FR2674744A1 - Femoral replacement shaft - Google Patents

Femoral replacement shaft Download PDF

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Publication number
FR2674744A1
FR2674744A1 FR9104599A FR9104599A FR2674744A1 FR 2674744 A1 FR2674744 A1 FR 2674744A1 FR 9104599 A FR9104599 A FR 9104599A FR 9104599 A FR9104599 A FR 9104599A FR 2674744 A1 FR2674744 A1 FR 2674744A1
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France
Prior art keywords
rod according
rod
cement
distal part
proximal part
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Granted
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FR9104599A
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French (fr)
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FR2674744B1 (en
Inventor
Weber Frans
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FABRICATION ETU REALISA IMPLAN
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FABRICATION ETU REALISA IMPLAN
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30721—Accessories
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • 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
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3672—Intermediate parts of 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of 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
    • A61F2002/30589—Sealing means
    • 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
    • A61F2002/30614—Sets comprising both primary and revision endoprostheses
    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/3069—Revision endoprostheses
    • 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
    • A61F2002/3625—Necks
    • A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
    • 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
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented

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

Abstract

The femoral replacement shaft has a proximal part (1a) designed to be blocked in the metaphysis of the medullary cavity and a distal part (1b) intended to be cemented in the said cavity, the said parts (1a) and (1b) being separated by a means capable of permitting the application of an orthopaedic cement, only in the area of the distal part (1b).

Description

Tige fémorale de reprise. Revival femoral stem.

Plus particulièrement, l'invention concerne une tige fémorale de révison ou de reprise, pour les prothèses de la hanche. More particularly, the invention relates to a femoral revision or resumption rod, for hip prostheses.

On connait des ensembles prothétiques employés dans le cas d'une arthroplastie de la hanche. Généralement, ces ensembles comprennent une tige fémorale conformée pour être impactée dans le canal médullaire de l'os. La tête de cette tige reçoit directement ou d'une manière rapportée, une pièce complémentaire du type cupule, apte à coopérer avec un implant cotyloidien impacté dans la cavité cotyloïde de l'os iliaque. A ce jour, de nombreuses solutions, notamment au niveau de la tige fémorale, quant à sa forme et à son mode d'impaction et de fixation, ont été proposées. There are known prosthetic sets used in the case of a hip replacement. Generally, these sets include a femoral stem shaped to be impacted in the medullary canal of the bone. The head of this rod receives directly or in an attached manner, an additional part of the cup type, capable of cooperating with an acetabular implant impacted in the acetabular cavity of the iliac bone. To date, many solutions, in particular at the level of the femoral stem, as to its shape and its mode of impact and fixation, have been proposed.

Quelles que soient les solutions employées, il peut se produire des phénomènes de rejet et des problèmes de descellement dans le temps. Dans de tels cas, il est nécessaire d'extraire l'implant d'origine et de le remplacer par un implant dit de révision ou de reprise. Ce problème se pose notamment au niveau de la tige fémorale. Whatever the solutions used, there can be rejection phenomena and loosening problems over time. In such cases, it is necessary to extract the original implant and replace it with a so-called revision or recovery implant. This problem arises in particular at the level of the femoral stem.

Généralement, les tiges fémorales de révision ou de reprise, qui sont de dimensionnements plus importants que ceux des tiges d'origine de première implantation, sont fixées par ciment. Compte-tenu de la conception de ces tiges de reprise, le ciment de fixation remplit la totalité du canal médullaire. Generally, the femoral revision or resumption rods, which are larger in size than those of the original rods of first implantation, are fixed by cement. Given the design of these recovery rods, the fixing cement fills the entire medullary canal.

Le problème que se propose de résoudre l'invention, est de faciliter la technique opératoire pour l'impaction de cette tige fémorale de reprise. Plus particulièrement, le problème que se propose de résoudre l'invention est d'assurer la fixation de cette tige par une méthode hybride, consistant à mettre du ciment uniquement au niveau de la partie distale de la tige, tandis que la partie proximale, est impactée à force dans le canal médullaire. The problem which the invention proposes to solve is to facilitate the operating technique for the impaction of this femoral recovery rod. More particularly, the problem which the invention proposes to solve is to ensure the fixing of this rod by a hybrid method, consisting in placing cement only at the distal part of the rod, while the proximal part is forcibly impacted in the spinal canal.

Pour résoudre ce problème, il a été nécessaire de concevoir une tige de conception particulière. Dans ce but, selon l'invention, la tige présente une partie proximale conformée pour être bloquée dans la métaphyse du canal médullaire et une partie distale destinée à être cimentée dans ledit canal, lesdites parties étant séparées par un moyen apte à permettre la mise en place d'un ciment orthopédique uniquement au niveau de la partie distale. To solve this problem, it was necessary to design a particular design rod. For this purpose, according to the invention, the rod has a proximal part shaped to be blocked in the metaphysis of the medullary canal and a distal part intended to be cemented in said canal, said parts being separated by means capable of allowing the setting in place an orthopedic cement only at the distal part.

Avantageusement, le moyen est constitué par un épaulement formé au niveau du raccordement entre la partie proximale et la partie distale. Advantageously, the means consists of a shoulder formed at the connection between the proximal part and the distal part.

Le problème posé de pouvoir limiter la mise en place du ciment au niveau uniquement de la partie distale de la tige, est résolu en ce que l'épaulement fait office de butée à un élément d'étanchéité sous forme d'une bague apte à assurer la retenue du ciment en constituant un chambrage dans le canal médullaire, pour l'injection dudit ciment, au niveau de la partie distale seulement. The problem posed of being able to limit the placement of the cement at the level only of the distal part of the rod, is solved in that the shoulder acts as a stop for a sealing element in the form of a ring capable of ensuring the retention of the cement by constituting a recess in the medullary canal, for the injection of the said cement, at the level of the distal part only.

La bague est en polyéthylène et déborde de la section de l'extrémité inférieure de la partie proximale de la tige, au niveau de l'épaulement. The ring is made of polyethylene and extends beyond the section of the lower end of the proximal part of the rod, at the level of the shoulder.

Un autre problème que se propose de résoudre l'invention, est d'assurer une fixation primaire obtenue par l'injection du ciment au niveau de la partie distale de la tige et une fixation secondaire au niveau de la partie proximale de la tige.  Another problem which the invention proposes to solve is to ensure a primary fixation obtained by the injection of cement at the distal part of the rod and a secondary fixation at the proximal part of the rod.

Un tel problème est résolu en ce que la partie proximale présente un traitement de surface apte à assurer la repousse osseuse. Avantageusement, ce traitement de surface peut être constitué par un revêtement de titane poreux. Such a problem is solved in that the proximal part has a surface treatment capable of ensuring bone regrowth. Advantageously, this surface treatment can consist of a coating of porous titanium.

La tige est de section degressive continue depuis son extrémité supérieure jusqu'à son extrémité inférieure, d'une part, au niveau de sa partie proximale et, d'autre part, au niveau de sa partie distale. The rod has a continuous tapering section from its upper end to its lower end, on the one hand, at its proximal part and, on the other hand, at its distal part.

Pour résoudre le problème posé d'éviter tout risque de descellement, la tige présente un profil déterminé pour remplir au maximum la partie métaphysaire du canal médullaire. To solve the problem posed of avoiding any risk of loosening, the rod has a determined profile to fill as much as possible the metaphyseal part of the medullary canal.

L'invention est exposée, ci-après, plus en détail à l'aide des dessins annexés, dans lesquels
La figure 1 est une vue de face de la tige selon l'invention.The invention is set out below in more detail with the aid of the appended drawings, in which
Figure 1 is a front view of the rod according to the invention.

La figure 2 est une vue correspondant à la figure I, après mise en place de ltélément d'étanchéité au niveau de l'épaulement. Figure 2 is a view corresponding to Figure I, after placement of the sealing element at the shoulder.

La figure 3 est une vue en coupe longitudinale montrant la mise en place de la tige fémorale de revision avant l'injection du ciment de fixation. Figure 3 is a longitudinal sectional view showing the establishment of the femoral revision rod before injection of the fixing cement.

La figure 4 est une vue correspondant à la figure 3, après injection du ciment. Figure 4 is a view corresponding to Figure 3, after injection of the cement.

La tige fémorale de reprise, désignée dans son ensemble par (1), comprend une partie proximale (la) et une partie distale (lb). Selon l'invention, les parties proximale et distale sont séparées par un épaulement (il), qui constitue un changement de section à ce niveau (figure 1). Il apparait donc que la tige (i) est de section dégressive continue depuis son extrémité supérieure, jusqu'à son extrémité inférieure, d'une part, au niveau de sa partie proximale et, d'autre part, au niveau de sa partie distale. The femoral recovery rod, generally designated by (1), comprises a proximal part (la) and a distal part (lb). According to the invention, the proximal and distal parts are separated by a shoulder (il), which constitutes a change of section at this level (FIG. 1). It therefore appears that the rod (i) is of continuous tapering section from its upper end, to its lower end, on the one hand, at its proximal part and, on the other hand, at its distal part. .

Le profil général de la tige est déterminé pour remplir au maximum la partie métaphysaire du canal médullaire. The general profile of the stem is determined to fill the metaphyseal part of the medullary canal as much as possible.

Comme le montre la figure 2, cet épaulement (lc) fait office de butée à un élément d'étanchéité (2). Par exemple, cet élément (2) peut être constitué par un joint ou bague en polyéthylène. As shown in Figure 2, this shoulder (lc) acts as a stop for a sealing element (2). For example, this element (2) may consist of a polyethylene seal or ring.

Avantageusement, cet élément (2), dont la section correspond très sensiblement à la section transversale de la tige, déborde de la plus petite section de la partie proximale (la), c'est-à-dire celle située au niveau de l'épaulement. Advantageously, this element (2), the section of which corresponds very substantially to the cross section of the rod, projects beyond the smallest section of the proximal part (la), that is to say that located at the level of the shoulder.

Comme indiqué ci-après, cet élément (2) permet de délimiter, après introduction de la tige (1) dans le canal médullaire, un chambrage (A) constituant une réserve pour un ciment orthopédique (C) de fixation, au niveau de la partie distale (lb). As indicated below, this element (2) makes it possible to delimit, after introduction of the rod (1) into the medullary canal, a recess (A) constituting a reserve for an orthopedic cement (C) for fixing, at the level of the distal part (lb).

On se réfère maintenant aux figures 3 et 4, qui montrent la technique de pose de la prothèse. Reference is now made to FIGS. 3 and 4, which show the technique for fitting the prosthesis.

La tige (1), équipée de l'élément (2) est introduite dans le canal médullaire du fémur (F), préalablement préparé, après extraction de l'implant d'origine. Un bouchon diaphysaire (B) est disposé dans le fond du canal médullaire. On voit à la figure 3, que l'élément d'étanchéité (2), compte-tenu, d'une part, de sa nature et, d'autre part, de son dimensionnement, permet de délimiter le chambrage (A) dans le fond du canal médullaire de l'os. Cet élément à tendance à s'écraser contre les corticales. The rod (1), equipped with the element (2) is introduced into the medullary canal of the femur (F), previously prepared, after extraction of the original implant. A diaphyseal plug (B) is placed at the bottom of the medullary canal. It can be seen in FIG. 3 that the sealing element (2), taking into account, on the one hand, its nature and, on the other hand, its dimensioning, makes it possible to delimit the recess (A) in the bottom of the bone marrow canal. This element tends to crash against the cortices.

L'injection du ciment dans le chambrage (A) ainsi formé, s'effectue comme suit
- un premier trou (T) est percé dans le fémur, sous l'élément (2) et à proximité de ce dernier. Un second trou (T1) est percé à la base distale de la tige, juste au dessus du bouchon diaphysaire (B).The cement is injected into the recess (A) thus formed, as follows
- A first hole (T) is drilled in the femur, under the element (2) and near the latter. A second hole (T1) is drilled at the distal base of the stem, just above the diaphyseal plug (B).

- après nettoyage de la diaphyse, le ciment orhtopédique (C) est injecté sous pression, par le trou inférieur (Ti), qui remplit le chambrage (A), jusqu'à débordement dudit ciment par le trou supérieur (T). - After cleaning the diaphysis, the orthopedic cement (C) is injected under pressure, through the lower hole (Ti), which fills the recess (A), until said cement overflows through the upper hole (T).

Il en résulte donc, comme le montre la figure 4, que seule la partie distale est cimentée. La partie proximale (la) de la tige présente un traitement de surface apte à engendrer la repousse osseuse. Par exemple, ce traitement peut être constitué par une couche de titane poreux. La partie distale cimentée de la tige assure donc la fixation primaire, tandis que la partie proximale assure la fixation secondaire. As a result, as shown in FIG. 4, only the distal part is cemented. The proximal part (la) of the stem has a surface treatment capable of generating bone regrowth. For example, this treatment can consist of a layer of porous titanium. The cemented distal portion of the stem therefore provides primary fixation, while the proximal portion provides secondary fixation.

Les avantages ressortent bien de la description, en particulier on souligne et on rappelle la conception particulère de la tige qui permet une nouvelle méthode de fixation par ciment, d'une manière particulièrement sûre et efficace.  The advantages emerge clearly from the description, in particular the particular design of the rod which underlines a new method of fixing by cement is emphasized and recalled, in a particularly safe and effective manner.

Claims (8)

REVENDICATIONS -1- Tige fémorale de reprise, caractérisée en ce qu'elle présente une partie proximale (la) conformée pour être bloquée dans la métaphyse du canal médullaire et une partie distale (lb) destinée à être cimentée dans ledit canal, lesdites parties (la) et (lb) étant séparées par un moyen apte à permettre la mise en place d'un ciment orthopédique, uniquement au niveau de la partie distale (lb).-1- Femoral stem of resumption, characterized in that it presents a proximal part (the) shaped to be blocked in the metaphysis of the medullary canal and a distal part (lb) intended to be cemented in said canal, said parts (the ) and (lb) being separated by a means capable of allowing the installation of an orthopedic cement, only at the level of the distal part (lb). -2- Tige selon la revendication 1, caractérisée en ce que le moyen est constitué par un épaulement (lc) formé au niveau du raccordement entre la partie proximale (la) et la partie distale (lb).-2- Rod according to claim 1, characterized in that the means consists of a shoulder (lc) formed at the connection between the proximal part (la) and the distal part (lb). -3- Tige selon la revendication 2, caractérisée en ce que l'épaulement (lc) fait office de butée à un élément d'étanchéité (2) sous forme d'une bague apte à assurer la retenue du ciment en constituant un chambrage (A) dans le canal médullaire, pour l'injection dudit ciment, au niveau de la partie distale (lb) seulement.-3- Rod according to claim 2, characterized in that the shoulder (lc) acts as a stop for a sealing element (2) in the form of a ring capable of ensuring the retention of the cement by constituting a recess ( A) in the medullary canal, for the injection of said cement, at the distal part (lb) only. -4- Tige selon la revendication 3, caractérisé en ce que la bague (2) déborde de la section de l'extrémité inférieure de la partie proximale (la) de la tige, au niveau de l'épaulement (lc). -4- Rod according to claim 3, characterized in that the ring (2) projects from the section of the lower end of the proximal part (la) of the rod, at the shoulder (lc). -5- Tige selon la revendication 3, caractérisée en ce que la bague (2) est en polyéthylène.-5- Rod according to claim 3, characterized in that the ring (2) is made of polyethylene. -6- Tige selon la revendication 1, caractérisée en ce que la partie proximale (la) présente un traitement de surface apte à assurer la repousse osseuse.-6- Rod according to claim 1, characterized in that the proximal part (la) has a surface treatment capable of ensuring bone regrowth. -7- Tige selon la revendication 1, caractérisée en ce qu'elle est de section degressive continue depuis son extrémité supérieure jusqu a son extrémité inférieure, d'une part, au niveau de sa partie proximale (la) et, d'autre part, au niveau de sa partie distale (lb).-7- Rod according to claim 1, characterized in that it is of continuous tapering section from its upper end to its lower end, on the one hand, at its proximal part (la) and, on the other hand , at its distal part (lb). -8- Tige selon la revendication 1, caractérisée en ce qu'elle présente un profil déterminé pour remplir au maximum la partie métaphysaire du canal médullaire. -8- Rod according to claim 1, characterized in that it has a determined profile to fill to the maximum the metaphyseal part of the medullary canal.
FR9104599A 1991-04-02 1991-04-02 FEMALE RECOVERY ROD. Expired - Fee Related FR2674744B1 (en)

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FR9104599A FR2674744B1 (en) 1991-04-02 1991-04-02 FEMALE RECOVERY ROD.

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FR9104599A FR2674744B1 (en) 1991-04-02 1991-04-02 FEMALE RECOVERY ROD.

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Cited By (8)

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EP0629386A2 (en) * 1993-05-26 1994-12-21 KABUSHIKI KAISHA KOBE SEIKO SHO also known as Kobe Steel Ltd. Artificial joint
EP0746273A1 (en) * 1993-11-02 1996-12-11 Hospital For Joint Diseases Control of cell growth
WO1997036558A1 (en) * 1996-04-02 1997-10-09 Franz Copf Shaft prosthesis part and material kit for use therewith
JP4838731B2 (en) * 2004-01-22 2011-12-14 メディシンロッジ インコーポレイテッド ディービーエー アイエムディーエス コーイノベーション Femoral hip prosthesis and transplantation method
WO2012101255A1 (en) * 2011-01-27 2012-08-02 Zimmer Gmbh Straight stem for the implantation into a proximal femur
FR2971699A1 (en) * 2011-02-23 2012-08-24 Biomet IMPLANT OF FEMORAL AND ANCILLARY REPRISE OF SURGICAL IMPLEMENTATION
EP2668928A1 (en) * 2012-05-31 2013-12-04 King Saud University Computer-implemented method of preoperatively determining the optimized external shape of a prosthetic femoral hip stem and a corresponding reamer
EP3332746A1 (en) * 2016-12-06 2018-06-13 WALDEMAR LINK GmbH & Co. KG Revision prosthesis shaft for a revision joint endoprosthesis

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US4546501A (en) * 1982-09-28 1985-10-15 Gustilo Ramon B Hip prosthesis
FR2585945A1 (en) * 1985-08-06 1987-02-13 Armor Method of implanting a resection prosthesis in the diaphysis of a long bone and prosthesis allowing implementation of this method.
US4881536A (en) * 1987-01-22 1989-11-21 Noble Phillip C Method and apparatus for prosthesis placement
EP0385585A1 (en) * 1989-02-06 1990-09-05 Stephen M. Horowitz, M.D. A hip prosthesis and method for implanting the same

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US4274163A (en) * 1979-07-16 1981-06-23 The Regents Of The University Of California Prosthetic fixation technique
US4546501A (en) * 1982-09-28 1985-10-15 Gustilo Ramon B Hip prosthesis
FR2585945A1 (en) * 1985-08-06 1987-02-13 Armor Method of implanting a resection prosthesis in the diaphysis of a long bone and prosthesis allowing implementation of this method.
US4881536A (en) * 1987-01-22 1989-11-21 Noble Phillip C Method and apparatus for prosthesis placement
EP0385585A1 (en) * 1989-02-06 1990-09-05 Stephen M. Horowitz, M.D. A hip prosthesis and method for implanting the same

Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0629386A2 (en) * 1993-05-26 1994-12-21 KABUSHIKI KAISHA KOBE SEIKO SHO also known as Kobe Steel Ltd. Artificial joint
EP0629386A3 (en) * 1993-05-26 1995-09-13 Kobe Steel Ltd Artificial joint.
EP0746273A1 (en) * 1993-11-02 1996-12-11 Hospital For Joint Diseases Control of cell growth
EP0746273A4 (en) * 1993-11-02 1998-11-25 Hospital For Joint Diseases Control of cell growth
WO1997036558A1 (en) * 1996-04-02 1997-10-09 Franz Copf Shaft prosthesis part and material kit for use therewith
JP4838731B2 (en) * 2004-01-22 2011-12-14 メディシンロッジ インコーポレイテッド ディービーエー アイエムディーエス コーイノベーション Femoral hip prosthesis and transplantation method
WO2012101255A1 (en) * 2011-01-27 2012-08-02 Zimmer Gmbh Straight stem for the implantation into a proximal femur
EP2484314A1 (en) * 2011-01-27 2012-08-08 Zimmer GmbH Straight stem for the implantation into a proximal femur
EP2484313A1 (en) * 2011-01-27 2012-08-08 Zimmer GmbH Straight stem for the implantation into a proximal femur
US9351841B2 (en) 2011-01-27 2016-05-31 Zimmer Gmbh Straight stem for the implantation into a proximal femur
EP2491893A1 (en) * 2011-02-23 2012-08-29 Biomet Femoral repair implant and ancillary for surgical implementation
FR2971699A1 (en) * 2011-02-23 2012-08-24 Biomet IMPLANT OF FEMORAL AND ANCILLARY REPRISE OF SURGICAL IMPLEMENTATION
EP2668928A1 (en) * 2012-05-31 2013-12-04 King Saud University Computer-implemented method of preoperatively determining the optimized external shape of a prosthetic femoral hip stem and a corresponding reamer
US8768674B2 (en) 2012-05-31 2014-07-01 King Saud University Computer-implemented method of preoperatively determining the optimized external shape of a prosthetic femoral hip stem
EP3332746A1 (en) * 2016-12-06 2018-06-13 WALDEMAR LINK GmbH & Co. KG Revision prosthesis shaft for a revision joint endoprosthesis
WO2018104331A1 (en) * 2016-12-06 2018-06-14 Waldemar Link Gmbh & Co. Kg Revision prosthesis shaft for a revision joint endoprosthesis
CN109982663A (en) * 2016-12-06 2019-07-05 沃尔德马连接两合公司 For repairing the prosthesis bar of articulated endoprosthesis
RU2727582C1 (en) * 2016-12-06 2020-07-22 ВАЛЬДЕМАР ЛИНК ГМБХ энд КО. КГ Joint revision endoprosthesis leg
CN109982663B (en) * 2016-12-06 2021-10-01 沃尔德马连接两合公司 Prosthetic stem for repairing an articular endoprosthesis
US11213399B2 (en) 2016-12-06 2022-01-04 Waldemar Link Gmbh & Co. Kg Revision prosthesis shaft for a revision joint endoprosthesis
AU2017370359B2 (en) * 2016-12-06 2022-11-17 Waldemar Link Gmbh & Co. Kg Revision prosthesis shaft for a revision joint endoprosthesis

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