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FR2758256A1 - Humeral prosthesis for orthopaedic rehabilitation - Google Patents

Humeral prosthesis for orthopaedic rehabilitation Download PDF

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Publication number
FR2758256A1
FR2758256A1 FR9700398A FR9700398A FR2758256A1 FR 2758256 A1 FR2758256 A1 FR 2758256A1 FR 9700398 A FR9700398 A FR 9700398A FR 9700398 A FR9700398 A FR 9700398A FR 2758256 A1 FR2758256 A1 FR 2758256A1
Authority
FR
France
Prior art keywords
recess
rod
prosthesis
plates
humeral
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
FR9700398A
Other languages
French (fr)
Other versions
FR2758256B1 (en
Inventor
Pierre Massard
Laurent Lafosse
Dominique Saragaglia
Olivier Gregoire
Thierry Heckel
Bernard Reignier
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.)
Aesculap SAS
Original Assignee
Aesculap SAS
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
Application filed by Aesculap SAS filed Critical Aesculap SAS
Priority to FR9700398A priority Critical patent/FR2758256B1/en
Publication of FR2758256A1 publication Critical patent/FR2758256A1/en
Application granted granted Critical
Publication of FR2758256B1 publication Critical patent/FR2758256B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/40—Joints for shoulders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4059—Humeral shafts
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2002/30733—Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
    • 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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    • 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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    • A61F2/30767—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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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys

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 prosthesis consists of a shank (1) for anchoring in the humerus having a metaphysis section (3) with a hemispherical head (13) attached to it, and at least one aperture (5) to receive bone fragments. Where appropriate the aperture(s) can be covered by plates (6, 7) coated with a porous metal. The plates can be connected by a fixing screw (10) passing through the aperture. The shank of the prosthesis is made from stainless steel or a titanium or cobalt-chrome alloy, and the hemispherical head can be of stainless steel or a chrome-cobalt alloy.

Description

La présente invention concerne une prothèse humérale. The present invention relates to a humeral prosthesis.

Une prothèse humérale comporte principalement une tige d'ancrage ayant un corps allongé pénétrant dans le canal huméral pour s'y ancrer, la tête humérale ayant été préalablement réséquée. Cette tige d'ancrage possède une extrémité en saillie de l'humérus, à laquelle est raccordée une tête hémisphérique se substituant à la tête humérale naturelle. A humeral prosthesis mainly comprises an anchor rod having an elongated body penetrating into the humeral canal to anchor there, the humeral head having been previously resected. This anchor rod has a protruding end of the humerus, to which is connected a hemispherical head replacing the natural humeral head.

Toutefois, l'humérus, du fait de sa taille réduite, possède un capital osseux qui est nécessairement réduit lui aussi et qu'il convient donc de préserver au maximum. Or les prothèses actuelles n'assurent pas suffisamment cette préservation. En particulier, pour les indications traumatologiques, les tubérosités ou fragments d'os brisés ne peuvent être conservés. However, the humerus, because of its reduced size, has a bone capital which is necessarily reduced too and which should therefore be preserved as much as possible. However, the current prostheses do not sufficiently ensure this preservation. In particular, for trauma indications, the tuberosities or broken bone fragments cannot be preserved.

Le but de l'invention est précisément de réaliser une prothèse humérale permettant de mieux préserver le capital osseux. The object of the invention is precisely to produce a humeral prosthesis allowing better preservation of the bone capital.

En vue de la réalisation de ce but, on prévoit selon l'invention une prothèse humérale comportant une tige d'ancrage ayant une partie métaphysaire à laquelle est raccordée une tête hémisphérique, cette partie métaphysaire présentant au moins un évidement. With a view to achieving this aim, a humeral prosthesis is provided according to the invention comprising an anchoring rod having a metaphyseal part to which a hemispherical head is connected, this metaphyseal part having at least one recess.

L'évidement de la tige d'ancrage offre un espace libre pour loger les fragments et/ou ramifications osseux. The recess of the anchor rod provides a free space to accommodate the bone fragments and / or ramifications.

Le capital osseux peut donc se reconstituer par ostéosynthèse au travers de cet évidement, ce qui permet de préserver le capital osseux et assure de plus un ancrage positif de la tige à l'intérieur du canal huméral. La localisation métaphysaire de l'évidement de la tige à l'intérieur du canal huméral permet d'assurer un bridage par vissage transversal en vue de la synthèse des tubérosités. A terme, un pont osseux se crée au travers de l'évide- ment, ce qui assure la pérennité du capital osseux métaphy saire.The bone capital can therefore be reconstituted by osteosynthesis through this recess, which preserves the bone capital and also ensures positive anchoring of the rod inside the humeral canal. The metaphyseal location of the stem recess inside the humeral canal allows clamping by transverse screwing in order to synthesize the tuberosities. Ultimately, a bone bridge is created through the recess, which ensures the sustainability of the metaphyseal bone capital.

Selon une caractéristique avantageuse de l'invention, la prothèse comporte des moyens d'obturation amovibles de l'évidement. Pour les indications dégénératives, l'évidement est obturé par les moyens d'obturation amovibles et la fixation de la tige d'ancrage s'effectue classiquement par scellement dans l'os. On a donc réalisé une prothèse ambivalente, dont la tige d'ancrage permet une utilisation pour les indications aussi bien dégénératives que traumatologiques. According to an advantageous characteristic of the invention, the prosthesis comprises removable closing means of the recess. For degenerative indications, the recess is closed by removable closure means and the anchoring rod is conventionally fixed by sealing in the bone. An ambivalent prosthesis was therefore produced, the anchor rod of which allows use for both degenerative and trauma indications.

Dans un mode de réalisation, les moyens d'obturation amovibles comportent deux plaquettes emboîtables dans l'évidement, de part et d'autre de la tige. Les deux plaquettes sont bridables l'une vers l'autre au moyen d'une vis transversable traversant l'évidement. In one embodiment, the removable closure means comprise two plates which can be fitted into the recess on either side of the rod. The two plates can be clamped towards each other by means of a transverse screw passing through the recess.

D'autres caractéristiques et avantages de l'invention apparaîtront à la lecture de la description qui suit d'un mode de réalisation particulier donné à titre d'exemple non limitatif. Other characteristics and advantages of the invention will appear on reading the following description of a particular embodiment given by way of non-limiting example.

Il sera fait référence aux dessins en annexe, parmi lesquels
- la figure 1 est une vue en perspective éclatée d'une prothèse conforme à l'invention
- la figure 2 est une vue de profil, selon la flèche II de la figure 3, de la tige d'ancrage implantée dans un humérus, l'évidement étant laissé libre sans ses plaquettes d'obturation
- la figure 3 est une vue de face selon la flèche
III de la figure 2.Reference will be made to the accompanying drawings, among which
- Figure 1 is an exploded perspective view of a prosthesis according to the invention
- Figure 2 is a side view, along arrow II of Figure 3, of the anchor rod implanted in a humerus, the recess being left free without its sealing plates
- Figure 3 is a front view along the arrow
III of Figure 2.

En référence aux figures, la prothèse humérale selon l'invention comporte une tige d'ancrage 1 destinée à être insérée dans le canal osseux d'un humérus H, schématisé en traits pointillés aux figures 2 et 3, dont l'épiphyse a été préalablement réséquée. Cette tige comporte un corps allongé 2 et, à l'extrémité supérieure de ce corps, une partie métaphysaire 3 sensiblement plus large que le reste du corps de tige et située, in situ, dans la zone métaphysaire M de humérus.  With reference to the figures, the humeral prosthesis according to the invention comprises an anchoring rod 1 intended to be inserted into the bone channel of a humerus H, shown diagrammatically in dotted lines in Figures 2 and 3, the epiphysis of which was previously resected. This rod has an elongated body 2 and, at the upper end of this body, a metaphyseal part 3 substantially wider than the rest of the rod body and located, in situ, in the metaphyseal zone M of the humerus.

Cette partie métaphysaire 3 présente un évidement débouchant 5 dont les fonctions seront ultérieurement décrites. This metaphyseal part 3 has a through recess 5 whose functions will be described later.

Comme cela est visible à la figure 1, l'évidement 5 est associé à deux plaquettes d'obturation amovibles 6, 7 emboîtables dans l'évidement 5 de part et d'autre de la tige 1. Une vis de fixation 10 est prévue pour assurer la fixation par bridage des plaquettes 6, 7 l'une vers l'autre, en appui contre les pourtours de l'évidement 5 sur chacun des deux flancs de la tige 1. As can be seen in FIG. 1, the recess 5 is associated with two removable closure plates 6, 7 which fit into the recess 5 on either side of the rod 1. A fixing screw 10 is provided for securing by clamping the plates 6, 7 towards each other, pressing against the edges of the recess 5 on each of the two sides of the rod 1.

Une ailette de réinsertion 11 présentant une série de trous 12 est ménagée dans la partie métaphysaire 3, sensiblement dans le plan médian de la tige 1, pour permettre le rapprochement et le maintien des fragments osseux, en combinaison avec des fils de suture. La structure et la fonction de cette ailette sont bien connues par ailleurs et ne seront pas davantage décrits. A reinsertion fin 11 having a series of holes 12 is formed in the metaphyseal part 3, substantially in the median plane of the rod 1, to allow the approximation and the maintenance of the bone fragments, in combination with sutures. The structure and function of this fin are well known elsewhere and will not be described further.

L'ensemble de la tige d'ancrage 1 est réalisé en un matériau métallique tel que de l'acier inoxydable, un alliage de titane, ou un alliage cobalt-chrome. The whole of the anchor rod 1 is made of a metallic material such as stainless steel, a titanium alloy, or a cobalt-chromium alloy.

Une tête hémisphérique 13, visible seulement à la figure 1, est rapportée sur la tige 1, à l'extrémité de la partie métaphysaire 3. Cette tête se substitue à la tête humérale naturelle. In situ, elle remplit la cavité articulaire humérale et vient en appui contre la glène (ou une prothèse de glène) et l'acromion. Elle peut être réalisée en un matériau métallique tel que de l'acier inoxydable ou un alliage chrome-cobalt. A hemispherical head 13, visible only in FIG. 1, is attached to the rod 1, at the end of the metaphyseal part 3. This head replaces the natural humeral head. In situ, it fills the humeral joint cavity and comes to bear against the glenoid (or a glenoid prosthesis) and the acromion. It can be made of a metallic material such as stainless steel or a chrome-cobalt alloy.

En l'espèce, la tête 13 présente une face de glissement 14 de forme sensiblement sphérique et une face de fixation 15 plane. Un logement 16, de forme sensiblement conique, est ménagé dans la tête 13, en renfoncement de la face 15, pour recevoir un pion de fixation 17 de forme légèrement conique, solidaire de la tige d'ancrage 1. Ce pion est disposé en saillie d'une collerette d'extrémité 18 de la partie métaphysaire 3 de la tige 1. In this case, the head 13 has a sliding face 14 of substantially spherical shape and a fixing face 15 planar. A housing 16, of substantially conical shape, is formed in the head 13, in the recess of the face 15, to receive a fixing pin 17 of slightly conical shape, integral with the anchoring rod 1. This pin is projecting an end flange 18 of the metaphyseal part 3 of the rod 1.

La prothèse ainsi constituée peut être implantée avec ou sans ses plaquettes d'obturation amovibles, selon le type de pathologie rencontrée. The prosthesis thus formed can be implanted with or without its removable closure plates, depending on the type of pathology encountered.

Ainsi, pour une indication traumatologique, les plaquettes 6, 7 ne sont pas mises en place. Tel est le cas dans la configuration des figures 2 et 3. L'évidement 5 est donc dégagé et permet, à terme, une reconstitution optimum par ostéosynthèse des tubérosités dans la partie métaphysaire de l'os. Il se crée ainsi au travers de l'évidement 5 un pont osseux qui préserve le capital osseux métaphysaire et assure un ancrage positif de la tige 1 dans l'os. Thus, for a trauma indication, the plates 6, 7 are not put in place. This is the case in the configuration of FIGS. 2 and 3. The recess 5 is therefore cleared and allows, in the long term, an optimum reconstruction by osteosynthesis of the tuberosities in the metaphyseal part of the bone. A bone bridge is thus created through the recess 5 which preserves the metaphyseal bone capital and ensures positive anchoring of the rod 1 in the bone.

Dans l'exemple illustré aux figures 2 et 3, on a réalisé un bridage transversal de la partie métaphysaire M de l'humérus H au moyen de deux vis 20. Ces vis, qui traversent la partie métaphysaire M de part en part grâce au passage offert par l'évidement 5, assurent un maintien des fragments osseux. Ces fragments ou tubérosités peuvent ainsi se reconstituer par ostéosynthèse. On notera toutefois que le maintien de ces tubérosités peut aussi être réalisé plus classiquement par cerclage. In the example illustrated in FIGS. 2 and 3, a transverse clamping of the metaphyseal part M of the humerus H has been carried out by means of two screws 20. These screws, which pass through the metaphyseal part M through and through thanks to the passage offered by the recess 5, ensure maintenance of the bone fragments. These fragments or tuberosities can thus be reconstituted by osteosynthesis. Note, however, that the maintenance of these tuberosities can also be carried out more conventionally by strapping.

Pour les indications traumatologiques, l'évide- ment 5 peut être obturé par les plaquettes 6, 7 et la fixation de la tige 1 dans le canal huméral s'effectue de manière classique par accrochage de l'os sur la surface extérieure de la tige, qui est à cet effet revêtue de métal poreux. For trauma indications, the recess 5 can be closed by the plates 6, 7 and the fixation of the rod 1 in the humeral canal is carried out in a conventional manner by hooking the bone on the external surface of the rod. , which for this purpose is coated with porous metal.

L'invention n'est pas limitée au mode de réalisation qui vient d'être décrit, mais englobe au contraire toute variante reprenant, avec des moyens équivalents ses caractéristiques essentielles. The invention is not limited to the embodiment which has just been described, but on the contrary encompasses any variant incorporating, with equivalent means, its essential characteristics.

Par exemple, bien qu'il ait été décrit une prothèse à tête hémisphérique fixe, il est également possible de réaliser une prothèse à tête mobile dans laquelle la tête hémisphérique est montée sur la tige d'ancrage au moyen d'une liaison rotule.  For example, although a prosthesis with a fixed hemispherical head has been described, it is also possible to produce a prosthesis with a movable head in which the hemispherical head is mounted on the anchoring rod by means of a ball joint.

Claims (4)

REVENDICATIONS 1. Prothèse humérale comportant une tige d'ancrage (1) ayant une partie métaphysaire (3) à laquelle est raccordée une tête hémisphérique (13), caractérisée en ce que la partie métaphysaire (3) de la tige d'ancrage (1) présente au moins un évidement (5). 1. Humeral prosthesis comprising an anchor rod (1) having a metaphyseal part (3) to which a hemispherical head (13) is connected, characterized in that the metaphyseal part (3) of the anchor rod (1) has at least one recess (5). 2. Prothèse selon la revendication 1, caractérisée en ce qu'elle comporte des moyens d'obturation amovibles (6, 7) de l'évidement (5). 2. Prosthesis according to claim 1, characterized in that it comprises removable closure means (6, 7) of the recess (5). 3. Prothèse selon l'une des revendications précédentes, caractérisée en ce que les moyens d'obturation amovibles comportent deux plaquettes (6, 7) emboîtables dans l'évidement (5), de part et d'autre de la tige (1). 3. Prosthesis according to one of the preceding claims, characterized in that the removable closure means comprise two plates (6, 7) nestable in the recess (5), on either side of the rod (1) . 4. Prothèse selon la revendication 3, caractérisée en ce que les deux plaquettes (6, 7) sont bridables l'une vers l'autre au moyen d'une vis transversable (10) traversant l'évidement (5).  4. Prosthesis according to claim 3, characterized in that the two plates (6, 7) can be clamped towards one another by means of a transverse screw (10) passing through the recess (5).
FR9700398A 1997-01-16 1997-01-16 HUMERAL PROSTHESIS WITH OBVIOUSLY CLOSABLE Expired - Fee Related FR2758256B1 (en)

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Cited By (14)

* Cited by examiner, † Cited by third party
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WO2000018335A1 (en) * 1998-09-25 2000-04-06 Sulzer Orthopedics Inc. Implantable humeral prosthesis having offset head and stem connection
EP1088532A3 (en) * 1999-09-28 2002-04-10 aap Implantate AG Shoulder endoprosthesis
FR2826256A1 (en) * 2001-06-21 2002-12-27 Depuy France PROSTHESIS FOR TRAUMATIC SHOULDER
WO2004024029A3 (en) * 2002-09-10 2004-06-17 Tantum Ag Kit for the therapy of capital and subcapital humerus fractures and humerus head prostheses
WO2012152900A1 (en) * 2011-05-12 2012-11-15 Materialise N.V. Methods and devices for validating the position of patient-specific devices
US8939982B2 (en) 2011-05-12 2015-01-27 Materialise N.V. Methods and devices for validating the position of patient-specific devices
BE1021547B1 (en) * 2011-05-12 2015-12-11 Materialise N.V. METHODS DEVICES FOR VALIDATING THE POSITION OF PATIENT-SPECIFIC DEVICES
US10433967B2 (en) 2014-12-10 2019-10-08 Tornier Convertible stem / fracture stem
US10548737B2 (en) 2011-10-31 2020-02-04 Tornier Orthopedics Ireland Ltd. Reverse shoulder prostheses with anti-rotation features
WO2020058634A1 (en) * 2018-09-20 2020-03-26 Shoulder Friends Institute Surgical kit for humeral shoulder prosthesis implant
US10898336B2 (en) 2006-03-21 2021-01-26 Tornier, Inc. Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction
US10973645B2 (en) 2012-10-29 2021-04-13 Tornier Orthopedics Ireland, Ltd. Systems for reverse shoulder implants
US10987226B2 (en) 2016-04-19 2021-04-27 Imascap Sas Pre-operatively planned humeral implant and planning method
USD938590S1 (en) 2019-10-01 2021-12-14 Howmedica Osteonics Corp. Humeral implant

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000018335A1 (en) * 1998-09-25 2000-04-06 Sulzer Orthopedics Inc. Implantable humeral prosthesis having offset head and stem connection
EP1088532A3 (en) * 1999-09-28 2002-04-10 aap Implantate AG Shoulder endoprosthesis
FR2826256A1 (en) * 2001-06-21 2002-12-27 Depuy France PROSTHESIS FOR TRAUMATIC SHOULDER
EP1269941A1 (en) * 2001-06-21 2003-01-02 Depuy France Shoulder prosthesis
WO2004024029A3 (en) * 2002-09-10 2004-06-17 Tantum Ag Kit for the therapy of capital and subcapital humerus fractures and humerus head prostheses
US10898336B2 (en) 2006-03-21 2021-01-26 Tornier, Inc. Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction
US8939982B2 (en) 2011-05-12 2015-01-27 Materialise N.V. Methods and devices for validating the position of patient-specific devices
BE1021547B1 (en) * 2011-05-12 2015-12-11 Materialise N.V. METHODS DEVICES FOR VALIDATING THE POSITION OF PATIENT-SPECIFIC DEVICES
WO2012152900A1 (en) * 2011-05-12 2012-11-15 Materialise N.V. Methods and devices for validating the position of patient-specific devices
US10548737B2 (en) 2011-10-31 2020-02-04 Tornier Orthopedics Ireland Ltd. Reverse shoulder prostheses with anti-rotation features
US11679006B2 (en) 2011-10-31 2023-06-20 Tornier Orthopedics Ireland, Ltd. Systems for shoulder prostheses
US12064353B2 (en) 2012-10-29 2024-08-20 Stryker European Operations Limited Systems for reverse shoulder implants
US10973645B2 (en) 2012-10-29 2021-04-13 Tornier Orthopedics Ireland, Ltd. Systems for reverse shoulder implants
US11173037B2 (en) 2014-12-10 2021-11-16 Tornier Sas Convertible stem / fracture stem
US11471291B2 (en) 2014-12-10 2022-10-18 Tornier Sas Convertible stem/fracture stem
US10433967B2 (en) 2014-12-10 2019-10-08 Tornier Convertible stem / fracture stem
US12343262B2 (en) 2014-12-10 2025-07-01 Tornier Sas Convertible stem/fracture stem
US10987226B2 (en) 2016-04-19 2021-04-27 Imascap Sas Pre-operatively planned humeral implant and planning method
US12109120B2 (en) 2016-04-19 2024-10-08 Stryker European Operations Limited Pre-operatively planned humeral implant and planning method
FR3086163A1 (en) * 2018-09-20 2020-03-27 Shoulder Friends Institute SURGICAL KIT FOR HUMERAL IMPLANT OF SHOULDER PROSTHESIS
WO2020058634A1 (en) * 2018-09-20 2020-03-26 Shoulder Friends Institute Surgical kit for humeral shoulder prosthesis implant
USD938590S1 (en) 2019-10-01 2021-12-14 Howmedica Osteonics Corp. Humeral implant
USD983373S1 (en) 2019-10-01 2023-04-11 Howmedica Osteonics Corp. Humeral implant

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