WO2019193373A1 - Système d'arthroplastie de l'épaule à surface en céramique - Google Patents

Système d'arthroplastie de l'épaule à surface en céramique Download PDF

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Publication number
WO2019193373A1
WO2019193373A1 PCT/GR2019/000028 GR2019000028W WO2019193373A1 WO 2019193373 A1 WO2019193373 A1 WO 2019193373A1 GR 2019000028 W GR2019000028 W GR 2019000028W WO 2019193373 A1 WO2019193373 A1 WO 2019193373A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
ceramic surface
hemispherical
arthroplasty system
shoulder arthroplasty
Prior art date
Application number
PCT/GR2019/000028
Other languages
English (en)
Inventor
Ioannis Vlachos
Original Assignee
Ioannis Vlachos
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 Ioannis Vlachos filed Critical Ioannis Vlachos
Publication of WO2019193373A1 publication Critical patent/WO2019193373A1/fr

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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
    • A61F2/40—Joints for shoulders
    • A61F2/4003—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft
    • 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
    • A61F2/30749—Fixation appliances for connecting prostheses to the body
    • 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
    • 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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30797—Blind bores, e.g. of circular cross-section internally-threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—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
    • A61F2002/30879—Ribs
    • 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
    • A61F2/4003—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft
    • A61F2002/4007—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft implanted without ablation of the whole natural humeral head
    • 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
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A61F2002/4018—Heads or epiphyseal parts of humerus
    • A61F2002/4022—Heads or epiphyseal parts of humerus having a concave shape, e.g. hemispherical 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00598—Coating or prosthesis-covering structure made of compounds based on metal oxides or hydroxides
    • A61F2310/00634—Coating made of zirconium oxide or hydroxides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00928—Coating or prosthesis-covering structure made of glass or of glass-containing compounds, e.g. of bioglass
    • A61F2310/0094—Coating made of porcelain

Definitions

  • the invention relates to the field of surgical instruments, devices or methods, and more particularly to artificial substitutes or replacements for parts of the body, and more particularly to implants for the replacement of only the humeral head surface and the glenoid cavity, without cutting off the entire humeral head.
  • the ceramic surface shoulder arthroplasty system disclosed in the present invention has not been disclosed in the prior art.
  • the humeral head is articulated with the scapula’s glenoid cavity for shoulder movements.
  • Numerous conditions, such as osteoarthritis, can lead to disruption of joint function due to lesion of the articular cartilage and consequent pain, distortion and loss of functionality thereof.
  • Total shoulder arthroplasty includes total replacement of both the humeral head and the glenoid cavity, usually with metal alloy and polyethylene implants. This orthopaedic surgery is performed to reduce the intense pain that comes from the friction of the degenerated cartilage, in order to restore functionality and improve the quality of life.
  • a further advantage of the present invention is to provide a ceramic surface shoulder arthroplasty system where both the implant placed inside the glenoid cavity and the implant placed on the humeral head respectively carry porcelain or zirconium oxide coatings on the portions that come into contact between them. As a result of the friction of the above, only calcium, zirconium and kaolin microparticles are produced that are compatible with the human body.
  • a further object of the invention in order to make functional the ceramic surface arthroplasty system is to present an implant for the humeral head carrying a navel at the pole, within which a threaded metal needle is screwed which passes through the humeral head and emerging out of the greater tuberocity, by tightening a nut, applies pretension for initial stabilization.
  • Another advantage of the invention is to present a ceramic surface arthroplasty system which does not require the use of acrylic polymer to attach the humeral head to the corresponding implant, since it carries meridian thin protruding ribs for greater postoperative rotation stability.
  • Figure 1 shows a perspective illustration of the convex, hemispherical metal implant, where the protruding ribs, the navel and a portion of the metal needle, used in the case of conventional arthroplasty, are shown.
  • Figure 2 shows a schematic illustration of the reverse implant of humeral head.
  • Figure 3 shows a side view of the implant of humeral head, the navel and the pretensioning needle attached thereto.
  • Figure 4 shows in 3D the reverse implant of humeral head with the shallow surface coated with porcelain or zirconium oxide for the implant application as illustrated in Figure 5.
  • the convex, hemispherical, metallic implant (1) of the proposed system consists of a metal shell which is externally covered with a porcelain or zirconium oxide layer and is a part of a thin metallic spherical shell of exactly 180 ° , forming substantially internally a hemisphere.
  • This has the beneficial effect that the circumference of the implant (1) socket is as wide as possible and limited carving is sufficient for its placement on the humeral head, without significant bone removal.
  • the inner side (10) of the spherical shell is all covered with a porous metal layer for osteointegration with the underlying bone.
  • the system consists of two metallic implants, the "female" implant, Fig. 4, being placed on the humeral bone, and the "male” one, Fig. 5, being placed in the glenoid cavity.
  • the reverse humeral implant (4) is made of metal, such as titanium, cobalt, tantalum and chromium, or respective alloys thereof, as their biocompatibility allows for medical use.
  • the implant has a concave shallow surface (5) in which a convex and hemispherical 180° glenoid cavity metallic implant (6), Fig. 5 is fitted, fitting into the glenoid cavity in the presently known ways.
  • the reverse humeral implant (4) has at its base (7) thin projecting ribs (2), Fig. 2, and a threaded navel (8) for screwing a pretensioning needle (3) which at a part or all of its length has a thread corresponding to that of the navel (8).
  • One end of the needle (3) is sharp. In this way, it pierces the neck of the humerus and emerging from the greater tuberocity, is tightened by a combination of nut-washer (9), in the desired direction and with the desired pretensioning chosen by the surgeon.
  • the underside (10) of the base (7) of the convex implant (4) is all covered with a porous metal layer which, over the time, leads to permanent osteointegration to the underlying bone.
  • Each implant's thickness is never less than 1,5 mm and more usually ranges between 2 and 2,5 mm, depending on the anatomy of the individual patient.
  • the application of the ceramic surface shoulder arthroplasty system in the surgical technique requires the head and neck to be pierced by using a needle (3) in the cervicobrachial direction to the greater tuberocity and according to the desired axis, as it results from the preoperative design.
  • the needle (3) is centrally sufficiently projecting from the humeral head while peripherally emerging from the tuberocity.
  • the pretensioning needle (3) remains in place and is used as a guide for the slightly hemispherical carving of the humeral head and the creation of a socket for the short navel (8), according to the size of the proposed convex, hemispherical, metallic implant (4). Then the implant (4) is screwed onto the needle (3) and it is pulled from the side of the greater tuberocity.
  • the nut/washer combination (9) is placed on the circumferentially protruding part of the needle (3) and up to the cortex of the greater tuberocity.
  • the needle (3) portion that is left after the nut (9) is tightened in the area of the greater tuberocity is cut off.
  • the clamping of the nut (9) results in the precipitation of the implant (4) on the humeral head, the penetration of the ribs (2) of the implant (4) onto the surface of the head and finally the creation of the desired pretensioning along the needle (3).
  • the humeral head is reset so that the porcelain or zirconium oxide layer of the convex implant (4) comes into contact with the concave surface of the concave implant (1), which is internally covered on its concave surface by porcelain or zirconium oxide layer, Fig. 5.

Abstract

L'invention concerne un système d'arthroplastie de l'épaule à surface en céramique, qui est constitué d'un implant huméral métallique inverse (4) et d'un implant de cavité glénoïde métallique hémisphérique convexe (6). Les implants sont revêtus de porcelaine ou d'oxyde de zirconium sur les surfaces de frottement entre eux pour éviter la production de microparticules métalliques. L'implant convexe (4) possède une partie centrale filetée (8) sur laquelle est enfilée une aiguille de précontrainte (3) qui coupe l'os et est serrée par une rondelle (9) dans la zone de la plus grande tubérosité. Il possède en outre des nervures saillantes (2) pénétrant dans la surface de la tête.
PCT/GR2019/000028 2018-04-04 2019-04-02 Système d'arthroplastie de l'épaule à surface en céramique WO2019193373A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GR20190100146 2018-04-04
GR20190100146 2018-04-04

Publications (1)

Publication Number Publication Date
WO2019193373A1 true WO2019193373A1 (fr) 2019-10-10

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ID=66589578

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GR2019/000028 WO2019193373A1 (fr) 2018-04-04 2019-04-02 Système d'arthroplastie de l'épaule à surface en céramique

Country Status (1)

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WO (1) WO2019193373A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011048486A1 (fr) * 2009-10-23 2011-04-28 Wilko Fockens Prothèse d'épaule avec pièce rapportée pour vis de verrouillage
EP2586387A1 (fr) * 2011-10-31 2013-05-01 Tornier Orthopedics Ireland Ltd. Aléseur d'os
US20150297354A1 (en) * 2007-01-30 2015-10-22 Tornier Sas Intra-articular joint replacement

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150297354A1 (en) * 2007-01-30 2015-10-22 Tornier Sas Intra-articular joint replacement
WO2011048486A1 (fr) * 2009-10-23 2011-04-28 Wilko Fockens Prothèse d'épaule avec pièce rapportée pour vis de verrouillage
EP2586387A1 (fr) * 2011-10-31 2013-05-01 Tornier Orthopedics Ireland Ltd. Aléseur d'os

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