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FR2748654A1 - Implant cotyloidien fixe sans ciment - Google Patents

Implant cotyloidien fixe sans ciment 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
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English (en)
Other versions
FR2748654B1 (fr
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/fr
Application filed by Individual filed Critical Individual
Priority to DK97924098T priority patent/DK0839016T3/da
Priority to EP97924098A priority patent/EP0839016B1/fr
Priority to PT97924098T priority patent/PT839016E/pt
Priority to JP9540605A priority patent/JPH11509460A/ja
Priority to ES97924098T priority patent/ES2187778T3/es
Priority to CA002224478A priority patent/CA2224478C/fr
Priority to PCT/FR1997/000860 priority patent/WO1997042913A1/fr
Priority to AT97924098T priority patent/ATE228805T1/de
Priority to US08/983,465 priority patent/US6231612B1/en
Priority to DE69717586T priority patent/DE69717586T2/de
Publication of FR2748654A1 publication Critical patent/FR2748654A1/fr
Application granted granted Critical
Publication of FR2748654B1 publication Critical patent/FR2748654B1/fr
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
    • 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
    • A61F2/32—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
    • 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
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    • A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
    • 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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    • 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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    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • 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
    • A61F2002/30143—Convex polygonal shapes hexagonal
    • 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
    • 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
    • A61F2002/30148—Convex polygonal shapes lozenge- or diamond-shaped
    • 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
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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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    • A61F2002/30316—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
    • A61F2002/30317—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
    • 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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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

Cet implant (1) comprend une cupule (5) fixée par impaction et un insert (7) pouvant être engagé dans cette cupule (5). Selon l'invention: - 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, - le trou (16) que comprend la cupule (5) 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 - 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).

Description

La présente invention concerne un implant cotyloidien fixé sans ciment.
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.
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.
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.
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.
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.
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.
En outre, les implants cotyloïdiens comprennent fréquemment un revêtement favorisant l'ostéogenèse, tel qu'un revêtement poreux ou d'hydroxyapatite de calcium.
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.
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.
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".
Ces débris de polyéthylène provoquent une ostéolyse néfaste à la bonne tenue des implants dans le temps, et sont mal tolérés par l'organisme.
La présente invention vise à remédier à cet inconvénient.
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.
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.
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.
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.
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.
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.
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.
Cette structure assure en outre une parfaite rétention de l'insert dans la cupule.
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.
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.
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.
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.
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.
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.
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.
La cupule 5 présente une forme hémisphérique et délimite une cavité intérieure 10 dans laquelle peut être engagé l'insert 7.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
L'outil d'impaction est ensuite retiré et l'obturateur 6 est vissé dans le trou 16, ainsi que le montre la figure 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.
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.
L'émission de particules d'usure est donc extrêmement limitée, et les frottements et micromouvements de l'insert sont réduits au maximum.
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.
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.

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
- 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,
- 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
- 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).
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).
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).
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).
FR9606243A 1996-05-14 1996-05-14 Implant cotyloidien fixe sans ciment Expired - Fee Related FR2748654B1 (fr)

Priority Applications (11)

Application Number Priority Date Filing Date Title
FR9606243A FR2748654B1 (fr) 1996-05-14 1996-05-14 Implant cotyloidien fixe sans ciment
AT97924098T ATE228805T1 (de) 1996-05-14 1997-05-14 Zementfrei verankertes hüftgelenkpfannenimplantat
PT97924098T PT839016E (pt) 1996-05-14 1997-05-14 Implante cotiloidiano fixo sem cimento
JP9540605A JPH11509460A (ja) 1996-05-14 1997-05-14 接合剤を使用せずに取り付けられた脚窩インプラント
ES97924098T ES2187778T3 (es) 1996-05-14 1997-05-14 Implante cotiloideo fijado sin cemento.
CA002224478A CA2224478C (fr) 1996-05-14 1997-05-14 Implant cotyloidien fixe sans ciment
DK97924098T DK0839016T3 (da) 1996-05-14 1997-05-14 Kotyloidt implantat fastgjort uden cement
EP97924098A EP0839016B1 (fr) 1996-05-14 1997-05-14 Implant cotyloidien fixe sans ciment
US08/983,465 US6231612B1 (en) 1996-05-14 1997-05-14 Acetabular implant fixed without cement
DE69717586T DE69717586T2 (de) 1996-05-14 1997-05-14 Zementfrei verankertes hüftgelenkpfannenimplantat
PCT/FR1997/000860 WO1997042913A1 (fr) 1996-05-14 1997-05-14 Implant cotyloidien fixe sans ciment

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DE19926923A1 (de) * 1999-06-14 2000-12-21 Ceramtec Ag Modular aufgebaute Gelenkpfanne für eine Kugelgelenk-Prothese
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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EP0444381A1 (fr) * 1990-03-01 1991-09-04 GebràœDer Sulzer Aktiengesellschaft Prothèse d'acétabule métallique destinée à être fixée sans ciment
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EP0485678A1 (fr) * 1989-10-24 1992-05-20 Societe Civile Essor Prothèse totale de hanche
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EP0169978A1 (fr) * 1984-07-16 1986-02-05 GebràœDer Sulzer Aktiengesellschaft Endoprothèse cotyloidiènne munie d'une partie intérieure et d'une partie extérieure
EP0245527A1 (fr) * 1986-04-15 1987-11-19 GebràœDer Sulzer Aktiengesellschaft Endoprothèse acétabulaire
FR2638963A1 (fr) * 1988-11-14 1990-05-18 Tornier Sa Cotyles artificiels a ergots pour prothese totale de la hanche
EP0485678A1 (fr) * 1989-10-24 1992-05-20 Societe Civile Essor Prothèse totale de hanche
EP0444381A1 (fr) * 1990-03-01 1991-09-04 GebràœDer Sulzer Aktiengesellschaft Prothèse d'acétabule métallique destinée à être fixée sans ciment
FR2660546A1 (fr) * 1990-04-06 1991-10-11 Setiey Louis Module de reconstruction cotylouidienne.
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19926923A1 (de) * 1999-06-14 2000-12-21 Ceramtec Ag Modular aufgebaute Gelenkpfanne für eine Kugelgelenk-Prothese
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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