FR2839641A1

FR2839641A1 - Fe mural component of hip prosthesis has truncated conical tip on neck with oblong or rectangular cross-section

Info

Publication number: FR2839641A1
Application number: FR0206122A
Authority: FR
Inventors: Jean Claude Cartillier; Bruno Balay; Louis Setiey; Jean Pierre Vidalain; Alain Machenaud; Jean Marc Semay; Jean Christophe Chatelet; Michel Henri Fessy; Claude Charlet
Original assignee: Individual
Current assignee: Individual
Priority date: 2002-05-17
Filing date: 2002-05-17
Publication date: 2003-11-21
Anticipated expiration: 2022-05-17
Also published as: FR2839641B1

Abstract

The Fe mural component, made from titanium alloy TA6V4 with a tapering shank (2) having transverse grooves (5), an inclined neck (3) and a truncated conical tip to receive a head (8), has the tip made with a length of 11.2 mm or less, while the neck has an oblong or rectangular cross-section with two parallel main faces and a thickness less than the mean diameter of the tip, i.e. not more than 14 mm. The whole shank of the prosthesis is coated with a material promoting osteo-integration, especially hydroxyapatite.

Description

orifice (30).orifice (30).

La presente invention a trait a une partie femorale de prothese pour articulation de la hanche, du type presentant une tige ou queue femorale allongee destinee a etre engagee puis fixce dans le canal medullaire ou fut femoral et presentant, a son extremite libre, des moyens de reception et de fixation d'une tete de prothese femorale destinee a cooperer avec une prothese acetabulaire. Le brevet francais 2 600 527 decrit une partie femorale de prothese de hanche comportant une queue dont la section, sensiblement quadrangulaire, va en se retrecissant progressivement de sa partie superieure jusquta sa pointe, cette queue comportant a sa partie superieure et sur au moins chacune de ses deux plus grandes faces opposees, une serie de rainures transversales a ondulations en dents de loup dont la pente est montante de la partie haute de la queue vers sa partie basse, ces rainures etant transversales, par exemple perpendiculaires a l' axe longitudinal de la queue, la serie de rainures etant suivie, de preference, jusqu'a la pointe de la queue, d'une serie de rainures longitudinales pratiquees sur les quatre faces de la queue. Ces queues de prothese s'averent d'une stabilite et d'une longevite tres grande et ont rencontre un grand succes. La presente invention se propose de perfectionner les parties femorales de prothese de hanche de ce type, et notamment, d'augmenter le debattement angulaire de la partie femorale de la prothese par rapport a la cupule acetabulaire dans laquel le est art iculee la tete prothetique femorale, et ceci dans toutes les directions, y compris pour les mouvements de flexion, d' extension, d'abduction, dadJuction, de rotations interne et externe The present invention relates to a femoral part of a hip joint prosthesis, of the type having an elongated femoral rod or tail intended to be inserted and then fixed in the medullary canal where the femoral was and having, at its free end, means for reception and fixation of a femoral prosthesis head intended to cooperate with an acetabular prosthesis. French patent 2,600,527 describes a femoral part of a hip prosthesis comprising a tail whose section, substantially quadrangular, gradually narrows from its upper part to its tip, this tail comprising at its upper part and on at least each of its two largest opposite faces, a series of transverse grooves with undulations in wolf's teeth whose slope is rising from the upper part of the tail towards its lower part, these grooves being transverse, for example perpendicular to the longitudinal axis of the tail , the series of grooves being followed, preferably, up to the tip of the tail, a series of longitudinal grooves practiced on the four faces of the tail. These prosthetic tails prove to be of very great stability and longevity and have met with great success. The present invention proposes to improve the femoral parts of hip prosthesis of this type, and in particular to increase the angular movement of the femoral part of the prosthesis relative to the acetabular cup in which it is articulated the femoral prosthetic head. , and this in all directions, including for movements of flexion, extension, abduction, dadJuction, internal and external rotations

de la cuisse.thigh.

I1 est ainsi possible de reduire les risques de luxation ainsi que les sollicitations osseuses, tendineuses et musculaires dans les positions extremes de It is thus possible to reduce the risks of dislocation as well as the bone, tendon and muscular stresses in the extreme positions of

debattement du membre inferieur.lower limb deflection.

Par ailleurs ce debattement accru compense des positions non ideales de la cupule acetabulaire qui peuvent etre dues soit aux conditions operatoires, soit a Furthermore, this increased deflection compensates for non-ideal positions of the acetabular cup which may be due either to the operating conditions, or to

des circonstances anatomiques particulieres. particular anatomical circumstances.

L' invention a pour objet une partie femorale de prothese de hanche, du type comportant une queue dont la section va se retrecissant progressivement de sa partie superieure jusqu'a sa pointe, ladite section etant quadrangulaire ou oblongue et comportant a sa partie superieure, et sur au moins chacune de ses deux plus grandes faces opposees, une serie de rainures transversales a ondulations en dents de loup dont la pente est montante de la partie haute de la queue vers la partie basse, cette serie de rainures etant suivie de preference jusqu'a la pointe de la queue, d'une serie de rainures longitudinales pratiquees sur deux et; de preference, quatre faces de la queue, ladite partie femorale presentant, a l' oppose de la pointe, un col incline par rapport a l'axe longitudinal de la queue proprement cite et se terminant par une surface tronconique de reception de la tete prothetique femorale, cette partie femorale etant caracterisee en ce que la hauteur de ladite partie tronconique est inferieure ou egale ou a 11,2 mm, et en ce que le col presente une section quadrangulaire a deux grandes faces sensiblement paralleles et ayant une epaisseur inferieure au diametre The subject of the invention is a femoral part of a hip prosthesis, of the type comprising a tail, the section of which is progressively narrowing from its upper part to its tip, said section being quadrangular or oblong and comprising at its upper part, and on at least each of its two largest opposite faces, a series of transverse grooves with undulations in wolf's teeth whose slope is rising from the upper part of the tail towards the lower part, this series of grooves being preferably followed up at the tip of the tail, a series of two practical longitudinal grooves and; preferably four sides of the tail, said femoral part having, opposite the point, a neck inclined relative to the longitudinal axis of the tail properly mentioned and ending in a frustoconical surface for receiving the prosthetic femoral head , this femoral part being characterized in that the height of said frustoconical part is less than or equal to or 11.2 mm, and in that the neck has a quadrangular section with two large substantially parallel faces and having a thickness less than the diameter

moyen de ladite partie conique.by means of said conical part.

De preference la partie femorale de prothese est realisee en un materiau tel que l'alliage de titane TA6V4 ou un materisu presentant des proprietes mecaniques similaires. De facon particulierement preferee, la queue est entierement recouverte d'un revetement facilitant l'osteo- integration, tel qu'une preparation d'hydroxyapatite. Le diametre moyen de la partie conique est de Preferably, the femoral part of the prosthesis is made of a material such as the titanium alloy TA6V4 or a material having similar mechanical properties. Particularly preferably, the tail is completely covered with a coating facilitating osteo-integration, such as a preparation of hydroxyapatite. The average diameter of the conical part is

preference inferieur ou egal a 14 mm. preferably less than or equal to 14 mm.

De facon particulierement preferee, la hauteur de cette partie tronconique est de l'ordre de 10,5 a 11,5 mm. La partie de col, qui se termine par la surface tronconique destinee a recevoir la tete femorale, presente une section non circulaire sensiblement rectangulaire ou oblongue, dont les deux grandes faces vent paralleles au plan frontal de la queue proprement cite et dont l'epaisseur, transversalement a ces faces, est de preference inferieure ou egale a 9,2 mm, les deux faces etant sensiblement paralleles entre l'extremite tronconique et la zone de raccordement avec la queue de Particularly preferably, the height of this frustoconical part is of the order of 10.5 to 11.5 mm. The neck portion, which ends in the frustoconical surface intended to receive the femoral head, has a non-circular section which is substantially rectangular or oblong, the two large faces of which are parallel to the frontal plane of the tail properly mentioned and the thickness of which, transversely to these faces, is preferably less than or equal to 9.2 mm, the two faces being substantially parallel between the frustoconical end and the zone of connection with the tail of

prothese proprement cite.prosthesis properly cited.

Il est ainsi possible, grace a l' invention, dans le cas ou l'on utilise une tete cite a col long, c'est-a dire dont le centre geometrique spherique est eloigne, de recouvrir entierement la surface conique, qui coopere avec un receptacle tronconique correspondent de la tete prothetique, d'une facon telle que la totalite de la surface tronconique soit situee a l'interieur de la tete prothetique femorale, et ceci queue que soit la tete choisie. Par ailleurs, la disposition en retrait des deux grands cotes de la section quadrangulaire du col autorise un debattement plus important jusquta venir au contact de la cupule acetabulaire, et ceci aussi bien en flexion It is thus possible, thanks to the invention, in the case where a quoted head with a long neck, that is to say one whose spherical geometric center is far away, is used to completely cover the conical surface, which cooperates with a frustoconical receptacle correspond to the prosthetic head, in such a way that the entire frustoconical surface is located inside the prosthetic femoral head, and this tail whatever the head chosen. Furthermore, the recessed arrangement of the two large sides of the quadrangular section of the neck allows greater travel until it comes into contact with the acetabular cup, and this in flexion as well

qu'en extension.that in extension.

En out re, le parallelisme des deux faces du col assure un meilleur debattement angulaire, dans toutes les configurations d' implantation. En effet, quel que soit l' engagement de la tete prothetique sur son cone, la zone de contact entre le col prothetique femoral et la cupule acetabulaire est touj ours positionnee sur les deux faces paralleles, ce In addition, the parallelism of the two sides of the neck ensures better angular movement, in all the configurations of implantation. Indeed, whatever the engagement of the prosthetic head on its cone, the contact zone between the femoral prosthetic neck and the acetabular cup is always positioned on the two parallel faces,

qui augmente le debattement angulaire permis. which increases the angular travel allowed.

De plus, on peut mettre a profit la forme aplatie du col avec deux faces sensiblement paralleles sur une grande partie de leur longueur, pour assurer un blocage angulaire de la prothese dans un ancillaire de pose de partie femorale de prothese et qui vient se fixer provisoirement a l'extremite superieure de la queue de prothese. L' invention a done egalement pour objet un ancillaire pour une telle prothese, caracterisee en ce qutil comporte des moyens, par exemple sous forme d'une fourche, venant se disposer de part et dautre des surfaces plates du col, de facon a sensiblement solidariser en rotation la partie femorale de prothese selon ['invention et l'ancillaire, ainsi qu'un moyen de In addition, one can take advantage of the flattened shape of the neck with two substantially parallel faces over a large part of their length, to ensure an angular blocking of the prosthesis in an ancillary for placing the femoral part of the prosthesis and which is temporarily fixed. at the upper end of the prosthesis tail. The invention therefore also relates to an ancillary device for such a prosthesis, characterized in that it comprises means, for example in the form of a fork, coming to be disposed on either side of the flat surfaces of the neck, so as to substantially join in rotation the femoral part of the prosthesis according to the invention and the ancillary, as well as a means of

solidarisation temporaire.temporary solidarity.

D'autres avantages et caracteristiques de Other advantages and characteristics of

l' invention apparaltront a la lecture de la description the invention will appear on reading the description

suivante, faite a titre dexemple non limitatif et se referent au dessin annexe dans lequel: la figure 1 represente une vue en elevation d'une prothese selon l' invention (vue de face) et, la figure 2 represente une vue, laterale externe de cette prothese (vue de profil), la figure 3 represente une vue laterale interne de cette prothese, la figure 4 represente une vue en coupe longitudinale de la prothese, la figure 5 represente une vue en section transversale V-V du col de la prothese de la figure 1. La figure 6 represente une vue en coupe du debattement angulaire de la prothese dans une cupule acetabulaire. La figure 7 represente une vue en perspective d'un ancillaire. En se reportant tout d'abord a ['ensemble des figures 1 a 5, la partie femorale de prothese de hanche 1 selon l' invention comporte une queue allongee 2, dont la section va en se retrecissant du haut vers le teas comme represente, et un col 3 portent une extremite tronconique 4 sur laquelle on viendra fixer une tete spherique 8 conformee de maniere a pouvoir etre engagee dans la cupule cotyloldienne. La piece 1 peut etre equipee, a la jonction entre sa queue 2 et son col 3, d'une collerette (non representee) destinee a venir prendre appui sur le calcar, et deja participer ainsi a la stabilisation primaire de la prothese contre les forces varisantes de following, made by way of nonlimiting example and refer to the appended drawing in which: FIG. 1 represents an elevation view of a prosthesis according to the invention (front view) and, FIG. 2 represents a view, external lateral of this prosthesis (side view), FIG. 3 represents an internal lateral view of this prosthesis, FIG. 4 represents a view in longitudinal section of the prosthesis, FIG. 5 represents a cross-sectional view VV of the neck of the prosthesis of the Figure 1. Figure 6 shows a sectional view of the angular displacement of the prosthesis in an acetabular cup. Figure 7 shows a perspective view of an ancillary. Referring first of all to FIGS. 1 to 5, the femoral part of hip prosthesis 1 according to the invention comprises an elongated tail 2, the section of which narrows from the top to the teas as shown, and a neck 3 carry a frustoconical end 4 on which we will fix a spherical head 8 conformed so as to be able to be engaged in the acetabular cup. Piece 1 can be fitted, at the junction between its shank 2 and its neck 3, with a collar (not shown) intended to come to bear on the calcar, and already participate in the primary stabilization of the prosthesis against forces varying from

basculement et contre les forces denfoncement axial. tilting and against axial driving forces.

Pour stabiliser parfaitement la prothese a la fois contre les forces de rotation, les forces denfoncement et les forces varisantes, la queue 2 presente les caracteristiques supplementaires suivantes: - sa section est quadrangulaire, - sa partie superieure est pourvue, sur ses deux plus grandes faces et sur environ le premier tiers de la longueur totale de la queue, d'une serie de rainures transversales 5, par exemple perpendiculaires a l'axe longitudinal 6 de la queue 2, et a ondulations en dents de loup, a l 2839641 pente montante du haut vers le teas, -, - le restart de la queue 2, c'est-a-dire environ ses deux derniers tiers est pourvu, sur ses | quatre faces, de rainures longitudinales 7, a ondulations symetriques. Comme on le volt sur la figure 1, la serie de rainures longitudinal es 7 est cont igue a la serie de rainures transversales 5, ce qui permet dobtenir un effet optimal de resistance aux forces denfoncement et To perfectly stabilize the prosthesis against rotational forces, sinking forces and varying forces, the shank 2 has the following additional characteristics: - its section is quadrangular, - its upper part is provided, on its two largest sides and over approximately the first third of the total length of the tail, a series of transverse grooves 5, for example perpendicular to the longitudinal axis 6 of the tail 2, and with wolf tooth undulations, al 2839641 rising slope of the top towards the teas, -, - the restart of the tail 2, that is to say about its last two thirds is provided, on its | four faces, of longitudinal grooves 7, with symmetrical undulations. As shown in FIG. 1, the series of longitudinal grooves 7 is contiguous to the series of transverse grooves 5, which makes it possible to obtain an optimal effect of resistance to the driving forces and

aux forces de rotation.rotational forces.

La forme et les dimensions des rainures transversales et longitudinales peuvent etre, par exemple, analogues a celles decrites dans le brevet The shape and dimensions of the transverse and longitudinal grooves can be, for example, similar to those described in the patent

fran,cais 2 600 527.fran, cais 2,600,527.

L'extremite tronconique 4, dont la conicite est de preference de l'ordre de 5 , de fac,on a permettre un blocage avec un logement conique complementaire presente a l'interieur de la tete prothetique 8 destinee a etre montee sur la partie conique 4, possede une longueur The frustoconical end 4, the conicity of which is preferably of the order of 5, so that a blocking is allowed with a complementary conical housing present inside the prosthetic head 8 intended to be mounted on the conical part 4, has a length

axiale de l'ordre de 11,2 mm.axial of the order of 11.2 mm.

Comme on le volt sur les figures, le col 3 presente une section egalement quadrangulaire, bien vue sur la figure 3 et dont les deux plus grandes faces vent sensiblement paralleles. L'epaisseur de ce col, comme on le volt egalement sur la figure 3, est nettement inferieure au diametre moyen de l'extremite conique 4, et ceci sur la plus grande partie, et de preference sur pratiquement la totalite du col a peu pres jusqu'au niveau du trait de section III-III. Ensuite il est prefere que l'epaisseur croisse assez rapidement pour rejoindre l'epaisseur de la partie superieure de la queue As shown in the figures, the neck 3 has a section also quadrangular, clearly seen in Figure 3 and the two largest faces are substantially parallel. The thickness of this neck, as can also be seen in FIG. 3, is clearly less than the average diameter of the conical end 4, and this over most of it, and preferably over practically the whole of the neck approximately. up to the level of the line in section III-III. Then it is preferable that the thickness grows quickly enough to reach the thickness of the upper part of the tail

proprement cite.properly quoted.

Grace a la hauteur relativement falble de l'extremite tronconique 4, on peut obtenir que la base inferieure de cette extremite, se trouve, queue que soit la taille de la tete spherique, entierement incluse dans Thanks to the relatively falble height of the frustoconical end 4, it is possible to obtain that the lower base of this end, is, tail whatever the size of the spherical head, entirely included in

cette fete, comme on le volt, notamment, sur la figure 4. this party, as we volt, in particular, in Figure 4.

Il en resulte que lorsque l' implant femoral, revetu de sa tete femorale, est articule dans la cavite cotyloidienne, par exemple, une cupule acetabulaire 15, le debattement angulaire de la partie femorale de prothese s'effectuera jusqutau moment ou la peripherie 16 de la cupule 15 viendra en contact avec une face du col 3. Les mouvements de flexion et d' extension etant effectues dans une direction sensiblement perpendiculaire aux grandes faces It follows that when the femoral implant, coated with its femoral head, is articulated in the acetabular cavity, for example, an acetabular cup 15, the angular movement of the femoral part of the prosthesis will take place until the periphery 16 of the cup 15 will come into contact with one face of the neck 3. The flexion and extension movements being carried out in a direction substantially perpendicular to the large faces

de la section de la partie de prothese femorale, c'est-a- of the section of the femoral prosthesis part, i.e.

dire dans des directions perpendiculaires au plan de la say in directions perpendicular to the plane of the

figure 1, on obtiendra un debattement A accru. Figure 1, we will get an increased travel A.

1 5 La part ie de prothese femoral e representee sur l es dessins est realisee en un materiau tel que l'alliage de - titane TA6V4, (alliage de titane TA6V4 Extra Low 1 5 The part ie of femoral prosthesis represented on the drawings is realized in a material such as the alloy of - titanium TA6V4, (titanium alloy TA6V4 Extra Low

Interstitial selon la norme americaine ASTM F136). Interstitial according to American standard ASTM F136).

Le choix de ce materiau permet de combiner les avantages dus aux caracteristiques dimensionnelles de la presente invention aux necessites mecaniques et chirurgicales requises pour les implants de tige femorale. De preference, la partie femorale de prothese est revetue dhydroxyapatite sur la totalite de sa longueur The choice of this material makes it possible to combine the advantages due to the dimensional characteristics of the present invention with the mechanical and surgical necessities required for femoral stem implants. Preferably, the femoral part of the prosthesis is coated with hydroxyapatite over its entire length.

qui porte les rainures telles que 5 et 7. which carries the grooves such as 5 and 7.

En se referent a la figure 7, on volt un exemple d'un ancillaire qui peut etre utilise pour presenter et impacter la tige femorale. Cet ancillaire presente un manchon tubulaire 9 presentant, a son extremite, une fourche 10 orientee de facon oblique vers le teas, de facon a ce que les deux branches de la fourche puissent venir enserrer les grandes faces du col 3. Dans le manchon 9 peut coulisser une tige 11 presentant, a son Referring to Figure 7, there is an example of an ancillary that can be used to present and impact the femoral stem. This ancillary has a tubular sleeve 9 having, at its end, a fork 10 oriented obliquely towards the teas, so that the two branches of the fork can grip the large faces of the neck 3. In the sleeve 9 can slide a rod 11 presenting, at its

extremite superieure une enclume dtimpaction 12. upper end of an impact anvil 12.

L'extremite inferieure de la tige 11 vient penetrer dans un trou 13 situe usuellement sur la face correspondante de la prothese femorale pour bloquer la prothese en position. On garantit ainsi une parfaite solidarisation temporaire de l'ancillaire et de la partie femorale de prothese de hanche pendant la presentation et limpaction. Une poignee transversale 14 facilite la The lower end of the rod 11 comes into a hole 13 usually located on the corresponding face of the femoral prosthesis to lock the prosthesis in position. This guarantees perfect temporary attachment of the ancillary and the femoral part of the hip prosthesis during presentation and limpaction. A transverse handle 14 facilitates the

manipulation de l'ancillaire.manipulation of the ancillary.

Claims

1. Femoral part of hip prosthesis, of the type comprising a tail (2), the section of which will progressively narrow from its upper part to its tip, said section being quadrangular or oblong and comprising at its upper part, and on at least each of its two largest opposite faces, a series of transverse grooves (5) with undulations in wolf's teeth whose slope is rising from the upper part of the tail towards the lower part, said femoral part having, opposite the point , a neck (3) inclined relative to the longitudinal axis of the tail properly mentioned and ending in a frustoconical surface (4), for receiving the prosthetic femoral head, this femoral part being characterized in that the height of said frustoconical part (4) is less than or equal to 11.2 mm, and in that the neck (3) has an oblong or quadrangular section with two large faces that are substantially parallel and have a thickness less than the diameter means of said part

conical (4).

2. Femoral part of hip prosthesis according to claim 1 characterized in that the tail is entirely covered with a coating facilitating osteo-integration, in particular a preparation of hydroxyapatite.

3. Femoral part of hip prosthesis according to one

of claims 1 and 2 characterized in that the

mean diameter of the conical part (4), is smaller or

equal to 14 mm.

4. Femoral part of hip prosthesis according to one

of claims 1 to 3 characterized in that the

height of the conical part (4) is of the order of 10.5

mm to 11.5 mm.

5. Femoral part of hip prosthesis according to one

of claims 1 to 4, characterized in that

the thickness of the neck (3) transversely to its two large faces, is less than or equal to 9 mm, the two faces being substantially parallel to the axis of the prosthesis between the frustoconical end and a zone of

connection with the prosthesis tail proper.

6. Femoral part of hip prosthesis according to one

of claims 1 to 5 characterized by a travel

angular increases and identical tail whatever

lt frustoconical engagement of prosthetic holidays.

7. Femoral part of hip prosthesis according to one

of claims 1 to 6, characterized in that it is

made of a material such as the titanium alloy TA6V4 or a material having similar mechanical properties.

8. Ancillary for the installation of a prosthesis according to

one of claims 1 to 7, characterized in that

qutil comprises means (10), coming to dispose on either side of the flat surfaces of the neck, so as to substantially ground idari ser in rotation the femoral

prosthesis according to the invention and the ancillary.

9. Ancillary device according to claim 8, characterized in that said means (10) comprise a fork, a

temporary blocking means (11) being further provided.

10. Ancillary device according to claim 9, characterized in that said locking means comprises a rod (11) sliding in a sleeve (9) and of which the liextremite temporarily penetrates into a hole (13)