EP1965736A2 - Prothèse - Google Patents

Prothèse

Info

Publication number
EP1965736A2
EP1965736A2 EP07726285A EP07726285A EP1965736A2 EP 1965736 A2 EP1965736 A2 EP 1965736A2 EP 07726285 A EP07726285 A EP 07726285A EP 07726285 A EP07726285 A EP 07726285A EP 1965736 A2 EP1965736 A2 EP 1965736A2
Authority
EP
European Patent Office
Prior art keywords
implant
implant according
edge portion
recess
textile
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.)
Withdrawn
Application number
EP07726285A
Other languages
German (de)
English (en)
Inventor
Ralph Howald
Peter Heuberger
Ulrike Trommsdorff
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.)
Zimmer GmbH
Original Assignee
Zimmer GmbH
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 Zimmer GmbH filed Critical Zimmer GmbH
Publication of EP1965736A2 publication Critical patent/EP1965736A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • 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
    • 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
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
    • 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
    • A61F2/40—Joints for shoulders
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30242—Three-dimensional shapes spherical
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30242—Three-dimensional shapes spherical
    • A61F2002/30245—Partial spheres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317—The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324—The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • 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
    • A61F2/30756—Cartilage endoprostheses
    • A61F2002/30757—Cartilage endoprostheses made of a sheet covering the natural articular surface, e.g. cap
    • 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
    • A61F2002/30971—Laminates, i.e. layered products
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0071—Three-dimensional shapes spherical
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness

Definitions

  • the invention relates to an implant for the relief of damaged areas of the articular surfaces of hip or shoulder joints.
  • both articular surfaces are replaced by coordinated artificial joint parts. As is known, this takes place within the scope of surgery, in which a more or less large part of the healthy bone is removed, depending on the prosthesis used in each case.
  • hip surgery for example, the femoral head is partially or completely removed to make room for a condyle that is usually anchored in the femur via a shaft.
  • acetabulum acetabulum
  • resurfacing techniques The first surgery that results in relevant loss of bone material may be delayed by so-called resurfacing techniques become.
  • resurfacing techniques require stressful operations, which are also not minimally invasive possible.
  • resurfacing also requires the removal of healthy bone material in the area of the involved articular surfaces, albeit to a lesser extent than in the aforementioned operations.
  • the invention provides an implant for relief of damaged areas of the articular surfaces, which can be introduced into the gap between the interacting in the natural joint articular surfaces of the condyle and the acetabulum, wherein the implant is designed as a shell or cap in the implanted state with a convex Outer side is located in the socket and sits with a concave inner side on the condyle, wherein the implant comprises a shell or cap forming body portion having an opening, and an edge portion which defines the opening, and wherein the Implant is made of a flexible material which is deformable for introducing the implant in the existing between the joint surfaces gap.
  • the implant can significantly reduce pressure and / or shear loads on arthrosis affected areas of the articular surfaces. As a result, the implant is not exclusively suitable, but especially well for joints affected by osteoarthritis in the early stages.
  • the implant is not exclusive, but especially interesting for relatively young patients.
  • the advantage is that the implant can be used as part of a minimally invasive procedure. There is no processing of the bone required.
  • the implant can be designed so that it aligns itself in the joint space. Alternatively, the implant can be fixed to the natural bone or tissue structures.
  • the insertion of the implant does not require subluxation of the condyle.
  • the implant can be made of one or more different metallic or non-metallic materials.
  • a hydrogel, polyurethane or polyethylene is, for example, a hydrogel, polyurethane or polyethylene.
  • the implant may contain a textile material or consist of a textile material, wherein the textile material comprises a textile substrate, and wherein at least on a part of the surface of the textile substrate, a coating is provided which is one of the hydrogels, polyurethanes, polyvinyl chloride, Polytetrafluoroethylene and any combination of two or more of the aforementioned compounds selected compound.
  • the textile substrate may be made of fibers, at least a portion of the fibers being provided with a coating containing a compound selected from the group consisting of hydrogels, polyurethanes, polyvinylchloride, polytetrafluoroethylene and any combination of two or more of the aforementioned compounds.
  • the implant may have a sandwich construction of a plurality of individual layers. At least two layers may differ from one another in terms of their construction and / or their material.
  • the implant or at least one layer of a sandwich construction of the implant comprising a plurality of individual layers may be provided with a textile, fibrous, braid, knit or fabric reinforcement.
  • Two adjacent layers which have the same material but a different structure, can be chemically mixed with one another be, wherein the crosslinking was generated for example by irradiation.
  • the material of the implant may be bioresorbable.
  • the implant comprises a plurality of respectively a partial area of the outside and / or the inside forming relief elements.
  • the relief elements can be designed as upholstery, cushions or bales.
  • the relief elements can be connected to each other by a flat support structure.
  • the support structure may comprise a textile, fiber, braid, knit or fabric material.
  • the edge portion may be provided with a reinforcement.
  • separate strength carrier can be integrated.
  • a reinforcement of the edge portion can be made by a fiber or cord structure.
  • the edge portion is hollow and provided with a filling.
  • the filling may be a gas, for example air, or a liquid. It may be provided a filler whose state changes with time. While the filler material is liquid or pasty upon insertion of the implant to facilitate insertion, over time, the filler material transitions to a solid state such that the rim portion imparts high dimensional stability to the implant and / or for stable positioning of the implant between the two articular surfaces.
  • the body portion of the implant may comprise a ball portion and a cylinder portion, the cylinder portion being attached to the ball portion. cut connects.
  • the ball portion may have the shape of a hemisphere.
  • the edge portion may be thickened relative to the wall thickness of the body portion. It can be provided that the edge portion is formed bead-shaped.
  • the implant can be dimensioned such that in the implanted state the edge section is located outside the gap existing between the joint surfaces.
  • the body portion of the implant may have at least one recess.
  • this recess can serve to preserve the so-called H Commonkopfband (ligamentum capitis femoris).
  • the recess may extend into the edge portion, wherein the edge portion may have an interruption formed by the recess.
  • a separate fitting may be provided which, after inserting the implant into the gap between the articular surfaces, may be inserted into the interruption of the rim portion to close the rim portion. The fitting can thus give the implant in the inserted state dimensional stability again.
  • the implant prefferably has a constant wall thickness. If a recess of the type described above is provided, then the wall thickness of the body portion of the vary in that the wall thickness near the recess is greater than in the region further away from the recess.
  • a wall thickness distribution results in that, starting from a symmetrical state in which the body portion has a constant wall thickness between the inside and the outside, the inside and the outside are shifted from one another. This offset may be in a direction parallel to an equatorial plane of a sphere portion of the body portion.
  • FIG. 1-3 an embodiment of an implant according to the
  • Fig. 4-7 another embodiment of an implant according to the invention.
  • the implant can be used for both hip joints and shoulder joints. Two embodiments will be explained below, for example only in connection with the hip joint.
  • the implant according to FIGS. 1 to 3 is designed as a cap, which comprises a sphere section 15 in the form of a hemisphere. At the ball portion 15, a cylindrical portion 17 connects.
  • the cap is open at the bottom.
  • the opening 27 is delimited by an edge section 19.
  • the edge portion 19 comprises a bead-shaped thickening such that the edge portion 19 projects radially outward relative to the cylinder portion 17.
  • the insertion of the implant can be done as part of an arthroscopic procedure.
  • the articular surfaces e.g. using an extraction table, without subluxation of the femoral head 11.
  • Implant placement may also be accomplished by other minimally invasive techniques.
  • the implant consists of a flexible material. In this way, the implant can be deformed during insertion and adapt to the shape of the joint gap between the femoral head 11 and the socket 13. With regard to the possible materials or the possible structure of the implant, reference is also made to the introductory part.
  • the material may be metallic or non-metallic. In question is, for example, a hydrogel, polyurethane or polyethylene.
  • the material can be reinforced by fiber or canvas structures. Furthermore, the material can consist of several layers or layers, which are either made of different materials or of the same material with the same material. Different structures are made.
  • the implant material may comprise a substrate and a substrate coating.
  • the substrate may be a textile material.
  • the inner radius A of the ball portion and the cylinder portion may be in the range of 38-60 mm.
  • the length D of the cylinder portion 17 is, for example, half of the inner radius A or less.
  • the cylinder portion 17 may be arbitrarily short, with a cylinder portion 17 can be completely dispensed with.
  • the wall thickness C of the implant is constant and is for example 0.5 to 3 mm.
  • the bead-shaped edge portion 19 is at least approximately circular in cross section.
  • the radius E of the bead is, for example, in the range of 0.5 to 4.0 times the wall thickness C.
  • the bead-shaped edge portion 19 may be solid and made entirely of the same material as the body portion formed by the ball portion 15 and the cylinder portion 17.
  • the edge portion 19 may be reinforced by a cord structure, for example. It is also possible to make the edge section 19 hollow and to be filled with a gas, a liquid or a material which over the course of time changes from a liquid or pasty initial state to a solid final state, as explained in the introductory part.
  • the bead-shaped edge portion 19 can ensure that the implant aligns itself in the inserted state.
  • the implant can be fastened to the edge area of the acetabulum, namely on the bone or on the fibrocartilaginous material of the labrum acetabuli.
  • edge section 19 of the implant it is also possible to fasten the edge section 19 of the implant to the femoral neck, wherein a possibly provided cord reinforcement of the edge section 19 can be used. As a result, femoral articulation of the implant can be prevented or reduced in its extent.
  • FIGS. 4 to 7 differs from the exemplary embodiment according to FIGS. 1 to 3 by a recess 21 provided in the body section 15, 17 and by a non-constant wall thickness.
  • the recess 21 extends from the ball section 15 via the cylinder section 17 into the edge section 19.
  • the edge section 19 is interrupted due to the recess 21.
  • a separate fitting piece 23 is provided in order to close the interruption again after insertion of the implant and to restore the dimensional stability of the implant.
  • the fitting piece 23 When inserting the implant, the fitting piece 23 is removed.
  • the implant is pushed from the cranial edge of the acetabulum 13 between the articular surfaces of the femoral head 1 1 and the hip bone 12.
  • the flexible implant adapts itself to the shape of the joint surfaces.
  • the ligamentum capitis femoris 33 which is located in the implanted state in the region of the recess 21 (FIG. 5).
  • the edge portion 19 can then be closed by the fitting piece 23.
  • the implant again acquires a dimensional stability in accordance with the exemplary embodiment without a recess according to FIGS. 1 to 3.
  • a slight asymmetry in wall thickness distribution provides the implant with rotational stability. Stability to rotation can also be achieved by fixing the edge section 19 of the implant at the edge region of the acetabulum 13.
  • the non-uniform wall thickness distribution of the implant arises as a result (FIG. 6) that the outer side 29 and the inner side 31 are displaced from one another with a constant wall thickness starting from a symmetrical state along a line k, which runs parallel to an equatorial plane Q.
  • the outer side 29 and the inner side 31 form two eccentrically adjacent spherical partial surfaces.
  • the direction of the displacement is chosen such that the inner side 31 is displaced away from the recess 21.
  • the center Ma of the inner side 31 thus lies on the side of the center Mb of the outer side 29 facing away from the recess 21.
  • center points Ma, Mb and the center O of a circular region of a projection of the recess 21 lie on the equatorial plane Q on a line k (FIG. 7).
  • the circular area with Teltician O has a diameter G, which is basically arbitrary, as long as the recess 21 does not reach to the pole of the implant (Fig. 6). It is therefore possible to define two half-spaces which are separated from each other by a plane T in which the center Mb of the outer side 29 lies, through which the center axis Zb of the corresponding outer surface of the cylinder section 17 extends. In the one half space is the recess 21, while in the other half space of the center Ma of the inner side 31 and the central axis Za of the corresponding inner surface of the cylinder portion 17 are.
  • the size of the inner radius A and the length D of the cylinder portion 17 may be sized according to the embodiment of FIG. 1 to 3.
  • the difference between outer radius B and inner radius A is, for example, in the range of 0.5 to 3 mm.
  • the radius E of the bead-shaped edge portion 19 is, for example, in the range of 0.5 to 3.0 times the aforementioned difference between outer radius B and inner radius A.
  • the offset F between the two centers Ma and Mb and thus the central axes Za, Zb can be up to 2.5 mm.
  • the implant can consist of a plurality of soft individual elements which are formed in a cushion, pillow or bale shape and serve as relief elements.
  • the relief Elements define the contact surfaces of the implant to the articular surfaces of the femoral head 1 1 and the acetabulum 13 and thus serve to relieve already damaged areas of the articular surfaces.
  • the relief elements are interconnected by a flat support structure, which may consist of a metallic or non-metallic material.
  • the support structure may comprise a textile, fiber, braid, knit or fabric material.
  • the invention provides an implant, by means of which the damaged areas of the joint surfaces can be relieved. This relief can cause the damaged areas to recover. Patient-burdening operations that result in the loss of healthy bone can be delayed in this way. As already explained, this is of great advantage, above all for relatively young patients.

Landscapes

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

Abstract

La présente invention concerne une prothèse qui est destinée à décharger les zones endommagées des surfaces articulaires de l'articulation de la hanche et de l'épaule et qui est insérée dans l'interstice entre les surfaces articulaires, coopérant dans l'articulation naturelle, de la tête articulaire et de la cavité articulaire. La prothèse, en forme de coupe ou de cupule est en contact par sa face externe convexe lorsqu'elle est implantée dans la cavité articulaire et elle repose par sa face interne sur la tête articulaire. La prothèse présente une section corps constituant la coupe ou la cupule, un orifice et une section bordure qui délimite l'ouverture. La prothèse est réalisée dans un matériau flexible déformable, ce qui permet son insertion dans l'interstice situé entre les surfaces articulaires.
EP07726285A 2006-02-09 2007-02-02 Prothèse Withdrawn EP1965736A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH2072006 2006-02-09
PCT/EP2007/051008 WO2007090790A2 (fr) 2006-02-09 2007-02-02 Prothèse

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EP1965736A2 true EP1965736A2 (fr) 2008-09-10

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US20090048679A1 (en) 2009-02-19

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