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FR2913590A1 - Modular recovery femoral rod for hip prosthesis of patient, diaphyseal and metaphyseal elements comprising respective conical surfaces that couple with metaphyseal and epiphyseal elements, where surfaces are same - Google Patents

Modular recovery femoral rod for hip prosthesis of patient, diaphyseal and metaphyseal elements comprising respective conical surfaces that couple with metaphyseal and epiphyseal elements, where surfaces are same Download PDF

Info

Publication number
FR2913590A1
FR2913590A1 FR0753810A FR0753810A FR2913590A1 FR 2913590 A1 FR2913590 A1 FR 2913590A1 FR 0753810 A FR0753810 A FR 0753810A FR 0753810 A FR0753810 A FR 0753810A FR 2913590 A1 FR2913590 A1 FR 2913590A1
Authority
FR
France
Prior art keywords
metaphyseal
diaphyseal
epiphyseal
femoral stem
frustoconical
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
FR0753810A
Other languages
French (fr)
Other versions
FR2913590B1 (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.)
LOUCHAHI NACREDDINE
MOUZAYEK HICHAM
Original Assignee
LOUCHAHI NACREDDINE
MOUZAYEK HICHAM
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 LOUCHAHI NACREDDINE, MOUZAYEK HICHAM filed Critical LOUCHAHI NACREDDINE
Priority to FR0753810A priority Critical patent/FR2913590B1/en
Publication of FR2913590A1 publication Critical patent/FR2913590A1/en
Application granted granted Critical
Publication of FR2913590B1 publication Critical patent/FR2913590B1/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

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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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3607—Femoral heads ; Femoral endoprostheses including proximal or total replacement of the femur
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4637—Special tools for implanting artificial joints for connecting or disconnecting two parts of a prosthesis
    • 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
    • A61F2/30721—Accessories
    • A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
    • 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
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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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    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of shafts
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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
    • A61F2/28—Bones
    • A61F2002/2825—Femur
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—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
    • A61F2002/30331—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
    • A61F2002/30339—Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • 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
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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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    • A61F2002/30535—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
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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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    • A61F2002/30535—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
    • A61F2002/3055—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting length
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30574—Special structural features of bone or joint prostheses not otherwise provided for with an integral complete or partial collar or flange
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
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Landscapes

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

Abstract

The femoral rod has a diaphyseal element (1) comprising a rod to be introduced in a medullary cavity, and a coaxial conical surface (1c) emerging from the cavity, where the surface couples with a metaphyseal element (2) that constitutes a sleeve. The element (2) has a conical surface (2c) coupling with an epiphyseal element (3), and the element (2) is formed with different heights for reconstituting the anatomical metaphysis. The conical surface between the elements (1, 2) and the surface between the elements (2, 3) are same such that the element (3) is coupled directly to the element (1).

Description

L'invention se rattache au secteur technique des implants orthopédiques etThe invention relates to the technical sector of orthopedic implants and

plus particulièrement des tiges fémorales de reprise.  more particularly femoral stems of recovery.

Il est connu, pour un homme du métier, d'utiliser, dans certains cas pathologiques qui génèrent, par exemple, une dégradation de la partie proximale du fémur et autres, des tiges fémorales de reprise, généralement de longueur plus importante qu'une tige fémorale classique, afin d'avoir une stabilité distale suffisante.  It is known, for a person skilled in the art, to use, in certain pathological cases which generate, for example, a degradation of the proximal portion of the femur and the like, femoral stems of recovery, generally of greater length than a rod. classic femoral, in order to have sufficient distal stability.

Afin de pouvoir s'adapter à différents cas de reprise, on a proposé de réaliser des tiges du type modulaire comprenant, par exemple, un élément métaphysaire et un élément diaphysaire en deux parties distinctes et indépendantes. Une solution de ce type ressort, par exemple, de l'enseignement du brevet FR 2.701.205. Selon l'enseignement de ce brevet, chacun des éléments métaphysaire et diaphysaire, a une courbure sagittale antéro-postérieure spécifique pour correspondre à la double courbure anatomique du fémur. Des difficultés peuvent apparaître pour la mise en place des différents éléments et leur accouplement. On observe également que les agencements pour la mise en place d'un col destiné à recevoir une tête fémorale, sont formés au niveau de l'élément métaphysaire avec, par conséquent, un angle cervico-diapysaire figé.  In order to be able to adapt to different cases of recovery, it has been proposed to produce rods of the modular type comprising, for example, a metaphyseal element and a diaphyseal element in two distinct and independent parts. A solution of this type emerges, for example, from the teaching of patent FR 2 701 205. According to the teaching of this patent, each of the metaphyseal and diaphyseal elements, has a specific sagittal anteroposterior curvature to correspond to the double anatomical curvature of the femur. Difficulties can arise for the setting up of the various elements and their coupling. It is also observed that the arrangements for the establishment of a neck intended to receive a femoral head, are formed at the level of the metaphyseal element with, consequently, a fixed cervico-diapysary angle.

Une autre solution ressort de l'enseignement du brevet FR 2.799.115 qui concerne une tige modulaire pour prothèse de hanche, en étant particulièrement conformée pour constituer une tige de reprise. Cette tige modulaire comprend un clou centro-médullaire prolongé, à sa partie proximale, par une portion cylindrique pour le montage d'une pièce d'appui constituant un alignement métaphysaire, laquelle pièce d'appui est conformée pour permettre l'accouplement et le centrage d'une pièce support présentant un col disposé angulairement pour recevoir une tête sphérique. Compte tenu de sa conception, cette tige fémorale de reprise est réservée dans le cas d'un patient dont la métaphyse est encore de qualité suffisante pour assurer le maintien en positionnement de l'ensemble de la tige.  Another solution emerges from the teaching of FR 2,799,155 which relates to a modular stem for hip prosthesis, being particularly shaped to form a recovery rod. This modular rod includes a centromedullary nail extended, at its proximal portion, by a cylindrical portion for mounting a bearing piece constituting a metaphyseal alignment, which support piece is shaped to allow coupling and centering a support member having a neck arranged angularly to receive a spherical head. Given its design, this femoral stem recovery is reserved in the case of a patient whose metaphysis is still of sufficient quality to maintain the positioning of the entire stem.

A partir de cet état de la technique, le problème que se propose de résoudre l'invention est de trouver un appui dans la diaphyse lorsque la partie métaphysaire de l'os est retirée, ou présente une multiplicité de fragments, tout en ayant pour objectif de reconstituer la hauteur manquante de la partie métaphysaire et de restituer le bras de levier musculaire au niveau de la partie épiphysaire, ainsi que la longueur du membre du patient.  From this state of the art, the problem to be solved by the invention is to find a support in the diaphysis when the metaphyseal part of the bone is removed, or has a multiplicity of fragments, while having as objective to reconstruct the missing height of the metaphyseal part and to restore the muscle lever arm at the epiphyseal part, as well as the length of the patient's limb.

Pour résoudre ces problèmes, il a été conçu une tige fémorale de reprise modulaire comprenant un élément diaphysaire, un élément métaphysaire et un élément épiphysaire. Selon l'invention : l'élément diaphysaire présente une partie destinée à être introduite dans le canal médullaire et une partie débordant dudit canal et présentant des agencements d'accouplement avec l'élément métaphysaire ; l'élément métaphysaire présente, à l'opposé de son accouplement avec l'élément diaphysaire, des agencements d'accouplement avec l'élément épiphysaire et est réalisé selon différentes hauteurs pour reconstituer la métaphyse anatomique ; les agencements d'accouplement entre l'élément diaphysaire et l'élément métaphysaire et les agencements d'accouplement entre l'élément métaphysaire et l'élément épiphysaire, sont les mêmes, de sorte que ledit élément épiphysaire peut être accouplé directement à l'élément diaphysaire.  To solve these problems, a modular femoral resurfacing rod comprising a diaphyseal element, a metaphyseal element and an epiphyseal element has been designed. According to the invention: the diaphyseal element has a part intended to be introduced into the medullary canal and an overflowing portion of said channel and having arrangements for coupling with the metaphyseal element; the metaphyseal element has, in contrast to its coupling with the diaphyseal element, coupling arrangements with the epiphyseal element and is made in different heights to reconstruct the anatomical metaphysis; the coupling arrangements between the diaphyseal element and the metaphyseal element and the coupling arrangements between the metaphyseal element and the epiphyseal element are the same, so that said epiphyseal element can be coupled directly to the element diaphyseal.

Pour résoudre le problème posé d'assurer l'accouplement de différents éléments diaphysaire, métaphysaire et épiphysaire ou diaphysaire et épiphysaire, les agencements d'accouplement sont constitués par des portées tronconiques mâles formées à l'extrémité supérieure de l'élément diaphysaire et de l'élément métaphysaire, lesdites portées coopérant avec des chambrages tronconiques complémentaires que présente la base de l'élément métaphysaire et de l'élément diaphysaire.  To solve the problem of ensuring the coupling of various diaphyseal, metaphyseal and epiphyseal or diaphyseal and epiphyseal elements, the coupling arrangements consist of male frustoconical bearing surfaces formed at the upper end of the diaphyseal element and the metaphyseal element, said litters cooperating with complementary frustoconical chamberings that has the base of the metaphyseal element and the diaphyseal element.

Selon une autre caractéristique, une vis assure la liaison des trois éléments, la vis étant engagée librement dans l'élément épiphysaire et dans un alésage du corps de l'élément métaphysaire, pour être vissé dans un taraudage que présente la portée tronconique de l'élément diaphysaire.  According to another characteristic, a screw ensures the connection of the three elements, the screw being freely engaged in the epiphyseal element and in a bore of the body of the metaphyseal element, to be screwed into a tapping which has the frustoconical bearing surface of the diaphyseal element.

Pour résoudre le problème posé d'avoir une auto-adaptation de l'élément diaphysaire dans le canal médullaire, ledit élément diaphysaire présente une courbure anatomique pour être autocentré dans le canal médullaire et une collerette d'appui sur les coupes osseuses, ladite collerette étant formée à la base de la portée tronconique.  To solve the problem of having a self-adaptation of the diaphyseal element in the medullary canal, said diaphyseal element has an anatomical curvature to be autocentered in the medullary canal and a support collar on the bone sections, said collar being formed at the base of the frustoconical span.

Avantageusement, la collerette présente au moins une encoche coopérant avec une partie d'un ensemble de pose et d'impaction. Pour résoudre le problème posé de pouvoir facilement adapter l'élément métaphysaire, ce dernier est constitué par un manchon cylindrique. L'alésage du manchon est taraudé pour permettre le vissage25 d'une partie de l'ensemble de pose et d'impaction, ledit taraudage ayant un diamètre déterminé pour le libre engagement de la vis de fixation.  Advantageously, the flange has at least one notch cooperating with a part of a laying and impaction assembly. To solve the problem of being able to easily adapt the metaphyseal element, the latter is constituted by a cylindrical sleeve. The bore of the sleeve is threaded to allow the screwing of a portion of the assembly of application and impaction, said tapping having a determined diameter for the free engagement of the fixing screw.

Selon une autre caractéristique, l'élément épiphysaire présente un corps prolongé angulairement, selon différentes orientations, par un col apte à recevoir une tête fémorale, ledit corps présentant le chambrage tronconique d'accouplement avec la portée tronconique de l'élément métaphysaire ou diaphysaire.  According to another characteristic, the epiphyseal element has a body angularly extended, in different orientations, by a neck adapted to receive a femoral head, said body having frustoconical counterboring coupling with the frustoconical bearing surface of the metaphyseal or diaphyseal element.

Pour faciliter la mise en place de l'ensemble de la tige fémorale de reprise, le chambrage tronconique du corps de l'élément épiphysaire est prolongé coaxialement par un trou taraudé pour le vissage d'une partie de l'ensemble de pose et d'impaction.  To facilitate the implementation of the entire femoral stem recovery, the frustoconical chambering of the body of the epiphyseal element is extended coaxially by a threaded hole for screwing a portion of the assembly and pose impaction.

Pour éviter tout problème de dévissage, l'extrémité du trou taraudé est évasée en forme de cuvette pour coopérer avec la tête de vis et créer un effet de coincement.  To avoid any problem of unscrewing, the end of the tapped hole is flared in the form of a bowl to cooperate with the screw head and create a wedging effect.

Selon une autre caractéristique, le corps de l'élément épiphysaire présente des trous débouchants pour le passage de liens aptes à assurer la fixation du grand trochanter.  According to another characteristic, the body of the epiphyseal element has through holes for the passage of links capable of securing the fixation of the greater trochanter.

Pour résoudre le problème posé de permettre un réglage de l'antéversion, le corps de l'élément épiphysaire présente, à sa base, une série de repères destinés à être mis en correspondance avec un repère que présente le manchon constituant l'élément métaphysaire.  To solve the problem posed to allow adjustment of anteversion, the body of the epiphyseal element has, at its base, a series of pins intended to be matched with a mark that has the sleeve constituting the metaphyseal element.

L'invention est exposée ci-après plus en détail à l'aide des figures des dessins annexés dans lesquels : - la figure 1 est une vue en perspective, avant assemblage, des principaux éléments constituant la tige fémorale de reprise selon l'invention ; - la figure 2 est une vue correspondant à la figure 1 après accouplement des différents éléments ; - la figure 3 est une vue en perspective en coupe longitudinale avant assemblage des principaux éléments de la tige fémorale de reprise ; - la figure 4 est, à une échelle plus importante, une vue en coupe montrant l'accouplement des différents éléments ; - la figure 5 est une vue partielle montrant la coopération de l'élément diaphysaire avec un élément de l'ensemble de mise en place et d'impaction ; - la figure 6 montre la mise en place d'un élément de l'ensemble d'impaction au niveau de l'élément épiphysaire.  The invention is described below in more detail with reference to the figures of the accompanying drawings, in which: FIG. 1 is a perspective view, before assembly, of the main elements constituting the femoral stem of recovery according to the invention; - Figure 2 is a view corresponding to Figure 1 after coupling of the various elements; - Figure 3 is a perspective view in longitudinal section before assembly of the main elements of the femoral stem recovery; - Figure 4 is, on a larger scale, a sectional view showing the coupling of the various elements; FIG. 5 is a partial view showing the cooperation of the diaphyseal element with an element of the set-up and impaction assembly; - Figure 6 shows the establishment of an element of the impaction assembly at the epiphyseal element.

Selon l'invention, la tige fémorale de reprise comprend un élément diaphysaire (1), un élément métaphysaire (2) et un élément épiphysaire (3). L'élément diaphysaire (1) présente une tige (la) destinée à être introduite dans le canal médullaire. Cette tige (la) présente une courbure anatomique permettant un calage et une auto-adaptation dans le canal médullaire, que cette tige soit impactée avec du ciment ou sans ciment. La partie supérieure de la tige (la) présente une collerette (lb) destinée à prendre appui sur la coupe osseuse en zone saine résultant de l'ablation de la métaphyse osseuse. En débordement de la collerette (lb), la tige (la) présente une portée tronconique coaxiale (1c) présentant un taraudage (1 c l).  According to the invention, the femoral stem of recovery comprises a diaphyseal element (1), a metaphyseal element (2) and an epiphyseal element (3). The diaphyseal element (1) has a rod (la) intended to be introduced into the medullary canal. This rod (la) has an anatomical curvature allowing wedging and self-adaptation in the medullary canal, that this rod is impacted with cement or without cement. The upper part of the rod (1a) has a flange (1b) intended to bear on bone cutting in a healthy zone resulting from the removal of the bone metaphysis. In overflow of the flange (lb), the rod (la) has a coaxial frustoconical bearing surface (1c) having a tapping (1 c l).

Cette portée tronconique (1c) coopère avec un chambrage tronconique de forme complémentaire (2a) formé à la base de l'élément métaphysaire (2). L'élément métaphysaire (2) est constitué par un manchon de forme générale cylindrique dont l'alésage (2b) débouche coaxialement dans le chambrage tronconique (2a). La partie supérieure du manchon (2) présentent une portée tronconique (2c) identique à la portée tronconique (lc) de l'élément diaphysaire. A noter que l'alésage (2b) est taraudé pour permettre, comme il sera indiqué dans la suite de la description, le vissage de l'un des éléments constitutifs de l'ensemble de pose et d'impaction. Le manchon (2) peut être réalisé dans différents matériaux, par exemple en titane. En fonction de la pathologie à traiter, le manchon (2) est réalisé selon différentes hauteurs.  This frustoconical span (1c) cooperates with a frustoconical chambering of complementary shape (2a) formed at the base of the metaphyseal element (2). The metaphyseal element (2) is constituted by a sleeve of generally cylindrical shape, the bore (2b) opens coaxially in the frustoconical chambering (2a). The upper part of the sleeve (2) has a frustoconical bearing surface (2c) identical to the frustoconical bearing surface (1c) of the diaphyseal element. Note that the bore (2b) is threaded to allow, as will be indicated in the following description, the screwing of one of the constituent elements of the assembly of pose and impaction. The sleeve (2) can be made of different materials, for example titanium. Depending on the pathology to be treated, the sleeve (2) is made according to different heights.

Sur la portée tronconique (2c) du manchon (2), est monté et centré l'élément épiphysaire (3). Dans ce but, le corps (3a) de l'élément épiphysaire présente un chambrage tronconique (3b) (identique au chambrage (2a)), de forme complémentaire à la portée tronconique (2c) du manchon. Compte tenu de ces dispositions, il apparaît que le chambrage (3b) peut également être monté directement sur la portée tronconique (1c) de l'élément diaphysaire dans l'hypothèse où le manchon métaphysaire (2) n'est pas nécessaire. Le corps (3a) de l'élément épiphysaire est prolongé angulairement selon différentes orientations par un col (3c) apte à recevoir une tête fémorale.  On the frustoconical bearing surface (2c) of the sleeve (2) is mounted and centered the epiphyseal element (3). For this purpose, the body (3a) of the epiphyseal element has a frustoconical recess (3b) (identical to the recess (2a)), of complementary shape to the frustoconical bearing surface (2c) of the sleeve. Given these provisions, it appears that the recess (3b) can also be mounted directly on the frustoconical bearing surface (1c) of the diaphyseal element in the event that the metaphyseal sleeve (2) is not necessary. The body (3a) of the epiphyseal element is angularly extended in different orientations by a neck (3c) adapted to receive a femoral head.

L'angle cervico-diaphysaire du col (3c) est compris entre 110 et 140 environ. A noter également que le corps de l'élément épiphysaire (3) présente des trous débouchants (3d) pour le passage d'un lien quelconque apte à assurer la fixation du grand trochanter. De même, le corps (3a) de l'élément diaphysaire (3) présente, à sa base, des traits de repère ou autres marquage, destinés à être mis en correspondance avec un repère (2d) formé à la partie supérieure du manchon (2). Ces dispositions permettent l'orientation angulaire de l'élément épiphysaire (3).  The cervico-diaphyseal angle of the neck (3c) is between 110 and about 140. It should also be noted that the body of the epiphyseal element (3) has through holes (3d) for the passage of any link capable of securing the fixation of the greater trochanter. Similarly, the body (3a) of the diaphyseal element (3) has, at its base, marker lines or other marking, intended to be matched with a reference mark (2d) formed at the upper part of the sleeve ( 2). These arrangements allow the angular orientation of the epiphyseal element (3).

L'assemblage des trois éléments (1), (2) et (3) est réalisé par une vis (4) engagée librement dans le corps (3a) de l'élément épiphysaire et dans le trou taraudé (2b) du manchon (2) pour être vissé dans le taraudage (ici) de la partie tronconique (1c) de l'élément diaphysaire (1). La tête de vis (4a) est du type hémisphérique ou tronconique et prend appui dans une cuvette (3e) que prolonge un trou taraudé (3f) en communication avec le chambrage tronconique (3b). Ce trou (3f) permet le vissage d'un élément de l'ensemble de pose et d'impaction.  The assembly of the three elements (1), (2) and (3) is achieved by a screw (4) freely engaged in the body (3a) of the epiphyseal element and in the threaded hole (2b) of the sleeve (2). ) to be screwed into the tapping (here) of the frustoconical portion (1c) of the diaphyseal element (1). The screw head (4a) is of the hemispherical or frustoconical type and is supported in a bowl (3e) that extends a threaded hole (3f) in communication with the frustoconical chambering (3b). This hole (3f) allows the screwing of an element of the pose and impaction assembly.

La vis (4) assure donc une fixation sure et efficace des différents éléments (1), (2) et (3), en combinaison avec les différentes portées tronconiques et les chambrages complémentaires, qui assurent un serrage de type cône-morse.  The screw (4) thus ensures secure and effective attachment of the various elements (1), (2) and (3), in combination with the various frustoconical surfaces and the complementary counterbores, which ensure a cone-walrus type clamping.

La mise en place des différents éléments de cette tige fémorale de reprise selon l'invention, s'effectue au moyen d'éléments, de type parfaitement connu pour un homme du métier, que présente un ensemble de pose et d'impaction. A titre d'exemple, on renvoie à la figure 5 qui montre un impacteur (5) centré sur la portée tronconique (1c), et présentant un doigt d'indexation (5a) coopérant avec une encoche (lbl) de la collerette (lb).  The establishment of the various elements of this femoral stem recovery according to the invention is effected by means of elements, of a type perfectly known to a skilled person, that presents a set of laying and impaction. By way of example, reference is made to FIG. 5 which shows an impactor (5) centered on the frustoconical bearing surface (1c), and having an indexing finger (5a) cooperating with a notch (lbl) of the collar (1b). ).

A la figure 6, une tige d'extraction (7) est vissée dans le trou taraudé du corps de l'élément épiphysaire (3), afin de dé-coopter l'élément métaphysaire lorsque le chirurgien le désire dans le but, par exemple, de modifier les réglages anatomiques.  In FIG. 6, an extraction rod (7) is screwed into the tapped hole of the body of the epiphyseal element (3), in order to de-coact the metaphyseal element when the surgeon so desires for the purpose, for example , to modify the anatomical settings.

Les avantages ressortent bien de la description, en particulier on souligne que la reconstitution est effectuée à partir du bas, c'est-àdire à partir de la portée tronconique (1c) de l'élément diaphysaire en opposition aux solutions existantes dont la reconstitution se fait à partir du haut (la tête fémorale) et non du bas (la coupe osseuse de la diaphyse saine).15  The advantages are apparent from the description, in particular it is emphasized that the reconstruction is performed from the bottom, that is to say from the frustoconical scope (1c) of the diaphyseal element in opposition to existing solutions whose reconstitution is made from the top (the femoral head) and not from the bottom (the bone cut of the healthy diaphysis) .15

Claims (1)

REVENDICATIONS -1- Tige fémorale de reprise modulaire comprenant un élément diaphysaire (1), un élément métaphysaire (2) et un élément épiphysaire (3), caractérisée en ce que: l'élément diaphysaire (1) présente une partie (la) destinée à être introduite dans le canal médullaire et une partie (1c) débordant dudit canal et présentant des agencements d'accouplement avec l'élément métaphysaire (2) ; l'élément métaphysaire (2) présente, à l'opposé de son accouplement avec l'élément diaphysaire (1), des agencements (2c) d'accouplement avec l'élément épiphysaire (3), ledit élément métaphysaire étant réalisé selon différentes hauteurs pour reconstituer la métaphyse anatomique ; les agencements d'accouplement entre l'élément diaphysaire (1) et l'élément métaphysaire (2) et les agencements d'accouplement entre l'élément métaphysaire (2) et l'élément épiphysaire (3), sont les mêmes, de sorte que ledit élément épiphysaire (3) peut être accouplé directement à l'élément diaphysaire (1). -2- Tige fémorale selon la revendication 1, caractérisée en ce que les agencements d'accouplement sont constitués par des portées tronconiques mâles (lc) et (2c) formées à l'extrémité supérieure de l'élément diaphysaire (1) et de l'élément métaphysaire (2), lesdites portées coopérant avec des chambrages tronconiques complémentaires (2a) et (3b) que présente la base de l'élément métaphysaire (2) et de l'élément diaphysaire (3). -3- Tige fémorale selon la revendication 1, caractérisée en ce qu'une vis (4) assure la liaison des trois éléments (1), (2) et (3), la vis étant engagée librement dans l'élément épiphysaire (3) et dans un alésage du corps del'élément métaphysaire (2) pour être vissé dans un taraudage (1cl) que présente la portée tronconique (1c) de l'élément diaphysaire (1). - 4Tige fémorale selon les revendications 1 et 2, caractérisée en ce que l'élément diaphysaire (la) présente une courbure anatomique pour être autocentré dans le canal médullaire et une collerette (lb) d'appui sur les coupes osseuses, ladite collerette étant formée à la base de la portée tronconique (lc). -5- Tige fémorale selon la revendication 4, caractérisée en ce que la collerette (1b) présente au moins une encoche (1b 1) coopérant avec une partie d'un ensemble de pose et d'impaction. - 6- Tige fémorale selon la revendication 1, caractérisée en ce que l'élément métaphysaire (2) est constitué par un manchon cylindrique. - 7- Tige fémorale selon les revendications 3 et 6, caractérisée en ce que l'alésage (2a) du manchon (2) est taraudé pour permettre le vissage d'une partie de l'ensemble de pose et d'impaction, ledit taraudage (2b) ayant un diamètre déterminé pour le libre engagement de la vis de fixation (4). - 8- Tige fémorale selon les revendications 1 et 2, caractérisée en ce que l'élément épiphysaire (3) présente un corps (3a) prolongé angulairement, selon différentes orientations, par un col (3c) apte à recevoir une tête fémorale, ledit corps présentant le chambrage tronconique (3b) d'accouplement avec la portée tronconique (2c) ou (1c) de l'élément métaphysaire (2) ou diaphysaire (1).- 9- Tige fémorale selon la revendication 8, caractérisée en ce que le chambrage tronconique (3b) du corps (3a) de l'élément épiphysaire (3) est prolongé coaxialement par un trou taraudé (3f) pour le vissage d'une partie d'un ensemble de pose et d'impaction. - 10- Tige fémorale selon la revendication 9, caractérisée en ce que l'extrémité du trou taraudé (3f) est évasée en forme de cuvette (3e) pour coopérer avec la tête de vis (4a) et créer un effet de coincement. 10 -11- Tige fémorale selon la revendication 1, caractérisée en ce que le corps de l'élément épiphysaire (3) présente des trous débouchants (3d) pour le passage de liens aptes à assurer la fixation du grand trochanter. - 12- Tige fémorale selon les revendications 1 et 6, caractérisée en ce que le 15 corps de l'élément épiphysaire (3) présente, à sa base, des repères destinés à être mis en correspondance avec un repère que présente le manchon (2) constituant l'élément métaphysaire. 20  Modular recovery femoral stem comprising a diaphyseal element (1), a metaphyseal element (2) and an epiphyseal element (3), characterized in that: the diaphyseal element (1) has a portion (1a) intended for being introduced into the medullary canal and a portion (1c) projecting from said channel and having arrangements for coupling with the metaphyseal element (2); the metaphyseal element (2) has, in contrast to its coupling with the diaphyseal element (1), arrangements (2c) for coupling with the epiphyseal element (3), said metaphyseal element being produced according to different heights to reconstruct the anatomical metaphysis; the coupling arrangements between the diaphyseal element (1) and the metaphyseal element (2) and the coupling arrangements between the metaphyseal element (2) and the epiphyseal element (3) are the same, so said epiphyseal element (3) can be coupled directly to the diaphyseal element (1). Femoral stem according to claim 1, characterized in that the coupling arrangements consist of male frustoconical bearing surfaces (1c) and (2c) formed at the upper end of the diaphyseal element (1) and the metaphyseal element (2), said spans cooperating with complementary frustoconical chamberings (2a) and (3b) that has the base of the metaphyseal element (2) and the diaphyseal element (3). -3- femoral stem according to claim 1, characterized in that a screw (4) ensures the connection of the three elements (1), (2) and (3), the screw being freely engaged in the epiphyseal element (3). ) and in a bore of the body of the metaphyseal element (2) to be screwed into a tapping (1cl) that has the frustoconical bearing surface (1c) of the diaphyseal element (1). - 4 femoral shaft according to claims 1 and 2, characterized in that the diaphyseal element (la) has an anatomical curvature to be autocentered in the medullary canal and a flange (1b) bearing on the bone cuts, said flange being formed at the base of the frustoconical span (lc). -5- femoral stem according to claim 4, characterized in that the flange (1b) has at least one notch (1b 1) cooperating with a portion of a set of pose and impaction. - 6- femoral stem according to claim 1, characterized in that the metaphyseal element (2) is constituted by a cylindrical sleeve. - 7- femoral stem according to claims 3 and 6, characterized in that the bore (2a) of the sleeve (2) is threaded to allow the screwing of a portion of the assembly of installation and impaction, said tapping (2b) having a diameter determined for the free engagement of the fixing screw (4). - 8- Femoral stem according to claims 1 and 2, characterized in that the epiphyseal element (3) has a body (3a) angularly extended, in different orientations, by a neck (3c) adapted to receive a femoral head, said body having the frustoconical recess (3b) for coupling with the frustoconical bearing surface (2c) or (1c) of the metaphyseal element (2) or diaphyseal (1) .- The femoral stem according to claim 8, characterized in that the frustoconical recess (3b) of the body (3a) of the epiphyseal element (3) is coaxially extended by a threaded hole (3f) for screwing a part of a laying and impaction assembly. Femoral stem according to claim 9, characterized in that the end of the tapped hole (3f) is flared in the form of a bowl (3e) to cooperate with the screw head (4a) and to create a wedging effect. Femoral stem according to claim 1, characterized in that the body of the epiphyseal element (3) has through holes (3d) for the passage of links capable of securing the fixation of the greater trochanter. Femoral stem according to Claims 1 and 6, characterized in that the body of the epiphyseal element (3) has, at its base, markings intended to be matched with a reference mark which the sleeve (2) presents. ) constituting the metaphyseal element. 20
FR0753810A 2007-03-14 2007-03-14 FEMALE ROD OF MODULAR REPEAT Expired - Fee Related FR2913590B1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009106866A1 (en) * 2008-02-29 2009-09-03 Depuy International Ltd An instrument for use in a joint replacement procedure

Citations (7)

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EP0145641A1 (en) * 1983-11-08 1985-06-19 Mecron Medizinische Produkte Gmbh Modular resection prosthesis assembly
DE4320086A1 (en) * 1993-06-17 1994-12-22 Peter Brehm Modular shaft for a revision hip prosthesis system
DE29506036U1 (en) * 1995-04-07 1995-06-01 Brehm, Peter, 91085 Weisendorf Modular femoral prosthesis system with a shaft or prosthesis nail on which various modules can be placed
EP0729732A2 (en) * 1995-03-03 1996-09-04 Industrias Quirurgicas De Levante, S.A. Modular design osseous substitution prosthesis
FR2735971A1 (en) * 1995-06-30 1997-01-03 Mecanurgie Sa Soc Modular femoral surgical prosthesis
FR2735972A1 (en) * 1995-06-30 1997-01-03 Mecanurgie Sa Soc Surgical femoral reconstruction prosthesis
US6102956A (en) * 1995-11-20 2000-08-15 Artos Medizinische Produkte Gmbh Modular endoprosthesis

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Publication number Priority date Publication date Assignee Title
EP0145641A1 (en) * 1983-11-08 1985-06-19 Mecron Medizinische Produkte Gmbh Modular resection prosthesis assembly
DE4320086A1 (en) * 1993-06-17 1994-12-22 Peter Brehm Modular shaft for a revision hip prosthesis system
EP0729732A2 (en) * 1995-03-03 1996-09-04 Industrias Quirurgicas De Levante, S.A. Modular design osseous substitution prosthesis
DE29506036U1 (en) * 1995-04-07 1995-06-01 Brehm, Peter, 91085 Weisendorf Modular femoral prosthesis system with a shaft or prosthesis nail on which various modules can be placed
FR2735971A1 (en) * 1995-06-30 1997-01-03 Mecanurgie Sa Soc Modular femoral surgical prosthesis
FR2735972A1 (en) * 1995-06-30 1997-01-03 Mecanurgie Sa Soc Surgical femoral reconstruction prosthesis
US6102956A (en) * 1995-11-20 2000-08-15 Artos Medizinische Produkte Gmbh Modular endoprosthesis

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009106866A1 (en) * 2008-02-29 2009-09-03 Depuy International Ltd An instrument for use in a joint replacement procedure

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