DE4223373A1 - Endoprosthesis shaft for knee joint - is blade shaped for anchoring purposes and has profile preventing rotation and blade-shaped vanes - Google Patents

Endoprosthesis shaft for knee joint - is blade shaped for anchoring purposes and has profile preventing rotation and blade-shaped vanes

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Publication number
DE4223373A1
DE4223373A1 DE4223373A DE4223373A DE4223373A1 DE 4223373 A1 DE4223373 A1 DE 4223373A1 DE 4223373 A DE4223373 A DE 4223373A DE 4223373 A DE4223373 A DE 4223373A DE 4223373 A1 DE4223373 A1 DE 4223373A1
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DE
Germany
Prior art keywords
shaft
endoprosthesis
wings
shaft according
blade
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
DE4223373A
Other languages
German (de)
Other versions
DE4223373C2 (en
Inventor
Guenter Dr Ing Bensmann
Karl-Heinz Dipl Ing Borowy
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.)
Krupp Medizintechnik GmbH
Original Assignee
Krupp Medizintechnik GmbH
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Publication date
Application filed by Krupp Medizintechnik GmbH filed Critical Krupp Medizintechnik GmbH
Priority to DE4223373A priority Critical patent/DE4223373C2/en
Publication of DE4223373A1 publication Critical patent/DE4223373A1/en
Application granted granted Critical
Publication of DE4223373C2 publication Critical patent/DE4223373C2/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30179—X-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30785—Plurality of holes parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30789—Plurality of holes perpendicular with respect to each other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30899—Protrusions pierced with apertures
    • A61F2002/30902—Protrusions pierced with apertures laterally or radially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30955—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using finite-element analysis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2002/3678—Geometrical features
    • A61F2002/368—Geometrical features with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0058—X-shaped

Landscapes

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

Abstract

The endprosthesis shaft for a knee joint, comprises a shaft (10) which narrows to its distal end and is blade shaped for anchoring in a tibia or femur medulla space or in a bone channel. The shaft (1) has a profile preventing rotation and more than two vanes (12), each of which is blade-shaped. Each vane comprises a metal plate with assistance to bending matching the bone. The shaft is made of CoCrMo-, CoNiCrMo- or a titanium alloy or unalloyed titanium or tantalum or niobium. The resistance of the shaft (10) to bending is different over the axial length. The vanes (12) have holes and the shaft or the vanes over the surface have differeing thicknesses. At least one vane in one cross-section had a width differing to that of the other vane. USE/ADVANTAGE - The shaft is for an artificial knee joint. The shaft transmits forces and torque via the contact surfaces implant/corticalis and implant/spongiosa in the femur or tibia.

Description

Die Erfindung betrifft einen Endoprothesenschaft für Kniege­ lenke, bestehend aus einem in einem Tibia- oder Femur-Markraum oder in einem Knochenkanal zu verankernden blattförmigen sich zum distalen Ende hin verjüngenden Schaft mit einem rotations­ hindernden Profil.The invention relates to an endoprosthesis socket for knees steer, consisting of one in a tibia or femur medullary cavity or leaf-shaped to be anchored in a bone canal tapered shaft towards the distal end with a rotating hindering profile.

Bereits in der DE 28 39 093 A1 wird eine Endoprothese für Hüft-, Knie- oder Winkelgelenke beschrieben, bei der der Schaft als ein sich kegelig verjüngender Steckzapfen ausgebildet ist, der umfangsseitig Gewindegänge besitzt, die durch vier Längsnu­ ten ausgenommen sind.DE 28 39 093 A1 describes an endoprosthesis for Hip, knee or angle joints are described in which the shaft is designed as a tapered plug, which has threads on the circumference, which are defined by four longitudinal grooves are exempted.

Auch in der WO 83/02555 wird eine Kniegelenk-Endoprothese be­ schrieben, die im femuralen sowie tibialen Verankerungsteil einen ein Außengewinde tragenden ersten Abschnitt, einen hieran angebrachten Zapfen sowie im unteren Teil ein Endstück mit Längsnuten aufweist.WO 83/02555 also describes a knee joint endoprosthesis wrote that in the femoral as well as tibial anchoring part a first section carrying an external thread, one thereon attached pin and in the lower part with an end piece Has longitudinal grooves.

Die nach dem Stand der Technik bekannten Endoprothesen für Kniegelenke haben jedoch verschiedene Nachteile. So muß zum einen durch großvolumige Vorbohrung relativ gesunde Knochensub­ stanz geopfert werden, um eine Aufnahmehöhlung für das Schaft- Verankerungsteil zu schaffen. Darüber hinaus reichen die be­ kannten Oberflächenstrukturen von Prothesenschäften regelmäßig nicht aus, um ein Lockern des Schaftes im Knochen wirksam zu verhindern.The endoprostheses known for the prior art for However, knee joints have several disadvantages. So has to a relatively healthy bone sub through large-volume pre-drilling be sacrificed to create a cavity for the shaft To create anchoring part. In addition, the be knew the surface structures of prosthetic sockets regularly not effective to loosen the shaft in the bone effectively prevent.

Es ist daher Aufgabe der vorliegenden Erfindung, die eingangs genannte Endoprothese dahingehend zu verbessern, daß Kräfte und Momente vornehmlich über die Kontaktfläche Implantat/Kortikalis und Implantat/Spongiosa in Femur oder Tibia unter Erhaltung und weitestgehender Schonung der vorhandenen Knochensubstanz über­ tragen werden, daß die aus auftretenden Torsionsmomenten einge­ leiteten Kräfte sicher aufgenommen werden können und daß eine Lockerung der Prothese verhindert wird. Hierbei soll der Endo­ prothesenschaft weitgehend dem individuellen Patientenfemur oder -tibia angepaßt werden können.It is therefore an object of the present invention to begin with improve the endoprosthesis so that forces and Moments primarily via the implant / cortex contact surface  and implant / cancellous bone in the femur or tibia while maintaining and the greatest possible protection of the existing bone substance will wear that from the occurring torsional moments directed forces can be safely absorbed and that a Loosening of the prosthesis is prevented. Here, the endo prosthesis largely to the individual patient femur or -tibia can be customized.

Diese Aufgabe wird durch einen Endoprothesenschaft der eingangs genannten Art gelöst, der durch mehr als zwei Flügel gekenn­ zeichnet ist. Anders als die nur eine geringe Tiefe aufweisen­ den Rippen oder Nuten erlauben die Flügel einen festen Sitz der in den Tibia- oder Femurhohlraum eingebrachten Endoprothese. Die Flügel verhindern eine Rotation des Schaftes gegenüber dem Knochen, wobei zusätzlich Endoprothesenschaftmaterial einge­ spart werden kann, da die erfindungsgemäßen Prothesen in ihrem größten Durchmesser nicht größer als die bisher nach dem Stand der Technik bekannten Endoprothesen für Kniegelenke sind.This task is accomplished by an endoprosthesis stem mentioned type solved, which is characterized by more than two wings is drawing. Other than that they only have a small depth the ribs or grooves allow the wings to be firmly seated endoprosthesis inserted into the tibia or femoral cavity. The wings prevent the shaft from rotating relative to the Bones, with additional endoprosthesis shaft material inserted can be saved because the prostheses according to the invention in their largest diameter is not larger than that previously available are known endoprostheses for knee joints.

Vorzugsweise ist jeder der Flügel blattförmig ausgebildet, wo­ mit sich eine optimale Materialersparnis für den Endoprothesen­ schaft und damit eine Verringerung des auszuräumenden Knochen­ volumens ergibt.Preferably, each of the wings is leaf-shaped, where with an optimal material saving for the endoprosthesis shaft and thus a reduction in the bone to be removed volume results.

Eine weitere Verringerung der Lockerungsgefahr läßt sich da­ durch erzielen, daß jeder der Flügel aus einem Blech mit einer dem Knochen angepaßten Biegesteifigkeit besteht. Als Material für den Endoprothesenschaft werden Cobalt-Chrom-Molybdän-, Co­ balt-Nickel-Chrom-Molybdän- oder Titan-Legierungen oder unle­ giertem Titan oder Tantal oder Niob verwendet. Diese Stoffe sind weitgehend korrosionsresistent und bioverträglich. Bevor­ zugt wird der Schaft eine über seine axiale Länge unterschied­ liche Biegesteifigkeit aufweisen.There is a further reduction in the risk of loosening by making each of the wings from a sheet with a bending rigidity adapted to the bone. As a material for the endoprosthesis shaft, cobalt-chromium-molybdenum, Co balt-nickel-chromium-molybdenum or titanium alloys or unle alloyed titanium or tantalum or niobium. These substances are largely corrosion-resistant and biocompatible. Before the shaft is differentiated over its axial length have flexural rigidity.

Um eine bessere Verankerung des Schaftes im Tibia oder Femur zu erreichen, sind im Flügel bzw. in den Flügeln Löcher versehen, durch welche Spongiosa wachsen kann. Vorzugsweise kann der Schaft oder können die Flügel über die Fläche unterschiedliche Stärken aufweisen, insbesondere zum distalen Ende hin eine ge­ ringere Stärke als zum proximalen Ende hin.To better anchor the shaft in the tibia or femur there are holes in the wing or wings,  through which cancellous bone can grow. Preferably, the Shaft or wings can be different over the surface Have strengths, especially towards the distal end less strength than towards the proximal end.

Des weiteren können der zu erwartenden unterschiedlichen Kraft­ einleitung an verschiedenen Orten und der Tibia- oder Fe­ mur-Form entsprechend die Flügel eine unterschiedliche Breite aufweisen, wobei vorzugsweise die jeweils benachbarten Flügel zueinander gleiche Winkelstellungen aufweisen. Bei vier Flügeln stehen diese rechtwinklig-kreuzweise zueinander.Furthermore, the expected different force Introduction to different locations and the tibia or Fe Mur shape corresponding to the wings of a different width have, preferably the respective adjacent wing have the same angular positions to each other. With four wings they are at right angles to one another in a cross shape.

Im konstruktiv einfachsten Fall kann der Endoprothesenschaft derart beschaffen sein, daß die Flügel aus mehreren Blechstrei­ fen bestehen, die in der Mitte entlang der Längsachse zusammen­ geschweißt sind. Vorzugsweise besitzt der Schaft an seinem pro­ ximalen Ende eine konusförmige Ausnehmung als Träger für Lager und Gleitflächen des Gelenkteiles.In the simplest case, the endoprosthesis socket can be such that the wings consist of several strips of sheet metal fen exist, which together in the middle along the longitudinal axis are welded. Preferably, the shaft has on its pro ximal end a conical recess as a support for bearings and sliding surfaces of the joint part.

Die Erfindung betrifft ferner ein Verfahren zur Herstellung ei­ nes Endoprothesenschaftes, das dadurch gekennzeichnet ist, daß für eine vorgebbare Biegesteifigkeit die Löcher in Blechstrei­ fen vor oder nach dem Zuschnitt in einer bestimmten Größe und in bestimmter Anordnung gestanzt, gebohrt oder anderweitig ein­ gebracht werden und/oder die Blechstärke der Blechstreifen über die Fläche an verschiedenen Stellen in verschiedenem Ausmaß durch spanabhebende Bearbeitung verringert wird, wobei die Blechstreifen derart vorgeformt werden, daß sie entlang einer Längsmittelachse durch Schweißen verbindbar sind. Mit diesem Herstellverfahren ist es möglich, aus standardisierten Blech­ teilen für jeweilige Patienten spezielle Formgebungen durch Anpassung an Geometrie und Innenkontur von Femur oder Tibia auf einfache Art und Weise zu schaffen, wenn Röntgenaufnahmen aus mindestens zwei Ebenen hinzugezogen werden können. Im Gegensatz zu den bisher verwendeten Stielen können die Flügel in Markhöhle positionsgenau eingeschoben werden, wobei die Veran­ kerungsteile dadurch fixiert werden, daß sie optimalen Kontakt zur vorhandenen Spongiosa und Wandung der Knochenhöhlung auf­ nehmen, dort einwachsen und so eine gesicherte Kraftübertragung vornehmen können. Durch die Formgebung der Verankerungsteile mit einer Vielzahl von Durchbrüchen und das in diese Durchbrü­ che nach Implantation eingewachsene Knochenmaterial wird ge­ genüber herkömmlichen starren, relativ glatten Verankerungstei­ len eine weitestgehende sichere sekundäre Fixierung mit optima­ ler Rotationsstabilität und mit einer besseren Annäherung an die natürliche Spannungsverteilung im Knochen erreicht als dies bisher möglich war. Durch Auswahl der Anzahl der Blechstreifen sowie durch deren mechanische Präparation können weitere Biege­ steifigkeitsänderungen vorgenommen werden.The invention further relates to a method for producing egg Nes endoprosthesis shaft, which is characterized in that The holes in sheet metal strips for a predefinable bending stiffness before or after cutting to a certain size and punched, drilled or otherwise in a specific arrangement are brought over and / or the sheet thickness of the sheet strips the area in different places to different degrees is reduced by machining, the Metal strips are preformed so that they are along a Longitudinal central axis can be connected by welding. With this Manufacturing process is possible from standardized sheet metal share special shapes for each patient Adaptation to the geometry and inner contour of the femur or tibia easy way to create when x-rays out at least two levels can be consulted. In contrast to the stems used so far, the wings in  The medullary cavity is inserted in the correct position, the veran kerungsteile be fixed in that they optimal contact to the existing cancellous bone and wall of the bone cavity take, wax there and so a secure power transmission can make. Due to the shape of the anchoring parts with a variety of breakthroughs and that into these breakthroughs bone material that has grown in after implantation is collected compared to conventional rigid, relatively smooth anchoring part len a largely secure secondary fixation with optima rotation stability and with a better approximation the natural stress distribution in the bone reaches this was previously possible. By selecting the number of sheet metal strips as well as through their mechanical preparation, further bending changes in stiffness are made.

Ein Ausführungsbeispiel der Erfindung ist in den Zeichnungen dargestellt. Es zeigenAn embodiment of the invention is in the drawings shown. Show it

Fig. 1 und b jeweils Längsschnitte des erfindungsgemäßen Endoprothesenschaftes, Fig. 1 and b are longitudinal sections respectively of the Endoprothesenschaftes according to the invention,

Fig. 2 einen Querschnitt längs der Linie II-II und Fig. 2 shows a cross section along the line II-II and

Fig. 3 einen Querschnitt längs der Linie III-III in Fig. 1a. Fig. 3 shows a cross section along the line III-III in Fig. 1a.

Der in Fig. 1a, b bis 3 dargestellte Endoprothesenschaft 10 be­ sitzt an seinem proximalen Ende eine konische Aufnahme 11. Der Schaft besteht typischerweise aus vier kreuzförmig im rechten Winkel zueinander angeordneten Flügeln 13, die in ihrer Außen­ kontur, basierend auf senkrecht zueinander angefertigten, prä­ operativen Röntgenaufnahmen, individuell an die Form der Mark­ höhle angepaßt werden können. Die Außenkontur des Verankerungs­ schaftes stützt sich dann auf ihrer gesamten Länge auf der Kor­ tikalis ab. Jeder der Flügel besitzt Löcher 13 verschiedener Größe und Anordnung, womit einerseits die Biegesteifigkeit des Endoprothesenverankerungsteiles der Biegesteifigkeit des auf­ nehmenden Knochens (Femur, Tibia) angepaßt werden kann und an­ dererseits das Durchwachsen von Knochen ermöglicht wird. Die Flügel sind entlang der Längsachse im Bereich der Schweiß­ stelle 14 miteinander verbunden. Die Berechnung der Geometrie und Verteilung der Löcher für die vorgebbare Biegefestigkeit kann beispielsweise durch die Methode der Finiten-Elemente er­ mittelt werden.The endoprosthesis shaft 10 shown in FIGS. 1 a, 3 b is a conical receptacle 11 at its proximal end. The shaft typically consists of four cross-shaped wings 13 arranged at right angles to one another, the outer contour of which can be individually adapted to the shape of the medullary cavity based on pre-operative X-ray recordings made perpendicular to one another. The outer contour of the anchoring shaft is then supported over its entire length on the cor tikalis. Each of the wings has holes 13 of different sizes and arrangements, which on the one hand the bending stiffness of the endoprosthesis anchoring part can be adapted to the bending stiffness of the bone (femur, tibia) and on the other hand allows bone to grow through. The wings are connected to one another along the longitudinal axis in the area of the weld 14 . The calculation of the geometry and distribution of the holes for the predeterminable bending strength can be determined, for example, by the method of the finite elements.

Grundsätzlich ist die dargestellte Flügelform auch für andere als Kniegelenksendoprothesen geeignet, solange die Steifigkeit der das Schaftprofil im wesentlichen prägenden Endoprothese ausreichend groß ist.Basically, the wing shape shown is also for others suitable as a knee joint endoprosthesis, as long as the rigidity the endoprosthesis that essentially shapes the shaft profile is sufficiently large.

Claims (13)

1. Endoprothesenschaft für Kniegelenke, bestehend aus einem in einem Tibia- oder Femur-Markraum oder in einem Knochen­ kanal zu verankernden blattförmigen sich zum distalen Ende hin verjüngenden Schaft (10) mit einem rotationshindernden Profil, dadurch gekennzeichnet, daß der Schaft (10) mehr als zwei Flügel (12) aufweist.1. endoprosthesis for the knee joints, consisting be anchored channel from a in a tibial or femoral medullary cavity or in a bone sheet located toward the distal end tapered shank (10) having a rotation-inhibiting profile, characterized in that the shaft (10) more has two wings ( 12 ). 2. Endoprothesenschaft nach Anspruch 1, dadurch gekennzeich­ net, daß jeder der Flügel (10) blattförmig ausgebildet ist.2. Endoprosthesis shaft according to claim 1, characterized in that each of the wings ( 10 ) is leaf-shaped. 3. Endoprothesenschaft nach Anspruch 1 oder 2, dadurch ge­ kennzeichnet, daß jede der Flügel (10) aus einem Blech mit einer dem Knochen angepaßten Biegesteifigkeit besteht.3. Endoprosthesis shaft according to claim 1 or 2, characterized in that each of the wings ( 10 ) consists of a sheet metal with a bending stiffness adapted to the bone. 4. Endoprothesenschaft nach einem der Ansprüche 1 bis 3, da­ durch gekennzeichnet, daß der Schaft (10) aus CoCrMo-, Co- NiCrMo- oder einer Titan-Legierung oder unlegiertem Titan oder Tantal oder Niob besteht.4. Endoprosthesis socket according to one of claims 1 to 3, characterized in that the shaft ( 10 ) consists of CoCrMo-, Co- NiCrMo- or a titanium alloy or unalloyed titanium or tantalum or niobium. 5. Endoprothesenschaft nach einem der Ansprüche 1 bis 4, da­ durch gekennzeichnet, daß die Biegesteifigkeit des Schaf­ tes (10) über die axiale Länge unterschiedlich ist.5. Endoprosthesis shaft according to one of claims 1 to 4, characterized in that the bending stiffness of the shaft ( 10 ) is different over the axial length. 6. Endoprothesenschaft nach einem der Ansprüche 1 bis 5, da­ durch gekennzeichnet, daß die Flügel (12) Löcher (13) auf­ weisen.6. Endoprosthesis shaft according to one of claims 1 to 5, characterized in that the wings ( 12 ) have holes ( 13 ). 7. Endoprothesenschaft nach einem der Ansprüche 1 bis 6, da­ durch gekennzeichnet, daß der Schaft (10) oder die Flü­ gel (12) über die Fläche unterschiedliche Stärken aufwei­ sen. 7. Endoprosthesis shaft according to one of claims 1 to 6, characterized in that the shaft ( 10 ) or the wing gel ( 12 ) on the surface have different strengths. 8. Endoprothesenschaft nach einem der Ansprüche 1 bis 7, da­ durch gekennzeichnet, daß mindestens ein Flügel (12) in einem Querschnitt eine von der Breite der anderen Flü­ gel (12) unterschiedliche Breite aufweist.8. Endoprosthesis shaft according to one of claims 1 to 7, characterized in that at least one wing ( 12 ) in a cross section has a width different from the width of the other wing ( 12 ). 9. Endoprothesenschaft nach einem der Ansprüche 1 bis 8, da­ durch gekennzeichnet, daß jeweils benachbarte Flügel (12) zueinander gleiche Winkelstellungen aufweisen.9. Endoprosthesis shaft according to one of claims 1 to 8, characterized in that each adjacent wing ( 12 ) have the same angular positions to each other. 10. Endoprothesenschaft nach einem der Ansprüche 1 bis 9, da­ durch gekennzeichnet, daß vier Flügel (12) vorgesehen sind.10. Endoprosthesis shaft according to one of claims 1 to 9, characterized in that four wings ( 12 ) are provided. 11. Endoprothesenschaft nach einem der Ansprüche 1 bis 10, da­ durch gekennzeichnet, daß die Flügel (12) aus mehreren Blechstreifen bestehen, die in der Mitte entlang der Längsachse zusammengeschweißt (14) sind.11. Endoprosthesis shaft according to one of claims 1 to 10, characterized in that the wings ( 12 ) consist of several sheet metal strips which are welded together in the middle along the longitudinal axis ( 14 ). 12. Endoprothesenschaft nach einem der Ansprüche 1 bis 11, da­ durch gekennzeichnet, daß der Schaft (10) an seinem proxi­ malen Ende eine konusförmige Ausnehmung (11) als Träger für Lager und Gleitflächen besitzt.12. Endoprosthesis shaft according to one of claims 1 to 11, characterized in that the shaft ( 10 ) has at its proximal end a conical recess ( 11 ) as a carrier for bearings and sliding surfaces. 13. Verfahren zur Herstellung eines Endoprothesenschaftes nach einem der Ansprüche 1 bis 12, dadurch gekennzeichnet, daß für eine vorgebbare Biegesteifigkeit Löcher in einen Blechstreifen vor oder nach dem Zuschnitt in einer be­ stimmten Größe in bestimmter Anordnung gestanzt, gebohrt oder anderweitig eingebracht werden und/oder die Blech­ stärke der Blechstreifen über die Fläche an verschiedenen Stellen in verschiedenem Ausmaß durch spanabhebende Bear­ beitung verringert wird, daß die Blechstreifen vorgeformt werden und zur Bildung eines mehrflügeligen Schaftes mit­ einander verschweißt werden.13. Process for the production of an endoprosthesis shaft one of claims 1 to 12, characterized in that holes in one for a predeterminable bending stiffness Sheet strips before or after cutting in a be agreed size punched in a certain arrangement, drilled or otherwise introduced and / or the sheet Strengthen the sheet metal strips across the surface at different Places to different degrees by machining Bear processing is reduced that the metal strips are preformed and to form a multi-winged shaft with are welded to each other.
DE4223373A 1992-07-16 1992-07-16 Endoprosthesis socket for knee joints and process for its manufacture Expired - Fee Related DE4223373C2 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1044665A2 (en) * 1999-04-13 2000-10-18 Plus Endoprothetik Ag Blade-shaped stem of a hip joint prosthesis for anchoring in the femur
FR2838633A1 (en) * 2002-04-17 2003-10-24 Andre Raoult Complete knee prosthesis has articulating axis connecting femoral element to tibial element moved back on horizontal level by 5 mm from center of two spherical portions to obtain higher inflection amplitude
US7494510B2 (en) 2000-04-13 2009-02-24 Smith And Nephew Orthopaedics Ag Leaflike shaft of a hip-joint prosthesis for anchoring in the femur

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102013104935B4 (en) * 2013-05-14 2020-03-05 Vacuumschmelze Gmbh & Co. Kg CoNiCrMo alloy and method for producing a CoNiCrMo alloy

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Publication number Priority date Publication date Assignee Title
DE2154338A1 (en) * 1971-11-02 1973-05-17 Eduard Hartmann JOINT PROSTHESIS
DE2839093A1 (en) * 1978-09-08 1980-03-20 Hans Dr Reimer Hip or knee endoprosthesis - with serrated oblique face on ball joint anchored by threaded shank
DE2631351C2 (en) * 1975-07-14 1982-04-29 Research Corp., New York, N.Y. Knee joint prosthesis
WO1983002555A1 (en) * 1982-01-21 1983-08-04 Us Medical Corp Prosthesis fixation to bone
DE3743329C1 (en) * 1987-12-21 1989-06-22 Krupp Gmbh Endoprosthesis hollow stem for cement-free implantation

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2154338A1 (en) * 1971-11-02 1973-05-17 Eduard Hartmann JOINT PROSTHESIS
DE2631351C2 (en) * 1975-07-14 1982-04-29 Research Corp., New York, N.Y. Knee joint prosthesis
DE2839093A1 (en) * 1978-09-08 1980-03-20 Hans Dr Reimer Hip or knee endoprosthesis - with serrated oblique face on ball joint anchored by threaded shank
WO1983002555A1 (en) * 1982-01-21 1983-08-04 Us Medical Corp Prosthesis fixation to bone
DE3743329C1 (en) * 1987-12-21 1989-06-22 Krupp Gmbh Endoprosthesis hollow stem for cement-free implantation

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1044665A2 (en) * 1999-04-13 2000-10-18 Plus Endoprothetik Ag Blade-shaped stem of a hip joint prosthesis for anchoring in the femur
EP1044665A3 (en) * 1999-04-13 2001-01-31 Plus Endoprothetik Ag Blade-shaped stem of a hip joint prosthesis for anchoring in the femur
US6808539B2 (en) 1999-04-13 2004-10-26 Plus Endoprothetik Ag Leaflike shaft of a hip-joint prosthesis for anchoring in the femur
US7175668B2 (en) 1999-04-13 2007-02-13 Plus Orthopedics Ag Leaflike shaft of a hip-joint prosthesis for anchoring in the femur
US7455693B2 (en) 1999-04-13 2008-11-25 Smith & Nephew Orthopaedics, Ag Leaflike shaft of a hip-joint prosthesis for anchoring in the femur
US7494510B2 (en) 2000-04-13 2009-02-24 Smith And Nephew Orthopaedics Ag Leaflike shaft of a hip-joint prosthesis for anchoring in the femur
FR2838633A1 (en) * 2002-04-17 2003-10-24 Andre Raoult Complete knee prosthesis has articulating axis connecting femoral element to tibial element moved back on horizontal level by 5 mm from center of two spherical portions to obtain higher inflection amplitude

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