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WO2024231204A1 - Orthopaedic distraction device for distraction of a patient 's joint, advantageously the knee - Google Patents

Orthopaedic distraction device for distraction of a patient 's joint, advantageously the knee Download PDF

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Publication number
WO2024231204A1
WO2024231204A1 PCT/EP2024/062023 EP2024062023W WO2024231204A1 WO 2024231204 A1 WO2024231204 A1 WO 2024231204A1 EP 2024062023 W EP2024062023 W EP 2024062023W WO 2024231204 A1 WO2024231204 A1 WO 2024231204A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
distraction device
securing means
translation
arm
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/EP2024/062023
Other languages
French (fr)
Inventor
Hugo PEIGNE
Grégoire LARCHE
Jean-Pierre Podgorski
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.)
Newclip International SARL
Original Assignee
Newclip International SARL
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 Newclip International SARL filed Critical Newclip International SARL
Priority to AU2024268786A priority Critical patent/AU2024268786A1/en
Publication of WO2024231204A1 publication Critical patent/WO2024231204A1/en
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00982—General structural features
    • A61B2017/00991—Telescopic means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/567—Joint mechanisms or joint supports in addition to the natural joints and outside the joint gaps

Definitions

  • Orthopedic distraction device for the distraction of a patient's joint, advantageously the knee
  • the present invention relates to the technical field of orthopedic devices.
  • Osteoarthritis of a joint is a degenerative joint disease that is characterized by persistent pain and can lead to loss of function.
  • Treatment options are currently limited. And standard treatments can only slow the disease.
  • this disease usually leads to surgery for prosthetic replacement of the joint (for example in bicompartmental joint degeneration).
  • joint distraction could be an interesting solution in that it improves joint homeostasis by temporary mechanical unloading of the joint.
  • the present invention proposes an orthopedic distraction device, for the distraction of a patient's joint, advantageously the knee.
  • the orthopedic distraction device according to the invention advantageously internal or external, comprises:
  • securing means for securing said orthopedic distraction device with the bones forming said joint
  • securing means comprise first securing means for securing with at least one first bone of said joint, advantageously a tibia, and second securing means for securing with at least one second bone of said joint, advantageously a femur, - telescopic connecting means, connecting said securing means and defining a degree of freedom in translation between said securing means,
  • - maneuvering means adapted to generate a separation maneuver between said securing means according to said degree of freedom in translation to create a distraction between the bones of said joint
  • - locking means adapted to lock in translation said telescopic connection means after the creation of said distraction.
  • Such an orthopedic distraction device has various advantages, namely in particular reduced bulk, improved comfort for the patient, a possibility of versatile arrangement (possibly external and preferably internal which makes it possible to eliminate the risks of infection linked to percutaneous pins) and ease of installation for the orthopedic surgeon.
  • the telescopic connecting means comprise at least two arms which together form a slide defining said degree of freedom in translation, which arms each comprise a proximal end which is connected to one of said securing means; preferably, said at least two arms comprise a first arm, comprising a tubular wall which defines an elongated housing opening at an opening, and a second arm, attached to said elongated housing through said opening and guided in translation along said elongated housing; more preferably, the locking means comprise at least one stop screw which is guided in translation on one of said arms and which cooperates with the other of said arms to ensure said locking, advantageously among an axial stop screw, to maintain the distraction, preferably implanted parallel to the degree of freedom in translation, advantageously in a bottom of the elongated housing located opposite the opening, and a lateral stop screw, to lock the translational play, preferably implanted perpendicular to the degree of freedom in translation, advantageously in the tubular wall of the first arm; the operating means advantageously comprise a cam, removable and
  • the locking means comprise complementary securing means forming a spacer, which are structured to bridge the joint and to be fixed to an opposite bone of said joint.
  • the securing means consist of two osteosynthesis plates, namely a first osteosynthesis plate, forming the first securing means intended to be secured to the first bone of said joint, and a second osteosynthesis plate, forming the second securing means intended to be secured to the second bone of said joint, which osteosynthesis plates advantageously comprise orifices suitable for the installation of fixing screws; preferably, the proximal end of an arm is in one piece with the associated osteosynthesis plate, or assembled with the osteosynthesis plate, for example by screwing;
  • the orthopedic distraction device comprises angulation means for providing a degree of freedom in rotation between said securing means, perpendicular to said degree of freedom in translation, in order to allow distraction with the flexed joint;
  • the angulation means advantageously comprise articulation means which are provided between one of the securing means and the telescopic connection means, and rotation locking means, adapted to lock said articulation means in rotation after adjustment of said angulation, for example in the form of complementary toothed crowns associated with a clamping member.
  • the present invention also relates to the method of orthopedic distraction, by implementing an orthopedic distraction device according to the invention, which method comprises:
  • FIG. 1 is a general view of a first orthopedic distraction device according to the invention
  • FIG. 2 is a general exploded view of the first orthopedic distraction device according to FIG. 1;
  • FIG. 3 is a general view of a first part of the orthopedic distraction device according to figure 1, namely a first arm (comprising an elongated housing) with its osteosynthesis plate intended to be secured here to the tibia;
  • FIG. 4 is a general view of a second part of the orthopedic distraction device according to figure 1, namely a second arm (intended to be attached to the elongated housing) with its osteosynthesis plate intended to be secured here to the femur;
  • FIG. 5 is a general view, in perspective, of the orthopedic distraction device according to figure 1, secured to the bones forming the joint and prior to the step of creating the distraction;
  • FIG. 6 is a general front view of the orthopedic distraction device according to Figure 5;
  • FIG. 7 is a general view of the orthopedic distraction device according to Figure 1, secured to the bones forming the joint and following the distraction creation step;
  • FIG. 8 is a general view of a second orthopedic distraction device according to the invention.
  • FIG. 9 is a general exploded view of the second orthopedic distraction device according to FIG. 8.
  • FIG. 10 is a general view of the orthopedic distraction device according to Figure 8, secured to the bones forming the joint;
  • FIG. 11 is a general view of a third orthopedic distraction device according to the invention.
  • FIG. 12 is a general exploded view of the third orthopedic distraction device according to FIG. 11;
  • FIG. 13 is a general view of the orthopedic distraction device according to Figures 11 and 12, secured to the bones forming the joint, showing the implantation before distraction (part A.) and after distraction (part B.);
  • FIG. 14 is a general view of a fourth orthopedic distraction device according to the invention, distinguished from the second orthopedic distraction device by additional securing means forming a spacer.
  • the present invention therefore relates to an orthopedic distraction device 1 which is designed for the distraction of a joint A of a patient, advantageously of the knee.
  • displacement we mean a temporary mechanical unloading of the joint A by creating a separation between the two bones S forming this joint A.
  • the orthopedic distraction device 1 advantageously consists of a surgical or implantable orthopedic distraction device 1.
  • the orthopedic distraction device 1 is here internal, advantageously implanted under the skin and soft tissues of the patient, which eliminates the risk of infection linked to percutaneous pins.
  • the orthopedic distraction device 1 is external, advantageously positioned outside the patient's skin, with securing means intended to be implanted through the skin and soft tissues.
  • the orthopedic distraction device 1 comprises:
  • - maneuvering means 4 adapted to generate a separation maneuver between the securing means 2 according to the degree of freedom in translation T to create distraction between the bones S of the joint A, and
  • the degree of freedom in translation T advantageously extends perpendicularly to the folding axis of the joint A or to the joint space.
  • the means of solidarity 2 include:
  • first means of securing 21 for securing with at least one first bone S1 of the joint A (advantageously a tibia for the knee), and
  • - second securing means 22 for securing with at least one second bone S2 of the joint A (advantageously a femur for the knee).
  • the securing means 2 consist of two osteosynthesis plates 2, namely:
  • the first securing means 21 are adapted to securing with the tibia, forming tibial securing means 21; and the second securing means 22 are adapted to securing with the femur, forming femoral securing means 22.
  • the securing means 2 are adapted to an inverted assembly compared to Figures 5 et seq.:
  • the first securing means 21 are adapted to securing with a first bone S1 which is here the femur, forming femoral securing means 21, and
  • the second securing means 22 are adapted for securing with a second bone S1 which is here the tibia, forming tibial securing means 22.
  • the osteosynthesis plates 2 advantageously include orifices 23 adapted to the placement of fixing screws V in the bone S.
  • the holes 23 are arranged so that the fixing screws V preserve the articular surfaces and the fixing screws V diverge to increase the anchoring force.
  • osteosynthesis plates 2 comprise:
  • the thickness of such an osteosynthesis plate 2 is advantageously a few millimeters.
  • the securing means 2 are advantageously shaped for fixing on the medial and/or lateral and/or anteromedial and/or anterior faces of the bones S of the joint A.
  • the telescopic connecting means 3 advantageously comprise at least two arms 31, 32 which together form a slide defining the degree of freedom in translation T.
  • the arms 31, 32 each have a proximal end 311, 321 which is connected (or coupled) with one of the securing means 2.
  • a first arm 31 cooperates with the first securing means 21 (figures 2 and 3, or figures 8 and following).
  • the first arm 31 (advantageously in the form of a sleeve or sheath) advantageously comprises a tubular wall 313 which defines an elongated housing 314, advantageously a blind housing, opening at an opening 315.
  • the elongated housing 314 advantageously consists of a blind housing, comprising a bottom 316 located opposite the opening 315.
  • the elongated housing 314 advantageously extends coaxially with respect to the degree of freedom in translation T.
  • a second arm 32, cooperating with the second securing means 22, is visible in more detail in figures 2 and 4 or in figures 8 and following.
  • the second arm 32 is intended to be attached to the elongated housing 314 of the first arm 31, through its opening 315 and guided in translation along the elongated housing 314 (coaxially to the degree of freedom in translation T).
  • the cross section of the second arm 32 corresponds, apart from the clearance, to the cross section of the elongated housing 314 of the first arm 31 so as to ensure relative translational guidance between these two arms 31, 32 according to the degree of freedom in translation T.
  • the second arm 32 advantageously comprises a visual marking 325 which is useful for observing/measuring the movement of this second arm 32 relative to the opening 315 of the first arm 31, corresponding to the distraction applied to the joint A.
  • first arm 31 cooperates for example with first “tibial” securing means 21 and the second arm 32 cooperates with second “femoral” securing means 22 (figures 1 to 7 for example).
  • the first arm 31 cooperates with first “femoral” securing means 21 and the second arm 32 cooperates with second “tibial” securing means 22.
  • the telescopic connecting means 3 can be made in one piece (figures 9 to 11), or assembled (figures 1 to 8 or figures 11 and 12), with the securing means 2.
  • proximal end 311, 321 of an arm 31, 32 is advantageously:
  • the proximal end 311 of the first arm 31 is in one piece with the first osteosynthesis plate 21.
  • the proximal end 321 of the second arm 32 is assembled with the associated second osteosynthesis plate 22.
  • the assembly means 7, 9 (between the proximal end 321 of the second arm 32 and the second associated osteosynthesis plate 22) are advantageously chosen from:
  • - articulation means 7 forming part of angulation means 6 described below in connection with figures 1 to 7, conferring a degree of freedom in rotation between the proximal end 321 of the second arm 32 and the associated second osteosynthesis plate 22, or
  • the second osteosynthesis plate 22 advantageously comprises a location 225 intended to receive the proximal end 321 of the second arm 32 and to ensure the angular locking of this second arm 32.
  • the proximal end 321 of the second arm 32 is advantageously:
  • a clamping member 71, 91 for example a screw, which is attached through a pair of aligned orifices 72, 92 which are provided respectively in the arm 32 (at its proximal end 321) and in the associated osteosynthesis plate 22.
  • the second osteosynthesis plate 22 preferably consists of an osteosynthesis plate adapted to be attached to a bone S1 after a surgical procedure applied to said bone S2 (for example a fracture osteosynthesis or a corrective osteotomy, as illustrated in FIG. 13).
  • a surgical procedure applied to said bone S2 for example a fracture osteosynthesis or a corrective osteotomy, as illustrated in FIG. 13.
  • the proximal end 311 of the first arm 31 is in one piece with the first osteosynthesis plate 21.
  • the proximal end 321 of the second arm 32 is in one piece with the associated second osteosynthesis plate 22.
  • the operating means 4 advantageously consist of a cam 41, here removable and free to rotate, to generate a relative movement of the arms 31, 32 by its rotational movement.
  • the removable cam 41 is temporarily assembled on the second arm 32, preferably at its proximal end 321.
  • cam 41 cooperates with the tubular wall 313 of the first arm 31, on the side of its opening 315.
  • Such a removable cam 41 is of particular interest for limiting the size of the orthopedic distraction device 1, in particular when it is implanted internally.
  • This “removable” structure also makes it possible to choose the cam 41 from a range of cams 41 which have respective distraction values and which make it possible to take into account a possible variation in initial length at the level of the telescopic connection means 3.
  • the cam 41 advantageously consists of a cam of the external profile type whose rotation around its axis of rotation 4 T generates a radial force (perpendicular to the axis of rotation 4T) between the arms 31, 32.
  • the cam 41 has an external profile 411 which is curved and which gradually moves away from the axis of rotation 4T.
  • the cam 41 advantageously comprises a cylindrical section 412 which is intended to cooperate with the second arm 32 to define the degree of freedom in rotation.
  • cylindrical section 412 is intended to be housed within a housing located at the proximal end 321 of the second arm 32.
  • This housing is here formed by the female head 711 of the aforementioned clamping member 71.
  • the cam 41 advantageously comprises a gripping member 413, here centered on the axis of rotation 41', adapted to cooperate with an maneuvering tool.
  • This gripping member 413 is presented here in the form of a hexagonal head.
  • the operating means 4 comprise stop means 42, for defining the end of rotation position of the cam 41 during distraction.
  • the stop means 42 comprise a pair of lugs 421, 422 intended to cooperate in the end-of-rotation position of the cam 41.
  • the pair of lugs 421, 422 comprises:
  • first lug 421 carried by the cam 41, at the end of its external profile 411, and - a second lug 422, here protruding, carried by the tubular wall 313 of the first arm 31 (on the side of the opening 315).
  • the second lug 422 here sandwiches the cam 41 (at its outer profile 411) with the second arm 32 so as to participate in maintaining the cam 41 when it is rotated.
  • the second lug 422 defines a groove with the second arm 32 which is intended to receive and guide the outer profile 411, to participate in maintaining the cam 41.
  • the second lug 422 can optionally serve as a reference point in relation to the visual marking 325, so as to check the distraction dimension applied to the joint A.
  • the operating means 4 comprise an axial operating screw 45 which is guided in translation on one of the arms 31, parallel to the degree of freedom in translation T.
  • Such an axial operating screw 45 has the advantage of eliminating additional instruments compared to a cam 41, thus simplifying the operating technique.
  • this axial operating screw 45 is installed parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31.
  • this axial operating screw 45 is intended to travel in translation along the degree of freedom in translation T.
  • This axial operating screw 45 advantageously comprises two ends (figure 9):
  • the rotational maneuver of the axial maneuver screw 45 (in screwing or unscrewing) generates a maneuver of the arms 21, 22 relative to each other, leading to a maneuver in separation between the securing means 2 according to the degree of freedom in translation T to create a distraction between the bones S of the joint A.
  • the locking means 5 advantageously comprise at least one stop screw 51, 52 which is guided in translation on one of the arms 31, 32 and which cooperates with the other of the arms 31, 32 to ensure this locking.
  • the locking means 5 comprise at least one stop screw 51, 52 among:
  • the axial stop screw 51 provides an end-of-travel stop for the first arm 31 relative to the second arm 32.
  • this stop screw 51 is implanted parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31 to serve as a support stop with an end wall 323 of the second arm 32.
  • the stop screw 51 is advantageously identical to the axial operating screw 45 according to Figures 8 and following, to form operating means 4 adapted to be operated in addition to (or in combination with) the cam 41 in order to adjust the distraction.
  • the lateral stop screw 52 is preferably installed perpendicular to the degree of freedom in translation T.
  • This lateral stop screw 52 is for example implanted:
  • said lateral stop screw 52 advantageously comprises:
  • an operating head 522 advantageously accessible through a window 317 provided in the tubular wall 313 of the first arm 31.
  • the locking means 5 advantageously comprise additional securing means 55 forming a spacer, which are structured to bridge the joint A and to be fixed to a bone S1, S2 opposite this joint A.
  • the complementary securing means 55 advantageously consist of a spacer which has a fixed length and which is secured to the two bones S1, S2 forming the joint A.
  • Such complementary securing means 55 can be implemented in the different embodiments according to the invention.
  • the complementary securing means 55 advantageously comprise complementary securing means 55, equipping: - the first securing means 21 and/or the first arm 31 cooperating with a bone S, for securing with another bone S of the joint A (figure 14), and/or
  • the complementary securing means 55 extend from the first arm 31 cooperating with a bone S2, in particular from its tubular wall 313. These complementary securing means 55 bridge the joint A and are fixed to a bone S1 opposite this joint A.
  • the additional securing means 55 advantageously comprise at least one arm 551 (or a strut), which is intended to span or bridge the articulation A.
  • This arm 551 advantageously comprises at least one orifice 552 for the installation of a fixing screw 553 which is fixed to the opposite bone segment S1.
  • This arm 551 advantageously has a fixed length.
  • This arm 551 is preferably divergent with respect to the degree of freedom in translation T, from its upstream end 555 (here in one piece with the first arm 31).
  • the orthopedic distraction device 1 advantageously comprises angulation means 6 to provide a degree of freedom in rotation between the securing means 2, along an axis of rotation R which extends perpendicular to the degree of freedom in translation T.
  • This technical characteristic then allows, if necessary, distraction with the flexed A joint.
  • the angulation means 6 comprise:
  • the articulation means 7 define the aforementioned axis of rotation R.
  • the articulation means 7 comprise for example a clamping member 71, for example a screw, which is attached through a pair of orifices 72 which are provided respectively in an arm 32 (at its proximal end 321) and in its associated osteosynthesis plate 22.
  • the rotation locking means 8 consist for example of a pair of toothed crowns 81, complementary and frontal, forming a toothed wheel, which cooperates with the clamping member 71.
  • toothed crowns 81 are arranged around the aforementioned orifices 72 and at the level of the facing surfaces to mesh with them when tightening the clamping member 71.
  • the tightening of the tightening member 71 allows a gearing of the toothed crowns 81 which causes a rotational blockage between the arm 32 and its associated osteosynthesis plate 22.
  • the orthopedic distraction procedure 1 includes:
  • the orthopedic distraction device 1 has the advantage of allowing a positioning and securing step internally, advantageously under the skin and soft tissues.
  • the orthopedic distraction device 1 is positioned and locked on either side of the joint A by means of screws V attached to the two osteosynthesis plates 2.
  • an angulation step is authorized by the angulation means 6, by acting on the rotation locking means 8 (here tightening/loosening of the tightening member 71).
  • the removable operating means 4 can here be temporarily attached for the implementation of the step of creating the distraction, then can be removed following the step of maintaining the distraction.
  • the cam 41 is operated in rotation, preferably to the end of rotation position, to generate the desired distraction.
  • the distraction maintenance step is here ensured by the two stop screws 51 which are operated successively: - the axial stop screw 51, to maintain the distraction applied, then
  • the cam 41 can in particular be removed after tightening the axial stop screw 51.
  • the axial operating screw 45 is operated in rotation, preferably in the face, to generate the desired distraction.
  • the distraction maintenance step is here ensured by a combined action of the axial operating screw 45 and the lateral stop screw 52, intervening in the locking of the translational play.
  • the step of maintaining the distraction is still ensured by the implementation of the additional securing means 55.
  • these complementary securing means 55 provide a spacer (or strut) function between the two bones S1, S2 forming the joint A.
  • the method may comprise a prior surgical operation applied to at least one of the bones S1, S2 forming the joint A, for example a fracture osteosynthesis or a corrective osteotomy.
  • a preliminary surgical operation C (for example a fracture osteosynthesis or a corrective osteotomy) is performed on the first bone S1 of the joint A (advantageously a tibia for the knee).
  • This preliminary surgical operation is stabilized by the implantation of the second securing means 22 on the first bone S1 (figure 13, part A).
  • the other components of the orthopedic distraction device 1 are then reported to carry out the step of positioning and securing the orthopedic distraction device 1 with the bones S forming the joint A (figure 13, part B).
  • the proximal end 321 of the second arm 32 is secured to the second securing means 22 secured to the first bone S1 by means of the assembly means 7, 9.
  • the first securing means 21 carrying the first arm 31 are secured to the second bone S2.
  • the orthopedic distraction device 1 is intended to be subjected to an ablation procedure.
  • the ablation process is performed in the reverse order to the orthopedic distraction process 1:

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Abstract

The present invention relates to an orthopaedic distraction device for distraction of a patient's joint (A), which comprises: - securing means (2), for securing said orthopaedic distraction device (1) to the bones (S) that make up said joint (A), - telescopic connecting means (3), connecting said securing means (2) and defining a degree of freedom in translational movement (T), - manoeuvring means (4), suitable for generating a manoeuvre of spacing said securing means (2) apart, and - locking means (5), suitable for locking said telescopic connecting means (3) in terms of translation after said distraction has been created.

Description

Dispositif de distraction orthopédique, pour la distraction d’une articulation d’un patient, avantageusement du genou Orthopedic distraction device, for the distraction of a patient's joint, advantageously the knee

Domaine technique de l'invention Technical field of the invention

La présente invention concerne le domaine technique des dispositifs orthopédiques. The present invention relates to the technical field of orthopedic devices.

Elle concerne en particulier les dispositifs de distraction orthopédique qui sont adaptés à la distraction d’une articulation d’un patient, avantageusement du genou. It particularly concerns orthopedic distraction devices which are suitable for the distraction of a patient's joint, advantageously the knee.

Etat de la technique State of the art

L’arthrose d’une articulation, en particulier du genou, est une maladie dégénérative articulaire qui se caractérise par des douleurs persistantes et qui peut conduire à une perte de fonction. Osteoarthritis of a joint, particularly the knee, is a degenerative joint disease that is characterized by persistent pain and can lead to loss of function.

Les options de traitement sont actuellement limitées. Et les traitements standards ne peuvent que ralentir la maladie. Treatment options are currently limited. And standard treatments can only slow the disease.

Dans ce contexte, cette maladie conduit généralement à une chirurgie pour remplacement prothétique de l’articulation (par exemple lors d’une dégénérescence articulaire bicompartimentale). In this context, this disease usually leads to surgery for prosthetic replacement of the joint (for example in bicompartmental joint degeneration).

Il existe ainsi un intérêt certain pour des traitements chirurgicaux susceptibles de sauvegarder les articulations, en particulier chez les patients jeunes atteints d’arthrose du genou. There is therefore a definite interest in surgical treatments likely to save joints, particularly in young patients with knee osteoarthritis.

Dans ce cadre, la distraction articulaire pourrait consister une solution intéressante en ce qu’elle améliore l’homéostasie articulaire par une décharge mécanique provisoire de l’articulation. In this context, joint distraction could be an interesting solution in that it improves joint homeostasis by temporary mechanical unloading of the joint.

Mais les dispositifs de distraction orthopédique actuels présentent divers inconvénients pour obtenir cette distraction, à savoir notamment un encombrement important, un inconfort important pour le patient, un agencement externe (conduisant à un taux d’infection important en raison des broches percutanées) et une complexité de pose pour le chirurgien orthopédiste. However, current orthopedic distraction devices have various drawbacks for achieving this distraction, including significant bulk, significant discomfort for the patient, external arrangement (leading to a high infection rate due to the percutaneous pins) and complexity of installation for the orthopedic surgeon.

Présentation de l'invention Presentation of the invention

Afin de remédier aux inconvénients précités de l’état de la technique, la présente invention propose un dispositif de distraction orthopédique, pour la distraction d’une articulation d’un patient, avantageusement du genou. In order to remedy the aforementioned drawbacks of the state of the art, the present invention proposes an orthopedic distraction device, for the distraction of a patient's joint, advantageously the knee.

Le dispositif de distraction orthopédique selon l’invention, avantageusement interne ou externe, comprend : The orthopedic distraction device according to the invention, advantageously internal or external, comprises:

- des moyens de solidarisation, pour la solidarisation dudit dispositif de distraction orthopédique avec les os formant ladite articulation, lesquels moyens de solidarisation comprennent des premiers moyens de solidarisation pour la solidarisation avec au moins un premier os de ladite articulation, avantageusement un tibia, et des seconds moyens de solidarisation pour la solidarisation avec au moins un second os de ladite articulation, avantageusement un fémur, - des moyens de liaison télescopique, reliant lesdits moyens de solidarisation et définissant un degré de liberté en translation entre lesdits moyens de solidarisation, - securing means, for securing said orthopedic distraction device with the bones forming said joint, which securing means comprise first securing means for securing with at least one first bone of said joint, advantageously a tibia, and second securing means for securing with at least one second bone of said joint, advantageously a femur, - telescopic connecting means, connecting said securing means and defining a degree of freedom in translation between said securing means,

- des moyens de manœuvre, adaptés à générer une manœuvre en écartement entre lesdits moyens de solidarisation selon ledit degré de liberté en translation pour créer une distraction entre les os de ladite articulation, et - maneuvering means, adapted to generate a separation maneuver between said securing means according to said degree of freedom in translation to create a distraction between the bones of said joint, and

- des moyens de verrouillage, adaptés à verrouiller en translation lesdits moyens de liaison télescopique après la création de ladite distraction. - locking means, adapted to lock in translation said telescopic connection means after the creation of said distraction.

Un tel dispositif de distraction orthopédique selon l’invention présente différents avantages, à savoir notamment un encombrement réduit, un confort amélioré pour le patient, une possibilité d’agencement polyvalent (éventuellement externe et de préférence interne ce qui permet de supprimer les risques d’infection liés aux broches percutanées) et une facilité de pose pour le chirurgien orthopédiste. Such an orthopedic distraction device according to the invention has various advantages, namely in particular reduced bulk, improved comfort for the patient, a possibility of versatile arrangement (possibly external and preferably internal which makes it possible to eliminate the risks of infection linked to percutaneous pins) and ease of installation for the orthopedic surgeon.

D’autres caractéristiques non limitatives et avantageuses du produit conforme à l’invention, prises individuellement ou selon toutes les combinaisons techniquement possibles, sont les suivantes : Other non-limiting and advantageous characteristics of the product according to the invention, taken individually or in all technically possible combinations, are as follows:

- les moyens de liaison télescopique comprennent au moins deux bras qui forment ensemble une glissière définissant ledit degré de liberté en translation, lesquels bras comportent chacun une extrémité proximale qui est reliée avec l’un desdits moyens de solidarisation ; de préférence, lesdits au moins deux bras comprennent un premier bras, comportant une paroi tubulaire qui définit un logement allongé débouchant au niveau d’une ouverture, et un second bras, rapporté dans ledit logement allongé au travers de ladite ouverture et guidé en translation le long dudit logement allongé ; de préférence encore, les moyens de verrouillage comprennent au moins une vis de butée qui est guidée en translation sur l’un desdits bras et qui coopère avec l’autre desdits bras pour assurer ledit verrouillage, avantageusement parmi une vis de butée axiale, pour maintenir la distraction, de préférence implantée parallèlement au degré de liberté en translation, avantageusement dans un fond du logement allongé situé à l’opposé de l’ouverture, et une vis de butée latérale, pour verrouiller le jeu en translation, de préférence implantée perpendiculairement au degré de liberté en translation, avantageusement dans la paroi tubulaire du premier bras ; les moyens de manœuvre comprennent avantageusement une came, amovible et libre en rotation, pour générer un déplacement relatif desdits bras par un mouvement de rotation ; de préférence, la came amovible est assemblée sur un second bras et coopère avec un premier bras ; de préférence encore, la came amovible est assemblée sur le second bras, de préférence au niveau de son extrémité proximale, et coopère avec la paroi tubulaire du premier bras, du côté de son ouverture ; les moyens de manœuvre comprennent avantageusement des moyens de butées, pour définir la position de fin de course en rotation de ladite came, par exemple un couple d’ergots dont un premier ergot porté par ladite came et un second ergot porté par la paroi tubulaire du premier bras ; de manière alternative et/ou complémentaire, les moyens de manœuvre comprennent une vis de manœuvre axiale qui est guidée en translation sur l’un desdits bras, parallèlement au degré de liberté en translation (avantageusement dans un fond du logement allongé situé à l’opposé de l’ouverture), et qui coopère avec l’autre desdits bras pour assurer la manœuvre en écartement ; - the telescopic connecting means comprise at least two arms which together form a slide defining said degree of freedom in translation, which arms each comprise a proximal end which is connected to one of said securing means; preferably, said at least two arms comprise a first arm, comprising a tubular wall which defines an elongated housing opening at an opening, and a second arm, attached to said elongated housing through said opening and guided in translation along said elongated housing; more preferably, the locking means comprise at least one stop screw which is guided in translation on one of said arms and which cooperates with the other of said arms to ensure said locking, advantageously among an axial stop screw, to maintain the distraction, preferably implanted parallel to the degree of freedom in translation, advantageously in a bottom of the elongated housing located opposite the opening, and a lateral stop screw, to lock the translational play, preferably implanted perpendicular to the degree of freedom in translation, advantageously in the tubular wall of the first arm; the operating means advantageously comprise a cam, removable and free to rotate, to generate a relative movement of said arms by a rotational movement; preferably, the removable cam is assembled on a second arm and cooperates with a first arm; more preferably, the removable cam is assembled on the second arm, preferably at its proximal end, and cooperates with the tubular wall of the first arm, on the side of its opening; the operating means advantageously comprise stop means, to define the end-of-rotation position of said cam, for example a pair of lugs including a first lug carried by said cam and a second lug carried by the tubular wall of the first arm; alternatively and/or complementary, the operating means comprise an axial operating screw which is guided in translation on one of said arms, parallel to the degree of freedom in translation (advantageously in a bottom of the elongated housing located opposite the opening), and which cooperates with the other of said arms to ensure the spacing operation;

- les moyens de verrouillage comprennent des moyens de solidarisation complémentaire formant entretoise, qui sont structurés pour ponter l’articulation et pour venir se fixer sur un os opposé de ladite articulation. - the locking means comprise complementary securing means forming a spacer, which are structured to bridge the joint and to be fixed to an opposite bone of said joint.

- les moyens de solidarisation consistent en deux plaques d’ostéosynthèse, à savoir une première plaque d’ostéosynthèse, formant les premiers moyens de solidarisation destinés à être solidarisée avec le premier os de ladite articulation, et une seconde plaque d’ostéosynthèse, formant les seconds moyens de solidarisation destinés à être solidarisée avec le second os de ladite articulation, lesquelles plaques d’ostéosynthèse comportent avantageusement des orifices adaptés à la mise en place de vis de fixation ; de préférence, l’extrémité proximale d’un bras est monobloc avec la plaque d’ostéosynthèse associée, ou assemblée avec la plaque d’ostéosynthèse, par exemple par vissage ; - the securing means consist of two osteosynthesis plates, namely a first osteosynthesis plate, forming the first securing means intended to be secured to the first bone of said joint, and a second osteosynthesis plate, forming the second securing means intended to be secured to the second bone of said joint, which osteosynthesis plates advantageously comprise orifices suitable for the installation of fixing screws; preferably, the proximal end of an arm is in one piece with the associated osteosynthesis plate, or assembled with the osteosynthesis plate, for example by screwing;

- le dispositif de distraction orthopédique comprend des moyens d’angulation pour conférer un degré de liberté en rotation entre lesdits moyens de solidarisation, perpendiculairement audit degré de liberté en translation, afin d’autoriser une distraction avec l’articulation fléchie ; les moyens d’angulation comprennent avantageusement des moyens d’articulation qui sont ménagés entre l’un des moyens de solidarisation et les moyens de liaison télescopique, et des moyens de verrouillage en rotation, adaptés à verrouiller en rotation lesdits moyens d’articulation après ajustement de ladite angulation, par exemple sous la forme de couronnes dentées complémentaires associées à un organe de serrage. - the orthopedic distraction device comprises angulation means for providing a degree of freedom in rotation between said securing means, perpendicular to said degree of freedom in translation, in order to allow distraction with the flexed joint; the angulation means advantageously comprise articulation means which are provided between one of the securing means and the telescopic connection means, and rotation locking means, adapted to lock said articulation means in rotation after adjustment of said angulation, for example in the form of complementary toothed crowns associated with a clamping member.

La présente invention concerne également le procédé de distraction orthopédique, par la mise en œuvre d’un dispositif de distraction orthopédique selon l’invention, lequel procédé comprend : The present invention also relates to the method of orthopedic distraction, by implementing an orthopedic distraction device according to the invention, which method comprises:

- une opération préalable chirurgicale appliquée sur l’un au moins des os formant ladite articulation, - a prior surgical operation applied to at least one of the bones forming said joint,

- une étape de positionnement et de solidarisation dudit dispositif de distraction orthopédique avec les os formant ladite articulation, - a step of positioning and securing said orthopedic distraction device with the bones forming said joint,

- éventuellement une étape d’angulation entre les moyens de solidarisation, - possibly an angulation step between the means of solidarity,

- une étape de création de la distraction par la mise en œuvre des moyens de manœuvre qui provoque une manœuvre en écartement des moyens de solidarisation, - a step of creating the distraction by implementing the maneuvering means which causes a maneuver to separate the securing means,

- une étape de maintien de la distraction, par la mise en œuvre des moyens de verrouillage. Bien entendu, les différentes caractéristiques, variantes et formes de réalisation de l'invention peuvent être associées les unes avec les autres selon diverses combinaisons dans la mesure où elles ne sont pas incompatibles ou exclusives les unes des autres. - a step of maintaining the distraction, by implementing locking means. Of course, the various features, variants and embodiments of the invention may be combined with each other in various combinations to the extent that they are not incompatible or mutually exclusive.

Description détaillée de l'invention Detailed description of the invention

De plus, diverses autres caractéristiques de l'invention ressortent de la description annexée effectuée en référence aux dessins qui illustrent des formes, non limitatives, de réalisation de l'invention et où : In addition, various other characteristics of the invention emerge from the appended description given with reference to the drawings which illustrate non-limiting embodiments of the invention and where:

[Fig. 1] est une vue générale d’un premier dispositif de distraction orthopédique selon l’invention ; [Fig. 1] is a general view of a first orthopedic distraction device according to the invention;

[Fig. 2] est une vue une vue générale, en éclaté, du premier dispositif de distraction orthopédique selon la figure 1 ; [Fig. 2] is a general exploded view of the first orthopedic distraction device according to FIG. 1;

[Fig. 3] est une vue générale d’une première partie du dispositif de distraction orthopédique selon la figure 1 , à savoir un premier bras (comportant un logement allongé) avec sa plaque d’ostéosynthèse destinée à être solidarisée ici avec le tibia ; [Fig. 3] is a general view of a first part of the orthopedic distraction device according to figure 1, namely a first arm (comprising an elongated housing) with its osteosynthesis plate intended to be secured here to the tibia;

[Fig. 4] est une vue générale d’une seconde partie du dispositif de distraction orthopédique selon la figure 1 , à savoir un second bras (destiné à être rapporté dans le logement allongé) avec sa plaque d’ostéosynthèse destinée à être solidarisée ici avec le fémur ; [Fig. 4] is a general view of a second part of the orthopedic distraction device according to figure 1, namely a second arm (intended to be attached to the elongated housing) with its osteosynthesis plate intended to be secured here to the femur;

[Fig. 5] est une vue générale, en perspective, du dispositif de distraction orthopédique selon la figure 1 , solidarisé avec les os formant l’articulation et préalablement à l’étape de création de la distraction ; [Fig. 5] is a general view, in perspective, of the orthopedic distraction device according to figure 1, secured to the bones forming the joint and prior to the step of creating the distraction;

[Fig. 6] est une vue générale, de face, du dispositif de distraction orthopédique selon la figure 5 ; [Fig. 6] is a general front view of the orthopedic distraction device according to Figure 5;

[Fig. 7] est une vue générale du dispositif de distraction orthopédique selon la figure 1 , solidarisé avec les os formant l’articulation et suite à l’étape de création de la distraction ; [Fig. 7] is a general view of the orthopedic distraction device according to Figure 1, secured to the bones forming the joint and following the distraction creation step;

[Fig. 8] est une vue générale d’un second dispositif de distraction orthopédique selon l’invention ; [Fig. 8] is a general view of a second orthopedic distraction device according to the invention;

[Fig. 9] est une vue une vue générale, en éclaté, du second dispositif de distraction orthopédique selon la figure 8 ; [Fig. 9] is a general exploded view of the second orthopedic distraction device according to FIG. 8;

[Fig. 10] est une vue générale du dispositif de distraction orthopédique selon la figure 8, solidarisé avec les os formant l’articulation ; [Fig. 10] is a general view of the orthopedic distraction device according to Figure 8, secured to the bones forming the joint;

[Fig. 11] est une vue générale d’un troisième dispositif de distraction orthopédique selon l’invention ; [Fig. 11] is a general view of a third orthopedic distraction device according to the invention;

[Fig. 12] est une vue une vue générale, en éclaté, du troisième dispositif de distraction orthopédique selon la figure 11 ; [Fig. 13] est une vue générale du dispositif de distraction orthopédique selon les figures 11 et 12, solidarisé avec les os formant l’articulation, montant l’implantation avant distraction (partie A.) et après distraction (partie B.) ; [Fig. 12] is a general exploded view of the third orthopedic distraction device according to FIG. 11; [Fig. 13] is a general view of the orthopedic distraction device according to Figures 11 and 12, secured to the bones forming the joint, showing the implantation before distraction (part A.) and after distraction (part B.);

[Fig. 14] est une vue générale d’un quatrième dispositif de distraction orthopédique selon l’invention, se distinguant du second dispositif de distraction orthopédique par des moyens de solidarisation complémentaire formant entretoise. [Fig. 14] is a general view of a fourth orthopedic distraction device according to the invention, distinguished from the second orthopedic distraction device by additional securing means forming a spacer.

Il est à noter que, sur ces figures, les éléments structurels et/ou fonctionnels communs aux différentes variantes peuvent présenter les mêmes références. It should be noted that, in these figures, the structural and/or functional elements common to the different variants may have the same references.

Tel que décrit ci-après en lien avec les figures, la présente invention concerne donc un dispositif de distraction orthopédique 1 qui est conçu pour la distraction d’une articulation A d’un patient, avantageusement du genou. As described below in connection with the figures, the present invention therefore relates to an orthopedic distraction device 1 which is designed for the distraction of a joint A of a patient, advantageously of the knee.

Par « distraction », on entend une décharge mécanique provisoire de l’articulation A en créant un écartement entre les deux os S formant cette articulation A. By "distraction" we mean a temporary mechanical unloading of the joint A by creating a separation between the two bones S forming this joint A.

Par exemple, tel qu’illustré sur les figures 5 à 7 ou la figure 10 dans le cas du genou, la distraction provisoire est mise en œuvre entre le tibia S1 et le fémur S2, avantageusement avec une cote en écartement de l’ordre de 5 mm et maintenue entre 6 à 8 semaines. For example, as illustrated in Figures 5 to 7 or Figure 10 in the case of the knee, temporary distraction is implemented between the tibia S1 and the femur S2, advantageously with a spacing dimension of the order of 5 mm and maintained for between 6 and 8 weeks.

En l’espèce, le dispositif de distraction orthopédique 1 consiste avantageusement en un dispositif de distraction orthopédique 1 chirurgical ou implantable. In this case, the orthopedic distraction device 1 advantageously consists of a surgical or implantable orthopedic distraction device 1.

Le dispositif de distraction orthopédique 1 est ici interne, avantageusement implanté sous la peau et les tissus mous du patient, ce qui permet de supprimer le risque d’infection en lien avec des broches percutanées. The orthopedic distraction device 1 is here internal, advantageously implanted under the skin and soft tissues of the patient, which eliminates the risk of infection linked to percutaneous pins.

De manière alternative, le dispositif de distraction orthopédique 1 est externe, avantageusement positionné à l’extérieur de la peau du patient, avec des moyens de solidarisation destinés à être implantées à travers la peau et les tissus mous. Alternatively, the orthopedic distraction device 1 is external, advantageously positioned outside the patient's skin, with securing means intended to be implanted through the skin and soft tissues.

De manière générale, selon l’invention, le dispositif de distraction orthopédique 1 comprend : Generally speaking, according to the invention, the orthopedic distraction device 1 comprises:

- des moyens de solidarisation 2, pour la solidarisation du dispositif de distraction orthopédique 1 avec les os S formant l’articulation A, - securing means 2, for securing the orthopedic distraction device 1 with the bones S forming the joint A,

- des moyens de liaison télescopique 3, reliant les moyens de solidarisation 2 et définissant un degré de liberté en translation T entre les moyens de solidarisation 2, - telescopic connecting means 3, connecting the securing means 2 and defining a degree of freedom in translation T between the securing means 2,

- des moyens de manœuvre 4, adaptés à générer une manœuvre en écartement entre les moyens de solidarisation 2 selon le degré de liberté en translation T pour créer la distraction entre les os S de l’articulation A, et - maneuvering means 4, adapted to generate a separation maneuver between the securing means 2 according to the degree of freedom in translation T to create distraction between the bones S of the joint A, and

- des moyens de verrouillage 5, adaptés à verrouiller en translation les moyens de liaison télescopique 3 après la création de la distraction recherchée. En particulier, le degré de liberté en translation T s’étend avantageusement perpendiculairement par rapport à l’axe de pliage de l’articulation A ou par rapport à l’interligne articulaire. - locking means 5, adapted to lock in translation the telescopic connection means 3 after the creation of the desired distraction. In particular, the degree of freedom in translation T advantageously extends perpendicularly to the folding axis of the joint A or to the joint space.

Moyens de solidarisation Means of solidarity

Les moyens de solidarisation 2 comprennent : The means of solidarity 2 include:

- des premiers moyens de solidarisation 21 pour la solidarisation avec au moins un premier os S1 de l’articulation A (avantageusement un tibia pour le genou), et - first means of securing 21 for securing with at least one first bone S1 of the joint A (advantageously a tibia for the knee), and

- des seconds moyens de solidarisation 22 pour la solidarisation avec au moins un second os S2 de l’articulation A (avantageusement un fémur pour le genou). - second securing means 22 for securing with at least one second bone S2 of the joint A (advantageously a femur for the knee).

De préférence, les moyens de solidarisation 2 consistent en deux plaques d’ostéosynthèse 2, à savoir : Preferably, the securing means 2 consist of two osteosynthesis plates 2, namely:

- une première plaque d’ostéosynthèse 21 , formant les premiers moyens de solidarisation- a first osteosynthesis plate 21, forming the first means of attachment

21 destinés à être solidarisée avec au moins un premier os S1 de l’articulation A, et 21 intended to be secured with at least a first bone S1 of the joint A, and

- une seconde plaque d’ostéosynthèse 22, formant les seconds moyens de solidarisation- a second osteosynthesis plate 22, forming the second securing means

22 destinés à être solidarisée avec au moins un second os S2 de l’articulation A. 22 intended to be secured with at least a second bone S2 of the joint A.

De manière générale, pour le genou, les premiers moyens de solidarisation 21 sont adaptés à une solidarisation avec le tibia, formant des moyens de solidarisation 21 tibiale ; et les seconds moyens de solidarisation 22 sont adaptés à une solidarisation avec le fémur, formant des moyens de solidarisation 22 fémorale. Generally, for the knee, the first securing means 21 are adapted to securing with the tibia, forming tibial securing means 21; and the second securing means 22 are adapted to securing with the femur, forming femoral securing means 22.

De manière alternative, comme illustré sur les figures 8 et suivantes, les moyens de solidarisation 2 sont adaptés à un montage inversé par rapport aux figures 5 et suivante : Alternatively, as illustrated in Figures 8 et seq., the securing means 2 are adapted to an inverted assembly compared to Figures 5 et seq.:

- les premiers moyens de solidarisation 21 sont adaptés à une solidarisation avec un premier os S1 qui est ici le fémur, formant des moyens de solidarisation 21 fémorale, et - the first securing means 21 are adapted to securing with a first bone S1 which is here the femur, forming femoral securing means 21, and

- les seconds moyens de solidarisation 22 sont adaptés à une solidarisation avec un second os S1 qui est ici le tibia, formant des moyens de solidarisation 22 tibiale. - the second securing means 22 are adapted for securing with a second bone S1 which is here the tibia, forming tibial securing means 22.

De manière générale, les plaques d’ostéosynthèse 2 comportent avantageusement des orifices 23 adaptés à la mise en place de vis de fixation V dans l’os S. Generally speaking, the osteosynthesis plates 2 advantageously include orifices 23 adapted to the placement of fixing screws V in the bone S.

De préférence, les orifices 23 sont agencés de sorte que les vis de fixation V préservent les surfaces articulaires et que les vis de fixation V divergent pour augmenter la force d’ancrage. Preferably, the holes 23 are arranged so that the fixing screws V preserve the articular surfaces and the fixing screws V diverge to increase the anchoring force.

De manière classique en soi, de telles plaques d’ostéosynthèse 2 comportent : In a classic manner, such osteosynthesis plates 2 comprise:

- une face arrière, avantageusement anatomique et destinée à venir en contact avec l’os, et - a rear face, advantageously anatomical and intended to come into contact with the bone, and

- une face avant, opposée. - a front, opposite face.

L’épaisseur d’une telle plaque d’ostéosynthèse 2 est avantageusement de quelques millimètres. Encore de manière générale, tel qu’illustré notamment sur les figures 5 à 7, les moyens de solidarisation 2 sont avantageusement conformés pour une fixation sur les faces médiale et/ou latérale et/ou antéromédiale et/ou antérieure des os S de l’articulation A. The thickness of such an osteosynthesis plate 2 is advantageously a few millimeters. Again in general, as illustrated in particular in figures 5 to 7, the securing means 2 are advantageously shaped for fixing on the medial and/or lateral and/or anteromedial and/or anterior faces of the bones S of the joint A.

Moyens de liaison télescopique Telescopic connecting means

Les moyens de liaison télescopique 3 comprennent avantageusement au moins deux bras 31 , 32 qui forment ensemble une glissière définissant le degré de liberté en translation T. The telescopic connecting means 3 advantageously comprise at least two arms 31, 32 which together form a slide defining the degree of freedom in translation T.

Les bras 31 , 32 comportent chacun une extrémité proximale 311 , 321 qui est reliée (ou raccordée) avec l’un des moyens de solidarisation 2. The arms 31, 32 each have a proximal end 311, 321 which is connected (or coupled) with one of the securing means 2.

En l’espèce, un premier bras 31 coopère avec les premiers moyens de solidarisation 21 (figures 2 et 3, ou encore figures 8 et suivantes). In this case, a first arm 31 cooperates with the first securing means 21 (figures 2 and 3, or figures 8 and following).

Le premier bras 31 (avantageusement en forme de manchon ou fourreau) comporte avantageusement une paroi tubulaire 313 qui définit un logement allongé 314, avantageusement un logement borgne, débouchant au niveau d’une ouverture 315. The first arm 31 (advantageously in the form of a sleeve or sheath) advantageously comprises a tubular wall 313 which defines an elongated housing 314, advantageously a blind housing, opening at an opening 315.

Le logement allongé 314 consiste avantageusement un logement borgne, comportant un fond 316 situé à l’opposé de l’ouverture 315. The elongated housing 314 advantageously consists of a blind housing, comprising a bottom 316 located opposite the opening 315.

Le logement allongé 314 s’étend avantageusement coaxialement par rapport au degré de liberté en translation T. The elongated housing 314 advantageously extends coaxially with respect to the degree of freedom in translation T.

Un second bras 32, coopérant avec les seconds moyens de solidarisation 22, est visible plus en détails sur les figures 2 et 4 ou encore sur les figures 8 et suivantes. A second arm 32, cooperating with the second securing means 22, is visible in more detail in figures 2 and 4 or in figures 8 and following.

Le second bras 32 est destiné à être rapporté dans le logement allongé 314 du premier bras 31 , au travers de son ouverture 315 et guidé en translation le long du logement allongé 314 (coaxialement au degré de liberté en translation T). The second arm 32 is intended to be attached to the elongated housing 314 of the first arm 31, through its opening 315 and guided in translation along the elongated housing 314 (coaxially to the degree of freedom in translation T).

En particulier, la section transversale du second bras 32 correspond, au jeu près, à la section transversale du logement allongé 314 du premier bras 31 de manière à assurer le guidage en translation relatif entre ces deux bras 31 , 32 selon le degré de liberté en translation T. In particular, the cross section of the second arm 32 corresponds, apart from the clearance, to the cross section of the elongated housing 314 of the first arm 31 so as to ensure relative translational guidance between these two arms 31, 32 according to the degree of freedom in translation T.

En outre, le second bras 32 comporte avantageusement un marquage visuel 325 qui est intéressant pour observer / mesurer le déplacement de ce second bras 32 par rapport à l’ouverture 315 du premier bras 31 , correspondant à la distraction appliquée à l’articulation A. Furthermore, the second arm 32 advantageously comprises a visual marking 325 which is useful for observing/measuring the movement of this second arm 32 relative to the opening 315 of the first arm 31, corresponding to the distraction applied to the joint A.

De manière générale, pour le genou, le premier bras 31 coopère par exemple avec des premiers moyens de solidarisation 21 « tibiale » et le second bras 32 coopère avec des seconds moyens de solidarisation 22 « fémorale » (figures 1 à 7 par exemple). Generally speaking, for the knee, the first arm 31 cooperates for example with first “tibial” securing means 21 and the second arm 32 cooperates with second “femoral” securing means 22 (figures 1 to 7 for example).

De manière alternative, dans le cas d’un montage inverse à celui illustré sur les figures 5 et suivantes (figures 8 et suivantes), le premier bras 31 coopère avec des premiers moyens de solidarisation 21 « fémorale » et le second bras 32 coopère avec des seconds moyens de solidarisation 22 « tibiale ». De manière générale, les moyens de liaison télescopique 3 peuvent réalisés monoblocs (figures 9 à 11), ou assemblés (figures 1 à 8 ou figures 11 et 12), avec les moyens de solidarisation 2. Alternatively, in the case of an assembly opposite to that illustrated in figures 5 and following (figures 8 and following), the first arm 31 cooperates with first “femoral” securing means 21 and the second arm 32 cooperates with second “tibial” securing means 22. Generally speaking, the telescopic connecting means 3 can be made in one piece (figures 9 to 11), or assembled (figures 1 to 8 or figures 11 and 12), with the securing means 2.

En pratique, l’extrémité proximale 311 , 321 d’un bras 31 , 32 est avantageusement : In practice, the proximal end 311, 321 of an arm 31, 32 is advantageously:

- monobloc avec la plaque d’ostéosynthèse 21 , 22 associée (figures 9 à 11), ou - monobloc with the associated osteosynthesis plate 21, 22 (figures 9 to 11), or

- assemblée avec la plaque d’ostéosynthèse 21 , 22 associée, par exemple par vissage (figures 1 à 8 ou figures 11 et 12). - assembled with the associated osteosynthesis plate 21, 22, for example by screwing (figures 1 to 8 or figures 11 and 12).

Par exemple, selon les figures 1 à 7 ou 11 et 12, l’extrémité proximale 311 du premier bras 31 est monobloc avec la première plaque d’ostéosynthèse 21. L’extrémité proximale 321 du second bras 32 est assemblée avec la seconde plaque d’ostéosynthèse 22 associée. For example, according to FIGS. 1 to 7 or 11 and 12, the proximal end 311 of the first arm 31 is in one piece with the first osteosynthesis plate 21. The proximal end 321 of the second arm 32 is assembled with the associated second osteosynthesis plate 22.

De manière générale, les moyens d’assemblage 7, 9 (entre l’extrémité proximale 321 du second bras 32 et la seconde plaque d’ostéosynthèse 22 associée) sont avantageusement choisis parmi : Generally speaking, the assembly means 7, 9 (between the proximal end 321 of the second arm 32 and the second associated osteosynthesis plate 22) are advantageously chosen from:

- des moyens d’articulation 7 formant partie de moyens d'angulation 6 décrits par la suite en lien avec les figures 1 à 7, conférant un degré de liberté en rotation entre l’extrémité proximale 321 du second bras 32 et la seconde plaque d’ostéosynthèse 22 associée, ou - articulation means 7 forming part of angulation means 6 described below in connection with figures 1 to 7, conferring a degree of freedom in rotation between the proximal end 321 of the second arm 32 and the associated second osteosynthesis plate 22, or

- des moyens d’assemblage 9 fixe, décrits par la suite en lien avec les figures 11 à 13, définissant une position angulaire précise entre le second bras 32 et la seconde plaque d’ostéosynthèse 22 associée. - fixed assembly means 9, described below in connection with figures 11 to 13, defining a precise angular position between the second arm 32 and the second associated osteosynthesis plate 22.

Pour le mode de réalisation « moyens d’assemblage 9 fixe », la seconde plaque d’ostéosynthèse 22 comporte avantageusement un emplacement 225 destiné à recevoir l’extrémité proximale 321 du second bras 32 et à assurer le verrouillage angulaire de ce second bras 32. For the “fixed assembly means 9” embodiment, the second osteosynthesis plate 22 advantageously comprises a location 225 intended to receive the proximal end 321 of the second arm 32 and to ensure the angular locking of this second arm 32.

De manière générale, pour effectuer l’assemblage, l’extrémité proximale 321 du second bras 32 est avantageusement : Generally speaking, to carry out the assembly, the proximal end 321 of the second arm 32 is advantageously:

- superposée avec une face avant de la seconde plaque d’ostéosynthèse 22, puis - superimposed with a front face of the second osteosynthesis plate 22, then

- assemblée par un organe de serrage 71 , 91 , par exemple une vis, qui est rapporté au travers d’un couple d’orifices 72, 92 alignés qui sont ménagés respectivement dans le bras 32 (au niveau de son extrémité proximale 321) et dans la plaque d’ostéosynthèse 22 associée. - assembled by a clamping member 71, 91, for example a screw, which is attached through a pair of aligned orifices 72, 92 which are provided respectively in the arm 32 (at its proximal end 321) and in the associated osteosynthesis plate 22.

Selon le mode de réalisation illustré sur les figures 1 à 7 ou les figures 11 et 12, la seconde plaque d’ostéosynthèse 22 consiste de préférence en une plaque d’ostéosynthèse adaptée à être rapportée sur un os S1 postérieurement à une procédure chirurgicale appliquée audit os S2 (par exemple une ostéosynthèse de fracture ou une ostéotomie de correction, tel qu’illustré sur la figure 13). De manière alternative, selon les figures 8 à 10, l’extrémité proximale 311 du premier bras 31 est monobloc avec la première plaque d’ostéosynthèse 21. L’extrémité proximale 321 du second bras 32 est monobloc avec la seconde plaque d’ostéosynthèse 22 associée. According to the embodiment illustrated in FIGS. 1 to 7 or FIGS. 11 and 12, the second osteosynthesis plate 22 preferably consists of an osteosynthesis plate adapted to be attached to a bone S1 after a surgical procedure applied to said bone S2 (for example a fracture osteosynthesis or a corrective osteotomy, as illustrated in FIG. 13). Alternatively, according to FIGS. 8 to 10, the proximal end 311 of the first arm 31 is in one piece with the first osteosynthesis plate 21. The proximal end 321 of the second arm 32 is in one piece with the associated second osteosynthesis plate 22.

Moyens de manœuyre Means of maneuver

Selon un premier mode de réalisation illustré sur les figures 1 à 7, les moyens de manœuvre 4 consistent avantageusement en une came 41 , ici amovible et libre en rotation, pour générer un déplacement relatif des bras 31 , 32 par son mouvement de rotation. According to a first embodiment illustrated in Figures 1 to 7, the operating means 4 advantageously consist of a cam 41, here removable and free to rotate, to generate a relative movement of the arms 31, 32 by its rotational movement.

De préférence, la came 41 , amovible, est assemblée temporairement sur le second bras 32, de préférence au niveau de son extrémité proximale 321. Preferably, the removable cam 41 is temporarily assembled on the second arm 32, preferably at its proximal end 321.

Et cette came 41 coopère avec la paroi tubulaire 313 du premier bras 31 , du côté de son ouverture 315. And this cam 41 cooperates with the tubular wall 313 of the first arm 31, on the side of its opening 315.

Une telle came 41 amovible est intéressante notamment pour limiter l’encombrement du dispositif de distraction orthopédique 1 , en particulier lorsqu’il est implanté en interne. Such a removable cam 41 is of particular interest for limiting the size of the orthopedic distraction device 1, in particular when it is implanted internally.

Cette structure « amovible » permet également de choisir la came 41 parmi une gamme de cames 41 qui présentent des valeurs de distraction respectives et qui permettent de tenir compte d’une éventuelle variation de longueur initiale au niveau des moyens de liaison télescopique 3. This “removable” structure also makes it possible to choose the cam 41 from a range of cams 41 which have respective distraction values and which make it possible to take into account a possible variation in initial length at the level of the telescopic connection means 3.

En l’espèce, la came 41 consiste avantageusement en une came du type à profil extérieur dont la rotation autour de son axe de rotation 4 T génère un effort radial (perpendiculaire à l’axe de rotation 4T) entre les bras 31 , 32. In this case, the cam 41 advantageously consists of a cam of the external profile type whose rotation around its axis of rotation 4 T generates a radial force (perpendicular to the axis of rotation 4T) between the arms 31, 32.

Pour cela, la came 41 comporte un profil extérieur 411 qui est courbe et qui s’écarte progressivement de l’axe de rotation 4T. For this, the cam 41 has an external profile 411 which is curved and which gradually moves away from the axis of rotation 4T.

Pour son guidage en rotation, la came 41 comporte avantageusement un tronçon cylindrique 412 qui est destiné à coopérer avec le second bras 32 pour définir le degré de liberté en rotation. For its rotational guidance, the cam 41 advantageously comprises a cylindrical section 412 which is intended to cooperate with the second arm 32 to define the degree of freedom in rotation.

En l’espèce, le tronçon cylindrique 412 est destiné à venir se loger au sein d’un logement situé au niveau de l’extrémité proximale 321 du second bras 32. In this case, the cylindrical section 412 is intended to be housed within a housing located at the proximal end 321 of the second arm 32.

Ce logement est ici formé par la tête femelle 711 de l’organe de serrage 71 précité. This housing is here formed by the female head 711 of the aforementioned clamping member 71.

Pour sa manœuvre en rotation, la came 41 comporte avantageusement un organe de préhension 413, ici centré sur l’axe de rotation 41’, adapté à coopérer avec un outil de manœuvre. For its rotational maneuver, the cam 41 advantageously comprises a gripping member 413, here centered on the axis of rotation 41', adapted to cooperate with an maneuvering tool.

Cet organe de préhension 413 se présente ici sous la forme d’une tête hexagonale. This gripping member 413 is presented here in the form of a hexagonal head.

De préférence encore, les moyens de manœuvre 4 comprennent des moyens de butées 42, pour définir la position de fin de course en rotation de la came 41 lors de la distraction. More preferably, the operating means 4 comprise stop means 42, for defining the end of rotation position of the cam 41 during distraction.

Par exemple, les moyens de butées 42 comprennent un couple d’ergots 421 , 422 destinés à coopérer dans la position de fin de course en rotation de la came 41. For example, the stop means 42 comprise a pair of lugs 421, 422 intended to cooperate in the end-of-rotation position of the cam 41.

En l’espèce, le couple d’ergots 421 , 422 comprend : In this case, the pair of lugs 421, 422 comprises:

- un premier ergot 421 porté par la came 41 , à l’extrémité de son profil extérieur 411 , et - un second ergot 422, ici saillant, porté par la paroi tubulaire 313 du premier bras 31 (du côté de l’ouverture 315). - a first lug 421 carried by the cam 41, at the end of its external profile 411, and - a second lug 422, here protruding, carried by the tubular wall 313 of the first arm 31 (on the side of the opening 315).

Le second ergot 422 prend ici en sandwich la came 41 (au niveau de son profil extérieur 411) avec le second bras 32 de sorte à participer au maintien de la came 41 lors de sa mise en rotation. En d’autres termes, le second ergot 422 définit une gorge avec le second bras 32 qui est destinée à recevoir et à guider le profil extérieure 411 , pour participer au maintien de la came 41. The second lug 422 here sandwiches the cam 41 (at its outer profile 411) with the second arm 32 so as to participate in maintaining the cam 41 when it is rotated. In other words, the second lug 422 defines a groove with the second arm 32 which is intended to receive and guide the outer profile 411, to participate in maintaining the cam 41.

Le second ergot 422 peut éventuellement servir de repère par rapport au marquage visuel 325, de sorte à vérifier la cote en distraction appliquée à l’articulation A. The second lug 422 can optionally serve as a reference point in relation to the visual marking 325, so as to check the distraction dimension applied to the joint A.

Selon un second mode de réalisation illustré en particulier sur les figures 8 et suivantes, les moyens de manœuvre 4 comprennent une vis de manœuvre axiale 45 qui est guidée en translation sur l’un des bras 31 , parallèlement au degré de liberté en translation T. According to a second embodiment illustrated in particular in figures 8 and following, the operating means 4 comprise an axial operating screw 45 which is guided in translation on one of the arms 31, parallel to the degree of freedom in translation T.

Une telle vis de manœuvre axiale 45 a l’intérêt de supprimer des instruments supplémentaires par rapport à une came 41 , simplifiant ainsi la technique opératoire. Such an axial operating screw 45 has the advantage of eliminating additional instruments compared to a cam 41, thus simplifying the operating technique.

De préférence, cette vis de manœuvre axiale 45 est implantée parallèlement au degré de liberté en translation T, avantageusement dans le fond 316 du logement allongé 314 du premier bras 31 . Preferably, this axial operating screw 45 is installed parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31.

De préférence, cette vis de manœuvre axiale 45 est destinée à cheminer en translation le long du degré de liberté en translation T. Preferably, this axial operating screw 45 is intended to travel in translation along the degree of freedom in translation T.

Cette vis de manœuvre axiale 45 comprend avantageusement deux extrémités (figure 9) :This axial operating screw 45 advantageously comprises two ends (figure 9):

- une première extrémité 451 , située au sein du logement allongé 314 et destinée à appuyer sur une paroi d’extrémité 323 du second bras 32 pour sa manœuvre en translation, et - a first end 451, located within the elongated housing 314 and intended to press on an end wall 323 of the second arm 32 for its translational maneuver, and

- une seconde extrémité 452, située à l’extérieur du logement allongé 314 et formant une tête de manœuvre en rotation. - a second end 452, located outside the elongated housing 314 and forming a rotating operating head.

De manière générale, la manœuvre en rotation de la vis de manœuvre axiale 45 (en vissage ou en dévissage) génère une manœuvre des bras 21 , 22 l’un par rapport à l’autre, conduisant à une manœuvre en écartement entre les moyens de solidarisation 2 selon le degré de liberté en translation T pour créer une distraction entre les os S de l’articulation A. Generally speaking, the rotational maneuver of the axial maneuver screw 45 (in screwing or unscrewing) generates a maneuver of the arms 21, 22 relative to each other, leading to a maneuver in separation between the securing means 2 according to the degree of freedom in translation T to create a distraction between the bones S of the joint A.

Moyens de verrouillage Locking means

Les moyens de verrouillage 5 comprennent avantageusement au moins une vis de butée 51 , 52 qui est guidée en translation sur l’un des bras 31 , 32 et qui est coopère avec l’autre des bras 31 , 32 pour assurer ce verrouillage. The locking means 5 advantageously comprise at least one stop screw 51, 52 which is guided in translation on one of the arms 31, 32 and which cooperates with the other of the arms 31, 32 to ensure this locking.

Par exemple, les moyens de verrouillage 5 comprennent au moins une vis de butée 51 , 52 parmi : For example, the locking means 5 comprise at least one stop screw 51, 52 among:

- une vis de butée axiale 51 , pour maintenir la distraction appliquée, et - an axial stop screw 51, to maintain the distraction applied, and

- une vis de butée latérale 52, pour verrouiller le jeu en translation. La vis de butée axiale 51 assure une butée de fin de course du premier bras 31 par rapport au second bras 32. - a lateral stop screw 52, to lock the translational play. The axial stop screw 51 provides an end-of-travel stop for the first arm 31 relative to the second arm 32.

De préférence, cette vis de butée 51 est implantée parallèlement au degré de liberté en translation T, avantageusement dans le fond 316 du logement allongé 314 du premier bras 31 pour servir de butée d’appui avec une paroi d’extrémité 323 du second bras 32. Preferably, this stop screw 51 is implanted parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31 to serve as a support stop with an end wall 323 of the second arm 32.

De manière générale, selon le premier mode de réalisation illustré sur les figures 1 à 7, la vis de butée 51 est avantageusement identique à la vis de manœuvre axiale 45 selon les figures 8 et suivante, pour former des moyens de manœuvre 4 adaptés à être manœuvrés en complément (ou combinaison) de la came 41 afin d’ajuster la distraction. Generally speaking, according to the first embodiment illustrated in Figures 1 to 7, the stop screw 51 is advantageously identical to the axial operating screw 45 according to Figures 8 and following, to form operating means 4 adapted to be operated in addition to (or in combination with) the cam 41 in order to adjust the distraction.

La vis de butée latérale 52 est quant à elle de préférence implantée perpendiculairement au degré de liberté en translation T. The lateral stop screw 52 is preferably installed perpendicular to the degree of freedom in translation T.

Cette vis de butée latérale 52 est par exemple implantée : This lateral stop screw 52 is for example implanted:

- dans la paroi tubulaire 313 du premier bras 31 , de sorte à venir exercer une compression sur une paroi latérale 324 du second bras 32 (figures 1 à 7), ou - in the tubular wall 313 of the first arm 31, so as to exert compression on a side wall 324 of the second arm 32 (figures 1 to 7), or

- dans le second bras 32, au sein d’un orifice traversant taraudé 327 de sorte à venir exercer une pression de frottement sur le premier bras 31 (figures 8 à 10). - in the second arm 32, within a threaded through orifice 327 so as to exert friction pressure on the first arm 31 (figures 8 to 10).

Pour une vis de butée latérale 52 portée par le second bras 32, ladite vis de butée latérale 52 comporte avantageusement : For a lateral stop screw 52 carried by the second arm 32, said lateral stop screw 52 advantageously comprises:

- une platine d’appui 521 , destinée à exercer la force de frottement sur la paroi tubulaire 313 du premier bras 31 , et - a support plate 521, intended to exert the friction force on the tubular wall 313 of the first arm 31, and

- une tête de manœuvre 522, avantageusement accessible au travers d’une fenêtre 317 ménagée dans la paroi tubulaire 313 du premier bras 31. - an operating head 522, advantageously accessible through a window 317 provided in the tubular wall 313 of the first arm 31.

De manière alternative ou complémentaire, tel qu’illustré sur la figure 14, les moyens de verrouillage 5 comprennent avantageusement des moyens de solidarisation complémentaire 55 formant entretoise, qui sont structurés pour ponter l’articulation A et pour venir se fixer sur un os S1 , S2 opposé de cette articulation A. Alternatively or additionally, as illustrated in FIG. 14, the locking means 5 advantageously comprise additional securing means 55 forming a spacer, which are structured to bridge the joint A and to be fixed to a bone S1, S2 opposite this joint A.

En d’autres termes, les moyens de solidarisation complémentaire 55 consistent avantageusement en une entretoise qui présente une longueur fixe et qui est solidarisée avec les deux os S1 , S2 formant l’articulation A. In other words, the complementary securing means 55 advantageously consist of a spacer which has a fixed length and which is secured to the two bones S1, S2 forming the joint A.

Tel que développé par la suite, cette fixation complémentaire est mise en œuvre après l’étape de distraction (après la translation). As developed later, this complementary fixation is implemented after the distraction step (after translation).

De tels moyens de solidarisation complémentaire 55 peuvent être mis en œuvre dans les différents modes de réalisation selon l’invention. Such complementary securing means 55 can be implemented in the different embodiments according to the invention.

En d’autres termes, les moyens de solidarisation complémentaire 55 comprennent avantageusement des moyens de solidarisation complémentaire 55, équipant : - les premiers moyens de solidarisation 21 et/ou le premier bras 31 coopérant avec un os S, pour la solidarisation avec un autre os S de l’articulation A (figure 14), et/ou In other words, the complementary securing means 55 advantageously comprise complementary securing means 55, equipping: - the first securing means 21 and/or the first arm 31 cooperating with a bone S, for securing with another bone S of the joint A (figure 14), and/or

- les seconds moyens de solidarisation 22 et/ou le second bras 32 coopérant avec un os S, pour la solidarisation avec un autre os S de l’articulation A (non représentés). - the second securing means 22 and/or the second arm 32 cooperating with a bone S, for securing with another bone S of the joint A (not shown).

Par exemple, tel qu’illustré sur la figure 14, les moyens de solidarisation complémentaire 55 s’étendent depuis le premier bras 31 coopérant avec un os S2, en particulier depuis sa paroi tubulaire 313. Ces moyens de solidarisation complémentaire 55 pontent l’articulation A et viennent se fixer sur un os S1 opposé de cette articulation A. For example, as illustrated in FIG. 14, the complementary securing means 55 extend from the first arm 31 cooperating with a bone S2, in particular from its tubular wall 313. These complementary securing means 55 bridge the joint A and are fixed to a bone S1 opposite this joint A.

Les moyens de solidarisation complémentaire 55 comprennent avantageusement au moins un bras 551 (ou une jambe de force), qui est destinée à enjamber ou ponter l’articulation A. The additional securing means 55 advantageously comprise at least one arm 551 (or a strut), which is intended to span or bridge the articulation A.

Ce bras 551 comporte avantageusement au moins un orifice 552 pour la mise en place d’une vis de fixation 553 venant se fixer sur le segment osseux opposé S1. This arm 551 advantageously comprises at least one orifice 552 for the installation of a fixing screw 553 which is fixed to the opposite bone segment S1.

Ce bras 551 présente avantageusement une longueur fixe. This arm 551 advantageously has a fixed length.

Ce bras 551 est de préférence divergeant par rapport au degré de liberté en translation T, depuis son extrémité amont 555 (ici monobloc avec le premier bras 31). This arm 551 is preferably divergent with respect to the degree of freedom in translation T, from its upstream end 555 (here in one piece with the first arm 31).

Moyens d’angulation Means of angulation

Encore selon l’invention, tel qu’illustré sur les figures 1 à 7, le dispositif de distraction orthopédique 1 comprend avantageusement des moyens d’angulation 6 pour conférer un degré de liberté en rotation entre les moyens de solidarisation 2, selon un axe de rotation R qui s’étend perpendiculairement au degré de liberté en translation T. Still according to the invention, as illustrated in Figures 1 to 7, the orthopedic distraction device 1 advantageously comprises angulation means 6 to provide a degree of freedom in rotation between the securing means 2, along an axis of rotation R which extends perpendicular to the degree of freedom in translation T.

Cette caractéristique technique autorise alors, si besoin, une distraction avec l’articulation A fléchie. This technical characteristic then allows, if necessary, distraction with the flexed A joint.

Selon un mode de réalisation préféré, illustré sur la figure 2, les moyens d’angulation 6 comprennent : According to a preferred embodiment, illustrated in FIG. 2, the angulation means 6 comprise:

- des moyens d’articulation 7 qui sont ménagés entre l’un des moyens de solidarisation 2 et les moyens de liaison télescopique 3, pour autoriser l’angulation relative autour de l’axe de rotation R, et - articulation means 7 which are provided between one of the securing means 2 and the telescopic connection means 3, to allow relative angulation around the axis of rotation R, and

- des moyens de verrouillage en rotation 8, adaptés à verrouiller en rotation les moyens d’articulation 7 après ajustement de l’angulation autour de l’axe de rotation R. - rotation locking means 8, adapted to rotationally lock the articulation means 7 after adjustment of the angle around the rotation axis R.

En l’espèce, les moyens d’articulation 7 définissent l’axe de rotation R précité. In this case, the articulation means 7 define the aforementioned axis of rotation R.

Les moyens d’articulation 7 comprennent par exemple un organe de serrage 71 , par exemple une vis, qui est rapportée au travers d’un couple d’orifices 72 qui sont ménagés respectivement dans un bras 32 (au niveau de son extrémité proximale 321) et dans sa plaque d’ostéosynthèse 22 associée. Les moyens de verrouillage en rotation 8 consistent par exemple en un couple de couronnes dentées 81 , complémentaires et frontales, formant une roue crantée, qui coopère avec l’organe de serrage 71. The articulation means 7 comprise for example a clamping member 71, for example a screw, which is attached through a pair of orifices 72 which are provided respectively in an arm 32 (at its proximal end 321) and in its associated osteosynthesis plate 22. The rotation locking means 8 consist for example of a pair of toothed crowns 81, complementary and frontal, forming a toothed wheel, which cooperates with the clamping member 71.

Ces couronnes dentées 81 sont agencées autour des orifices 72 précités et au niveau des surfaces en regard pour les engrener lors du serrage de l’organe de serrage 71. These toothed crowns 81 are arranged around the aforementioned orifices 72 and at the level of the facing surfaces to mesh with them when tightening the clamping member 71.

En d’autres termes, le serrage de l’organe de serrage 71 permet un engrenage des couronnes dentées 81 qui provoque un blocage en rotation entre le bras 32 et sa plaque d’ostéosynthèse 22 associée. In other words, the tightening of the tightening member 71 allows a gearing of the toothed crowns 81 which causes a rotational blockage between the arm 32 and its associated osteosynthesis plate 22.

Procédé de distraction orthopédique Orthopedic distraction procedure

Un procédé de distraction orthopédique, par la mise en œuvre du dispositif de distraction orthopédique 1 selon l’invention, est décrit ci-dessous en lien avec les figures 5 à 7. A method of orthopedic distraction, by implementing the orthopedic distraction device 1 according to the invention, is described below in connection with figures 5 to 7.

Le procédé de distraction orthopédique 1 comprend : The orthopedic distraction procedure 1 includes:

- une étape de positionnement et de solidarisation du dispositif de distraction orthopédique 1 avec les os S formant l’articulation A (figures 5 et 6), - a step of positioning and securing the orthopedic distraction device 1 with the bones S forming the joint A (figures 5 and 6),

- éventuellement, et si besoin, une étape d’angulation entre les moyens de solidarisation 2,- possibly, and if necessary, an angulation step between the securing means 2,

- une étape de création de la distraction, avantageusement de l’ordre de 5 mm, par la mise en œuvre des moyens de manœuvre 4 qui provoque une manœuvre en écartement des moyens de solidarisation 2 (de la figure 6 à la figure 7), puis - a step of creating the distraction, advantageously of the order of 5 mm, by the implementation of the maneuvering means 4 which causes a maneuver in separation of the securing means 2 (from figure 6 to figure 7), then

- une étape de maintien de la distraction, par la mise en œuvre des moyens de verrouillage 5. - a step of maintaining the distraction, by implementing the locking means 5.

Le dispositif de distraction orthopédique 1 selon l’invention a l’intérêt d’autoriser ici une étape de positionnement et de solidarisation en interne, avantageusement sous la peau et les tissus mous. The orthopedic distraction device 1 according to the invention has the advantage of allowing a positioning and securing step internally, advantageously under the skin and soft tissues.

En l’espèce, le dispositif de distraction orthopédique 1 est positionné et verrouillé de part et d’autre de l’articulation A au moyen de vis V rapportées sur les deux plaques d’ostéosynthèse 2. In this case, the orthopedic distraction device 1 is positioned and locked on either side of the joint A by means of screws V attached to the two osteosynthesis plates 2.

Selon le mode de réalisation illustré sur les figures 1 à 7, une étape d’angulation est autorisée par les moyens d’angulation 6, en intervenant sur les moyens de verrouillage en rotation 8 (ici serrage / desserrage de l’organe de serrage 71). According to the embodiment illustrated in Figures 1 to 7, an angulation step is authorized by the angulation means 6, by acting on the rotation locking means 8 (here tightening/loosening of the tightening member 71).

Encore selon le premier mode de réalisation, les moyens de manœuvre 4 amovibles peuvent ici être rapportés temporairement pour la mise en œuvre de l’étape de création de la distraction, puis peuvent être retirés suite à l’étape de maintien de la distraction. Still according to the first embodiment, the removable operating means 4 can here be temporarily attached for the implementation of the step of creating the distraction, then can be removed following the step of maintaining the distraction.

Le cas échéant, la came 41 est manœuvrée en rotation, de préférence jusqu’à la position de fin de course en rotation, pour générer la distraction recherchée. If necessary, the cam 41 is operated in rotation, preferably to the end of rotation position, to generate the desired distraction.

L’étape de maintien de la distraction est ici assurée par les deux vis de butée 51 qui sont manœuvrées successivement : - la vis de butée axiale 51 , pour maintenir la distraction appliquée, puis The distraction maintenance step is here ensured by the two stop screws 51 which are operated successively: - the axial stop screw 51, to maintain the distraction applied, then

- la vis de butée latérale 52, pour verrouiller le jeu en translation. - the lateral stop screw 52, to lock the translational play.

La came 41 peut en particulier être retirée après serrage de la vis de butée axiale 51.The cam 41 can in particular be removed after tightening the axial stop screw 51.

Selon le second mode de réalisation (figures 8 et suivantes), la vis de manœuvre axiale 45 est manœuvrée en rotation, de préférence en visage, pour générer la distraction recherchée. According to the second embodiment (figures 8 and following), the axial operating screw 45 is operated in rotation, preferably in the face, to generate the desired distraction.

L’étape de maintien de la distraction est ici assurée par une action combinée de la vis de manœuvre axiale 45 et de la vis de butée latérale 52, intervenant dans le verrouillage du jeu en translation. The distraction maintenance step is here ensured by a combined action of the axial operating screw 45 and the lateral stop screw 52, intervening in the locking of the translational play.

Le cas échéant, selon le quatrième mode de réalisation décrit en lien avec la figure 14, l’étape de maintien de la distraction est encore assurée par la mise en œuvre des moyens de solidarisation complémentaire 55. Where applicable, according to the fourth embodiment described in connection with figure 14, the step of maintaining the distraction is still ensured by the implementation of the additional securing means 55.

Ces moyens de solidarisation complémentaire 55 sont destinés à ponter l’articulation A en venant se fixer sur le segment osseux opposé. These additional securing means 55 are intended to bridge the joint A by attaching to the opposite bone segment.

Une fois solidarisé, ces moyens de solidarisation complémentaire 55 assurent une fonction d’entretoise (ou de jambe de force) entre les deux os S1 , S2 formant l’articulation A. Once secured, these complementary securing means 55 provide a spacer (or strut) function between the two bones S1, S2 forming the joint A.

Par ailleurs, de préférence, le procédé peut comprendre une opération préalable chirurgicale appliquée sur l’un au moins des os S1 , S2 formant l’articulation A, par exemple une ostéosynthèse de fracture ou une ostéotomie de correction. Furthermore, preferably, the method may comprise a prior surgical operation applied to at least one of the bones S1, S2 forming the joint A, for example a fracture osteosynthesis or a corrective osteotomy.

Cette opération préalable chirurgicale est en particulier permise par le dispositif de distraction orthopédique 1 selon les figures 1 à 7, ou les figures 11 et 12. This preliminary surgical operation is in particular permitted by the orthopedic distraction device 1 according to figures 1 to 7, or figures 11 and 12.

En ce sens, une opération préalable chirurgicale C (par exemple une ostéosynthèse de fracture ou une ostéotomie de correction) est réalisée sur le premier os S1 de l’articulation A (avantageusement un tibia pour le genou). In this sense, a preliminary surgical operation C (for example a fracture osteosynthesis or a corrective osteotomy) is performed on the first bone S1 of the joint A (advantageously a tibia for the knee).

Cette opération préalable chirurgicale est stabilisée par l’implantation des seconds moyens de solidarisation 22 sur le premier os S1 (figure 13, partie A). This preliminary surgical operation is stabilized by the implantation of the second securing means 22 on the first bone S1 (figure 13, part A).

Les autres composants du dispositif de distraction orthopédique 1 sont ensuite rapportés pour réaliser l’étape de positionnement et de solidarisation du dispositif de distraction orthopédique 1 avec les os S formant l’articulation A (figure 13, partie B). The other components of the orthopedic distraction device 1 are then reported to carry out the step of positioning and securing the orthopedic distraction device 1 with the bones S forming the joint A (figure 13, part B).

En particulier, l’extrémité proximale 321 du second bras 32 est solidarisée avec les seconds moyens de solidarisation 22 solidarisés avec le premier os S1 par l’intermédiaire des moyens d’assemblage 7, 9. Et les premiers moyens de solidarisation 21 portant le premier bras 31 sont solidarisés avec le second os S2. In particular, the proximal end 321 of the second arm 32 is secured to the second securing means 22 secured to the first bone S1 by means of the assembly means 7, 9. And the first securing means 21 carrying the first arm 31 are secured to the second bone S2.

Le praticien peut ensuite poursuivre le procédé : The practitioner can then continue the process:

- une étape de création de la distraction, avantageusement de l’ordre de 5 mm, par la mise en œuvre des moyens de manœuvre 4 qui provoque une manœuvre en écartement des moyens de solidarisation 2, puis - une étape de maintien de la distraction, par la mise en œuvre des moyens de verrouillage 5. - a step of creating the distraction, advantageously of the order of 5 mm, by the implementation of the maneuvering means 4 which causes a maneuver in separation of the securing means 2, then - a step of maintaining the distraction, by implementing the locking means 5.

De manière générale, en fin de la période de distraction (généralement après quelques semaines), le dispositif de distraction orthopédique 1 est destiné à faire l’objet d’un procédé d’ablation. Generally, at the end of the distraction period (usually after a few weeks), the orthopedic distraction device 1 is intended to be subjected to an ablation procedure.

De préférence, le procédé d’ablation est réalisé en sens inverse par rapport au procédé de distraction orthopédique 1 : Preferably, the ablation process is performed in the reverse order to the orthopedic distraction process 1:

- une étape de déverrouillage de la distraction, par le déverrouillage des moyens de verrouillage 5, - une étape de désolidarisation du dispositif de distraction orthopédique 1 par rapport aux os S formant l’articulation A. - a step of unlocking the distraction, by unlocking the locking means 5, - a step of detaching the orthopedic distraction device 1 from the bones S forming the joint A.

Bien entendu, diverses autres modifications peuvent être apportées à l’invention dans le cadre des revendications annexées. Of course, various other modifications may be made to the invention within the scope of the appended claims.

Claims

Revendications Claims [Revendication 1] Dispositif de distraction orthopédique, pour la distraction d’une articulation (A) d’un patient, avantageusement du genou, caractérisé en ce que ledit dispositif de distraction orthopédique (1) comprend : [Claim 1] Orthopedic distraction device, for the distraction of a joint (A) of a patient, advantageously of the knee, characterized in that said orthopedic distraction device (1) comprises: - des moyens de solidarisation (2), pour la solidarisation dudit dispositif de distraction orthopédique (1) avec les os (S) formant ladite articulation (A), lesquels moyens de solidarisation (2) comprennent des premiers moyens de solidarisation (21) pour la solidarisation avec au moins un premier os (S1) de ladite articulation (A), et des seconds moyens de solidarisation (22) pour la solidarisation avec au moins un second os (S2) de ladite articulation (A), lesquels moyens de solidarisation (2) consistent en deux plaques d’ostéosynthèse (2), à savoir une première plaque d’ostéosynthèse (21), formant les premiers moyens de solidarisation (21) destinés à être solidarisée avec le premier os (S1) de ladite articulation (A), et une seconde plaque d’ostéosynthèse (22), formant les seconds moyens de solidarisation (22) destinés à être solidarisée avec le second os (S2) de ladite articulation (A), - securing means (2), for securing said orthopedic distraction device (1) with the bones (S) forming said joint (A), which securing means (2) comprise first securing means (21) for securing with at least one first bone (S1) of said joint (A), and second securing means (22) for securing with at least one second bone (S2) of said joint (A), which securing means (2) consist of two osteosynthesis plates (2), namely a first osteosynthesis plate (21), forming the first securing means (21) intended to be secured with the first bone (S1) of said joint (A), and a second osteosynthesis plate (22), forming the second securing means (22) intended to be secured with the second bone (S2) of said joint (A), - des moyens de liaison télescopique (3), reliant lesdits moyens de solidarisation (2) et définissant un degré de liberté en translation (T) entre lesdits moyens de solidarisation (2), - telescopic connecting means (3), connecting said securing means (2) and defining a degree of freedom in translation (T) between said securing means (2), - des moyens de manœuvre (4), adaptés à générer une manœuvre en écartement entre lesdits moyens de solidarisation (2) selon ledit degré de liberté en translation (T) pour créer une distraction entre les os (S) de ladite articulation (A), et - maneuvering means (4), adapted to generate a separation maneuver between said securing means (2) according to said degree of freedom in translation (T) to create a distraction between the bones (S) of said joint (A), and - des moyens de verrouillage (5), adaptés à verrouiller en translation lesdits moyens de liaison télescopique (3) après la création de ladite distraction. - locking means (5), adapted to lock in translation said telescopic connection means (3) after the creation of said distraction. [Revendication 2] Dispositif de distraction orthopédique, selon la revendication 1 , caractérisé en ce que les moyens de liaison télescopique (3) comprennent au moins deux bras (31 , 32) qui forment ensemble une glissière définissant ledit degré de liberté en translation (T), lesquels bras (31 , 32) comportent chacun une extrémité proximale (311 , 321) qui est reliée avec l’un desdits moyens de solidarisation (2). [Claim 2] Orthopedic distraction device, according to claim 1, characterized in that the telescopic connecting means (3) comprise at least two arms (31, 32) which together form a slide defining said degree of freedom in translation (T), which arms (31, 32) each comprise a proximal end (311, 321) which is connected to one of said securing means (2). [Revendication 3] Dispositif de distraction orthopédique, selon la revendication 2, caractérisé en ce que lesdits au moins deux bras (31 , 32) comprennent : [Claim 3] Orthopedic distraction device, according to claim 2, characterized in that said at least two arms (31, 32) comprise: - un premier bras (31), comportant une paroi tubulaire (313) qui définit un logement allongé (314) débouchant au niveau d’une ouverture (315), et - un second bras (32), rapporté dans ledit logement allongé (314) au travers de ladite ouverture (315) et guidé en translation le long dudit logement allongé (314). - a first arm (31), comprising a tubular wall (313) which defines an elongated housing (314) opening at an opening (315), and - a second arm (32), attached to said elongated housing (314) through said opening (315) and guided in translation along said elongated housing (314). [Revendication 4] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 2 ou 3, caractérisé en ce que les moyens de manœuvre (4) comprennent une came (41), amovible et libre en rotation, pour générer un déplacement relatif desdits bras (31 , 32) par un mouvement de rotation. [Claim 4] Orthopedic distraction device, according to any one of claims 2 or 3, characterized in that the operating means (4) comprise a cam (41), removable and free to rotate, to generate a relative movement of said arms (31, 32) by a rotational movement. [Revendication 5] Dispositif de distraction orthopédique, selon la revendication 4, caractérisé en ce que ladite came (41) amovible est assemblée sur un second bras (32) et coopère avec un premier bras (31). [Claim 5] Orthopedic distraction device, according to claim 4, characterized in that said removable cam (41) is assembled on a second arm (32) and cooperates with a first arm (31). [Revendication 6] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 2 à 5, caractérisé en ce que les moyens de manœuvre (4) comprennent une vis de manœuvre axiale (45) qui est guidée en translation sur l’un desdits bras (31), parallèlement au degré de liberté en translation (T), et qui coopère avec l’autre desdits bras (32) pour assurer la manœuvre en écartement. [Claim 6] Orthopedic distraction device, according to any one of claims 2 to 5, characterized in that the maneuvering means (4) comprise an axial maneuvering screw (45) which is guided in translation on one of said arms (31), parallel to the degree of freedom in translation (T), and which cooperates with the other of said arms (32) to ensure the separation maneuver. [Revendication 7] Dispositif de distraction orthopédique, selon la revendication 6 en combinaison avec la revendication 3, caractérisé en ce que ladite vis de manœuvre axiale (45) est dans un fond (316) du logement allongé (314) situé à l’opposé de l’ouverture (315). [Claim 7] Orthopedic distraction device, according to claim 6 in combination with claim 3, characterized in that said axial operating screw (45) is in a bottom (316) of the elongated housing (314) located opposite the opening (315). [Revendication 8] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 2 à 7, caractérisé en ce que les moyens de verrouillage (5) comprennent au moins une vis de butée (51 , 52) qui est guidée en translation sur l’un desdits bras (31) et qui coopère avec l’autre desdits bras (32) pour assurer ledit verrouillage. [Claim 8] Orthopedic distraction device, according to any one of claims 2 to 7, characterized in that the locking means (5) comprise at least one stop screw (51, 52) which is guided in translation on one of said arms (31) and which cooperates with the other of said arms (32) to ensure said locking. [Revendication 9] Dispositif de distraction orthopédique, selon la revendication 8, caractérisé en ce que ladite au moins une vis de butée (51 , 52) est choisie parmi : [Claim 9] Orthopedic distraction device, according to claim 8, characterized in that said at least one stop screw (51, 52) is chosen from: - une vis de butée axiale (51), pour maintenir la distraction, de préférence implantée parallèlement au degré de liberté en translation (T), le cas échéant avantageusement dans un fond (316) du logement allongé (314) situé à l’opposé de l’ouverture (315) selon la revendication 3, et - an axial stop screw (51), to maintain the distraction, preferably implanted parallel to the degree of freedom in translation (T), where appropriate advantageously in a bottom (316) of the elongated housing (314) located opposite the opening (315) according to claim 3, and - une vis de butée latérale (52), pour verrouiller le jeu en translation, de préférence implantée perpendiculairement au degré de liberté en translation (T), avantageusement dans la paroi tubulaire (313) du premier bras (31). - a lateral stop screw (52), to lock the translational play, preferably installed perpendicular to the degree of freedom in translation (T), advantageously in the tubular wall (313) of the first arm (31). [Revendication 10] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 2 à 9, caractérisé en ce que l’extrémité proximale (311 , 321) d’un bras (31 , 32) est : [Claim 10] Orthopedic distraction device, according to any one of claims 2 to 9, characterized in that the proximal end (311, 321) of an arm (31, 32) is: - monobloc avec la plaque d’ostéosynthèse (2) associée, ou - assemblée avec la plaque d’ostéosynthèse (2). - monobloc with the associated osteosynthesis plate (2), or - assembled with the osteosynthesis plate (2). [Revendication 11] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 1 à 10, caractérisé en ce que les moyens de verrouillage (5) comprennent des moyens de solidarisation complémentaire (55) formant entretoise, qui sont structurés pour ponter l’articulation (A) et pour venir se fixer sur un os (S1 , S2) opposé de ladite articulation (A). [Claim 11] Orthopedic distraction device, according to any one of claims 1 to 10, characterized in that the locking means (5) comprise complementary securing means (55) forming a spacer, which are structured to bridge the joint (A) and to be fixed on a bone (S1, S2) opposite said joint (A). [Revendication 12] Dispositif de distraction orthopédique, selon l’une quelconque des revendications 1 à 11 , caractérisé en ce qu’il comprend des moyens d’angulation (6) pour conférer un degré de liberté en rotation entre lesdits moyens de solidarisation (2), perpendiculairement audit degré de liberté en translation (T), afin d’autoriser une distraction avec l’articulation (A) fléchie. [Claim 12] Orthopedic distraction device, according to any one of claims 1 to 11, characterized in that it comprises angulation means (6) to confer a degree of freedom in rotation between said securing means (2), perpendicular to said degree of freedom in translation (T), in order to allow distraction with the articulation (A) flexed. [Revendication 13] Dispositif de distraction orthopédique, selon la revendication 12, caractérisé en ce que les moyens d’angulation (6) comprennent : [Claim 13] Orthopedic distraction device, according to claim 12, characterized in that the angulation means (6) comprise: - des moyens d’articulation (7) qui sont ménagés entre l’un des moyens de solidarisation (2) et les moyens de liaison télescopique (3), et - des moyens de verrouillage en rotation (8), adaptés à verrouiller en rotation lesdits moyens d’articulation (7) après ajustement de ladite angulation. - articulation means (7) which are provided between one of the securing means (2) and the telescopic connection means (3), and - rotation locking means (8), adapted to lock said articulation means (7) in rotation after adjustment of said angulation.
PCT/EP2024/062023 2023-05-05 2024-05-02 Orthopaedic distraction device for distraction of a patient 's joint, advantageously the knee Pending WO2024231204A1 (en)

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FR2304509A FR3148359A1 (en) 2023-05-05 2023-05-05 Orthopedic distraction device, for the distraction of a patient's joint, advantageously the knee
FRFR2304509 2023-05-05

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070239161A1 (en) * 2006-04-06 2007-10-11 Lukas Giger Remotely Adjustable Tissue Displacement Device
US20070276405A1 (en) * 2002-11-19 2007-11-29 Huebner Randall J Adjustable bone plates
US20130261670A1 (en) * 2012-03-29 2013-10-03 DePuy Synthes Products, LLC Implant and associated instruments and methods
US20130289730A1 (en) * 2007-05-01 2013-10-31 Moximed, Inc. Implantable brace for providing joint support

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070276405A1 (en) * 2002-11-19 2007-11-29 Huebner Randall J Adjustable bone plates
US20070239161A1 (en) * 2006-04-06 2007-10-11 Lukas Giger Remotely Adjustable Tissue Displacement Device
US20130289730A1 (en) * 2007-05-01 2013-10-31 Moximed, Inc. Implantable brace for providing joint support
US20130261670A1 (en) * 2012-03-29 2013-10-03 DePuy Synthes Products, LLC Implant and associated instruments and methods

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