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FR2674122A1 - Joint prosthesis, in particular for a joint of the enarthroidal type - Google Patents

Joint prosthesis, in particular for a joint of the enarthroidal type Download PDF

Info

Publication number
FR2674122A1
FR2674122A1 FR9103444A FR9103444A FR2674122A1 FR 2674122 A1 FR2674122 A1 FR 2674122A1 FR 9103444 A FR9103444 A FR 9103444A FR 9103444 A FR9103444 A FR 9103444A FR 2674122 A1 FR2674122 A1 FR 2674122A1
Authority
FR
France
Prior art keywords
base
prosthesis according
rod
support
bone
Prior art date
Legal status (The legal status 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 status listed.)
Withdrawn
Application number
FR9103444A
Other languages
French (fr)
Inventor
Surer Patrick
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
SUPER PATRICK
Original Assignee
SUPER PATRICK
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 SUPER PATRICK filed Critical SUPER PATRICK
Priority to FR9103444A priority Critical patent/FR2674122A1/en
Publication of FR2674122A1 publication Critical patent/FR2674122A1/en
Withdrawn legal-status Critical Current

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
    • A61F2/30721—Accessories
    • A61F2/30749—Fixation appliances for connecting prostheses to the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
    • A61B17/175—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for preparing the femur for hip prosthesis insertion
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • 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
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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
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—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
    • 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
    • A61F2002/30574—Special structural features of bone or joint prostheses not otherwise provided for with an integral complete or partial collar or flange
    • 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
    • A61F2002/30535—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
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
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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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    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
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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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    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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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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    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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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
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    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
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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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—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
    • 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
    • A61F2002/4051—Connections of heads directly to shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • 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
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

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

Abstract

This prosthesis comprises principally a base (14) in which are provided several seats (22, 28) and passages (24, 30) which are oriented obliquely with respect to one another and are designed to receive removable anchoring members (32) which are then made integral with the base. The base has a support (40) which itself receives a sliding joint component (48). Application in particular to hip and shoulder prostheses.

Description

La La présente invention concerne les prothèses articulairs, notamment pour articulations de type énarthrose. The present invention relates to joint prostheses, in particular for joints of the enarthrosis type.

On connalt à l'heure actuelle deux types de solution pour réaliser des prothèses d'extrémité supérieure du fémur, qui présentent tous deux des inconvénients sérieux. Two types of solution are currently known for making prostheses for the upper end of the femur, both of which have serious drawbacks.

La première solution consiste à mettre en place sur la tête fémorale correctement préparée une cupule de resurfaçage simplement ajustée ou fixée par tout moyen convenable. Une telle solution offre comme avantages de n'entraîner qu'une destruction osseuse réduite et de respecter l'architecture de l'extrémité supérieure du fémur ainsi que l'élasticité de l'os. The first solution consists in placing on the properly prepared femoral head a resurfacing cup simply adjusted or fixed by any suitable means. Such a solution offers the advantages of causing only reduced bone destruction and respecting the architecture of the upper end of the femur as well as the elasticity of the bone.

Ses inconvénients résident dans l'augmentation du taux de friction et la création de déchets, du fait notamment du fort diamètre prothétique. Par ailleurs il est nécessaire d'aléser plus fortement le cotyle, en cas de cupule couplée ou de prothèse totale. Enfin cette solution est inutilisable en cas d'altération de la tête fémorale ou de fracture du col du fémur.Its drawbacks lie in the increase in the friction rate and the creation of waste, due in particular to the large prosthetic diameter. Furthermore, it is necessary to bore the acetabulum more strongly, in the case of a coupled cup or total prosthesis. Finally, this solution cannot be used in the event of damage to the femoral head or fracture of the neck of the femur.

Les prothèses à fixation diaphysaire constituent un deuxième type de solution : dans ce cas la prothèse comprend une tige fémorale qui est introduite dans le canal diaphysaire, cette tige se terminant par un support, le col, porteur d'une tête prothétique amovible ou non. Les avantages de telles prothèses sont de permettre l'usage de nombreux diamètres de tête et de pouvoir être utilisées même en cas de destruction de la tête ou de fracture du col du fémur. Prostheses with diaphyseal fixation constitute a second type of solution: in this case the prosthesis comprises a femoral stem which is introduced into the diaphyseal canal, this stem ending in a support, the neck, carrying a removable or non-removable prosthetic head. The advantages of such prostheses are to allow the use of numerous head diameters and to be able to be used even in the event of destruction of the head or fracture of the neck of the femur.

Par contre, la tige diaphysaire subit des contraintes complexes liées notamment au porte-à-faux et aux forces de cisaillement lors des mouvements de rotation. De plus lors de la mise en charge, le fémur s'incurve de sorte que des allongements différents des corticales créent des problèmes relativement complexes à l'interface entre la tige et l'os adjacent, ces problèmes se posant de la même façon que la fixation soit réalisée avec ou sans ciment.On notera en outre une altération de l'élasticité fémorale avec un report des contraintes au voisinage de l'extrémité de la tige, risquant par conséquent de provoquer une rupture de l'os dans cette zone; une destruction considérable du stock osseux, surtout dans les prothèses à remplissage métaphysaire; enfin une grande difficulté à extraire ces prothèses, avec une altération supplémentaire du stock osseux lors de cette extraction.On the other hand, the diaphyseal rod undergoes complex stresses linked in particular to the overhang and to the shearing forces during the rotational movements. In addition during loading, the femur curves so that different lengths of the cortices create relatively complex problems at the interface between the rod and the adjacent bone, these problems being posed in the same way as the fixation is carried out with or without cement. We will also note an alteration of the femoral elasticity with a transfer of the stresses in the vicinity of the end of the rod, risking consequently to cause a rupture of the bone in this zone; considerable destruction of the bone stock, especially in prostheses with metaphyseal filling; finally a great difficulty in extracting these prostheses, with an additional alteration of the bone stock during this extraction.

Le but de cette invention est de proposer une prothèse articulaire qui permette de remédier aux inconvénients énoncés ci-dessus des solutions existantes. De façon plus précise, cette prothèse doit être facile et rapide à mettre en oeuvre, procurer un ancrage efficace, altérer de façon minimale le support, être facile à extraire et être capable d'assurer le rattachement d'un ou plusieurs fragments d'os. The object of this invention is to propose a joint prosthesis which makes it possible to remedy the drawbacks stated above of the existing solutions. More specifically, this prosthesis must be easy and quick to implement, provide effective anchoring, minimally alter the support, be easy to extract and be able to ensure the attachment of one or more bone fragments. .

A cet effet l'invention a pour objet une prothèse articulaire comprenant un support, des moyens de fixation de ce support sur l'os, et une pièce articulaire de glissement montée sur ce support, caractérisée en ce qu'elle comprend une embase dans laquelle sont ménagés plusieurs logements et perçages orientés suivant des directions obliques les unes par rapport aux autres, et adaptés pour recevoir des organes amovibles d'ancrage de l'embase sur l'os, cette embase portant le support adapté pour recevoir la pièce articulaire de glissement. To this end, the subject of the invention is a joint prosthesis comprising a support, means for fixing this support to the bone, and an articular sliding part mounted on this support, characterized in that it comprises a base in which are provided several housings and holes oriented in oblique directions relative to each other, and adapted to receive removable members for anchoring the base on the bone, this base carrying the support adapted to receive the articular sliding part .

Suivant d'autres caractéristiques
- l'embase comprend un logement et un pas sage ' centraux et plusieurs logements et passages périphériques;
- le logement central est adapté pour recevoir un organe d'ancrage ainsi que le support de la pièce articulaire de glissement;
- les organes amovibles d'ancrage comprennent chacun une tige adaptée pour être ancrée dans l'os et une tête adaptée pour être reçue dans un logement de l'embase, des moyens étant prévus pour solidariser ladite tête par rapport à l'embase;
- l'organe de fixation central est fixé de façon amovible sur une tige diaphysaire;
- la prothèse est adaptée pour remplacer une partie de l'épiphyse d'un os long.According to other characteristics
- The base includes a central housing and a step wise and several housing and peripheral passages;
- The central housing is adapted to receive an anchoring member as well as the support of the articular sliding part;
- The removable anchoring members each comprise a rod adapted to be anchored in the bone and a head adapted to be received in a housing of the base, means being provided for securing said head relative to the base;
- The central fixing member is removably fixed on a diaphyseal rod;
- the prosthesis is adapted to replace part of the epiphysis of a long bone.

L'invention va être décrite plus en détail ci-dessous en se référant aux dessins annexés, donnés uniquement à titre d'exemples et sur lesquels
La Fig. 1 est une vue en perspective avec arrachement d'une prothèse fémorale selon l'invention;
La Fig. 2 est une vue en élévation de l'embase faisant partie de cette prothèse;
La Fig. 3 est une vue en coupe illustrant une phase de mise en place de la prothèse selon l'invention;
Les Fig. 4 et 5 sont deux vues en coupe de deux variantes de prothèse fémorale; et
Les Fig. 6 et 7 sont deux vues illustrant deux variantes de prothèse humérale selon l'invention.The invention will be described in more detail below with reference to the accompanying drawings, given only by way of examples and in which
Fig. 1 is a perspective view with cutaway of a femoral prosthesis according to the invention;
Fig. 2 is an elevational view of the base forming part of this prosthesis;
Fig. 3 is a sectional view illustrating a phase of fitting the prosthesis according to the invention;
Figs. 4 and 5 are two sectional views of two variants of femoral prosthesis; and
Figs. 6 and 7 are two views illustrating two variants of a humeral prosthesis according to the invention.

On a représenté à la Fig. 1 l'extrémité supérieure d'un fémur 10 sur laquelle a été fixée une prothèse 12 selon l'invention Cette prothèse comprend une embase 14 réalisée en tout matériau convenable, acier, titane ou autre, revêtu ou non. Cette embase comprend une surface 16 d'appui sur l'os et une sur face sterne 18. Elle comporte dans sa partie centrale une partie 20 qui fait saillie en direction de l'os et dans laquelle est ménagé un logement 22 qui débouche d'une part sur la face externe de l'embase et d'autre part sur un passage 24 débouchant sur la face dirigée vers l'os. Ce passage 24 a une section transversale plus faible que l'ouverture du logement débouchant sur la face extérieure de sorte qu'un épaulement 26 est délimité dans le fond du logement.Autour du logement central l'embase comporte d'autres logements 28 et des passages 30 de forme analogue, ces logements et ces passages étant répartis par exemple comme représenté sur la Fig. 2 et ayant des axes orientés obliquement, entre eux et par rapport à l'axe du logement central. There is shown in FIG. 1 the upper end of a femur 10 on which a prosthesis 12 has been fixed according to the invention This prosthesis comprises a base 14 made of any suitable material, steel, titanium or the like, coated or not. This base includes a surface 16 for bearing on the bone and one on a tern face 18. It has in its central part a part 20 which projects in the direction of the bone and in which is provided a housing 22 which opens out from on the one hand on the external face of the base and on the other hand on a passage 24 opening onto the face directed towards the bone. This passage 24 has a smaller cross section than the opening of the housing opening onto the outer face so that a shoulder 26 is delimited in the bottom of the housing. Around the central housing the base comprises other housings 28 and passages 30 of similar shape, these housings and these passages being distributed for example as shown in FIG. 2 and having axes oriented obliquely, between them and relative to the axis of the central housing.

Dans l'exemple représenté à la Fig. 1, les parois des différents logements 22, 28 sont filetées. In the example shown in FIG. 1, the walls of the various housings 22, 28 are threaded.

Chaque logement est adapté pour recevoir une vis 32 d'ancrage et de fixation comportant une tige filetée 34 et une tête 36. Des organes 38 de blocage et de solidarisation, filetés extérieurement sont destinés à coopérer avec les logements 22, 28 munis d'un filetage correspondant.Each housing is adapted to receive a screw 32 for anchoring and fixing comprising a threaded rod 34 and a head 36. Locking and fastening members 38, externally threaded, are intended to cooperate with the housings 22, 28 provided with a corresponding thread.

Dans le logement central 22 est fixé un support 40 muni d'une part d'une tige filetée 42 vissée dans le logement et d'autre part un col 44 de forme tronconique, adapté pour s'engager dans un logement 46 de forme complémentaire ménagé dans une pièce articulaire de glissement 48. Cette pièce est réalisée en tout matériau convenable, acier inoxydable ou alumine par exemple, revêtu ou non d'un revêtement antifriction. In the central housing 22 is fixed a support 40 provided on the one hand with a threaded rod 42 screwed into the housing and on the other hand a neck 44 of frustoconical shape, adapted to engage in a housing 46 of complementary shape formed in a sliding articular part 48. This part is made of any suitable material, stainless steel or alumina for example, coated or not with an anti-friction coating.

Une telle prothèse est utilisée de la façon suivante : après une préparation convenable de la partie supérieure du fémur; on met en place sur ce dernier une tige diaphysaire 50 sur laquelle a été vissée l'embase (Fig. 3). Cette tige diaphysaire 50 comporte à sa partie supérieure un logement 52, de forme complémentaire à la partie adjacente 20 de l'embase et un orifice fileté 54 dans lequel est vissé une vis 56 qui la solidarise de cette embase. Des canons de guidage 58 sont alors vissés dans les logements 28 de l'embase, et servent à guider des organes de perçage permettant de réaliser des avant-trous dans le matériau de l'os. Après enlèvement de la tige diaphysaire, l'embase est présentée à nouveau sur le fémur et fixée exactement en place au moyen des différentes tiges d'ancrage 32.Celles-ci sont enfoncées progressivement dans l'os et en fin de pénétration, elles sont rendues solidaires de l'embase par vissage des pièces de blocage 38, filetées extérieurement, qui coopèrent avec les parties filetées des logements 22; 28 (Fig. 1). Such a prosthesis is used as follows: after proper preparation of the upper part of the femur; a diaphyseal rod 50 is placed on the latter on which the base has been screwed (Fig. 3). This diaphyseal rod 50 has at its upper part a housing 52, of shape complementary to the adjacent part 20 of the base and a threaded orifice 54 in which is screwed a screw 56 which secures it to this base. Guide guns 58 are then screwed into the housings 28 of the base, and serve to guide piercing members making it possible to make pilot holes in the bone material. After removal of the diaphyseal rod, the base is again presented on the femur and fixed exactly in place by means of the various anchor rods 32, which are gradually inserted into the bone and at the end of penetration, they are made integral with the base by screwing the locking pieces 38, externally threaded, which cooperate with the threaded parts of the housings 22; 28 (Fig. 1).

Les différentes tiges 32 orientées de façon oblique les unes par rapport aux autres, permettent de réaliser un ancrage épiphyso-métaphysaire dont la solidité est indépendante de l'existence d'une forte compression entre l'embase et l'os. Elles réalisent une stabilisation du type de celle obtenues par des pattes lors d'un scellement. The different rods 32 oriented obliquely with respect to each other, make it possible to achieve epiphyso-metaphyseal anchoring whose solidity is independent of the existence of strong compression between the base and the bone. They achieve stabilization of the type obtained by tabs during sealing.

Il suffit ensuite de visser dans la partie centrale de l'embase le support 40 et de l'équiper de la pièce articulaire de glissement 48. It then suffices to screw the support 40 in the central part of the base and to equip it with the sliding articular part 48.

Sur la Fig. 3, la tige diaphysaire 50 n'était utilisée que comme pièce ancillaire pour présenter et orienter correctement l'embase. Dans le cas de la Fig. 4, cette tige diaphysaire 50 est mise en place de façon permanente et fait donc partie de la prothèse. Elle a alors pour effet d'améliorer la liai son entre les parties méthaphysaire et diaphysaire de 1 'os
Dans le mode de réalisation de la Fig. 5, la modification apportée par rapport aux variantes précédentes porte sur le mode de solidarisation secondaire entre les tiges d'ancrage 132, 156 et l'embase 114. Dans l'exemple de la Fig. 5, cette solidarisation est obtenue en prévoyant une tête 136 filetée au même pas que la tige 134 et qui coopère, en fin de vissage de la tige 134, avec la partie filetée de façon correspondante des logements 122 et 128.In Fig. 3, the diaphyseal rod 50 was only used as an ancillary part to present and orient the base correctly. In the case of FIG. 4, this diaphyseal rod 50 is placed permanently and therefore forms part of the prosthesis. It then has the effect of improving the sound connection between the methaphyseal and diaphyseal parts of the bone.
In the embodiment of FIG. 5, the modification made with respect to the preceding variants relates to the mode of secondary connection between the anchoring rods 132, 156 and the base 114. In the example of FIG. 5, this connection is obtained by providing a head 136 threaded at the same pitch as the rod 134 and which cooperates, at the end of the screwing of the rod 134, with the correspondingly threaded part of the housings 122 and 128.

Bien entendu ce type de solidarisation peut être utilisé tout-à-fait indépendamment de la présence d'une tige diaphysaire permanente telle que 150. Of course, this type of attachment can be used completely independently of the presence of a permanent diaphyseal rod such as 150.

L'exemple de la Fig. 6 représente une prothèse d'épaule dont la structure est très voisine de celle décrite à propos de la Fig. 1. On retrouve en effet une embase 60 destinée à être fixée sur la partie supérieure de l'humérus 62, cette embase comprenant des logement et passage centraux 64, 66 et des logements et passages périphériques 68, 70, les axes de ces différents passages et logements étant disposés obliquement les uns par rapport aux autres. Les organes de fixation 72 peuvent comme dans le cas précédent être constitués par des tiges filetées amovibles vissées dans l'os et solidarisées ensuite avec l'embase par des pièces de blocage 74 vissées dans les logements 64, 68. The example in Fig. 6 shows a shoulder prosthesis whose structure is very similar to that described in connection with FIG. 1. There is indeed a base 60 intended to be fixed on the upper part of the humerus 62, this base comprising central housings and passages 64, 66 and peripheral housings and passages 68, 70, the axes of these various passages and housings being arranged obliquely to each other. The fixing members 72 may, as in the previous case, be constituted by removable threaded rods screwed into the bone and then secured to the base by blocking pieces 74 screwed into the housings 64, 68.

Comme précédemment, le support 76 est vissé dans le logement central 64 de l'embase et reçoit une pièce articulaire de glissement constituée ici par une cupule de resurfaçage 78 dont les dimensions sont bien entendu choisies en fonction du cas traité. As before, the support 76 is screwed into the central housing 64 of the base and receives an articular sliding part constituted here by a resurfacing cup 78 whose dimensions are of course chosen according to the case being treated.

D'autres modifications peuvent être appor tées à la prothèse selon l'invention, sans sortir du cadre de ce brevet
- c'est ainsi que dans l'exemple représenté à la Fig. 7, les têtes 80 des organes d'ancrage périphériques 82 affleurent la surface externe de l'embase 84 et sont bloquées par rapport à cette dernière par le support 86 de la pièce articulaire de glissement.Other modifications can be made to the prosthesis according to the invention, without departing from the scope of this patent.
- this is how in the example shown in FIG. 7, the heads 80 of the peripheral anchoring members 82 are flush with the external surface of the base 84 and are blocked with respect to the latter by the support 86 of the sliding articular part.

La tige centrale 88 est bloquée par la partie centrale 90 de fixation du support;
- les tiges des organes de fixation peuvent être lisses et engagées dans le matériau de l'os, après constitution d'un avant-trou, la tête de ces organes étant solidarisée secondairement à embase par tous moyens convenables;
- le support de la pièce articulaire de glissement peut être fixé sur l'embase autrement que par vissage dans le logement central de cette der nière, qui peut par exemple comporter un filetage externe sur lequel est vissé le support.The central rod 88 is blocked by the central part 90 for fixing the support;
- The rods of the fixing members can be smooth and engaged in the material of the bone, after constitution of a pilot hole, the head of these members being joined secondarily to the base by any suitable means;
- The support of the sliding articular piece can be fixed on the base other than by screwing in the central housing of the latter, which can for example include an external thread on which the support is screwed.

D'une façon générale, les avantages que procure l'invention dans ces diverses variantes sont les suivants
- la prothèse est réalisable dans tous les cas cliniques susceptibles d'être rencontrés. C'est ainsi en particulier qu'elle permet d'assembler des fragments d'os séparés par un traumatisme, en cas de fracture ou au cours de l'acte opératoire;
- la prothèse est immédiatement stable, sans qu'il soit nécessaire d'utiliser un ciment et sans attendre une réhabitation osseuse;
- elle peut recevoir toutes les formes de pièce articulaire de glissement;
- elle ne provoque pas d'atteinte de l'élasticité de l'os et supprime le risque de rupture rencontré lors de l'utilisation de tiges diaphysaires;
- l'altération du stock osseux est très faible;
- les organes de fixation sont tous amovibles et facilement extractibles, sans altération osseuse supplémentaire; ;
- les sollicitations mécaniques s'exercent dans de bonnes conditions, car les tiges sont orientées suivant les lignes de force de sorte qu'une telle prothèse peut résister de façon efficace aux forces de compression et de cisaillement. In general, the advantages which the invention provides in these various variants are the following:
- the prosthesis is feasible in all clinical cases likely to be encountered. It is thus in particular that it makes it possible to assemble bone fragments separated by a trauma, in the event of a fracture or during the operative act;
- the prosthesis is immediately stable, without the need to use a cement and without waiting for bone rehabitation;
- it can receive all forms of articular sliding part;
- it does not affect the elasticity of the bone and eliminates the risk of rupture encountered when using diaphyseal rods;
- the alteration of the bone stock is very low;
- the fasteners are all removable and easily extractable, without additional bone damage; ;
- The mechanical stresses are exerted in good conditions, because the rods are oriented along the lines of force so that such a prosthesis can effectively resist the forces of compression and shear.

Claims (14)

REVENDICATIONS 1. Prothèse articulaire comprenant un support, des moyens de fixation de ce support sur l'os, et une pièce articulaire de glissement montée sur ce support, caractérisée en ce qu'elle comprend une embase (14; 60, 84; 114) dans laquelle sont ménagés plusieurs logements (22, 28; 64, 68; 122, 128) et perçages (24, 30; 66, 70) orientés suivant des directions obliques les unes par rapport aux autres, et adaptés pour recevoir des organes amovibles(32; 72, 82; 132) d'ancrage de l'embase sur l'os, cette embase portant le support (40; 76; 86) adapté pour recevoir la pièce articulaire de glissement (48; 78). 1. Joint prosthesis comprising a support, means for fixing this support to the bone, and a sliding articular piece mounted on this support, characterized in that it comprises a base (14; 60, 84; 114) in which are provided with several housings (22, 28; 64, 68; 122, 128) and holes (24, 30; 66, 70) oriented in oblique directions relative to each other, and adapted to receive removable members (32 ; 72, 82; 132) anchoring the base on the bone, this base carrying the support (40; 76; 86) adapted to receive the sliding articular part (48; 78). 2. Prothèse suivant la revendication 1, caractérisée en ce que l'embase (14; 60) comprend un logement et un passage centraux (22, 24; 64, 66) et plusieurs logements et passages périphériques (28, 30; 68, 70). 2. Prosthesis according to claim 1, characterized in that the base (14; 60) comprises a central housing and passage (22, 24; 64, 66) and several housing and peripheral passages (28, 30; 68, 70 ). 3. Prothèse suivant la revendication 2, caractérisée en ce que le logement central (22; 64) est adapté pour recevoir un organe de fixation (32) ainsi que le support (40) de la pièce articulaire de glissement. 3. Prosthesis according to claim 2, characterized in that the central housing (22; 64) is adapted to receive a fixing member (32) as well as the support (40) of the articular sliding part. 4. Prothèse suivant la revendication 3, caractérisée en ce que le logement central (22; 64) comporte un filetage coopérant avec un organe (38) de solidarisation de l'organe de fixation (30; 72) avec l'embase (14; 60). 4. Prosthesis according to claim 3, characterized in that the central housing (22; 64) comprises a thread cooperating with a member (38) for securing the fixing member (30; 72) with the base (14; 60). 5. Prothèse suivant la revendication 4-, ca- ractérisée en ce que ledit filetage coopère avec une tige filetée (42) du support (40; 76). 5. Prosthesis according to claim 4-, characterized in that said thread cooperates with a threaded rod (42) of the support (40; 76). 6. Prothèse suivant l'une quelconque des revendications 1 à St caractérisée en ce que les organes amovibles d'ancrage (32; 72; 82; 132) com prennent chacun une tige (34) adaptée pour être ancrée dans l'os et une tête (36; 80; 136) adaptée pour être reçue dans un logement de l'embase, des moyens (38; 74) étant prévus pour solidariser ladite tête par rapport à l'embase. 6. Prosthesis according to any one of claims 1 to St characterized in that the removable anchoring members (32; 72; 82; 132) com each take a rod (34) adapted to be anchored in the bone and a head (36; 80; 136) adapted to be received in a housing of the base, means (38; 74) being provided for securing said head relative to the base. 7. Prothèse suivant la revendication 6, caractérisée en ce que la tête (136) de chaque organe d'ancrage est filetée et coopère avec un filetage correspondant du logement de l'embase. 7. Prosthesis according to claim 6, characterized in that the head (136) of each anchoring member is threaded and cooperates with a corresponding thread of the housing of the base. 8. Prothèse suivant la revendication 6, caractérisée en ce que chaque organe d'ancrage est bloqué par rapport à l'embase par des organes (38) filetés extérieurement et coopérant avec la paroi filetée des logements (22; 28). 8. Prosthesis according to claim 6, characterized in that each anchoring member is blocked relative to the base by members (38) externally threaded and cooperating with the threaded wall of the housings (22; 28). 9. Prothèse suivant la revendication 6, caractérisée en ce que les organes d'ancrage (82) sont bloqués par rapport à l'embase (84) par le support (86). 9. Prosthesis according to claim 6, characterized in that the anchoring members (82) are blocked relative to the base (84) by the support (86). 10. Prothèse suivant l'une quelconque des revendications 1 à 9, caractérisée en ce que l'organe de fixation central (56) est fixé de façon amovible sur une tige diaphysaire (50; 150). 10. Prosthesis according to any one of claims 1 to 9, characterized in that the central fixing member (56) is removably fixed on a diaphyseal rod (50; 150). 11. Prothèse suivant la revendication 6, caractérisée en ce que la tige diaphysaire (50) délimite un logement (52) de forme complémentaire à celle d'une partie adjacente (20) de l'embase (14).  11. Prosthesis according to claim 6, characterized in that the diaphyseal rod (50) delimits a housing (52) of shape complementary to that of an adjacent part (20) of the base (14). 12. Prothèse suivant l'une quelconque des revendications 10 et 11, caractérisée en ce que la tige diaphysaire (50) est une tige ancillaire d'orientation prothétique. 12. Prosthesis according to any one of claims 10 and 11, characterized in that the diaphyseal rod (50) is an ancillary rod of prosthetic orientation. 13. Prothèse suivant l'une quelconque des revendications Il et 12, caractérisée en ce que la tige diaphysaire (150) est une tige définitive adaptée pour solidariser la métaphyse et la diaphyse de l'os.  13. Prosthesis according to any one of claims 11 and 12, characterized in that the diaphyseal rod (150) is a final rod adapted to secure the metaphysis and the diaphysis of the bone. 14. Prothèse suivant l'une quelconque des revendications 1 à 13, caractérisée en ce qu'elle est adaptée pour remplacer une partie de l'épiphyse d'un os long (10; 62).  14. Prosthesis according to any one of claims 1 to 13, characterized in that it is adapted to replace part of the epiphysis of a long bone (10; 62).
FR9103444A 1991-03-21 1991-03-21 Joint prosthesis, in particular for a joint of the enarthroidal type Withdrawn FR2674122A1 (en)

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RU211694U1 (en) * 2021-09-05 2022-06-17 Андрей Юрьевич Худошин Shaftless endoprosthesis of the shoulder joint
RU218669U1 (en) * 2023-03-27 2023-06-05 Федеральное государственное бюджетное образовательное учреждение высшего образования "Самарский государственный медицинский университет" Министерства здравоохранения Российской Федерации ENDOPROSTHESIS OF THE PROXIMAL HEAD OF THE HUMERUS

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