FR2769489A1 - Support and plug for bone cavity - Google Patents

Support and plug for bone cavity Download PDF

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Publication number
FR2769489A1
FR2769489A1 FR9812964A FR9812964A FR2769489A1 FR 2769489 A1 FR2769489 A1 FR 2769489A1 FR 9812964 A FR9812964 A FR 9812964A FR 9812964 A FR9812964 A FR 9812964A FR 2769489 A1 FR2769489 A1 FR 2769489A1
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bone
cavity
wall
coating
dimensions
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Granted
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FR9812964A
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French (fr)
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FR2769489B1 (en
Inventor
La Caffiniere Jean Yves De
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Fixano SA
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Fixano SA
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Priority claimed from FR9712822A external-priority patent/FR2769488B1/en
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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
    • A61B17/68—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
    • 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
    • A61F2/28—Bones
    • 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
    • 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
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    • 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
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    • 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
    • A61F2/28—Bones
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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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30011—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in porosity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30228—Cylinders of elliptical or oval basis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0023—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in porosity
    • 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
    • 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
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants

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

Abstract

The plug (1) comprises a mesh ring (3) of a metal such as titanium, having an inner space (4) and two apertures (5). The ring has inner and outer surface coatings of an osteo-conductor material, e.g. tricalcium phosphate or hydroxyapatite. It has a certain rigidity but is capable of deformation to a greater or lesser degree, and its inner space can receive one or more screws for fixing the plug to the bone cortex.

Description

La présente invention concerne un dispositif pour l'étayage d'un os au niveau d'une cavité existant dans cet os, et pour le comblement de cette cavité. The present invention relates to a device for the shoring of a bone at the level of a cavity existing in this bone, and for the filling of this cavity.

Une cavité peut exister dans un os suite à un traumatisme ou à une opération chirurgicale. Lorsque l'os subit des contraintes importantes, notamment longitudinales, comme cela est le cas du calcanéum ou du tibia, il est nécessaire d'étayer cet os au niveau de cette cavité tout en comblant cette dernière. En particulier, I'opération dite de "relèvement ostéo-cartilagineux" d'un tibia, consiste à relever les surfaces articulaires d'appui que forme le plateau tibial, ce qui conduit à la création d'une telle cavité dans la tête du tibia, en dessous desdites surfaces d'appui. A cavity can exist in a bone following a trauma or a surgical operation. When the bone undergoes significant stresses, in particular longitudinal, as is the case of the calcaneus or tibia, it is necessary to support this bone at the level of this cavity while filling the latter. In particular, the operation known as "osteocartilaginous recovery" of a tibia, consists in raising the articular support surfaces that the tibial plateau forms, which leads to the creation of such a cavity in the head of the tibia , below said bearing surfaces.

Divers matériaux de comblement sont actuellement utilisés dans une telle indication: os autogène ou étranger, substitut calcique naturel (corail) ou artificiel (phosphate tricalcique ou hydroxyapatite). Various filling materials are currently used in such an indication: autogenic or foreign bone, natural calcium substitute (coral) or artificial (tricalcium phosphate or hydroxyapatite).

Ces matériaux doivent présenter une résistance suffisante pour assurer l'étayage de l'os et avoir une structure poreuse apte à permettre auxdits matériaux d'être colonisés par les cellules osseuses en croissance, pour leur ostéo-intégration. These materials must have sufficient strength to support the bone and have a porous structure capable of allowing said materials to be colonized by growing bone cells, for their osteointegration.

L'autogreffe cortico-spongieuse est le meilleur moyen de combler une cavité osseuse. Toutefois, le prélèvement d'un greffon bi ou tricortical conduit à une perte irrémédiable d'os pour le patient et présente un certain nombre d'inconvénients post-opératoires. The cortico-spongy autograft is the best way to fill a bone cavity. However, the removal of a bi or tricortical graft leads to an irreversible loss of bone for the patient and presents a certain number of postoperative drawbacks.

L'os spongieux constitue un matériau biologiquement idéal pour permettre une colonisation rapide et solide du matériau de comblement mais son absence de résistance mécanique conduit à une absence d'étayage. The cancellous bone constitutes a biologically ideal material to allow rapid and solid colonization of the filling material but its absence of mechanical strength leads to an absence of shoring.

Les autres matériaux utilisés sont moins adaptés sur le plan biologique, ce qui n'est pas sans conséquence sur ladite colonisation et donc sur la convalescence du patient. The other materials used are less adapted from a biological point of view, which is not without consequences for said colonization and therefore for the patient's recovery.

En outre, le maintien en position du matériau d'étayage et de comblement le temps que l'ostéo-intégration se produise peut être problématique, et la résistance de l'étayage peut être incertaine. In addition, maintaining the shoring and filling material in position until osteointegration occurs can be problematic, and the strength of the shoring may be uncertain.

La mise en place d'une plaque corticale permettant un étayage supplémentaire n'est la plupart du temps pas possible, compte tenu de la nécessité de percer le bloc de matériau de comblement mis en place dans la cavité en vue du passage d'une ou de plusieurs vis d'ancrage de cette plaque. Ce ou ces perçages conduisent en effet à un affaiblissement de la structure dudit bloc ou, dans le cas d'une greffe cortico-spongieuse, à des lésions des tissus. The establishment of a cortical plate allowing additional support is most of the time not possible, given the need to pierce the block of filling material placed in the cavity for the passage of one or more several anchor screws for this plate. This or these piercings in fact lead to a weakening of the structure of said block or, in the case of a cortico-spongy graft, to tissue damage.

II n'existe donc pas à ce jour de dispositif permettant de solutionner de manière satisfaisante l'ensemble des problèmes précités, et la présente invention vise à remédier à cette lacune. There is therefore no device to date making it possible to satisfactorily resolve all of the aforementioned problems, and the present invention aims to remedy this shortcoming.

A cet effet, le dispositif qu'elle concerne comprend une paroi périphérique ajourée, qui délimite un vide intérieur et deux ouvertures, situées en regard l'une de l'autre, permettant la communication de ce vide avec l'extérieur, ladite paroi étant revêtue sur ses faces intérieure et extérieure d'un matériau ostéo-conducteur. To this end, the device which it concerns comprises an openwork peripheral wall, which delimits an interior vacuum and two openings, located opposite one another, allowing the communication of this vacuum with the exterior, said wall being coated on its inner and outer faces with an osteoconductive material.

Le dispositif présente ainsi une structure de cage. II peut recevoir intérieurement des greffons et/ou copeaux d'os spongieux puis être introduit dans la cavité. Grâce à la structure ajourée de sa paroi et au revêtement ostéo-conducteur que celle-ci comprend, la colonisation osseuse peut s'opérer facilement et rapidement à travers la paroi, pour assurer la parfaite ostéo-intégration du dispositif. The device thus has a cage structure. It can internally receive grafts and / or chips of cancellous bone and then be introduced into the cavity. Thanks to the openwork structure of its wall and to the osteoconductive coating that it includes, bone colonization can be carried out easily and quickly through the wall, to ensure perfect osteointegration of the device.

Le dispositif peut présenter une structure rigide et peut venir en appui contre les faces osseuses à étayer, auquel cas il existe en plusieurs dimensions afin qu'un dispositif de dimensions adaptées aux dimensions de la cavité puisse être choisi. The device can have a rigid structure and can come to bear against the bony faces to be supported, in which case it exists in several dimensions so that a device of dimensions adapted to the dimensions of the cavity can be chosen.

Le dispositif ainsi conformé assure alors l'intégralité de l'étayage de l'os.  The device thus shaped then ensures the entire shoring of the bone.

Alternativement, le dispositif présente une structure ayant une certaine rigidité mais susceptible d'être plus ou moins déformée, la paroi étant dans ce cas notamment constituée par un treillis métallique, de préférence en titane. Alternatively, the device has a structure having a certain rigidity but capable of being more or less deformed, the wall being in this case in particular constituted by a wire mesh, preferably made of titanium.

Un même dispositif peut alors être plus ou moins déformé pour permettre son adaptation à la forme particulière de la cavité à traiter. Dans la mesure où la relative rigidité d'une telle cage ne suffirait pas à assurer un étayage suffisant de l'os, ou en vue d'obtenir toute assurance quant à la résistance de l'étayage de l'os, le vide intérieur que délimite le dispositif peut être mis à profit pour le passage d'une ou plusieurs vis osseuses assurant la fixation d'une plaque corticale, cette plaque permettant l'étayage complémentaire de l'os.  The same device can then be more or less deformed to allow its adaptation to the particular shape of the cavity to be treated. Insofar as the relative rigidity of such a cage would not be sufficient to ensure adequate shoring of the bone, or in order to obtain any assurance as to the strength of the shoring of the bone, the internal vacuum that delimits the device can be used for the passage of one or more bone screws ensuring the fixation of a cortical plate, this plate allowing the additional shoring of the bone.

Le dispositif selon l'invention permet ainsi la mise en place d'une telle plaque, sans amoindrissement de l'étayage produit au niveau de la cavité, à l'inverse des techniques antérieures. The device according to the invention thus allows the establishment of such a plate, without reducing the shoring produced at the level of the cavity, unlike the prior techniques.

Selon une caractéristique intéressante de l'invention, la porosité du revêtement ostéo-conducteur n'est pas constante, et décroît depuis la face superficielle de ce revêtement vers la profondeur de ce revêtement, c'est-à-dire aux abords de ladite paroi. According to an advantageous characteristic of the invention, the porosity of the osteoconductive coating is not constant, and decreases from the surface face of this coating towards the depth of this coating, that is to say around said wall .

Cette porosité favorise la croissance des cellules osseuses ainsi que l'ancrage du dispositif, pour assurer la parfaite ostéo-intégration de ce dernier. This porosity promotes the growth of bone cells as well as the anchoring of the device, to ensure perfect osteointegration of the latter.

L'invention sera bien comprise en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée du dispositif qu'elle concerne. The invention will be better understood with reference to the appended schematic drawing representing, by way of nonlimiting example, a preferred embodiment of the device which it relates to.

La figure 1 est une vue en perspective de ce dispositif, après sa mise en place dans une cavité osseuse existant au niveau de la tête d'un tibia, une plaque corticale ayant également été mise en place sur ce tibia au moyen de quatre vis
la figure 2 en est une vue en perspective à échelle agrandie, et
la figure 3 est une vue de détail, de face et à échelle encore agrandie, d'une portion de sa paroi.Figure 1 is a perspective view of this device, after its placement in a bony cavity existing at the head of a tibia, a cortical plate having also been placed on this tibia by means of four screws
FIG. 2 is a perspective view of it on an enlarged scale, and
Figure 3 is a detail view, front and on a still enlarged scale, of a portion of its wall.

Les figures 1 à 3 représentent, sous différents angles, un dispositif 1 pour l'étayage d'un os au niveau d'une cavité 2 existant dans cet os, et pour le comblement de cette cavité 2. FIGS. 1 to 3 represent, from different angles, a device 1 for the shoring of a bone at the level of a cavity 2 existing in this bone, and for the filling of this cavity 2.

Ce dispositif 1 comprend une paroi périphérique ajourée 3, lui conférant une structure de cage. La paroi 3 délimite un vide intérieur 4 ainsi que deux ouvertures 5 situées en regard l'une de l'autre, qui permettent la communication de ce vide 4 avec l'extérieur. This device 1 comprises a perforated peripheral wall 3, giving it a cage structure. The wall 3 delimits an interior vacuum 4 as well as two openings 5 located opposite one another, which allow the communication of this vacuum 4 with the outside.

La paroi 3 est constituée par un treillis métallique en titane et présente par conséquent une structure ayant une certaine rigidité tout en étant susceptible d'être plus ou moins déformée. Elle est revêtue sur ses faces intérieure et extérieure d'un matériau ostéo-conducteur 6, tel que phosphate tricalcique ou hydroxyapatite. II apparaît plus particulièrement aux figures 2 et 3 que la porosité du revêtement 6 n'est pas constante, et qu'elle décroît depuis la face superficielle 6a de ce revêtement vers la profondeur 6b de ce revêtement, c'est-à-dire aux abords de la paroi 3.  The wall 3 consists of a titanium wire mesh and therefore has a structure having a certain rigidity while being capable of being more or less deformed. It is coated on its inner and outer faces with an osteoconductive material 6, such as tricalcium phosphate or hydroxyapatite. It appears more particularly in FIGS. 2 and 3 that the porosity of the coating 6 is not constant, and that it decreases from the surface face 6a of this coating towards the depth 6b of this coating, that is to say at the around the wall 3.

Ainsi que cela apparaît à la figure 1, le dispositif 1 peut être plus ou moins déformé pour permettre son adaptation à la forme particulière de la cavité 2 à traiter, puis est inséré dans cette cavité de manière à prendre appui contre les parois osseuses qui délimitent cette dernière. As shown in Figure 1, the device 1 can be more or less deformed to allow its adaptation to the particular shape of the cavity 2 to be treated, then is inserted into this cavity so as to bear against the bony walls which delimit the latter.

Cette déformation n'a toutefois rien d'obligatoire et un dispositif de dimensions adaptées peut être choisi parmi une série de dispositifs de différentes tailles, en fonction des dimensions de la cavité à traiter. This deformation is however not obligatory and a device of suitable dimensions can be chosen from a series of devices of different sizes, depending on the dimensions of the cavity to be treated.

En cas de déformation, le vide 4 reste suffisant pour permettre le passage des vis osseuses 7 assurant la mise en place d'une plaque corticale 8, cette dernière étant prévue pour assurer un étayage complémentaire de l'os. Les vis 7 permettent par la même occasion d'assurer le maintien en position du dispositif 1 dans la cavité 2. In the event of deformation, the vacuum 4 remains sufficient to allow the passage of the bone screws 7 ensuring the establishment of a cortical plate 8, the latter being provided to provide additional shoring of the bone. The screws 7 make it possible at the same time to maintain the device 1 in position in the cavity 2.

Le dispositif 1 peut recevoir intérieurement des greffons et/ou copeaux d'os spongieux. Grâce à la structure ajourée de sa paroi 3 et au revêtement ostéo-conducteur 6, la colonisation osseuse peut s'opérer facilement et rapidement à travers la paroi 3, pour assurer la parfaite ostéo-intégration du dispositif. The device 1 can internally receive grafts and / or chips of cancellous bone. Thanks to the openwork structure of its wall 3 and to the osteoconductive coating 6, bone colonization can take place easily and quickly through the wall 3, to ensure perfect osteointegration of the device.

L'invention fournit ainsi un dispositif permettant de réaliser un parfait étayage d'un os au niveau d'une cavité existant dans cet os, et d'assurer en outre le comblement au moins partiel de cette cavité.  The invention thus provides a device making it possible to carry out perfect shoring of a bone at the level of a cavity existing in this bone, and to further ensure the at least partial filling of this cavity.

Claims (7)

1 - Dispositif pour l'étayage d'un os au niveau d'une cavité existant dans cet os, et pour le comblement de cette cavité, caractérisé en ce qu'il comprend une paroi périphérique ajourée (3), qui délimite un vide intérieur (4) et deux ouvertures (5), situées en regard l'une de l'autre, permettant la communication de ce vide (4) avec l'extérieur, ladite paroi (3) étant revêtue sur ses faces intérieure et extérieure d'un matériau ostéo-conducteur (6). 1 - Device for the shoring of a bone at the level of a cavity existing in this bone, and for the filling of this cavity, characterized in that it comprises an perforated peripheral wall (3), which delimits an internal void (4) and two openings (5), located opposite one another, allowing the communication of this vacuum (4) with the outside, said wall (3) being coated on its inner and outer faces with an osteoconductive material (6). REVENDICATIONS 2 - Dispositif selon la revendication 1, caractérisé en ce qu'il présente une structure rigide et en ce qu'il fait partie d'un ensemble de dispositifs similaires existant en plusieurs dimensions, afin qu'un dispositif de dimensions adaptées aux dimensions de la cavité puisse être choisi. 2 - Device according to claim 1, characterized in that it has a rigid structure and in that it is part of a set of similar devices existing in several dimensions, so that a device of dimensions adapted to the dimensions of the cavity can be chosen. 3 - Dispositif selon la revendication 1, caractérisé en ce qu'il présente une structure ayant une certaine rigidité mais susceptible d'être plus ou moins déformée. 3 - Device according to claim 1, characterized in that it has a structure having a certain rigidity but capable of being more or less deformed. 4- Dispositif selon la revendication 3, caractérisé en ce que la paroi (3) est constituée par un treillis métallique. 4- Device according to claim 3, characterized in that the wall (3) is constituted by a wire mesh. 5- Dispositif selon la revendication 4, caractérisé en ce que le treillis métallique est en titane. 5- Device according to claim 4, characterized in that the wire mesh is made of titanium. 6- Dispositif selon l'une des revendications 1 à 5, caractérisé en ce que le vide intérieur (4) qu'il délimite est dimensionné pour permettre le passage d'une ou plusieurs vis osseuses (7) assurant la fixation d'une plaque corticale (8). 6- Device according to one of claims 1 to 5, characterized in that the internal vacuum (4) which it delimits is dimensioned to allow the passage of one or more bone screws (7) ensuring the fixing of a plate cortical (8). 7 - Dispositif selon l'une des revendications 1 à 6, caractérisé en ce que la porosité du revêtement ostéo-conducteur (6) décroît depuis la face superficielle de ce revêtement vers la profondeur de ce revêtement, c'est-à-dire aux abords de ladite paroi (3).  7 - Device according to one of claims 1 to 6, characterized in that the porosity of the osteoconductive coating (6) decreases from the surface face of this coating towards the depth of this coating, that is to say to approaches to said wall (3).
FR9812964A 1997-10-14 1998-10-13 DEVICE FOR SHOULDERING A BONE AT A CAVITY EXISTING IN THIS BONE, AND FOR FILLING THIS CAVITY Expired - Fee Related FR2769489B1 (en)

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FR9812964A FR2769489B1 (en) 1997-10-14 1998-10-13 DEVICE FOR SHOULDERING A BONE AT A CAVITY EXISTING IN THIS BONE, AND FOR FILLING THIS CAVITY

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR9712822A FR2769488B1 (en) 1997-10-14 1997-10-14 ARMED HYDROXYAPATITE OSTEOARTICULAR SUPPORT DEVICE
FR9812964A FR2769489B1 (en) 1997-10-14 1998-10-13 DEVICE FOR SHOULDERING A BONE AT A CAVITY EXISTING IN THIS BONE, AND FOR FILLING THIS CAVITY

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US4089071A (en) * 1976-09-08 1978-05-16 Kalnberz Viktor Konstantinovic Material for making bone endoprosthesis and endoprosthesis made of said material
US4781721A (en) * 1981-02-25 1988-11-01 S+G Implants Bone-graft material and method of manufacture
EP0369034A1 (en) * 1988-05-27 1990-05-23 Sumitomo Cement Co. Ltd. Artificial bone structure for transplantation of bone
US5147402A (en) * 1990-12-05 1992-09-15 Sulzer Brothers Limited Implant for ingrowth of osseous tissue
EP0511686A2 (en) * 1984-12-14 1992-11-04 DRAENERT, Klaus, Dr.med. Artificial bone and method for making it
US5503164A (en) * 1994-01-28 1996-04-02 Osteogenics, Inc. Device and method for repair of craniomaxillofacial bone defects including burr holes

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US4089071A (en) * 1976-09-08 1978-05-16 Kalnberz Viktor Konstantinovic Material for making bone endoprosthesis and endoprosthesis made of said material
US4781721A (en) * 1981-02-25 1988-11-01 S+G Implants Bone-graft material and method of manufacture
EP0511686A2 (en) * 1984-12-14 1992-11-04 DRAENERT, Klaus, Dr.med. Artificial bone and method for making it
EP0369034A1 (en) * 1988-05-27 1990-05-23 Sumitomo Cement Co. Ltd. Artificial bone structure for transplantation of bone
US5147402A (en) * 1990-12-05 1992-09-15 Sulzer Brothers Limited Implant for ingrowth of osseous tissue
US5503164A (en) * 1994-01-28 1996-04-02 Osteogenics, Inc. Device and method for repair of craniomaxillofacial bone defects including burr holes

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1852135A1 (en) * 2005-02-23 2007-11-07 HI-LEX Corporation, Inc. Medical material, artificial tooth root and method of producing material for clinical use
EP1852135A4 (en) * 2005-02-23 2012-01-11 Hi Lex Corp Inc Medical material, artificial tooth root and method of producing material for clinical use

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