JPH0347253A - Modular prosthetic tool for hip joint - Google Patents

Abstract

PURPOSE: To make it possible to select parts during a surgery operation to engage a transplanting item altogether with a combination of these parts so selected, by adjusting the aid connected to support the femur and load and a means available to be fitted to the aid for keeping. CONSTITUTION: The top ends of the extended sleeves 30, 30A are provided each with an inner ring surface 38 inclined whose type agrees with the middle section 18 of an frusto-conical shape of the stem 13. Consequently, this allows both the extended sleeves 30, 30A and stem 13 to form a frictional tight engagement at assembling. The draw bolt is tightened after securing both the aid's main body 11 and the sleeves 30 (30A) into the bone-marrow inner tube. Like this, the extended sleeve 30 (30A) freely tracks the natural path of the bone- marrow inner tube during a period of insertion. Therefore, the long extended sleeve 30A naturally meets the patient's femur, i.e., a custom fit. This can obtain a modular pad structure available to be used easier and quickly.

Description

DETAILED DESCRIPTION OF THE INVENTION (a) Industrial Application Field The present invention enables parts of various elements of the implant to be selected during the surgical procedure, so that the implant can be specifically tailored to the patient. The present invention relates to a modular hip joint arrester that can be fitted together.

(b) Prior Art and Problems There is a growing desire among surgeons to be able to specifically fit the femoral conch to the patient. Instead of having to select an appropriately sized hlf piece from a prefabricated -R* implant, it would be advantageous to have a basic design that could be modified with various component parts.

This eliminates the need to maintain large assets;
In cases where the graft is provided with a damaged fit, the old cement must be removed and bone loss often occurs, requiring the implant to be removed or replaced. Specially fitted implants are of particular importance in cases where unpredictable proximal and/or distal bone loss or deformity often occurs; The problem must be resolved with an alternative trap.

For initial implants, the surgeon often encounters an unreliable anatomy of the affected awn.

Some patients have significantly longer or shorter femoral necks than others. Cortical defects in the diaphysis are not uncommon;
It is not discovered until surgery. The diameter of the intramedullary canal also varies, resulting in distal toggle (Logglc) if a properly sized implant is not used in this case.

In short, it is difficult, if not impossible, to predict the exact shape of a hip implant that will be suitable for all 4° patients. Maintaining implant assets for most patients is impractical and cost-prohibitive, so compromises sometimes have to be made when a fairly well-fitting implant is modified. There are implants available.

Several hip prostheses are known, which are formed from interchangeable or interchangeable components.

U.S. Pat. No. 3,641,590 discloses a selective individualized technique for replacing the hip socket itself, and U.S. Pat. No. 3,228,393 discloses a hip joint designed for all ages, including very young patients. Discloses an oil fitting for replacing the entire hip joint. A method of selective fixation of cup prostheses of two sizes selected from a limited number of cup sizes of different sizes is available for fl. Fixation techniques that replace the acetabular socket encounter variations in the dimensions, morphology, and position of the acetabular pelvic (medullary) canal in individual patients, and at least two long tapered fastenings are Or has a flared clamping tool.

A readily removable collar of low modulus material is disclosed in US Pat. No. 4,012,796. This collar is interposed between the collar of the hip joint spinal cord implanted in the intramedullary canal of the anterior femur and the adjacent collar or outer edge of the bone. A flange depends from the insert between the top of the stem and the inner wall of the bone. The intervening collar is either a sufficiently long tapered O-shape or a tapered U-shape that is open on one side.

U.S. Pat. No. 4,404,69i discloses that the joint
The present invention provides a modular hip prosthesis assembly for replacing a portion of the diaphysis and a portion of the diaphysis, which is similar in shape but dimensionally similar to the mounting element with a connection. The attachments each include at least two connecting elements that can be connected to the elements, and each connecting element according to item 1- is characterized in that the attachment comprises an engaging part and a connecting part configured to connect with the connecting parts of the members. each of the connecting elements providing a portion of the diaphysis and a portion of the joint capable of cooperating with appropriate portions of the natural or artificial joint;
ing.

U.S. Patent No. 4,578,081 is a natural joint! Discloses a bone trap comprising at least 61 connecting elements for replacing /2, the connecting elements comprising a shank configured to connect to the bone, and comprising - sets of connecting elements; The shank is designed as a bone replacement member and replaces the bone with
It has a connecting portion configured to be connected to the shank at one end and the other end thereof. One of the connecting elements is a hip prosthesis having a round head and a hollow hip element connecting the elongated attachment element. In other versions of the hip prosthesis, the conical neck portion connects the inner core to (
It accepts a suitable connection head to f.

A femoral component for a hip prosthesis is disclosed in US Pat. No. 4,608,055, which includes a stem portion and a joined unitary head and neck portion. Its stem is
A proximal portion and a distal portion are angularly related to each other, the proximal portion having a four-portion formed to receive a tapered portion of the angled neck element. The headed neck element has a generally spherical head attached to the neck and a tapered portion angled through the base of the neck, the tapered portion being adjacent to the stem. It is configured to be permanently inserted into the four parts of the distal end. The stem also includes a plurality of recesses that receive fiber metal pads to allow bone ingrowth to permanently seat the femoral component on the proximal end of the femur. , provided on the lengthwise portion of the outer seven circumferences.

The ablation assembly device of U.S. Pat. No. 4,676,797 includes a head member, a distal member, and an intermediate member between the head member and the distal stamp member, one member having a conical pin and the other having a conical pin. One member has a conical opening. The latter two members have respective first faces extending transversely to the insertion direction, these faces facing each other and forming a recess when the two spaced apart members connect. One of the two members further includes a second member extending in the insertion direction.
and having four parts that receive an insertable wedge to press against the first surface to separate the two members;
On the other hand, the force behind the wedge is absorbed by the first surface,
The wedge is guided by the second surface.

In addition, a similarly fitted distal sizer (sizcr) fitted to the end allows the surgeon to adapt the tip of the prosthesis to the diameter of the intramedullary canal, thus Distal toggle is reduced.

(c) Means for Solving the Problems The present invention provides a modular hip joint trap that allows the surgeon to custom fit the hip joint to a particular patient prior to surgically inserting the prosthesis. It is Rurano who provides 4 degrees.

According to the invention, a prosthetic body has an upper end portion having a neck portion configured to hold a rounded head portion for engagement with an acetabular or acetabular 8 prosthesis; a lower stem portion configured for placement in the intramedullary canal of the bone and attachable to a catch for adjusting and maintaining the catch in load-bearing engagement with the bifemoral bone; consisting of means,
A modular hip prosthesis is provided that can be inserted 111j and modified to suit individual requirements.

-1- The lower stem portion is provided with a lumen, and the above-mentioned attachment means has a hollow portion whose shape matches that of the stem portion, and is configured to receive the stem portion therein. A tubular stem extension sleeve having an open end, the extension sleeve being secured to the prosthetic body by an accommodation means connectable to the lumen of the stem.

According to one aspect of the invention, therefore, (a) the +lv
A hip joint complement having a wide upper end having a shaped neck and a lower stem having a lumen and terminating in a rounded tip and configured for placement in an intramedullary canal of a patient's femur. (b) a tubular stem extension sleeve having a hollow portion conforming in shape to the lower stem portion;
(c) an accommodation means connectable to the lumen of the stent and securing the extension sleeve and the trap body together to form a hole therebetween; A modular hip joint arrester is provided that allows for a custom fit for a particular patient prior to treatment.

In addition, attachment is possible by connecting the prosthesis body to the central part between the upper and lower parts, and it can be removed by increasing the cross-sectional area of the prosthesis in the central part. The connecting means is partially held by the pad means, and is configured to be continuously loaded by the reaction force of the hip joint, thereby fixing the pad means to the prosthesis body.

Further in accordance with aspects of the invention: (a) an upper end having a neck portion configured to retain a rounded head portion for mating with the patient's acetabulum and positioned in the intramedullary canal of the patient's femur; A main body of a complementary hip joint prosthesis having a lower stem portion configured as shown in FIG. (c) a connection means that is partially held by the bed means and that is continuously loaded with the reaction force of the hip joint to fix the pad means to the brace; A modular hip arrester is provided that can be custom fitted to a particular patient prior to insertion.

The device of the invention includes a wide upper central portion and an upper neck portion configured to hold a rounded head portion that mates with the patient's acetabulum or the acetabular element of the prosthesis. The main body of the prosthesis is included. A lower stem extends from the central portion and terminates in a lower rounded tip. The stem is also configured for placement in an intramedullary canal of a patient's femur.

an extension and/or augmentation of the stem is provided, which extension can extend the length of the femoral shaft;
This extension is locked to the main shaft using a tapered attachment. This attachment allows the surgeon to extend the length of the stem beyond the cortical defect of the diaphysis during surgery. Additionally, a distal mating cap attached in a similar manner would allow the surgeon to align the tip of the prong to the diameter of the intramedullary canal, reducing distal toggle. The prosthesis itself is
Monocolour head and/or neck module access. The inclination of the prosthesis body and the stem 11 relative to the longitudinal axis can be varied.

The surgeon can choose the most appropriate amount of tilt (anteversion or retroversion) during surgery to restore stability to the joint. By increasing the variation in neck length, either the femoral neck is very short (i.e. CD I+, small women) or the femoral neck is very long (i.e. for factors that replace proximal bone loss). It may not suit the patient. The head and neck assembly can be used in conjunction with a collar or increased D extension to convert a standard stem body into a proximal third replacement or modification stem. Another set of head and neck assemblies allows the surgeon to adjust the angle of the neck axis of the assembled device.

The distal sizer in the form of a tubular stem extension sleeve includes a hollow portion in the form of a corresponding stem.

The extension sleeve is DIE L for inserting the stay 11.
It has a J end. The lower stem portion includes a lumen.

The attachment member, preferably in the form of a threaded drawbolt, forms an attachment between the lumen of the stem and the extension sleeve to retain the extension sleeve relative to the prosthesis body.

The stem and sleeve seal out wear particles from body tissue that are typically scrubbed away when the stem is inserted into the sleeve.
"Forms a tight friction fit. When the drawbolt is tightened, its unthreaded end presses against the hip stem, tensioning the bolt and causing the corresponding contact between the hip stem and sleeve. A compression force is applied between the stem and the sleeve in the tapered region so that the corresponding tapered region fits tightly and forms a seal.

The tubular stem extension sleeve is generally conformal in cross-section. The two wires have an annular taper portion that fits into a corresponding taper portion of the stem. The prosthetic body of one embodiment has a longitudinal central open-ended opening extending substantially the length of the body. The attachment is
The elongated fastener preferably comprises an elongated threaded bolt which, when assembled, is disposed within the elongated aperture and extends substantially the length of the elongated aperture. It is configured to be This bolt allows the surgeon to tighten the fit between the sleeve and the prosthetic body at the top of the prosthesis.
It may have an upper head end that can be manipulated to tighten or loosen it.

Stem extension sleeve to connect by screw,
It may include a threaded portion that can engage the lower end of the bolt. This attachment of the sleeve and the turret body can be made using a very short bolt that is secured to a hole in the bottom of the stem through an opening in the bottom of the extension sleeve.

The stem extension sleeve includes a threaded portion that can engage the lower end of the bolt to create a threaded connection. This attachment of the sleeve and the trap body can also be made using a very short bolt that is secured through an opening in the bottom of the extension sleeve to a through hole in the bottom of the stem.

Steno and extension sleeves can vary in length and diameter, and can be straight or curved. The hollow bore of the sleeve may extend substantially the length of the sleeve, or may extend along a portion of its length.

The assembly drawbolt can be tightened after the prosthetic extension sleeve is in place so that the extension sleeve can be twisted to track the intramedullary canal during insertion. After placement, the draw port can be used to lock the extension sleeve and the catch body.

The prosthesis body includes a frustoconical neck portion that holds a round head element. Between the neck portion and the stem is an intermediate central portion having an upper portion that is generally rectangular in cross section and a lower portion that is generally circular in cross section. The extension sleeve can add 4" to the neck to lengthen the neck relative to the catch body and head.

Removable lateral support collar. It can be adjustably attached to the center of the prosthetic body.

The collar is attached transversely to the longitudinal axis of the prosthesis body and forms a load-bearing contact between the prosthesis body and the two lines of the patient's femur. In one embodiment, the removable support collar is attached to the proximal bone, i.e. W1.
It may include an extension to compensate for bone loss at the top of the patient's femur.

The removable pad can be attached to the central portion of the prosthesis and changes the cross-sectional shape of the central portion of the prosthesis. 1
Two or more sockets are built into the center of the prosthesis to hold the modular pads.

In one embodiment, each pad is secured to the prosthetic body by a wedge lock connection. A locking member behind each pad locks each pad into the prosthesis with a corresponding engagement surface.

each pad retains a corresponding locking tab member;
Ensure complete interlocking engagement of the pad and prosthesis before making the wedge lock connection. This safety mechanism requires that the surgeon be able to slide each pad into a wedge-lock position after fully engaging it in its socket.

Tabs on the locking member of each pad engage recesses or undercuts in the socket of the prosthetic body to prevent the pad from moving away from the prosthetic body after assembly is complete. Defense 1F, do it.

The shape of the pad is specifically tailored to the patient's anatomy.
can be varied to achieve the desired fit, so that the load of the shear force or compressive force between the prosthesis and the patient's bone is transferred as desired. Maximum stability is achieved by being able to move around. The pads may be made of different materials, such as porous or rough coatings, to encourage tissue ingrowth or growth on the surface. Additionally, manufacturing methods that may weaken the integrity of the prosthetic body, such as adding a coating of beads, can be used with removable beds and may reduce the structure of the prosthetic body. does not affect the integrity of

(Margins below) (d) Examples In order to further understand the features and objectives of this invention, this invention will be explained by the following examples with reference to the drawings.
This is not intended to limit the invention.

FIG. 1 is a side view showing a plurality of hip joint trap bodies used in the hip joint modulator system of the present invention.

FIG. 2 is a side view showing a portion of the modular collar being inserted into a pair of hip prosthesis bodies having different dimensions.

FIG. 3 is a 4° side view showing a plurality of sleeve extensions used in the hip joint mononylar according to the present invention.

FIG. 4 is a side view of a plurality of modular pads for use with the hip prosthesis bodies of FIGS. 1 and 2, illustrating changes in the cross-sectional shape of the pads.

FIG. 5 is an exploded perspective view showing a preferred embodiment of the device of the present invention.

FIG. 6 is a plan view of the trap body of a preferred embodiment of the device of the present invention.

FIG. 7 is a side view of a preferred embodiment of the device of the present invention.

8 and 9 are plan and side views of the assembly of a preferred embodiment of the apparatus of the present invention.

10 and 11 are a plan view and a side sectional view of a stem extension sleeve portion of a preferred embodiment of the device comb of the present invention.

FIG. 2 is a sectional view showing another configuration of the neck extension sleeve portion of a preferred embodiment of the device of the present invention.

FIG. 13 is a plan view of a portion of a modular collar of a preferred embodiment of the apparatus of the present invention.

FIG. 14 is a partial sectional view showing a preferred embodiment of the device of the present invention: the assembled hll lever body and stem extension sleeve.

FIG. 15 is an elevational view, partially in section, showing the assembly of the monocular pad to the prosthetic body.

FIG. 16 is a sectional view taken along line 16-16 in FIG. 15.

FIG. 17 is a cross-sectional elevational view of another embodiment showing assembly of the modular pad to the prosthetic body.

FIG. 18 is an exploded side view of a second embodiment of the pad of the modular hip joint prosthesis of the present invention.

FIG. 19 is a partial side view of a second embodiment of the modular hip arrest device of the present invention.

FIG. 20 shows the mononyler of the second embodiment of the device of the invention.
FIG. 3 is a rear view showing the configuration of the pad.

FIG. 21 shows the modular structure of the second embodiment of the device of the invention.
FIG. 3 is a side view showing the configuration of a pad.

FIG. 22 shows the mononyler of the second embodiment of the device of the invention.
FIG. 3 is an end view showing the configuration of a pad.

FIG. 23 is a cross-sectional view taken along line 23--23 of FIG. 19.

FIG. 24 is a cross-sectional view taken along line 24--24 of FIG. 19.

FIG. 25 is a cross-sectional view taken along line 25--25 of FIG. 19.

Figures 1-5 illustrate a preferred embodiment of the apparatus IO of the invention. FIG. 5 does not show the prosthetic body 11, which consists of a wide central portion I2, an elongated, generally cylindrical, elongated lower stem 13, and an upper neck portion 14. The central portion is composed of a second portion 15 having a substantially rectangular cross section, and a lower portion 16 having a substantially circular cross section that connects to the stem 13 having a substantially cylindrical shape.

The stem 1.13 is composed of a cylindrical -L portion 17, a truncated conical tapered intermediate portion 18, and a small diameter cylindrical lowermost portion 19. The prosthesis body II includes a plurality of prosthesis bodies II, a pad 26, a head 27, and a collar 21.22.
and the extension sleeve 30 is the prosthetic body +1A-11
J, pads 268~26■ and sleeves 30~30A
It is desirable to supply hospitals and surgeons with kits in a variety of sizes as shown in FIGS. 1-2 including:

6 The prosthetic body 11 includes a generally U-shaped annular portion 20 extending around one edge of the intermediate central portion 12 of the body 11, and a generally U-shaped collar 21 or 22 (FIG. 2).
enters. The recess 20 has a shape that matches the inner edge 21G of the collar 21.

Therefore, the second collar is almost U-shaped in plan view (Figure 13). In one embodiment (FIG. 2), the J-shaped collar 22 also covers the U-shaped body in plan view, but includes a downwardly extending tab 23 (FIG. 2). It can be used to help transfer the load between the tool 10 and the proximal bone tissue of the femur.

The lock pin 21B (FIG. 13) is in the opening 21Δ.

20 Δ to secure the collar 21 , 22 to the prosthesis body 11 . One of the backs of the opening 21△ is the wall 211
] and may be formed as a blind hole, not extending entirely into the outer surface of the collar, so that the pin 21B cannot advance too far forward and protrudes from the outer surface of the collar 21.

6 The trap main body 11 has a pair of left and right sockets 24 and 25.
, which includes one or more adjustment pads 26A to 261.
1 is entered. The cross-sectional shape of each pad 268-2 G tl is, for example, as shown in FIG.
Variations may include pads that are thicker at the top than at the bottom, such as pads 26D and 26H, which are thicker than pads 6E. The pads 26Δ-261+ can be installed by the surgeon in a custom fit to the trap body 11 at the face of the central portion 12.

Neck 14 is a frustoconical neck configured to receive head 27 . The head 27 includes a socket 28 that matches the neck 14 in shape. In order to match each prosthesis body 11Δ~IIJ,
The stem 13, which may be provided with a plurality of heads 27 in various sizes as parts of the killer 1, has a rounded lower tip. The lowermost part I9 of the stem 11 has a small diameter, but the circular trapezoidal middle part 18 of the stem (3) forms an accommodation by the stem extension sleeve 30 (Figs. 3.5.1! and 14).

The sleeve 30 is elongated, roughly cylindrical, and has an open end 31 into which the stem I3 can be inserted. The lowermost portion of the sleeve 30 includes a distal end portion 32 having a curved surface, for example, a hemispherical shape.

The extending sleeve 30 is hollow and has a through hole 33 extending in the length direction between the open end 31 and the slotted hole 34 . A threaded hole 34 extends downwardly from the through hole 33 and communicates with the distal end 32. The screw hole 34 accepts a 1-bolt 3G male screw. The bolt 36 includes an uppermost head portion 37 and a lower threaded portion 35 .

in this way. The prosthetic device itself! ! includes a central longitudinally extending bore 40 for receiving the elongated bolt 36.

The upper end of the extending sleeve 30.30A has a beveled annular inner surface 38 (FIGS. 3 and 11) which corresponds in form to the frustoconical intermediate section 18 of the stem 13 and which As a result, the extension sleeve 30.degree. 308 and the stem 13 can form a friction-tight fit during assembly (see FIG. 14). The draw bolt 36 is tightened after fixing the prosthesis body 11 and the sleeve 30 or 30Δ to the intramedullary canal. The extension sleeve 30 or 30A thus freely tracks the natural path of the intramedullary canal during insertion. After insertion, the bolt 40 is tightened and the beveled annular surface 38 of the sleeve 30 or 30A is drawn with the intermediate portion 18 of the stem I3.

The extension sleeve 30 may be a short variant having a longitudinally extending through hole 33 communicating with the through hole 34 and extending to the distal end 32 . In other aspects (see Figure 3)
, the extending sleeve 30A may be elongated and extend further beyond the threaded hole 34. As shown in the long sleeve of FIG. 3, the longitudinal axis of extension sleeve 30Δ may be slightly angled or curved to track the intramedullary canal. In other words, the tongue portion 39 of each extension sleeve 30Δ may be a solid integral piece and be slightly oblique with respect to the longitudinal axis of the through hole 33. This allows the extension sleeve 30A to track the natural path of the intramedullary canal, which is neither perfectly straight nor purely elongated. Thus, the elongated extension sleeve 30A custom-fits naturally to the patient's femur.

A plurality of heads 27 having a size of 4 are prepared.

The distance between the prosthetic body and the head 27 can be varied using extensions 45 or 50.

Extension member 45 is a hollow trunnion having a frustoconical outer surface 46 and a corresponding frustoconical inner surface 47 . The small open end 48 and the large open end 49 form a through hole therebetween into which the neck 14 enters when the extension member 45 is installed over the neck 14. The end portion 48 is small so that the head 27 can easily be slid onto the extension member 45 by means of the socket 28 of the extension member 45. Head 2 with a predetermined load using an impact driver.
7, the selected extension can be loaded, and the truncated conical surface will fit securely.

In a preferred embodiment, a plurality of prosthetic bodies provided in kit form include extension members 45 of different lengths and cross-sectional dimensions to accommodate a plurality of associated necks of different sizes.
(See Figure 1).

Another trunnion horizontal installation is shown in FIG. The extension member 50 in this figure has a frustoconical outer surface 5I and a frustocone inner surface 52, with a small diameter end 53 having a threaded hole 54 at a large diameter end 55 of the extension member 50 and a socket 5G. It's communicating. In this manner, the socket 28 of the specifically selected head 27 is fitted into the end of the extension member 50. Extension member 50
In order to remove it from the neck portion 14, a shaft-shaped removal tool, for example having a thread at one end and a handle at the other end, and a threaded hole 54 are engaged with each other with screws.

15 to 17 show the pad 26 removably attached to the ura-tetsu main body 11. In Figure 15, pad 2
It should be understood that only the assembly method for attaching 4 or 25 is shown.

In the embodiment of FIG. 17, pads 26 are held in place by a single attachment mechanism, which is generally held between pads forming a connection therebetween.

In the embodiment shown in FIG. 15, an annular bunyu 6I, which is an extended portion of each pad 26, is provided.

The bushing 61 consists of a plurality of arcuate members 62 to 65 (FIG. 16) with air gaps 66 between them, so that the bushing 61 is arranged at an angle of the opening 60 of the prosthetic body 11, which are superimposed. The annular wall 74 can be widened or narrowed. A bolt or set screw 70 is thread-to-threaded into a threaded bushing 61 so that the bolt 70
The screw 72 of is fitted into the screw 68 of the bushing 61,
The screws engage each other. If the screws are not connected to each other like this, each arc-shaped member 62-(i5 is the opening 6) of the bush 61.
It expands while urging the annular wall 74 of 0 (see arrow 73 in FIG. 15). The opening 67 of the pad 26 communicates with the open lower I cut into the bolt 70 so that a tool such as an allen wrench can be inserted through the opening 67 and matched with the tool used. It can be fitted into the slot 71 of the shape.

In the embodiment of FIG. 17, one assembly bolt 80 is used to secure one pair of pads 26 to prosthetic body II. The prosthesis body II has a cylindrical open core 9,
This opening contains an annular bushing 81 that is integrally attached to the pad 26.

The bunyu 81 has an inner socket part 83 with a female thread 82 cut therein.
It is equipped with Assembly bolt 80 has a corresponding male thread 89 that engages thread-to-thread with thread 82 of bushing 81 . Socket 88 accepts a tool, such as an Allen wrench, and rotates therewith to tighten pad 26. The pad 2G is a bush 85 that holds an annular retaining ring 86.
This ring may be a split ring or the like.

Opening 90 is the same as opening 8 cut through pad 26.
It may reach up to 8. The assembly bolt 80 has a generally circular annular head 91 which is held against the pad 26 by a ring 86 to tighten the threaded bolt 80 against the trap body 11.

18-25 show another embodiment of the device of the invention,
In this embodiment, the removable peds 40A, 40B are connected to the kti prosthesis body 11 by a wedge fit, and when the reaction force of the hip joint depresses the prosthesis against the femur during use, each pad 40Δ.

Tighten the connection between 40B and the prosthesis. Each pubdo 40Δ
, 40B and the prosthetic body II is a locking member with a tab that allows the surgeon to first attach the pad 40Δ, 4013 to the prosthetic body 11.
The pads 40Δ and 40B are fully engaged with the opening 100 provided in the prosthesis body 11, and then the pads 40Δ and 40B are slid into locking engagement with the prosthesis body 11.

Figure 19 shows a socket with a peripheral wall 25W! - shows a partial view of the prosthetic body 11 with. Similarly, Ura Tetsugu body l! On the opposite side there is also a socket 24 with a peripheral wall 25-V. Each socket 24, 25 accommodates a modular pad 4OA, 40B, respectively. 19-22, pad 40Δ is shown mated to pad socket 24 during operation. Modular pad 40 [3
is the vt image of the diagram shown for pad 40A in FIGS. 20-22.

Each modular pad 40A, 40B has its back surface 39.
- Support the wedge lob king member 41 F! j L, this member has a pair of oppositely inclined locking surfaces 42, as shown in FIG.
Form +. In use, the surgeon locks the locking member 41
A modular pad 40Δ is placed in an AI-like shaped socket 24 that registers 0 to aperture +00. The locking member 41 is open! It supports a pair of tabs 43 that are first fitted into the enlarged end 100B of 00. Similarly, the inclined locking surface 42 of the locking member 41 is
A similarly shaped locking surface 101 of opening 100 is fitted. The tab 43 is located at the enlarged end 10013 of the opening 100.
It has to fit together. Otherwise, the locking member 41 will not fit into the opening +00. The surgeon is
The locking member is provided with a safety mechanism, since a particular pad 40Δ, 40B must be securely placed within the socket 24.25 before wedge-locking the pad 40A, 40B to the trap body 11. - Once the locking member 41 is fully seated in the aperture 100, the surgeon then... Upper end 1 of prosthesis body 11
Slide the pad upward toward 5 (J. At this time, the tab 43 should be aligned with r1 as shown in FIG.
slide under the section 102 and insert the angular cut slot 10.
It fits into 3. When the surgeon moves each cut 40A, 4013 into the locking position, the surface 42 of the wedge lobking member 41 engages the sloped surface 101 of the opening D lo(). Using an impact driver element or punch, A secure wedge fit is obtained by mating surfaces 42 and 101. Since surface 42 is wedge fit to surface 101, each pad 40A, 4013 is securely secured to the prosthetic body. .

In a preferred embodiment, the outer circumference of each pad 40A, 40[3 is similar to the outer circumferential wall 24W. of each socket 24.25. It has a form that corresponds to 25W. Pad 40A. 40B is
Each socket 24.2 formed by outer peripheral walls 24W, 25W
Dimensions are slightly smaller than the outer form of 5. This allows room for each pad 40A, 40B to move slightly, resulting in a wedge between each pad 40Δ, 40r3 and its respective socket 24.25 (using sliding action to complete the knock connection). be able to. Therefore, the outer edge of each pad 40A, 40B is inward from the outer peripheral wall 24W, 25W of each socket l-24.25.
Maintaining small spacing.

Using an impact driver, drive each pad 40Δ. 4
A very secure wedge-lock connection can be formed between 0B and the trap body II. In a preferred embodiment, each pad has a generally flat lower surface 106. A similar flat surface 107 is provided for each socket 24.25.
is located at the bottom of the However, the surgeon
0A.

When assembling 40r3 with the prosthesis body II by hand, an impact driver can be used to securely attach the pads 40A, 40B to the prosthesis body 11. An impact driver is a commercially available product that has a machined end with a screwdriver tip or a wedge tip for commercial use, for example. After the surgeon places each pad 40A, 40B in its respective socket 24, 25, the tool tip (U° not shown) of the impact driver
Insert it into the gap formed between 7. Place the prosthetic device on a flat surface.
At L, the surgeon simply depresses the impact driver downwardly, causing the tool tip of the impact driver to separate the tool 106 from the tool 107. The surgeon then reverses the grapple and repeats the same procedure with the second pad u1. Starrett Kanbanyi (Starrett)
300 loads such as those supplied by
It has been found that each pad 4OA, 40B can be held in the prosthesis body 11 by using a commercially available relatively small impact driver such as Bond.

If one of the pads 40A and 40[3 becomes loose, perhaps because the surgeon did not apply enough force to the pads to lock them into the prosthesis body 11,
In this invention, each pad is 4oΔ.

40B supplementary tool itself! It provides a safety mechanism that is continuously attached to the That is, as shown in FIGS. 21 and 22, the outer surface 38 of the pad is generally sloped, so that the pad is narrower at the bottom and wider at the bottom of the pad to ensure this installation. be done. Therefore, when the pad is installed η1, when the catch is further pressed against the femur by the reaction force of the hip joint of the person who is wearing it, the pad itself is firmly fixed. The femur presses against the outer surface 38 of the pad and presses it upward, further locking the wedge lock 42 of each pad 40A, /1013 into the opening 10.
Press against 0 and 101.

Another safety feature of the invention is that even if the pad is accidentally dislodged from the locking mechanism, the walls 24W, 2 of the socket 24.
The mechanism is that 5W houses pads 40Δ and 4013.

An additional safety feature of the invention is that the pads 40Δ, 4
Locking tabs 43 for fully engaging the 0Bs in their respective slots 24 and 25. The surgeon applies pad 4
If 0A, 4013 is not fully engaged with opening 101, the locking tuff will prevent wedge locking with surface 101 of 42.

The invention is easy to handle and quick to use, allowing the prosthesis to have different shapes on the front or back side to completely fill the femoral cavity for better contact between the bone and the prosthesis. It provides a modular pad structure. The invention can be supplied with a large number of test sockets in the form of a kit, which can be used to completely size the device of the invention. Therefore, surgeons can choose the actual prosthesis and its modular pads.
Pre-packaged and sterile condition maintained 1. The test kit is used to size the prosthesis and its modular parts, and if a correct fit is achieved, the corresponding parts can be removed from the sterile packaging.

[Brief explanation of drawings]

Fig. 1 is a side view of a plurality of hip prosthesis bodies according to an embodiment of the present invention; Fig. 2 is a side view of a plurality of hip prosthesis bodies having different dimensions, with a portion of the modular collar inserted into a pair of hip prosthesis bodies with different dimensions. Figure 3 is a side view of a plurality of sleeve extensions in accordance with one embodiment of the invention; Figure 4 is a side view of a plurality of sleeve extensions for use with the hip prosthesis bodies of Figures 1 and 2; Fig. 5 is an exploded perspective view of an embodiment of the device of the present invention; Fig. 6 is a plan view of an embodiment of the main body of the device of the invention; Fig. 7 is a side view of the modular pad of the invention; A side view of one embodiment of the catch main body of the device of this invention; FIGS. 8 and 9 show an embodiment of the assembled parts of the device of this invention; a 4° plan view and a side view;
10 and 11 are a plan view and a side sectional view of one embodiment of the stem extension sleeve of the device of the invention; FIG. 12 is a sectional view of another embodiment of the neck extension sleeve of the device of the invention. FIG. 13 is a plan view of one embodiment of the modular collar portion of the device of the invention; FIG. 14 is a portion of one embodiment of the assembled prosthetic body and stem extension sleeve of the device of the invention; Cross-sectional view: Figure 15 shows the modular structure of the device of the invention.
FIG. 16 is a sectional view taken along line 16--16 of FIG. 15; FIG. 17 is a view of the modular pad of the device of the invention; Fig. 18 is an exploded side view of the second embodiment of the modular hip pad of the present invention; Fig. 19 20, 21 and 22 are respectively partial side views of a second embodiment of a modular hip cuff of the invention; FIGS. 23, 24, and 25 are respectively lines 23-23, 24-24, and 2 in FIG. 19.
5-25. 36゜1 5 61゜0 70.80... Bolt, ... Wedge locking member, 50... Extension member, 8 To... Bush, 62-65... ...Arc-shaped member, 2...Shoulder, 103...Slot.

Claims (40)

[Claims] 1. a prosthesis body having an upper end having a neck portion configured to hold a rounded head portion for engagement with an acetabulum or an acetabular prosthesis; an intramedullary canal of a femur; a lower stem portion configured to deploy; a means attachable to the prosthesis for adjusting and maintaining the prosthesis in load-bearing engagement with the femur; Modular prosthesis for the hip joint that can be modified in advance to suit individual requirements. 2. The prosthesis of claim 1, wherein the lower stem portion terminates in a rounded tip. 3. the lower stem portion comprises a lumen, and the attachable means is a tubular stem extension sleeve having a hollow portion conforming in configuration to the stem portion and having an open end configured to receive the stem portion therein. Yes, the above extension sleeve is
3. A prosthesis according to claim 1 or 2, wherein the prosthesis is fixed to the prosthesis body by attachment means connectable to the inner cavity of the stem portion. 4. The attachable means comprises a removable pad means attachable by connection to a central portion intermediate the upper and lower portions of the prosthetic body and increasing the cross-sectional area of the prosthesis at the central portion. 4. The connecting means is partially held by the padding means and is continuously loaded by the reaction force of the hip joint to fix the padding means to the prosthesis body. The prosthetic device described in item 1. 5. (a) a wide upper end having a neck configured to retain a rounded head that fits into a patient's acetabulum;
a hip prosthesis body comprising a lower stem portion having a lumen and terminating in a rounded tip and configured for placement in an intramedullary canal of a patient's femur; (b) a lower stem portion and a shape; (c) a tubular stem extension sleeve having a matching hollow portion and an open end configured to receive the stem portion therein; (c) a tubular stem extension sleeve connectable to the lumen of the stem; attachment means for securing the prosthesis together to form a seal therebetween; Ingredients. 6. 6. A prosthesis according to any one of claims 3 to 5, wherein the tubular stem extension sleeve has a substantially identical cross-section. 7. A prosthesis according to any one of claims 3 to 6, wherein the tubular stem extension sleeve is substantially straight. 8. A prosthesis according to any one of claims 3 to 6, wherein the tubular stem extension sleeve is curved to conform to the shape of the intramedullary canal. 9. The prosthetic body includes a through hole having a longitudinally central open end extending approximately the same length, and the attachment means extending approximately the same length as the through hole and opening the through hole during assembly. A trap as claimed in any one of claims 3 to 6, comprising a portion of an elongated fastener configured to be placed within the bore. 10. 10. The accessory of claim 9, wherein the fastener is a bolt having a threaded lower end, and the stem extension sleeve has a threaded portion engageable with the threaded lower end of the bolt. Tools. 11. Claims 3 to 1 wherein the lumen has an open end and a through hole.
The trap described in any one of 0. 12. The through hole has a female thread, and the attachment means includes:
12. The prosthesis according to claim 11, further comprising a threaded fastener that can be engaged thread-to-thread with the female threaded portion of the through hole. 13. (a) an upper end portion having a neck portion configured to hold a rounded head portion for mating with a patient's acetabulum; and a lower stem portion configured to be placed in an intramedullary canal of a patient's femur; (b) a removable pad means attachable to the central portion of the prosthesis for increasing the cross-sectional area of the central portion of the prosthesis; (c) a pad; connecting means for securing the pad means to the prosthesis, held in part by the means and continuously subjected to hip reaction forces; A modular hip prosthesis that can be fitted specifically to the hip. 14. Further, a collar means is securable to the wide portion of the prosthetic body generally transverse to the longitudinal axis of the prosthetic body, the collar means forming a load-bearing contact with the upper end of the patient's femur. A trap according to any one of claims 1 to 13. 15. attachable to an intermediate central portion of the prosthesis;
15. A trap as claimed in any one of claims 1 to 12 and 14, comprising removable padding means increasing the cross-sectional area of this central portion. 16. Claims 1 to 4 and 13 to 1, comprising a lateral opening in the intermediate central portion of the prosthesis and means retained by padding means and extending into the lateral opening to specifically retain the padding means to the prosthesis.
6. The trap described in any one of 6. 17. 2. The padding means comprises a pair of padding members, each member holding at least a portion of the holding means.
The prosthetic device described in 6. 18. 18. The prosthesis of claim 17, wherein the retaining means includes a portion of a locking bolt that fits approximately midway between the pair of pads to form a connection therebetween. 19. 19. A prosthesis according to any one of claims 14 to 18, wherein the body has one or more openings, and the padding means is attached to the body at the openings. 20. Claims 1 to 4 and 1, wherein the pad means comprises a pair of pads, each pad having an inner surface for retaining the connecting means.
20. The prosthetic device according to any one of 3 to 19. 21. 21. The prosthesis of claim 20, wherein each pad has a projection extending from the inner surface, and the connecting means includes a locking portion supported by the projection to form a removable connection with the prosthetic body. Tools. 22. The prosthetic body has a pair of opposing sockets on the interior and rear sides, each socket being formed by a peripheral side wall, each socket being configured to match a respective pad, such that each pad has a pair of opposing sockets at the outer peripheral edge of the socket. 21. The prosthesis of claim 20. 23. 21. The prosthesis of claim 20, wherein each pad has an inner surface shaped to fit over the outer surface of the prosthetic body, the outer surface of the pad having a shape different from the shape of the inner surface of the pad. 24. 23. The prosthesis of claim 22, wherein the socket communicates and defines a lateral opening through the prosthesis body. 25. a locking tab retained by the pad means; a socket means formed on the prosthesis body and configured to receive the pad means; and a locking tab retained by the tab and the prosthesis body at the location of the socket. and a pair of frictionally engaged load transfer surfaces.
4 and 13-24. 26. wedge means for firmly stiffening the connection between the pad means and the prosthesis body as the pad means moves longitudinally relative to the longitudinal axis of the prosthesis body when the load transfer surfaces are engaged; 26. A prosthesis as claimed in any one of claims 1 to 4 and 13 to 25, wherein the connecting means are provided. 27. 27. A prosthesis according to any one of claims 1 to 4 and 13 to 26, wherein the removable padding means are attachable to the anterior and posterior sides of the prosthetic body. 28. the upper neck having a generally frustoconical shape, the prosthesis further comprising a neck extension sleeve having a hollow portion conforming in shape to the neck and an open end for receiving and inserting the neck; 28. has an outer surface conforming in shape to the neck part, so that the round head part can be fitted interchangeably to the neck part and to the extension sleeve. Prosthetics. 29. 29. The trap of claim 28, wherein the neck extension sleeve is substantially uniform in longitudinal cross section. 30. 30. A prosthesis according to claim 28 or 29, wherein the extensions have walls of the same thickness. 31. 29. The neck portion has a frustoconical outer surface.
30. The prosthetic device according to any one of 30. 32. 32. A closed truncated conical socket within a circular head element, the head element being selectively fitted into the neck or into an extension sleeve to extend the length of the neck. A prosthetic device as described in one. 33. 33. A grapple according to any one of claims 28 to 32, wherein the external extension sleeve is an annular member having corresponding outer and inner surfaces. 34. 34. Any of claims 14 to 33, further comprising an attachment for retaining the collar to the prosthetic body, at least in part comprising a pin hole extending through the collar means and a pin means extending into the pin hole. or the prosthetic devices listed in item 1. 35. 35. The prosthetic body of claim 34, wherein the pin hole has a closed end configured to stop movement of the pin means within the pin hole. 36. 36. A prosthesis according to any one of claims 14 to 35, wherein the collar means comprises distal offset means to replace bone loss in the mid-proximal region of the patient's femur. 37. 37. The prosthesis of claim 36, wherein the distal offset means comprises a tab portion extending downwardly from a lateral surface of the support collar means. 38. 38. A hip prosthesis according to claim 36 or 37, wherein the distal offset means is attached to the intermediate portion of the collar means. 39. 39. A prosthesis according to any one of claims 3 to 38, wherein the stem extension sleeve has a through hole extending substantially the length of the sleeve. 40. 40. The prosthesis of claim 39, wherein the sleeve has a through hole extending over a portion of the length of the sleeve.