FR2598908A1 - Acetabular prosthesis with cementless impacting-screwing into the acetabulum - Google Patents

Acetabular prosthesis with cementless impacting-screwing into the acetabulum Download PDF

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Publication number
FR2598908A1
FR2598908A1 FR8607195A FR8607195A FR2598908A1 FR 2598908 A1 FR2598908 A1 FR 2598908A1 FR 8607195 A FR8607195 A FR 8607195A FR 8607195 A FR8607195 A FR 8607195A FR 2598908 A1 FR2598908 A1 FR 2598908A1
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cup
acetabulum
points
acetabular prosthesis
prosthesis according
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FR8607195A
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FR2598908B1 (en
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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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A61B17/8066—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for pelvic reconstruction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30131—Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • 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
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • 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
    • A61F2002/30769—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth madreporic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
    • A61F2002/30892—Plurality of protrusions parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A61F2002/3401—Acetabular cups with radial apertures, e.g. radial bores for receiving fixation screws
    • 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
    • A61F2002/3412—Acetabular cups with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
    • 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
    • A61F2002/4688—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means
    • A61F2002/4696—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor having operating or control means optical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

a. Acetabular prosthesis with cementless impacting-screwing into the acetabulum. b. Prosthesis characterised in that the hemispherical cup 10 with an open bottom 11 comprises points 16, 17, 18, 19 as well as perforations 20, 21, 22 for impaction and positioning of the screw for fastening the cup 10 into the osseous cotyle. c. The invention relates to the field of prostheses.

Description

"Prothèse cotyloldienne à impactage-vissage sans ciment
dans le cotyle"
La présente invention concerne une prothèse cotyloldienne à fixer dans le cotyle osseux d'une articulation de hanche et se composant d'une cupule fixée dans le cotyle osseux et d'un noyau lui-même fixé dans la cupule après mise en place de celle-ci et recevant la tête du fémur."Acetabular impact-screw prosthesis without cement
in the cup "
The present invention relates to an acetabular prosthesis to be fixed in the acetabulum of a hip joint and consisting of a cup fixed in the acetabulum and of a nucleus itself fixed in the cup after placement of the latter. Ci and receiving the head of the femur.

Les cupules cotyloidiennes sont des prothèses destinées à remplacer les défectuosités du cotyle osseux. De telles cupules sont déJà connues. The acetabular cups are prostheses intended to replace the defects of the osseous acetabulum. Such cups are already known.

Actuellement, il existe des cupules à impacter comportant un fond plein ne permettant pas de contrôler la qualité de l'impaction et trois pointes donnant une stabilité médiocre pour peu que l'une des pointes soit placée dans un endroit défectueux du cotyle. Currently, there are cups to impact with a solid bottom not allowing to control the quality of the impact and three tips giving poor stability as long as one of the tips is placed in a defective place of the acetabulum.

La surface externe de la cupule présente un revêtement dit madréporique, c'est-à-dire formé de minuscules billes facilitant l'accrochage de la repousse osseuse. The external surface of the cup has a so-called madreporic coating, that is to say formed of tiny beads facilitating the attachment of bone regrowth.

Il existe, d'autre part, des cupules à stabiliser par des vis placées dans les orifices réalisés dans le fond de ces cupules. Ces cupules ne comportent pas de pointes ; il est donc mal aisé de les placer car rien ne les stabilise lors de l'impaction et ensuite, il est nécessaire de placer plusieurs vis pour les stabiliser. There are, on the other hand, cups to be stabilized by screws placed in the holes made in the bottom of these cups. These cups do not have spikes; it is therefore difficult to place them because nothing stabilizes them during the impaction and then it is necessary to place several screws to stabilize them.

La présente invention a pour but de créer une prothèse cotyloidienne à fixer notamment sans ciment dans le cotyle, facilitant l'intervention du chirurgien, lui permettant une bonne mise en place et assurant une excellente fixation quelles que soient les défectuosités osseuses rencontrées. The object of the present invention is to create an acetabular prosthesis to be fixed in particular without cement in the acetabulum, facilitating the intervention of the surgeon, allowing it to be correctly placed and ensuring excellent fixation whatever the bone defects encountered.

A cet effet, l'invention concerne une prothèse cotyloldienne du type ci-dessus, caractérisée en ce que la cupule de forme hémisphérique à fond ouvert comporte des pointes ainsi que des perforations pour l'impaction et la mise en place de vis de fixation de la cupule dans le cotyle osseux. To this end, the invention relates to an acetabular prosthesis of the above type, characterized in that the hemispherical cup with open bottom has points as well as perforations for the impact and the placement of fixing screws of the cup in the acetabulum.

Cette prothèse combinant l'impactage et le vissage permet non seulement une meilleure fixation de la cupule et, par suite, de la prothèse même dans un tissu osseux fragile ou défectueux mais surtout une meilleure mise en place initiale par prépositionnement à l'aide des pointes avant le vissage. This prosthesis combining impacting and screwing not only allows better fixation of the cup and, consequently, of the prosthesis even in fragile or defective bone tissue, but above all better initial positioning by prepositioning using the tips. before screwing.

Cela évite avantageusement tout dépla cement de la cupule pendant la mise en place des vis. This advantageously avoids any displacement of the cup during the placement of the screws.

Le nombre de vis permet de s'adapter à toutes les qualités osseuses du cotyle.The number of screws makes it possible to adapt to all the bone qualities of the acetabulum.

Le vissage-impactage est essentiel pour assurer aux cotyles une bonne stabilité rotatoire à l'arrachement. Screwing-impacting is essential to ensure good acetabular rotation stability.

De plus, pour la facilité de l'intervention, il est plus rapide d'impacter le cotyle en bonne position puis d'assurer une bonne coaptation prothèse-os par le vissage. Cette coaptation prothèse-os est capitale car elle facilite la repousse osseuse dans les microporosités de la cupule. C'est le vissage qui permet cette coaptation maximum mais c'est l'impactage qui permet de placer et de stabiliser la prothèse en bonne position et cela de façon commode pour le chirurgien. In addition, for ease of intervention, it is faster to impact the acetabulum in the right position and then to ensure good prosthesis-bone coaptation by screwing. This prosthesis-bone coaptation is essential because it facilitates bone regrowth in the microporosities of the cup. It is the screwing which allows this maximum coaptation but it is the impacting which makes it possible to place and stabilize the prosthesis in good position and that in a way convenient for the surgeon.

Le vissage-impactage a donc deux avantages :
- Il facilite la pose de l'implant et la rapidité de cette pose puisqu'il n'est pas nécessaire de placer de nombreuses vis, la stabilité étant déjà en partie assurée par les pointes,
- Il améliore par le vissage la cohésion prothèse-os qui n'est pas suffisante par le simple impactage. Screwing-impacting therefore has two advantages:
- It facilitates the installation of the implant and the speed of this installation since it is not necessary to place many screws, the stability being already partly guaranteed by the points,
- It improves by screwing the prosthesis-bone cohesion which is not sufficient by simple impacting.

Suivant une autre caractéristique de l'invention, la cupule est de forme hémisphérique ouverte ayant une partie supérieure correspondant au toit du cotyle et, de part et d'autre, une corne, la partie supérieure et les cornes comportant des pointes et des orifices de vissage. According to another characteristic of the invention, the cup is of open hemispherical shape having an upper part corresponding to the roof of the acetabulum and, on both sides, a horn, the upper part and the horns comprising points and orifices of screwing.

Ainsi, le chirurgien peut à tout moment contrôler la position de la cupule à travers l'ouverture du fond de la cupule, ce qui permet une mise en place particulièrement précise. Thus, the surgeon can at any time control the position of the cup through the opening in the bottom of the cup, which allows particularly precise positioning.

De plus, comme cette cupule est mise en place de façon que la fente correspond à la séparation des cornes du cotyle osseux, la cupule correspond ainsi au cotyle osseux. L'ouverture de la cupule et la fente assurent à la cupule une certaine élasticité qui se rapproche de celle du cotyle ; cela permet à la cupule de suivre les mouvements naturels de rapprochement et d'écartement des cornes du cotyle, d'autant plus que les quatre pointes de fixation assurent une excellente stabilité de l'anneau (ou de la cupule). In addition, as this cup is placed so that the slot corresponds to the separation of the horns from the bone cup, the cup thus corresponds to the bone cup. The opening of the cup and the slot provide the cup with a certain elasticity which approximates that of the acetabulum; this allows the cup to follow the natural movements of approximation and spacing of the horns of the acetabulum, especially since the four fixing points ensure excellent stability of the ring (or of the cup).

De façon avantageuse, l'ouverture du fond est excentrée vers le bas pour laisser une partie supérieure de grande surface. En effet, le toit de la cupule ou partie supérieure doit être de grande surface car les charges s'appliquent sur ce toit et les contraintes sont maximales ; la réhabitation doit également y être maximum : plus grande surface d'appui et de porosité au contact de l'os. Advantageously, the opening of the bottom is eccentric downward to leave an upper part of large area. Indeed, the roof of the cup or upper part must be a large area because the loads apply to this roof and the stresses are maximum; rehabitation must also be maximum: greater support surface and porosity in contact with the bone.

Selon un mode de réalisation, la partie supérieure de la cupule comporte deux pointes et chaque corne comporte une pointe. Les différentes perforations réalisées dans le toit et les parties latérales de la cupule permettent de mettre en place des vis afin d'augmenter la stabilité de l'ensemble. According to one embodiment, the upper part of the cup has two points and each horn has a point. The various perforations made in the roof and the lateral parts of the cup make it possible to install screws in order to increase the stability of the assembly.

Une vis centrale semble nécessaire et suffisante dans la majorité des cas mais d'autres perforations doivent être prévues pour en cas de besoin a#ugmenter le nombre de vis.A central screw seems necessary and sufficient in the majority of the cases but other perforations must be provided for if necessary to increase the number of screws.

De plus, il est prévu une série de cupules de tailles différentes pour s'adapter aux différents cotyles osseux. In addition, a series of cups of different sizes is provided to adapt to the different acetabular cups.

Pour chaque taille, les pointes seront au nombre de quatre. Par contre le nombre de perforations sera différent. For each size, there will be four points. However, the number of perforations will be different.

De façon avantageuse, les pointes et les orifices de vissage sont réparties régulièrement et les pointes sont parallèles à l'axe de la cupule. Advantageously, the points and the screw holes are distributed regularly and the points are parallel to the axis of the cup.

La cupule mise en place reçoit le noyau qui recouvre par son bord, le bord extérieur de la cupule. The cup in place receives the core which covers by its edge, the outside edge of the cup.

Le recouvrement du bord extérieur de la cupule évite de traumatiser la tête du fémur lors de la réduction. Covering the outer edge of the cup prevents trauma to the head of the femur during reduction.

Le rebord évite également que pour un mouvement de bascule, le col de la prothèse fémorale ne bute contre le bord de la cupule. The rim also avoids that for a rocking movement, the neck of the femoral prosthesis does not abut against the edge of the cup.

Suivant une autre caractéristique de l'invention, le noyau est en polyéthylène. According to another characteristic of the invention, the core is made of polyethylene.

Suivant une autre caractéristique de l'invention, la cupule et les pointes solidaires de celle-ci sont en titane et la surface de la cupule et des pointes est le siège de multiples microcavités pour permettre la réhabitation osseuse.  According to another characteristic of the invention, the cup and the points integral with it are made of titanium and the surface of the cup and the points is the seat of multiple microcavities to allow bone rehabitation.

La presente invention sera décrite de façon plus détaillée à l'aide des dessins annexés dans lesquels
- La figure 1 est une vue schématique de face du cotyle osseux,
- La figure 2 est une vue de face de l'anneau à impactage - vissage de la prothèse cotyloidienne selon l'invention,
- La figure 3 est une vue en coupe III-III de la figure 2, le noyau'étant enlevé,
- La figure 4 est une vue en coupe selon IV-IV de la figure 2, le noyau étant enlevé,
- La figure 5 est une vue en coupe selon V-V de la figure 2, le noyau étant enlevé,
- La figure 6 est une vue en coupe schématique de la prothèse cotyloldienne complète.The present invention will be described in more detail with the aid of the accompanying drawings in which
- Figure 1 is a schematic front view of the bone cup,
FIG. 2 is a front view of the impact ring - screwing of the acetabular prosthesis according to the invention,
FIG. 3 is a sectional view III-III of FIG. 2, the core being removed,
FIG. 4 is a sectional view along IV-IV of FIG. 2, the core being removed,
FIG. 5 is a sectional view along VV of FIG. 2, the core being removed,
- Figure 6 is a schematic sectional view of the complete acetabular prosthesis.

La figure 1 montre un cotyle osseux 1, c'est-à-dire le logement dans lequel vient la rotule constituant la tête du fémur. Figure 1 shows a bony acetabulum 1, that is to say the housing in which comes the ball constituting the head of the femur.

Ce cotyle est un logement en forme de calotte sphérique définie par une partie supérieure appelée "toit" 2 et deux branches, la corne antérieure 3 et la corne postérieure 4. This acetabulum is a housing in the form of a spherical cap defined by an upper part called "roof" 2 and two branches, the anterior horn 3 and the posterior horn 4.

La forme particulière du cotyle permet à celui-ci d'avoir une certaine élasticité. EN effet, lors de la mise en charge de l'articulation, la corne antérieure 3 et la corne posérieure 4 du cotyle se rapprochent et en décharge, elles s'écartent. The particular shape of the acetabulum allows it to have a certain elasticity. Indeed, during the loading of the joint, the anterior horn 3 and the posterior horn 4 of the acetabulum come together and in discharge, they move apart.

La figure 2 montre la cupule d'une prothèse cotyloidienne selon l'invention. Cette cupule 10, destinée à être fixée par impaction et par vissage, se compose d'une pièce en forme de calotte hémisphérique dont le fond présente une ouverture 11 de sorte que cette cupule 10 se compose d'une partie supérieure 12 ou toit se terminant de chaque côté par une corne 13, 14.  Figure 2 shows the cup of an acetabular prosthesis according to the invention. This cup 10, intended to be fixed by impaction and by screwing, consists of a piece in the shape of a hemispherical cap whose bottom has an opening 11 so that this cup 10 consists of an upper part 12 or roof ending on each side by a horn 13, 14.

Les deux cornes 13, 14 laissent entre
elles, une fente 15. La cupule 10 possède ainsi une forme correspondant à celle du cotyle osseux. De manière
avantageuse, l'ouverture 11 du fond est excentrée vers
le bas de manière à laisser une grande surface à la
partie supérieure 12.The two horns 13, 14 leave between
they, a slot 15. The cup 10 thus has a shape corresponding to that of the bony acetabulum. So
advantageous, the opening 11 at the bottom is offset towards
the bottom so as to leave a large area at the
upper part 12.

La cupule 10 comporte des pointes 15, 16,
17, 18, 19 d'axe parallèle à l'axe X-X de la cupule 10
(voir figures 3 et 4).The cup 10 has points 15, 16,
17, 18, 19 with an axis parallel to the axis XX of the cup 10
(see figures 3 and 4).

Dans le mode de réalisation représenté,
la partie supérieure 12 porte deux pointes 16, 17 et chaque corne 13, 14 porte une pointe 18, 19. De plus,
la partie supérieure 12 est munie de perforations 20 et la base de chaque corne 13, 14 comporte une perfora
tion 21, 22 pour le passage d'une vis. En fait, les
perforations 20 de la partie supérieure 12 sont relativement
nombreuses pour permettre au chirurgien de choisir l'empla ceint le plus approprié des vis, après le positionnement de
la cupule 10 dans le cotyle osseux et son blocage par
les pointes 16, 17, 18, 19.In the embodiment shown,
the upper part 12 carries two points 16, 17 and each horn 13, 14 carries a point 18, 19. In addition,
the upper part 12 is provided with perforations 20 and the base of each horn 13, 14 has a perfora
tion 21, 22 for the passage of a screw. In fact,
perforations 20 of the upper part 12 are relatively
numerous to allow the surgeon to choose the most suitable location for the screws, after positioning
the cup 10 in the acetabulum and its blocking by
points 16, 17, 18, 19.

Les figures 3 et 4 sont des vues en
coupe de la cupule 10 seule sans noyau. Ces figures montrent
l'une la disposition des vis 23, 24, l'autre les pointes 17, 19. Les figures 3, 4, 5 montrent de façon générale la faible épaisseur de paroi de la cupule 10 et la disposition des pointes et des perforations.Figures 3 and 4 are views in
cup cup 10 only without core. These figures show
one the arrangement of the screws 23, 24, the other the points 17, 19. Figures 3, 4, 5 generally show the small wall thickness of the cup 10 and the arrangement of the points and perforations.

La figure 6 est une vue en coupe de la prothèse complète. Cette prothèse se compose de la cupule 10 (figures 2 à 5) qui reçoit un noyau 25 en polyéthylène recouvrant toute la cupule et débordant par rapport au bord extérieur 26 de celui-ci par un rebord 27. Figure 6 is a sectional view of the complete prosthesis. This prosthesis consists of the cup 10 (FIGS. 2 to 5) which receives a polyethylene core 25 covering the entire cup and projecting from the outer edge 26 thereof by a flange 27.

La tête du fémur vient se loger dans la cavité 28 de ce noyau. Le rebord 27 évite de traumatiser la tête de la prothèse fémorale lors de la réduction.The head of the femur is housed in the cavity 28 of this core. The rim 27 avoids traumatizing the head of the femoral prosthesis during reduction.

Selon l'invention, la cupule 10 est de préférence réalisée en titane et sa surface extérieure, c'est-à-dire la surface située du côté des pointes présente un état de surface correspondant à la porosité pour faciliter une bonne réhabitation osseuse et a-ssurer une bonne stabilité secondaire de l'anneau dans le cotyle. According to the invention, the cup 10 is preferably made of titanium and its outer surface, that is to say the surface located on the side of the tips has a surface state corresponding to the porosity to facilitate good bone rehabitation and a - ensure good secondary stability of the ring in the acetabulum.

Cet état de surface existe sur le corps des pointes 16, 17, 18, 19 à l'exception des extrémités. This surface condition exists on the body of the tips 16, 17, 18, 19 with the exception of the ends.

Il est intéressant de remarquer que l'ouverture 11, de préférence importante, réalisée dans le fond de la cupule 10, assure non seulement à la cupule l'élasticité requise en combinaison avec la fente 15 mais permet également au praticien de contrôler la bonne impaction de la cupule dans le cotyle osseux. It is interesting to note that the opening 11, preferably large, made in the bottom of the cup 10, not only provides the cup with the required elasticity in combination with the slot 15 but also allows the practitioner to control the correct impaction. of the cup in the acetabulum.

La mise en place de la prothèse, selon l'invention, se fait par la mise en place d'abord de la cupule 10 puis l'insertion du noyau 25 dans la cupule 10. The implantation of the prosthesis according to the invention is done by firstly placing the cup 10 and then inserting the core 25 into the cup 10.

Enfin, il est à noter que la réhabitation est non seulement favorisée par un état poreux, microporeux ou madréporé d'une surface mais que d'autres états de surface sont envisageables et entrent dans le cadre de l'invention. Finally, it should be noted that rehabitation is not only favored by a porous, microporous or madreporous state of a surface but that other surface states are possible and fall within the scope of the invention.

Suivant une autre variante, bien qu'il soit intéressant de réaliser la cupule en titane, d'autres matériaux sont envisageables comme l'acier ou le carbone ou des matières de synthèse, compatibles sur le plan physiologique et ayant les caractéristiques mécaniques requises.  According to another variant, although it is advantageous to produce the titanium cup, other materials can be envisaged, such as steel or carbon or synthetic materials, physiologically compatible and having the required mechanical characteristics.

Claims (8)

REVENDICATIONS 10) Prothèse cotyloldienne à fixer dans le cotyle osseux d'une articulation de hanche et se composant d'une cupule fixée dans le cotyle osseux et d'un noyau lui-même fixé dans la cupule après mise en place de celle-ci et recevant la tête du fémur, carac érigée en ce que la cupule (10) de forme hémisphérique à fond ouvert (11) comporte des pointes (16, 17, 18, 19) ainsi que des perforations (20, 21, 22) pour l'impaction et la mise en place de vis de fixation de la cupule (10) dans le cotyle osseux. 10) acetabular prosthesis to be fixed in the osseous acetabulum of a hip joint and consisting of a cup fixed in the osseous acetabulum and of a nucleus itself fixed in the cup after placement of the latter and receiving the head of the femur, charac erected in that the cup (10) of hemispherical shape with open bottom (11) has points (16, 17, 18, 19) as well as perforations (20, 21, 22) for the impaction and placement of the cup fixing screws (10) in the acetabulum. 20) Prothèse cotyloIdienne selon la revendication 1, caractérisée en ce que la cupule (10) est de forme hémisphérique ouverte (15) ayant une partie supérieure (12) correspondant au toit du cotyle et, de part et d'autre, une corne (13, 14), la partie supérieure (12) et les cornes (13, 14) comportant des pointes (16...19) et des orifices (20 - 22) de vissage. 20) acetabular prosthesis according to claim 1, characterized in that the cup (10) is of open hemispherical shape (15) having an upper part (12) corresponding to the roof of the acetabulum and, on both sides, a horn ( 13, 14), the upper part (12) and the horns (13, 14) comprising spikes (16 ... 19) and screw holes (20 - 22). 30) Prothèse cotyloldienne selon l'une quelconque des revendications 1 et 2, caractérisée en ce que l'ouverture (11) du fond est excentrée vers le bas pour laisser une partie supérieure (12) de grande surface. 30) acetabular prosthesis according to any one of claims 1 and 2, characterized in that the opening (11) of the bottom is eccentric downwards to leave an upper part (12) of large area. 40) Prothèse cotyloidienne selon l'une quelconque des revendications 1 à 3, caractérisée en ce que les pointes (16-19) et les orifices (20 - 22) de vissage sont réparties régulièrement et les pointes (16-19) sont parallèles à l'axe X-X de la cupule (10). 40) acetabular prosthesis according to any one of claims 1 to 3, characterized in that the points (16-19) and the screw holes (20 - 22) are distributed regularly and the points (16-19) are parallel to the axis XX of the cup (10). 50) Prothèse cotyloidienne selon l'une quelconque des revendications 1 à-4, caractérisée en ce que le noyau (25) recouvre par un bord (27) le bord extérieur (26) de la cupule (10). 50) acetabular prosthesis according to any one of claims 1 to-4, characterized in that the core (25) covers by an edge (27) the outer edge (26) of the cup (10). 60) Prothèse cotyloidienne, selon l'une quelconque des revendications 1 à 5, caractérisée en ce que le noyau (25) est en polyéthylène. 60) acetabular prosthesis according to any one of claims 1 to 5, characterized in that the core (25) is made of polyethylene. 70) Prothèse cotyloidienne selon l'une quelconque des revendications 1 à 6, caractérisée en ce que la cupule (10) et les pointes (16, 17, 18, 19) solidaires de celle-ci, sont en titane. 70) acetabular prosthesis according to any one of claims 1 to 6, characterized in that the cup (10) and the points (16, 17, 18, 19) integral with the latter, are made of titanium. 80) Prothèse cotyloIdienne, selon la revendication 7, caractérisée en ce que la surface de la cupule (10) et des pointes (16, 17, 18, 19) est poreuse.  80) Cotyloid prosthesis, according to claim 7, characterized in that the surface of the cup (10) and of the points (16, 17, 18, 19) is porous.
FR8607195A 1986-05-21 1986-05-21 COTYLOID-FREE COTYLID PROSTHESIS WITHOUT CEMENT IN COTYL Expired - Lifetime FR2598908B1 (en)

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Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2650174A1 (en) * 1989-07-26 1991-02-01 Maudhuit Bernard Artificial acetabulum for hip prostheses and system for putting it into position
FR2668056A1 (en) * 1990-10-22 1992-04-24 Icp Sa COTYLOUIDIAN IMPLANT.
EP0552949A1 (en) * 1992-01-23 1993-07-28 Howmedica International Inc. Acetabular cup for a total hip prosthesis and total hip prostheses embodying such cups
WO1996008214A1 (en) * 1994-09-16 1996-03-21 Piotr Rogala Implantation method and endoprosthesis to apply this implantation
DE4435497C1 (en) * 1994-10-04 1996-07-04 Amir Dr Zahedi Modular bone implant with socket
US5609646A (en) * 1992-01-23 1997-03-11 Howmedica International Acetabular cup for a total hip prosthesis
WO2006030392A1 (en) * 2004-09-17 2006-03-23 Arthrosearch (Proprietary) Limited Joint prosthesis component
US7473261B2 (en) 2003-10-20 2009-01-06 Henry Rennich External incontinence clamp

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US3840904A (en) * 1973-04-30 1974-10-15 R Tronzo Acetabular cup prosthesis
FR2245328A1 (en) * 1973-10-02 1975-04-25 Rosenthal Stemag Tech Kera
EP0147339A2 (en) * 1983-12-08 1985-07-03 Jean-Louis Brunet Apparatus for producing a hip prosthesis
EP0149975A1 (en) * 1984-01-11 1985-07-31 Robert Mathys Co Cup for hip joint prosthesis

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US2910978A (en) * 1955-03-28 1959-11-03 Marshall R Urist Hip socket means
DE2305333A1 (en) * 1973-02-03 1974-08-08 Rosenthal Stemag Tech Keramik TOTAL ENDOPROTHESIS, IN PARTICULAR HIP PROSTHESIS
US3840904A (en) * 1973-04-30 1974-10-15 R Tronzo Acetabular cup prosthesis
FR2245328A1 (en) * 1973-10-02 1975-04-25 Rosenthal Stemag Tech Kera
EP0147339A2 (en) * 1983-12-08 1985-07-03 Jean-Louis Brunet Apparatus for producing a hip prosthesis
EP0149975A1 (en) * 1984-01-11 1985-07-31 Robert Mathys Co Cup for hip joint prosthesis

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2650174A1 (en) * 1989-07-26 1991-02-01 Maudhuit Bernard Artificial acetabulum for hip prostheses and system for putting it into position
FR2668056A1 (en) * 1990-10-22 1992-04-24 Icp Sa COTYLOUIDIAN IMPLANT.
EP0483023A1 (en) 1990-10-22 1992-04-29 ICP FRANCE, Société Anonyme Acetabular cup
EP0552949A1 (en) * 1992-01-23 1993-07-28 Howmedica International Inc. Acetabular cup for a total hip prosthesis and total hip prostheses embodying such cups
AU659264B2 (en) * 1992-01-23 1995-05-11 Howmedica International S. De R.L. Acetabular cup for a total hip prosthesis and total hip prosthesis embodying such cups
US5609646A (en) * 1992-01-23 1997-03-11 Howmedica International Acetabular cup for a total hip prosthesis
US5911759A (en) * 1994-09-16 1999-06-15 Rogala; Piotr Acetabulum endoprosthesis and head
WO1996008214A1 (en) * 1994-09-16 1996-03-21 Piotr Rogala Implantation method and endoprosthesis to apply this implantation
DE4435497C1 (en) * 1994-10-04 1996-07-04 Amir Dr Zahedi Modular bone implant with socket
US5702475A (en) * 1994-10-04 1997-12-30 Zahedi; Amir Modular bone implant with pan and pins
EP0795306A1 (en) * 1994-10-04 1997-09-17 Amir Dr. Zahedi Modular bone prosthesis with cup and pins
US7473261B2 (en) 2003-10-20 2009-01-06 Henry Rennich External incontinence clamp
WO2006030392A1 (en) * 2004-09-17 2006-03-23 Arthrosearch (Proprietary) Limited Joint prosthesis component

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