EP0871418A1 - Hüftgelenkprothese - Google Patents

Hüftgelenkprothese

Info

Publication number
EP0871418A1
EP0871418A1 EP96942366A EP96942366A EP0871418A1 EP 0871418 A1 EP0871418 A1 EP 0871418A1 EP 96942366 A EP96942366 A EP 96942366A EP 96942366 A EP96942366 A EP 96942366A EP 0871418 A1 EP0871418 A1 EP 0871418A1
Authority
EP
European Patent Office
Prior art keywords
hip
socket insert
inserts
intermediate element
prosthesis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP96942366A
Other languages
English (en)
French (fr)
Inventor
Hartmut Kälberer
Hans-Georg Pfaff
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cerasiv GmbH Innovatives Keramik Engineering
Original Assignee
Cerasiv GmbH Innovatives Keramik Engineering
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from DE19622583A external-priority patent/DE19622583A1/de
Application filed by Cerasiv GmbH Innovatives Keramik Engineering filed Critical Cerasiv GmbH Innovatives Keramik Engineering
Publication of EP0871418A1 publication Critical patent/EP0871418A1/de
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/10—Ceramics or glasses
    • A61L27/105—Ceramics or glasses containing Al2O3
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30153—Convex polygonal shapes rectangular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—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 with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30378—Spherically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30451—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30492—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30682—Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
    • A61F2002/30685—Means for reducing or preventing the generation of wear particulates
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
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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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    • A61F2/32—Joints for the hip
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    • A—HUMAN NECESSITIES
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    • 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
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
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    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0019—Angular shapes rectangular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00203—Ceramics or ceramic-like structures based on metal oxides containing alumina or aluminium oxide

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  • Health & Medical Sciences (AREA)
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  • Heart & Thoracic Surgery (AREA)
  • Biomedical Technology (AREA)
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  • Prostheses (AREA)

Abstract

Die Erfindung betrifft eine Hüftgelenkprothese mit einer metallischen Prothesenschale (1) mit einem Pfanneneinsatz (2) mit einer kugelförmigen Ausbuchtung (3) und einem zwischen der Prothesenschale (1) und dem Pfanneneinsatz (2) angeordneten Zwischenelement (4) aus Kunststoff. Zur Vermeidung von Osteolyse wird vorgeschlagen, daß das Zwischenelement (4) aus einem Oberteil (5) und einem Unterteil (6) besteht, daß Oberteil (5) und Unterteil (6) miteinander verbindbar sind und daß der Pfanneneinsatz (2) zwischen Oberteil (5) und Unterteil (6) verankert ist.

Description

Hüftgelenkprothese
Die Erfindung betrifft eine Hüftgelenkprothese nach dem Oberbegriff des Anspruchs 1.
Aus dem Gebrauchsmuster FR 2 715 828 ist eine Hüftgelenkprothese mit drei ineinanderliegenden kugelförmigen Kalotten bekannt.
Die kugelförmige Außenkalotte besteht aus einem biokompatiblen, starren Werkstoff wie INOX-Stahl oder Titan, welche an der Außenseite mit radialen Unebenheiten zur Befestigung in der Gelenkpfanne des Beckenknochens versehen ist.
Die kugelförmige Innenkalotte besteht aus einem harten, biokompatiblen Werkstoff wie beispielsweise Aluminiumoxidkeramik oder einem ähnlichen Material, mit einem niedrigen Reibungskoeffizienten in bezug auf das Material, aus dem der Kopf des daran anschließenden Oberschenkelelements besteht.
Die kugelförmige Zwischenkalotte besteht aus einem halbstarren Material wie Kunststoff, insbesondere Polyethylen.
Ein Problem bei Zwischenkalotten oder Zwischenelementen aus Kunststoff ist, daß diese durch hohen Abrieb Osteolyse auslösen können, wenn keine formschlüssige Verbindung zwischen der Gleitschale und dem Kunststoff-Mantel besteht. Andererseits kann eine formschlüssige Verbindung durch Schmelzen des Kunststoff-Mantels erreicht werden, wie in EP 0 554 214 A1 beschrieben. Dies kann jedoch zur Zerstörung der Molekülstruktur führen und damit Verschleiß auslösen.
Der Erfindung liegt die Aufgabe zugrunde, eine Hüftgelenkprothese nach dem Oberbegriff des Anspruchs 1 derart zu verbessern, daß die Gefahr von Osteolyse weitgehend aufgehoben ist
Erfindungsgemäß wird diese Aufgabe durch die kennzeichnenden Merkmale des Anspruchs 1 gelöst. Dadurch, daß das Zwischenelement aus einem Oberteil und einem Unterteil besteht, daß Oberteil und Unterteil miteinander verbindbar sind und daß der Pfanneneinsatz zwischen Oberteil und Unterteil verankert ist, wird der Verschleiß des Zwischenelements vermieden und dadurch die Gefahr von Osteolyse vermindert.
In bevorzugter Ausführungsform ist der Pfanneneinsatz allseitig bis auf seine kugelförmige Ausbuchtung vom Zwischenelement, d.h. dem Ober- und Unterteil ummantelt, so daß keine freien Stellen vorhanden sind, an denen ein Abrieb auftreten kann.
Die Verbindung des Oberteils mit dem Unterteil kann auf die verschiedensten Arten durchgeführt werden. Als zweckmäßig erweisen sich Schraubver¬ bindungen über ein Gewinde, Schnappverbindungen, Verstiftungen, Kleben oder Schweißen.
Der Pfanneneinsatz kann aus Metall oder Keramik hergestellt sein. Bevorzugt eignet sich diese Erfindung für alle keramischen Pfanneneinsätze.
Zweckmäßigerweise sind im Pfanneneinsatz und im angrenzenden Unterteil gegenüberliegende Aussparungen vorgesehen, in denen zur Rotationssicherung Einsätze eingebracht sind. Hierdurch sitzt der Pfanneneinsatz in seiner Lage fixiert im Zwischenelement. Die Einsätze können z. B. Stifte, Nutensteine bzw. Paßfedersysteme oder Keile sein und z. B. aus Metall oder Kunststoff gefertigt sein. Zur besseren Fixierung füllen die Einsätze die Aussparungen vorteilhafterweise vollständig aus.
Weitere Merkmale der Erfindung ergeben sich aus den Figuren, die nachfolgend beschrieben sind.
Fig. 1 zeigt angedeutet im Schnitt eine metallische Prothesenschale 1, die in die nicht gezeigte Gelenkpfanne eines Beckenknochens implantierbar ist. Zur besseren Verankerung sind an der Außenseite der Prothesenschale 1 Rippen oder ein Gewinde 10 angeordnet. In die Prothesenschale 1 ist ein Zwischenelement 4 aus Kunststoff eingesetzt, das wiederum einen keramischen Pfanneneinsatz 2 ummantelt. Das Zwischenelement 4 ist mit seiner äußeren Kontur an die Form der Prothesenschale 1 angepaßt und besteht aus einem Oberteil 5 und einem Unterteil 6.
Das Unterteil 6 ist zum Oberschenkelknochen gewandt und weist eine Ausbuchtung 11 zur Aufnahme des Pfanneneinsatzes 2 auf. Der Pfanneneinsatz
2 ist dabei bis auf seine kugelförmige Ausbuchtung 3 vollständig vom Zwischenelement 4 ummantelt. Besonders hervorzuheben ist, daß das Oberteil 6 auch die der Ausbuchtung 3 benachbarte Auflagefläche 12 abdeckt. Das Oberteil 5 deckt den Pfanneneinsatz 2 auf seiner Rückseite ab und ist mit dem Unterteil 6 auf die verschiedensten Arten und Weisen verbunden. Die kugelförmige Ausbuchtung 3 dient zur Aufnahme des Kopfes eines Oberschenkelelements.
Fig. 1 zeigt eine Ausführungsform für den Fall, daß der Patient eine Displasie hat, d.h. daß der Pfanneneinsatz 2 unsymmetrisch in die Prothesenschale 1 eingebaut werden muß. Fig. 2 zeigt einen symmetrischen Einbau des Pfanneneinsatzes 2 in der Prothesenschale 1.
Die Figuren 3 bis 5 zeigen verschiedene Verbindungen des Oberteils 5 mit dem Unterteil 6. Diese Verbindung ist in den Figuren 1 und 2 mit X bezeichnet. In Fig.
3 ist das Oberteil 5 mit dem Unterteil 6 über ein Gewinde 7 verbunden bzw. verschraubt. Fig. 8 zeigt eine Schnappverbindung 8.
Hierzu sind am Oberteil 5 und Unterteil 6 einzelne kleine Erhebungen angeordnet, die beim Einpassen des Oberteils 5 in das Unterteil 6 ineinandergreifen und so eine gute Verbindung schaffen. Fig. 5 zeigt eine Verstiftung 9. Hierzu ist im Unterteil 6 und Oberteil 5 eine Bohrung 13 eingebracht, in die ein durchgehender Stift 14 eingebracht ist.
Der Pfanneneinsatz 2 besteht aus einer Keramik, wie z.B. einer Aluminiumoxidkeramik. Es ist jedoch auch jede andere Keramik einsetzbar.
Die Figuren 6 und 7 zeigen Ausführungsformen ähnlich der in den Fig. 1 und 2 gezeigten, jedoch sind zusätzlich im Pfanneneinsatz 2 und im angrenzenden Unterteil 6 gegenüberliegende Aussparungen 15 vorgesehen, in denen zur Rotationssicherung Einsätze 16 eingebracht sind. Diese Einsätze 16 füllen die Aussparungen 15 vollständig aus und bestehen aus Metall oder Kunststoff. Fig. 8 zeigt einen Schnitt entlang der Linie A-A und Fig. 9 einen Schnitt entlang der Linie B-B in Fig. 7. In Fig. 8 ist ein Stift 17 und in Fig. 9 ein im Querschnitt rechteckiger Nutenstein 18 in die Aussparung 15 eingebracht.
Mit diesen Einsätzen 16 ist eine Verdrehsicherung des Pfanneneinsatzes 2 im Zwischenelement 4 erreicht.

Claims

Patentansprüche
1.) Hüftgelenkprothese mit einer metallischen Prothesenschale (1) mit einem Pfanneneinsatz (2) mit einer kugelförmigen Ausbuchtung (3) und einem zwischen der Prothesenschale (1) und dem Pfanneneinsatz (2) angeordneten Zwischenelement (4) aus Kunststoff, dadurch gekennzeichnet, daß das Zwischenelement (4) aus einem Oberteil (5) und einem Unterteil (6) besteht, daß Oberteil (5) und Unterteil (6) miteinander verbindbar sind und daß der Pfanneneinsatz (2) zwischen Oberteil (5) und Unterteil (6) verankert ist.
2.) Hüftgelenkprothese nach Anspruch 1 , dadurch gekennzeichnet, daß der Pfanneneinsatz (2) allseitig bis auf seine kugelförmige Ausbuchtung (3) vom Zwischenelement (4) ummantelt ist.
3.) Hüftgelenkprothese nach einem der Ansprüche 1 oder 2, dadurch gekennzeichnet, daß die Verbindung des Oberteils (5) mit dem Unterteil
(6) über Gewinde (7), Schnappverbindungen (8) , Verstiftungen (9) , Kleben oder Schweißen erfolgt.
4.) Hüftgelenkprothese nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß der Pfanneneinsatz (2) aus Keramik besteht.
5.) Hüftgelenkprothese nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, daß im Pfanneneinsatz (2) und im angrenzenden Unterteil (6) gegenüberliegende Aussparungen (15) vorgesehen sind, in denen zur Rotationssicherung Einsätze (16) eingebracht sind.
6.) Hüftgeienkprothese nach Anspruch 5, dadurch gekennzeichnet, daß die Einsätze (16) Stifte (17), Nutensteine (18) oder Keile sind.
7.) Hüftgeienkprothese nach Anspruch 5 oder 6, dadurch gekennzeichnet, daß die Einsätze (16) die Aussparungen (15) vollständig ausfüllen.
8.) Hüftgeienkprothese nach einem der Ansprüche 5 bis 7, dadurch gekennzeichnet, daß die Einsätze (16) aus Metall oder Kunststoff gefertigt sind.
EP96942366A 1995-12-19 1996-12-06 Hüftgelenkprothese Withdrawn EP0871418A1 (de)

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DE19547514 1995-12-19
DE19547514 1995-12-19
DE19547814 1995-12-20
DE19547814 1995-12-20
DE19622583 1996-06-05
DE19622583A DE19622583A1 (de) 1995-12-19 1996-06-05 Hüftgelenkprothese
PCT/EP1996/005455 WO1997022311A1 (de) 1995-12-19 1996-12-06 Hüftgelenkprothese

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WO1997022311A1 (de) 1997-06-26
TW386873B (en) 2000-04-11
US6224633B1 (en) 2001-05-01
CA2239801A1 (en) 1997-06-26
JP2000501965A (ja) 2000-02-22

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