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WO2000030570A2 - Endoprothese partielle pour articulations du genou - Google Patents

Endoprothese partielle pour articulations du genou Download PDF

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Publication number
WO2000030570A2
WO2000030570A2 PCT/EP1999/008904 EP9908904W WO0030570A2 WO 2000030570 A2 WO2000030570 A2 WO 2000030570A2 EP 9908904 W EP9908904 W EP 9908904W WO 0030570 A2 WO0030570 A2 WO 0030570A2
Authority
WO
WIPO (PCT)
Prior art keywords
tool
recess
inlay
tibia
femur
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.)
Ceased
Application number
PCT/EP1999/008904
Other languages
German (de)
English (en)
Other versions
WO2000030570A3 (fr
Inventor
W. Skripitz
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.)
Coripharm Medizinprodukte GmbH and Co KG
Original Assignee
Coripharm Medizinprodukte GmbH and Co KG
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 Coripharm Medizinprodukte GmbH and Co KG filed Critical Coripharm Medizinprodukte GmbH and Co KG
Publication of WO2000030570A2 publication Critical patent/WO2000030570A2/fr
Publication of WO2000030570A3 publication Critical patent/WO2000030570A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1659—Surgical rasps, files, planes, or scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30153—Convex polygonal shapes rectangular
    • 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
    • A61F2002/30795—Blind bores, e.g. of circular cross-section
    • A61F2002/30805—Recesses of comparatively large area with respect to their low depth
    • 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
    • A61F2002/30836—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves knurled
    • 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
    • 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
    • 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
    • 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
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2002/3895—Joints for elbows or knees unicompartimental
    • 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
    • A61F2002/4631—Special tools for implanting artificial joints the prosthesis being specially adapted for being cemented
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A61F2230/0019—Angular shapes rectangular
    • 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
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • 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

Definitions

  • the invention relates to a partial endoprosthesis for knee joints, consisting of two prosthesis parts, one of which is formed by an inlay which can be inserted into a recess previously made in the original joint surface of the tibia and can be fixed by means of bone cement and whose side facing the femur as Sliding surface for the assigned second prosthetic part which can be fastened in a receptacle incorporated in the area of the femur opposite the sliding surface
  • the receptacles for the prosthesis parts are milled out by milling out the bone structure by means of a ball head designed in the manner of a milling head used in dental practices.
  • the milling head is created by first placing the milling head along the previously recorded boundary of the recess to be produced and guiding it along and creating a slot-like circumferential recess, whereupon the material in between is gradually milled out, thus creating the recess for the inlay, which is made of suitable plastic becomes.
  • the recessed recess to be produced must be dimensioned as precisely as possible in accordance with the inlay in terms of its limitation and also its depth, so that the inlay, after being fixed in the recess with bone cement, consists of the metal-like prosthetic part of the femur contrasts that the original knee function is optimally imitated. It has been shown that this type of milled-out of the receptacle for the inlay is labor-intensive even with a mechanical ant ⁇ eo of the spherical milling cutter, and is not always satisfactory with regard to the accuracy and surface quality of the created receptacle surface of the cutout, which also entails the risk of that the inlay is not implanted with the desired and precisely specified fit.
  • the invention is based on the object of a two-part partial endoprosthesis for knee joints, in which the desired, resilient and precisely aligned seat on or in the bone can be achieved in a simplified manner compared to the previous surgical technique.
  • a tool which enables the production of the recess for receiving the part of the prosthesis on the Tibia side, which is designed as an inlay, is to be created with increased accuracy and reduced workload.
  • erfmdungsgehold proposed that at a part endoprosthesis of the type mentioned at least the erfmdungsgeclar m of the recess of the tibia to be fixed inlay in its femurabgewandten underside with a serving as a bone cement depot recess ver ⁇ see is that prior to insertion is fulloar in the recess in the tibia with a predetermined amount of bone cement that meets the requirements.
  • the inlay m the recess by pressing on the outer surface, a part of the freshly mixed bone cement m the spongiosis is pressed and thus ensures the desired firm connection after hardening.
  • the recess n on the underside facing away from the femur expediently has an at least largely all-round closed wall, so that bone cement is only displaced to a small extent to the recess walls surrounding the inlay.
  • the wall of the inlay surrounding the recess is if it is expedient to provide all or part of a texturing, roughening or a number of regularly or irregularly distributed projections which increase the adhesion of bone cement, in order to improve the adhesion of the bone cement on the prosthesis side.
  • At least the part of the inlay facing the skid-like prosthetic part on the femur side is preferably made of a highly durable plastic with good sliding properties, for example the high-pressure polyethylene used for total endoprostheses for the tibial component.
  • the skid-like prosthesis part to be fastened in the associated receptacle in the femur is also provided in its underside facing away from the tibia with a depression serving as a bone cement depot, which then - analogously to the inlay - m around the underside facing away from the tibia by a circumferential wall is at least mostly closed all around.
  • the deepening limiting wall of the ski-like prosthesis part can be provided to ensure a safe seat on or in the femur with the liability of the bone cement increasing Textu ⁇ réelle, roughening o ⁇ er an on ⁇ number of regularly or irregularly distributed Vorsprungen.
  • the skid-like prosthesis part is preferably made in a known manner from metal, preferably a high-alloy steel, for example a cobalt-chromium-molybdenum alloy, with the skid area of this prosthesis part interacting with the joint surface of the tibial-side inlay being appropriately polished.
  • metal preferably a high-alloy steel, for example a cobalt-chromium-molybdenum alloy
  • At least one pin that is known per se and that can be inserted into a prepared bore in the receptacle of the femur projects.
  • a tool that can be inserted in a motor-driven drive machine and can be displaced by this oscillating working movement is proposed according to the invention, which tool is designed according to the invention such that it is at the end of a Form-grinding tool arranged in the tool holder of the drive machine, the working grinding surface of which is coated with abrasive particles that act on the bone substance, and the shape of which is selected in accordance with the limitation of the recess in the tibia for the inlay to be implanted, its dimensions being only m in the oscillation direction smaller by the oscillation stroke than the recess to be produced.
  • This tool is brought into the intended working position, which rests on the working grinding surface of the form grinding tool in the region of the tibia recess to be produced.
  • the grinding tool is then set into oscillating motion and grinds the recess required for the inlay into the damaged joint area of the tibia, with only sufficient pressure having to be applied in the direction of the recess to be produced.
  • the corresponding limitation of the grinding tool taking into account the oscillation stroke, creates a recess that is optimally adapted to the inlay to be implanted.
  • the correct insertion depth of the recess is also automatically obtained as soon as the tool shaft comes into contact with the bone areas delimiting the recess.
  • the tool shank is advantageously designed as an elongated flat profile, one end region of which is suitably designed to be held in the tool holder of the drive machine, in which case the form grinding tool is formed by a shaped body which appears in the other end region from a flat side of the flat profile, whose surface opposite the fastening surface on the flat profile forms the working grinding surface.
  • a second form grinding tool can be provided, which e.g. is used when the first form grinding tool shows a deteriorated grinding effect after prolonged use.
  • the second grinding tool can also be coated with different, for example finer, grinding particles, so that the second grinding molding tool can then be used for the final fine machining of the bottom surface of the cut-out created after processing with the first molding grinding tool.
  • the tool shank must be inserted into the tool holder of the drive machine in a position rotated by 180 °.
  • a stop protruding from the tool shank for example a stop point, can be provided, the distance from the respectively assigned form grinding tool corresponding to the distance for the recess to be made in the tibial joint surface the inlay corresponds to the outer wall of the tibia.
  • the stop pin enables simple and precise placement of the form grinding Tool in the area of the recess to be produced, in which the tool is guided up to the abutment pin against the outer bone wall. This also ensures that the hard bone wall (cortex) surrounding the recess is not attacked during the grinding process.
  • the length of the respective stop pin is dimensioned such that it protrudes beyond the plane of the working grinding surface of the associated form grinding tool, i.e. effective as a stop at the start of the grinding process
  • FIG. 1 shows a perspective view of a two-part partial endoprosthesis according to the invention, with the two prosthesis parts at a spacing from one another,
  • FIG. 2 shows a bottom view of the prosthesis part assigned to the tibia, viewed in the direction of the arrow 2 FIG. 1;
  • FIG 3 shows a plan view of a tool for producing the recess in the tibial-side joint surface for receiving the prosthesis part designed as an inlay
  • FIG. 4 is a view of the tool, seen in the direction of arrow 4.
  • the bottom of the depression is provided with a roughening or texturing or with a plurality of regularly or irregularly arranged protruding low projections.
  • This roughening serves to increase the adhesion of the bone cement introduced into the depression serving as a bone cement depot in the shapeable state after it has set on the prosthesis part 12.
  • the part of the knee joint on the femur side in the area of the prosthesis part 12 to be implanted must be machined by appropriate machining in such a way that a suitable receptacle for the prosthesis part 12 is produced, a hole also being made in the femur, into which the pin 20 is inserted and thus transmits acting shear stress in the thigh.
  • the depression 18 provided as a bone cement depot is thus filled with the freshly mixed and still plastic bone cement in a predetermined amount before the implantation and then pressed into or onto the previously produced receptacle of the thigh bone, with bone cement introduced in excess in the depression in the subsequent ones cancellous bone area penetrates and hardens there.
  • the second lower prosthesis part 24 is provided as an elongated, in its upper side facing the skid surface 14 with a slightly concave sliding surface 26, Inlay trained.
  • the prosthesis part 24 is made of a high-strength plastic with good sliding properties, for example a high-pressure polyethylene.
  • a depression 28 provided as a bone cement depot is also formed in this underside within an all-round wall 30 which defines the height of the inlay and thus also the depth of the receptacle Inlays in the tibial joint surface recess to be provided.
  • the bottom surface of the depression 28 is in turn textured, roughened or provided with a plurality of low projections in a regular or irregular arrangement in order to increase the adhesion of the bone cement.
  • FIGS. 3 and 4 show a tool 34 which is intended for incorporating a recess which fits the inlay 24 exactly and the region of the knee joint of the tibia to be replaced by the inlay.
  • the tool 34 has an elongated flat tool shaft 36, stiffened if necessary by the indicated low embossed ribs against deflection, the right end of which in the drawing figures is suitably designed for releasable mounting in the tool holder of a motor drive machine.
  • motor drive machines are used in surgical operating technology, among other things, for sawing, ie for making cuts in or for severing bones. These drive machines therefore generate an oscillating, ie back and forth working movement of the driven tool.
  • the actual form-grinding tool 38 which removes the bone material in a grinding process, is illustrated on the top of the shaft 36, the outline of which corresponds substantially to the shape of the inlay 24, although the dimension of the form-grinding tool 38 towards the working stroke is shorter by the amount of this working stroke. In this way it is ensured that the recess made in the bone with the tool 34 placed on the bone and driven in an oscillating manner corresponds exactly in its outer contour to the inlay 24 to be picked up.
  • the abrasive tool itself consists of a pillow-like metallic carrier that protrudes from the upper side of the tool shaft 36 and has an abrasive layer 42 of diamond particles firmly bonded to the carrier on its upper flat side facing away from the tool shaft and located in the region of the knee joint bone to be machined is provided.
  • FIGS. 3 and 4 each show a stop pin 44 protruding from the tool shank 36 at a distance from the actual form grinding tool 38, which protrudes beyond the actual working surface coated with the diamond particle coating and is at such a distance from the actual form grinding tool. that when the tool is placed in the working area in such a way that the stop pin 44 lies against the outside of the bone, it is ensured that the working area of the form grinding tool lies outside the area of the hard bone wall (cortex).
  • the arrangement of a shape grinding tool 38 ′ which essentially corresponds in shape and structure to the shape grinding tool 38, on the side of the tool shaft 36 opposite the grinding tool 18 is indicated by dash-dotted lines.
  • a stop pin 44 ' also protrudes from the opposite side of the tool shank 36.

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

Abstract

L'invention concerne une endoprothèse partielle (10) pour articulations du genou, qui comprend deux parties de prothèse (12; 24) dont une est formée d'une incrustation en profondeur (24) pouvant être introduite au préalable dans la surface d'articulation initiale du tibia et pouvant être fixée avec du ciment osseux et dont la face qui fait face au fémur se présente sous forme de surface de glissement (26) pour une seconde partie de prothèse (12) associée de type baquet pouvant être fixée dans une cavité incorporée dans la zone du fémur opposée à la surface de glissement. Au moins l'incrustation en profondeur (24) à fixer dans la cavité du tibia est munie, dans sa face intérieure opposée au fémur, d'un évidement (28) servant à déposer le ciment osseux. En outre, la partie de prothèse (12) de type baquet à fixer dans la cavité associée du fémur est munie dans sa face inférieure opposée au tibia, d'un évidement (18) servant à déposer le ciment osseux.
PCT/EP1999/008904 1998-11-23 1999-11-22 Endoprothese partielle pour articulations du genou Ceased WO2000030570A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE29820903U DE29820903U1 (de) 1998-11-23 1998-11-23 Teil-Endoprothese für Kniegelenke
DE29820903.9 1998-11-23

Publications (2)

Publication Number Publication Date
WO2000030570A2 true WO2000030570A2 (fr) 2000-06-02
WO2000030570A3 WO2000030570A3 (fr) 2000-08-31

Family

ID=8065701

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1999/008904 Ceased WO2000030570A2 (fr) 1998-11-23 1999-11-22 Endoprothese partielle pour articulations du genou

Country Status (2)

Country Link
DE (1) DE29820903U1 (fr)
WO (1) WO2000030570A2 (fr)

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH674798A5 (fr) * 1988-02-29 1990-07-31 Sulzer Ag
US4872452A (en) * 1989-01-09 1989-10-10 Minnesota Mining And Manufacturing Company Bone rasp
FR2651114B1 (fr) * 1989-08-29 1991-10-18 Commissariat Energie Atomique Dispositif de positionnement et de guidage de la lame d'une scie chirurgicale.
US5171276A (en) * 1990-01-08 1992-12-15 Caspari Richard B Knee joint prosthesis
US5171244A (en) * 1990-01-08 1992-12-15 Caspari Richard B Methods and apparatus for arthroscopic prosthetic knee replacement
US5246530A (en) * 1990-04-20 1993-09-21 Dynamet Incorporated Method of producing porous metal surface
US5344423A (en) * 1992-02-06 1994-09-06 Zimmer, Inc. Apparatus and method for milling bone

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
None

Also Published As

Publication number Publication date
DE29820903U1 (de) 2000-04-06
WO2000030570A3 (fr) 2000-08-31

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