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WO2024241355A1 - Dispositif prothétique acétabulaire - Google Patents

Dispositif prothétique acétabulaire Download PDF

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Publication number
WO2024241355A1
WO2024241355A1 PCT/IT2024/050105 IT2024050105W WO2024241355A1 WO 2024241355 A1 WO2024241355 A1 WO 2024241355A1 IT 2024050105 W IT2024050105 W IT 2024050105W WO 2024241355 A1 WO2024241355 A1 WO 2024241355A1
Authority
WO
WIPO (PCT)
Prior art keywords
stem
iliac
coupling
safety cap
acetabular cup
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.)
Pending
Application number
PCT/IT2024/050105
Other languages
English (en)
Inventor
Federico LEANDRIN
Thomas Ferro
Michele Pressacco
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.)
Limacorporate SpA
Original Assignee
Limacorporate SpA
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 Limacorporate SpA filed Critical Limacorporate SpA
Priority to AU2024277030A priority Critical patent/AU2024277030A1/en
Publication of WO2024241355A1 publication Critical patent/WO2024241355A1/fr
Anticipated expiration legal-status Critical
Pending 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
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • 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
    • 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
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • 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
    • A61F2002/30378—Spherically-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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • 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
    • A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
    • 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
    • A61F2002/3093—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth for promoting ingrowth of bone tissue
    • 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
    • A61F2/34—Acetabular cups
    • A61F2002/3401—Acetabular cups with radial apertures, e.g. radial bores for receiving fixation screws
    • A61F2002/3403—Polar aperture
    • 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
    • A61F2/34—Acetabular cups
    • A61F2002/3412—Acetabular cups with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
    • 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
    • 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
    • A61F2310/00023—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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
    • A61F2310/00407—Coating made of titanium or of Ti-based alloys

Definitions

  • the present invention concerns an acetabular prosthetic device used to restore the correct functioning of the hip joint, for example in the event a patient’s pelvis presents notable bone deformities or cavities of a natural origin, for example due to osteoarthritis, tumor, dysplasia, and/or of an artificial origin, for example caused by the removal of a previous prosthetic implant.
  • Acetabular prosthetic devices are generally formed by an acetabular cup configured to be stably attached in a patient’s acetabulum.
  • the acetabular cup can be associated with a stem that is inserted into the iliac canal of the pelvis.
  • this stem can be attached to the patient’s sacrum, as a replacement for or in addition to the anchoring in the iliac canal. Regardless of where the anchoring takes place, this type of stem is, here and hereafter, called “iliac stem”.
  • acetabular prosthetic devices with an iliac stem made in a single body with the acetabular cup, or with an iliac stem that can be coupled to the external surface of the acetabular cup by means of threaded attachment means, before inserting the cup and stem into the patient’s acetabular cavity.
  • a disadvantage of prosthetic devices that have the acetabular cup with integrated or pre-assembled stem is that they have significant mass and overall dimensions that complicate the surgical operation.
  • Another disadvantage of the aforementioned prosthetic devices with stem either integrated or pre-mounted on the acetabular cup is that the position of the acetabular cup, during surgery, could be different from the one originally planned by the surgeon, and the iliac stem, whether integrated or rigidly clamped onto the acetabular cup, is therefore also incorrectly positioned, that is, in a bone portion with low bone density.
  • Acetabular prosthetic devices are also known in which the iliac stem can be inserted from the inside, that is, from the concave side, of the acetabular cup after the insertion of the acetabular cup into the patient’s acetabular cavity.
  • a disadvantage of these acetabular prosthetic devices is that the iliac stem cannot be screwed to the acetabular cup because a rotation of the stem would induce an axial torsion of the tissues present in the iliac canal, with the risk of losing contact between the prosthetic implant and the anatomy.
  • the locking screws are inserted into the patient’s anatomy downstream of the acetabular cup positioning. This allows to first insert the acetabular cup in the correct position, and then insert the locking screws, resulting in a “pack-closure” of the acetabular cup with the acetabulum.
  • Document WO 2009/081346 Al describes an acetabular prosthesis comprising a cup able to be inserted into a corresponding acetabulum and a cup attachment screw able to engage by screwing into a portion of pelvic bone.
  • Document DE 19542116 Al describes a device for attaching an implant to a bone.
  • One purpose of the present invention which corresponds to the technical problem that the Applicant intends to solve, is to provide an acetabular prosthetic device, of the type with an iliac stem able to be inserted from inside the acetabular cup, in which the coupling between the iliac stem and the acetabular cup prevents axial displacements of the stem and is obtained without applying torsion/rotation on the stem itself.
  • one purpose of the present invention is to prevent axial displacements of the stem with respect to the acetabular cup following the determination of the reciprocal axial coupling by the surgeon.
  • Another purpose of the present invention is to provide an acetabular prosthetic device in which the axis of the stem can be oriented angularly with respect to the acetabular cup before the reciprocal axial coupling is determined.
  • the Applicant has devised, tested and embodied the present invention to overcome the shortcomings of the state of the art and to obtain these and other purposes and advantages.
  • an acetabular prosthetic device comprises an acetabular cup provided with a through aperture configured to receive both an iliac stem and also a safety element, that is, a safety cap.
  • the iliac stem, the acetabular cup and the safety cap form the acetabular prosthetic device.
  • the iliac stem has a first end provided both with a first coupling portion conformed to be accommodated in a mating first coupling seating defined in the aperture, and also with an abutment surface against which the safety cap can abut, the safety cap being conformed to be accommodated in a mating second coupling seating defined in the aperture.
  • the first coupling seating and the first coupling portion can have a mating truncated conical shape.
  • the conical coupling between the first coupling portion and the first coupling seating allows for a univocal axial positioning between iliac stem and acetabular cup.
  • the abutment surface of the iliac stem is at least partly flat, and the safety cap can abut against it with an essentially flat contact surface thereof.
  • This configuration of contact between safety cap and iliac stem allows for an orientation of the iliac stem along a single axis regardless of the spherical or conical coupling between stem and acetabular cup.
  • the first coupling seating and the first coupling portion can have a mating at least partly spherical shape.
  • the spherical coupling between the first coupling portion and the coupling seating can allow for a “polyaxial” positioning, that is, along a multiplicity of axes, between iliac stem and acetabular cup, before the stem is clamped with respect to the acetabular cup by means of the safety cap.
  • This aspect of the invention advantageously allows the iliac stem to be inserted inside the iliac canal with an optimal positioning, that is, in a zone with greater bone density, even in the event the acetabular cup is firmly attached but in a different position from what was originally planned by the surgeon.
  • the first end of the iliac stem has a concave receiving portion configured to receive a mating central protrusion which protrudes from the contact surface of the safety cap.
  • the receiving portion can have a truncated conical shape and the central protrusion can be at least partly spherical or truncated conical.
  • the receiving portion can have an at least partly spherical shape and the central protrusion can have a corresponding at least partly spherical shape.
  • the “polyaxial” positioning between iliac stem and acetabular cup is permitted only if the receiving portion has a truncated conical shape and the central protrusion has an at least partly spherical shape, or if the receiving portion and the central protrusion both have an at least partly spherical shape, given the spherical coupling between iliac stem and acetabular cup.
  • the second coupling seating is provided with a threaded segment and the safety cap is provided with a corresponding peripheral threaded segment, in order to determine a threaded coupling between the two components.
  • Some embodiments of the present invention also concern an iliac stem for an acetabular prosthetic device having a first end provided both with a first coupling portion, with a truncated conical or at least partly spherical shape, and also with a frontal abutment surface from which a concave receiving portion develops internally having a truncated conical or at least partly spherical shape.
  • FIG. 1 is a schematic view that shows the use of an acetabular prosthetic device, according to the present invention
  • - figs. 2-6 are enlarged partial section views of some embodiments of the acetabular prosthetic device of fig. 1.
  • an acetabular prosthetic device 10 comprises an acetabular cup 12, stably attached in a patient’s acetabulum, and an iliac stem 11 inserted into the iliac canal of the patient’s pelvis.
  • the device 10 also comprises a safety cap 13, visible in figs. 2-6, configured to determine an axial coupling between the iliac stem 11 and the acetabular cup 12.
  • the iliac stem 11 has a cylindrical shape.
  • the shape of the iliac stem 11 is not limited to the cylindrical one and may have one or more conical segments, and/or one or more attachment tabs on a lateral surface thereof.
  • the iliac stem 11 can be made of metallic material, preferably titanium or an alloy thereof.
  • the iliac stem 11 can be coated completely or in part with a layer of titanium pore and/or hydroxyapatite in order to promote osseointegration with the bone.
  • the iliac stem 11 develops along a longitudinal axis X and has a first end, or head, 14 and an opposed second end, or tip, 15, the latter visible in fig. 1.
  • the first end 14 is conformed to couple to the acetabular cup 12 and to cooperate with the safety cap 13 while the second end 15 is the “first insertion” portion of the iliac stem 11 into the patient’s iliac canal.
  • the first end 14 has a first coupling portion 16 conformed to couple to a mating first coupling seating 17 present in the acetabular cup 12.
  • the first coupling portion 16 has a conical/truncated conical shape, figs. 2 and 3.
  • the first coupling seating 17 also has a mating conical/truncated conical shape.
  • the conical coupling between the first coupling portion 16 and the first coupling seating 17 allows for a univocal axial positioning between iliac stem 11 and acetabular cup 12.
  • the longitudinal axis X of the iliac stem 11 coincides with the axes around which the first coupling portion 16 and the first coupling seating 17 are defined.
  • the taper of the first coupling portion 16 and of the first coupling seating 17 can be slightly different so as to improve the axial coupling by interference (fig. 3).
  • 17 also has a mating at least partly spherical shape.
  • the first end 14 of the iliac stem 11 is configured to articulate in an angularly orientable manner in the first coupling seating 17.
  • the spherical coupling between the first coupling portion 16 and the first coupling seating 17 allows for a “polyaxial” positioning, that is, along a multiplicity of axes, between iliac stem 11 and acetabular cup 12.
  • a “polyaxial” positioning that is, along a multiplicity of axes, between iliac stem 11 and acetabular cup 12.
  • an inclination, or orientation, of the iliac stem 11 in the first coupling seating 17 is allowed before the position is blocked by means of the safety cap 13, as will be described below.
  • the first end 14 of the iliac stem 11 has a frontal abutment surface 18 against which the safety cap 13 can abut, fig. 2.
  • the abutment surface 18 can be at least partly flat. In this case, a polyaxial adjustment is not allowed since the contact of the safety cap 13 against the abutment surface 18 determines a univocal positioning, regardless of the conical or spherical coupling between iliac stem 11 and acetabular cup 12.
  • a cavity 19 is made in the body of the iliac stem 11 which develops along the longitudinal axis X toward the second end 15.
  • the cavity 19 can be provided with a threaded segment 25.
  • the cavity 19 is configured to receive a surgical impactor, guided to move and position the iliac stem 11 during surgery.
  • the first end 14 of the iliac stem 11 can have a hollow receiving portion 20, having a concave conformation that develops inside the body of the iliac stem 11.
  • the receiving portion 20 develops around the longitudinal axis X starting from the abutment surface 18.
  • the receiving portion 20 substantially forms an extension of the abutment surface 18.
  • the receiving portion 20 is located upstream with respect to the cavity 19, in an entrance zone of the first end 14.
  • the receiving portion 20 is configured to cooperate with the safety cap 13, in particular to receive a central protrusion 24 of the safety cap 13, as will be described in more detail below.
  • the receiving portion 20 can have a spherical or hemispherical shape (figs. 2-5), or it can have a truncated conical shape, coaxial with the body of the iliac stem 11 (fig. 6).
  • the iliac stem 11 is constrained within the first coupling seating 17 by the safety cap 13, which is configured to prevent the axial displacement of the iliac stem 11 with respect to the acetabular cup 12.
  • the safety cap 13 is configured to be inserted in a second coupling seating 22 of the acetabular cup 12 to translate in an axial direction toward the first end 14 of the iliac stem 11.
  • the second coupling seating 22 has, by way of example, a cylindrical shape mating with the shape of the safety cap 13.
  • the first coupling seating 17 together with the second coupling seating 22 defines an aperture, passing through the hemispherical wall that defines the acetabular cup 12.
  • the first coupling seating 17 and the second coupling seating 22 can be completely created in the thickness of said hemispherical wall.
  • the second coupling seating 22 of the acetabular cup 12 can have a threaded segment 26, and the safety cap 13 can be provided with a corresponding peripheral threaded segment 23 to allow, by screwing, a translation of the safety cap 13 inside the second coupling seating 22 in an axial direction toward the iliac stem 11.
  • the second coupling seating 22 can advantageously have a “female” thread of the self-locking type.
  • the safety cap 13 is provided with an at least partly flat contact surface 21.
  • the contact surface 21 faces, during use, toward the abutment surface 18 or toward the receiving portion 20 in order to “pack-tighten” the iliac stem 11 against the first coupling seating 17 and constrain the iliac stem 11 in position, preventing an axial displacement thereof.
  • the contact surface 21 is completely flat (fig. 2).
  • the contact surface 21 can advantageously have a central protrusion 24 which, during use, is able to come into contact with the receiving portion 20 of the iliac stem 11, figs. 3-6.
  • the central protrusion 24 can have a hemispherical shape.
  • the receiving portion 20 can, in this case, have an at least partly spherical shape, figs. 2 and 4. Alternatively, the receiving portion 20 can have a truncated conical shape (figs. 3 and 5). This coupling configuration between safety cap 13 and iliac stem 11 allows the iliac stem 11 to be oriented angularly (polyaxiality).
  • the first end 14 of the iliac stem 11 is at least partly spherical, mating with the at least partly spherical first coupling portion 16.
  • the iliac stem 11 can advantageously be oriented angularly with respect to the axis that defines the first coupling portion 16 and the first coupling seating 17 to provide the surgeon, during use, with the most correct positioning for the iliac stem 11.
  • the receiving portion 20 of the embodiment described in fig. 5, moreover, is truncated conical, while the safety cap 13 has the central protrusion 24.
  • This combination advantageously allows to pack-tighten the safety cap 13 in the second coupling seating 22 against the iliac stem 11 , whatever the position of the iliac stem 11 with respect to the axis that defines the first coupling portion 16 and the first coupling seating 17.
  • the at least partial sphericity of the central protrusion 24 allows to maximize the contact surface against the truncated conical receiving portion 20, thus increasing the tightness of the safety cap 13.
  • the central protrusion 24 can have a truncated conical shape, fig. 6.
  • the receiving portion 20 can, in this case, have a mating truncated conical shape. This coupling configuration between safety cap 13 and iliac stem 11 does not allow the iliac stem 11 to be oriented angularly.
  • the central protrusion 24 pack-tightens the iliac stem 11 against the first coupling seating 17 of the acetabular cup 12 and constrains it in position, preventing any axial displacements.
  • the polyaxiality between iliac stem 11 and acetabular cup 12 advantageously allows to offer the surgeon wide versatility during surgery.
  • the surgeon can insert the iliac stem 11 into the first coupling seating 17 of the acetabular cup 12 so that the longitudinal axis X of the iliac stem 11 is coincident with the axis that defines the first coupling portion 16 and the first coupling seating 17.
  • the surgeon can clamp the iliac stem 11 along the same axis by means of an embodiment of the safety cap 13 in accordance with the present invention that determines a univocal positioning, regardless of the spherical coupling between iliac stem 11 and acetabular cup 12, for example the safety cap 13 having a truncated conical protrusion shown, by way of a non-limiting example, in fig. 6.
  • the surgeon can vary the angular positioning of the iliac stem 11 with respect to the first coupling seating 17 of the acetabular cup 12, and clamp the iliac stem 11 in the angular position identified by means of an embodiment of the safety cap 13 in accordance with the present invention that allows polyaxiality, for example, the safety cap 13 having an at least partly spherical protrusion, as in the example shown, purely by way of a non-limiting example, in fig. 5.

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

L'invention concerne un dispositif prothétique acétabulaire (10) comprenant une cupule acétabulaire (12) pourvue d'une ouverture traversante configurée pour recevoir à la fois une tige iliaque (11) et également un embout de sécurité (13).
PCT/IT2024/050105 2023-05-25 2024-05-24 Dispositif prothétique acétabulaire Pending WO2024241355A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2024277030A AU2024277030A1 (en) 2023-05-25 2024-05-24 Acetabular prosthetic device

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
IT102023000010662 2023-05-25
IT202300010662 2023-05-25
IT102023000018252 2023-09-05
IT202300018252 2023-09-05

Publications (1)

Publication Number Publication Date
WO2024241355A1 true WO2024241355A1 (fr) 2024-11-28

Family

ID=91953807

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT2024/050105 Pending WO2024241355A1 (fr) 2023-05-25 2024-05-24 Dispositif prothétique acétabulaire

Country Status (2)

Country Link
AU (1) AU2024277030A1 (fr)
WO (1) WO2024241355A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19542116A1 (de) * 1995-11-11 1997-05-15 Peter Brehm Anordnung zur Befestigung eines Implantats an einem Knochen des menschlichen Körpers
WO2009081346A1 (fr) * 2007-12-19 2009-07-02 Istituto Ortopedico Rizzoli Prothèse acétabulaire
WO2010072604A1 (fr) * 2008-12-22 2010-07-01 Dot Gmbh Élément de stabilisation à orientation polyaxiale pour endoprothèses
US20100256771A1 (en) * 2007-09-11 2010-10-07 Paul Roberts Acetabular component
US8556985B2 (en) * 2008-02-20 2013-10-15 Biomet Manufacturing, Llc Acetabular cup fixation

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19542116A1 (de) * 1995-11-11 1997-05-15 Peter Brehm Anordnung zur Befestigung eines Implantats an einem Knochen des menschlichen Körpers
US20100256771A1 (en) * 2007-09-11 2010-10-07 Paul Roberts Acetabular component
WO2009081346A1 (fr) * 2007-12-19 2009-07-02 Istituto Ortopedico Rizzoli Prothèse acétabulaire
US8556985B2 (en) * 2008-02-20 2013-10-15 Biomet Manufacturing, Llc Acetabular cup fixation
WO2010072604A1 (fr) * 2008-12-22 2010-07-01 Dot Gmbh Élément de stabilisation à orientation polyaxiale pour endoprothèses

Also Published As

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AU2024277030A1 (en) 2025-11-27

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