DE4133433C1 - Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoring - Google Patents
Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoringInfo
- Publication number
- DE4133433C1 DE4133433C1 DE4133433A DE4133433A DE4133433C1 DE 4133433 C1 DE4133433 C1 DE 4133433C1 DE 4133433 A DE4133433 A DE 4133433A DE 4133433 A DE4133433 A DE 4133433A DE 4133433 C1 DE4133433 C1 DE 4133433C1
- Authority
- DE
- Germany
- Prior art keywords
- outer shell
- endoprosthesis according
- anchoring
- bores
- endoprosthesis
- 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.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
- A61B17/8066—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for pelvic reconstruction
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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
- A61F2/30—Joints
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- A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
-
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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
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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
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- A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
- A61F2002/30326—The prosthesis having different structural features at different locations within the same prosthesis differing in height or in length
-
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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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
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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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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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
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
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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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- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0037—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in height or in length
Abstract
Description
Die Erfindung betrifft eine Endoprothese zum Ersatz eines menschlichen Beckenteils im Bereich des Hüftge lenks, bestehend aus einer prothetischen Pfanne mit einer metallischen Außenschale, und mehreren Veranke rungsteilen zur Verankerung der Pfanne im Schambein- und Darmbein-Bereich des Beckens.The invention relates to a replacement endoprosthesis of a human pelvis in the hip area steering, consisting of a prosthetic socket with a metallic outer shell, and several anchors parts for anchoring the pan in the pubic and Iliac area of the pelvis.
Aus der DE 36 29 799 C2 ist eine derartige Endoprothese bekannt, bei welcher an der metallischen Schale der prothetischen Pfanne zwei Ansätze mit jeweils einer Aufnahmebohrung angeformt sind. Vorgesehen sind ferner Anschlußelemente, die einerseits am Beckenknochen befe stigt werden und andererseits je einen Zapfen aufweisen, der mit selbsthemmendem Festsitz in den Aufnahmebohrun gen verankert wird. Zwischen der Pfanne und den Befesti gungspunkten der Anschlußelemente am Beckenknochen be finden sich daher vor der endgültigen Fixierung nur zwei - durch Zapfen und Aufnahmebohrung gebildete - Schar niergelenke, deren Schwenkachsen relativ zur Außenschale festliegen. Eine frei einstellbare Positionierung der Pfanne nach dem Anbringen der Anschlußelemente am Bek kenknochen ist daher nicht möglich. Vielmehr legen die einmal am Beckenknochen fixierten Anschlußelemente die Lage der Pfanne eindeutig fest. Da die beiden Schwenk achsen der Scharniergelenke relativ zueinander festlie gen, können die beiden Anschlußelemente nicht unabhängig voneinander am Beckenknochen befestigt werden. Vielmehr ergibt sich die Position des zweiten Anschlußelements - bis auf einen Freiheitsgrad - zwangsweise aus der Befe stigung des ersten Anschlußelements. Eine geeignete Wahl der Befestigungspunkte und/oder eine freie Anpassung der Pfannenpositionen an die erforderlichen Resektions schnitte ist daher nicht möglich.Such an endoprosthesis is known from DE 36 29 799 C2 known in which the metallic shell of the prosthetic cup two approaches, each with one Location hole are formed. Are also provided Connection elements, on the one hand, on the pelvic bone Stigt and on the other hand each have a pin, the one with a self-locking tight fit in the mounting hole is anchored. Between the pan and the fasteners the connecting elements on the pelvic bone there are therefore only two before the final fixation - Coulter formed by tenons and locating hole kidney joints, their swivel axes relative to the outer shell be stuck. A freely adjustable positioning of the Pan after attaching the connection elements to the Bek knee bones are therefore not possible. Rather put the once attached to the pelvic bone connecting elements The position of the pan is clearly firm. Because the two pan axes of the hinge joints are fixed relative to each other gen, the two connection elements can not be independent attached to each other on the pelvic bone. Much more the position of the second connection element results - except for one degree of freedom - compulsorily from the befe Stigung the first connection element. An appropriate choice the attachment points and / or a free adjustment of the Cup positions to the required resection cuts are therefore not possible.
Aus der DE 36 20 460 C1 ist eine Acetabulumgelenkpfanne bekannt, in der mehrere Durchtrittsöffnungen angeordnet sind, durch die hindurch Verankerungszapfen eingesetzt werden, nachdem die Pfanne in eine vorbereitete Knochen ausnehmung eingesetzt worden ist. Die Verankerungszapfen sind als streifenförmiges Flachprofil ausgebildet und lassen sich in unterschiedlichen Längen und unterschied lichen Richtungen am Knochen befestigen.DE 36 20 460 C1 is an acetabular socket known, arranged in the several openings through which anchoring pins are inserted after the pan is in a prepared bone recess has been used. The anchoring pins are designed as a strip-shaped flat profile and can be of different lengths and different fasten the directions on the bone.
Aufgabe der Erfindung ist es daher, eine Endoprothese der eingangs genannten Art derart weiterzubilden, daß die Lage der Pfanne in Abhängigkeit von den Resektions ebenen und Patientenabmessungen beim Implantieren in dividuell eingestellt werden kann.The object of the invention is therefore an endoprosthesis of the type mentioned in such a way that the position of the pan depending on the resection planes and patient dimensions when implanting in can be set individually.
Diese Aufgabe wird bei der Endoprothese der eingangs genannten Art erfindungsgemäß dadurch gelöst, daß mehrere Durchgangsbohrungen in der Außenschale vorgese hen sind und daß mehrere Zwischenstücke, einerseits mit den Verankerungsteilen, andererseits durch ausgewählte Durchgangsbohrungen hindurch fest mit der Außenschale verbindbar sind.This task is the beginning of the endoprosthesis mentioned type according to the invention solved in that several through bores in the outer shell hen and that several intermediate pieces, on the one hand with the anchoring parts, on the other hand by selected ones Through holes firmly with the outer shell are connectable.
Die Vorteile der Erfindung liegen insbesondere darin, daß zwischen den am Beckenknochen befestigbaren Veranke rungsteilen und der Außenschale der Pfanne jeweils ein Zwischenstück vorgesehen ist, welche mit den Veranke rungsteilen verbindbar sind. Die Außenschale besitzt mehrere Durchgangsbohrungen, durch die hindurch die Außenschale nach einer individuellen Positionierung oder Lageanpassung mit den freien Enden der Zwischenstücke verbunden, und auf diese Weise verankert werden kann. Mit der erfindungsgemäßen Endoprothese ist es also mög lich, die Verankerungsteile zuerst an den vorhandenen- Resektionsebenen zu befestigen, welche sich durch den individuellen Tumorbefund ergeben. Anschließend werden die Zwischenstücke mit den Verankerungsteilen verbunden. Dann wird die Pfanne an die freien Enden der Zwischen stücke angesetzt und individuell so ausgerichtet, daß die Pfannenhöhe und -neigung mit der Position der in der Regel vorhandenen anderen Pfannenöffnung des natürli chen Beckenknochens korrespondiert, wobei erforder lichenfalls auch die Zwischenstücke eine individuelle Länge aufweisen müssen. Schließlich wird die Außenschale der Pfanne durch ihre Durchgangsbohrungen hindurch an den freien Enden der Zwischenstücke in der gewünschten Position befestigt. Es ist auf diese Weise möglich, die Pfanne vor der endgültigen Fixierung auch in Retro torsion oder Antetorsion richtig zu positionieren.The advantages of the invention are in particular that between the anchors attachable to the pelvic bone parts and the outer shell of the pan Intermediate piece is provided, which with the anchoring parts are connectable. The outer shell has several through holes through which the Outer shell according to an individual positioning or Position adjustment with the free ends of the intermediate pieces connected, and can be anchored in this way. It is therefore possible with the endoprosthesis according to the invention Lich, the anchoring parts first on the existing Fix resection planes, which are through the individual tumor findings. Then be the intermediate pieces are connected to the anchoring parts. Then the pan to the free ends of the intermediate pieces set and individually aligned so that the pan height and incline with the position of the in the Usually existing other pan opening of the naturli Chen pelvic bone corresponds, whereby required If necessary, the spacers are also individual Must have length. Finally, the outer shell the pan through its through holes the free ends of the spacers in the desired one Position fixed. It is possible in this way that Pan also in retro before final fixation Correctly position torsion or anti-torsion.
Besonders bevorzugt ist ein erstes Zwischenstück mit einer Durchgangsbohrung versehen, und die Außenschale der Pfanne wird durch eine ihrer Durchgangsbohrungen und durch die Durchgangsbohrung des ersten Zwischenstücks hindurch an dem Verankerungsteil angebracht, welches am Darmbein-Bereich des Beckens befestigt ist. Das erste Zwischenstück besitzt dann die Wirkung eines Distänz stückes, welches den Abstand zwischen dem betreffenden Verankerungsteil und der Außenschale herstellt, während die Befestigung der Außenschale direkt - durch das erste Zwischenstück hindurch - am Verankerungsteil erfolgt. Auf diese Weise läßt sich eine besonders sichere Fixa tion der Pfanne verwirklichen, da diese Verankerung eine Krafteinleitung in den Beckenknochen im wesentlichen in Richtung der bei Belastung vorhandenen vertikalen Kraft linien ermöglicht.A first intermediate piece is particularly preferred provided with a through hole, and the outer shell the pan is through one of its through holes and through the through hole of the first intermediate piece attached to the anchoring part, which on Iliac region of the pelvis is attached. The first The intermediate piece then has the effect of a distance piece, which is the distance between the concerned Anchoring part and the outer shell creates while fastening the outer shell directly - through the first Intermediate piece - on the anchoring part. In this way, a particularly safe fixa can be used tion of the pan because this anchoring a Force transmission in the pelvic bones essentially in Direction of vertical force under load lines enabled.
Besonders bevorzugt ist zwischen dem ersten Zwischen stück und dem zugeordneten Verankerungsteil eine Konus steckverbindung vorgesehen. So enthält z. B. das am Darm bein fixierte Verankerungsteil einen Konuszapfen und das erste Zwischenstück eine entsprechende Konusbohrung. Diese Ausgestaltung besitzt den Vorteil, daß bei der Verschraubung der Außenschale - durch die Durchgangs bohrung des ersten Zwischenstücks hindurch - am Veranke rungsteil die zwischen Verankerungsteil und Zwischen stück vorgesehene Konussteckverbindung sich verklemmt und auf diese Weise eine störungsfreie, absolut feste Verbindung zwischen Verankerungsteil und Zwischenstück herstellt. Vorteilhafterweise wird mindestens ein zwei tes Zwischenstück eingesetzt, welches einen der Außen schale zugewandten Fuß mit einer Gewindebohrung, und einen angeformten Flansch zur Befestigung an dem am Schambein fixierten Verankerungsteil aufweist. Bevorzugt besitzen der Flansch des zweiten Zwischenstücks und ein entsprechender Flansch des Verankerungsteils in ihren Überlappungsbereich Bohrungen oder Gewindebohrungen und gegenüberliegende Rastprofile, damit die beiden Flansche zuerst schwenkbar und zum Ende der Implantationen in der geeigneten Schwenklage fest miteinander verbindbar sind. Zur Verbesserung der Befestigung lassen sich am Scham bein auch zwei Verankerungsteile setzen, die jeweils ein entsprechendes zweites Zwischenstück tragen, an dem dann die Außenschale angeschraubt wird.Between the first intermediate is particularly preferred piece and the associated anchoring part a cone connector provided. So contains z. B. the intestine in the anchoring part fixed a cone and the first intermediate piece a corresponding conical hole. This configuration has the advantage that the Screwing the outer shell - through the passage drilling the first intermediate piece through - at the anchoring The part between the anchoring part and the intermediate part piece provided cone connector jammed and in this way a trouble-free, absolutely firm Connection between anchoring part and intermediate piece manufactures. Advantageously, at least one becomes two t used intermediate piece, which is one of the outside shell facing foot with a threaded hole, and a molded flange for attachment to the Pubic fixed anchoring part. Prefers have the flange of the second adapter and a corresponding flange of the anchoring part in their Overlap area bores or tapped holes and opposite locking profiles, so that the two flanges first swiveling and at the end of the implantations in the suitable pivot position are firmly connected. To improve the attachment can be on the pubic Also insert two anchoring parts, one each wear the corresponding second adapter, on which then the outer shell is screwed on.
Besonders bevorzugt weisen die der Außenschale zuge wandten Stützflächen der Zwischenstücke eine der Außen schale angepaßte Form auf. Zur Herstellung eines Form schlusses zwischen den Zwischenstücken und der Außen schale weisen besonders bevorzugt die Stützflächen der Zwischenstücke und die Außenfläche der Außenschale ent sprechende Rastprofile, z. B. ineinandergreifende pyra-= midenförmige Ansätze, auf, die beim Verankern der Außen schale an den Zwischenstücken formschlüssig ineinander greifen.The outer shell is particularly preferably assigned support surfaces of the spacers turned one of the outside shell adapted shape. To make a mold between the intermediate pieces and the outside shell particularly preferably have the support surfaces of the Intermediate pieces and the outer surface of the outer shell ent speaking locking profiles, e.g. B. interlocking pyra = middle-shaped approaches, which when anchoring the outside shell on the intermediate pieces in a form-fitting manner to grab.
Die Durchgangsbohrungen in der Außenschale der Pfanne sind bevorzugt an der Innenfläche angefast, damit die zum Befestigen der Außenschale an den Zwischenstücken verwendeten Schrauben nicht auftragen, so daß ein in den Innenraum der Außenschale eingesetztes Kunststoffteil störungsfrei in der Außenschale anliegt.The through holes in the outer shell of the pan are preferably chamfered on the inner surface so that the for attaching the outer shell to the intermediate pieces Do not apply the screws used, so that one in the Plastic part inserted into the interior of the outer shell fits smoothly in the outer shell.
Die Verankerungsteile besitzen bevorzugt einen Stütz kragen, mit dem diese an den Resektionsebenen anliegen. Außerdem sind bevorzugt beckenseitige Verankerungs laschen mit Bohrungen vorgesehen, welche in dem Gewebe des Beckenknochens mittels entsprechender Schrauben befestigt werden können.The anchoring parts preferably have a support collar with which they rest on the resection planes. In addition, anchoring on the pool side is preferred tabs provided with holes in the fabric the pelvic bone using appropriate screws can be attached.
Um eine individuelle Positionierung der Pfanne zu ermög lichen, werden besonders bevorzugt Zwischenstücke unter schiedlicher Längen angeboten, so daß der Operateur je nach Lage der Resektionsebenen längere oder kürzere Zwischenstücke einsetzen kann.To allow the pan to be positioned individually Lichen, intermediate pieces are particularly preferred offered different lengths, so that the surgeon ever longer or shorter depending on the location of the resection planes Can use spacers.
Vorteilhafte Weiterbildungen der Erfindung sind durch die Merkmale der Unteransprüche gekennzeichnet.Advantageous developments of the invention are through characterized the features of the subclaims.
Im folgenden wird ein Ausführungsbeispiel der Erfindung anhand der Zeichnung näher erläutert.The following is an embodiment of the invention explained in more detail with reference to the drawing.
Es zeigtIt shows
Fig. 1 eine Seitenansicht einer implantierten Endopro these, teilweise im Schnitt; Figure 1 is a side view of an implanted endopro thesis, partially in section.
Fig. 2 eine vergrößerte Schnittansicht der Befestigung der Endoprothese am Darmbein-Bereich; und Fig. 2 is an enlarged sectional view of the mounting of the endoprosthesis at the iliac region; and
Fig. 3 eine vergrößerte Schnittdarstellung der prothe tischen Pfanne. Fig. 3 is an enlarged sectional view of the prothe table pan.
Die Fig. 1 und 2 zeigen einen Schnitt durch eine Außen schale 4, einer prothetischen Pfanne 2, die mehrere Durchgangsbohrungen 10 enthält, welche auf der Innen seite jeweils eine Senkfase 12 aufweisen. Die Außen fläche der Außenschale 4 ist mit einem pyramidenförmigen Rastprofil 25 versehen. Wie insbesondere der Fig. 3 entnehmbar ist, nimmt die Außenschale 4 in der Regel einen Kunststoffeinsatz 6 auf, der großflächig gegen die Innenfläche der Außenschale 4 anliegt und eine halb kugelförmige Ausnehmung 8 zur Aufnahme einer protheti schen Gelenkkugel aufweist. Figs. 1 and 2 contains a sectional view of an outer shell 4, a prosthetic socket 2, the plurality of through holes 10, which have on the inner side of a respective countersink 12th The outer surface of the outer shell 4 is provided with a pyramid-shaped locking profile 25 . As shown in particular in FIG. 3 can be removed, engages the outer shell 4 usually a plastic insert 6, the large surface area abutting against the inner surface of the outer shell 4 and having a semi-spherical recess 8 for receiving a protheti's joint ball.
Am Darmbein-Bereich des Beckenknochens 50 ist ein erstes Verankerungsteil 30 befestigt, welches mit einem Stütz kragen 34 an der Resektionsebene anliegt und gegen den beckenknochen gerichtete Verankerungslaschen 38 mit Durchgangsbohrungen 36 aufweist. Die Verankerungslaschen 38 werden in den Beckenknochen 50 eingesetzt und dann durch die Bohrungen 36 mit geeigneten Befestigungsmit teln befestigt.At the iliac region of the pelvic bone 50 , a first anchoring part 30 is attached, which rests with a support collar 34 on the resection plane and has anchoring tabs 38 with through-holes 36 directed against the pelvic bone. The anchoring tabs 38 are inserted into the pelvic bones 50 and then fastened through the holes 36 with suitable fastening means.
Das erste Verankerungsteil 30 weist einen zur Pfanne 2 hin gerichteten Konuszapfen 32 auf, vgl. insbesondere Fig. 2. Gemäß Fig. 1, und insbesondere Fig. 2 ist ein erstes Zwischenstück 20 zwischen der Außenschale 4 und dem ersten Verankerungsteil 30 vorgesehen. Das erste Zwischenstück 20 besitzt eine zur Außenschale gerichtete Stützfläche, deren Form der Außenfläche der Außenschale 4 angepaßt ist, und die ebenfalls ein gegen die Außen schale gerichtetes Rastprofil 27 aufweist, welches form schlüssig in das Rastprofil 25 der Außenschale 4 ein greifen kann.The first anchoring part 30 has a cone pin 32 directed towards the socket 2 , cf. in particular Fig. 2. According to Fig. 1 and in particular Fig. 2 is a first spacer 20 between the outer shell 4 and the first anchor portion 30 is provided. The first intermediate piece 20 has a support surface directed towards the outer shell, the shape of which is adapted to the outer surface of the outer shell 4 , and which also has a locking profile 27 directed against the outer shell, which can positively engage in the locking profile 25 of the outer shell 4 .
Zum Verankerungsteil hin weist das erste Zwischenstück 20 eine Konusbohrung 24 auf, die formschlüssig den Ko nuszapfen 32 des Verankerungsteils umgreift. Das erste Zwischenstück 20 ist ferner mit einer zentralen Durch gangsbohrung 22 versehen, die koaxial zur Konusbohrung 24 verläuft. Der Konuszapfen 32 weist eine zentrale Gewindebohrung auf. Mit einer Schraube 16, welche durch eine Durchgangsbohrung 10 der Außenschale 4 und die Durchgangsbohrung 22 des ersten Zwischenstücks 20 hin durch in die Gewindebohrung 33 des Konuszapfens 32 faßt, ist die Außenschale an dem ersten Verankerungsteil 30 je nach Wahl der Durchgangsbohrung 10 - in einer indivi duell einstellbaren Position befestigbar, wobei mit dem Festziehen der Schraube 16 pfannenseitig der Formschluß zwischen den Rastprofilen 25, 27 greift, und beckensei tig die Konussteckverbindung 24, 32 verklümmt wird.Towards the anchoring part, the first intermediate piece 20 has a conical bore 24 which positively engages around the cone 32 of the anchoring part. The first intermediate piece 20 is also provided with a central through bore 22 which extends coaxially to the conical bore 24 . The cone pin 32 has a central threaded bore. With a screw 16 , which grips through a through hole 10 of the outer shell 4 and the through hole 22 of the first intermediate piece 20 through into the threaded bore 33 of the conical pin 32 , the outer shell on the first anchoring part 30, depending on the choice of the through hole 10 - in an individual duel adjustable position attachable, with the tightening of the screw 16 engages the form fit between the locking profiles 25 , 27 , and beckensei tig the conical connector 24 , 32 is jammed.
Wie insbesondere Fig. 1 entnehmbar ist, sind am Scham bein-Bereich des Beckenknochens 50 zwei weitere Veranke rungsteile 40 befestigt, die ebenfalls mit einer Veran kerungslasche 48 im Beckenknochen befestigt sind und mit einem Stützkragen 43 an der Resektionsebene anliegen und einen gegen die Pfanne 2 gerichteten Flansch 42 besit zen. Am freien Ende des Flansches sind eine Bohrung oder Gewindebohrung 44 sowie radial verlaufende Rastprofile 46 vorhanden.As can be seen in particular in FIG. 1, two additional anchoring parts 40 are fastened to the pubic region of the pelvic bone 50 , which are also fastened with an anchoring strap 48 in the pelvic bone and rest with a support collar 43 on the resection plane and one against the socket 2 Directional flange 42 have zen. At the free end of the flange there is a bore or threaded bore 44 and radially extending locking profiles 46 .
Zwischen den Verankerungsteilen 40 und der Außenschale 4 sitzt jeweils ein zweites Zwischenstück 21. Die Zwi schenstücke 21 besitzen einen der Außenschale 4 zuge wandten Fuß 26 mit einer der Außenschale angepaßten Formgebung und einem zu der Außenschale hin gerichteten pyramidenförmigen Rastprofil 27. Vom Fuß 26 weg gerich tet läuft ein Flansch 29, dessen freies Ende ebenfalls eine Bohrung bzw. Gewindebohrung 29a und radiale Rast profile 29b besitzt. Der Flansch 29 der zweiten Zwischenstücke 21 und der Flansch 42 der Verankerungs teile 40 überlappen sich und sind durch die Bohrungen/Ge windebohrungen 29a, 44 hindurch mit geeigneten Befesti gungsmitteln in der geeigneten Winkelstellung fest mit einander verbindbar. Durch den Fuß 26 und den Flansch 29 verläuft in Längsrichtung eine Gewindebohrung, so daß die zweiten Zwischenstücke 21 durch die Außenschale 4 hindurch ebenfalls mit einer Schranke 16 verbindbar sind. Beim Anschrauben der Außenschale 4 an die Zwischenstücke 21 bzw. an das Verankerungsteil 30 grei fen das schalenseitige Rastprofil 25 und die Rastprofile 27 der Zwischenstücke ineinander und bilden einen Form schluß.A second intermediate piece 21 sits between the anchoring parts 40 and the outer shell 4 . The inter mediate pieces 21 have one of the outer shell 4 facing foot 26 with a shape adapted to the outer shell and a pyramid-shaped locking profile 27 directed towards the outer shell. From the foot 26 away tet runs a flange 29 , the free end of which also has a bore or threaded hole 29 a and radial locking profile 29 b. The flange 29 of the second intermediate pieces 21 and the flange 42 of the anchoring parts 40 overlap and are through the holes / Ge threaded bores 29 a, 44 with suitable fastening means in the suitable angular position firmly connected to each other. A threaded hole extends in the longitudinal direction through the foot 26 and the flange 29 , so that the second intermediate pieces 21 can also be connected to a barrier 16 through the outer shell 4 . When screwing the outer shell 4 to the spacers 21 or to the anchoring part 30, the shell-side latching profile 25 and the latching profiles 27 of the spacers engage one another and form a positive connection.
Fig. 3 zeigt einen Querschnitt durch eine prothetische Pfanne, welche in den Fig. 1 und 2 einsetzbar ist. Die Außenschale ist mit gleichmäßig beabstandeten Durch gangsbohrungen 10 versehen und trägt auf der Außenseite das Rastprofil 27. In den Innenraum der Außenschale 4 ist ein Kunststoffeinsatz 6 eingesetzt, der eine halb kugelförmige Ausnehmung 8 zur Aufnahme einer Gelenkkugel aufweist. Fig. 3 shows a cross section through a prosthetic socket, which can be used in Figs. 1 and 2. The outer shell is provided with evenly spaced through holes 10 and carries the latching profile 27 on the outside. In the interior of the outer shell 4 , a plastic insert 6 is inserted, which has a semi-spherical recess 8 for receiving a joint ball.
Das erste Zwischenstück 20 wird in verschiedenen Längen verfügbar gehalten. Auf diese Weise läßt sich - je nach dem Verlauf der Resektionsebene am Darmbein der Gelenk- Mittelpunkt der prothetischen Pfanne in eine Position bringen, welche der Position des Gelenks-Mittelpunkts des natürlichen Hüftgelenks entspricht. Um auch die Resektionsebenen am Scharmbein je nach dem Tumorbefund wählen zu können, und um dabei gleichwohl die protheti sche Pfanne in eine solche Position einjustieren zu können, welche dem natürlichen Hüftgelenk entspricht, müssen auch die zweiten Zwischenstücke 21 in verschiede nen Längen verfügbar gehalten werden. Alternativ ist es auch möglich, Zwischenbuchsen vorzusehen, welche zwi schen die Zwischenstücke 20, 21 und die Außenfläche der Außenschale 4 eingesetzt werden und eine entsprechenden Durchgangsbohrung aufweisen müssen, durch welche die Befestigungsschrauben 16 hindurchgeführt werden, um dann mit dem Gewinde 28 in den Zwischenstücken 21 bzw. mit der Gewindebohrung 33 des Konuszapfens 32 des Veranke rungsteils 30 eine Schraubverbindung einzugehen. Die Distanzbuchsen besitzten an der Außenschale 4 zugewand ten Stirnfläche ein Rastprofil, welches mit dem entspre chenden Rastprofil 25 der Außenschale 4 zusammenwirkt. Zusätzlich kann auch dies den Zwischenstücken 21 zuge wandte Stirnfläche mit einem entsprechenden Rastprofil versehen werden, welches dann mit dem Rastprofil 26 der Zwischenstücke 21 zusammenwirkt. Die Distanzbuchsen unterschiedlicher Länge ermöglichen im Individualfall eine Positionierung der prothetischen Pfanne, welche derjenigen des natürlichen Gelenks weitgehend ent spricht.The first intermediate piece 20 is kept available in different lengths. In this way, depending on the course of the resection plane on the ilium, the center of the joint of the prosthetic socket can be brought into a position which corresponds to the position of the center of the joint of the natural hip joint. In order to be able to choose the resection planes on the shin bone depending on the tumor findings, and in order to be able to adjust the prosthetic socket in such a position that corresponds to the natural hip joint, the second intermediate pieces 21 must also be kept available in different lengths. Alternatively, it is also possible to provide intermediate bushings which are inserted between the intermediate pieces 20 , 21 and the outer surface of the outer shell 4 and must have a corresponding through-hole through which the fastening screws 16 are passed, in order to then use the thread 28 in the intermediate pieces 21 or with the threaded hole 33 of the cone 32 of the anchoring tion part 30 to enter into a screw connection. The spacers have on the outer shell 4 facing th end face a locking profile, which interacts with the corresponding locking profile 25 of the outer shell 4 . In addition, this also the intermediate pieces 21 facing end face may be provided with a corresponding locking profile, which then interacts with the latching profile 26 of the intermediate pieces 21st The spacers of different lengths enable the prosthetic socket to be positioned in individual cases, which largely corresponds to that of the natural joint.
Claims (16)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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DE4133433A DE4133433C1 (en) | 1991-10-09 | 1991-10-09 | Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoring |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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DE4133433A DE4133433C1 (en) | 1991-10-09 | 1991-10-09 | Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoring |
Publications (1)
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DE4133433C1 true DE4133433C1 (en) | 1993-05-19 |
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DE4133433A Expired - Fee Related DE4133433C1 (en) | 1991-10-09 | 1991-10-09 | Hip region pelvic joint prosthesis - has through bores in metal outer shell and coacting intermediate member for anchoring |
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Cited By (22)
Publication number | Priority date | Publication date | Assignee | Title |
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EP0628294A1 (en) * | 1993-06-08 | 1994-12-14 | ESKA Implants GmbH & Co. | Partial pelvic endoprothesis |
WO1998029058A1 (en) * | 1996-12-31 | 1998-07-09 | M.P.R.S. Ltd. | A modular implant for pelvis reconstruction |
EP1032330A2 (en) * | 1997-10-31 | 2000-09-06 | Midwest Orthopedic Research Foundation | Acetabular cup prosthesis with extension for deficient acetabulum |
EP1236450A1 (en) * | 2001-02-23 | 2002-09-04 | Biomet, Inc. | A method and apparatus for acetabular reconstruction |
EP1243234A1 (en) * | 2001-03-20 | 2002-09-25 | ESKA Implants GmbH & Co. | Set for constructing an implant for replacing a damaged acetabular cavity |
EP1348407A1 (en) * | 2002-03-29 | 2003-10-01 | LIMA Lto SpA | Acetabular cup for the hip |
EP1532946A2 (en) * | 2001-02-23 | 2005-05-25 | Biomet Manufacturing Corp. | Method and apparatus for acetabular reconstruction |
EP1570810A1 (en) * | 2004-02-25 | 2005-09-07 | Centerpulse Orthopedics Ltd. | Partial pelvic endoprothesis |
NL1026925C2 (en) * | 2004-08-30 | 2006-03-01 | Univ Delft Tech | Joint prosthesis, blocking organ and method for bone fixation. |
US7291177B2 (en) | 2001-02-23 | 2007-11-06 | Biomet Manufacturing Corp. | Method and apparatus for acetabular reconstruction |
US8021432B2 (en) | 2005-12-05 | 2011-09-20 | Biomet Manufacturing Corp. | Apparatus for use of porous implants |
US8066778B2 (en) | 2005-04-21 | 2011-11-29 | Biomet Manufacturing Corp. | Porous metal cup with cobalt bearing surface |
US8123814B2 (en) | 2001-02-23 | 2012-02-28 | Biomet Manufacturing Corp. | Method and appartus for acetabular reconstruction |
US8197550B2 (en) | 2005-04-21 | 2012-06-12 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8266780B2 (en) | 2005-04-21 | 2012-09-18 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8292967B2 (en) | 2005-04-21 | 2012-10-23 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
WO2016086119A1 (en) * | 2014-11-26 | 2016-06-02 | Smith & Nephew, Inc. | Variable angle blade augment |
DE102016202333B3 (en) * | 2016-02-16 | 2017-08-03 | Waldemar Link Gmbh & Co. Kg | Implant for reconstruction of an acetabular cup |
US9931210B2 (en) | 2014-11-26 | 2018-04-03 | Smith & Nephew, Inc. | Variable angle blade augment |
US10350073B2 (en) | 2017-03-14 | 2019-07-16 | Smith & Nephew, Inc. | Modular variable angle blade augment |
EP3482722A4 (en) * | 2016-07-08 | 2019-08-28 | Beijing AK Medical Co., Ltd. | Prosthesis for acetabular defect reconstruction |
US10568741B2 (en) | 2010-06-08 | 2020-02-25 | Smith & Nephew, Inc. | Implant components and methods |
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DE4319010C1 (en) * | 1993-06-08 | 1994-12-15 | Eska Medical Gmbh & Co | Pelvic endoprosthesis |
EP0628294A1 (en) * | 1993-06-08 | 1994-12-14 | ESKA Implants GmbH & Co. | Partial pelvic endoprothesis |
WO1998029058A1 (en) * | 1996-12-31 | 1998-07-09 | M.P.R.S. Ltd. | A modular implant for pelvis reconstruction |
EP1032330A4 (en) * | 1997-10-31 | 2004-10-13 | Midwest Orthopedic Res Foundat | Acetabular cup prosthesis with extension for deficient acetabulum |
EP1032330A2 (en) * | 1997-10-31 | 2000-09-06 | Midwest Orthopedic Research Foundation | Acetabular cup prosthesis with extension for deficient acetabulum |
US9375316B2 (en) | 2001-02-23 | 2016-06-28 | Biomet Manufacturing, Llc. | Method and apparatus for acetabular reconstruction |
US7713306B2 (en) | 2001-02-23 | 2010-05-11 | Biomet Manufacturing Corp. | Method and apparatus for acetabular reconstruction |
US8123814B2 (en) | 2001-02-23 | 2012-02-28 | Biomet Manufacturing Corp. | Method and appartus for acetabular reconstruction |
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US8551181B2 (en) | 2001-02-23 | 2013-10-08 | Biomet Manufacturing, Llc | Method and apparatus for acetabular reconstruction |
EP1236450A1 (en) * | 2001-02-23 | 2002-09-04 | Biomet, Inc. | A method and apparatus for acetabular reconstruction |
US7291177B2 (en) | 2001-02-23 | 2007-11-06 | Biomet Manufacturing Corp. | Method and apparatus for acetabular reconstruction |
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EP1243234A1 (en) * | 2001-03-20 | 2002-09-25 | ESKA Implants GmbH & Co. | Set for constructing an implant for replacing a damaged acetabular cavity |
EP1348407A1 (en) * | 2002-03-29 | 2003-10-01 | LIMA Lto SpA | Acetabular cup for the hip |
US7635391B2 (en) * | 2004-02-25 | 2009-12-22 | Zimmer, Gmbh | Endoprosthesis for part of the pelvis |
EP1570810A1 (en) * | 2004-02-25 | 2005-09-07 | Centerpulse Orthopedics Ltd. | Partial pelvic endoprothesis |
WO2006025729A1 (en) * | 2004-08-30 | 2006-03-09 | Technische Universiteit Delft | Joint prosthesis and method of bone fixation |
NL1026925C2 (en) * | 2004-08-30 | 2006-03-01 | Univ Delft Tech | Joint prosthesis, blocking organ and method for bone fixation. |
US8266780B2 (en) | 2005-04-21 | 2012-09-18 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8197550B2 (en) | 2005-04-21 | 2012-06-12 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8292967B2 (en) | 2005-04-21 | 2012-10-23 | Biomet Manufacturing Corp. | Method and apparatus for use of porous implants |
US8066778B2 (en) | 2005-04-21 | 2011-11-29 | Biomet Manufacturing Corp. | Porous metal cup with cobalt bearing surface |
US8021432B2 (en) | 2005-12-05 | 2011-09-20 | Biomet Manufacturing Corp. | Apparatus for use of porous implants |
US10568741B2 (en) | 2010-06-08 | 2020-02-25 | Smith & Nephew, Inc. | Implant components and methods |
US9889013B2 (en) | 2014-11-26 | 2018-02-13 | Smith & Nephew, Inc. | Variable angle blade augment |
US9931210B2 (en) | 2014-11-26 | 2018-04-03 | Smith & Nephew, Inc. | Variable angle blade augment |
WO2016086119A1 (en) * | 2014-11-26 | 2016-06-02 | Smith & Nephew, Inc. | Variable angle blade augment |
DE102016202333B3 (en) * | 2016-02-16 | 2017-08-03 | Waldemar Link Gmbh & Co. Kg | Implant for reconstruction of an acetabular cup |
US11419728B2 (en) | 2016-02-16 | 2022-08-23 | Waldemar Link Gmbh & Co. Kg | Implant for reconstructing an acetabulum and at least part of a pelvic structure |
EP3482722A4 (en) * | 2016-07-08 | 2019-08-28 | Beijing AK Medical Co., Ltd. | Prosthesis for acetabular defect reconstruction |
US10779948B2 (en) | 2016-07-08 | 2020-09-22 | Beijing AK Medical Co., Ltd. | Acetabular defect reconstructive prosthesis |
US10350073B2 (en) | 2017-03-14 | 2019-07-16 | Smith & Nephew, Inc. | Modular variable angle blade augment |
US11213396B2 (en) | 2017-03-14 | 2022-01-04 | Smith & Nephew, Inc. | Modular variable blade augment |
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