WO2003075801A1 - Prothese a emboiture amelioree - Google Patents

Prothese a emboiture amelioree Download PDF

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Publication number
WO2003075801A1
WO2003075801A1 PCT/IL2003/000187 IL0300187W WO03075801A1 WO 2003075801 A1 WO2003075801 A1 WO 2003075801A1 IL 0300187 W IL0300187 W IL 0300187W WO 03075801 A1 WO03075801 A1 WO 03075801A1
Authority
WO
WIPO (PCT)
Prior art keywords
socket
prosthesis assembly
socket prosthesis
prosthesis
assembly
Prior art date
Application number
PCT/IL2003/000187
Other languages
English (en)
Inventor
Jacob Rosen
Ory Keynan
Original Assignee
Orthoscope Ltd.
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 Orthoscope Ltd. filed Critical Orthoscope Ltd.
Priority to AU2003214597A priority Critical patent/AU2003214597A1/en
Publication of WO2003075801A1 publication Critical patent/WO2003075801A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—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
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. 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
    • A61F2/30721—Accessories
    • A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
    • 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
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—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
    • A61F2/4612—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 shoulders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30242—Three-dimensional shapes spherical
    • A61F2002/30245—Partial spheres
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30886—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts externally-threaded
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    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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    • A61F2310/00005—The prosthesis being constructed from a particular material
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    • A61F2310/00005—The prosthesis being constructed from a particular material
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    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
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    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00239—Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2

Definitions

  • the present invention relates to a prosthetic device and system for replacing the hip or shoulder joint, in particular the socket thereof.
  • the present invention also relates to such a device and system that requires reduced surgical intervention, and a surgical procedure for implanting such a prosthetic device/system in a shoulder or hip joint.
  • Ball and socket joints in the human body include the hip joint and the shoulder joint.
  • the hip joint is a ball and socket joint with three degrees of freedom allowing for movement towards, flexion, extension, abduction, adduction, internal rotation and external rotation, and comprises a femur received in the acetabulum for enabling rotational movement with respect thereto.
  • the two major pathologies regarding the hip joint that require surgery are trauma and osteoarthritis. Traumatic fractures about the hip joint can involve the femur, the acetabulum, or both.
  • Osteoarthritis is a degenerative process whereby the hip joint loses the cartilaginous covering of the femoral head and or acetabulum, leading to decreased range of motion and pain in the hip joint, and is usually treated in its most severe form by replacement of both the femoral head and the acetabulum. This procedure is called total hip arthroplasty.
  • hip hemiarthroplasty Current accepted surgical treatment for femoral fractures include internal fixation or hip hemiarthroplasty, while the most common surgical intervention performed for advanced symptomatic osteoarthritis include total hip arthoplasty.
  • hip hemiarthroplasty the current technique involves incision of the skin, different muscle groups (depending on the specific approach used), and the hip capsule. Then the femoral head is removed via an osteotomy (i.e., it is sawed off, with part of the neck about a centimeter above the lesser trochanter), and the hip joint dislocated.
  • the femoral canal is prepared using bone reamers in the shape of the intended prosthesis.
  • a metal alloy prosthesis is inserted into the medullary canal with a head size matching the original femoral head size, and the hip joint is manually reduced. Finally the soft tissue envelope is sutured.
  • prostheses There are different types of prostheses, which entail slight changes in the surgical technique.
  • the shoulder girdle of a human consists of three bones: the humerus, the scapula, and the clavicle.
  • the scapula glenoid is a pear-shaped concave bony structure having a short neck and lined with articular cartilage, reinforced on its outer rim by a fibrous structure called the labrum. Together with the humeral head, the glenoid forms the glenohumeral joint.
  • the glenohumeral joint is a shallow ball and socket joint with six degrees of freedom allowing for movement towards flexion, extension, abduction, adduction, internal rotation and external rotation.
  • the two major pathologies of the shoulder which require arthroplasty are trauma and osteoarthritis.
  • Fractures about the glenohumeral joint can involve the humerus, the glenoid, or both, and a special subgroup of the humeral head fractures is currently generally treated by surgical replacement of the humeral head with a metal prosthesis.
  • Proximal humeral fractures are classified according to the number and type of fracture fragments. The four basic fragments referred to are: the articular portion of the humeral head (the fracture line goes through the anatomical neck), the shaft portion, or subcapital fractures (the fracture line goes through the surgical neck), the greater tuberosity, and the lesser tuberosity.
  • humeral head replacement of the humeral head by prosthesis (hemiarthroplasty) is usually the treatment of choice for four-part fractures and/or fracture lines which split the humeral head up to its articular cartilage.
  • Osteoarthritis is a degenerative process whereby the glenohumeral joint loses the cartilaginous covering of the humeral head and/or glenoid, leading to decreased range of motion and pain in the joint. It is usually treated in its most severe form by replacement of both the humeral head and the glenoid. This procedure is called total shoulder arthroplasty.
  • the humeral head is removed via an osteotomy (i.e., it is sawed off, with part of the neck), and the glenohumeral joint dislocated.
  • the humeral canal is prepared using bone reamers in the shape of the intended prosthesis.
  • the metal alloy prosthesis is inserted into the canal with a head size roughly matching the original humeral head size, and the joint is manually reduced. Finally the soft tissue envelope is sutured.
  • There are different types of prostheses which entail slight changes in the surgical technique.
  • the humeral head is removed with part of the neck, after an osteotomy is made in the anatomical neck.
  • the glenoid is prepared for implantation of a polyethylene cup, by reaming the remains of the articular cartilage and part of the underlying bone. Then the cup is implanted with cement or with a metal backing outer shell.
  • the humeral canal is prepared as described for hemiarthroplasty, and a metal alloy humeral prosthesis is inserted with or without cement. Finally, the joint is manually reduced and the soft tissue envelope and the detached bony fragments (tuberosities) are sutured.
  • there are different types of prostheses for the humerus and glenoid which entail minor variations in the above procedure.
  • both these procedures Hemiarthroplasty and Arthroplasty - involve extensive dissection and disturbance of the normal anatomy of the joint in question - i.e., whether the hip joint or of the shoulder joint - usually involving the abductors and internal rotators, after which only part of the soft tissue envelope of the joint is restored. This diminishes the contribution to the stability of the joint afforded by the joint capsule and surrounding muscles and increasing the risk of dislocation of the prosthesis. In addition, the strength of the muscles necessary for postoperative rehabilitation is diminished, thus necessitating longer postoperative rehabilitation and hospitalization. Furthermore, the wide exposure of the hip joint necessary for currently used technique exposes the joint to risk of infection.
  • Some prior art prostheses address, with some success, the installation of a ball prosthesis in a manner such as to reduce the trauma to the patient, by configuring the ball prosthesis such as to be insertible into position via a lateral portal in the long bone.
  • the socket prosthesis no such solution success has been achieved in the prior art: either the socket prosthesis is considerably wider than the ball prosthesis, and therefore needs special surgical procedures in order to accommodate the same in the joint capsule, or, the socket prosthesis is small enough to be inserted via the lateral portal, but the diminished size requires substantial anchoring in the bone, with the ensuing trauma to the patient and reduction in the mechanical integrity of the surrounding socket bone.
  • a superior, non-collapsible ball prosthesis is disclosed which is inserted into position in the femur via a lateral portal therein, with important advantages to the patient.
  • the socket prosthesis may comprise a HMWPE acetabulum cup having an inner curvature to match the ball member, this being inserted into the joint through the lateral hip incision previously performed.
  • the open side i.e.
  • the concavity of the socket prosthesis is facing the femur (face down) and an interval or space between the bone and overlying muscles is developed (with retraction) until the hip capsule is reached, incised longitudinally (along the axis of the femoral neck) and the socket prosthesis is dropped into the joint.
  • the cup is navigated through the incision in the leg, but then around the femur and into the capsule then cement is injected and the cup is pressed against the acetabulum until the cement cures.
  • the cup may be directly inserted into the joint through a separate skin incision in the groin, and fixed in place as before.
  • the prosthesis' distal and proximal parts are spherical supports in spherical cups, fixed by threaded rods with support washers, alignment washers and nuts joining the cups.
  • the supports are joined through their longitudinal axis by a connector with diameter 0.3-0.5 of the supports' diameter.
  • the connector's length is at least twice the cups' walls' thickness.
  • the supports' diameter is 0.5-0.2 that of the humerus head.
  • the cups' interior corresponds to the supports' outline and their depth is at least 2/3 of the supports' diameter.
  • the cups are fastened by rods with threaded outer ends and inner faces adjoining the cups' outer back surface at an angle to the spheres' longitudinal axis.
  • the threaded parts of rods support washers with outline corresponding to the bone surface. Alignment washers align the surfaces under nut, giving regular pressure on bones. Thus, this arrangement does not provide a socket prosthesis in the meaning of this invention.
  • a hip prosthesis having a fastening assembly for mounting to the hip bone and another fastening assembly for mounting to the femur.
  • the two fastening assemblies are interconnected by means of a pivotable connection, and the various components are of a size such as to enable them to be arranged in their final positions via a bore in the femur.
  • the pivotable connection is a type of universal joint, and thus these hip prostheses do not comprise a socket prosthesis at all.
  • the pivotable connection comprises a ball portion and a socket portion which is smaller than the bore made for the ball portion.
  • the socket portion which is a unitary component, is inserted into place via the bore in the femur.
  • the small cross-section of the socket prosthesis of this embodiment while being useful in the insertion of the same into the hip capsule has the disadvantage that there is potentially little contact area between the prosthesis and the hip bone. Therefore a substantial bore has to be drilled into the hip bone to receive and secure a screw that is longitudinally attached to the socket portion. This procedure results in considerable trauma to the patient, and in any case reduces the mechanical integrity of the hip bone itself, which is a significant disadvantage and thus not desirable.
  • the socket prosthesis is connected irreversibly with the femoral component of the prosthesis, creating an artificial joint having a geometry that strays greatly from the original anatomy of the joint, and from currently acceptable and biomechanically proven principles of joint replacement.
  • US 4,936,856 discloses a hip joint socket prosthesis having devices for anchoring to the bone. These devices are in the form of supports which project from the socket surface and which may be extensible from the inside of the socket, in order to bridge an interspace between the socket surface and the bone.
  • the socket prosthesis itself is unitary and thus has to be installed in the patient in the normal way, leading to the known trauma with respect to the joint capsule and surrounding tissues.
  • the present invention relates to a socket prosthetic assembly for an enarthrosis of an extremity, such as of the hip joint or of the shoulder joint of a human body, comprising: -
  • socket prosthesis components that are adapted to be assembled into said socket prosthesis assembly, that is, that are adapted to be assembled together to form the assembly;
  • each said socket prosthesis component comprises a transverse profile adapted for enabling the same to be individually introduced into said enarthrosis via a suitable portal formed through the lateral cortex of the long bone of said enarthrosis; and wherein said socket prosthesis assembly comprises a transverse profile substantially greater that that of any one of said at least two socket prosthesis components.
  • the socket prosthesis assembly comprises a transverse profile such as to prevent return passage of the socket prosthesis assembly through such a portal.
  • the socket prosthesis components comprise a central hub member, a plurality of peripheral members adapted for engagement with said hub member, and a locking member adapted for locking together said peripheral members and said hub member.
  • the hub member comprises an outer proximal substantially convex face and a plurality of U-shaped walls depending distally therefrom; optionally, each said U-shaped wall is connected to adjacent said U-shaped walls on either side thereof, and further comprises a first slot having a distal open end.
  • the number of said U-shaped walls corresponds to the number of said peripheral members.
  • the hub member comprises a first proximal aperture providing communication between said convex face and the distal side of the hub member, said first aperture adapted for inserting a guide pin therethrough and into the socket bone to secure the hub member thereto, and wherein said first aperture opens distally to a second aperture.
  • Each said peripheral member is in the form of a pie-shaped sector of a dome, having a base, an apex, a convex outer face, an inner face, and two angled sides.
  • the inner face of each peripheral member comprises a first tab member that is complementary to said first slot, and adapted for enabling each corresponding peripheral member to slidingly engage with said hub member.
  • the outer faces of said prosthesis components form a substantially continuous convex surface when assembled together.
  • the continuous convex surface is substantially complementary to the part of the socket bone where it is desired to implant the said socket assembly.
  • the angled sides have substantially flat surfaces along planes which mutually intersect at an angle to each other such that facing sides of adjacent peripheral members, when engaged with respect to the hub member, may be in abutting contact.
  • the angled sides each comprise one of a projections and a complementary slot such as to enable adjacent peripheral members to interlock via engagement of a said projection of one peripheral member with a said complementary slot of an adjacent member.
  • alternate peripheral members arranged circumferentially around said hub member may comprise said complementary slots on both said sides thereof, and wherein the intercalated peripheral members therebetween each comprise said projections on both said sides thereof.
  • the peripheral members comprise one peripheral member having said complementary slots on both said sides thereof, one peripheral member having said projections on both sides thereof, and wherein the remainder of said peripheral members may be substantially identical, each having a said complementary slot on one of the said sides thereof, and a said projection on the other side thereof.
  • the inner face of each said peripheral member comprises a shoulder such that when the peripheral members may be engaged with said hub member, the said shoulders form a substantially continuous mating surface, which is typically annular.
  • At least one said peripheral member comprises a suitable aperture extending from the inner face thereof to the outer face thereof, said aperture adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly thereto.
  • at alternate said peripheral members each comprises a suitable aperture extending from the inner face thereof to the outer face thereof, said aperture adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly thereto.
  • at least one said peripheral member further comprises at least one suitable spike arranged on the outer face thereof, said spike adapted for securing the prosthesis assembly to a socket bone in abutting contact therewith.
  • each said peripheral member comprises a suitable bore adapted for reversibly engaging a suitable tool that may be used for introducing and guiding each peripheral member into engagement with the hub member.
  • the locking member preferably comprises a substantially cylindrical body portion having a distal annular rim and an external screwthread formed on the outer surface of the proximal end thereof, adapted for engagement with a complementary internal screwthread formed in said second aperture of said hub member.
  • the rim of said locking member is adapted for engagement with said annular mating surface.
  • the locking member may also comprise at least one suitable bore adapted for reversibly engaging a suitable tool that may be used for introducing and guiding said locking member into locking engagement with said peripheral members and/or said hub member.
  • the prosthesis components may comprise between two and ten said peripheral members, preferably between four and eight said peripheral members, and more preferably six said peripheral members.
  • the socket prosthesis assembly preferably further comprises a said socket prosthesis component in the form of a ball-receiving member, comprising a concavity on a distal side thereof, and a projection extending outwards from the proximal side thereof.
  • the concavity is adapted for receiving a ball prosthesis portion for use therewith.
  • the projection of said ball-receiving member comprises an external screw thread complementary to an internal screwthread formed in an aperture comprised in said locking member.
  • the ball-receiving member may further comprise a convex wall that is adapted for abutting against the said inner walls of said peripheral members.
  • the ball- receiving member may comprise at least one suitable bore adapted for reversibly engaging a suitable tool that may be used for introducing and guiding said ball-receiving member into engagement with said locking member.
  • the socket prosthesis components comprise a pair of wing members, a central member, and a locking member.
  • the wing members may be engageable with said central member such as to form a substantially continuous proximal convex surface.
  • the continuous convex surface is substantially complementary to the part of the socket bone where it is desired to implant the said socket prosthesis assembly.
  • Each wing member comprises an outer substantially convex outer face, a base, an apex and an inner concave face. Further, each said wing members may also comprise a first planar side and a second planar side.
  • the wing members each comprise at their apexes complementary parts of a hinge, and the wing members may be hinged together via said hinge, wherein said hinge enables said wing members to collapse inwards to form a combined collapsed cross- section that is smaller than the corresponding cross-section of the pair of said wing members when they may be assembled in the said socket prosthesis assembly.
  • the collapsed cross-section is of a transverse profile adapted for enabling the collapsed pair of wing members to be introduced together into the enarthrosis via a suitable portal formed through the lateral cortex of the long bone of the enarthrosis.
  • the hinge further comprises an aperture, formed as co- alignable apertures at the corresponding apexes of the wing members.
  • the central member comprises a pair of outer convex faces and an inner concave face.
  • the central member further comprises a first pair of substantially planar sides complementary to the planar sides of said wing members, and a second pair of outer planar sides recessed with respect to the outer convex faces and complementary to the planar sides of said wing members.
  • the central member further comprises a central aperture, and preferably at least one and preferably two apertures providing communication between said convex face and said concavity of said central member, said at least one aperture being adapted for inserting a pin or screw therethrough for securing said socket prosthesis assembly to a socket bone.
  • the locking member comprises a substantially cylindrical body portion having a distal annular rim, and an external screwthread formed on the outer surface of the proximal end thereof.
  • the socket prosthesis assembly further comprises a said socket prosthesis component in the form of a ball-receiving member, comprising a concavity on a distal side thereof, and a projection extending outwards from the proximal side thereof.
  • the concavity adapted for receiving a ball prosthesis portion for use therewith.
  • the projection of said ball-receiving member comprises an external screw thread complementary to an internal screwthread formed in an aperture comprised in said locking member.
  • the ball-receiving member further comprises a convex wall that is adapted for abutting against the said inner walls of said wing members and said central member.
  • the ball-receiving member preferably also comprises at least one suitable bore adapted for reversibly engaging a suitable tool that may be used for introducing and guiding said ball-receiving member into engagement with said locking member.
  • the prosthesis components comprise three interlocking peripheral members.
  • the peripheral members may be interconnected to form a substantially continuous convex surface.
  • the continuous convex surface is substantially complementary to the part of the socket bone where it is desired to implant the socket assembly.
  • the peripheral members may be each formed as a pie-shaped sector of a dome, having a base, an apex, a convex outer face, a concave inner face, and two planar sides at an angle to each other.
  • the peripheral members each comprise at their corresponding apexes a lateral projection in the form of a ring.
  • At least one of said peripheral members comprises at least one aperture for providing communication between the convex face and the concavity, said apertures being adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly thereto.
  • the socket prosthesis assembly as preferably further comprises a socket prosthesis component in the form of a locking member for locking said peripheral member together.
  • the socket prosthesis assembly preferably further comprises another socket prosthesis component in the form of a ball- receiving member, comprising a concavity on a distal side thereof, and a projection extending outwards from the proximal side thereof.
  • each said socket prosthesis component is made from any suitable biocompatible and substantially robust material, preferably chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • the socket prosthesis assembly may be adapted for the shoulder joint, wherein said extremity is the corresponding arm, or for the hip joint, wherein said extremity is the corresponding leg.
  • the present invention also relates to a prosthesis system for an enarthrosis comprising :-
  • the present invention also relates to a method for installing a socket prosthesis assembly for the hip joint comprising the steps:-
  • the present invention also relates to a method for installing a prosthetic system having a ball prosthesis and a socket prosthesis assembly for the hip joint, comprising: -
  • the present invention also relates to a method for instalhng a socket prosthesis assembly for the shoulder joint comprising the steps:-
  • the present invention also relates to a method for installing a prosthetic system having a ball prosthesis and a socket prosthesis assembly for the shoulder joint, comprising:-
  • Figure 1 shows in side view part of the anatomy of a hip joint.
  • Figure 2(a) and Figure 2(b) show in exploded view and assembled view, respectively, a preferred embodiment of the invention
  • Figure 3 shows in plan view the embodiment of Figures 2(a) and 2(b).
  • Figure 4 shows in side elevational cross-sectional view, the embodiment of Figure 3 along A-A.
  • Figure 5 shows in perspective view, a peripheral member of the embodiment of Figures 2(a) to 4.
  • Figure 6 shows in side view, a peripheral member of the embodiment of Figures 2(a) to 4.
  • Figure 7 shows in exploded perspective view a second embodiment of the invention.
  • Figure 8(a) and Figure 8(b) show in exploded top view and assembled top view, respectively, a second embodiment of the invention.
  • Figure 9(a) and Figure 9(b) show in exploded side view and assembled side view, respectively, a second embodiment of the invention.
  • Figure 10 shows in exploded perspective view a third embodiment of the invention.
  • Figure 11 shows in assembled perspective view a third embodiment of the invention. Disclosure of Invention
  • distal refers to a direction away from the trunk or body of the patient
  • proximal refers to a direction towards the trunk or body of the patient
  • a socket prosthesis is defined as a prosthetic device for replacing the socket portion of an enarthrosis.
  • a socket prosthesis is used in conjunction with a complementary ball prosthesis to provide an enarthrosis prosthesis system.
  • a prosthetic device for replacing the socket portion of an enarthrosis or ball-and-socket joint requires being substantially larger at least in transverse section than the diameter of the ball portion.
  • Such a size provides high mechanical integrity for the enarthrosis, and provides a high degree of stability and mobility of the ball portion within the socket, minimizing the risk of the ball portion coming out of the socket portion under conditions of large stress coupled with large angular displacement between the long bone and the enarthrosis.
  • such a prosthetic device advantageously has a substantially large convex surface which can be adapted to complement the contour of the hip or shoulder socket bone, and therefore for mating thereonto, thereby minimizing trauma to the socket bone.
  • a relatively small ball portion and socket portion is used, for example as described in WO 98/34567
  • deep and thick anchoring is required for the socket prosthesis, typically by means of a thick and deep pin or screw, generally causing trauma to the socket bone and reduction in the mechanical integrity thereof.
  • the relatively size of the larger socket prostheses with respect to the socket bone substantially determines in the prior art that the surgical procedure for implantation/insertion of the prosthesis requires an extensive surgical approach entailing substantial trauma to the soft tissue envelope of the joint, with the ensuing problems and disadvantages discussed above.
  • the situation regarding the shoulder joint is similar to that described above for the hip joint, mutatis mutandis.
  • the present invention thus relates to a prosthetic assembly for an enarthrosis of a limb or extremity, such as of the hip joint or of the shoulder joint of a human body, comprising
  • socket prosthesis components that are adapted to be assembled into said socket prosthesis assembly
  • each said prosthesis component comprises a transverse profile adapted for enabling the same to be individually introduced into said enarthrosis via a suitable portal formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the long bone;
  • socket prosthesis assembly comprises a transverse profile such as to prevent passage of the same through said portal, i.e., that is substantially larger than said portal.
  • each socket prosthesis assembly has a proximal end adapted for securement onto the socket of the enarthrosis, and a distal side having a concavity adapted for receiving the ball member of the ball prosthesis such as to permit relative rotational movement therebetween.
  • the socket prosthesis assembly is adapted to fit and be secured in the acetabulum of the particular patient.
  • the socket prosthesis assembly is adapted to fit and be secured in the glenoid of the particular patient.
  • each of the socket prosthesis components comprises a profile, particularly a transverse profile, enabling the socket prosthesis components to be individually implanted in said enarthrosis via a suitable portal (17) formed through the lateral cortex (19) of the proximal part of the hmb (16), and to be subsequently assembled and secured to the socket bone (15) by suitable manipulations or other operations carried out via the portal (17).
  • transverse profile of the socket prosthesis components it is meant the size and/or shape and/or geometrical configuration of the individual socket prosthesis components in planes normal to the axis (99) of the portal (17) when the components are individually passed through the portal.
  • both the shape and size of each of the socket prosthesis components is such as to enable these portions to navigate through the portal (17) into position in the joint capsule - in other words to enable at least these parts of the socket prosthesis assembly to be inserted into the joint capsule via the portal (17).
  • the socket prosthesis components are sufficiently small and/or slim and/or slender to enable their passage through the bore or portal in the long bone.
  • the maximum cross-sections of each of the socket prosthesis components are thus smaller, or at least not greater than, the diameter or other cross-sectional dimension of the portal (17), such as to enable the socket prosthesis components to be inserted into the hip or shoulder capsule from a lateral direction via a portal (17) in the femur or humerus, respectively.
  • the portal (17) is typically specially bored into the corresponding femur or humerus substantially co-axially with axis (99) of the neck section thereof. This procedure is discussed below.
  • the maximum diameter (D) of the portal (17) is typically limited by the diameter of the neck of the femur, and/or the amount of bony tissue left in the greater and lesser trochanters such as to provide sufficient mechanical integrity of the upper part of the bone.
  • the socket prosthesis assembly has all the advantages of prior art socket prostheses that are relatively large and thus provide excellent securement to the socket bone with relatively little trauma thereto.
  • the socket prosthesis assembly of the present invention is comprised of two or more components, each of which is of a profile that enables the components to be introduced into position in the enarthrosis capsule via a portal formed in the long bone, extending from the outside of the enarthrosis to the socket bone.
  • Such a socket prosthesis is preferably part of a prosthetic system for an enarthrosis that further comprises a ball prosthesis portion that is adapted for being received into the concavity of the socket prosthesis such as to permit relative rotational movement therebetween.
  • the ball prosthesis portion is also implantable into position via the same portal as is used for the socket prosthesis portion, for example as described in WO 01/49218, the contents of which are incorporated herein in their entirety.
  • the socket prosthesis assembly generally designated (100) comprises a plurality of socket prosthesis components, each of which is adapted to be accommodated in a portal (17) formed in the long bone (i.e., the femur or humerus) of the extremity or limb.
  • the prosthesis components comprise a central hub member (30), a plurality, typically six, of interlocking peripheral members (20), and a locking member (40).
  • each of these components can be manipulated such that at least at one orientation thereof when aligned with portal (17) presents a transverse section that is smaller than the cross-section of the portal (17), and thus allows the components, one at a time, to be inserted into the joint capsule via the portal (17).
  • the central hub member (30) comprises an outer proximal substantially convex face (31) centered on a longitudinal axis (90), and a plurality of U- shaped walls (32) depending from the convex face (31) and extending substantially parallel to the said axis in a direction opposed to the face (31).
  • the longitudinal axis (90) is defined, for all embodiments, as the axis of the femoral neck from the lateral cortex to the head of the femur when the femur is at a neutral rotational position with respect to the joint, i.e., when the femur is at the center of the loci of maximum rotational movement about the socket (or the equivalent definition with respect to the shoulder joint, mutatis mutandis).
  • Each wall (32) is connected to adjacent walls (32) on either side thereof, and comprises a slot (33) extending substantially parallel to the axis (90) and having an open end.
  • the number of walls (32) corresponds to the number of peripheral members (20), and in the illustrated embodiment there are thus six walls (32), which form a hexagon when viewed along the axis (90).
  • the hub member (30) preferably comprises an aperture (39) along the axis (90), providing communication between the convex face (31) and the distal side (35) of the hub member (30) longitudinally opposed to the convex face (31), adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly (100) thereto.
  • the interlocking peripheral members (20) are each formed as a pie-shaped sector of a dome, having a base (55) and an apex (56), a convex outer face (21), an inner face (22), and two angled sides (23).
  • the inner face (22) of each peripheral member (20) comprises a tab member (25) that is complementary to the slot (32), and thus adapted for enabling each corresponding peripheral member (20) to slidingly engage with the hub member (30) in a proximal direction parallel to the axis (90), such that the outer faces (21) and the outer face (31) form a substantially continuous convex surface (57), as illustrated in Figure 2(b).
  • This convex surface (57) is typically substantially complementary to the part of the socket bone where it is desired to implant the socket assembly (100).
  • the tab member (25) is adapted to engage with the slot (33) such as to prevent any substantial lateral movement between the hub member (30) and the peripheral members (20), particularly when they are assembled together to form the socket prosthesis assembly (100).
  • the angled sides (23) have substantially flat surfaces along planes which intersect the axis (90) at angle to each other such that facing sides (23) of adjacent peripheral members (20), when engaged with respect to the hub member (30), are in abutting contact.
  • the sides (23) preferably comprise projections (26) and/or complementary slots (27) such as to enable adjacent peripheral members to interlock, as illustrated in Figure 3, for example.
  • alternate peripheral members may comprise slots (27) on both sides (23) thereof, while the intercalated peripheral members (20) therebetween have complementary tabs or projections (26). Since the projections (26) are to be inserted into the slots (27) in a proximal direction only, it is clear that the peripheral members (20) need to be engaged with the hub member (30) in a particular order. In other words, for each pair of interlocking projection (26) and slot (27), the peripheral member (20) having the slot (27) needs to be engaged with the hub member (30) before the peripheral member (20) having the corresponding projection (26).
  • peripheral members (20) that comprise slots (27) on both sides (23) thereof are first engaged with the hub member (30), and afterwards the other intercalated peripheral members (20) which have complementary tabs or projections (26), are engaged with the hub member (30) as well as with the peripheral members (20) on either side thereof. While this configuration eases manufacture and supply of the peripheral members (20), since only two different types thereof are required, the assembly process within the joint capsule is more complex.
  • the peripheral members (20) comprise one peripheral member (20B) having slots (27) on both sides (23) thereof, one peripheral member (20C) having projections (26) on both sides (23) thereof, and four substantially identical peripheral members (20A), (20D), (20E) and (20F), each having a slot (27) on one of the sides (23) thereof, and a tab or projection (26) on the other side (23) thereof. While this configuration requires the manufacture of three different types of peripheral members (20), it nevertheless eases the assembly of these components with respect to the hub member, and reduces any possibility of two peripheral member (20) being engaged in adjacent arrangement onto the hub member (20), wherein facing sides both comprise slots (27) or projections (26).
  • first peripheral member (20B) is engaged in the hub member (30), followed in turn by the closest peripheral member (20) having a projection (26) and a slot (27), i.e. peripheral member (20A). Subsequently, the remaining peripheral members (20) having a projection (26) and a slot (27), are engaged in turn with the hub member (30) and the adjacent peripheral member (20) that is already engaged thereto. In other words, peripheral members (20F), (20E) and 20(D) are engaged with the hub member (30) in this order, leaving “open” the slots (27) of the first and fifth peripheral members (20B) and (20D), respectively. Finally, the sixth peripheral member (20C), comprising two projections (26), is engaged with respect to the hub member (30) and the flanking peripheral members (20B) and (20D).
  • each peripheral member (20) comprises a shoulder (28) substantially perpendicular to the axis (90), such that when the peripheral members (20) are properly engaged with the hub member (30), the shoulders (28) of the peripheral members (20) form a substantially continuous mating surface (50), which is typically annular.
  • At least one, and preferably every alternate peripheral member (20) comprises a suitable aperture (29) extending from the inner face (22) to the outer face (21), adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly (100) thereto.
  • a suitable aperture (29) extending from the inner face (22) to the outer face (21), adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly (100) thereto.
  • members (20D), (20E) and (20F) are substantially interchangeable while only member (20E) includes the aperture (29) allows the surgeon to replace member (20E) with either member (20D) or (20F), and in this manner change the distribution of the apertures in the cup.
  • all the peripheral members (20) comprise said apertures (29).
  • spikes may be provided on the convex outer face (21) of some or all of the peripheral members (20) may be provided for augmenting fixation of the socket prosthesis assembly to the bone. Similar spikes may also be provided to the other embodiments described herein, mutatis mutandis.
  • the locking member (40) comprises a substantially cylindrical body portion (41), which comprises an annular rim (42) projecting radially from one longitudinal end thereof and an external screwthread (45) formed on the outer surface of the other end thereof.
  • the locking member (40) is introduced into the concavity (52) formed by the inner faces (22), such as to engage the external screwthread (45) with a complementary internal screwthread (35) formed in an aperture (36) comprised in hub member (30) along the axis (90).
  • the inner facing part of rim (42) engages with the annular mating surface (50), thereby locking the prosthesis members together.
  • the external screwthread (45) may be engaged with the peripheral members (20) themselves, which thus comprise suitable threaded surfaces.
  • each peripheral member (20) comprises a bore (58) at the base thereof, adapted for reversibly engaging a suitable tool that may be used for introducing and guiding each peripheral member (20) into engagement with the hub member (30).
  • the bore (58) may have an internal screwthread, and the tool has a complementary external screwthread at its tip.
  • interlocking members (20) in this embodiment is six, in other versions of this embodiments there may be a larger or smaller number of peripheral members (20).
  • hub member (30) needs to be modified to accept the appropriate number of peripheral members, which still interlock to form a substantially continuous outer convex shell.
  • the actual or minimum number of peripheral members depends on the size of the socket prosthesis required, and of the maximum size of the portal that may be made in the long bone.
  • the socket prosthesis assembly (100) further comprises another socket prosthesis component in the form of an inner lining or ball-receiving member (60), comprising a concavity (62) on a distal side thereof, and a projection (64) extending outwards from the proximal side thereof.
  • the concavity (62) is substantially complementary to the curvature of the ball prosthesis portion that it is intended to be used with the socket assembly (100) and thus adapted for receiving the same and for allowing all the required rotational movements therebetween.
  • the projection (64) comprises an external screw thread (65) complementary to an internal screwthread (46) formed in an aperture (47) comprised in locking member (40) along the axis (90).
  • the ball-receiving member (60) also comprises an annular convex wall (61) that is complementary with and designed to abut against the inner walls (22) of the peripheral members (20).
  • the ball-receiving member (60) further comprises a planar annular wall (63), typically frustro-conical in form, that is designed to abut against the outer part of rim (42) of the locking member (40).
  • the proximal end (66) of the projection (64) comprises a rounded or conical apex (48) and a circumferential groove (43) between the apex (48) and the proximal end (66).
  • this groove (43) is such as to be aligned with a corresponding groove (38) provided on hub (30), as illustrated in Figure 4, when the ball-receiving member (60) is fully engaged with respect to the hub (30)
  • a suitable retaining ring, circlip or snap ring (not shown) is preferably provided in the annular space between grooves (43) and (38) to lock together the hub (30), locking member (40) and ball- receiving member (60), and substantially prevent unintentional separation of these components due to biomechanical loads.
  • the retaining ring is first inserted into the groove (38) by first compressing it in the normal manner. When released in the groove, the ring expands back into its neutral diameter and is captured in the groove (38).
  • the locking member (40) is screwed along the axis (90) and locks the peripheral members (20) with respect to the hub (30).
  • the apex (48) expands the retaining clip into the groove (38).
  • bores are advantageously comprised on the distal periphery of the ball-receiving member (60),adapted for reversibly engaging a suitable tool that may be used for introducing and guiding this component into engagement with the locking member (40).
  • the bore may have an internal screwthread, and the tool has a complementary external screwthread at its tip.
  • each one of the hub member (30), the plurality of peripheral members (20), the locking member (40) and the ball-receiving member (60) is of a transverse profile, i.e. size and shape, adapted for enabling the same to be individually introduced into the enarthrosis via a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the long bone.
  • a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis typically in the proximal part of the long bone.
  • the socket assembly (100) formed by these components is too large to be passed through the portal, but provides the advantages of a more anatomically compatible socket prosthesis.
  • peripheral members (20), the hub member (30) and the locking member (40) are preferably made from any suitable biocompatible and substantially robust material, preferably chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt- chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt- chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • the ball-receiving member (60) is preferably made from any suitable biocompatible and substantially robust material, preferably high molecular weight polyethylene (HMWPE), but may also be chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, or ceramics including zirconium oxide.
  • HMWPE high molecular weight polyethylene
  • the prosthesis components of the socket assembly (200) comprises a pair of wing members (120), (122), which are engaged with respect to a central member (124) to form a substantially continuous proximal convex surface (157), and a locking member (140).
  • This convex surface (157) is substantially complementary to the part of the socket bone where it is desired to implant the socket assembly (200).
  • the wing members (120), (122) each comprise an outer substantially convex outer face (121) a base (155) and an apex (156), an inner concave face (127).
  • the wing members (120), (122) each further comprise a substantially a first planar side (123) substantially parallel to the axis (90), and a second planar side (125), at an angle to the axis (90).
  • the wing members (120), (122) each comprise at their apexes (156) complementary parts of a hinge (130), and are thus hinged together via said hinge (130).
  • the hinge (130) enables the two wing members (120), (122) to collapse inwards to form a combined collapsed cross-section that is smaller than the corresponding cross-section of the pair when they are assembled in the socket prosthesis assembly (200).
  • This collapsed cross-section is of a transverse profile, i.e. size and shape, adapted for enabling the collapsed pair of wing members (120), (122) to be introduced into the enarthrosis in a linked manner via a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the long bone.
  • the wing members (120), (122) may each be individually introduced into the enarthrosis.
  • the hinge (130) further comprises an aperture (133), formed as co-alignable apertures (131), (132) at the apexes (156) of the wing members (120), (122), respectively.
  • the central member (124) comprises a pair of outer convex faces (157) in opposed arrangement with respect to axis (90), and an inner concave face (152).
  • the central member (124) further comprises a first pair of substantially planar sides (153), substantially parallel to the axis (90) and complementary to the planar sides (123) of the wing members (120), (122).
  • the central member (124) also comprises a second pair of outer planar sides (159), at an angle to the axis (90) and recessed with respect to the outer convex faces (157), complementary to the planar sides (125) of the wing members (120), (122).
  • the central member (124) also comprises a central aperture (133) aligned with axis (90).
  • the central member (124) comprises a transverse profile, i.e. size and shape, adapted for enabling same to be individually introduced into the enarthrosis via a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the
  • At least the central member (124) preferably comprises at least one and preferably two apertures (139) providing communication between the convex face (157) and the concavity (152), the apertures (139) being adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly (200) thereto
  • assembly of the socket prosthesis (200) is by first inserting the hinged wing members (120), (122) in collapsed configuration, into the bone capsule via portal (17), and thereafter the wing members (120), (122) are opened out to their opened configuration. Then, the central member (124) is similarly inserted, and engaged with respect to the wing members (120), (122), via slinging contact between the planar surfaces (123) and (153), until the second planar sides (159) of the central member (124) abut against the complementary planar sides (125) of the wing members (120), (122). At this point, a substantially continuous outer convex surface (157) is formed by the convex faces (121) and (157), and a substantially continuous concavity (152) is formed by the concave members (127) and (152).
  • the socket assembly (200) also comprises a locking member (140), having a substantially cylindrical body portion (141), which comprises an annular rim (142) projecting radially from one longitudinal end thereof and an external screwthread (145) formed on the outer surface of the other end thereof.
  • the locking member (140) is introduced into the concavity (152), such as to engage the external screwthread (145) with a complementary internal screwthread (135) formed in said apertures (131), (132), (133) which are aligned along the axis (90), thereby locking the prosthesis members together.
  • the wing members (120), (122) and the central member (124) each comprise a bore (not shown), adapted for reversibly engaging a suitable tool that may be used for introducing and guiding each prosthesis component into place.
  • a suitable tool typically such a bore may have an internal screwthread, and the tool has a complementary external screwthread at its tip.
  • the socket prosthesis components may be engaged by the tool, and once in place, the tip of the tool is unscrewed therefrom and removed.
  • the socket prosthesis assembly (200) further comprises another socket prosthesis component in the form of a ball-receiving member (160), comprising a concavity (162) on one side thereof, and a projection (164) extending outwards from the other side thereof.
  • the concavity (162) is substantially complementary to the curvature of the ball prosthesis portion that it is intended to be used with the socket assembly (200) and thus adapted for receiving the same and for allowing all the required rotational movements therebetween.
  • the projection (164) comprises an external screw thread (165) complementary to an internal screwthread (146) formed in an aperture (147) comprised in locking member (140) along the axis (90).
  • the ball-receiving member (160) also comprises a convex face (61) that is complementary with and designed to abut against the inner face (22) of the peripheral members (20).
  • the ball-receiving member (60) further comprises a planar annular wall (63) that is designed to abut against the concavity (152).
  • each one of the central member (124), the pair of wing members (120), (122) (in their hinged and collapsed configuration), the locking member (140) and the ball-receiving member (160) is of a transverse profile, i.e. size and shape, adapted for enabling the same to be individually introduced into the enarthrosis via a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the long bone.
  • the socket assembly (200) formed by these components is too large to be passed through the portal, but provides the advantages of a more anatomically compatible socket prosthesis.
  • the wing members (120), (122), the central member (124) and the locking member (140) are preferably made from any suitable biocompatible and substantially robust material, preferably chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • the ball-receiving member (160) is preferably made from any suitable biocompatible and substantially robust material, preferably high molecular weight polyethylene (HMWPE), but may also be chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, or ceramics including zirconium oxide.
  • HMWPE high molecular weight polyethylene
  • the prosthesis components of the socket assembly (400) comprise three interlocking peripheral members (420), (422) and (424), each typically in the form of third a dome, which are interconnected to form a continuous convex surface (457).
  • This convex surface (457) is substantially complementary to the part of the socket bone where it is desired to implant the socket assembly (400).
  • the peripheral members (420), (422), (424) are each formed as a pie-shaped sector of a dome, having a base (455) and an apex (456), a convex outer face (421), a concave inner face (426), and two angled sides (423) which are planar and substantially parallel to axis (90).
  • the peripheral members (420), (422), (424) each comprise at their corresponding apexes (456) a lateral projection (427A), (427B), (427C), respectively, that is in the form of a ring.
  • the projection (427A) is formed at the longitudinal end of the first peripheral member (420) having apex (456), while the projection (427B) is displaced in a distal direction from the longitudinal end of the second peripheral member (422) by the thickness of projection (427A), and the projection (427C) of the third peripheral member (424) is similarly displaced from the longitudinal end by the combined thicknesses of the projection (427A) and (427B).
  • the first peripheral member (420) also comprises a pair of lateral tabs (446) on either sides thereof near the apex (456).
  • the second peripheral member (422) comprises a recessed tab (447) at one lateral side thereof, and a lateral tab (446) at the other lateral side thereof, both near the apex (456).
  • the third peripheral member (424) also comprises a pair of recessed lateral tabs (447) on either sides thereof near the apex (456). In each case, each lateral tab (446) is adapted to engage longitudinally with a said recessed tab (447) brought into alignment therewith.
  • At least one of the peripheral members (420), (422), (424), and preferably all three, comprise at least one aperture (439) providing communication between the convex face (457) and the concavity (452), the apertures (439) being adapted for inserting a pin or screw therethrough and into the socket bone to secure the prosthesis assembly (400) thereto.
  • the socket assembly (400) also comprises a locking member (not shown), substantially as described for the second embodiment, mutatis mutandis.
  • This locking member has an external thread which engages with an internal thread comprised in apertures (427A), (427B) and (427C), and thus locks together the peripheral members (420), (422) and (424).
  • the socket prosthesis assembly (400) further comprises another socket prosthesis component in the form of an inner lining or ball-receiving member (460), comprising a concavity (462) on a distal side thereof, and a projection (464) extending outwards from the proximal side thereof.
  • the concavity (462) is substantially complementary to the curvature of the ball prosthesis portion that it is intended to be used with the socket assembly (400) and thus adapted for receiving the same and for allowing all the required rotational movements therebetween.
  • the projection (464) comprises an external screw thread (465) complementary to an internal screwthread formed in an aperture comprised in locking member along the axis (90).
  • the ball-receiving member (460) also comprises a convex wall (461) that is complementary with and designed to abut against the inner faces (426) of the peripheral members (420), (422), and (424). Thus, after the locking member has been screwed into the peripheral members (420), (422), (424) the ball-receiving member (460) is screwed into the locking member (40).
  • assembly of the socket prosthesis (400) is by first inserting the first peripheral member (420) into the bone capsule via portal (17), and thereafter the second peripheral member (422) is similarly inserted, and laterally engaged with respect to the first peripheral member (420) via sliding contact between adjacent sides (423) thereof, such that the projection (427B) of the second peripheral member (420) is aligned with and is seated on the projection (427A) of the first peripheral member (420).
  • the recessed tab (447) of the second peripheral member (422) is received by and engaged with one of the tabs (446) of the first peripheral member (420).
  • the third peripheral member (424) is similarly inserted, and laterally engaged with respect to the first peripheral member (420) and second peripheral member (422) via sliding contact between adjacent sides (423) thereof, such that the projection (427C) of the third peripheral member (420) is aligned with and is seated on the projection (427B) of the second peripheral member (424).
  • the recessed tabs (447) on either side of the third peripheral member (424) are received by and engaged with the corresponding free tabs (446) of the first peripheral member (420) and the second peripheral member (422).
  • a substantially continuous outer convex surface (457) is formed by the convex faces (421), and a substantially continuous concavity (452) is formed by the concave faces (426).
  • Each one of the peripheral members (420), (422), (424) and the ball-receiving member (460) comprises a transverse profile, i.e. size and shape, adapted for enabling same to be individually introduced into the enarthrosis via a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis, typically in the proximal part of the long bone.
  • a suitable portal (17) formed through the lateral cortex of the long bone of the enarthrosis typically in the proximal part of the long bone.
  • the socket assembly (400) formed by these components is too large to be passed through the portal, but provides the advantages of a more anatomically compatible socket prosthesis.
  • the peripheral members (420), (422), (424) are preferably made from any suitable biocompatible and substantially robust material, preferably chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, ceramics including zirconium oxide, or high molecular weight polyethylene (HMWPE).
  • the ball-receiving member (460) is preferably made from any suitable biocompatible and substantially robust material, preferably high molecular weight polyethylene (HMWPE), but may also be chosen from among metals such as stainless steel, titanium, titanium alloys, supermetallic alloys including for example cobalt-chromium-molybdenum, or ceramics including zirconium oxide.
  • HMWPE high molecular weight polyethylene
  • the central axis (90) of the socket prosthesis assembly of each embodiment is substantially aligned with the axis (99) of the portal (17), which is typically coaligned with the axis of the neck section (14) of the femur (10).
  • the portal (17) is typically or circular cross-section, formed in a manner known in the art.
  • the portal (17) may be substantially rectangular or any other shape in transverse cross-section, and each of the socket prosthesis components in each embodiment of the present invention a suitable cross- sectional profile such as to enable passage through the portal (17), wherein the transverse widths of the prosthesis components are each typically slightly smaller than the minimum width of the portal (17), for example.
  • the surgical procedure for implanting the said socket prosthesis assembly in the hip joint of a patient comprises the following steps: -
  • an approximately 3 cm. skin incision is made in the lateral thigh centered with respect to the greater trochanter of the femur. Then, a similar incision is made in the fascia lata, and the Vastus Lateralis Muscle is split longitudinally along its fibers and depthwise until reaching the greater trochanter, the slit being of a similar length as the fascia lata incision.
  • These incisions and split are retracted with a special automatic or alternatively with a manual retractor, and such retractors are well-known in the art.
  • a guide pin (95) is then inserted into the bone, centralised within the femoral neck and head (in both anteriorposterior (AP) and axial views), the insertion being typically carried out under fluoroscopy.
  • a portal (17) is then formed extending from the side of the femur and through the neck portion (14) thereof. This may be achieved, for example, by removing a cyhndrical section of bone from the femoral neck and head, centered over the guide, with a canullated cylindrical cutter.
  • the portal (17) may be formed by drilling into the femur with any suitable drill, in particular such a drill adapted for being centralised on, and guided by, the guide pin.
  • the femur head (12) is then removed.
  • This may be performed in any number of ways.
  • a transverse cervical osteotomy of the femur is first made with any suitable device including a small diameter oscillating saw, for example, and the remains of the femoral head removed with a specially designed instrument or currently used bone reamers or burrs.
  • the remains of the femoral head may be cut into transverse slices using specially adapted bladed tools or laser cutters or the like, and the sections removed via the portal with the aid of forceps, for example.
  • the head of the femur may be removed using a special tool such as described in US 4,714,478, for example, the contents of which are incorporated herein by reference thereto.
  • the acetabulum may be prepared typically by reaming with any suitable reamer such as a Charnley Acetabulum Reamer, for example, and optionally drilling several small holes in its articular surface for providing anchor points for the bone cement.
  • any suitable reamer such as a Charnley Acetabulum Reamer, for example, and optionally drilling several small holes in its articular surface for providing anchor points for the bone cement.
  • the various prosthesis components are individually inserted into the joint capsule via the portal (17) in a particular order, and assembled therein.
  • one particular prosthesis component is inserted first via the guide pin (95) and fixed onto the socket bone, and subsequently, other socket prosthesis components are engaged with the first prosthesis component, optionally at least some of these later prosthesis components are also secured to the bone, and then the assembly is locked together.
  • the socket prosthesis assembly may be first assembled in the joint capsule, and then secured to the socket bone in a suitable manner.
  • the socket assembly according to the present invention is assembled and installed in the socket bone as follows:-
  • the hub member (30) is threaded onto the guide pin (95) via aperture (39) and guided to the socket bone by means of a tool such that the convex face (31) is in a proximal facing position.
  • the guide pin (95) preferably comprises an external threaded portion at the proximal end thereof that engages with a threaded aperture(39') that is at the proximal end of the hub member (30), as illustrated in Figure 4.
  • the hub member (30) is temporarily secured to the bone by means of a small spike (not shown) at the proximal tip of the guide pin (95).
  • peripheral members (20) are individually introduced into the joint capsule and engaged with the hub member (30) in a proximal direction, such that each subsequent peripheral member (20) has its one or two projections (26) engaged in the slot or slots (27) of adjacent peripheral member(s) (20), as described hereinbefore.
  • a special tool reversibly engaged with respect to the individual peripheral members (20) via bore (58) facilitates insertion and manipulation of the peripheral members.
  • the locking member (40) is inserted into the joint capsule and screwed into the assembly of peripheral members (20) and hub member (30), and this assembly is further secured to the bone by means of suitable pins or screws via the apertures (29) comprised in at least some of the peripheral members (20).
  • the guide pin (95) is removed, and the ball-receiving member (60) is inserted into the joint capsule, and screwed into the locking member (40) as hereinbefore described to form the socket assembly (100) according to the first embodiment of the invention.
  • the wing members (120) and (122) are connected together via the hinge (130), and their bases (155) brought into proximity by means of the rotation of the wing members at the hinge (130), so as to minimize the cross-sectional profile.
  • the hinged wing members are then threaded onto the guide pin (95) via apertures (131) and (132), and inserted into the joint capsule via the portal (17), after which the wings are rotated back to their uncoUapsed positions.
  • the central member (124) is then threaded onto the guide wire (95) with the convex faces (157) facing a proximal direction, and inserted into the joint capsule via the portal (17) such as to engage with the wing members (120), (122) as described hereinbefore, after which, these assembled components are secured to the socket bone by means of pins or screws via apertures (139).
  • the locking member (140) is inserted into the joint capsule and screwed into the assembly of wing members (120), (122) and central member (124), Thereafter, the ball-receiving member (160) is inserted into the joint capsule, and screwed into the locking member (140) as hereinbefore described to form the socket assembly (200) according to the second embodiment of the invention.
  • the most proximal peripheral member (420) is threaded onto the guide pin (95) via projection (427A) and introduced into the joint capsule via the portal (17) such that the convex face (457) is in the proximal direction.
  • the second peripheral member (422) is threaded onto the guide pin (95) via projection (427B) and introduced into the joint capsule via the portal (17) and engaged with the first peripheral member (420).
  • the third peripheral member (424) is threaded onto the guide pin (95) via projection (427C) and introduced into the joint capsule via the portal (17), and engaged with the first and second peripheral members (420), (422), as described hereinbefore.
  • step (b) is followed by step (f) below.
  • the ball prosthesis may comprise a telescopic strut at its distal end.
  • the required infrastructure in the femur is a shaft prepared in the medullary canal. This may be accomplished with a minimally invasive procedure making use of the portal already formed in step (a) of the procedure.
  • a shaft (72) is made through the medullary canal in the normal way, beginning from the upper part of the femur.
  • the securement means for the ball prosthesis comprises a side plate and compression screw
  • the said infrastructure is a plurality of transverse apertures in the femur for inserting and locking therein a plurality of screws.
  • this step is preferably performed after the ball prosthesis is implanted in the joint.
  • the ball prosthesis may then be inserted into the joint via the portal (17), until the ball member of the prosthesis is engaged in the concave or cup-like cavity provided by the ball-receiving member of the socket prosthesis assembly. This may be done manually by pushing with fingers or alternatively with a special tool.
  • the ball prosthesis is fixed in place within the portal (17) by cementing at least a portion thereof within the said portal (17). The cement is typically applied with the use of a suitable cement gun or applicator.
  • the ball prosthesis comprises a telescopic strut or any other suitable strut at its distal end, such that when the latter is fully inserted through the portal (17) and into engaging contact with the socket prosthesis assembly, the telescopic strut is properly aligned with the shaft (72) made in the medullary canal.
  • the telescopic strut is then opened and locked according to its particular opening mechanism, thereby extending into the shaft (72) and providing a suitable anchor for the ball prosthesis.
  • the telescopic strut may be inserted first into the medullary canal such that it clears the portal (17).
  • the ball prosthesis is inserted into the portal (17) into engaging contact with the socket prosthesis assembly.
  • An angled joining member (not shown) is joined (permanently, removably or integrally) to the distal end of the ball prosthesis such that when the latter is fully inserted through the portal (17) and into engaging contact with the socket prosthesis assembly, the angled joining member is also properly aligned with the top of the strut that is already accommodated in the shaft (72) made in the medullary canal.
  • the angled joining member is then attached to the strut
  • the ball prosthesis is inserted into the portal (17) into engaging contact with the socket prosthesis assembly.
  • the angled aperture is positioned at the distal end of the ball prosthesis such that when the latter is fully inserted through the portal (17) and into engaging contact with the socket prosthesis assembly, the angled aperture is properly aligned with the shaft (72) made in the medullary canal.
  • the intramedullary nail is then inserted into the medullary canal and through angled aperture of the ball prosthesis and secured with respect thereto by suitable means, thereby providing a suitable anchor for the ball prosthesis.
  • the ball prosthesis is inserted into the portal (17) into engaging contact with the socket prosthesis assembly.
  • the compression screw is then screwed into the complementary shaft, bringing the plate into abutting contact with the outer part of the femur.
  • suitable holes are drilled into the femur, and side screws are screwed through the plate and into the femur in the normal way to provide a suitable anchor for the ball prosthesis
  • step (This step will typically depend on the specific securing means used with the ball prosthesis, and in general with the infrastructure prepared in step (c) above and the securement procedure in step (e) above.)
  • the ball prosthesis comprises a telescopic strut
  • part of the bone cylinder previously removed when forming the portal (17) is replaced, so as to fill the distal part of the portal (17).
  • the portal (17) was formed by drilhng and no such bone cylinder is available, the distal part of the canal (17) is plugged by using bone graft from the removed femoral head.
  • similar methods may be used to plug the distal end of the portal (17).
  • the surgical procedure for implanting the socket prosthesis assembly adapted for the shoulder joint of a patient is similar to the procedure for the hip joint as hereinbefore described, mutatis mutandis.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention porte sur une prothèse à emboîture et son procédé de mise en place. Ladite prothèse est assemblée à partir de deux ou plusieurs composants montés ensemble dans une capsule commune. Chacun des composants présente une forme géométrique lui permettant de l'installer dans l'articulation via un portail latéral ménagé dans l'os long de l'articulation. On peut donc ainsi faire passer une prothèse relativement large dans une ouverture relativement étroite, ce qui limite le traumatisme du patient.
PCT/IL2003/000187 2002-03-10 2003-03-06 Prothese a emboiture amelioree WO2003075801A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003214597A AU2003214597A1 (en) 2002-03-10 2003-03-06 Improved socket prosthesis

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL14859602A IL148596A0 (en) 2002-03-10 2002-03-10 Improved socket prosthesis
IL148596 2002-03-10

Publications (1)

Publication Number Publication Date
WO2003075801A1 true WO2003075801A1 (fr) 2003-09-18

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AU (1) AU2003214597A1 (fr)
IL (1) IL148596A0 (fr)
WO (1) WO2003075801A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201600080874A1 (it) * 2016-08-01 2018-02-01 Alfonso Sciarrabone Impianto protesico artroscopico di spalla
WO2020207938A1 (fr) * 2019-04-08 2020-10-15 Eo-Sol Gmbh Prothèse pour fractures du cotyle
US11202674B2 (en) 2018-04-03 2021-12-21 Convergent Dental, Inc. Laser system for surgical applications

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4325701A1 (de) * 1993-07-30 1995-02-02 Chiropro Gmbh Zementlos implantierbare Hüftgelenkpfanne
US5549692A (en) * 1992-01-16 1996-08-27 Sulzer Medizinaltechnik Ag Two-part hipjoint socket for anchoring in the pelvic bone
WO2002067811A2 (fr) * 2001-01-16 2002-09-06 Hyde Edward R Jr Protheses et instruments permettant le remplacement et la reparation d'articulations
WO2003047469A1 (fr) * 2001-12-06 2003-06-12 Societe Chirurgicale D'aide A La Recherche Et Aux Realisations Cotyle pour rotule de prothese de hanche ou analogue

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5549692A (en) * 1992-01-16 1996-08-27 Sulzer Medizinaltechnik Ag Two-part hipjoint socket for anchoring in the pelvic bone
DE4325701A1 (de) * 1993-07-30 1995-02-02 Chiropro Gmbh Zementlos implantierbare Hüftgelenkpfanne
WO2002067811A2 (fr) * 2001-01-16 2002-09-06 Hyde Edward R Jr Protheses et instruments permettant le remplacement et la reparation d'articulations
WO2003047469A1 (fr) * 2001-12-06 2003-06-12 Societe Chirurgicale D'aide A La Recherche Et Aux Realisations Cotyle pour rotule de prothese de hanche ou analogue

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201600080874A1 (it) * 2016-08-01 2018-02-01 Alfonso Sciarrabone Impianto protesico artroscopico di spalla
US11202674B2 (en) 2018-04-03 2021-12-21 Convergent Dental, Inc. Laser system for surgical applications
WO2020207938A1 (fr) * 2019-04-08 2020-10-15 Eo-Sol Gmbh Prothèse pour fractures du cotyle

Also Published As

Publication number Publication date
AU2003214597A1 (en) 2003-09-22
IL148596A0 (en) 2002-09-12

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