significant expansion of the balloon may be required to expand the balloon from within the radial confines of a slender tool to a sufficient radius to seal a large cavity in a bone, the material from which the balloon is made may be under significant tension at full radial expansion of the balloon. This, in turn, may make the balloon vulnerable to puncture by, e.g., sharp bone fragments or edges or the tool itself. Similarly, the material may rupture due to inherent weaknesses or expansion beyond the material's inherent elastic limit.
  • the balloon has a relaxed diameter larger than the diameter of the tool and retaining means are provided for retaining the excess balloon material within the diameter of the tool or cement delivery device .
  • retaining means for sealing a cavity within a human or animal body
  • the tool comprising an elongate housing and annular seal for sealing the cavity, the seal being confined within the radial dimensions of the elongate housing for insertion of the tool into the human or animal body and expandable beyond the radial dimensions of the elongate housing to seal the cavity.
  • the seal is a balloon.
  • the means for retaining the seal within the radial dimensions of the tool or housing comprises means for extending the balloon along the length of the housing.
  • the balloon in a retracted position, the balloon extends along the length of the housing, and, in its extended position, the balloon extends along the shorter length of the housing such that it bulges outwardly. This reduces the degree to which the balloon must be inflated to achieve a given radial expansion.
  • the balloon is made of latex. Likewise, it is also preferred that the balloon has a thickness of between 0.6 and 1 millimetre as this provides sufficient strength and resiliency for sealing cavities in bones.
  • the device may preferably, though not essentially, comprise means for detachably mounting, at its distal end, a component, such as a component of a prosthesis, to be secured in a cavity in a bone. This assists in initial positioning of the component, as in earlier aspects of the invention.
  • cement can be applied to the cavity in a conventional manner and the tool, can be used to carry the component and position it in the cavity through a small aperture incision or bore, i.e. using minimally invasive surgical techniques.
  • the seal may then be expanded to seal the cavity and/or pressurise cement by which the component is to be fixed into the cavity as appropriate.
  • the seal can be retracted to remove the tool through the aperture when the cement has set .
  • the component may be releasably attached to the tool as desired.
  • the component is attached to the tool by suction.
  • the tool may be provided with a head arranged to cooperate with the component and provided with a seal for providing an airtight seal between the head and the component a passage through which the pressure within the space defined by the seal, the head and the component can be reduced to hold the component on the head of the tool .
  • the means for providing a seal may be an 'O'-ring seal, and an external surface of the head may co-operate with an inside surface of a cap-shaped component to bound the defined space.
  • the aspect of the invention is again considered to be particularly advantageous in its own right, and to be a departure from the prior art .
  • a tool for positioning a component in a human or animal body comprising an elongate body having a head with a surface arranged to cooperate a surface of the component; a seal for sealing a perimeter of the cooperating surfaces; and a passage for withdrawing air from the space defined by the sealed surfaces so as to releasably hold the component on the head of the tool .
  • a component may be attached to the tool by withdrawing air through the passage and, when the component has been positioned correctly in the human or animal body it can be released by releasing the vacuum in the passage.
  • This has the particular advantage in surgical procedures of providing for releasable mounting of a component on a positioning tool without requiring any moving parts within the human or animal body during the procedure. The possibility of malfunction is reduced as there are no moving parts that can become blocked or stuck and prevent release of the component .
  • a cement delivery device for a prosthesis component comprising cement supply means and a generally ring or doughnut shaped balloon which is carried by a part through which cement for cementing the component in place is supplied in use.
  • cementing components for example anchoring components of joint prostheses, such as elongate pins which are fitted in an elongate artificial bore or natural canal in a bone.
  • anchoring components of joint prostheses such as elongate pins which are fitted in an elongate artificial bore or natural canal in a bone.
  • femoral components of hip prostheses are generally located in the medullary canal of a femur.
  • the femoral component may be fitted in an artificial extra- medullary bore, for example as described in W098/34567.
  • Cement is generally provided from an accessible end of the bore or canal and the anchoring means is then positioned in the bore or canal.
  • the cement delivery means may therefore comprise plural elongate tubes which can extend into a bore or channel in which the component is located and simultaneously provide cement at different radial locations around the component .
  • an apparatus for delivering cement around a component located in a recess, bore or canal in a bone comprising plural nozzles which can simultaneously provide cement at different circumferential locations around the component .
  • the nozzles are preferably in the form of elongate tubes which can extend, in use, into a bone cavity such as an elongate bore or canal .
  • a method of delivering cement around a component located in a recess, bore or canal of a bone comprising providing cement through one or more elongate tubes and retracting the tube(s) from the recess, bore or canal as the cement is delivered.
  • the method further comprises moving the tube(s) circumferentially around the prosthesis as the cement is delivered. This further enhances the provision of a homogeneous cement mantle and the chance of air or fluid pockets developing in the cement as it is delivered.
  • the tube or tubes is/are flexible, so that they can more easily be inserted into and withdrawn from an elongate bore or canal in a bone in use.
  • two or more ideally four tubes are provided. This is particularly suitable for the risk of high viscosity cement as the tubes can be narrow in cross-section allowing restricted spaces to be assessed whilst providing plural outlet points such that a homogeneous cement mantle can be achieved.
  • one or more tubes of circumferentially elongate cross- sections are provided. For example, two tubes of horse shoe cross-section may be provided.
  • Figure 1 is a sectional side view of a cement delivery device according to the present invention
  • Figure 2 is partial cross sectional view of the cement delivery device of Figure 1 along the line I-I in figure 1 ;
  • Figure 3 is view similar to that in Figure 1 of a second cement delivery device according to the invention in use;
  • Figure 4 is a sectional side view of first example of a component of a joint prosthesis cemented in an acetabulum
  • Figure 5 is a sectional side view of second example of a component of a joint prosthesis cemented in an acetabulum
  • Figure 6 is a sectional side view of third example of a component of a joint prosthesis cemented in an acetabulum
  • Figure 7 is a sectional side view of fourth example of a component of a joint prosthesis cemented in an acetabulum
  • Figure 8 is a sectional side view of a third embodiment of a cement delivery device according to the invention.
  • Figure 9 is a sectional side view of a fifth example of a component of a joint prosthesis which has been cemented in an acetabulum using the cement delivery device shown in Figure 8 ;
  • Figure 10 is a sectional side view of a head of a tool for positioning a component of a joint prosthesis according to the invention with its seal retracted;
  • Figure 11 is a sectional side view of the head of the tool of Figure 10 with its seal extended;
  • Figure 12 is a sectional side view of a fourth embodiment of a cement delivery device according to the invention in a femur;
  • Figures 13a and 13b are views of caps for use with the cement delivery device shown in Figure 12;
  • Figure 14 is a view of the cement delivery device of Figure 12 in use;
  • Figure 15 is a sectional side view of a fourth embodiment of a cement delivery device according to the invention in a femur; and
  • FIG 16 is a view of the delivery device of Figure 15 in use.
  • a cement delivery device 1 having a generally elongate construction, is provided.
  • This cement delivery device 1 is particularly suited to applications in which cement is to be delivered to a location through a restricted orifice, an aperture in body tissue, or a narrow bore in a bone such as described, for example, in W098/34567 (i.e. minimally invasive surgery) .
  • the cement delivery device may be used, with or without modification, for other purposes.
  • use of the device in other applications such as conventional hip replacement procedures may be realised with a construction which is not elongate.
  • the cement delivery device 1 has main body 2 with a placement head 3 mounted at a distal end of the body 2 such that it can slide in the direction of the longitudinal axis of the body 2 (and cement delivery device 1) toward and away from the body 2. More specifically, the head 3 is mounted on a tube 4 which fits inside a tube 5 in the body 2 having an inner diameter at its distal end the same or slightly larger than the outer diameter of the tube 4.
  • the tubes 4 and 5 form part of a cement delivery passage 16 along the longitudinal central axis of the cement delivery device 1.
  • annular seal 6 extends around the tube 4 of the head 3.
  • the seal 6 is collapsable and expandable. This facilitates insertion of the device through a narrow opening or bore and subsequent expansion of the seal to suitable dimensions when the device has been inserted.
  • the seal 6 comprises an annular or doughnut shaped balloon 6 extending around the tube 4.
  • the balloon 6 is inflatable and to allow inflation and deflation the balloon 6 has an opening 7 connected to a passage 8 in the body 2.
  • the passage 8 extends from the balloon to an inlet opening 9 at a proximal end of the body 2 of the cement delivery device 1.
  • the inlet opening 9 is adapted to receive a connector of a fluid delivery apparatus, such as a syringe, containing saline or some other suitable medium for inflating the balloon 6.
  • a fluid delivery apparatus such as a syringe, containing saline or some other suitable medium for inflating the balloon 6.
  • the head 3 has a shape which tapers away from the body 2 and is arranged to fit with a cup shaped component 10 of a joint prosthesis.
  • the component 10 need not be a component of a joint prosthesis, but may equally well be any component for fitting in any cavity or bore (whether natural or artificial) in a bone of a human or animal body, such as an anchoring means for a joint prosthesis or the head of a fracture nail .
  • the head 3 is provided with one or more retaining pins 11, each slidably disposed in a bore 12 in the head 3, for detachably retaining the component 10 on the head 3.
  • each bore 12 extends between the cement delivery passage 16 in the head 3 and an outer tapering surface of the head 3.
  • Each retaining pin 11 is slightly longer than the length of the bore 12 in which it is arranged, such that it protrudes either from the tapering surface or into the hollow cavity, and its movement is restricted by a collar in the bore 12 such that it remains in the bore 12.
  • the retaining pins 11 are each arranged to co-operate with an indent 70 in a surface of the component 10 that faces the tapering surface of the head 3.
  • the indent 70 comprises an annular recess running around the surface of the component 10 for engaging all of the retaining pins 11, but smaller individual indents 70 may be provided for each retaining pin 11 if preferred.
  • An actuating tool (not shown) comprising a long shaft with a tapering head or cam surface can be inserted along the cement delivery passage 16 to force the retaining pins
  • a cement injecting apparatus 74 is shown inserted into the passage 16.
  • the cement injecting apparatus 74 comprises an arrangement 75 for carrying and injecting cement and a tube or sleeve 73 which fits in the passage 16.
  • the distal end of the body 2 (proximal to the head 3) carries retaining means for retaining the balloon 6 within the radial dimensions of the body 2 and for supporting the balloon 6 when it is inflated.
  • the retaining means comprises a plurality of pins 13 carried by the body 2 and spaced around its circumference.
  • the pins 13 are pivotally connected to the body 2 by pivot means 71 such that they can pivot from a position parallel to the major axis of the body 2 outwardly through an angle A to a position in which they extend partially radially from the body 2, as shown in Figures 1 and 2.
  • the head 3 is moved away from the body 2 and the pins 3 are positioned such that they are parallel to the major axis of the body 2 and retain the balloon 6 under them, within the diameter of the body 2.
  • the head 3 is then moved back toward the body 2 such that the end of each pin 13 distal from its pivotal engagement with the body 2 engages a corresponding recess 14 on a surface of the head 3 facing the body 2.
  • the pins 13 aid insertion of the cement delivery device 1 through an orifice or bore by confining the balloon 6.
  • the head may be urged away from the body 2. In this example, this is achieved by pushing the sleeve 73 in the passage 16 toward the head 3.
  • the pins 13 disengage from the indent (s) 14 and may be urged outwards by the balloon 6 as it is inflated.
  • the pins 13 support the proximal surface of the seal or balloon 6 when it is inflated, as shown in Figure 3. This allows any force exerted along the direction of the major axis of the cement delivery device 1 toward the position of the component 10 or area of cementing to push the seal or balloon 6 as well as the head 3.
  • a cement delivery device 1 similar to that shown in Figures 1 and 2 is shown in position for cementing a component 10 into a socket 18 of an acetabulum 15.
  • This cement delivery device 1 has a head adapted to carry a component which is adapted to be located in pre-drilled holes 76 in a socket or cavity 18, as opposed to on the spike 77 of the component 10 shown in Figure 1.
  • the end of each pin 13 proximal to the body 2 rests against a stop 78 which limits the angle A through which the pins can pivot .
  • the pins therefore securely support the inflated balloon 6.
  • the cement delivery device 1 is inserted through a bore in a bone, such that the head 3 is proximal to a bore, recess or, in this example, a cavity 18 in which a component of a joint prosthesis is to be placed. This is particularly useful when placing the joint prostheses described in International Patent Application No. W098/34567, which may be put into place through a bore in a femur.
  • the cement delivery device 1 is used to manipulate the component 10 until it is in the correct position. This may be aided by using X-ray imaging to show the position of the component next to the bone. The manipulation may be carried out by a robotic or other computer-aided surgical technique.
  • Marks may be provided or placed on the body 2 of the cement delivery device 1 to help to show the position of the component 10 either visually or in X-ray imaging.
  • the length of the body 2 may be marked with indications along its length which may, for example, protrude from the diameter of the body 2 to show up in X-ray imaging.
  • the devices may be fitted with temperature and/or pressure transducers to provide feedback to an automated system.
  • the cement delivery device 1 may have a cooling system, for example comprising tubes for carrying coolant around the body 2, to regulate the temperature of the cement as it is injected into a cavity or bore and sets.
  • the balloon 6 is inflated by passing a suitable medium, such as saline, through inlet opening 9 and along the passage 8.
  • a suitable medium such as saline
  • the balloon 6 expands to form a seal with tissue in the socket of the acetabulum 15.
  • the balloon 6 may seal the cavity by taking any suitable shape, but the seal shown in this example is particularly adapted for sealing a socket or cup shaped cavity (such as the acetabulum 15 shown in Figure 3) as it presses radially outward against a ring of tissue or bone rather than resting on the rim of bone surrounding the socket.
  • the pins 13 support the balloon 6 such that it does not pop out of the socket, and such that it exerts some pressure on the cavity 17 formed between the balloon 6 and the socket 18.
  • a force toward the cavity 18 is maintained on the device by a robot arm, automated clamp type device or manually by a surgeon, to keep the seal in place and hold the component still .
  • cement is injected using the cement injecting apparatus 74 along the passage 16 or, more specifically, through the sleeve 73 in the passage 16.
  • the cement passes along the sleeve 73 and through one or more openings in the component 10 into the cavity 17 between the balloon and the acetabular socket 18.
  • the cement can be provided at a pressure higher than that of fluids within the body such that any fluid in the cavity 17 is driven out of the cavity 17 and the cavity 17 is filled with cement.
  • a socket component 19 of a joint prosthesis is cemented in place using the cement delivery device 1. This component 19 has two apertures 20 through which cement may be passed to cement the component 19 in place. Additionally, in the embodiment shown the acetabular socket 17 has been prepared by drilling a number of holes 72 in its surface to aid location of the cement and strengthen the bond between the cement and the bone.
  • the apertures 20 through which cement is injected are located close to the rim of the socket 21 of the component 19. Thus, when a ball is placed in the socket 21 to complete the joint prosthesis, the major forces exerted on the socket are not exerted in the area of the apertures 20. This reduces any erosion or wear that may be caused by the ball rotating over cement exposed in the apertures 20.
  • This two part component 22 comprises an anchoring part or anchoring means 24 and an articulation part 23.
  • the anchoring part 24 is cemented in place in a similar manner to the components 10 and 19 of the above described embodiments, i.e. it is put in position using a cement delivery device 1, a seal is provided and cement is injected.
  • the anchoring part 24 does not have a socket 21, but instead has a tape recess 25 for receiving a portion 26 of the articulation part 23.
  • cement can be inserted through apertures (not shown) in the anchoring part 24, and the articulation part 23 can be located in the anchoring part 24 after the anchoring part 24 has been cemented in place.
  • the portion 26 of the articulation part 23 fits in the recess 25 of the anchoring part 24 by a friction fit.
  • the articulation part 23 and the component 22 generally, provide a smooth socket 27 which has no apertures in its surface. This further reduces wear of a ball and socket joint.
  • a two-part component 22 of a joint prosthesis is again provided.
  • an anchoring part 28 is cemented in place and articulation part 29 component having a socket 30 is joined to the anchoring part 28 by means of a screw thread, rather than the friction fit of tapering surfaces .
  • a fifth embodiment of a component of a joint prosthesis comprises a pin 31 which may be inserted into an artificial bore 32 in an acetabulum 15.
  • the pin 31 comprises two parts, a first outer sleeve 33 having orifices 34 through which cement can be inserted, and a second inner sleeve 35 which fits inside the outer sleeve 33 to provide a stable support.
  • the outer sleeve 33 is fitted in a similar manner to the anchoring parts of the above described embodiment and the inner sleeve 35 in position later.
  • a sixth embodiment of a component for a joint prosthesis comprises a cup- shaped component 40.
  • a component 40 having dimensions similar to that shown in the Figure cannot be inserted through a narrow bore or orifice, and it is intended that this is inserted in an acetabulum using a conventional joint replacement technique.
  • a cement delivery device 1 in accordance with the invention may still be utilised, although it is preferred that the cement delivery device then comprises a head 41 (as shown in Figure 9) having a larger diameter than the head 3 of previous embodiments .
  • the head 41 has an annular seal 43 which fits over the bone or tissue surrounding the socket 17 of the acetabulum 15 to provide a seal which is supported by pressure exerted through the cement delivery device 1 towards the socket 17, rather than radially outwards around the inside of the rim of the socket 17 as in the previous embodiments described above.
  • the annular seal 43 need not be inflatable, and may comprise a sealed annular 'O'-ring.
  • the head 41 has two or more passages 42 for delivering cement through apertures 78 at the periphery of the component 40.
  • cement is injected around the periphery of the socket 17 and a more homogeneous cement mantle may be provided.
  • a further annular seal 78 is provided inward of the passages 42 to prevent cement from entering the artificial socket 79.
  • Pins 80 on the head 41 engage recesses 81 to hold the component 40 during positioning and cement delivery.
  • a tool 100 for positioning a component of a joint prosthesis which can be used in a slightly more conventional method of fixing components to bones, has a number of features in common with the cement delivery devices described above.
  • the tool 100 comprises an elongate housing 101 which, in this example, is suitable for positioning a component of a prosthesis by inserting it through a bore in a bone such as described in W098/34567.
  • a head 102 is provided at the distal end of the housing 101 for carrying the component.
  • the head comprises a domed or conical surface adapted to mate with a surface of the component (in this case a socket of a ball and socket joint to be mounted in an acetabulum) .
  • a passage 103 Passing through the central axis of the dome or cone of the head is a passage 103 connected to a main passage 104 passing along the length of the housing 101 of the tool 100.
  • an 'O'-ring seal 105 adapted to form a seal with the component when it is mounted on the head 103.
  • the 'O'-ring seal is an annulus around the base of the domed or conical surface of the head 103.
  • the tool 100 carries a balloon 106.
  • the balloon 106 comprises a tube of suitably pliable and elastic material such as rubber or latex. Typically, a thickness of 0.6 millimetres to 1 millimetre is suitable.
  • the balloon 106 extends from a fixed collar 107 just behind the head 102 to a movable collar 108 provided within the housing 101.
  • One end of the balloon is sandwiched between a base 109 and retaining portion 110 of the fixed collar 107 and two 'O' -rings seals are provided between the balloon and the retaining portion 110 to provide a water-tight seal around the entire circumference of that end of the balloon.
  • the movable collar 108 similarly comprises a base
  • the base 112 and retaining cover 113 of the movable collar 108 are fixed to an accuator, which in this example comprises a tube 115 disposed within the housing 101.
  • the base 112 and retaining cover 113 of the movable collar 108 are attached to the tube 115 by sandwiching the tube 115.
  • the whole assembly of the tube 115, collar 108 and balloon 106 is slidable within the housing 101, although the distal end of the balloon, behind the head 102 is fixed.
  • the balloon 106 extends between two cars or collars 107, 108, one of which is movable to decrease the length of the balloon 106 and accordingly increase its diameter.
  • a fluid passage 105 extends along the length of the housing 101 into the space defined inwardly of the balloon 106.
  • Fluid such as saline
  • the movable collar 108 slides forward on inflation to increase the diameter of the balloon.
  • the balloon 106 need not be as elastic as the balloon as the embodiments described above, as the balloon 106 is not required to inflate to the same extent .
  • cement is first applied to the area to which a component for a prosthesis is to be attached.
  • the tool 100 is prepared by placing the component (such as that illustrated in Figure 4 although without the apertures 20 through which cement is injected) on the head 102 of the tool 100.
  • a seal is formed between the rim of the component and the 'O'-ring 105 and air is withdrawn through the passages 103 and 104 such that the component is held on the head 102 by vacuum.
  • the tool 100 carrying the component is then inserted by the incision or bore through which access is gained to the area or cavity in which the component is to be fixed, such that the component is brought into a position close to the position in which it is to be fixed.
  • the balloon 106 is in the retracted position shown in Figure 10 during insertion such that the balloon is protected and the tool 100 can be easily inserted through the incision or bore.
  • the collar 108 is moved towards the distal end of the tool 100 and saline is injected into the space defined by the balloon 106 through the passage 115 to inflate the balloon 106.
  • the balloon 106 is thus inflated as shown in Figure 11 without the material from which the balloon is made being stretched to a large extent. This reduces the possibility of the balloon 106 being punctured or ruptured due to contact with bone or body tissues, as the balloon 106 does not stretch to a large extent .
  • the tool 100 is then pushed forward such that the component is brought forward into the final position in which the component is to be fixed and the balloon 106 seals the cavity or area in which cement has been provided and pressurises the cement . This ensures that any bodily fluids are expelled from the area of the cement and that a homogenous cement mantel is produced.
  • the vacuum or reduced pressure in the passages 103 and 104 is released such that the component is no longer held on the head 102 and the tool 100 is released.
  • saline is withdrawn from the balloon 106 of the movable collar 108 is moved away from the head such that the balloon 106 is retracted.
  • the tool 100 may then be withdrawn through the bore or incision through which it was inserted.
  • the cement delivery device has a plurality of tubes 50 which extend from the end of the cement delivery device into a cavity in which cement is to be injected.
  • a component 52 is cemented in an extra- medullary bore 54 in a femur 51.
  • the component 52 has a seal 53 at its medial, wider end, which seals one end of the bore 54.
  • a cap 55 or 57 is fitted over the other end of the bore 54. This engages the distal end of the component 52 to hold it along the central axis B of the bore 54.
  • the cap 55 or 57 also seals the end of the bore over which it fits.
  • the cap 55 has a plurality of apertures 56 (shown in Figures 13a and 13b) through which the cement delivery tubes 50 can be inserted and, in use, the delivery tubes 50 are inserted through the cap 55 or 57 as far as the seal 53.
  • the apertures 56 may formed as slots which extend circumferentially around the cap 55 or 57, or the cap 55 or 57 may be arranged to rotate. This enables the tubes 50 to be rotated circumferentially around the pin 52 as they are withdrawn (i.e. along generally helical paths) which also aids the provision of a homogenous cement mantle.
  • the cement delivery device of the above embodiment can be adapted for use with a femoral component 63 which extends along the medullary canal of a femur 51.
  • the medullary canal 60 is plugged at its lower end with a seal 61, and the femoral component 63 is inserted in the bore 60.
  • cement is delivered to the bore 62 in a way similar to that of the above embodiment, by withdrawing the tube 64 from the bore 62 as cement is injected.
  • the tubes may be rotated around the circumference of the bore as they are withdrawn, although this is only possible where the shape of the prosthesis 63 or other component being cemented in position allows.
  • FIG. 12 and 13a four flexible tubes 50, which are circular in cross-section, are provided.
  • Such an arrangement is suitable for the application of low viscosity cement.
  • larger diameter tubes 50 may be used for higher viscosity cements, which generally have quicker setting times and are generally advantageous as they can reduce the length of surgical procedures .
  • two tubes 50 may be used each having a horse shoe cross-section.
  • Such an arrangement uses a cap 57, as shown in Figure 13b, having two apertures comprising diametrically opposed horse shoe shaped slots. This arrangement is useful for the application of higher viscosity cement around a component, such as that shown in Figure 12 in a circumferentially confined space as it maximises the cross-sectional area of the cement delivery tubes for a given circumferential space.
  • the device 1 may not have means for placing a component and may instead be used fill joints or, if preferable, to place cement in a cavity or bore in a bone before a component is positioned, as the device still has the advantage of being able to cleanly and reliably deliver cement to a cavity or bore through a small aperture or bore.
  • the various corresponding features of each of the various embodiments are broadly interchangeable with one another.

Landscapes

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

Abstract

La présente invention concerne un système de distribution de ciment (1), de construction généralement allongée. Ce système de distribution de ciment (1) comprend un corps principal (2) pourvu d'une tête de mise en place (3) qui est montée à une extrémité distale dudit corps (2) et est conçue de façon à s'adapter à un composant cupuliforme (10) d'une prothèse articulaire. Des tubes (4 et 5) forment une partie d'un passage de distribution de ciment (16), le long de l'axe central longitudinal du système de distribution de ciment (1). Un joint annulaire (6) s'étend autour du tube (4) de la tête (3), entre la tête (3) et le corps (2). Ce joint peut s'écraser et s'étendre, afin de faciliter l'insertion du système (1) à travers une ouverture ou un orifice étroit, puis l'extension subséquente du joint, à des dimensions adaptées, lorsque le système (1) a été inséré. Le joint (6) comprend un ballonnet de forme annulaire (6) qui s'étend autour du tube (4). Cette invention concerne également un outil permettant la mise en place d'un composant dans une cavité située dans un os. Cet outil porte un joint annulaire, similaire à celui du système de distribution de ciment (1), qui est utilisé pour mettre en place un composant et sceller une cavité dans laquelle du ciment a déjà été distribué.
PCT/GB2000/003089 1999-08-10 2000-08-10 Procede et appareil permettant de distribuer du ciment a des os et/ou de positionner des composants WO2001010356A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU64590/00A AU6459000A (en) 1999-08-10 2000-08-10 Method and apparatus for delivering cement to bones and/or positioning components

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9918884.9 1999-08-10
GBGB9918884.9A GB9918884D0 (en) 1999-08-10 1999-08-10 Method and apparatus for delivering cement to bones

Publications (2)

Publication Number Publication Date
WO2001010356A2 true WO2001010356A2 (fr) 2001-02-15
WO2001010356A3 WO2001010356A3 (fr) 2001-08-23

Family

ID=10858929

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2000/003089 WO2001010356A2 (fr) 1999-08-10 2000-08-10 Procede et appareil permettant de distribuer du ciment a des os et/ou de positionner des composants

Country Status (3)

Country Link
AU (1) AU6459000A (fr)
GB (1) GB9918884D0 (fr)
WO (1) WO2001010356A2 (fr)

Cited By (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6506214B1 (en) * 2000-05-02 2003-01-14 R. Michael Gross Method and means for cementing a liner onto the face of the glenoid cavity of a scapula
EP1575460A2 (fr) * 2002-11-27 2005-09-21 Conformis, Inc. Dispositifs d'arthroplastie pouvant etre selectionnes en fonction du patient et instruments chirurgicaux permettant de realiser une arthroplastie totale et partielle de maniere plus precise, plus rapide et plus simple
EP1698306A1 (fr) * 2005-03-01 2006-09-06 Corin Limited Introducteur chirurgical
EP1900346A1 (fr) * 2006-09-18 2008-03-19 Tecres S.P.A. Dispositif pour le remplissage de cavités osseuses avec du ciment fluide, en particulier de cavités acétabulaires
WO2008038322A2 (fr) * 2006-09-29 2008-04-03 2B1 S.R.L. Dispositif d'injection de ciment osseux, notamment pour vertébroplastie
WO2008079613A1 (fr) * 2006-12-20 2008-07-03 Zimmer Orthobiologics, Inc. Appareil destiné à administrer un matériau biocompatible dans un site chirurgical, et son procédé d'utilisation
WO2009144440A1 (fr) * 2008-05-31 2009-12-03 Depuy International Ltd Maniement de ciment osseux
WO2012142032A1 (fr) * 2011-04-10 2012-10-18 The Cleveland Clinic Foundation Procédés et dispositifs pour la préparation d'os
US8834914B2 (en) 2003-12-11 2014-09-16 Zimmer, Inc. Treatment methods using a particulate cadaveric allogenic juvenile cartilage particles
US8951260B2 (en) 2001-05-25 2015-02-10 Conformis, Inc. Surgical cutting guide
US8951259B2 (en) 2001-05-25 2015-02-10 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9023050B2 (en) 2001-05-25 2015-05-05 Conformis, Inc. Surgical tools for arthroplasty
US9055953B2 (en) 2001-05-25 2015-06-16 Conformis, Inc. Methods and compositions for articular repair
US9066728B2 (en) 2001-05-25 2015-06-30 Conformis, Inc. Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty
US9089342B2 (en) 2009-02-24 2015-07-28 Microport Orthopedics Holdings Inc. Patient specific surgical guide locator and mount
US9138318B2 (en) 2007-04-12 2015-09-22 Zimmer, Inc. Apparatus for forming an implant
US9308053B2 (en) 2006-02-06 2016-04-12 Conformis, Inc. Patient-specific joint arthroplasty devices for ligament repair
US9326780B2 (en) 2006-02-06 2016-05-03 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief
US9579110B2 (en) 2001-05-25 2017-02-28 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9603711B2 (en) 2001-05-25 2017-03-28 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US9642632B2 (en) 2009-02-24 2017-05-09 Microport Orthopedics Holdings Inc. Orthopedic surgical guide
US9649117B2 (en) 2009-02-24 2017-05-16 Microport Orthopedics Holdings, Inc. Orthopedic surgical guide
US9675471B2 (en) 2012-06-11 2017-06-13 Conformis, Inc. Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components
US9700971B2 (en) 2001-05-25 2017-07-11 Conformis, Inc. Implant device and method for manufacture
US9700420B2 (en) 2008-03-05 2017-07-11 Conformis, Inc. Implants for altering wear patterns of articular surfaces
CN106994038A (zh) * 2017-05-23 2017-08-01 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于脊柱椎弓根破壁补救固定装置
CN107028649A (zh) * 2017-05-23 2017-08-11 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于骨质疏松患者螺钉加强固定装置
CN107115140A (zh) * 2017-05-23 2017-09-01 温州医科大学附属第二医院温州医科大学附属育英儿童医院 一种用于脊柱加强椎弓根螺钉内固定装置
US9775680B2 (en) 2001-05-25 2017-10-03 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US10085839B2 (en) 2004-01-05 2018-10-02 Conformis, Inc. Patient-specific and patient-engineered orthopedic implants
US10167447B2 (en) 2012-12-21 2019-01-01 Zimmer, Inc. Supports and methods for promoting integration of cartilage tissue explants
CN109171939A (zh) * 2018-08-02 2019-01-11 重庆市华港科技有限公司 骨水泥假体一体化3d打印成型模具及其成型方法
US10806529B2 (en) 2017-07-20 2020-10-20 Mako Surgical Corp. System and method for robotically assisting a surgical procedure
WO2022117994A1 (fr) * 2020-12-03 2022-06-09 University Of Newcastle Upon Tyne Pressuriseur de ciment osseux

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8556983B2 (en) 2001-05-25 2013-10-15 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs and related tools
US8545569B2 (en) 2001-05-25 2013-10-01 Conformis, Inc. Patient selectable knee arthroplasty devices
US8882847B2 (en) 2001-05-25 2014-11-11 Conformis, Inc. Patient selectable knee joint arthroplasty devices
US8234097B2 (en) 2001-05-25 2012-07-31 Conformis, Inc. Automated systems for manufacturing patient-specific orthopedic implants and instrumentation
WO2000035346A2 (fr) 1998-09-14 2000-06-22 Stanford University Estimation de l'etat d'une articulation et prevention de lesions
US7239908B1 (en) 1998-09-14 2007-07-03 The Board Of Trustees Of The Leland Stanford Junior University Assessing the condition of a joint and devising treatment
ATE414310T1 (de) 2000-09-14 2008-11-15 Univ Leland Stanford Junior Verfahren zur manipulation medizinischer bilder
US9308091B2 (en) 2001-05-25 2016-04-12 Conformis, Inc. Devices and methods for treatment of facet and other joints
JP2006505366A (ja) 2002-11-07 2006-02-16 コンフォーミス・インコーポレイテッド 半月板サイズおよび形状の決定および工夫した処置の方法
WO2012112698A2 (fr) 2011-02-15 2012-08-23 Conformis, Inc. Implants articulaires adaptés à un patient et améliorés, procédures et outils destinés à déterminer, évaluer, corriger, modifier et/ou s'adapter à une variation et/ou à une asymétrie anatomique
US9486226B2 (en) 2012-04-18 2016-11-08 Conformis, Inc. Tibial guides, tools, and techniques for resecting the tibial plateau

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2082072A (en) * 1980-07-09 1982-03-03 Brown Byron L Femoral stem hip prosthesis
US4627434A (en) * 1985-05-03 1986-12-09 Murray William M Bone cement system and method
DE3835853A1 (de) * 1988-10-21 1990-04-26 Gmt Medizinische Technik Gmbh Vorrichtung zur durchfuehrung operativer eingriffe
EP0393425A1 (fr) * 1989-04-15 1990-10-24 Bristol-Myers Squibb Company Partie fémorale implantable avec ciment d'une endoprothèse pour l'articulation de la hanche
WO1995022286A1 (fr) * 1994-02-19 1995-08-24 Depuy International Ltd. Article destine a etre utilise en chirurgie et outil servant a le manier
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer
US5591171A (en) * 1991-06-14 1997-01-07 Brown; Byron L. Adapter and method for measuring pressures of fluid materials
WO1998015240A1 (fr) * 1996-10-09 1998-04-16 Smith & Nephew, Inc. Prothese acetabulaire de type annulaire renforcee de contre-boutants
DE19722923A1 (de) * 1997-02-06 1998-08-13 Ceramtec Ag Verfahren zum Einsetzen einer Einsatzschale in eine Außenschale einer Gelenkpfannen-Prothese

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2082072A (en) * 1980-07-09 1982-03-03 Brown Byron L Femoral stem hip prosthesis
US4627434A (en) * 1985-05-03 1986-12-09 Murray William M Bone cement system and method
DE3835853A1 (de) * 1988-10-21 1990-04-26 Gmt Medizinische Technik Gmbh Vorrichtung zur durchfuehrung operativer eingriffe
EP0393425A1 (fr) * 1989-04-15 1990-10-24 Bristol-Myers Squibb Company Partie fémorale implantable avec ciment d'une endoprothèse pour l'articulation de la hanche
US5591171A (en) * 1991-06-14 1997-01-07 Brown; Byron L. Adapter and method for measuring pressures of fluid materials
US5468245A (en) * 1994-02-03 1995-11-21 Vargas, Iii; Joseph H. Biomedical cement bonding enhancer
WO1995022286A1 (fr) * 1994-02-19 1995-08-24 Depuy International Ltd. Article destine a etre utilise en chirurgie et outil servant a le manier
WO1998015240A1 (fr) * 1996-10-09 1998-04-16 Smith & Nephew, Inc. Prothese acetabulaire de type annulaire renforcee de contre-boutants
DE19722923A1 (de) * 1997-02-06 1998-08-13 Ceramtec Ag Verfahren zum Einsetzen einer Einsatzschale in eine Außenschale einer Gelenkpfannen-Prothese

Cited By (71)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6506214B1 (en) * 2000-05-02 2003-01-14 R. Michael Gross Method and means for cementing a liner onto the face of the glenoid cavity of a scapula
AU2001267046B2 (en) * 2000-05-02 2006-07-20 Michael R. Gross Method and means for cementing a liner onto the face of the glenoid cavity of a scapula
US7244241B2 (en) 2000-05-02 2007-07-17 Gross R Michael Method and means for cementing a liner onto the face of the glenoid cavity of a scapula
US9216025B2 (en) 2001-05-25 2015-12-22 Conformis, Inc. Joint arthroplasty devices and surgical tools
US8951260B2 (en) 2001-05-25 2015-02-10 Conformis, Inc. Surgical cutting guide
US9775680B2 (en) 2001-05-25 2017-10-03 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US9877790B2 (en) 2001-05-25 2018-01-30 Conformis, Inc. Tibial implant and systems with variable slope
US9107679B2 (en) 2001-05-25 2015-08-18 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9603711B2 (en) 2001-05-25 2017-03-28 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US9579110B2 (en) 2001-05-25 2017-02-28 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9295482B2 (en) 2001-05-25 2016-03-29 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9700971B2 (en) 2001-05-25 2017-07-11 Conformis, Inc. Implant device and method for manufacture
US9186161B2 (en) 2001-05-25 2015-11-17 Conformis, Inc. Surgical tools for arthroplasty
US9107680B2 (en) 2001-05-25 2015-08-18 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9084617B2 (en) 2001-05-25 2015-07-21 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US8951259B2 (en) 2001-05-25 2015-02-10 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9023050B2 (en) 2001-05-25 2015-05-05 Conformis, Inc. Surgical tools for arthroplasty
US9055953B2 (en) 2001-05-25 2015-06-16 Conformis, Inc. Methods and compositions for articular repair
US9066728B2 (en) 2001-05-25 2015-06-30 Conformis, Inc. Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty
US9072531B2 (en) 2001-05-25 2015-07-07 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
EP1575460A2 (fr) * 2002-11-27 2005-09-21 Conformis, Inc. Dispositifs d'arthroplastie pouvant etre selectionnes en fonction du patient et instruments chirurgicaux permettant de realiser une arthroplastie totale et partielle de maniere plus precise, plus rapide et plus simple
US8834914B2 (en) 2003-12-11 2014-09-16 Zimmer, Inc. Treatment methods using a particulate cadaveric allogenic juvenile cartilage particles
US10085839B2 (en) 2004-01-05 2018-10-02 Conformis, Inc. Patient-specific and patient-engineered orthopedic implants
EP1698306A1 (fr) * 2005-03-01 2006-09-06 Corin Limited Introducteur chirurgical
US9220516B2 (en) 2006-02-06 2015-12-29 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
US9326780B2 (en) 2006-02-06 2016-05-03 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief
US9308053B2 (en) 2006-02-06 2016-04-12 Conformis, Inc. Patient-specific joint arthroplasty devices for ligament repair
US9220517B2 (en) 2006-02-06 2015-12-29 Conformis, Inc. Patient selectable joint arthroplasty devices and surgical tools
JP2010503446A (ja) * 2006-09-18 2010-02-04 テクレス・ソシエタ・ペル・アチオニ 流体セメントで骨空洞、特に寛骨臼空洞を充填するための装置
WO2008035160A3 (fr) * 2006-09-18 2008-07-03 Tecres Spa Dispositif permettant de remplir des cavités osseuses de ciment, en particulier des cavités acétabulaires
EP1900346A1 (fr) * 2006-09-18 2008-03-19 Tecres S.P.A. Dispositif pour le remplissage de cavités osseuses avec du ciment fluide, en particulier de cavités acétabulaires
WO2008038322A3 (fr) * 2006-09-29 2008-05-22 2B1 S R L Dispositif d'injection de ciment osseux, notamment pour vertébroplastie
WO2008038322A2 (fr) * 2006-09-29 2008-04-03 2B1 S.R.L. Dispositif d'injection de ciment osseux, notamment pour vertébroplastie
WO2008079613A1 (fr) * 2006-12-20 2008-07-03 Zimmer Orthobiologics, Inc. Appareil destiné à administrer un matériau biocompatible dans un site chirurgical, et son procédé d'utilisation
US9138318B2 (en) 2007-04-12 2015-09-22 Zimmer, Inc. Apparatus for forming an implant
US9700420B2 (en) 2008-03-05 2017-07-11 Conformis, Inc. Implants for altering wear patterns of articular surfaces
WO2009144440A1 (fr) * 2008-05-31 2009-12-03 Depuy International Ltd Maniement de ciment osseux
US8500820B2 (en) 2008-05-31 2013-08-06 Depuy International Limited Bone cement collector and method of use
US9642632B2 (en) 2009-02-24 2017-05-09 Microport Orthopedics Holdings Inc. Orthopedic surgical guide
US10660654B2 (en) 2009-02-24 2020-05-26 Microport Orthopedics Holdings Inc. Method for forming a patient specific surgical guide mount
US11911046B2 (en) 2009-02-24 2024-02-27 Microport Orthopedics Holdings, Inc. Patient specific surgical guide locator and mount
US11779347B2 (en) 2009-02-24 2023-10-10 Microport Orthopedics Holdings Inc. System for forming a patient specific surgical guide mount
US11779356B2 (en) 2009-02-24 2023-10-10 Microport Orthopedics Holdings, Inc. Orthopedic surgical guide
US11534186B2 (en) 2009-02-24 2022-12-27 Microport Orthopedics Holdings Inc. Orthopedic surgical guide
US11464527B2 (en) 2009-02-24 2022-10-11 Microport Orthopedics Holdings Inc. Systems and methods for installing an orthopedic implant
US9649117B2 (en) 2009-02-24 2017-05-16 Microport Orthopedics Holdings, Inc. Orthopedic surgical guide
US9883870B2 (en) 2009-02-24 2018-02-06 Microport Orthopedics Holdings Inc. Method for forming a patient specific surgical guide mount
US9901353B2 (en) 2009-02-24 2018-02-27 Microport Holdings Inc. Patient specific surgical guide locator and mount
US9949747B2 (en) 2009-02-24 2018-04-24 Microport Orthopedics Holdings, Inc. Systems and methods for installing an orthopedic implant
US10039557B2 (en) 2009-02-24 2018-08-07 Micorport Orthopedics Holdings, Inc. Orthopedic surgical guide
US9089342B2 (en) 2009-02-24 2015-07-28 Microport Orthopedics Holdings Inc. Patient specific surgical guide locator and mount
US11389177B2 (en) 2009-02-24 2022-07-19 Microport Orthopedics Holdings Inc. Method for forming a patient specific surgical guide mount
US11154305B2 (en) 2009-02-24 2021-10-26 Microport Orthopedics Holdings Inc. Patient specific surgical guide locator and mount
US10512476B2 (en) 2009-02-24 2019-12-24 Microport Orthopedics Holdings, Inc. Orthopedic surgical guide
US10646238B2 (en) 2009-02-24 2020-05-12 Microport Orthopedics Holdings, Inc. Systems and methods for installing an orthopedic implant
US9675365B2 (en) 2009-02-24 2017-06-13 Microport Orthopedics Holdings Inc. System and method for anterior approach for installing tibial stem
US10973536B2 (en) 2009-02-24 2021-04-13 Microport Orthopedics Holdings, Inc. Orthopedic surgical guide
WO2012142032A1 (fr) * 2011-04-10 2012-10-18 The Cleveland Clinic Foundation Procédés et dispositifs pour la préparation d'os
US9675471B2 (en) 2012-06-11 2017-06-13 Conformis, Inc. Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components
US10167447B2 (en) 2012-12-21 2019-01-01 Zimmer, Inc. Supports and methods for promoting integration of cartilage tissue explants
CN107115140A (zh) * 2017-05-23 2017-09-01 温州医科大学附属第二医院温州医科大学附属育英儿童医院 一种用于脊柱加强椎弓根螺钉内固定装置
CN107028649A (zh) * 2017-05-23 2017-08-11 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于骨质疏松患者螺钉加强固定装置
CN106994038A (zh) * 2017-05-23 2017-08-01 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于脊柱椎弓根破壁补救固定装置
CN107115140B (zh) * 2017-05-23 2024-01-02 温州医科大学附属第二医院温州医科大学附属育英儿童医院 一种用于脊柱加强椎弓根螺钉内固定装置
CN106994038B (zh) * 2017-05-23 2024-03-26 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于脊柱椎弓根破壁补救固定装置
CN107028649B (zh) * 2017-05-23 2024-03-26 温州医科大学附属第二医院、温州医科大学附属育英儿童医院 一种用于骨质疏松患者螺钉加强固定装置
US11471226B2 (en) 2017-07-20 2022-10-18 Mako Surgical Corp. System and method for robotically assisting a surgical procedure
US10806529B2 (en) 2017-07-20 2020-10-20 Mako Surgical Corp. System and method for robotically assisting a surgical procedure
US11903662B2 (en) 2017-07-20 2024-02-20 Mako Surgical Corp. System and method for robotically assisting a surgical procedure
CN109171939A (zh) * 2018-08-02 2019-01-11 重庆市华港科技有限公司 骨水泥假体一体化3d打印成型模具及其成型方法
WO2022117994A1 (fr) * 2020-12-03 2022-06-09 University Of Newcastle Upon Tyne Pressuriseur de ciment osseux

Also Published As

Publication number Publication date
GB9918884D0 (en) 1999-10-13
WO2001010356A3 (fr) 2001-08-23
AU6459000A (en) 2001-03-05

Similar Documents

Publication Publication Date Title
WO2001010356A2 (fr) Procede et appareil permettant de distribuer du ciment a des os et/ou de positionner des composants
US20210338441A1 (en) Shoulder Implant For Simulating A Bursa
US4462394A (en) Intramedullary canal seal for cement pressurization
AU2015246133B2 (en) Systems and methods for vertebral or other bone structure height restoration and stabilization
US11633287B2 (en) Percutaneous implantable nuclear prosthesis
US4714478A (en) Prosthesis, method, and tool for installing same
EP1820463B1 (fr) Dispositifs de compression d'un os spongieux comprenant l'utilisation d'un corps expansible à contrainte interne
US20230218409A1 (en) Implantable nuclear prosthesis
EP3612113B1 (fr) Système de stabilisation et implant pour empêcher un mouvement relatif entre des sections de tissu
US20070078477A1 (en) Anatomical spacer and method to deploy
JPH08252275A (ja) 管状骨の骨髄腔に骨髄腔遮断物を配置するための装置及び管状骨用の骨髄腔遮断物
US20110319996A1 (en) Expandable vertebral body replacement device and method
JPH0553131B2 (fr)
JP2001258915A (ja) 整形外科インプラント及びそれを骨に移植する方法
US11246633B1 (en) Kyphoplasty system and method
US9138243B2 (en) Bone compactor
CN110584770A (zh) 一种高压椎体扩张球囊及其制备方法
US11903628B1 (en) Kyphoplasty system and method
US20200197063A1 (en) Bone Filling Systems, Devices, and Methods of Use
WO2002096308A1 (fr) Dispositif chirurgical

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A2

Designated state(s): AE AG AL AM AT AT AU AZ BA BB BG BR BY BZ CA CH CN CR CU CZ CZ DE DE DK DK DM DZ EE EE ES FI FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NO NZ PL PT RO RU SD SE SG SI SK SK SL TJ TM TR TT TZ UA UG US UZ VN YU ZA ZW

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): GH GM KE LS MW MZ SD SL SZ TZ UG ZW AM AZ BY KG KZ MD RU TJ TM AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
WWE Wipo information: entry into national phase

Ref document number: 10049229

Country of ref document: US

REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase in:

Ref country code: JP