|Número de publicación||USRE42805 E1|
|Tipo de publicación||Concesión|
|Número de solicitud||US 11/801,429|
|Fecha de publicación||4 Oct 2011|
|Fecha de presentación||9 May 2007|
|Fecha de prioridad||28 May 2003|
|También publicado como||DE602004000199D1, DE602004000199T2, EP1481653A1, EP1481653B1, US6890357, US20040243243|
|Número de publicación||11801429, 801429, US RE42805 E1, US RE42805E1, US-E1-RE42805, USRE42805 E1, USRE42805E1|
|Inventores||Alain Tornier, Shawn O'Driscoll, Graham King, Ken Yamaguchi, Yves Alain Ratron, Bruno Scialom|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (88), Otras citas (3), Citada por (5), Clasificaciones (6), Eventos legales (4)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
This application claims the benefit of U.S. provisional application No. 60/473,446 filed May 28, 2003.
The present invention relates to an elbow prosthesis comprising at least one humeral component and one ulnar component.
It concerns more particularly an elbow prosthesis of which the ulnar component is adapted to receive a locking element which forms an articulating surface extending that of the ulnar component, the articulating surfaces of the locking element and of the ulnar component being adapted to be arranged together around at least a part of another articulating surface belonging to a humeral component. A prosthesis of this type is known from EP-A-1 051 954.
In such a prosthesis, the locking element is maintained in position on the ulnar component thanks to a screw introduced in a through housing in this element and tightened in a tapping provided on the ulnar component. It has proved in practice that the positioning of the locking element on the ulnar component is not always optimum when such a screw is tightened, which may lead to a skewed positioning of the screw with respect to the tapping, to such a point that the thread of the screw or the tapping may be distorted, thus preventing the locking element from being mounted. In addition, the afore-mentioned screw serves both to bring the locking element into correct position with respect to the ulnar component and to ensure blocking of these two elements with respect to each other. As a result, such an ulnar component must most often be fitted while the articulation of the elbow is in maximum flexion, which renders the surgeon's work more complex. It even happens that such fitting in maximum flexion is not possible, particularly in the case of marked obesity of the patient.
It is a more particular object of the invention to overcome these drawbacks by proposing an elbow prosthesis whose fit is facilitated, when it comprises a locking element as mentioned hereinabove.
To that end, the present invention relates to an elbow prosthesis comprising a humeral component, forming a first articulating surface, and an ulnar component forming a second articulating face adapted to be disposed around a part of the first articulating surface and to pivot about a longitudinal axis of this surface, the ulnar component being provided with means for mounting a locking element which forms a third articulating surface extending the second articulating surface and adapted likewise to be disposed around a part of the first articulating surface. This prosthesis is characterized in that the afore-mentioned mounting means comprise guiding means adapted to cooperate with complementary means provided on the locking element in order to guide this element in translation with respect to the ulnar component, up to a position where blocking means provided respectively on the locking element and on the ulnar component may be employed to immobilize the locking element on the ulnar component, these blocking means being able to be employed only in this position.
Thanks to the invention, the guiding means ensure an adequate positioning of the locking element with respect to the ulnar component before the blocking means are employed to effect an efficient immobilization of the locking element with respect to the ulnar component. In other words, the blocking means do not serve to bring the locking element in a configuration allowing its blocking, this function being performed by the guiding means which may be positioned and configured to ensure this function best.
In addition, an elbow prosthesis may incorporate one or more of the following characteristics, taken in any technically admissible combination:
The blocking means comprise a screw and a complementary tapping provided respectively on the locking element and on the ulnar component, or vice versa, the direction of relative translation between the locking element and the ulnar component as imposed by the guiding means being non-parallel to the longitudinal axis of the tapping and/or of the afore-mentioned screw.
The guiding means comprise at least one element in relief projecting with respect to a principal part of the ulnar component, while the complementary means provided on the locking element are adapted to interact with this element in relief by cooperation of shapes. In that case, the aforementioned element in relief may be a nose, while the complementary means comprise a fork of which two branches define therebetween a volume for receiving and for slide of this nose.
The guiding means and the blocking means are arranged in the vicinity of two opposite edges of the second articulating surface of the ulnar component, while the complementary means and the blocking means provided on the locking element are arranged on two opposite edges of that element.
The blocking means comprise a screw and a tapping, which are complementary and respectively provided on the locking element and on the ulnar component, or vice versa, while means are provided for blocking this screw in rotation. The head of the screw may thus be of non-circular section, while the piece against which this head bears forms a space for receiving this head, with contact between the surface of this piece and the outer surface of the head. More particularly, the head of the screw may be provided with catch elements adapted to penetrate superficially in the surface of the afore-mentioned piece. In a variant, the piece against which the head of the screw bears may be provided with a tab foldable into configuration of blockage of this head. In that case, the head of the screw may be of polygonal profile, with faces whose width is greater than the width of the foldable tab.
The invention will be more readily understood and other advantages thereof will appear more clearly in the light of the following description of a form of embodiment of a prosthesis in accordance with its principle, given solely by way of example and made with reference to the accompanying drawings, in which:
Referring now to the drawings, the prosthesis visible in
An elongated piece 16 is provided with a central bore 16a whose dimensions are such as to receive the screw 14, this making it possible to mount the piece 16 between the branches 12 and 13. The piece 16 is provided with two end surfaces 16b and 16c provided to come respectively into contact with the opposite surfaces of the branches 12 and 13.
Between the surfaces 16b and 16c, the piece 16 is substantially cylindrical, with circular base, and forms a surface of articulation S1 which is also substantially cylindrical, whose generatrix G1 is curved and concave, in that the diameter of the surface S1 is minimum in the central part of the piece 16 included between the surfaces 16b and 16c. X1 denotes the axis of symmetry of the surface S1.
The piece 16 extends in an extension 16d whose outer surface S4 is convex and which covers the branch 12 when the piece 16 is mounted between the branches 12 and 13.
The whole of the humeral component 10 is made of metal.
The ulnar component 20 comprises a metal stem 21 intended to be inserted in the medullary canal of the ulna C and which is in one piece with a branch 22 likewise made of metal, of concave shape and whose inner surface is covered with a lining 23 made of a material adapted to the friction with the metal piece 16, for example polyethylene. The lining 23 is mounted on the branch 22 by cooperation of shapes. A pin 27 makes it possible to immobilize elements 22 and 23 with respect to each other.
The inner surface of the lining 23 forms a surface of articulation S2 whose shape is complementary to that of surface S1. X2 denotes the central axis of elements 22 and 23.
The respective diameters of surfaces S1 and S2, which diameters are variable along axes X1 and X2, are chosen so that the surface S2 may be disposed around the surface S1, with a slight clearance, this allowing a rotation of the components 10 and 20 with respect to each other about axes X1 and X2 which, in that case, merge.
Moreover, the profiles of the generatrices of surfaces S1 and S2 are chosen so as to allow a degree of mobility of the surface S1 in surface S2, in the sense of varus-valgus, i.e. about an axis perpendicular to X1 and X2.
A locking element 30 is intended to be mounted on the component 20 and comprises a metal casing 32 and a lining 33 immobilized with respect to each other by clipping. The lining 33 is advantageously made of the same material as the lining 23 and forms a concave articulating surface S3 intended to extend the surface S2 and, with it, surround the surface S1.
In order to facilitate assembly of the element 30 on the component 20, this component is provided, in extension of the outer surface 24 of the branch 22, with an element in relief 25 in the form of a nose or beak which projects beyond the part 22a of the branch 22 covered by the lining 23.
Furthermore, the casing 32 of the element 30 extends beyond its part 32a covered by the lining 33, in an extension in the form of a fork 35 of which the two branches 35a and 35b together define a volume 35c for slide and reception of the nose 25 when the element 30 is mounted on the component 20.
The nose 25 is disposed in a space 23c defined by the lining 23 which extends beyond the part 22a of the branch 22 that it covers. In its part 23d which extends in overhang with respect to the part 22a, the lining has a substantially U-shaped cross-section. The space 23c is defined at the centre of this U.
The nose 25 has a width decreasing in the direction of the bottom of the U formed by the part 23d. In this way, the sides 25a and 25b of the nose 25 diverge, moving away from this bottom and approaching the branches of the U formed by the part 23d. The nose 25 has a section substantially in the form of a dove-tail.
In addition, grooves 25c and 25d are formed on either side of the nose 25. These grooves have profiles allowing them to receive convex parts 35d and 35e of the branches 35a and 35b.
The branches 35a and 35b thus have a geometry compatible with their introduction in the space 23c, on either side of the nose 25. Their surfaces intended to face towards the nose 25 deviate from each other towards the outside of the element 30, with the result that these surfaces are substantially parallel to sides 25a and 25b.
In this way, the direction of assembly of the element 30 on the component 20 is necessarily that indicated by arrow F1 in
Furthermore, the component 20 is provided with a tapping 26 for receiving a screw 36 which traverses a through housing 37 provided to that end in the element 30.
The tapping 26 and the housing 37 are configured so that they are aligned, in a direction Y1 perpendicular to axis X2, at the end of the slide of the element 30 with respect to the component 20. Such slide takes place until the linings 23 and 33 come into abutment against each other in the vicinity of the members 25 and 35, as shown in
The direction Y1 is not parallel to the direction of displacement of the element 30 with respect to the component 20 during its assembly, i.e. to arrow F1, with the result that the screw 36 can be introduced in the tapping 26 only at the end of slide of the clement 30 on the component 20 in the direction of arrow F1.
In this way, the screw 36 serves solely for blocking the element 30 in position on the component 20 and can be tightened only once a correct position of the element 30 on the component 20 has been attained. The risks of the screw 36 being tightened askew in the tapping 26 are thus avoided.
In addition, the mechanical strength of the assembly formed by the elements 20 and 30 in the configuration of
In effect, the nose 25 is provided in the vicinity of a first edge 20a of the component 20 and of the surface S2, while the tapping 26 is provided near the opposite edge 20b of this component. In the same way, elements 35 and 37 are respectively provided in the vicinity of the two opposite edges 30a and 30b of the element 30 and of the surface S3.
In other words, the function of guiding of the element 30 with respect to the component 20 is obtained in the vicinity of the edges 20a and 30a of these members, while the function of blocking is obtained in the vicinity of the edges 20b and 30b.
The housing 37 is formed by a circular orifice 37a made in the metal casing 32 for the passage of the shank of the screw 36, as well as by a concave zone 37b made in an end part of the lining 33, in the vicinity of the edge 30b.
The head 36a of the screw 36 presents a non-circular external section as it is equipped with peripheral catching elements or teeth 36b provided to engage superficially in the inner radial surface 37c of the concave zone 37b, this contributing to the immobilization of the screw 36 in rotation and thus ensures an efficient blocking of the element 30 on the component 20.
In addition, a tab 38 extends the casing 32 in the vicinity of the housing 37, this tab being able to be folded into abutment against the head 36a of the screw 36 when the latter is tightened, in the direction of arrow F3 in
According to a variant embodiment of the invention (not shown), the head 36a may present a polygonal profile, for example hexagonal or octagonal, with planar faces. In that case, the width of the tab 38 is chosen to be less than the width of the lateral faces of this head, this allowing the screw 36 to be blocked in rotation by surface abutment of one of these faces against this tab.
When the element 30 is mounted on the component 20, the assembly thus produced may pivot about axis X1 and the joining of surfaces S2 and S3 surrounds the surface S1 over 360°.
A radial component adapted to be mounted on the radius R is advantageously provided in the prosthesis according to the invention, this component 40 defining a surface intended to cooperate with the surface S4. However, this is not compulsory.
The invention is not limited to the sole form of embodiment represented. In particular, it may concern a prosthesis in which the projecting element, such as the nose 25, is provided on the element 30, while a structure of fork type is provided on the ulnar component. Similarly, the tapping for receiving the blocking screw may be provided on the locking element, the ulnar component in that case defining a housing for receiving the locking screw.
Any mechanical means for blocking the locking element on the ulnar component may be envisaged within the framework of the present invention.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US2696817 *||30 Abr 1952||14 Dic 1954||Samuel B Prevo||Prosthetic elbow joint|
|US4131956||14 Feb 1977||2 Ene 1979||Richards Manufacturing Company, Inc.||Elbow prosthesis|
|US4134158 *||22 Ago 1977||16 Ene 1979||Laure Prosthetics, Inc.||Knee joint prosthesis|
|US4242758||30 May 1978||6 Ene 1981||University Of Leeds Industrial Service Ltd.||Elbow prosthesis|
|US4383337||22 Oct 1980||17 May 1983||Zimmer Usa, Inc.||Elbow prosthesis|
|US4538306||22 Jun 1983||3 Sep 1985||Feldmuhle Aktiengesellschaft||Implantable elbow joint|
|US4822364||21 Dic 1987||18 Abr 1989||New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery||Elbow joint prosthesis|
|US4892546||3 May 1988||9 Ene 1990||Howmedica Gmbh||Adjustable prosthesis for a joint bone|
|US5133761||12 Jun 1991||28 Jul 1992||Research Development Foundation||Finger joint prosthesis|
|US5171289||18 Nov 1991||15 Dic 1992||Etablissements Tornier||Femoral prosthesis with cement retaining seal|
|US5314484||19 Ene 1993||24 May 1994||Huene Donald R||Bi-axial elbow joint replacement|
|US5314485||11 Sep 1992||24 May 1994||Etablissements Tornier||Total prosthesis of the wrist|
|US5326359||24 Nov 1992||5 Jul 1994||Etablissements Tornier||Knee prosthesis with adjustable centro-medullary stem|
|US5358526||10 Nov 1992||25 Oct 1994||Etablissements Tornier||Modular shoulder prosthesis|
|US5405399||11 May 1993||11 Abr 1995||Etablissements Tornier||Total prosthesis for the metacarpo-phalangeal joint|
|US5429639||9 May 1994||4 Jul 1995||Tornier S.A.||Spine fixator for holding a vertebral column|
|US5458650||8 Mar 1994||17 Oct 1995||Tornier S.A.||Elastically deformable cotyloidal prosthesis|
|US5505731||26 Ago 1994||9 Abr 1996||Tornier Sa||Screw for lumbar-sacral fixator|
|US5591168||7 May 1996||7 Ene 1997||Tornier S.A.||Device for stabilizing fractures of the upper end of the femur|
|US5662651||5 Sep 1995||2 Sep 1997||Tornier S.A.||External or internal fixator for repairing fractures or arthroplasties of the skeleton|
|US5676702||1 Dic 1995||14 Oct 1997||Tornier S.A.||Elastic disc prosthesis|
|US5702447||27 Nov 1996||30 Dic 1997||Tornier S.A.||Device for the attachment of a glenoid prosthesis of the shoulder blade|
|US5702457||14 Nov 1995||30 Dic 1997||Tornier Sa||Humeral prosthesis incorporating a sphere|
|US5702471||18 Mar 1996||30 Dic 1997||Eska Medical Gmbh & Co.||Finger joint|
|US5702478||7 Jun 1996||30 Dic 1997||Tornier Sa||Acetabular implant intended in particular for the iliac joint socket|
|US5723015||9 Feb 1994||3 Mar 1998||Risung; Finn||Elbow prosthesis|
|US5766256||22 Ene 1997||16 Jun 1998||Tornier Sa||Tibial prosthesis|
|US5824106||9 Abr 1997||20 Oct 1998||Tornier Sa||Ankle prosthesis|
|US5879395||21 Ene 1998||9 Mar 1999||Tornier Sa||Total elbow prosthesis|
|US6027534||3 Nov 1997||22 Feb 2000||Deputy Orthopaedics, Inc.||Modular elbow|
|US6162254||14 Oct 1998||19 Dic 2000||Tornier S.A.||Knee prosthesis|
|US6165224||1 Oct 1998||26 Dic 2000||Tornier Sa||Prosthesis intended to be anchored in a long bone|
|US6168629||14 Oct 1998||2 Ene 2001||Tornier S.A.||Femoral component for knee prosthesis|
|US6171341||28 Jul 1997||9 Ene 2001||Tornier Sa||Prosthesis for the upper extremity of the humerus|
|US6183519||9 Mar 1998||6 Feb 2001||Tornier Sa||Ankle prosthesis|
|US6206925||11 Sep 1998||27 Mar 2001||Tornier Sa||Elbow prosthesis with indexed sphere|
|US6290725||29 Dic 1998||18 Sep 2001||Depuy Orthopaedics, Inc.||Modular elbow|
|US6299646||23 Sep 1998||9 Oct 2001||Tornier Sa||Knee prosthesis with a rotational plate|
|US6328758||21 Abr 1999||11 Dic 2001||Tornier Sa||Suture anchor with reversible expansion|
|US6334874||9 Jun 2000||1 Ene 2002||Tornier Sa||Humeral prosthesis|
|US6379387||10 May 2000||30 Abr 2002||Tornier Sa||Elbow prosthesis|
|US6454809||2 Mar 1999||24 Sep 2002||Tornier Sa||Modular acetabular or cotyloid implant|
|US6488712||3 Ago 2000||3 Dic 2002||Tornier Sa||Malleolar implant for partial or total ankle prosthesis|
|US6540770||21 Abr 1999||1 Abr 2003||Tornier Sa||Reversible fixation device for securing an implant in bone|
|US6582469||11 Dic 1998||24 Jun 2003||Tornier S.A.||Knee prosthesis|
|US6599295||21 Abr 1999||29 Jul 2003||Tornier Sa||Device for setting and removing an implant such as a suture anchor|
|US6626946||29 Jul 1999||30 Sep 2003||Tornier Sa||Shoulder prosthesis and humeral stems for such a prosthesis|
|US6699290 *||12 Nov 1999||2 Mar 2004||Depuy Orthopaedics, Inc.||Modular elbow|
|US6761740||12 Feb 2003||13 Jul 2004||Tornier||Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component|
|US6767368||29 Abr 2002||27 Jul 2004||Tornier Sa||Elbow prosthesis|
|US6802864||29 Oct 2002||12 Oct 2004||Toriner Sa||Patellar implant and knee prosthesis incorporating such an implant|
|US6824567||26 Sep 2002||30 Nov 2004||Tornier||Method of positioning a malleolar implant for partial or total ankle prosthesis|
|US6890357||21 May 2004||10 May 2005||Tornier||Elbow prosthesis|
|US6969406||4 Feb 2003||29 Nov 2005||Tornier Sa||Prosthetic element comprising two components and process for assembling such a prosthetic element|
|US7033396||3 Jul 2003||25 Abr 2006||Tornier||Shoulder or hip prosthesis facilitating abduction|
|US20020165614||29 Abr 2002||7 Nov 2002||Alain Tornier||Elbow prosthesis|
|US20030009170||8 Jul 2002||9 Ene 2003||Alain Tornier||Ancillary tool for fitting an ulnar component and/or a radial component of an elbow prosthesis|
|US20030009171||8 Jul 2002||9 Ene 2003||Alain Tornier||Ancillary tool for fitting a humeral component of an elbow prosthesis|
|US20030028198||26 Sep 2002||6 Feb 2003||Alain Tornier||Tool for placing a malleolar implant for partial or total ankle prosthesis|
|US20030208276 *||17 Jul 2001||6 Nov 2003||Berelsman Brian K.||Elbow prosthesis|
|US20030208277||29 Jun 2001||6 Nov 2003||Weiss Arnold-Peter C.||Modular elbow|
|US20040134821||9 Dic 2003||15 Jul 2004||Alain Tornier||Process for the sterile packaging of a prosthetic implant made of polyethylene|
|US20040210220||17 Jul 2002||21 Oct 2004||Alain Tornier||Osteosynthesis plate for the upper end of the arm bone|
|US20040215200||16 Ene 2004||28 Oct 2004||Alain Tornier||Ancillary tool and method for positioning a prosthetic acetabulum of a hip prosthesis|
|US20040230197||8 Mar 2004||18 Nov 2004||Alain Tornier||Ancillary tool for positioning a glenoid implant|
|US20050049709||25 Ago 2004||3 Mar 2005||Alain Tornier||Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component|
|US20050055102||11 May 2004||10 Mar 2005||Alain Tornier||Set of prosthetic elements for a tibial prosthetic assembly|
|US20050165490||15 Dic 2004||28 Jul 2005||Alain Tornier||Shoulder or hip prosthesis and process for fitting same|
|US20050203536||10 Feb 2005||15 Sep 2005||Philippe Laffargue||Surgical device for implanting a total hip prosthesis|
|US20050278030||8 Jun 2005||15 Dic 2005||Tornier||Glenoidal component, set of such components and shoulder prosthesis incorporating such a glenoidal component|
|US20050278031||9 Jun 2005||15 Dic 2005||Tomier||Set of humeral components for total shoulder prosthesis|
|US20050278032||14 Jun 2005||15 Dic 2005||Tornier||Glenoidal component of a shoulder prosthesis, set of elements constituting such a component and total shoulder prosthesis incorporating such a component|
|US20050278033||14 Jun 2005||15 Dic 2005||Alain Tornier||Total shoulder prosthesis or inverted type|
|US20050288791||24 Jun 2005||29 Dic 2005||Tornier||Shoulder or hip prosthesis|
|US20060015185||3 Jun 2005||19 Ene 2006||Pierre Chambat||Knee prosthesis with a rotational plate|
|US20060173457||27 Ene 2006||3 Ago 2006||Tornier||Humeral nail|
|US20060235538||11 Abr 2006||19 Oct 2006||Tornier||Surgical apparatus for implantation of a partial of total knee prosthesis|
|US20070043265||2 Ago 2005||22 Feb 2007||Tornier||Patellar retractor and method of surgical procedure on knee|
|US20070162025||23 Feb 2007||12 Jul 2007||Tornier||Tool for placing a malleolar implant for partial or total ankle prosthesis|
|US20070173947||24 Ene 2007||26 Jul 2007||Tornier||surgical instrumentation kit for inserting an ankle prosthesis|
|US20070179628||1 Feb 2007||2 Ago 2007||Tornier||Offset stem tibial implant|
|DE19512854C1||6 Abr 1995||1 Ago 1996||Eska Medical Gmbh & Co||Finger joint prosthesis|
|EP0006314A1||25 May 1979||9 Ene 1980||Thomas Gordon Wadsworth||Elbow prosthesis and instrumentation for implantation of the prosthesis|
|EP0098466A1||23 Jun 1983||18 Ene 1984||Feldmühle Aktiengesellschaft||Implantable elbow joint|
|EP0913133A2||19 Sep 1998||6 May 1999||Depuy Orthopaedics, Inc.||Modular elbow prosthesis|
|EP1051954A1||12 May 2000||15 Nov 2000||Tornier Sa||Elbow prosthesis|
|FR2663838A1||Título no disponible|
|GB1537479A||Título no disponible|
|1||U.S. Appl. No. 11/401,415, filed Apr. 11, 2006.|
|2||U.S. Appl. No. 11/735,027, filed Apr. 13, 2007.|
|3||U.S. Appl. No. 11/770,285, filed Jun. 28, 2007.|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US8449620 *||5 Nov 2008||28 May 2013||Gs Development Ab||Artificial joint|
|US9283081 *||19 Abr 2012||15 Mar 2016||Waldemar Link Gmbh & Co. Kg||Joint prosthesis having a bending hinge that comprises a spreading axle|
|US20100256770 *||5 Nov 2008||7 Oct 2010||Gs Development Ab||Artificial joint|
|US20140039635 *||19 Abr 2012||6 Feb 2014||Deru Gmbh||Joint prosthesis having a bending hinge that comprises a spreading axle|
|US20150209149 *||15 Ene 2015||30 Jul 2015||Btg International Limited||Tibial component|
|Clasificación de EE.UU.||623/20.12, 623/20.11, 623/20.13|
|8 Feb 2008||AS||Assignment|
Owner name: TORNIER, FRANCE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TORNIER, ALAIN;REEL/FRAME:020483/0569
Effective date: 20040517
|20 May 2008||AS||Assignment|
Effective date: 20080417
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TORNIER;REEL/FRAME:020963/0681
Owner name: TORNIER SAS, FRANCE
|22 Nov 2011||CC||Certificate of correction|
|4 Oct 2012||FPAY||Fee payment|
Year of fee payment: 8