DE10250390A1 - Hip joint cup handling involves spreader cone of axi-slots dividing wall sectors expanded radially onto cup inner wall by central expander for handling all cup types. - Google Patents
Hip joint cup handling involves spreader cone of axi-slots dividing wall sectors expanded radially onto cup inner wall by central expander for handling all cup types. Download PDFInfo
- Publication number
- DE10250390A1 DE10250390A1 DE10250390A DE10250390A DE10250390A1 DE 10250390 A1 DE10250390 A1 DE 10250390A1 DE 10250390 A DE10250390 A DE 10250390A DE 10250390 A DE10250390 A DE 10250390A DE 10250390 A1 DE10250390 A1 DE 10250390A1
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- Germany
- Prior art keywords
- pan
- expanding mandrel
- cup
- handling
- wall
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Ceased
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/34—Acetabular cups
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
- A61B17/8888—Screwdrivers, spanners or wrenches holding the screw head at its central region
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- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
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- A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Physical Education & Sports Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
Die Erfindung betrifft ein Gerät zum Setzen oder Entfernen von Gelenkpfannen, insbesondere Schraubpfannen, eines künstlichen Gelenks, insbesondere Hüftgelenks, mit gegen die Pfanneninnenseite spreizbaren Pfannenanschlusselementen.The invention relates to a device for setting or Removal of sockets, in particular screw cups, one artificial Joints, especially hip joints, with spreadable against the pan inside Pfannenanschlusselementen.
Eine Gelenk-, insbesondere Hüftgelenkspfanne besteht in der Regel aus Titan oder einem anderen knochenfreundlichen Material, welches zum Beckenknochen hin eine das Einwachsen begünstigende Struktur, wie Gitternetzstruktur, mittels Laser hergestellte Löcher, Zapfen oder eine durch Plasmasprühen hergestellte raue Oberfläche aufweist. Um einen noch besseren Halt der Pfanne im Knochen zu erreichen, werden zunehmend sog. Schraubpfannen implantiert, die sich dadurch auszeichnen, dass sie an der äußeren Umfangswand ein Schraubgewinde aufweisen. Die Pfanne dient zur Aufnahme eines reibungsarmen Inlays, welches aus PE, Keramik, Metall wie Kobalt, Chrom oder CFK (Carbonfaserkohlenstoff) bestehen kann. Dieses Inlay wirkt im implantierten Zustand mit einem Gelenkkopf aus Metall zusammen.A joint, in particular acetabular cup is usually made of titanium or another bone-friendly Material which promotes ingrowth towards the pelvic bone Structure, such as grid structure, holes made by laser, cones or one by plasma spraying made rough surface having. To achieve an even better hold of the pan in the bone, are increasingly implanted so-called. Screw cups, which is characterized Make a mark on the outer peripheral wall have a screw thread. The pan is used to hold a low-friction inlays, which are made of PE, ceramics, metal such as cobalt, Chrome or CFK (carbon fiber carbon) may exist. This inlay Acts in the implanted state with a condyle made of metal together.
Zur Extraktion einer zementierten
Pfanne, also insbesondere nicht Schraubpfanne, ist bereits ein Gerät mit gegen
die Pfanneninnenseite spreizbaren Pfannenanschlusselementen vorgeschlagen worden,
und zwar in der
Der vorliegenden Erfindung liegt die Aufgabe zugrunde, ein Gerät der eingangs genannten Art zu schaffen, welches eine homogene Spannungsverteilung auf das Implantat, d.h. die Pfanne gewährleistet und insbesondere die Übertragung von höheren Drehmomenten von mindestens bis zu 30 Nm erlaubt, ohne dass die Gefahr besteht, dass die Pfanne sich lokal oder insgesamt verformt.The present invention is the task is based on a device of the aforementioned type, which provides a homogeneous stress distribution on the implant, i. the pan is guaranteed and in particular the transfer of higher torques of at least 30 Nm allowed without the risk of that the pan is deformed locally or in total.
Diese Aufgabe wird durch die kennzeichnenden Merkmale des Anspruches 1 gelöst, wobei konstruktive Details und Ausführungsformen in den Unteransprüchen beschrieben sind.This task is characterized by the characterizing Features of claim 1 solved, wherein structural details and embodiments in the subclaims described are.
Der Kern der vorliegenden Erfindung liegt also darin, dass die Kraft zwischen Setzinstrument und Pfanne großflächig übertragen wird. Spannungsspitzen am Implantat werden vermieden, wie sie zum Beispiel bei Setzinstrumenten entstehen würden, die formschlüssig am Implantat angreifen. Durch den großflächigen Kraftschluß zwischen Setzinstrument und Pfanne wird eine homogene Spannungsverteilung im Implantat bzw. in der Pfanne erreicht. Es besteht auch nicht die Gefahr, dass die Implantatoberfläche durch das Setzinstrument verletzt wird. Selbst bei äußerst dünnwandigen Gelenkpfannen besteht nicht die Gefahr einer Verformung derselben. Auch solche Pfannen können problemlos implantiert oder auch wieder explantiert werden. Dabei muß bedacht werden, dass man zunehmend sehr dünnwandige Gelenkpfannen einsetzt, die nach der Implantation verformbar und an die natürliche Form des Beckens anpassbar sind.The core of the present invention So it lies in the fact that the force between setting instrument and pan transferred over a large area becomes. Voltage peaks on the implant are avoided, as for example would arise with setting instruments, the form-fitting attack the implant. Due to the extensive frictional connection between Setting instrument and pan becomes a homogeneous stress distribution achieved in the implant or in the pan. It does not exist either the risk that the implant surface by the setting instrument get hurt. Even with extremely thin-walled Joint sockets are not liable to be deformed. Even such pans can easily implanted or explanted again. there must be considered that increasingly you have very thin-walled sockets which deforms after implantation and to the natural shape of the pelvis are customizable.
Die Pfannenanschlusselemente sind also erfindungsgemäß jeweils Teil eines sich über den Pfannenumfang erstreckenden Spreizdornes. Die Pfannenanschlusselemente greifen also nicht punktuell, sondern großflächig an der Pfanneninnenseite an, wodurch ein entsprechend hoher Kraftschluß zwischen den Pfannenanschlusselementen bzw. Spreizdorn und Pfanne erreicht wird, ohne dass die Gefahr einer unzulässigen Verformung oder Beschädigung der Pfanne besteht. Bei einer kegelstumpf- bzw. konusförmigen Pfanne ist der Spreizdorn entsprechend als Spreizkonus ausgebildet.The pan connection elements are So according to the invention respectively Part of a over the pan circumference expanding mandrel. The ladle connection elements So do not grab punctually, but a large area on the inside of the pan on, whereby a correspondingly high adhesion between the pan connection elements or expanding mandrel and pan is achieved without the risk of unacceptable Deformation or damage to the Pan exists. In a truncated cone or cone-shaped pan the expanding mandrel is designed accordingly as an expansion cone.
Durch den großflächigen Kraftschluß ist es auch möglich, die Pfanne in den Knochen einzuschrauben bzw. bei Bedarf die Pfanne aus dem Knochen wieder herauszuschrauben.Due to the extensive frictional connection it is too possible, screw the pan into the bone or, if necessary, the pan to unscrew from the bone again.
Bei einer Pfanne mit an der Innenseite mehrstufig ausgebildeter Umfangswand ist die dieser Umfangswand zugeordnete Umfangsfläche des Spreizdorns entsprechend mehrstufig ausgebildet. Damit ist gewährleistet, dass auch bei dieser Ausführungsform ein maximal großflächiger Kraftschluß erreicht wird.For a pan with on the inside multi-level trained peripheral wall is the peripheral wall assigned peripheral surface formed of the expanding mandrel according to multi-stage. This ensures that that also in this embodiment a maximum large-scale frictional connection is achieved.
Konkret weist der Spreizdorn bzw. Spreizkonus wenigstens zwei, insbesondere drei oder vier jeweils durch Axialschlitze voneinander getrennte Spreizwandabschnitte auf, die die kraftschlüssig wirksamen Pfannenanschlusselemente definieren.Specifically, the expanding mandrel or Spreizkonus at least two, in particular three or four each Spreizwandabschnitte separated by axial slots, which the non-positively effective Define ladle connection elements.
Die radiale Spreizung der Spreizwandabschnitte erfolgt vorzugsweise durch einen zentralen Spreizkörper, durch den die Spreizpfannenabschnitte radial nach außen bringbar sind. Vorzugsweise ist der Spreizkörper als Kugelabschnitt oder Kegelstumpf ausgebildet. Bei letztgenannter Ausführungsform weist die kleinere Grundfläche im montierten Zustand zum Inneren des Spreizdornes hin. Wird der Spreizkörper dann in das Innere das Spreizdornes gezogen, erfolgt eine zunehmende Spreizung der Spreizwandabschnitte des Spreizdornes radial nach außen, und zwar durch die zunehmend wirksame größere Grundfläche des Kegelstumpfes.The radial spreading of the Spreizwandabschnitte is preferably carried out by a central spreader, through which the Spreizpfannenabschnitte can be brought radially outward. Preferably, the expansion body is formed as a ball portion or truncated cone. In the latter embodiment, the smaller base surface in the mounted state to the interior of the expanding mandrel. If the expansion body is then pulled into the interior of the expanding mandrel, there is an increasing spread of the Spreizwandabschnitte of the expanding mandrel radially outward, by the zuneh mend effective larger footprint of the truncated cone.
Um die notwendig hohen Kräfte auf die Spreizwandabschnitte des Spreizdornes aufbringen zu können, ist der erwähnte Spreizkörper mit einem Kniehebelmechanismus verbunden. Durch diesen lässt sich auch eine definierte Spreizkraft erzeugen.To the necessary high forces to be able to apply the Spreizwandabschnitte of the expanding mandrel is the mentioned one spreader connected to a toggle mechanism. Through this one can be also generate a defined spreading force.
Um die Sicherheit bei der Operation zu erhöhen, ist die Pfanne vor der Implantation mit dem Spreizdorn axial verrastbar. Vorzugsweise weist die Pfanne zu diesem Zweck eine „Schnapplippe" auf, die beim Aufsetzen der Pfanne auf den Spreizdorn mit diesem verrastet, so dass die Pfanne nicht unbeabsichtigt vom Spreizdorn fallen kann, bevor die kraftschlüssige Verbindung zwischen Spreizdorn und Pfanne hergestellt ist. Es handelt sich dabei natürlich nur um eine sehr leichte Verrastung, so dass bei Bedarf die Pfanne jederzeit wieder vom Spreizdorn abgezogen werden kann, bevor dieser in Spreizstellung gebracht ist.For safety during the operation to increase, the pan is axially latched before implantation with the expanding mandrel. Preferably, for this purpose, the pan has a "snap-on lip" which, when placed on the pan on the expanding mandrel with this latched, so that the Pan can not fall unintentionally from the expanding mandrel before the non-positive connection made between expanding mandrel and pan. It is about of course only around a very slight latch, so if necessary, the pan at any time can be withdrawn again from the expanding mandrel before this brought into spread position is.
Um ein „Anfressen" des Spreizdornes bzw. Spreizkonus an der Pfanne zu vermeiden, ist zumindest die Wirkfläche des Spreizdornes mit einem Trennmittel, wie z.B. Balinit C" beschichtet.To a "eroding" of the expanding mandrel or expansion cone To avoid the pan is at least the effective area of the Expanding mandrel with a release agent, such. Balinit C "coated.
Mit dem erfindungsgemäßen Gerät lässt sich die Lage der Schale sehr leicht feststellen und aufrechterhalten. Das erfindungsgemäße Gerät ist leicht, gut zu reinigen und einfach in der Handhabung. Wie oben dargelegt, lässt sich eine Beschädigung des Implantats sicher vermeiden. Das Gerät eignet sich sowohl zum Setzen als auch Entfernen von Standard-Implantaten, insbesondere jedoch Schraubpfannen.With the device according to the invention can be the Determine and maintain the position of the shell very easily. The device according to the invention is lightweight, easy to clean and easy to handle. As stated above, let yourself a damage safely avoid the implant. The device is suitable both for setting as well as removing standard implants, but especially screw cups.
Die Spreizkraft des Spreizdornes kann über den erwähnten Kniehebelmechanismus so eingestellt werden, dass bei Überschreiten einer vorbestimmten Krafteinwirkung auf das Implantat, insbesondere eines vorbestimmten Drehmoments bei einer Schraubpfanne der Kniehebelmechanismus öffnet. Damit kann eine Beschädigung des Knochens beim Implantieren, aber auch beim Explantieren sicher vermieden werden. Eine andere Möglichkeit besteht in der Integration einer Sollbruchstelle am Instrument, insbesondere an der mit dem Spreizdorn in Verbindung stehenden Zugstange.The spreading force of the expanding mandrel can over the mentioned Toggle mechanism can be adjusted so that when exceeding a predetermined force on the implant, in particular of a predetermined torque in a Schraubpfanne the toggle mechanism opens. In order to may be a damage the bone during implantation, but also when explanting sure be avoided. Another possibility consists in the integration of a predetermined breaking point on the instrument, in particular at the connecting rod with the expansion mandrel in connection.
Der Kniehebelmechanismus umfasst vorzugsweise noch ein elastisches, insbesondere Federelement, durch welches Implantats-Toleranzen ausgeglichen werden.The toggle mechanism includes preferably still an elastic, in particular spring element, by which implant tolerances are compensated.
Da das Gerät absolut spielfrei mit dem Implantat verbunden werden kann, eignet sich das Gerät auch optimal für den Einsatz von sog. Navigationsgeräten.Because the device is absolutely free of play with the Implant can be connected, the device is also optimal for the Use of so-called navigation devices.
Wie bereits erwähnt, eignet sich das erfindungsgemäße Gerät insbesondere auch zur Implantation oder Explantation von Schraubpfannen. In diesem Zusammenhang sind nur formschlüssige Setzinstrumente bekannt, die jedoch den bereits eingangs erwähnten Nachteil besitzen, dass an den formschlüssigen Angriffspunkten Spannungsspitzen entstehen, die zu einer Beschädigung der Pfanne führen können.As already mentioned, the device according to the invention is particularly suitable also for implantation or explantation of threaded cups. In this Context are only positive Setting instruments known, however, the already mentioned at the beginning disadvantage own that to the interlocking Attack points generate voltage surges, which can damage the Can lead pan.
Nachstehend wird eine bevorzugte Ausführungsform eines erfindungsgemäßen Implantations-/Explantationsgerätes und dessen Handhabung anhand der beigefügten Zeichnungen näher erläutert. Es zeigen:Below is a preferred embodiment an implantation / explantation device according to the invention and its handling explained in more detail with reference to the accompanying drawings. It demonstrate:
Die
Der Spreizkonus
Die innere Umfangswand
Die Größe des Spreizdornes bzw. Spreizkonus
Wie bereits eingangs erwähnt, ist
dem Spreizkonus
Das bereits erwähnte Spanngerät, mit dem der
Spreizkonus
Es sei an dieser Stelle noch erwähnt, dass der
durch die Spreizwandabschnitte
Nach der vorbeschriebenen Fixierung
des Spreizkörpers
In
Während
des Ein- oder Ausdrehvorganges kann das beschriebene Gerät bzw. Instrument
jederzeit gelöst
und wieder neu fixiert werden. Sollte sich der Spreizkonus samt
Spanngerät
nicht spontan aus der Pfanne lösen,
kann mit einem sanften Hammerschlag auf das proximate Ende des Spanngerätes
Wie bereits oben kurz dargelegt,
kann entweder der Spreizkonus oder aber auch die Pfanne eine „Schnapplippe" aufweisen, die beim
Aufsetzen der Pfanne auf den Spreizdorn bzw. Spreizkonus wirksam
wird. Damit soll sichergestellt sein, dass die Pfanne nicht unbeabsichtigt
vom Spreizkonus
Zwischen Kniehebelmechanismus und
Zugstange
Sämtliche in den Anmeldungsunterlagen offenbarten Merkmale werden als erfindungswesentlich beansprucht, soweit sie einzeln oder in Kombination gegenüber dem Stand der Technik neu sind.All Features disclosed in the application documents are considered to be essential to the invention as far as they are individually or in combination with respect to State of the art are new.
- 1010
- Spreizdorn bzw. Spreizkonusexpanding mandrel or expansion cone
- 1111
- SchraubpfanneScrewcup
- 1212
- Axialschlitzaxial slot
- 1313
- SpreizwandabschnittSpreizwandabschnitt
- 1414
- innere Umfangswandinner peripheral wall
- 1515
- Gewindegängethreads
- 1616
- Spreizkörperspreader
- 1717
- Spanngerättensioning device
- 1818
- Zugstangepull bar
- 1919
- Hülseshell
- 2020
- Spannhebelclamping lever
- 2121
- Abschnittsection
- 2222
- Anschlagattack
- 2323
- StabRod
- 2424
- Vierkantsquare
- 2525
- Schraubenschlüssel bzw. RatscheWrench or ratchet
Claims (17)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10250390A DE10250390A1 (en) | 2002-10-29 | 2002-10-29 | Hip joint cup handling involves spreader cone of axi-slots dividing wall sectors expanded radially onto cup inner wall by central expander for handling all cup types. |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10250390A DE10250390A1 (en) | 2002-10-29 | 2002-10-29 | Hip joint cup handling involves spreader cone of axi-slots dividing wall sectors expanded radially onto cup inner wall by central expander for handling all cup types. |
Publications (1)
Publication Number | Publication Date |
---|---|
DE10250390A1 true DE10250390A1 (en) | 2004-05-13 |
Family
ID=32103158
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE10250390A Ceased DE10250390A1 (en) | 2002-10-29 | 2002-10-29 | Hip joint cup handling involves spreader cone of axi-slots dividing wall sectors expanded radially onto cup inner wall by central expander for handling all cup types. |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE10250390A1 (en) |
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DE102005003097A1 (en) * | 2005-01-22 | 2006-07-27 | Aesculap Ag & Co. Kg | Coupling for dimensionally stable connection of a prosthesis part with a holding element |
EP1721586A1 (en) * | 2005-05-12 | 2006-11-15 | Finsbury (Development) Limited | Cap and activation tool |
FR2932678A1 (en) * | 2008-06-24 | 2009-12-25 | Tornier Sa | Prosthesis e.g. reverse shoulder prosthesis, gripping device for use in e.g. femur during articular fracture treatment, has handle with deformation units permitting reversible passage of grip unit between grip and detached configurations |
EP2476397A1 (en) * | 2011-01-17 | 2012-07-18 | Greatbatch Medical SA | Straight cup impactor with lever arm |
US8375780B2 (en) * | 2005-09-28 | 2013-02-19 | Airbus Operations Sas | Traction pad for device testing adhesion of a coating on a substrate |
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US8419800B2 (en) | 2007-06-26 | 2013-04-16 | Finsbury (Development) Limited | Prosthesis |
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DE102014012440A1 (en) | 2014-08-19 | 2016-03-10 | Ohst Medizintechnik Ag | Instrument for setting sockets |
US10433967B2 (en) | 2014-12-10 | 2019-10-08 | Tornier | Convertible stem / fracture stem |
US10548737B2 (en) | 2011-10-31 | 2020-02-04 | Tornier Orthopedics Ireland Ltd. | Reverse shoulder prostheses with anti-rotation features |
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2002
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US10898336B2 (en) | 2006-03-21 | 2021-01-26 | Tornier, Inc. | Femoral and humeral stem geometry and implantation method for orthopedic joint reconstruction |
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FR2932678A1 (en) * | 2008-06-24 | 2009-12-25 | Tornier Sa | Prosthesis e.g. reverse shoulder prosthesis, gripping device for use in e.g. femur during articular fracture treatment, has handle with deformation units permitting reversible passage of grip unit between grip and detached configurations |
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US10433967B2 (en) | 2014-12-10 | 2019-10-08 | Tornier | Convertible stem / fracture stem |
US11173037B2 (en) | 2014-12-10 | 2021-11-16 | Tornier Sas | Convertible stem / fracture stem |
US11471291B2 (en) | 2014-12-10 | 2022-10-18 | Tornier Sas | Convertible stem/fracture stem |
US10987226B2 (en) | 2016-04-19 | 2021-04-27 | Imascap Sas | Pre-operatively planned humeral implant and planning method |
US10588756B2 (en) | 2017-03-31 | 2020-03-17 | DePuy Synthes Products, Inc. | System and method for implanting an acetabular prosthetic component |
US10596011B2 (en) | 2018-01-31 | 2020-03-24 | Depuy Ireland Unlimited Company | Orthopaedic surgical instrument and method for positioning an acetabular prosthetic component |
USD938590S1 (en) | 2019-10-01 | 2021-12-14 | Howmedica Osteonics Corp. | Humeral implant |
USD983373S1 (en) | 2019-10-01 | 2023-04-11 | Howmedica Osteonics Corp. | Humeral implant |
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