EP3930633A1 - Range of articular implant systems with double mobility - Google Patents
Range of articular implant systems with double mobilityInfo
- Publication number
- EP3930633A1 EP3930633A1 EP20710242.7A EP20710242A EP3930633A1 EP 3930633 A1 EP3930633 A1 EP 3930633A1 EP 20710242 A EP20710242 A EP 20710242A EP 3930633 A1 EP3930633 A1 EP 3930633A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- joint
- internal cavity
- ball
- insert
- range
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
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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
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/34—Acetabular cups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- 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
- A61F2/30767—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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
-
- 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
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- 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
- A61F2002/3208—Bipolar or multipolar joints, e.g. having a femoral head articulating within an intermediate acetabular shell whilst said shell articulates within the natural acetabular socket or within an artificial outer shell
-
- 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
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00035—Other metals or alloys
- A61F2310/00059—Chromium or Cr-based alloys
Definitions
- the present invention relates to the field of joint implants, in particular with dual mobility, and aimed at replacing the bone joints of substantially hemispherical geometry of the human or animal body.
- the small joint is used in low amplitude movements and the large joint comes into action when the femoral neck of the prosthetic stem comes into contact with said constriction of the movable insert during large amplitude movements.
- This contact is described in the literature as being the third joint, often the most fragile.
- ⁇ a series of anchoring cups, the external diameter of which varies discretely and incrementally, in order to adapt to the different acetabular cavities, the standard thickness of which is generally between 2 and 4 millimeters;
- the object of the present invention is to provide a range of joint implant systems which significantly overcome these various drawbacks.
- the invention relates to a range of joint implant systems, said implant being of the type comprising:
- the ratio of the internal diameter of the internal cavity of the anchoring cup to the internal diameter of the internal cavity of the mobile insert, for all the elements of the range, is constant.
- the ratio of the areas of the small joint to the large joint is constant for a chosen ball diameter.
- the respective diameters and surfaces are linked to each other by the classical and well-known relations of the calculation of a sphere, particularly truncated, with regard to the insert.
- the practicing surgeon determines, after the patient's acetabulum has been reamed, the external diameter of the appropriate anchoring cup, in particular in order to conserve as much bone capital as possible.
- This determined anchoring cup will have a thickness such that it respects the aforementioned constant dimensional ratio, so as to reduce the friction torque of the large joint, and consequently further reduce the phenomena of dislocation, in addition to the phenomena of wear liable to to lead, as indicated above, to blockage of the joint and other risks of prosthetic failure mentioned above.
- this ratio is between 1.1 and 3.
- Figure 1 is a schematic representation illustrating a dual mobility joint implant according to the prior art.
- FIG. 2 is a series of sagittal sections of a range of articular implants in accordance with the invention, mainly illustrating the variation in the thickness, in particular of the outer cup.
- Figure 1 shows the block diagram of a dual mobility joint implant according to the prior art.
- this implant consists first of all of an anchoring cup (1), in the shape of a cap, intended to be fixed within a first element of a joint to be prosthesis (2), and for example , the acetabular cavity of a patient's pelvis as part of a hip prosthesis.
- This anchoring cup is made of a rigid biocompatible material, for example of metal such as one-piece chromium-cobalt, or a chromium-cobalt composite with an added thickness of trabecular titanium, for example in order to lighten it.
- This anchoring cup defines an internal cavity of substantially hemispherical shape, defining a first internal surface (SI) of articulation.
- This internal cavity of the anchoring cup is intended to cooperate and receive a mobile insert (3), also made of biocompatible material, and typically of high density polyethylene.
- This movable insert (3) also of substantially hemispherical shape, is therefore intended to be received in the internal cavity of the anchoring cup (1) to form a first ball joint called large joint.
- the external diameter of this movable insert (3) is therefore, except for the clearance, substantially equal to the internal diameter of the internal cavity of the anchoring cup (1).
- This movable insert (3) also comprises an internal cavity, also of substantially hemispherical shape, and defining a second articulation surface (S2), called small articulation, said internal cavity being intended to receive and cooperate with a head or ball (4 ) of spherical shape, secured to another element of the prosthesis joint, in this case, to a femoral rod (5), inserted into the medullary cavity of the femur of the joint in question.
- S2 second articulation surface
- this ball (4) is mounted on a Morse taper located at the end of the neck (7) of the femoral stem (5), in a known manner.
- the femoral stem is typically made made of a rigid biocompatible material such as titanium, cobalt-chromium, stainless steel, etc.
- the base of the movable insert is of flared shape defining a constriction (6), able to cooperate with the frustoconical shape of the neck (7) located at the upper end of the rod (5).
- the dimensions of the anchoring cup (1) are inherent, on the one hand, to the joint considered, with the primary objective of conserving the patient's bone stock, and on the other hand, to the constraints that 'she is meant to endure.
- the outer diameter of the anchoring cups of a range typically varies between 44 and 74 millimeters in 2 millimeter increments.
- the thickness of the anchoring cup of the implants of the prior art is constant in a standard range, and therefore depending on the growth of the external diameter thereof, the articular surface (SI), that is to say of the internal surface of the internal cavity of the anchoring cup, is impacted according to this growth, as is the thickness of the mobile insert. Due to the increase in the thickness of the insert, the articulation surface (SI) increases, and therefore the frictional torque at this level increases; It follows that the wear of the prosthesis at this level also increases for large amplitude movements.
- SI articular surface
- the size of the movable insert will vary, and more precisely its external diameter, in contact with the articulation surface SI, de facto increasing its thickness.
- the choice of insert is naturally deduced, and consequently that of the ball. More practically, for external diameters of the anchoring cup typically between 52 and 74 millimeters, a ball 28 millimeters in diameter will be preferred for the sake of limiting the friction torque at the surface (SI). Once this ball has been selected, there is no more choice as to the insert, the latter being unique for a ball of determined diameter.
- the choice of the anchoring cup in terms of thickness is dictated by the constant ratio sought from the invention of the internal diameter of the internal cavity of the anchoring cup, and in the species of the surface of the joint (SI), on the internal diameter of the mobile implant, and therefore in this case (S2), and typically between 1.1 and 3, advantageously close to 1.6 .
- the range considered comprises only two balls, respectively of diameter 22 or 28 millimeters, and corollary two movable inserts, depending on the diameter of the ball adopted.
- the mobile insert selected (itself dependent only on the diameter of the ball chosen), and on the other hand, the external diameter of the anchoring cup, determined by the acetabular environment observed by the surgeon, the latter is able to choose the most suitable anchoring cup for the desired result while respecting the ratio in accordance with the invention.
- FIG. 2 shows a series of views in sagittal section of different cup / movable insert pairs in accordance with the invention, in which it can be observed that for a given movable insert, in this case suitable for a 28-millimeter diameter ball, the thickness of the anchoring cup increases with the increase in its external diameter, in order to respect the constancy of the ratio of diameters, respectively internal of the anchoring cup and internal of the insert.
- the range of balls (4) is composed of 2 sizes, typically with a diameter of 22 millimeters and a diameter of 28 millimeters for a hip, there are for the range of inserts (3) only two sizes corresponding respectively to the sizes of the balls (4).
- the present invention aims to further significantly reduce the few prosthetic failures of dual mobility implants of the prior art.
- reducing the starting torque differential in the joint between the small and the large joint results in:
- the external surface of the mobile insert is optimized so that, even in anchoring cups of large external diameter, the external surface of said mobile insert remains constant and reduced, thus limiting wear debris can lead to osteolysis and therefore prosthetic failure;
- the literature shows that the number of particles emitted in a hip joint depends, among other things, on said external surface of the mobile insert.
- the simplification of the number of joint implants avoids a number of operating errors, such as resulting from labeling errors or size compatibility errors between the mobile insert and the cup. anchor.
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- 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
In this range of articular implant systems, the implant is of the type comprising: - an anchoring chamber (1) in one of the elements of the articulation (2) being considered, defining a smooth internal cavity which is substantially hemispherical; - an insert (3) which is movable within the internal cavity of the anchoring chamber (1) and the smooth external surface of which is intended to cooperate via a ball and socket joint with the internal cavity of the anchoring chamber (1), and in turn defining a smooth internal cavity which is substantially hemispherical; - a head or ball (4) which is fixedly joined to a second element of the articulation, which is spherical and which is intended to be received in the internal cavity of the movable insert (3) and to constitute a second ball and socket joint. The ratio of the internal diameter of the internal cavity of the anchoring chamber to the internal diameter of the internal cavity of the movable insert is constant for all the elements of the range, whatever the diameter of the ball (4) selected.
Description
GAMME DE SYSTEMES D’IMPLANTS ARTICULAIRES A DOUBLE RANGE OF DOUBLE JOINT IMPLANT SYSTEMS
MOBILITE MOBILITY
DOMAINE DE L’INVENTION FIELD OF THE INVENTION
La présente invention concerne le domaine des implants articulaires, notamment à double mobilité, et visant à remplacer les articulations osseuses de géométrie sensiblement hémisphérique du corps humain ou animal. The present invention relates to the field of joint implants, in particular with dual mobility, and aimed at replacing the bone joints of substantially hemispherical geometry of the human or animal body.
Elle concerne plus spécifiquement, mais non limitativement l’articulation de la hanche. It relates more specifically, but not limited to the hip joint.
ETAT ANTERIEUR DE LA TECHNIQUE PRIOR STATE OF THE ART
Dans le domaine des prothèses totales de hanche, il est connu depuis de nombreuses années le principe dit de la double mobilité, c’est-à-dire de la rotation d’une tête ou bille sphérique, fixée sur une tige prothétique insérée dans le fémur au sein d’un noyau ou insert mobile, capturée par le rétreint dont est pourvu ledit insert mobile, articulation décrite de manière générale comme constituant la petite articulation, l’ insert mobile étant le plus souvent réalisé en polyéthylène haute densité. Ledit insert est lui-même mobile également en rotation dans une cupule ou un cotyle ancré dans la cavité acétabulaire du bassin, généralement dénommée grande articulation. Ces deux articulations, grande et petite, sont appelées double mobilité. La petite articulation est mise en œuvre dans les mouvements de faible amplitude et la grande articulation se met en action lorsque le col fémoral de la tige prothétique vient au contact dudit rétreint de l’ insert mobile lors des mouvements de grande amplitude. Ce contact est décrit dans la littérature comme étant la troisième articulation, souvent la plus fragile. In the field of total hip prostheses, the so-called dual mobility principle has been known for many years, i.e. the rotation of a spherical head or ball, fixed on a prosthetic rod inserted into the femur within a core or movable insert, captured by the constriction with which said movable insert is provided, joint described generally as constituting the small joint, the movable insert being most often made of high density polyethylene. Said insert is itself also mobile in rotation in a cup or acetabulum anchored in the acetabular cavity of the pelvis, generally called the large joint. These two joints, large and small, are called dual mobility. The small joint is used in low amplitude movements and the large joint comes into action when the femoral neck of the prosthetic stem comes into contact with said constriction of the movable insert during large amplitude movements. This contact is described in the literature as being the third joint, often the most fragile.
Cette double mobilité a permis de diminuer de manière importante les luxations de l’articulation ainsi prothésée. Une telle prothèse a, par exemple, été décrite dans le document LR 2 710 836.
Si, incontestablement, la mise en œuvre de telles prothèses de hanche à double mobilité a, d’une part, réduit le nombre de luxations des articulations ainsi prothésées, et d’autre part, augmenté leur durée de vie, l’expérience montre qu’il demeure cependant un certain nombre de cas pour lesquels ces phénomènes de luxation apparaissent toujours, ou encore que des blocages de l’insert mobile, par de multiples facteurs, au sein de la cupule d’ancrage, résultant de la coopération entre les différentes surfaces de coopération entre les éléments constitutifs de telles prothèses entraînent l’échec prothétique. This double mobility made it possible to significantly reduce the dislocations of the joint thus prosthesis. Such a prosthesis has, for example, been described in document LR 2 710 836. If, undoubtedly, the implementation of such dual mobility hip prostheses has, on the one hand, reduced the number of dislocations of the joints thus prosthesis, and on the other hand, increased their lifespan, experience shows that 'however, there remain a certain number of cases in which these dislocation phenomena always appear, or even that blockages of the mobile insert, by multiple factors, within the anchoring cup, resulting from cooperation between the different cooperative surfaces between the constituent elements of such prostheses lead to prosthetic failure.
Dans la pratique, le chirurgien orthopédique confronté à la nécessité de procéder à la mise en place d’une prothèse totale de hanche, dispose d’une gamme d’implants, typiquement constitués : In practice, the orthopedic surgeon faced with the need to proceed with the placement of a total hip prosthesis, has a range of implants, typically made up of:
■ d’une série de cupules d’ancrage, dont le diamètre externe varie de manière discrète et incrémentale, afin de s’adapter aux différentes cavités cotyloïdiennes, dont l’épaisseur standard généralement se situe entre 2 et 4 millimètres ; ■ a series of anchoring cups, the external diameter of which varies discretely and incrementally, in order to adapt to the different acetabular cavities, the standard thickness of which is generally between 2 and 4 millimeters;
■ de deux ou trois tailles de bille ou tête articulaires, mais généralement d’un diamètre de 22 et 28 millimètres, destinées, comme déjà dit, à venir se fixer sur la tige prothétique insérée dans le fémur ; ■ two or three sizes of ball or joint head, but generally with a diameter of 22 and 28 millimeters, intended, as already said, to come to be fixed on the prosthetic rod inserted in the femur;
■ et enfin d’une série d’inserts mobiles, tenant compte du diamètre externe de la bille et de la variation du diamètre interne de la cavité interne de la cupule d’ancrage. ■ and finally a series of mobile inserts, taking into account the external diameter of the ball and the variation in the internal diameter of the internal cavity of the anchoring cup.
En d’autres termes, dans une telle gamme, tout d’abord le chirurgien doit choisir l’insert mobile adéquat tenant compte de la cupule d’ancrage choisie, ainsi que du diamètre de la bille choisie. D’un point de vue purement physique, on observe que plus le diamètre des surfaces en contact respectives augmente, et plus le couple de frottement augmente. De ce fait, davantage d’usure est générée au niveau de la grande articulation, c’est-à-dire entre l’insert mobile et la cavité interne de la cupule d’ancrage, qu’au niveau de la petite articulation, c’est-à-dire entre la tête ou bille et la cavité interne de l’insert mobile, sur des amplitudes de mouvements équivalentes. De fait, nonobstant la qualité améliorée des matériaux mis en œuvre, des débris d’usure sont générés, susceptibles d’entraîner des ostéolyses pouvant amener à l’échec prothétique.
Une autre problématique est inhérente à l’épaisseur de l’insert mobile. En effet, si cette épaisseur est trop réduite, la bille ou tête qui le reçoit est susceptible d’engendrer le bris de l’insert en raison des contraintes que ce dernier reçoit, typiquement par fluage par exemple. Corollairement, si l’épaisseur est trop élevée, on est pénalisé au niveau de la grande articulation, c’est-à-dire la coopération entre la surface externe de l’insert et la cavité interne de la cupule d’ancrage. En effet, plus le diamètre externe de l’insert est grand et plus son couple de démarrage, lié au couple de frottement des surfaces mises en jeu et de la masse de cet insert mobile, est élevé, ce qui se traduit par un contact de plus grande énergie au niveau du rétreint de l’insert mobile pouvant être préjudiciable à long terme et souvent observé. In other words, in such a range, first of all the surgeon must choose the suitable mobile insert taking into account the chosen anchoring cup, as well as the diameter of the chosen ball. From a purely physical point of view, it is observed that the more the diameter of the respective contacting surfaces increases, the more the friction torque increases. As a result, more wear is generated at the level of the large joint, i.e. between the movable insert and the internal cavity of the anchoring cup, than at the level of the small joint, i.e. 'That is to say between the head or ball and the internal cavity of the mobile insert, on equivalent amplitudes of movement. In fact, notwithstanding the improved quality of the materials used, wear debris is generated which may lead to osteolysis which can lead to prosthetic failure. Another problem is inherent in the thickness of the mobile insert. In fact, if this thickness is too small, the ball or head which receives it is liable to cause the insert to break due to the stresses that the latter receives, typically by creep for example. As a corollary, if the thickness is too great, one is penalized at the level of the large articulation, that is to say the cooperation between the external surface of the insert and the internal cavity of the anchoring cup. In fact, the greater the external diameter of the insert, the greater its starting torque, linked to the friction torque of the surfaces involved and the mass of this mobile insert, which results in a contact of greater energy at the shrinkage of the mobile insert which can be detrimental in the long term and often observed.
Enfin, il a également été observé des cas de blocage de la grande articulation, notamment par des fibroses ou ostéophytes péri-prothétiques. Finally, cases of blockage of the large joint have also been observed, in particular by peri-prosthetic fibrosis or osteophytes.
L’objet de la présente invention est de proposer une gamme de systèmes d’implants articulaires permettant de surmonter de manière significative ces différents inconvénients. The object of the present invention is to provide a range of joint implant systems which significantly overcome these various drawbacks.
EXPOSE DE L’INVENTION DISCLOSURE OF THE INVENTION
A cet effet, l’invention vise une gamme de systèmes d’implants articulaires, ledit implant étant du type comprenant : To this end, the invention relates to a range of joint implant systems, said implant being of the type comprising:
■ une cupule d’ancrage dans l’un des éléments de l’articulation considérée, définissant une cavité interne lisse de forme sensiblement hémisphérique ; ■ an anchoring cup in one of the elements of the joint in question, defining a smooth internal cavity of substantially hemispherical shape;
■ un insert, mobile au sein de la cavité interne de la cupule d’ancrage, et dont la surface externe lisse est destinée à coopérer par liaison rotule avec la cavité interne de la cupule d’ancrage, et définissant à son tour une cavité interne lisse de forme sensiblement hémisphérique ; ■ an insert movable within the internal cavity of the anchoring cup, whose smooth outer surface is intended to cooperate by ball bonding with the internal cavity of the anchoring cup and in turn defining an inner cavity smooth, substantially hemispherical in shape;
■ une tête ou bille, solidarisée à un second élément de l’articulation, de forme sphérique, destinée à être reçue dans la cavité interne de l’insert mobile, et à constituer une seconde liaison rotule.
Selon l’invention, le rapport du diamètre interne de la cavité interne de la cupule d’ancrage sur le diamètre interne de la cavité interne de l’insert mobile, pour l’ensemble des éléments de la gamme, est constant. ■ a head or bead, integral with a second element of the joint, spherical in shape, intended to be received in the internal cavity of the movable insert, and constitute a second ball joint. According to the invention, the ratio of the internal diameter of the internal cavity of the anchoring cup to the internal diameter of the internal cavity of the mobile insert, for all the elements of the range, is constant.
Dit autrement, le rapport des surfaces de la petite articulation et de la grande articulation est constant pour un diamètre de bille choisi. En effet, diamètres et surfaces respectives sont liés entre eux par les relations classiques et bien connues du calcul d’une sphère, tronquée notamment, s’agissant de l’insert. In other words, the ratio of the areas of the small joint to the large joint is constant for a chosen ball diameter. In fact, the respective diameters and surfaces are linked to each other by the classical and well-known relations of the calculation of a sphere, particularly truncated, with regard to the insert.
D’où il résulte que, quel que soit le paramètre choisi (diamètre ou surface), on conserve le caractère constant des rapports respectifs. From which it follows that, whatever the chosen parameter (diameter or area), the constant character of the respective ratios is retained.
En d’autres termes, le chirurgien praticien détermine, après le fraisage du cotyle du patient, le diamètre externe de la cupule d’ancrage appropriée, afin notamment de conserver le plus de capital osseux possible. Cette cupule d’ancrage déterminée aura une épaisseur telle qu’elle respecte le rapport dimensionnel constant précité, de telle sorte à réduire le couple de frottement de la grande articulation, et corollairement davantage réduire les phénomènes de luxation, outre les phénomènes d’usure susceptibles de conduire, comme indiqué ci-dessus, au blocage de l’articulation et autres risques d’échec prothétique susmentionnés. In other words, the practicing surgeon determines, after the patient's acetabulum has been reamed, the external diameter of the appropriate anchoring cup, in particular in order to conserve as much bone capital as possible. This determined anchoring cup will have a thickness such that it respects the aforementioned constant dimensional ratio, so as to reduce the friction torque of the large joint, and consequently further reduce the phenomena of dislocation, in addition to the phenomena of wear liable to to lead, as indicated above, to blockage of the joint and other risks of prosthetic failure mentioned above.
Avantageusement, ce rapport est compris entre 1,1 et 3. Advantageously, this ratio is between 1.1 and 3.
BREVE DESCRIPTION DES FIGURES BRIEF DESCRIPTION OF THE FIGURES
D’autres caractéristiques et avantages de l’invention ressortiront clairement de la description qui en est faite ci-après, à titre indicatif et nullement limitatif, en référence aux dessins annexés, dans lesquels : Other characteristics and advantages of the invention will emerge clearly from the description which is given below, by way of indication and in no way limiting, with reference to the accompanying drawings, in which:
La figure 1 est une représentation schématique illustrant un implant articulaire à double mobilité conforme à l’art antérieur. Figure 1 is a schematic representation illustrating a dual mobility joint implant according to the prior art.
La figure 2 est une série de coupes sagittales d’une gamme d’implants articulaires conformes à l’invention, illustrant principalement la variation de l’épaisseur notamment de la cupule externe.
DESCRIPTION DETAILLEE DE L’INVENTION FIG. 2 is a series of sagittal sections of a range of articular implants in accordance with the invention, mainly illustrating the variation in the thickness, in particular of the outer cup. DETAILED DESCRIPTION OF THE INVENTION
Comme déjà indiqué, la figure 1 représente le schéma de principe d’un implant articulaire à double mobilité conforme à l’état antérieur de la technique. As already indicated, Figure 1 shows the block diagram of a dual mobility joint implant according to the prior art.
Fondamentalement, cet implant se compose tout d’abord d’une cupule d’ancrage (1), en forme de calotte, destinée à être fixée au sein d’un premier élément d’une articulation à prothéser (2), et par exemple, la cavité acétabulaire du bassin d’un patient dans le cadre d’une prothèse de hanche. Basically, this implant consists first of all of an anchoring cup (1), in the shape of a cap, intended to be fixed within a first element of a joint to be prosthesis (2), and for example , the acetabular cavity of a patient's pelvis as part of a hip prosthesis.
Cette cupule d’ancrage est réalisée en matériau rigide biocompatible, et par exemple en métal tel que du chrome-cobalt monobloc, ou composite chrome-cobalt adjoint d’une surépaisseur de titane trabéculaire par exemple afin d’alléger celle-ci. Cette cupule d’ancrage définit une cavité interne de forme sensiblement hémisphérique, définissant une première surface interne (SI) d’articulation. This anchoring cup is made of a rigid biocompatible material, for example of metal such as one-piece chromium-cobalt, or a chromium-cobalt composite with an added thickness of trabecular titanium, for example in order to lighten it. This anchoring cup defines an internal cavity of substantially hemispherical shape, defining a first internal surface (SI) of articulation.
Cette cavité interne de la cupule d’ancrage est destinée à coopérer et recevoir un insert mobile (3), également réalisé en matériau biocompatible, et typiquement en polyéthylène haute densité. Cet insert mobile (3) de forme également sensiblement hémisphérique, est donc destiné à être reçu dans la cavité interne de la cupule d’ancrage (1) pour constituer une première liaison rotule dénommée grande articulation. Le diamètre externe de cet insert mobile (3) est donc, au jeu près, sensiblement égal au diamètre interne de la cavité interne de la cupule d’ancrage (1). This internal cavity of the anchoring cup is intended to cooperate and receive a mobile insert (3), also made of biocompatible material, and typically of high density polyethylene. This movable insert (3) also of substantially hemispherical shape, is therefore intended to be received in the internal cavity of the anchoring cup (1) to form a first ball joint called large joint. The external diameter of this movable insert (3) is therefore, except for the clearance, substantially equal to the internal diameter of the internal cavity of the anchoring cup (1).
Cet insert mobile (3) comporte également une cavité interne, également de forme sensiblement hémisphérique, et définissant une seconde surface d’articulation (S2), dénommée petite articulation, ladite cavité interne étant destinée à recevoir et coopérer avec une tête ou bille (4) de forme sphérique, solidarisée à un autre élément de l’articulation prothésée, en l’espèce, à une tige fémorale (5), insérée dans la cavité médullaire du fémur de l’articulation considérée. This movable insert (3) also comprises an internal cavity, also of substantially hemispherical shape, and defining a second articulation surface (S2), called small articulation, said internal cavity being intended to receive and cooperate with a head or ball (4 ) of spherical shape, secured to another element of the prosthesis joint, in this case, to a femoral rod (5), inserted into the medullary cavity of the femur of the joint in question.
Classiquement, cette bille (4) est montée sur un cône morse situé à l’extrémité du col (7) de la tige fémorale (5), ce de manière connue. La tige fémorale est typiquement réalisée
en un matériau rigide biocompatible comme du titane, du chrome-cobalt, de l’acier inoxydable, etc. Conventionally, this ball (4) is mounted on a Morse taper located at the end of the neck (7) of the femoral stem (5), in a known manner. The femoral stem is typically made made of a rigid biocompatible material such as titanium, cobalt-chromium, stainless steel, etc.
Ce faisant, on crée un double mouvement possible de rotation selon une double liaison rotule, respectivement de l’insert mobile (3) par rapport à la cupule d’ancrage (1), et de la bille (4) par rapport à l’insert mobile (3). In doing so, a possible double rotational movement is created according to a double ball joint connection, respectively of the movable insert (3) relative to the anchoring cup (1), and of the ball (4) relative to the mobile insert (3).
Avantageusement, et pour optimiser le débattement de l’articulation, et corollairement limiter les phénomènes de luxation, la base de l’insert mobile est de forme évasée définissant un rétreint (6), apte à coopérer avec la forme tronconique du col (7) situé à l’extrémité supérieure de la tige (5). Advantageously, and to optimize the movement of the joint, and as a corollary to limit dislocation phenomena, the base of the movable insert is of flared shape defining a constriction (6), able to cooperate with the frustoconical shape of the neck (7) located at the upper end of the rod (5).
De manière connue, les dimensions de la cupule d’ancrage (1) sont inhérentes, d’une part, à l’articulation considérée, avec pour objectif premier la conservation du capital osseux du patient, et d’autre part, aux contraintes qu’elle est destinée à supporter. De manière classique s’agissant d’un implant pour articulation de la hanche, le diamètre externe des cupules d’ancrage d’une gamme varie typiquement entre 44 et 74 millimètres par incrément de 2 millimètres. In a known manner, the dimensions of the anchoring cup (1) are inherent, on the one hand, to the joint considered, with the primary objective of conserving the patient's bone stock, and on the other hand, to the constraints that 'she is meant to endure. Conventionally in the case of a hip joint implant, the outer diameter of the anchoring cups of a range typically varies between 44 and 74 millimeters in 2 millimeter increments.
L’épaisseur de la cupule d’ancrage des implants de l’art antérieur est constante dans une gamme standard, et donc suivant la croissance du diamètre extérieur de celle-ci, la surface articulaire (SI), c’est-à-dire de la surface interne de la cavité interne de la cupule d’ancrage, est impactée suivant cette croissance de même que l’épaisseur de l’insert mobile. En raison de l’augmentation de l’épaisseur de l’insert, la surface d’articulation (SI) augmente, et donc corollairement le couple de frottement à ce niveau augmente ; Il s’ensuit que l’usure de la prothèse à ce niveau augmente également pour les mouvements de grande amplitude. The thickness of the anchoring cup of the implants of the prior art is constant in a standard range, and therefore depending on the growth of the external diameter thereof, the articular surface (SI), that is to say of the internal surface of the internal cavity of the anchoring cup, is impacted according to this growth, as is the thickness of the mobile insert. Due to the increase in the thickness of the insert, the articulation surface (SI) increases, and therefore the frictional torque at this level increases; It follows that the wear of the prosthesis at this level also increases for large amplitude movements.
Dans le même esprit, deux tailles de billes articulaires (4) sont classiquement retenues, pour une prothèse de hanche, respectivement un diamètre de 22 et de 28 mm. In the same spirit, two sizes of articular balls (4) are conventionally retained, for a hip prosthesis, respectively a diameter of 22 and 28 mm.
Il s’infère que, comme indiqué précédemment, avec les implants de l’art antérieur, afin de tenir compte de la variation du diamètre de la cupule d’ancrage (1), et du diamètre
standard de la bille (4), la taille de l’insert mobile va varier, et plus précisément son diamètre externe, en contact avec la surface d’articulation SI, faisant augmenter de facto son épaisseur. It is inferred that, as indicated above, with the implants of the prior art, in order to take account of the variation in the diameter of the anchoring cup (1), and of the diameter standard of the ball (4), the size of the movable insert will vary, and more precisely its external diameter, in contact with the articulation surface SI, de facto increasing its thickness.
Selon la présente invention, une fois le diamètre externe de la cupule d’ancrage déterminé par le chirurgien, fonction de l’état du cotyle du patient après fraisage et de la conservation maximale recherchée du capital osseux, au sein d’une même gamme de tels implants articulaires, il se déduit naturellement le choix de l’insert, et corollairement celui de la bille. Plus pratiquement, pour des diamètres externes de cupule d’ancrage typiquement compris entre 52 et 74 millimètres, on préférera une bille de 28 millimètres de diamètre dans un souci de limitation du couple de frottement au niveau de la surface (SI). Une fois cette bille sélectionnée, il n’y a plus de choix quant à l’insert, ce dernier étant unique pour une bille de diamètre déterminé. En revanche, et compte tenu de cette unicité, le choix de la cupule d’ancrage en termes d’épaisseur est dicté par le rapport constant recherché de l’invention du diamètre interne de la cavité interne de la cupule d’ancrage, et en l’espèce de la surface de l’articulation (SI), sur le diamètre interne de l’implant mobile, et donc en l’espèce (S2), et typiquement compris entre 1,1 et 3, avantageusement voisin de 1,6. According to the present invention, once the external diameter of the anchoring cup has been determined by the surgeon, which is a function of the state of the patient's acetabulum after milling and of the desired maximum conservation of bone stock, within the same range of such joint implants, the choice of insert is naturally deduced, and consequently that of the ball. More practically, for external diameters of the anchoring cup typically between 52 and 74 millimeters, a ball 28 millimeters in diameter will be preferred for the sake of limiting the friction torque at the surface (SI). Once this ball has been selected, there is no more choice as to the insert, the latter being unique for a ball of determined diameter. On the other hand, and taking into account this uniqueness, the choice of the anchoring cup in terms of thickness is dictated by the constant ratio sought from the invention of the internal diameter of the internal cavity of the anchoring cup, and in the species of the surface of the joint (SI), on the internal diameter of the mobile implant, and therefore in this case (S2), and typically between 1.1 and 3, advantageously close to 1.6 .
En revanche, pour des diamètres externes de cupule d’ancrage inférieurs à 52 millimètres, on favorisera une bille de 22 millimètres de diamètre, déterminant alors le choix du second insert dans la gamme d’implants, dont la cavité interne est adaptée à ce diamètre de bille. Là encore, le choix de la cupule d’ancrage en termes d’épaisseur est directement inhérent à cet insert, toujours pour respecter le rapport constant de l’invention. On the other hand, for external diameters of the anchoring cup less than 52 millimeters, a ball of 22 millimeters in diameter will be favored, then determining the choice of the second insert in the range of implants, the internal cavity of which is adapted to this diameter. ball. Here again, the choice of the anchoring cup in terms of thickness is directly inherent in this insert, again to respect the constant ratio of the invention.
Dans l’exemple décrit d’implants pour prothèse de hanche, et selon l’invention, la gamme considérée ne comporte que deux billes, respectivement de diamètre 22 ou 28 millimètres, et corollairement deux inserts mobiles, fonction du diamètre de la bille adoptée. In the example described of implants for a hip prosthesis, and according to the invention, the range considered comprises only two balls, respectively of diameter 22 or 28 millimeters, and corollary two movable inserts, depending on the diameter of the ball adopted.
En d’autres termes, tenant compte d’une part, de l’insert mobile sélectionné (dépendant lui-même uniquement du diamètre de la bille choisie), et d’autre part, du diamètre externe de la cupule d’ancrage, déterminé par l’environnement acétabulaire
observé par le chirurgien, ce dernier est à même de choisir la cupule d’ancrage la plus adaptée pour le résultat recherché en respectant le rapport conforme à l’invention. In other words, taking into account, on the one hand, the mobile insert selected (itself dependent only on the diameter of the ball chosen), and on the other hand, the external diameter of the anchoring cup, determined by the acetabular environment observed by the surgeon, the latter is able to choose the most suitable anchoring cup for the desired result while respecting the ratio in accordance with the invention.
En l’espèce on a représenté sur la figure 2 une série de vues en section sagittale de différents couples cupule/insert mobile conformes à l’invention, dans lesquels on peut observer que pour un insert mobile donné, en l’espèce adapté pour une bille de diamètre 28 millimètres, l’épaisseur de la cupule d’ancrage augmente avec l’augmentation de son diamètre externe, afin de respecter la constance du rapport des diamètres, respectivement interne de la cupule d’ancrage et interne de l’insert. En d’autres termes, si la gamme de billes (4) est composée de 2 tailles, typiquement de diamètre 22 millimètres et de diamètre 28 millimètres pour une hanche, il n’y a pour la gamme d’inserts (3) que deux tailles correspondant respectivement aux tailles des billes (4). Dans les faits, on peut observer au sein de la figure 2, de la gauche vers la droite six cupules d’ancrage dont le diamètre externe varie de 52 à 62 millimètres par incrément discret de 2 millimètres, et corollairement, un seul insert mobile, adapté pour une bille de 28 millimètres. In this case, FIG. 2 shows a series of views in sagittal section of different cup / movable insert pairs in accordance with the invention, in which it can be observed that for a given movable insert, in this case suitable for a 28-millimeter diameter ball, the thickness of the anchoring cup increases with the increase in its external diameter, in order to respect the constancy of the ratio of diameters, respectively internal of the anchoring cup and internal of the insert. In other words, if the range of balls (4) is composed of 2 sizes, typically with a diameter of 22 millimeters and a diameter of 28 millimeters for a hip, there are for the range of inserts (3) only two sizes corresponding respectively to the sizes of the balls (4). In fact, we can observe in Figure 2, from left to right six anchor cups whose external diameter varies from 52 to 62 millimeters in discrete increments of 2 millimeters, and corollary, a single movable insert, suitable for a 28 millimeter ball.
La situation est rigoureusement analogue pour des cupules d’ancrage, dont le diamètre externe varie de 44 à 50 millimètres, à la différence près que le diamètre de la bille est cette fois de 22 millimètres, et qu’en conséquence, l’insert mis en œuvre est adapté à ce diamètre de la bille. The situation is strictly similar for anchor cups, the external diameter of which varies from 44 to 50 millimeters, with the difference that the diameter of the ball is this time of 22 millimeters, and that consequently, the insert placed implementation is adapted to this diameter of the ball.
Avec le respect d’un tel rapport, la présente invention vise à diminuer encore de façon significative les quelques échecs prothétiques des implants à double mobilité de l’art antérieur. En effet la réduction du différentiel de couple de mise en route dans l’articulation entre la petite et la grande articulation entraîne : With respect to such a ratio, the present invention aims to further significantly reduce the few prosthetic failures of dual mobility implants of the prior art. In fact, reducing the starting torque differential in the joint between the small and the large joint results in:
■ d’une part, le fait que lorsque le col prothétique de la tige vient au contact de l’insert mobile dans les grands débattements, la grande articulation nécessite moins d’énergie à sa mise en action et s’avère donc moins dommageable au rétreint de l’insert mobile qui est le point faible des implants à double mobilité, et ■ on the one hand, the fact that when the prosthetic neck of the rod comes into contact with the mobile insert in the large deflections, the large articulation requires less energy to be put into action and therefore proves to be less damaging to the shrinkage of the mobile insert which is the weak point of dual mobility implants, and
■ d’autre part, la surface externe de l’insert mobile est optimisée de sorte que, même dans les cupules d’ancrage de grand diamètre externe, la surface externe dudit insert mobile demeure constante et réduite, limitant ainsi les débris d’usure
pouvant entraîner des ostéolyses et donc des échecs prothétiques ; la littérature montre que le nombre de particules émise dans une articulation de la hanche est fonction entre autre de ladite surface externe de l’insert mobile. Corollairement, en raison de la réduction de ces couples de frottement, les phénomènes d’usure, qui apparaissent inéluctablement nonobstant la mise en œuvre de matériau de dureté élevée, sont également réduits, entraînant ainsi une réduction des débris, et donc optimisant dans le temps la durée de tels implants articulaires. On conçoit dès lors tout intérêt de la présente invention qui, outre la réduction des phénomènes de luxation d’une part, et de genèse des débris d’autre part, permet sur le plan économique de réduire le nombre d’éléments appartenant à une gamme d’implants articulaires, et sur le plan logistique la réduction des stocks. En outre, d’un point de vue sécurité pour le patient, la simplification du nombre d’implants articulaires évite nombre d’erreurs opératoires, telles que résultant des erreurs d’étiquetage ou de compatibilité de tailles entre l’insert mobile et la cupule d’ancrage.
■ on the other hand, the external surface of the mobile insert is optimized so that, even in anchoring cups of large external diameter, the external surface of said mobile insert remains constant and reduced, thus limiting wear debris can lead to osteolysis and therefore prosthetic failure; the literature shows that the number of particles emitted in a hip joint depends, among other things, on said external surface of the mobile insert. As a corollary, due to the reduction in these friction torques, the wear phenomena, which inevitably appear notwithstanding the use of material of high hardness, are also reduced, thus leading to a reduction in debris, and therefore optimizing over time. the duration of such joint implants. One can therefore see the advantage of the present invention which, in addition to reducing the phenomena of dislocation on the one hand, and the genesis of debris on the other hand, economically makes it possible to reduce the number of elements belonging to a range joint implants, and logistically the reduction of stocks. In addition, from a patient safety point of view, the simplification of the number of joint implants avoids a number of operating errors, such as resulting from labeling errors or size compatibility errors between the mobile insert and the cup. anchor.
Claims
1. Gamme de systèmes d’implants articulaires, ledit implant étant du type comprenant :1. Range of joint implant systems, said implant being of the type comprising:
■ une cupule d’ancrage (1) dans l’un des éléments de l’articulation (2) considérée, définissant une cavité interne lisse de forme sensiblement hémisphérique ; ■ an anchoring cup (1) in one of the elements of the joint (2) considered, defining a smooth internal cavity of substantially hemispherical shape;
■ un insert (3), mobile au sein de la cavité interne de la cupule d’ancrage (1), et dont la surface externe lisse est destinée à coopérer par liaison rotule avec la cavité interne de la cupule d’ancrage (1), et définissant à son tour une cavité interne lisse de forme sensiblement hémisphérique ; ■ an insert (3), movable within the internal cavity of the anchoring cup (1), and the smooth outer surface of which is intended to cooperate by ball joint with the internal cavity of the anchoring cup (1) , and in turn defining a smooth internal cavity of substantially hemispherical shape;
■ une tête ou bille (4), solidarisée à un second élément de l’articulation, de forme sphérique, destinée à être reçue dans la cavité interne de l’insert mobile (3), et à constituer une seconde liaison rotule, ■ a head or ball (4), secured to a second element of the joint, of spherical shape, intended to be received in the internal cavity of the movable insert (3), and to form a second ball joint,
caractérisée en ce que le rapport du diamètre interne de la cavité interne de la cupule d’ancrage (1) sur le diamètre interne de la cavité interne de G insert mobile (3), pour l’ensemble des éléments de la gamme, est constant, quel que soit le diamètre de la bille (4) sélectionnée. characterized in that the ratio of the internal diameter of the internal cavity of the anchoring cup (1) to the internal diameter of the internal cavity of the mobile insert (3), for all the elements of the range, is constant , whatever the diameter of the ball (4) selected.
2. Gamme de systèmes d’implants articulaires selon la revendication 1, caractérisée en ce que le rapport est compris entre 1,1 et 3, avantageusement voisin de 1,6. 2. Range of joint implant systems according to claim 1, characterized in that the ratio is between 1.1 and 3, advantageously close to 1.6.
3. Gamme de système d’implants articulaires selon la revendication 1 ou 2, caractérisé en ce que l’épaisseur de G insert mobile demeure constante pour une taille de bille donnée, quel que soit la cupule d’ancrage mise en œuvre. 3. Range of joint implant system according to claim 1 or 2, characterized in that the thickness of the mobile insert G remains constant for a given ball size, regardless of the anchoring cup used.
4. Gamme de systèmes d’implants articulaires selon les revendications 1 à 3, caractérisée en ce que l’insert mobile (3) comporte au niveau de sa base un rétreint (6), destiné à coopérer avec le second élément de l’articulation.
4. Range of joint implant systems according to claims 1 to 3, characterized in that the movable insert (3) comprises at its base a constriction (6) intended to cooperate with the second element of the joint .
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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FR1902133A FR3093285B1 (en) | 2019-03-01 | 2019-03-01 | RANGE OF DOUBLE MOBILITY JOINT IMPLANT SYSTEMS |
PCT/FR2020/050297 WO2020178494A1 (en) | 2019-03-01 | 2020-02-18 | Range of articular implant systems with double mobility |
Publications (1)
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EP3930633A1 true EP3930633A1 (en) | 2022-01-05 |
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EP20710242.7A Pending EP3930633A1 (en) | 2019-03-01 | 2020-02-18 | Range of articular implant systems with double mobility |
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EP (1) | EP3930633A1 (en) |
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WO2007091521A1 (en) * | 2006-02-06 | 2007-08-16 | Japan Medical Materials Corporation | Low-wear sliding member and artificial joint making use of the same |
US8123815B2 (en) * | 2008-11-24 | 2012-02-28 | Biomet Manufacturing Corp. | Multiple bearing acetabular prosthesis |
US9820853B2 (en) * | 2009-05-06 | 2017-11-21 | Biomet Manufacturing, Llc | Acetabular cup system |
US9649194B2 (en) * | 2009-07-10 | 2017-05-16 | Peter Forsell | Hip joint device |
FR2958533B1 (en) * | 2010-04-08 | 2012-03-23 | Jean Claude Cartillier | RANGE OF COTYLOID IMPLANTS OF DIFFERENT SIZES |
WO2011146628A2 (en) * | 2010-05-18 | 2011-11-24 | Smith & Nephew Inc. | Applications of diffusion hardened material |
CN105263447A (en) * | 2012-09-27 | 2016-01-20 | 马萨诸塞总医院运营总医院公司 | Femoral heads, mobile inserts, acetabular components, and modular junctions for orthopedic implants and methods of using femoral heads, mobile inserts, acetabular components, and modular junctions for orthopedic implants |
US20140303743A1 (en) * | 2013-03-15 | 2014-10-09 | Sambhu Choudhury | Inner acetabular liner for a dual mobility femoral head construct |
WO2015051471A1 (en) * | 2013-10-13 | 2015-04-16 | Startech Engineering Ag | Joint implant |
EP3525726B1 (en) * | 2016-10-17 | 2024-03-06 | Smith & Nephew, Inc. | Lateralized dual-mobility assembly |
-
2019
- 2019-03-01 FR FR1902133A patent/FR3093285B1/en active Active
- 2019-07-12 US US16/509,985 patent/US11951011B2/en active Active
-
2020
- 2020-02-18 WO PCT/FR2020/050297 patent/WO2020178494A1/en active Application Filing
- 2020-02-18 EP EP20710242.7A patent/EP3930633A1/en active Pending
Also Published As
Publication number | Publication date |
---|---|
FR3093285A1 (en) | 2020-09-04 |
WO2020178494A1 (en) | 2020-09-10 |
FR3093285B1 (en) | 2021-03-05 |
US11951011B2 (en) | 2024-04-09 |
US20200276021A1 (en) | 2020-09-03 |
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