ITMI950322A1 - Protesi anatomica totale dell'anca - Google Patents

Protesi anatomica totale dell'anca Download PDF

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Publication number
ITMI950322A1
ITMI950322A1 IT95MI000322A ITMI950322A ITMI950322A1 IT MI950322 A1 ITMI950322 A1 IT MI950322A1 IT 95MI000322 A IT95MI000322 A IT 95MI000322A IT MI950322 A ITMI950322 A IT MI950322A IT MI950322 A1 ITMI950322 A1 IT MI950322A1
Authority
IT
Italy
Prior art keywords
prosthesis according
acetabulum
cap
compensator
prosthesis
Prior art date
Application number
IT95MI000322A
Other languages
English (en)
Inventor
Francesco Caracciolo
Original Assignee
Francesco Caracciolo
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Francesco Caracciolo filed Critical Francesco Caracciolo
Priority to ITMI950322A priority Critical patent/IT1273952B/it
Publication of ITMI950322A0 publication Critical patent/ITMI950322A0/it
Priority to EP96101737A priority patent/EP0728449B1/en
Priority to DE69622452T priority patent/DE69622452T2/de
Publication of ITMI950322A1 publication Critical patent/ITMI950322A1/it
Priority to US08/739,929 priority patent/US5725593A/en
Application granted granted Critical
Publication of IT1273952B publication Critical patent/IT1273952B/it

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
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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
    • A61F2/30—Joints
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    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • A61F2/3603—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices implanted without ablation of the whole natural femoral head
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A—HUMAN NECESSITIES
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    • 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
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    • 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
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    • 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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
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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
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
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    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
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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
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Landscapes

  • Health & Medical Sciences (AREA)
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Abstract

Viene descritta una "Protesi anatomica totale dell'anca" la quale comprende un acetabolo protesico (10) semisferico sovrastante una calotta (14) semisferica, entrambi provvisto di mezzi di ancoraggio mediante inserimento a pressione nella fossa iliaca (22) l'acetabolo (10) e rispettivamente nulla testa femorale (24) la calotta (14), quest'ultima essendo associata a componenti (12, 16, 18 e 20) che stabilmente la bloccano sulla detta tenta femorale (24).

Description

Domanda di bre vetto per invenzione industriale dal
"PROTESI ANATOMICA TOTALE DELL'ANCA
D E S C R I Z I O N E
La presente invenzione riguarda una "Protesi anatomica totale dell'anca", con sistema di bloccaggio a "pressione" da utilizzarsi per la riabilitazione di soggetti che non pre sentino patologie invasive, tali da richiedere l'asportazione della testa femorale.
Viene definita "anatomica" poich? ? in grado di ripristinare, senza ricorso a significative menomazioni, le caratteristiche anatomico-funzionali naturali.
In linea generale l'attuale metodica impiantologiea
- - -coxofemorale si basa, sostanzialmente, su un unico principio fisico, cio? quello della "leva", in antitesi alle leggi naturali che governano il pr?cesso fisiologico dell'essere umano.
L'apporto agli attuali elementi protesici di alcune modifiche: nuove leghe metalliche, rivestimenti in ceramica o d'?drossiapatite (HA), hiovetri, stiati porosi, alveolazioni, inscatolamento della carnieia acetabolare, oppure l'introduzione di nuove sostanze osteocompatibili o osteoconducenti (?) non ? valso ad eliminare l'insuccesso impiantologico. Infatti, gli esiti clinici continuano a registrare algia, deambulazione non corretta, mobilit? del co-
ile protesico e dello stelo infisso nel dotto diaifisardo, frammentazione del cemento acrilico (P MtfA) osteolisi perimplantare con evidente riassorbimento dell'osso endostale e dell'osso corticale diafisario, nonch? altre patologie da impianto, inoltre, in atto operatorio, possono verificarsi fratture in zona piccolo trocantere e spiroide diafisaria con successivo ricorso al "cerchiaggio metallico".
la principale "causa" degli insuccessi e delle paiologie da impianto , quindi , ? di natura chiaramente meccanica, dovuta cio? alle caratteristiche morfologi co -funzionali delle attuali protesi non idonee all 'uso.
E' stata ora ideata, e forma oggetto della presente invenzione , una "Protesi anatomica totale dell'anca" realizzata con caratteristlche moifologico-funzionali in grado di eliminare i summenzionati inconve nienti ed altri ancora.
La protesi anatomica totale dell'anca, secondo la presente invenzione, si caratterizza dal fatto di comprendere un acetabolo (10) semisferico sovrastane te una calotta (14) semisferica, entrambi provvisti di mezzi di ancoraggio mediante inserimento a pres sione nella fossa iliaca (22) l'acetabolo (10) e rispettivamente sulla testa femorale (24) la calot ta (14). auest'ultima essendo associata a componen ti (12.16.18 e 20) che stabilmente la bloccano sullaa detta testa femorale (24)._
Vantaggiosamente , i mezzi di ancoraggio primario dell'acetabolo (10) nella fossa iliaca (22) sono costituiti da una pluralit? di dentini (I0d) stabilizzatori "a fiocina" disposti sulla superficie esterna (10c) dell'acetabolo (10) medesimo, inoltre jsu detta superficie esterna (10c) sono presenti delle zigrinature (lOe) cbe contribuiscono ad un secondario ancoraggio biologico nella fossa iliaca (22). Pure vantaggiosamente, i mezzi di ancoraggio della calotta (14) alla testa femorale (24) sono costituiti da una dentellatura (14g) collocata sul piano di imposta della calotta (14) medesima=
Una variante esecutiva della protesi, secondo la presente invenzione, deriva dal fatto che i mezzi di ancoraggio dell?acetaholo (10') (fig.4) nella fossa iliaca (22) sono costituiti da un anello (30) staliilizzatore, all 'occorrenza interrotto (30e) (fig.7), provvisto sulla circonferenza esterna (30t) di uncini (30a), detto anello (30) essendo associabile all'acetabolo (10?) stesso.
Opportunamente , detta associazione ? determinata da 'cave (30c) con un piano inclinato (30d) presenti nella superficie interna dell'anello f30). le ouali permettono l'inserimento ed il passaggio di suor genze (10'a) radiali ricavate sulla superficie esterna dell'acetabolo (10') che, successivamente ruotato, determina la suddetta associazione.
Queste ed altre caratteristiche nonch? i vantaggi della protesi anatomica totale dell'anca, secondo la presente invenzione, risulteranno pi? chiaramente dalla seguente particolareggiata descrizione di una sua forma realizzativa non limitativa, fatta con riferimento alle figure allegate delle cuali: - la fig.1 illustra una vista esplosa dei componenti, parzialmente in sezione, della protesi anatomica totale dell'anca secondo la pre sente invenzione: - la fig.2 illustra, in scala maggiore, i componenti di fig.1 assemblati ed inseriti nell 'anca del paziente ;
- la fig.3 Illustra una vista in alzato del componente a staffa;
- la fig.4 illustra una vista esplosa, parzialmente in sezione, di una variante relativa ai componer ti della protesi inseribili nella fossa iliaca;
- la fig.5 illustra i componenti di fig.4 parzialmente inseriti nella fossa iliaca;
- la fig.6 illustra i componenti di fig.5 inseriti nella fossa iliaca, e
- la fig.7 illustra una vista in pianta del componente secondo la variante di fig.4 destinato ad ancorarsi nella fossa iliaca.
Facendo dapprima riferimento alla fig.1 la protesi anatomica totale dell'anca, secondo la presente invenzinne, ? costituita, in una sua preferita forma realizzativa. da una pluralit? di componenti di cui un acetabolo (10), un compensatore superiore cieco (12), una calotta (14), una staffa (16), un compensatcre inferiore?passante (18) ed un tirante (20). La -articolare e caratteristica conformazione strul
- - turale dei summenzionati componenti viene qui di . .
seguito descritta.
l?acetabolo protesico (10) presenta una conformazic ne sostanzialdente semisferica, internamente cava (iCa) e provvista alla sua sommit? di una apertura o foro (10b) per fini applicativi e biologici.
Secondo una caratteristica della presente invenzione, l'acetabolo (10) include, sulla sua superficie esterna (10c). una serie di dentini (lOd) stabilizzatcri "a fiocina" nonch? delle zone zigrinate (lOe), Detti dentini (lOd) consentono, mediante pressione un ancoraggio primario dell'acetabolo (10) nella j fossa iliaca (22) (illustrata con linea tratteggia4 ta in fig.1), mentre le zigrinature (lOe) contribuiscono ad una migliore fusione biologica osso-impianto.
Facendo ora riferimento al compensatore superiore cieco (12), lo stesso ? strutturato in modo da ineludere una testa (12a) ed una porzione cilindrica (12b) internamente filettata (12c) per gli scopi in seguito specificati.
La calotta (14?), inseribile nella cavit? (10a) dell'acetabolo (10) (fig.1), presenta una analoga conformazione semisferica, internamente cava (14a), alla cui sommit? ? prevista una sede (14-b) con aperdura o foro (14c) centrale, tale sede (14b) es-- sendo atta ad accogliere la testa (12a) del comperisatore superiore cieco C12)-Vantaggiosamente, la suddetta calotta (14) presenta sulla sua superficie esterna (14d), una pluralit? di forellini (He) nonch? rilievi circonferenziali (14f), questi ultimi diminuiscono l'attrito con la cavit? (10a) interna dell'acetabolo (10), per raggiungere, anche con elevati carichi radiali imponibili, il massimo scorrimento e la minima dissipazione della potenza meccanica per attrito, mentre la detta pluralit? di forellini (I4e) consente un'equa distribuzione del liquido sinoviale fra le due superfici in fase di strisciamento.
Pure vantaggiosamente, la suddetta calotta (14) inelude una dentellatura (l4g) collocata sul proprio : piano d'imposta, che contribuisce a vincolarla alla testa femorale (24), illustrata con linea tratteggiata in fig.1.
Inoltre, la summenzionata calotta (14) presenta, nella sua cavit? (Ha), una particolare struttura alveolata (Hh), atta a garantire, dopo l'intervento chirurgico di asportazione dei tessuti patologici, l 'osteogenesi riparativa, la successiva omeostasi scheletrica e minerale, nonch? il trofismo della struttura ossea sottostante.
La finalit? della calotta (14), che sostituisce il
tessuto patologico asportato, ? anche quella di sod_
disfai^,' mediante la convessit?, le esigenze statiche, dinamiche e tribologiche e con la concavit? di
operare in continua simbiosi con la base ossea trabecolare .
Facendo ora riferimento alla staffa (16) (fig.1,2
e 3), la stessa presenta una conformazione strutturale comparabile ad una "C" che riproduce la sagoma
della corticale laterale esterna del femore sotto
il grande trocantere ed include, sulla sua superfieie maggiore (16a), una nicchia (16b) con apertura
(16c) oblunga centrale, nicchia (16b) atta ad allcggiare il compensatore inferiore passante (18) e la
testa del tirante (20b).
Tale compensatore inferiore passante (18) comporta
un lato piatto (18a) e l'altro convesso (18b) ed ?
attraversato da un foro (18c) per il passaggio del
tirante (20).
Detto tirante (20) ? costituito da una porzione cilindrica (20a) provvista ad una estremit? di una te-- -sta (2Cb), mentre l'estremit? opposta presenta una
porzione cilindrica filettata (20c) atta ad essere
avvitata nel compensatore superiore cieco (12).
L'applicazione della protesi, realizzata per pazien-- ? ti con patologie che non necessitino della asporta? zione della testa femorale (24), secondo la presente invenzione, comporta un procedimento semplificato che qui di seguito viene sintetizzato.
Partendo dalla resezione della capsula articolare e lussazione dell'anca, escludendo l'osteotomia della testa (24) e del collo femorale, si arriva alla esposizione della fossa iliaca (22).
L'alesaggio della stessa (22) si effettua mediante alcune frese calibrate, di diametro crescente affinche la cartilagine venga completamente asportata sino alla comparsa dell'osso sottostante.
E' indisoensabile effettuare pi? controlli dimensionali prima dell'ultima fresatura, da eseguirsi a mano, avendo l'accortezza di mantenere integri i margini della fossa liaca (22).
Iteli'alesare il cotile iliaco (22), va tenuto conto, delle dimensioni dell'acetabolo protesico (10), prescelto, infatti, l'elemento meccanico (10) per lo ancoraggio primario alla struttura ossea di base, deve avere una dimensione diametrale superiore di almeno 10 millimetri a quella dell'ultima fresa che ha operato nel cotile iliaco (22).
la protesi acetubolare (10), costituita da dentini (iCd) e zigrinature (I0e), per favorire una fusione biologica osso?impianto immediata, compatibilmente cor.le condizioni del tessuto interfacciale che deve aderire alla protesi sressa, va inserita a pressione nella fossa iliaca (22) ove vi si ancora.
Esiste anche una seconda protesi acetaholare (10') (fig.4), che per l?ancoraggio dispone di un anello (30) stabilizzatore, da collocarsi nei pressi del "labrum acetabulare " una volta terminate le alesaturedel cotile iliaco (22) come sopra descritto. L'anello (30) stabilizzatore, espandendosi autonomamente essendo di materia con propriet? a "memoria di forma", si ancora nella posizione prestabilita dall ' peratore,_ e , incastrandosi nel tessuto osseo tramite uncini (30a) e simili, consegue l'immobilit? necessaria per consentile alla protesi acetabolare. (1o0) di agganciarsi, con torsione e scatto, al suddetto anello (30).
Deciso l'allineamento mediante l'apposito "collimatore", si perfora la struttura ossea interessata partendo dalla sommit? della testa (24), si attraversa il centro del collo femorale e, obliquamente, l'intera epifisi superiore (26) fino ad emergere all'estremit? della diafisi sotto il grande trocantere, Con strumento a cappa si procede alla decorticazione della met? sugariore della testa femorale (24), secondo la Normativa predisposta per l 'applicazio -ne della presente protesi anatomica.
Completata la decorticazione, si posizionano le specifiche componenti (12,14,16 e 18) nel seguente assetto: la calotta (14) sopra la testa decorticata (24), il compensatore superiore cieco (12) nell'apposito avallamento (14b) della calotta (14), la staffa (16) con alloggiato il compensatore inferiore passante (16) sotto il grande trocantere.
Nella staffa (16) viene introdotto il tirante (20) che, dopo aver attraversato l'epifisi superiore (26), collo e testa femorale (24) di avvita al compensatore superiore cieco (12) posizionato scura la calotta (14), assemblando a "pressione" tutte le det4 te componenti.
Facendo ora particolare riferimento alle figg.4,5? :6 e 7, nelle stesse viene illustrata una variante strutturale dei soli componenti inseribili nella fossa iliaca (22) essendo gli altri analoghi a quelli sopra descritti.
Uno dei componenti ? costituito da un anello (30) stabilizzatore di sezione prevalentemente ovale, dotato di uncini (30a) o simili disposti sulla parte convessa esterna (30b) dell'anello (30) stesso, il quale pu? in tal modo essere inserito e vincolato alla fossa iliaca (22) nei pressi del "labrum acetabulare".
A tale anello (30) ? associabile, nel modo in segui to descritto, un secondo componente quale l'acetabolo protesico (TO') di forma sostanzialmente ana-Ioga all?acetabolo protesico (10) privo di dentini (10d) e di zigrinature (lOe), ma includente sporgenze radiali (10'a) atte a consentire l'associazione con detto anello (30)? quest'ultimo a tale scopo presenta passaggi (30c) con piani inclinati (30d) disposti radialmente al suo interno ed in numero uguale alle suddette sporgenze radiali (10*a) dell 'acetabolo(10 ') medesimo.
la suddetta associazione avviene inserendo dapprima; l'anello (30) nella fossa iliaca (22), in prossimi t? del "labrum acetabulare" accertandosi che gli uncini (30a) abbiano salda presa, auindi si intro ducono nei passaggi (30c) le sporgenze radiali (10'a) (fig.5) sino alla loro fuoriuscita, agevolai ta dai piani inclinati (30d) (fig.7), successivamenite si ruota su se stesso l'acetabolo (10') sino a che le dette sporgenze radiali (10'a) non risultino. pi? allineate con i summenzionati passaggi (30c). Vantaggiosamente, l'anello (30) stabilizzatore ? di: materiale con propriet? a "memoria di forma", nei suoi specifici sistemi, per finalit? applicative. Infine, tutti i componenti la protesi anatomica totale dell'anca, secondo la presente invenzione, sono prodotti con materiale determinato "inerte" e quindi altamente biocompatibili.
Da quanto sopra descritto risulta evidente che la protesi, secondo la presente invenzione, realizzata mediante concetti innovativi e con caratteristiche pi? rispondenti alle esigenze ed alle strutture fisiologiche dei destinatari, nonch? agli aspetti teenologici della "metallurgia" e soprattutto alia leggi della "meccanica" in generale, con particolare riguardo a "statica", "dinamica" e "tribologi?", si prefigge di risolvere le seguenti problematiche: 1 - eccettuare l'occupazione del dotto diafisario con "braccio potenza", ovvero lo stelo delle attuali protesi, la relativa cementazione (PLIMA) e tutti gli altri fenomeni patologici da impianto come i micro-macromovimenti correlati alle caratteristiche morfologico-funzionali dell'ente meccanico realizza to in conformit? al "principio della leva";
2) - ottenere corretto equilibrio ed equa distribuzione delle forze statiche e dinamiche operanti sul la struttura ossea del paziente;
l) - conservare la sfericit? del cotile iliaco e rendere pi? statile l'acetabolo protesico, sinora sottoposta a movimenti oscillatori, vibrazioni e inarenamenti, connessi ?i profili delle attuali pr?tesi d'anca, che rendono anomale le forze operanti radialmente ;
4) - eliminare ogni tipo di inserto (HCH 1000, UHLE-V7PZ, ecc.) la cui inevitabile micro frammentazione, oltre ad annullare la specifica funzione lubrificatrice e ammortizzatrice , provoca significativi danni alla salute del paziente;
5) - delimitare l'intervento chirurgico alla sola asportazione dei tessuti patologici, molli (manicotto fibroso, legamenti, ecc.) e scheletrici, componenti l'articolazione coxofemorale e salvaguardare , nella zona anatomica interessata la funzione "emopoietica", nonch? i fenomeni definiti "omeostasi scheletrica" e "omeostasi minerale (metabolismo fosfocalcico) ";
6) - escludere l'uso di metalli che provochino feromeni elettrici, magnetici e di metallosi, causa, per le loro tossicit?, di malattie degenerative; 7) - ripartire uniformemente nel moto relativo (strisciamento) i carichi radiali sulla superficie in adesione;
8) - precludere fenomeni d'instabilit? dinamica; 9) - sostituire la "doppia curvatura" con accorgisenti tecnici innovativi che, per il diminuito contatto diretto delle mutue superfici operanti, porti no a infinitesimo la "resistenza d'attrito radente" 10) - distribuire equamente la disponibile sostanza fluida (liquido sinoviale ? 3,0 ni.) sulle superfici in contatto diretto e in "attrito limite (0 epilaminico ) ";
11) - ottenere il massimo scorrimento anche con eie vati carichi radiali imponibili, una minima dissipa zione della potenza meccanica per attrito ed ampi movimenti in ogni direzione.
E' chiaro, infine, che le modifiche potranno essere apportate dagli esperti del ramo, alla protesi secondo la presente invenzione, senza per questo usci re dall'ambito di una 0 pi? qualsiasi delle rivendicazioni che seguono.

Claims (1)

  1. R I V E N D I C A Z I O N I 1 ? Protesi anatomica totale dell'anca, in partico? lare per pazienti che non richiedono l'asportazione della testa femorale, caratterizzata dal comprendere un acetabolo protesico (10) semisferico sovra? stante una calotta (14) semisferica, entrambi provvisti di mezzi di ancoraggio mediante inserimento a pressione nella fossa iliaca (22) l'acetabolo (10] e rispettivamente sulla testa femorale (24) la ca? lotta (14), quest'ultima essendo associata a compo? nenti (12,16,18 e 20) che stabilmente la bloccano sulla detta testa femorale (24). a - Protesi secondo la rivendicazione ?, caretterizzata dal fatto che i mezzi di ancoraggio primario dell'acetabolo (10) semisferico nella fossa iliaca (22) sono costituiti da una pluralit? di dentini (10d) stabilizzatori "a fiocina" disposti sulla superficie esterna (1CC) dell'acetabolo (1C) mede? simo, inoltre su detta superficie esterna (10c) sono presenti delle zigrinature (10e) che contribui? scono ad un secondario ancoraggio biologico dello acetabolo (10) stesso nella fossa iliaca (22). 3 - Protesi secondo la rivendicazione 2, carat? terizzata dal fatto che la sommit? dell'acetabolo protesico (10) presenta un'apertura 0 foro (10b) centrale per fini tecnici applicativi e biologici. .4- Protesi secondo la rivendicazione if caratterizzata dal fatto che i mezzi di ancoraggio della calotta (14) alla testa femorale (24) sono costitu? ti da una dentellatura (14g) collacata sul piano di imposta della calotta (14) medesima. 5- Protesi secondo la rivendicazione 4, caratterizzata dal fatto che all'interno (14a) della calot ta (14) ? disposta una struttura alveolata (l4h) con forellini (l4e) comunicanti con la superficie esterna (14d). 6 - Protesi secondo le rivendicazioni 4 e 5, caratterizzata dal fatto che la superficie esterna (14d) della calotta (14) presenta rilievi (I4f) circonferenziali e, all'occorrenza, grani radiali, segmenti vari 0 sferici, pattini 0 similari, atti a diminuire l'attrito con la superficie interna dello acetabolo (10) sovrastante. 7 ? Protesi secondo le rivendicazioni 4 , 5 e 6 , caratterizzata dal fatto che alla sommit? della calotta (14) ? presente una sede (14b) con apertura 0 foro (14c) centrale. 8 _ Protesi secondo la rivendicazione i, caratte rizzata dal fatto che i detti mezzi di ancoraggio dell?acetabolo (10') nella fossa iliaca (22) sono costituiti da un anello (30) statilizzatore, alla occorrenza interrotto (30e), provvisto sulla circonferenza esterna (30b) di uncini (30a) o simili, detto anello (30) essendo associabile all'acetabolo (10') stesso. 9 - Protesi secondo la rivendicazione e, caratterizzata dal fatto che detta associazione ? determinata da cave (30c) con un piano inclinato (30d) presenti nella superficie interna dell'anello (30)? le quali permettono l'inserimento ed il passaggio di sporgenze (10'a) radiali ricavate sulla superfieie esterna dell'acetabolo (10') che successivamente ruotato determina la suddetta associazione. io- Protesi secondo le rivendicazioni 8 e 9, caratterizzata dal fatto che l'anello (30) stabilizzatore ? realizzato con materiale a "memoria di forma". il - Protesi secondo la rivendicazione ?, caratterizzata dal fatto che i componenti che bloccano la calotta (14) sulla testa femorale (24) comprendono un compensatore superiore cieco (12) internamente filettato (12c) e provvisto di testa (12a), una staffa (16), un compensatore inferiore passante (18) ed un tirante (20). 12 - Protesi secondo la rivendicazione u , caratterizzata dal fatto che la staffa (16) presenta una conformazione strutturale comparabile ad una "C" che riproduce la sagoma della corticale laterale esterna del femore sotto il grande trocantere, detta staffa (16) essendo dotata di una nicchia (16b) con apertura (16c) oblunga centrale, atta ad alloggiare il compensatore inferiore passante (18) che presenta un lato piatto (18a) e l'altro convesso (18b) e la testa del tirante (20b). 13 - Protesi secondo la rivendicazione 9, caratterizzata dal fatto che detto tirante (20) ? dotato di testa (20b) e di una filettatura (20c) all*estremit? opposta. 14 - Protesi secondo le rivendicazioni 9 , 12 e 13 , caratterizzata dal fatto che il tirante (20) viene inserito nel compensatore inferiore passante (18), quindi nella staffa (16) e, penetrando dalla sommit? della diafisi sotto il grande trocantere, attraversa obliquamente l'intera epifisi superiore (26), il centro del collo e della testa femorale (24), per avvitarsi nel compensatore superiore eieco (12) la cui testa (12a) disposta nella sede (14b) della calotta (14), vincola il tutto. 15 - Protesi secondo le rivendicazioni 11, 12 , _13 e 14 , caratterizzata dal fatto che mediante la convessit? (18b) del compensatore inferiore passante (18) e l'apertura (16c) oblunga centrale della nicchia (I6?)f il tirante (20) pu? compiere una oscillazione, unitamente al compensatore inferiore passante (18), da circa 120?a 160? in riferimento all'asse gravitazionale. 16-- Protesi secondo le rivendicazioni precedenti, caratterizzata dal fatto che tutti ? componenti la protesi sono realizzati con metallo determinato "inerte" e quindi altamente biocompatihile. 17 - Protesi anatomica totale dell'anca, il tutto come sostanzialmente descritto ed esemplificativa? mente illustrato nelle annesse tavole di disegno.
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EP96101737A EP0728449B1 (en) 1995-02-22 1996-02-07 Total anatomic hip prosthesis
DE69622452T DE69622452T2 (de) 1995-02-22 1996-02-07 Total anatomische Hüftgelenkprothese
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US5725593A (en) 1998-03-10
EP0728449B1 (en) 2002-07-24
ITMI950322A0 (it) 1995-02-22
EP0728449A2 (en) 1996-08-28
DE69622452D1 (de) 2002-08-29
EP0728449A3 (en) 1998-04-22

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