WO2022153992A1 - Tige fémorale et système de prothèse de hanche - Google Patents

Tige fémorale et système de prothèse de hanche Download PDF

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Publication number
WO2022153992A1
WO2022153992A1 PCT/JP2022/000649 JP2022000649W WO2022153992A1 WO 2022153992 A1 WO2022153992 A1 WO 2022153992A1 JP 2022000649 W JP2022000649 W JP 2022000649W WO 2022153992 A1 WO2022153992 A1 WO 2022153992A1
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WO
WIPO (PCT)
Prior art keywords
stem
inserter
tip
spherical
femur
Prior art date
Application number
PCT/JP2022/000649
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English (en)
Japanese (ja)
Inventor
友亮 中村
正典 佐藤
Original Assignee
ニプロ株式会社
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 ニプロ株式会社 filed Critical ニプロ株式会社
Priority to JP2022575593A priority Critical patent/JPWO2022153992A1/ja
Publication of WO2022153992A1 publication Critical patent/WO2022153992A1/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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses

Definitions

  • the present invention relates to a femoral stem of an artificial hip joint and an artificial hip joint system including a femoral stem and a stem inserter that inserts the femoral stem into the femur.
  • total hip arthroplasty has been performed to replace the hip joint with an artificial one in order to restore the function of the hip joint whose function has deteriorated due to a disease or an accident.
  • Document 1 discloses a configuration in which the inclination of the stem inserter in the medial-lateral direction at the time of insertion can be adjusted.
  • the femoral stem and the artificial hip joint system disclosed in Patent Document 1 have an inner wall portion and a posterior wall portion of a recess formed in the shoulder portion of the femoral stem in order to make the rotation angle of the stem inserter adjustable. All of them have a flat region, and there is a problem that the contact area between the femoral stem and the stem inserter becomes small.
  • an object of the present invention is to provide a femoral stem and an artificial hip joint system capable of increasing the contact area between the femoral stem and the stem inserter while making it possible to adjust the rotation angle of the stem inserter. ..
  • the first aspect of the present invention is a femoral stem of an artificial hip joint.
  • the body that is inserted into the medullary cavity of the femur, Has a neck part to which the stem head is attached,
  • a recess is formed in the shoulder portion of the main body portion to accommodate the tip portion of the stem inserter.
  • the recess has a spherical portion that comes into contact with the tip end portion of the stem inserter, and a key groove that extends inward from the spherical portion and regulates the rotation of the stem inserter.
  • the contact area between the femoral stem and the stem inserter is increased by providing a spherical portion that contacts the tip of the stem inserter while allowing the rotation angle of the femoral stem to be adjusted by the keyway.
  • the durability of the stem inserter and the insertability of the femoral stem can be improved.
  • the first aspect further preferably has the following configuration.
  • the spherical surface portion comes into contact with the tip end portion of the stem inserter on an arc surface.
  • the key groove extends inward from the inner tip of the spherical surface portion.
  • the length in the inner-outer direction of the key groove is shorter than the diameter of the spherical surface portion.
  • the width of the key groove is shorter than the diameter of the spherical surface portion.
  • the contact area between the spherical surface portion and the tip portion can be easily increased by bringing the spherical surface portion and the tip portion of the stem inserter into contact with each other on an arc surface.
  • the recess is located on the outside of the shoulder and the recess is arranged on the central axis of the femoral stem. Can be done.
  • the holding property of the stem inserter by the spherical surface portion can be improved.
  • the rotation of the stem inserter by the keyway can be easily regulated.
  • a second aspect of the present invention is an artificial hip joint system.
  • the femoral stem of the first aspect and A stem inserter for inserting the femoral stem into the medullary cavity of the femur is provided.
  • the stem inserter includes a spherical tip portion that contacts the spherical surface portion and a key portion that engages with the key groove.
  • an artificial hip joint system capable of improving the durability of the stem inserter and the insertability of the femoral stem while making the rotation angle of the femoral stem adjustable.
  • the second aspect is further preferably provided with the following configuration.
  • the key portion is formed so as to project outward from the tip portion.
  • the tip of the key portion has an arc shape when viewed from the side.
  • the key portion of the stem inserter can be easily engaged with the key groove of the concave portion of the femoral stem.
  • the inclination of the stem inserter in the medial-lateral direction can be easily adjusted.
  • the contact area between the spherical surface portion and the tip portion can be easily increased by bringing the spherical surface portion and the tip portion of the stem inserter into contact with each other on an arc surface.
  • a femoral stem and an artificial hip joint system capable of increasing the contact area between the femoral stem and the stem inserter while making the rotation angle of the stem inserter adjustable.
  • FIG. 1 is a schematic view of FIG. 1 as viewed from the direction III. It is a partially enlarged view of FIG. It is a perspective view of a shoulder part. It is a top view of the shoulder part. It is a side view of a shoulder part. It is a partial perspective view of a stem inserter. It is a partial side view of the stem inserter. It is an X arrow view of the stem inserter of FIG. It is a perspective view which shows that the stem inserter is engaged with a femoral stem. It is a perspective view which shows adjusting the inclination in the medial-lateral direction of a stem inserter after engaging a stem inserter with a femoral stem.
  • FIG. 1 is a schematic view of the artificial hip joint system 10 according to the embodiment of the present invention as viewed from the front side
  • FIG. 2 is a partially enlarged view of FIG.
  • FIG. 3 is a schematic view of FIG. 1 as viewed from the direction III (outside)
  • FIG. 4 is a partially enlarged view of FIG.
  • FIGS. 1 to 4 show a diagram in which the artificial hip joint system 10 is applied to the left foot, the artificial hip joint system 10 of the present invention can also be applied to the right foot.
  • the position closer to the head of the human body than the comparison target is referred to as the proximal side, and the comparison target is compared with the human body.
  • the side far from the head is called the distal side.
  • the position closer to the center line of the human body than the comparison target is called the inside, and the position is located farther from the center line of the human body compared to the comparison target. What you are doing is called the outside.
  • the direction in which the face of the human body is facing is referred to as the front
  • the direction in which the back of the human body is facing is referred to as the rear.
  • the artificial hip joint system 10 includes a femur stem 1 and a stem inserter 2 that inserts the femur stem 1 into the medullary cavity 101 of the femur 100.
  • the femur stem 1 has a main body portion 11 inserted into the medullary space 101 of the femur 100, and a neck portion 12 attached to the acetabulum via a stem head and an acetabular component.
  • the femoral stem 1 has a curved substantially rod-like shape, and the length of the femoral stem 1 from the shoulder to the distal end on the stem central axis is, for example, 90 to 200 mm.
  • Titanium alloy, pure titanium, cobalt-chromium alloy, stainless steel, etc. are used as the base material of the femoral stem 1, and pure titanium, titanium alloy, hydroxyapatite, phosphorus, etc. are used as coating materials on the surface in contact with the pulp cavity 101. Calcium hydrogen acid and the like are used.
  • the length of the inner surface of the proximal portion 11a of the main body 11 is longer than the length of the outer surface. Further, the length of the outer surface of the distal portion 11b of the main body 11 is substantially equal to the length of the inner surface.
  • the stem central axis S1 of the femoral stem 1 is defined by the bisector of the angle formed by the inner and outer surfaces of the distal portion 11b in the anterior view.
  • the proximal portion 11a has a shoulder portion 13 on the proximal end side and the outer side.
  • 5 is a perspective view of the shoulder portion 13
  • FIG. 6 is a top view of the shoulder portion 13
  • FIG. 7 is a side view of the shoulder portion 13.
  • the shoulder portion 13 is formed with a recess 14 in which the tip portion 21 of the stem inserter 2 is housed.
  • the recess 14 has a spherical portion 15 that comes into contact with the tip portion 21 of the stem inserter 2, and a key groove 16 that extends inward from the inner tip of the spherical portion 15 and regulates the rotation of the stem inserter 2. is doing.
  • a part of the recess 14 is located on the stem central axis S1.
  • the recess 14 has a screw hole 14a at the distal end.
  • the screw hole 14a can be screw-fixed to the screw portion located at the tip of the stem remover when the femur stem 1 is removed for some reason after the femur stem 1 is inserted into the medullary cavity 101.
  • the key groove 16 has an arc shape when viewed from the side, and the length L1 and the width W1 (length in the front-rear direction) in the inner-outer direction of the key groove 16 are shorter than the diameter R1 of the spherical portion 15.
  • the width W1 of the key groove 16 is about 1.0 mm to 6.0 mm, preferably about 2.0 mm to 5.0 mm.
  • the effective depth D1 of the key groove 16 (distance from the tip center O1 of the tip 21 to the bottom surface of the key groove 16) is about 5.0 mm to 10.0 mm when the radius of the tip 21 is 4.5 mm. It is preferably about 5.5 mm to 8.5 mm.
  • the substantial depth D2 (distance from the spherical surface portion 15 to the bottom surface of the key groove 16) of the key groove 16 is about 0.5 mm to 5.5 mm when the radius of the tip portion 21 is 4.5 mm, and is preferably 1. It is about 0.0 mm to 4.0 mm.
  • FIG. 8 is a partial perspective view of the stem inserter 2
  • FIG. 9 is a partial side view of the stem inserter 2
  • FIG. 10 is an X arrow view of the stem inserter 2 of FIG.
  • FIG. 11 is a perspective view showing that the stem inserter 2 is engaged with the femur stem 1
  • FIG. 12 is a perspective view showing that the stem inserter 2 is engaged with the femur stem 1 and then the stem inserter. It is a perspective view which shows that the inclination in the inside-out direction of 2 is adjusted.
  • the stem inserter 2 includes a spherical tip portion 21 that contacts the spherical portion 15 and a key portion 22 that engages with the key groove 16.
  • At least a part of the tip portion 21 is accommodated in the spherical portion 15, and has a shape corresponding to the spherical portion 15. Further, at least a part of the key portion 22 is accommodated in the key groove 16, and has a shape corresponding to the key groove 16.
  • the tip portion 21 and the key portion 22 are integrally molded and are made of a material such as stainless steel that can withstand the sterilization process of surgical instruments such as high-pressure steam sterilization.
  • the key portion 22 is formed so as to project outward from the tip portion 21 inward from the tip portion 21.
  • the key portion 22 is formed over substantially the entire vertical direction of the tip portion 21, and the vertical length 22L of the key portion 22 is slightly shorter than the vertical length of the tip portion 21. More specifically, the lower end 22D of the key portion 22 is located above the lower end of the tip portion 21.
  • the key portion 22 has a substantially square shape when viewed from above, and has an arc shape at the tip when viewed from the side.
  • the upper end 22U of the tip of the key portion 22 is located inward with respect to the lower end 22D of the tip.
  • the tip portion 21 of the stem inserter 2 comes into contact with the spherical portion 15 on the arc surface 15a.
  • the arcuate surface 15a is the upper edge surface of the spherical surface portion 15, and has a substantially C shape because the inside is notched by the key groove 16.
  • the stem inserter 2 can be tilted in the directions of arrows A1 and A2 about the center O1 of the tip portion.
  • the stem inserter 2 is freely tilted in the directions of arrows A1 and A2 with the tip center O1 as the center, and the femur stem 1 is inserted from various angles.
  • the inclination angle ⁇ of the stem inserter 2 is an angle formed by the rotation axis O2 of the stem inserter 2 and the reference line S2.
  • the reference line S2 is a line that passes through the tip center O1 and is parallel to the stem center axis S1.
  • the inclination angle ⁇ of the stem inserter if the angle outside the reference line S2 is defined as positive and the angle inside the reference line S2 is defined as minus, in the present embodiment, the inclination angle ⁇ of the stem inserter 2 is defined as minus. Is in the range of maximum plus 49 degrees to minus 66 degrees.
  • the femur stem 1 can be inserted while controlling the insertion angle by inclining the stem inserter 2.
  • the key portion 22 engages with the key groove 16, when the stem inserter 2 is rotated in the directions of arrows B1 and B2 about the inserter rotation axis, the key portion 22 rotates with respect to the key groove 16. Is regulated. Therefore, the femoral stem 1 can be rotated in the directions of arrows b1 and b2. As a result, the femoral stem 1 can be inserted while adjusting the rotation angle of the femoral stem 1. The key portion 22 comes into contact with the key groove 16 when the stem inserter 2 is rotated, but the key portion 22 does not come into contact with the bottom surface of the key groove 16.
  • the spherical portion 15 that comes into contact with the tip 21 of the stem inserter 2 while the rotation angle of the femoral stem 1 can be adjusted by the key groove 16.
  • the contact area between the femoral stem 1 and the stem inserter 2 can be increased, and the durability of the stem inserter 2 and the insertability of the femoral stem 1 can be improved.
  • the key groove 16 extends inward from the inner tip of the spherical portion 15, the recess 14 can be positioned on the stem central axis S1. As a result, the force when inserting the femoral stem 1 can be easily applied to the femoral stem 1.
  • the artificial hip joint system 10 includes a femur stem 1 and a stem inserter 2 for inserting the femur stem 1 into the medullary space 101 of the femur 100, and the stem inserter 2 is a femur stem 1. Since the spherical tip portion 21 that contacts the spherical portion 15 and the key portion 22 that engages with the key groove 16 of the femur stem 1 are provided, the rotation angle of the femur stem 1 can be adjusted while the stem is inserted. The durability of the sirter 2 can be improved.
  • the key portion 22 of the stem inserter 2 is formed so as to project outward from the tip portion, the key portion 22 of the stem inserter 2 is inserted into the key groove 16 of the recess 14 of the femur stem 1. Can be easily engaged.
  • the inclination angle of the stem inserter 2 can be increased.
  • the width W1 (length in the anteroposterior direction) of the key groove 16 is defined within a predetermined range of about 1.0 mm to 6.0 mm, the key portion 22 of the stem inserter 2 and the femur stem 1
  • the durability of the main body 11 can be improved. If the width W1 of the key groove 16 is too small, the key portion 22 of the stem inserter 2 becomes thin, and there is a concern that the durability of the key portion 22 may decrease. Further, if the width W1 of the key groove 16 is too large, the engraving of the key groove 16 becomes large, and there is a concern that the durability of the main body portion 11 may decrease.
  • the effective depth D1 of the key groove 16 (distance from the tip center O1 of the tip 21 to the bottom surface of the key groove 16) is 5.0 mm to 10.0 mm when the radius of the tip 21 is 4.5 mm. Since the degree is specified, the rotational property of the femur stem 1 by the stem inserter 2 can be ensured, and the durability of the main body 11 of the femur stem 1 can be improved. If the effective depth D1 of the keyway 16 is too shallow, there is a concern that it will be difficult for the stem inserter 2 to rotate the femoral stem 1. Further, if the effective depth D1 of the key groove 16 is too deep, the engraving of the key groove 16 becomes large, and there is a concern that the durability of the main body portion 11 may decrease.
  • the actual depth D2 of the key groove 16 (distance from the spherical surface portion 15 to the bottom surface of the key groove 16) is defined to be about 0.5 mm to 5.5 mm when the radius of the tip portion 21 is 4.5 mm. Therefore, the rotational property of the femoral stem 1 by the stem inserter 2 can be ensured, and the durability of the main body portion 11 can be improved. If the substantial depth D2 of the keyway 16 is too shallow, there is a concern that it will be difficult for the stem inserter 2 to rotate the femoral stem 1. Further, if the actual depth D2 of the key groove 16 is too deep, the engraving of the key groove 16 becomes large, and there is a concern that the durability of the main body portion 11 may decrease.
  • the recess 14 of the femur stem 1 has a screw hole 14a at the distal end. Therefore, for the femur stem 1, a stem remover having a threaded portion at the tip can be used, and the femur stem 1 can be extracted from the medullary cavity 101 of the femur 100.
  • the key portion 22 Since the key portion 22 has a shape that does not contact the bottom surface of the key groove 16, the key portion 22 is inserted when the femur stem 1 is inserted by hitting the stem inserter 2 with another tool (hammer) or the like. It is possible to reduce the load on the stem.
  • one key groove 16 is formed so as to extend inward from the inner tip of the spherical surface portion 15, but a plurality of key grooves 16 may be formed. Even in that case, in order to bring the recess 14 closer to the stem central axis S1, it is preferable that all of the plurality of keyways extend inward from the inner edge of the spherical portion 15.
  • the femur stem 1 and the artificial hip joint system 10 capable of increasing the contact area between the femur stem 1 and the stem inserter 2 while making the rotation angle of the stem inserter 2 adjustable. It has great industrial utility value.

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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

Tige fémorale (1) d'une prothèse de hanche comprenant un corps principal (11) destiné à être inséré dans une cavité médullaire (101) d'un fémur (100), et une section collet (12) à laquelle est fixée une tête de tige. Un évidement (14) dans lequel l'extrémité (21) d'un dispositif d'insertion de tige (2) est stocké est disposé dans la section d'épaulement (13) du corps principal (11). L'évidement (14) comprend une section de surface sphérique (15) en contact avec l'extrémité (21) du dispositif d'insertion de tige (2), et une rainure de clavette (16) partant de la section de surface sphérique (15) pour rejoindre le côté interne et régulant la rotation du dispositif d'insertion de tige (2).
PCT/JP2022/000649 2021-01-13 2022-01-12 Tige fémorale et système de prothèse de hanche WO2022153992A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2022575593A JPWO2022153992A1 (fr) 2021-01-13 2022-01-12

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202163136819P 2021-01-13 2021-01-13
US63/136,819 2021-01-13

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WO2022153992A1 true WO2022153992A1 (fr) 2022-07-21

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6626913B1 (en) * 1999-03-03 2003-09-30 Smith & Nephew, Inc. Methods, systems, and instruments for inserting prosthetic implants
WO2015098729A1 (fr) * 2013-12-27 2015-07-02 京セラメディカル株式会社 Système d'articulation de hanche artificielle, élément d'introduction de tige, système d'articulation de hanche artificielle le comprenant, et articulation de hanche artificielle

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6626913B1 (en) * 1999-03-03 2003-09-30 Smith & Nephew, Inc. Methods, systems, and instruments for inserting prosthetic implants
WO2015098729A1 (fr) * 2013-12-27 2015-07-02 京セラメディカル株式会社 Système d'articulation de hanche artificielle, élément d'introduction de tige, système d'articulation de hanche artificielle le comprenant, et articulation de hanche artificielle

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Publication number Publication date
JPWO2022153992A1 (fr) 2022-07-21

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