FR2870717A1 - Hip prosthesis for restoring articulation of femur and acetabular bone, has prosthesis rod with retaining bracket having portions with trapezoidal and circular sections tapering off between respective bracket ends and intermediate section - Google Patents
Hip prosthesis for restoring articulation of femur and acetabular bone, has prosthesis rod with retaining bracket having portions with trapezoidal and circular sections tapering off between respective bracket ends and intermediate section Download PDFInfo
- Publication number
- FR2870717A1 FR2870717A1 FR0405853A FR0405853A FR2870717A1 FR 2870717 A1 FR2870717 A1 FR 2870717A1 FR 0405853 A FR0405853 A FR 0405853A FR 0405853 A FR0405853 A FR 0405853A FR 2870717 A1 FR2870717 A1 FR 2870717A1
- Authority
- FR
- France
- Prior art keywords
- prosthesis
- axis
- fixing lug
- intermediate section
- spherical head
- 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.)
- Granted
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/367—Proximal or metaphyseal parts of shafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/3676—Distal or diaphyseal parts of 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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- 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
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- 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
- A61F2002/30614—Sets comprising both primary and revision endoprostheses
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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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- 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
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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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- A61F2/02—Prostheses implantable into the body
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- 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
Landscapes
- 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)
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- Prostheses (AREA)
Abstract
Description
2870717 12870717 1
PROTHESE DE HANCHEHIP PROSTHESIS
La présente invention concerne les prothèses de hanche, c'est-à-dire les prothèses aptes à restaurer l'articulation entre le fémur et l'os cotyloïdien du bassin d'une personne. The present invention relates to hip prostheses, that is to say the prostheses able to restore the joint between the femur and the acetabulum of the pelvis of a person.
On connaît déjà de nombreuses structures de prothèse de hanche. D'une façon schématique générale, une prothèse de hanche comporte un cotyle apte à être implanté dans l'os cotyloïdien du bassin et une tige de prothèse apte à coopérer par rotation rotulienne avec le cotyle, la tige de prothèse comportant une patte de fixation apte à être implantée dans le canal médullaire du fémur de façon que son axe soit sensiblement confondu avec l'axe de ce canal médullaire, cette patte comportant de ce fait une extrémité proximale et une extrémité distale, un collerette dont une première extrémité est solidaire de l'extrémité proximale de la tige de fixation, l'axe de la collerette faisant avec l'axe de la patte de fixation un angle f3 d'une valeur donnée, et une tête sphérique solidaire de la seconde extrémité de la collerette et apte à coopérer par rotation rotulienne avec une cavité hémisphérique réalisée dans le cotyle. Many hip prosthesis structures are already known. In a general schematic manner, a hip prosthesis comprises an acetabular cup capable of being implanted in the acetabulum of the pelvis and a prosthesis stem adapted to cooperate by rotulian rotation with the acetabulum, the prosthesis stem comprising a suitable fixation lug. to be implanted in the medullary canal of the femur so that its axis is substantially merged with the axis of this medullary canal, this tab thus having a proximal end and a distal end, a collar having a first end integral with the proximal end of the fixing rod, the axis of the flange making with the axis of the fixing lug an angle f3 of a given value, and a spherical head integral with the second end of the collar and able to cooperate rotulienne rotation with a hemispherical cavity made in the acetabulum.
Afin de bien asseoir la patte de fixation dans le canal médullaire du fémur, sa section transversale est généralement de forme sensiblement trapézoïdale, étant entendu que, dans certains cas, la petite base et la grande base peuvent avoir des dimensions très voisines. In order to properly seat the bracket in the medullary canal of the femur, its cross section is generally substantially trapezoidal shape, it being understood that, in some cases, the small base and the large base may have very similar dimensions.
De plus, pour absorber les efforts de torsion qui s'exercent sur la tige de prothèse lorsqu'elle est implantée dans un fémur, la face de la patte de fixation correspondant à la grande base de la section transversale trapézoïdale est généralement sensiblement plane et parallèle à l'axe de la patte de fixation. De ce fait, la face de la patte de fixation correspondant à la petite base de la section transversale trapézoïdale rejoint la face de la patte de fixation correspondant à la grande base par un pan oblique par rapport à l'axe de la patte de fixation. In addition, to absorb the torsional forces exerted on the prosthesis stem when it is implanted in a femur, the face of the fastening tab corresponding to the large base of the trapezoidal cross section is generally substantially flat and parallel. to the axis of the bracket. As a result, the face of the fixing lug corresponding to the small base of the trapezoidal cross-section joins the face of the fixing lug corresponding to the large base by an oblique pan with respect to the axis of the fixing lug.
L'implantation d'une telle tige de prothèse se fait en disposant une couche de ciment ou analogue entre la patte de fixation et la paroi du canal médullaire du fémur. Mais il arrive, pour différentes raisons, notamment pour le remplacement de la prothèse, que l'on soit amené à desceller la patte de fixation initiale pour en implanter une nouvelle. The implantation of such a prosthesis rod is done by placing a layer of cement or the like between the bracket and the wall of the medullary canal of the femur. But it happens, for various reasons, including the replacement of the prosthesis, that it is necessary to unseal the initial fixing lug to implant a new one.
2870717 2 Avant de procéder à l'implantation de la patte de fixation d'une nouvelle prothèse, qui est généralement plus longue que la patte initiale, il est nécessaire d'éliminer la couche de ciment initiale. L'élimination de la couche de ciment initiale est généralement effectuée en utilisant des mèches de perçage montées en rotation sur le mandrin d'une perceuse à main. L'élimination de la partie de couche de ciment se trouvant sur la paroi du canal médullaire ne pose en général pas de difficulté, car la mèche est naturellement guidée sur l'axe longitudinal du canal médullaire du fémur. 2870717 2 Before proceeding with the implantation of the bracket of a new prosthesis, which is generally longer than the initial leg, it is necessary to eliminate the initial layer of cement. The removal of the initial cement layer is generally carried out using drill bits mounted in rotation on the mandrel of a hand drill. The elimination of the portion of cement layer on the wall of the medullary canal is generally not difficult, because the wick is naturally guided on the longitudinal axis of the medullary canal of the femur.
En revanche, lorsque l'extrémité de la mèche vient buter contre le pan oblique du bouchon de ciment se trouvant en dessous de l'extrémité distale de la première patte de fixation, elle est déviée et peut percer la corticale du fémur. On the other hand, when the end of the wick abuts against the oblique end of the cement plug lying below the distal end of the first fastening lug, it is deflected and can pierce the cortex of the femur.
La présente invention a donc pour but de réaliser une prothèse de hanche qui pallie les inconvénients des prothèses de hanche connues de l'art antérieur et qui favorise le travail des praticiens lorsqu'ils doivent procéder au remplacement d'une patte de fixation par une autre. The present invention therefore aims to provide a hip prosthesis that overcomes the disadvantages of hip prostheses known in the prior art and which favors the work of practitioners when they must proceed to replace a bracket by another .
Plus précisément, la présente invention a pour objet une prothèse de hanche comportant un cotyle apte à être implanté dans l'os cotyloïdien du bassin d'une personne, ledit cotyle comportant une cavité hémisphérique, et une tige de prothèse comportant une patte de fixation apte à être implantée dans le canal médullaire du fémur de façon que son axe soit sensiblement confondu avec l'axe du canal médullaire, ladite patte de fixation comportant de ce fait une extrémité proximale et une extrémité distale, une collerette dont une première extrémité est solidaire de l'extrémité proximale de la patte de fixation, l'axe de la collerette faisant avec l'axe de la patte de fixation un angle R d'une valeur donnée, une tête sphérique solidaire de la seconde extrémité de la collerette, ladite tête sphérique étant apte à coopérer en rotation rotulienne avec ladite cavité hémisphérique, caractérisée par le fait que la patte de fixation présente une première partie définie entre son extrémité proximale et une section intermédiaire définie à une distance non nulle de l'extrémité distale, ladite première partie ayant des sections transversales de forme sensiblement trapézoïdale diminuant de façon continue entre l'extrémité proximale et la section intermédiaire pour sensiblement épouser la forme du canal médullaire, et une seconde partie définie entre ladite section intermédiaire et l'extrémité distale, cette dite seconde partie ayant des sections transversales de forme sensiblement circulaire centrées sur l'axe de la patte de fixation et diminuant de façon continue entre la section intermédiaire et l'extrémité distale. More specifically, the subject of the present invention is a hip prosthesis comprising an acetabular cup capable of being implanted in the acetabulum of a person's pelvis, said acetabulum comprising a hemispherical cavity, and a prosthesis stem comprising a suitable fixing lug. to be implanted in the medullary canal of the femur so that its axis is substantially merged with the axis of the medullary canal, said fixing lug thus comprising a proximal end and a distal end, a collar whose first end is integral with the proximal end of the fixing lug, the axis of the flange forming with the axis of the fixing lug an angle R of a given value, a spherical head secured to the second end of the flange, said spherical head being able to cooperate in rotational rotation with said hemispherical cavity, characterized in that the fixing lug presents a first a portion defined between its proximal end and an intermediate section defined at a non-zero distance from the distal end, said first portion having cross-sections of substantially trapezoidal shape continuously decreasing between the proximal end and the intermediate section to substantially conform to the shape of the medullary canal, and a second portion defined between said intermediate section and the distal end, said second portion having cross sections of substantially circular shape centered on the axis of the bracket and decreasing continuously between the section intermediate and the distal end.
Selon une autre caractéristique de l'invention, l'angle f3 entre l'axe de la collerette et l'axe de la patte de fixation a une valeur sensiblement comprise entre deux valeurs (31 et 132 prédéterminées, avec (32 < (31, avantageusement respectivement sensiblement égales à 130 degrés et 120 degrés. According to another characteristic of the invention, the angle f3 between the axis of the flange and the axis of the fixing lug has a value substantially between two values (31 and 132 predetermined, with (32 <(31, advantageously respectively substantially equal to 130 degrees and 120 degrees.
Selon une autre caractéristique de l'invention, pour une seconde tige de prothèse apte être implantée sur une personne en remplacement d'une première tige de prothèse précédemment implantée sur cette même personne, la distance séparant le centre de la tête sphérique et le point d'intersection de l'axe de la collerette avec l'axe de la patte de fixation est sensiblement égale à L sin R, sin R2, dans laquelle L est la distance séparant le centre de la tête sphérique et le point d'intersection de l'axe de la collerette avec l'axe de la patte de fixation pour la première tige de prothèse, et f31 et (32 sont les valeurs de l'angle entre l'axe de la collerette et l'axe de la tige de fixation dans respectivement les première et seconde tiges de prothèse. According to another characteristic of the invention, for a second prosthesis stem adapted to be implanted on a person in replacement of a first prosthesis stem previously implanted on the same person, the distance separating the center of the spherical head and the point d intersection of the axis of the flange with the axis of the fixing lug is substantially equal to L sin R, sin R2, in which L is the distance separating the center of the spherical head and the point of intersection of the the axis of the flange with the axis of the fastening tab for the first prosthesis stem, and f31 and (32 are the values of the angle between the axis of the flange and the axis of the fastening rod in respectively the first and second prosthesis stems.
D'autres caractéristiques et avantages de l'invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif mais nullement limitatif, dans lesquels: La figure 1 représente le schéma de principe d'un mode de réalisation d'une prothèse de hanche selon l'invention, dans lequel certaines dimensions ont été dilatées par rapport à celles selon une échelle donnée pour une réalisation industrielle, dans le but de mieux faire ressortir les caractéristiques de l'invention, et Les figures 2 et 3 représentent deux coupes transversales d'un élément structurel de la prothèse de hanche selon l'invention telle qu'illustrée sur la figure 1, respectivement référencées II-II et III-III sur cette figure 1. Other features and advantages of the invention will become apparent from the following description given with reference to the accompanying drawings for illustrative but not limiting purposes, in which: FIG. 1 represents the block diagram of an embodiment of a hip prosthesis according to the invention, wherein certain dimensions have been expanded relative to those on a given scale for an industrial embodiment, in order to better highlight the characteristics of the invention, and Figures 2 and 3 show two transverse sections of a structural element of the hip prosthesis according to the invention as illustrated in FIG. 1, respectively referenced II-II and III-III in this FIG.
Il est bien précisé que, sur les figures, les mêmes références désignent les mêmes éléments, quelle que soit la figure sur laquelle elles apparaissent et quelle 30 que soit la forme de représentation de ces éléments. It is clearly stated that, in the figures, the same references designate the same elements, whatever the figure on which they appear and whatever the form of representation of these elements.
De même, si des éléments ne sont pas spécifiquement référencés sur l'une des figures, leurs références peuvent être aisément retrouvées en se reportant à une autre figure. Similarly, if elements are not specifically referenced in one of the figures, their references can be easily found by referring to another figure.
Il est aussi précisé que les figures représentent un seul mode de réalisation de l'objet selon l'invention, mais qu'il peut exister d'autres modes de réalisation qui répondent à la définition de cette invention. It is also stated that the figures represent a single embodiment of the object according to the invention, but that there may be other embodiments that meet the definition of this invention.
Il est aussi précisé en outre que, lorsque, selon la définition de l'invention, l'objet de l'invention comporte "au moins un" élément ayant une fonction donnée, le mode de réalisation décrit peut comporter plusieurs de ces éléments, et que, si les modes de réalisation de l'objet selon l'invention tel qu'illustré comportent plusieurs éléments de fonction identique et que si, dans la description, il n'est pas spécifié que l'objet selon cette invention doit obligatoirement comporter un nombre particulier de ces éléments, l'objet de l'invention pourra être défini comme comportant "au moins un" de ces éléments. It is furthermore specified that, when, according to the definition of the invention, the object of the invention comprises "at least one" element having a given function, the described embodiment may comprise several of these elements, and whereas, if the embodiments of the object according to the invention as illustrated comprise several elements of identical function and if, in the description, it is not specified that the object according to this invention must obligatorily comprise a particular number of these elements, the object of the invention may be defined as comprising "at least one" of these elements.
Il est enfin précisé que lorsque, dans la présente description, une expression définit à elle seule, sans mention particulière spécifique la concernant, un ensemble de caractéristiques structurelles, [par exemple E = 1(a, t, y, ...)], ces caractéristiques peuvent être prises, pour la définition de l'objet de la protection demandée, quand cela est techniquement possible, soit séparément, [par exemple a, et/ou T, et/ou y, Lastly, it is specified that when, in the present description, an expression alone defines, without any specific specific reference to it, a set of structural characteristics, [for example E = 1 (a, t, y, ...)] , these characteristics can be taken, for the definition of the object of the protection requested, when technically possible, either separately, [for example a, and / or T, and / or y,
.], soit en combinaison totale et/ou partielle, [par exemple E(a, T,y), et/ou E(a, t), et/ou E(T,y), et/ou E(a,y)]...DTD: Les trois figures représentent, sous forme schématique, un mode de réalisation d'une prothèse de hanche selon l'invention, étant souligné que le schéma selon cette représentation ne respecte pas les proportions d'une prothèse telle qu'elle est ou peut être réellement réalisée. En effet, dans ces représentations schématiques, certaines des dimensions de la prothèse ont été sciemment dilatées par rapport à celles selon une échelle donnée pour une réalisation industrielle, uniquement afin de mieux illustrer et faire ressortir les caractéristiques structurelles de la prothèse selon l'invention. .], whether in full and / or partial combination, [eg E (a, T, y), and / or E (a, t), and / or E (T, y), and / or E (a , y)] ... DTD: The three figures represent, in schematic form, an embodiment of a hip prosthesis according to the invention, being underlined that the diagram according to this representation does not respect the proportions of a prosthesis as it is or can be actually realized. Indeed, in these schematic representations, some of the dimensions of the prosthesis have been deliberately dilated compared to those on a given scale for an industrial realization, only to better illustrate and highlight the structural features of the prosthesis according to the invention.
La prothèse comporte un cotyle 1 apte à être implanté, de façon connue par les hommes du métier, dans l'os cotyloïdien du bassin d'un patient, ce cotyle comportant une cavité hémisphérique 12, et une tige de prothèse 2. The prosthesis comprises an acetabular cup 1 capable of being implanted, in a manner known to those skilled in the art, in the cotyloidal bone of a patient's pelvis, this acetabulum comprising a hemispherical cavity 12, and a prosthesis stem 2.
La tige de prothèse 2 comporte une patte de fixation 3 apte à être implantée dans le canal médullaire du fémur de façon que son axe 4 soit sensiblement confondu avec celui du canal médullaire, la patte de fixation 3 comportant de ce fait une extrémité proximale 5 et une extrémité distale 6. The prosthesis stem 2 comprises a fixing lug 3 adapted to be implanted in the medullary canal of the femur so that its axis 4 is substantially merged with that of the medullary canal, the fixing lug 3 thus having a proximal end 5 and a distal end 6.
La tige de prothèse 2 comporte en outre une collerette 7 qui peut présenter différentes formes, celle qui est illustrée n'étant qu'une forme possible parmi beaucoup d'autres. Une première extrémité 8 de la collerette 7 est solidaire de l'extrémité proximale 5 de la patte de fixation, l'axe 10 de la collerette faisant avec l'axe 4 de la patte de fixation un angle d'une valeur donnée. The prosthesis stem 2 further comprises a flange 7 which may have different shapes, the one illustrated being only one possible form among many others. A first end 8 of the collar 7 is secured to the proximal end 5 of the bracket, the axis 10 of the flange making with the axis 4 of the bracket an angle of a given value.
La tige de prothèse comporte aussi une tête sphérique 11 solidaire de la seconde extrémité 13 de la collerette 7, cette tête sphérique 11 étant apte à coopérer, de façon connue en soi, en rotation rotulienne avec la cavité hémisphérique 12. The prosthesis stem also comprises a spherical head 11 secured to the second end 13 of the collar 7, this spherical head 11 being able to cooperate, in a manner known per se, in rotulian rotation with the hemispherical cavity 12.
Selon une caractéristique de l'invention, la patte de fixation 3 présente une première partie 21 définie entre son extrémité proximale 5 et une section intermédiaire 23 définie à une distance non nulle de son extrémité distale 6, cette première partie 21 ayant des sections transversales 24 de forme sensiblement trapézoïdale, ou proche de cette forme comme spécifié au préambule de la présente description, diminuant de façon continue entre l'extrémité proximale 5 et la section intermédiaire 23 pour sensiblement épouser la forme du canal médullaire, et une seconde partie 22 définie entre la section intermédiaire 23 et l'extrémité distale 6, cette seconde partie 22 ayant des sections transversales 25 de forme sensiblement circulaire centrées sur l'axe 4 de la patte de fixation 3 et diminuant de façon continue entre la section intermédiaire 23 et l'extrémité distale. According to a characteristic of the invention, the fixing lug 3 has a first part 21 defined between its proximal end 5 and an intermediate section 23 defined at a non-zero distance from its distal end 6, this first part 21 having transverse sections 24 of substantially trapezoidal shape, or close to this shape as specified in the preamble of the present description, decreasing continuously between the proximal end 5 and the intermediate section 23 to substantially match the shape of the medullary canal, and a second part 22 defined between the intermediate section 23 and the distal end 6, this second portion 22 having cross sections 25 of substantially circular shape centered on the axis 4 of the fixing lug 3 and decreasing continuously between the intermediate section 23 and the end distal.
Avantageusement, cette seconde partie 22 est définie dans une enveloppe 25 de forme sensiblement conique de révolution dont l'angle au sommet est de préférence égal à au plus cent vingt degrés. Advantageously, this second portion 22 is defined in an envelope 25 of substantially conical shape of revolution whose angle at the top is preferably equal to at most one hundred twenty degrees.
La structure de la prothèse de hanche décrite ci-dessus, est particulièrement avantageuse, notamment quand il est nécessaire de procéder, pour différentes raisons, au remplacement d'une telle première prothèse par une seconde. The structure of the hip prosthesis described above is particularly advantageous, especially when it is necessary to proceed, for various reasons, to replace such a first prosthesis with a second.
En effet, pour solidariser la patte de fixation 3 avec la partie osseuse du fémur, on utilise de façon connue un ciment ou analogue qui enrobe totalement la partie de patte qui se trouve dans le canal médullaire du fémur, en la liant avec la partie osseuse du fémur. Indeed, to secure the fastening lug 3 with the bony part of the femur, is used in a known manner a cement or the like which completely encapsulates the leg portion which is in the medullary canal of the femur, by linking it with the bone part of the femur.
Or, pour différentes raisons, quelques années après qu'une prothèse hanche ait été implantée, par exemple généralement une quinzaine d'années sauf accident ou analogue, il arrive qu'il soit nécessaire de remplacer cette première prothèse par une seconde dite "de reprise", bien entendu en tenant compte des modifications morphologiques de la personne survenues après la pose de la première prothèse. However, for various reasons, a few years after a hip prosthesis has been implanted, for example generally about fifteen years except accident or the like, it sometimes happens that it is necessary to replace this first prosthesis by a so-called second "recovery" ", of course taking into account the morphological changes of the person that occurred after the first prosthesis was placed.
Pour ce faire, il est nécessaire de désolidariser la patte de fixation 3 de la première tige de prothèse 2 et le fémur, ce qui s'effectue de façon relativement classique sans trop de difficulté. To do this, it is necessary to separate the fixing lug 3 of the first prosthesis rod 2 and the femur, which is done in a relatively conventional manner without much difficulty.
En revanche, pour implanter la patte de fixation 3 de la seconde prothèse, il faut préalablement procéder au nettoyage du canal médullaire de tout le ciment qui enrobait la patte de fixation de la première prothèse et qui est collé à la partie osseuse du fémur. Comme explicité dans le préambule, on utilise essentiellement des fraises ou mèches d'un diamètre sensiblement égal à la section transversale du canal médullaire, plongeant dans celui-ci tout en étant animées d'un mouvement de rotation. Ces mèches permettent d'enlever le ciment collé sur la paroi du canal médullaire, mais aussi le bouchon de ciment situé en dessous de l'extrémité distale de la première patte de fixation, sans risquer d'endommager la corticale du fémur. En effet, elles sont guidées par la partie conique correspondant à l'empreinte en creux de la seconde partie 22 de la patte de fixation 3 de la première prothèse, qui joue le rôle d'un avant-trou parfaitement centré. On the other hand, to implant the fixing lug 3 of the second prosthesis, it is first necessary to clean the medullary canal of all the cement which encapsulated the fixing lug of the first prosthesis and which is glued to the bony part of the femur. As explained in the preamble, use is essentially strawberries or wicks of a diameter substantially equal to the cross section of the medullary canal, immersed in it while being driven by a rotational movement. These wicks are used to remove the cement stuck on the wall of the medullary canal, but also the cement plug located below the distal end of the first bracket, without risking damage to the cortex of the femur. Indeed, they are guided by the conical portion corresponding to the indentation of the second portion 22 of the bracket 3 of the first prosthesis, which plays the role of a perfectly centered pilot hole.
Par ailleurs, comme rappelé ci-dessus, le remplacement d'une première prothèse par une seconde s'effectue généralement après un certain nombre d'années relativement important et sur des personnes qui ont un âge certain et qui ont donc incontestablement subi des modifications morphologiques, par exemple un tassement de leur structure osseuse. Moreover, as mentioned above, the replacement of a first prosthesis with a second is generally carried out after a relatively large number of years and on persons who are of certain age and who have undeniably undergone morphological changes. , for example a settlement of their bone structure.
Il se pose donc par exemple un problème lorsque la personne ne porte une prothèse de hanche que d'un seul côté. En effet, il est bien évident que, les prothèses étant réalisées dans des matériaux solides comme un alliage de titane ou analogue, il n'y a pas un affaissement de ce matériel. Un affaissement se produit en revanche sur la hanche qui ne possède pas de prothèse et, pour rétablir un équilibre et une symétrie morphologiques et éviter des problèmes notamment rachidiens, il est nécessaire de remplacer la première prothèse avec une seconde prothèse qui doit tenir compte des modifications morphologiques survenues dans la hanche sans prothèse. This poses a problem, for example, when the person wears a hip prosthesis only on one side. Indeed, it is obvious that, since the prostheses are made of solid materials such as a titanium alloy or the like, there is no sagging of this material. A collapse occurs on the other hand on the hip which does not have a prosthesis and, to restore a morphological balance and symmetry and to avoid problems in particular spinal, it is necessary to replace the first prosthesis with a second prosthesis which must take into account the modifications. morphological changes in the hip without prosthesis.
Aussi, la prothèse selon l'invention comporte-t-elle en outre les caractéristiques structurelles suivantes. Also, the prosthesis according to the invention further comprises the following structural features.
Tout d'abord, la valeur de l'angle R entre l'axe 10 de la collerette 7 et l'axe 4 de la patte de fixation 3 est sensiblement comprise entre deux valeurs R1 et j32 prédéterminées, avec 132 < J31, la différence entre ces deux valeurs étant illustrée sur la figure 1 par l'angle a. Firstly, the value of the angle R between the axis 10 of the flange 7 and the axis 4 of the fixing lug 3 is substantially between two predetermined values R1 and J32, with 132 <J31, the difference between these two values being illustrated in Figure 1 by the angle a.
L'expérience a démontré aux Demandeurs que les deux valeurs 131 et (32 prédéterminées sont respectivement sensiblement égales à 130 degrés et 120 degrés, et que la valeur de l'angle a est le plus souvent de l'ordre de huit degrés. The experiment has demonstrated to the applicants that the two predetermined values 131 and 32 are respectively substantially equal to 130 degrees and 120 degrees, and that the value of the angle a is most often of the order of eight degrees.
Selon l'invention aussi, la seconde tige de prothèse apte être implantée sur une personne, en remplacement d'une première tige de prothèse précédemment implantée sur cette même personne, est définie de façon que la distance séparant le centre de la tête sphérique 11 et le point d'intersection 26 de l'axe 10 de la collerette 7 avec l'axe 4 de la patte de fixation 3 soit sensiblement égale à L S'nPI, dans laquelle L est la distance séparant le centre de la tête sphérique 11 sin132 et le point d'intersection 26 de l'axe 10 de la collerette 7 avec l'axe 4 de la patte de fixation 3 pour la première tige de prothèse, et R1 et (32 sont les valeurs de l'angle entre l'axe 10 de la collerette 7 et l'axe 4 de la tige de fixation 3 dans respectivement les première et seconde tiges de prothèse. According to the invention also, the second prosthesis stem adapted to be implanted on a person, replacing a first prosthesis stem previously implanted on the same person, is defined so that the distance separating the center of the spherical head 11 and the point of intersection 26 of the axis 10 of the flange 7 with the axis 4 of the fixing lug 3 is substantially equal to L S'nPI, in which L is the distance separating the center of the spherical head 11 sin132 and the point of intersection 26 of the axis 10 of the flange 7 with the axis 4 of the fixing lug 3 for the first prosthesis stem, and R1 and (32 are the values of the angle between the axis 10 of the collar 7 and the axis 4 of the fixation rod 3 in the first and second prosthesis rods respectively.
De plus, pour permettre au praticien d'encore mieux respecter la morphologie du patient, la tête sphérique 11 de la seconde tige de prothèse est choisie dans un ensemble de têtes sphériques ayant des rayons de valeurs progressant de façon arithmétique entre deux limites prédéterminées, par exemple de 2 mm en 2 mm, et/ou la seconde tige de prothèse 2 est choisie dans un ensemble de tiges de prothèse ayant des valeurs de distance I progressant de façon arithmétique entre deux limites prédéterminées, à titre d'exemple de 10 mm en 10 mm. In addition, to enable the practitioner to better respect the morphology of the patient, the spherical head 11 of the second prosthesis stem is chosen from a set of spherical heads having radii of values progressing arithmetically between two predetermined limits, for example 2 mm in 2 mm, and / or the second prosthesis stem 2 is chosen from a set of prosthesis rods having distance values I progressing arithmetically between two predetermined limits, for example 10 mm in diameter. 10 mm.
Claims (8)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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FR0405853A FR2870717B1 (en) | 2004-06-01 | 2004-06-01 | HIP PROSTHESIS |
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FR0405853A FR2870717B1 (en) | 2004-06-01 | 2004-06-01 | HIP PROSTHESIS |
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FR2870717A1 true FR2870717A1 (en) | 2005-12-02 |
FR2870717B1 FR2870717B1 (en) | 2007-04-27 |
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FR0405853A Expired - Lifetime FR2870717B1 (en) | 2004-06-01 | 2004-06-01 | HIP PROSTHESIS |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN112618111A (en) * | 2020-12-14 | 2021-04-09 | 徐州医科大学 | Femoral stem prosthesis design method based on vein skeleton structure |
Citations (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2629707A1 (en) * | 1988-04-07 | 1989-10-13 | Roux Jean Pierre | Femoral piece and equipment for making a hip prosthesis |
EP0629386A2 (en) * | 1993-05-26 | 1994-12-21 | KABUSHIKI KAISHA KOBE SEIKO SHO also known as Kobe Steel Ltd. | Artificial joint |
GB2281213A (en) * | 1993-08-12 | 1995-03-01 | Biomet Ltd | Prosthetic hip component |
FR2729481A1 (en) * | 1995-01-12 | 1996-07-19 | Landanger Landos | Generation of instructions for formation of hip replacement joint |
FR2729292A1 (en) * | 1995-01-12 | 1996-07-19 | Medinov Sa | Modular assembly of femoral rods for prosthetic hips |
EP0974317A1 (en) * | 1998-07-24 | 2000-01-26 | BEJUI, Jacques | Anchoring shaft for hip joint prosthesis and set of such shafts |
EP1025817A1 (en) * | 1999-02-08 | 2000-08-09 | Provis S.A. | Femoral shaft for hip prosthesis |
WO2000059410A2 (en) * | 1999-04-07 | 2000-10-12 | Plus Endoprothetik Ag | Flat shaft of a hip joint prosthesis for anchoring in the femur |
EP1216668A2 (en) * | 2000-12-14 | 2002-06-26 | Depuy Orthopaedics, Inc. | Prosthesis with feature aligned to trabeculae |
FR2844994A1 (en) * | 2002-09-27 | 2004-04-02 | Medacta Int Sa | Hip joint prosthesis nail has defined angles between areas of shank and neck in two planes |
-
2004
- 2004-06-01 FR FR0405853A patent/FR2870717B1/en not_active Expired - Lifetime
Patent Citations (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2629707A1 (en) * | 1988-04-07 | 1989-10-13 | Roux Jean Pierre | Femoral piece and equipment for making a hip prosthesis |
EP0629386A2 (en) * | 1993-05-26 | 1994-12-21 | KABUSHIKI KAISHA KOBE SEIKO SHO also known as Kobe Steel Ltd. | Artificial joint |
GB2281213A (en) * | 1993-08-12 | 1995-03-01 | Biomet Ltd | Prosthetic hip component |
FR2729481A1 (en) * | 1995-01-12 | 1996-07-19 | Landanger Landos | Generation of instructions for formation of hip replacement joint |
FR2729292A1 (en) * | 1995-01-12 | 1996-07-19 | Medinov Sa | Modular assembly of femoral rods for prosthetic hips |
EP0974317A1 (en) * | 1998-07-24 | 2000-01-26 | BEJUI, Jacques | Anchoring shaft for hip joint prosthesis and set of such shafts |
EP1025817A1 (en) * | 1999-02-08 | 2000-08-09 | Provis S.A. | Femoral shaft for hip prosthesis |
WO2000059410A2 (en) * | 1999-04-07 | 2000-10-12 | Plus Endoprothetik Ag | Flat shaft of a hip joint prosthesis for anchoring in the femur |
EP1216668A2 (en) * | 2000-12-14 | 2002-06-26 | Depuy Orthopaedics, Inc. | Prosthesis with feature aligned to trabeculae |
FR2844994A1 (en) * | 2002-09-27 | 2004-04-02 | Medacta Int Sa | Hip joint prosthesis nail has defined angles between areas of shank and neck in two planes |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN112618111A (en) * | 2020-12-14 | 2021-04-09 | 徐州医科大学 | Femoral stem prosthesis design method based on vein skeleton structure |
CN112618111B (en) * | 2020-12-14 | 2021-09-21 | 徐州医科大学 | Femoral stem prosthesis design method based on vein skeleton structure |
Also Published As
Publication number | Publication date |
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FR2870717B1 (en) | 2007-04-27 |
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