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FR2748654A1 - Cotyloid implant cup - Google Patents

Cotyloid implant cup Download PDF

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Publication number
FR2748654A1
FR2748654A1 FR9606243A FR9606243A FR2748654A1 FR 2748654 A1 FR2748654 A1 FR 2748654A1 FR 9606243 A FR9606243 A FR 9606243A FR 9606243 A FR9606243 A FR 9606243A FR 2748654 A1 FR2748654 A1 FR 2748654A1
Authority
FR
France
Prior art keywords
cup
insert
cavity
shape
engaged
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.)
Granted
Application number
FR9606243A
Other languages
French (fr)
Other versions
FR2748654B1 (en
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.)
Individual
Original Assignee
Individual
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 to FR9606243A priority Critical patent/FR2748654B1/en
Application filed by Individual filed Critical Individual
Priority to ES97924098T priority patent/ES2187778T3/en
Priority to PT97924098T priority patent/PT839016E/en
Priority to EP97924098A priority patent/EP0839016B1/en
Priority to AT97924098T priority patent/ATE228805T1/en
Priority to PCT/FR1997/000860 priority patent/WO1997042913A1/en
Priority to DE69717586T priority patent/DE69717586T2/en
Priority to CA002224478A priority patent/CA2224478C/en
Priority to DK97924098T priority patent/DK0839016T3/en
Priority to JP9540605A priority patent/JPH11509460A/en
Priority to US08/983,465 priority patent/US6231612B1/en
Publication of FR2748654A1 publication Critical patent/FR2748654A1/en
Application granted granted Critical
Publication of FR2748654B1 publication Critical patent/FR2748654B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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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
    • A61F2/30767—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
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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
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • 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
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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
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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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    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
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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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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30148—Convex polygonal shapes lozenge- or diamond-shaped
    • 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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    • 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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    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30322—The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
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Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The implant cup (5) is hemispherical in shape, with an inner cavity to receive an insert. It is fitted in the acetabulum by impaction and has, to this end, a series of anchoring projections (15) on its outer surface, created by two spiral grooves (38) with opposite pitches. The grooves intersect one another over a large proportion of the cup's outer face and are inclined towards its open end. They also increase in depth in the same direction. The are inclined at an angle of some 45 deg to the cup's open end and the anchoring projections formed by them have asymmetrical edges and a cross section in the shape of an eagle's beak, i.e. with a sharp tip which is slightly curved towards the open end of the cup. The projections are spaced evenly over the cup's outer surface, reducing progressively in size towards its polar zone. In addition, the cup can have an outer coating which promotes osteo-integration, especially of calcium hydroxyapatite.

Description

La présente invention concerne un implant cotyloidien fixé sans ciment. The present invention relates to an acetabular implant fixed without cement.

Un implant cotyloïdien comprend classiquement une cupule de forme hémisphérique, délimitant une cavité intérieure, et un insert pouvant être engagé dans cette cavité. La cupule est destinée à être engagée dans la cavité cotyloïdienne et à être fixée au bassin, et l'insert délimite une cavité sphérique destinée à recevoir, avec possibilité d'articulation, la tête sphérique correspondante d'une tige fémorale. A cotyloid implant conventionally comprises a cup of hemispherical shape, delimiting an interior cavity, and an insert that can be engaged in this cavity. The cup is intended to be engaged in the acetabular cavity and to be fixed to the pelvis, and the insert delimits a spherical cavity intended to receive, with possibility of articulation, the corresponding spherical head of a femoral stem.

La cupule est généralement en matériau métallique, notamment en titane, et l'insert est en matériau favorisant le glissement de la tête fémorale, notamment en polyéthylène à haute densité, en céramique ou en métal. The cup is generally made of metallic material, in particular of titanium, and the insert is of material favoring the sliding of the femoral head, in particular of high density polyethylene, ceramic or metal.

Certains implants sont fixés au bassin au moyen de ciment synthétique polymérisable, et d'autres sont fixés sans ciment grâce à des moyens d'ancrage aménagés dans la face extérieure de la cupule. Some implants are fixed to the pelvis by means of polymerizable synthetic cement, and others are fixed without cement thanks to anchoring means arranged in the external face of the cup.

I1 existe des implants dans lesquels ces moyens d'ancrage sont constitués par un pas de vis périphérique, la cupule d'un tel implant étant mise en place par vissage dans la cavité cotyloïdienne. Cette cupule comprend alors des évidements internes pour la prise d'appui de l'outil de vissage et est fréquemment percée de plusieurs trous pour la mise en place de vis engagées dans l'os, assurant un ancrage complémentaire. Ces trous permettent également, avant mise en place des vis, de contrôler la bonne venue de la cupule au contact du fond de la cavité. There are implants in which these anchoring means consist of a peripheral screw pitch, the cup of such an implant being put in place by screwing into the acetabular cavity. This cup then includes internal recesses for the support of the screwing tool and is frequently pierced with several holes for the placement of screws engaged in the bone, ensuring additional anchoring. These holes also make it possible, before fitting the screws, to check that the cup comes into good contact with the bottom of the cavity.

I1 existe également des implants dits "press fit", destinés à être insérés en force dans la cavité cotyloïdienne. La cupule d'un tel implant présente un diamètre externe légèrement supérieur à celui de la cavité cotyloïdienne et est impactée dans cette cavité. Elle comprend des plots ou des aspérités assurant son positionnement, un trou polaire pour la prise d'appui de l'outil d'impaction, et est également souvent percée de plusieurs trous pour la mise en place de vis osseuses. I1 also exist implants called "press fit", intended to be inserted by force into the acetabular cavity. The cup of such an implant has an external diameter slightly greater than that of the acetabular cavity and is impacted in this cavity. It includes studs or asperities ensuring its positioning, a pole hole for the support of the impaction tool, and is also often pierced with several holes for the placement of bone screws.

Certaines cupules peuvent comprendre des fentes, et éventuellement des ouvertures, permettant de leur conférer une certaine souplesse radiale en vue de leur ancrage par expansion dans la cavité cotyloïdienne.Certain cups may include slots, and possibly openings, allowing them to impart a certain radial flexibility with a view to their anchoring by expansion in the acetabular cavity.

En outre, les implants cotyloïdiens comprennent fréquemment un revêtement favorisant l'ostéogenèse, tel qu'un revêtement poreux ou d'hydroxyapatite de calcium. In addition, acetabular implants frequently include a coating promoting osteogenesis, such as a porous coating or calcium hydroxyapatite.

Les implants existants fixés sans ciment assurent un ancrage solide et fiable de la cupule dans le cotyle, mais ont toutefois pour inconvénient majeur de permettre la diffusion vers l'intérieur de la cavité cotyloïdienne et dans l'organisme de débris d'usure du matériau constituant l'insert.  The existing implants fixed without cement ensure a solid and reliable anchoring of the cup in the acetabulum, but however have the major drawback of allowing the diffusion towards the interior of the acetabular cavity and in the organism of wear debris of the constituent material. the insert.

Ces débris résultent du frottement de la tête fémorale dans l'insert et des micro-mouvements de l'insert dans la cupule. Ils résultent également du frottement de l'insert contre les arêtes plus ou moins vives qui délimitent les évidements, trous, fentes ou ouvertures précités de la cupule, et ce d'autant plus que l'insert a tendance à fluer dans ces évidements, trous, fentes ou ouvertures sous l'effet des contraintes répétées que subit la prothèse. This debris results from the friction of the femoral head in the insert and micro-movements of the insert in the cup. They also result from the friction of the insert against the more or less sharp edges which delimit the aforementioned recesses, holes, slots or openings of the cup, and this all the more since the insert tends to creep in these recesses, holes , slits or openings under the effect of repeated stresses to which the prosthesis is subjected.

En outre, ces mêmes trous, fentes ou ouvertures favorisent la circulation vers l'os de liquide synovial chargé de particules, la succession de mises en pression et de relâchements de l'implant dans la cavité lorsque le patient marche générant un "effet de pompe". In addition, these same holes, slits or openings promote the circulation towards the bone of synovial fluid charged with particles, the succession of pressurizations and loosening of the implant in the cavity when the patient walks generating a "pump effect". ".

Ces débris de polyéthylène provoquent une ostéolyse néfaste à la bonne tenue des implants dans le temps, et sont mal tolérés par l'organisme. These polyethylene debris cause osteolysis detrimental to the good performance of the implants over time, and are poorly tolerated by the body.

La présente invention vise à remédier à cet inconvénient. The present invention aims to remedy this drawback.

L'implant qu'elle concerne comprend une cupule et un insert tels que précités, la cupule étant mise en place par impaction et comprenant, à cet effet, des aspérités d'ancrage aménagées sur sa face extérieure et un trou aménagé au niveau de son pôle pour la prise d'appui de l'outil d'impaction. The implant to which it relates comprises a cup and an insert as mentioned above, the cup being put in place by impaction and comprising, for this purpose, asperities of anchoring arranged on its external face and a hole arranged at its pole for the support of the impaction tool.

Selon l'invention
- la cupule présente une paroi continue, c'est-àdire est dépourvue d'évidements, trous, fentes ou ouvertures, et présente une surface interne polie et parfaitement lisse,
- le trou aménagé pour la prise d'appui de l'outil d'impaction est taraudé et peut recevoir un obturateur fileté venant, en fin de serrage, affleurer avec la face interne de la cupule, et
- la partie de l'insert destinée à être engagée dans la cupule présente une forme complémentaire de celle de la cavité de la cupule et vient intimement au contact de la face interne de la cupule.According to the invention
the cup has a continuous wall, that is to say has no recesses, holes, slots or openings, and has a polished and perfectly smooth internal surface,
the hole arranged for the support of the impaction tool is tapped and can receive a threaded shutter coming, at the end of tightening, to be flush with the internal face of the cup, and
- The part of the insert intended to be engaged in the cup has a shape complementary to that of the cavity of the cup and comes intimately into contact with the internal face of the cup.

Ainsi, l'insert épouse la face interne lisse et continue de la cupule, ce qui permet de réduire au maximum les frottements et micro-mouvements de l'insert. L'absence d'évidements, de trous, de fentes ou d'ouvertures dans la paroi de la cupule, après mise en place de l'obturateur fileté, permet d'éliminer le risque de fluage de l'insert, et d'éliminer toute arête plus ou moins vive contre laquelle l'insert pourrait s'user. Thus, the insert marries the smooth and continuous internal face of the cup, which makes it possible to reduce friction and micro-movements of the insert as much as possible. The absence of recesses, holes, slots or openings in the wall of the cup, after fitting the threaded plug, eliminates the risk of creep of the insert, and eliminates any more or less sharp edge against which the insert could wear.

I1 en résulte que l'usure de l'insert, et donc l'émission de particules, est extrêmement limitée dans l'implant selon l'invention. La large surface d'appui de l'insert contre la cupule limite également cette usure. It follows that the wear of the insert, and therefore the emission of particles, is extremely limited in the implant according to the invention. The large bearing surface of the insert against the cup also limits this wear.

En outre, l'absence de trous, fentes ou ouvertures permet de piéger les éventuelles particules à l'intérieur de la cupule et supprime, par conséquent, le risque de migration de particules vers l'os, au travers de la cupule. In addition, the absence of holes, slits or openings makes it possible to trap any particles inside the cup and therefore eliminates the risk of migration of particles to the bone, through the cup.

Avantageusement, la cavité de la cupule présente, du côté de son fond, une partie de forme parfaitement hémisphérique et, du côté de son ouverture, une partie de forme légèrement tronconique, ces deux parties étant séparées par un épaulement conique, et l'insert comprend une partie hémisphérique, une partie légèrement tronconique et une saillie de forme correspondant respectivement aux deux parties et à l'épaulement de la cavité de la cupule. Advantageously, the cavity of the cup has, on the side of its bottom, a part of perfectly hemispherical shape and, on the side of its opening, a part of slightly frustoconical shape, these two parts being separated by a conical shoulder, and the insert comprises a hemispherical part, a slightly frustoconical part and a projection of shape corresponding respectively to the two parts and to the shoulder of the cavity of the cup.

Les deux parties de l'insert viennent ainsi intimement au contact de la face interne de la cupule lorsque, après engagement en force de l'insert dans la cavité de la cupule, la saillie de l'insert est verrouillée derrière l'épaulement de la cupule. The two parts of the insert thus come intimately into contact with the internal face of the cup when, after forceful engagement of the insert in the cavity of the cup, the projection of the insert is locked behind the shoulder of the cup.

Cette structure assure en outre une parfaite rétention de l'insert dans la cupule. This structure also ensures perfect retention of the insert in the cup.

De préférence, l'insert comprend un rebord antiluxation, et la cupule comprend des moyens d'indexation pour le positionnement angulaire de ce rebord. Ces moyens d'indexation sont aménagés, d'une part, dans une collerette que comprend l'insert et, d'autre part, dans la surface ou tranche équatoriale de la cupule délimitant l'ouverture de la cavité. Preferably, the insert comprises an antiluxation rim, and the cup comprises indexing means for the angular positioning of this rim. These indexing means are arranged, on the one hand, in a flange that includes the insert and, on the other hand, in the equatorial surface or edge of the cup delimiting the opening of the cavity.

Le rebord anti-luxation peut ainsi être orienté de manière adéquate en fonction de l'anatomie spécifique du patient, et les moyens d'indexation se trouvent en dehors de la cavité de la cupule. D'éventuelles émissions de particules générées au niveau de ces moyens d'indexation sont ainsi diffusées à l'extérieur de l'implant, et non à l'intérieur, en direction de l'os. The anti-dislocation rim can thus be oriented appropriately according to the specific anatomy of the patient, and the indexing means are located outside the cavity of the cup. Any emissions of particles generated at these indexing means are thus diffused outside the implant, and not inside, towards the bone.

Selon une forme de réalisation préférée de l'invention, ces moyens d'indexation sont constitués par une pluralité d'encoches radiales aménagées à distance régulière les unes des autres dans la périphérie de la collerette de l'insert et par des tétons aptes à être engagés dans ces encoches, aménagés sur la face annulaire équatoriale de la cupule. According to a preferred embodiment of the invention, these indexing means are constituted by a plurality of radial notches arranged at regular distance from each other in the periphery of the collar of the insert and by pins capable of being engaged in these notches, arranged on the equatorial annular face of the cup.

Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de l'implant cotyloidien qu'elle concerne. For a good understanding, the invention is again described below with reference to the appended schematic drawing representing, by way of nonlimiting example, a preferred embodiment of the acetabular implant which it relates to.

La figure 1 est une vue en perspective de ses différents éléments constitutifs, avec arrachement partiel sur un élément
la figure 2 est une vue de l'un de ces éléments en cours d'implantation, en coupe selon l'axe de cet élément ;
la figure 3 est une vue similaire à la figure 2, après mise en place de l'élément, et
la figure 4 est une vue de l'implant après mise en place, en coupe selon l'axe de cet implant.Figure 1 is a perspective view of its various constituent elements, with partial cutaway on an element
Figure 2 is a view of one of these elements during implantation, in section along the axis of this element;
FIG. 3 is a view similar to FIG. 2, after the element has been put in place, and
Figure 4 is a view of the implant after placement, in section along the axis of this implant.

La figure 1 représente un implant cotyloïdien 1 de prothèse de hanche, destiné, ainsi que le montrent les figures 2 à 4, à être fixé sans ciment au bassin 2 du patient, en étant engagé dans la cavité cotyloïdienne. FIG. 1 represents an acetabular implant 1 of hip prosthesis, intended, as shown in FIGS. 2 to 4, to be fixed without cement to the pelvis 2 of the patient, while being engaged in the acetabular cavity.

L'implant 1 est constitué par une cupule 5 en matériau métallique, notamment en titane, par un obturateur fileté 6, en matériau métallique de même nature que la cupule 5, et par un insert 7 en matériau favorisant le glissement, notamment en polyéthylène à haute densité. The implant 1 is constituted by a cup 5 made of metallic material, in particular titanium, by a threaded obturator 6, made of metallic material of the same nature as the cup 5, and by an insert 7 made of material promoting sliding, in particular polyethylene with high density.

La cupule 5 présente une forme hémisphérique et délimite une cavité intérieure 10 dans laquelle peut être engagé l'insert 7. The cup 5 has a hemispherical shape and delimits an interior cavity 10 in which the insert 7 can be engaged.

La face intérieure de la cupule 5 présente, du côté du fond de cette cavité 10, une partie 11 de forme parfaitement hémisphérique et, du côté de l'ouverture de cette cavité 10, une partie 12 de forme légèrement tronconique, dont la plus faible section circulaire est située vers l'intérieur de la cavité 10. Ces deux parties 11,12 sont séparées par un épaulement conique 13 dont la plus faible section est située du côté de l'ouverture de la cavité 10. The inner face of the cup 5 has, on the side of the bottom of this cavity 10, a part 11 of perfectly hemispherical shape and, on the side of the opening of this cavity 10, a part 12 of slightly frustoconical shape, of which the weakest circular section is located towards the inside of the cavity 10. These two parts 11, 12 are separated by a conical shoulder 13, the smallest section of which is located on the side of the opening of the cavity 10.

La cupule 2 présente par ailleurs un diamètre externe légèrement supérieur à celui de la cavité cotyloïdienne et est destinée à être ancrée par impact ion dans celle-ci. Elle comprend à cet effet des aspérités circulaires 15 aménagées dans sa face extérieure, et un trou taraudé 16 aménagé au niveau de son pôle, pour la prise d'appui de l'outil d'impaction. The cup 2 also has an external diameter slightly greater than that of the acetabular cavity and is intended to be anchored by ion impact therein. To this end, it includes circular protrusions 15 arranged in its outer face, and a tapped hole 16 arranged at its pole, for taking support from the impaction tool.

Mis à part ce trou 16, la cupule 5 présente une paroi continue, c'est-à-dire est dépourvue d'évidements, de trous, de fentes ou d'ouvertures. Sa surface interne est polie et parfaitement lisse. Apart from this hole 16, the cup 5 has a continuous wall, that is to say is devoid of recesses, holes, slots or openings. Its internal surface is polished and perfectly smooth.

En outre, la cupule 5 comprend quatre tétons 17 aménagés à égale distance les uns des autres sur sa face annulaire équatoriale 18 délimitant l'ouverture de la cavité 10. In addition, the cup 5 comprises four pins 17 arranged at equal distance from each other on its equatorial annular face 18 delimiting the opening of the cavity 10.

L'obturateur fileté 6 est conformé pour pouvoir être vissé à l'intérieur du trou 16. I1 présente une tête annulaire 20 dans laquelle est aménagée une cavité 21 à six pans, pour sa manoeuvre en rotation et son serrage au moyen d'une clef appropriée. Cette tête 20 vient s'engager, en fin de vissage, dans un évidement annulaire 22 coaxial au trou 16, et vient par conséquent, ainsi que le montre la figure 3, affleurer avec la face interne de la cupule 5. The threaded shutter 6 is shaped so that it can be screwed inside the hole 16. It has an annular head 20 in which is provided a cavity 21 with a hexagon, for its rotation and tightening by means of a key appropriate. This head 20 engages, at the end of screwing, in an annular recess 22 coaxial with the hole 16, and therefore comes, as shown in FIG. 3, to be flush with the internal face of the cup 5.

L'insert 7 délimite une cavité sphérique 30 destinée à recevoir, avec possibilité d'articulation, la tête sphérique correspondante (non représentée) d'une tige fémorale, afin de permettre le jeu de l'articulation prothétique. The insert 7 delimits a spherical cavity 30 intended to receive, with the possibility of articulation, the corresponding spherical head (not shown) of a femoral rod, in order to allow the play of the prosthetic articulation.

Il comprend une partie hémisphérique 31, une partie légèrement tronconique 32 et une saillie 33 de forme correspondant respectivement aux parties 11, 12 et à l'épaulement 13 de la cavité 10. Ces parties 31 et 32 viennent ainsi intimement au contact de la face interne de la cupule 5 lorsque, après engagement en force de l'insert 7 dans la cavité 10, la saillie 33 est verrouillée derrière l'épaulement 13.  It comprises a hemispherical part 31, a slightly frustoconical part 32 and a projection 33 of shape corresponding respectively to the parts 11, 12 and to the shoulder 13 of the cavity 10. These parts 31 and 32 thus come intimately into contact with the internal face. of the cup 5 when, after forceful insertion of the insert 7 into the cavity 10, the projection 33 is locked behind the shoulder 13.

En outre, l'insert 7 comprend une collerette 35 venant, ainsi que le montre la figure 4, au contact de la face 18 lorsque l'insert est verrouillé dans la cavité 10. In addition, the insert 7 comprises a flange 35 coming, as shown in FIG. 4, in contact with the face 18 when the insert is locked in the cavity 10.

Cette collerette 35 comprend un rebord 36 antiluxation de la tête fémorale, et présente une pluralité d'encoches radiales 37, aménagées à distance régulière les unes des autres dans sa périphérie. Ces encoches peuvent être engagées autour des tétons 17. This flange 35 comprises a rim 36 antiluxation of the femoral head, and has a plurality of radial notches 37, arranged at regular distance from each other in its periphery. These notches can be engaged around the nipples 17.

En pratique, ainsi que le montre la figure 2, la cupule 5 est montée sur la tige 40 d'un instrument d'impaction, par vissage de l'extrémité libre filetée de cette tige 40 dans le trou 16. In practice, as shown in FIG. 2, the cup 5 is mounted on the rod 40 of an impact instrument, by screwing the threaded free end of this rod 40 into the hole 16.

La cupule 5 est impactée dans la cavité cotyloïdienne du bassin 2, de manière à ce que ses aspérités 15 viennent s'insérer dans la paroi osseuse. The cup 5 is impacted in the acetabular cavity of the pelvis 2, so that its asperities 15 are inserted into the bone wall.

L'outil d'impaction est ensuite retiré et l'obturateur 6 est vissé dans le trou 16, ainsi que le montre la figure 3. The impaction tool is then removed and the shutter 6 is screwed into the hole 16, as shown in FIG. 3.

L'insert 7 est alors partiellement engagé dans la cavité 10 et est positionné angulairement par rapport à la cupule 5 pour orienter au mieux le rebord 36 en fonction de l'anatomie spécifique du patient. Une fois ce positionnement effectué, l'insert 7 est engagé en force dans la cavité 10, jusqu'à verrouillage de sa saillie 33 derrière l'épaulement 13. The insert 7 is then partially engaged in the cavity 10 and is angularly positioned relative to the cup 5 to orient the flange 36 as best as possible according to the specific anatomy of the patient. Once this positioning has been carried out, the insert 7 is forcibly engaged in the cavity 10, until its projection 33 is locked behind the shoulder 13.

L'absence d'évidements, de trous, de fentes ou d'ouvertures dans la paroi de la cupule 5, après la mise en place de l'obturateur 16, élimine le risque de fluage de l'insert 7 et élimine toute arête plus ou moins vive contre laquelle cet insert pourrait fluer. The absence of recesses, holes, slots or openings in the wall of the cup 5, after the installation of the shutter 16, eliminates the risk of creep of the insert 7 and eliminates any more edges or less lively against which this insert could creep.

L'émission de particules d'usure est donc extrêmement limitée, et les frottements et micromouvements de l'insert sont réduits au maximum. The emission of wear particles is therefore extremely limited, and the friction and micromovements of the insert are reduced to a minimum.

Les éventuelles particules d'usure sont en outre piégées à l'intérieur de la cupule 5, ce qui supprime le risque d'une migration de ces particules vers l'os, au travers de la cupule 5. Any wear particles are also trapped inside the cup 5, which eliminates the risk of migration of these particles to the bone, through the cup 5.

Par ailleurs, d'éventuelles particules générées au niveau des encoches 37 sont diffusées à l'extérieur de l'implant 1, et non en direction de l'os.  Furthermore, any particles generated at the notches 37 are diffused outside the implant 1, and not in the direction of the bone.

Claims (4)

REVENDICATIONS 1 - Implant cotyloïdien fixé sans ciment, comprenant une cupule (5) de forme hémisphérique, délimitant une cavité intérieure (10), et un insert (7) pouvant être engagé dans cette cavité (10), la cupule (5) étant mise en place par impaction et comprenant, à cet effet, des aspérités d'ancrage (15) aménagées sur sa face extérieure et un trou (16) aménagé au niveau de son pôle pour la prise d'appui de l'outil d'impaction, implant (1) caractérisé en ce que 1 - Cotyloid implant fixed without cement, comprising a cup (5) of hemispherical shape, delimiting an interior cavity (10), and an insert (7) which can be engaged in this cavity (10), the cup (5) being placed place by impaction and comprising, for this purpose, anchoring roughness (15) arranged on its outer face and a hole (16) arranged at its pole for the support of the impaction tool, implant (1) characterized in that - la cupule (5) présente une paroi continue, c'est-à-dire est dépourvue d'évidements, trous, fentes ou ouvertures, et présente une surface interne polie et parfaitement lisse, the cup (5) has a continuous wall, that is to say is devoid of recesses, holes, slots or openings, and has a polished and perfectly smooth internal surface, - le trou (16) aménagé pour la prise d'appui de l'outil d'impaction est taraudé et peut recevoir un obturateur fileté (6) venant, en fin de serrage, affleurer avec la face interne de la cupule (5), et the hole (16) arranged for the support of the impaction tool is tapped and can receive a threaded shutter (6) coming, at the end of tightening, to be flush with the internal face of the cup (5), and - la partie (31,32,33) de l'insert (7) destinée à être engagée dans la cupule (5) présente une forme complémentaire de celle de la cavité (10) de la cupule (5) et vient intimement au contact de la face interne de la cupule (5). - The part (31, 32, 33) of the insert (7) intended to be engaged in the cup (5) has a shape complementary to that of the cavity (10) of the cup (5) and comes intimately into contact of the internal face of the cup (5). 2 - Implant cotyloïdien selon la revendication 1, caractérisé en ce que la cavité (10) de la cupule (5) présente, du côté de son fond, une partie (11) de forme parfaitement hémisphérique et, du côté de son ouverture, une partie (12) de forme légèrement tronconique, ces deux parties (11,12) étant séparées par un épaulement conique (13), et en ce que l'insert (7) comprend une partie hémisphérique (31), une partie légèrement tronconique (32) et une saillie (33) de forme correspondant respectivement aux deux parties (11,12) et à l'épaulement (13) de la cavité (10) de la cupule (5). 2 - acetabular implant according to claim 1, characterized in that the cavity (10) of the cup (5) has, on the side of its bottom, a part (11) of perfectly hemispherical shape and, on the side of its opening, a part (12) of slightly frustoconical shape, these two parts (11,12) being separated by a conical shoulder (13), and in that the insert (7) comprises a hemispherical part (31), a slightly frustoconical part ( 32) and a projection (33) of shape corresponding respectively to the two parts (11,12) and to the shoulder (13) of the cavity (10) of the cup (5). 3 - Implant cotyloïdien selon l'une des revendications 1 ou 2, caractérisé en ce qu'il comprend un insert (7) muni d'un rebord anti-luxation (36), et en ce que la cupule (5) comprend des moyens d'indexation (17,37) pour le positionnement angulaire de ce rebord (36), ces moyens d'indexation (17,37) étant aménagés, d'une part, dans une collerette (35) que comprend l'insert (7) et, d'autre part, dans la surface (18) ou tranche équatoriale de la cupule (5) délimitant l'ouverture de la cavité (10). 3 - cotyloid implant according to one of claims 1 or 2, characterized in that it comprises an insert (7) provided with an anti-dislocation rim (36), and in that the cup (5) comprises means indexing (17,37) for the angular positioning of this flange (36), these indexing means (17,37) being arranged, on the one hand, in a flange (35) that includes the insert (7 ) and, on the other hand, in the surface (18) or equatorial edge of the cup (5) delimiting the opening of the cavity (10). 4 - Implant cotyloïdien selon la revendications 3, caractérisé en ce que les moyens d'indexation sont constitués par une pluralité d'encoches radiales (37) aménagées à distance régulière les unes des autres dans la périphérie de la collerette (35) et par des tétons (17) aptes à être engagés dans ces encoches (37), aménagés sur la face annulaire équatoriale (18) de la cupule (5).  4 - acetabular implant according to claim 3, characterized in that the indexing means are constituted by a plurality of radial notches (37) arranged at regular distance from each other in the periphery of the flange (35) and by pins (17) capable of being engaged in these notches (37), arranged on the equatorial annular face (18) of the cup (5).
FR9606243A 1996-05-14 1996-05-14 FIXED COTYLOIDIAN IMPLANT WITHOUT CEMENT Expired - Fee Related FR2748654B1 (en)

Priority Applications (11)

Application Number Priority Date Filing Date Title
FR9606243A FR2748654B1 (en) 1996-05-14 1996-05-14 FIXED COTYLOIDIAN IMPLANT WITHOUT CEMENT
DK97924098T DK0839016T3 (en) 1996-05-14 1997-05-14 Cotyloid implant attached without cement
EP97924098A EP0839016B1 (en) 1996-05-14 1997-05-14 Cotyloidal implant fixed without cement
AT97924098T ATE228805T1 (en) 1996-05-14 1997-05-14 CEMENT-FREE ANCHORED HIP JOINT CUP IMPLANT
PCT/FR1997/000860 WO1997042913A1 (en) 1996-05-14 1997-05-14 Cotyloidal implant fixed without cement
DE69717586T DE69717586T2 (en) 1996-05-14 1997-05-14 CEMENT-FREE ANCHORED HIP PAN IMPLANT
ES97924098T ES2187778T3 (en) 1996-05-14 1997-05-14 IMPLANT COTILOID FIXED WITHOUT CEMENT.
PT97924098T PT839016E (en) 1996-05-14 1997-05-14 FIXED COTILOIDIAN IMPLANT WITHOUT CEMENT
JP9540605A JPH11509460A (en) 1996-05-14 1997-05-14 Foot implant implanted without cement
US08/983,465 US6231612B1 (en) 1996-05-14 1997-05-14 Acetabular implant fixed without cement
CA002224478A CA2224478C (en) 1996-05-14 1997-05-14 Cotyloidal implant fixed without cement

Applications Claiming Priority (1)

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FR9606243A FR2748654B1 (en) 1996-05-14 1996-05-14 FIXED COTYLOIDIAN IMPLANT WITHOUT CEMENT

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FR2748654A1 true FR2748654A1 (en) 1997-11-21
FR2748654B1 FR2748654B1 (en) 1998-11-20

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19926923A1 (en) * 1999-06-14 2000-12-21 Ceramtec Ag Modular socket for a ball joint prosthesis
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis

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EP0169978A1 (en) * 1984-07-16 1986-02-05 GebràœDer Sulzer Aktiengesellschaft Endoprosthesis with an interior and exterior part for a hip joint cup
EP0245527A1 (en) * 1986-04-15 1987-11-19 GebràœDer Sulzer Aktiengesellschaft Acetabular endoprosthesis
FR2638963A1 (en) * 1988-11-14 1990-05-18 Tornier Sa Artificial acetabula with studs for a total hip prosthesis
EP0444381A1 (en) * 1990-03-01 1991-09-04 GebràœDer Sulzer Aktiengesellschaft Metal hip socket which can be fitted without cement
FR2660546A1 (en) * 1990-04-06 1991-10-11 Setiey Louis Module for acetabular reconstruction
EP0485678A1 (en) * 1989-10-24 1992-05-20 Societe Civile Essor Hip joint prosthesis
EP0499475A2 (en) * 1991-02-14 1992-08-19 SMITH & NEPHEW RICHARDS, INC. Acetabular prosthesis with anchoring pegs
WO1995022944A1 (en) * 1994-02-25 1995-08-31 Intermedics Orthopedics, Inc. Acetabular cup composite insert and assembly method
DE4408527A1 (en) * 1994-03-14 1995-09-21 Gerd Hoermansdoerfer Screw=in hip joint socket with curved outer shape
EP0677280A1 (en) * 1994-04-15 1995-10-18 ALPHANORM MEDIZINTECHNIK GmbH Acetabular cup prosthesis

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0169978A1 (en) * 1984-07-16 1986-02-05 GebràœDer Sulzer Aktiengesellschaft Endoprosthesis with an interior and exterior part for a hip joint cup
EP0245527A1 (en) * 1986-04-15 1987-11-19 GebràœDer Sulzer Aktiengesellschaft Acetabular endoprosthesis
FR2638963A1 (en) * 1988-11-14 1990-05-18 Tornier Sa Artificial acetabula with studs for a total hip prosthesis
EP0485678A1 (en) * 1989-10-24 1992-05-20 Societe Civile Essor Hip joint prosthesis
EP0444381A1 (en) * 1990-03-01 1991-09-04 GebràœDer Sulzer Aktiengesellschaft Metal hip socket which can be fitted without cement
FR2660546A1 (en) * 1990-04-06 1991-10-11 Setiey Louis Module for acetabular reconstruction
EP0499475A2 (en) * 1991-02-14 1992-08-19 SMITH & NEPHEW RICHARDS, INC. Acetabular prosthesis with anchoring pegs
WO1995022944A1 (en) * 1994-02-25 1995-08-31 Intermedics Orthopedics, Inc. Acetabular cup composite insert and assembly method
DE4408527A1 (en) * 1994-03-14 1995-09-21 Gerd Hoermansdoerfer Screw=in hip joint socket with curved outer shape
EP0677280A1 (en) * 1994-04-15 1995-10-18 ALPHANORM MEDIZINTECHNIK GmbH Acetabular cup prosthesis

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19926923A1 (en) * 1999-06-14 2000-12-21 Ceramtec Ag Modular socket for a ball joint prosthesis
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445903B2 (en) 2008-11-24 2016-09-20 Biomet Manufacturing, Llc Multi-bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445904B2 (en) 2009-07-14 2016-09-20 Biomet Manufacturing, Llc Multiple bearing acetabular prosthesis

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