ITTO970665A1 - Protesi d'anca - Google Patents
Protesi d'anca Download PDFInfo
- Publication number
- ITTO970665A1 ITTO970665A1 IT97TO000665A ITTO970665A ITTO970665A1 IT TO970665 A1 ITTO970665 A1 IT TO970665A1 IT 97TO000665 A IT97TO000665 A IT 97TO000665A IT TO970665 A ITTO970665 A IT TO970665A IT TO970665 A1 ITTO970665 A1 IT TO970665A1
- Authority
- IT
- Italy
- Prior art keywords
- neck
- metaphyseal part
- metaphyseal
- shank
- prosthesis according
- Prior art date
Links
- 238000011540 hip replacement Methods 0.000 title description 3
- 210000000689 upper leg Anatomy 0.000 claims description 22
- 210000000988 bone and bone Anatomy 0.000 claims description 10
- 238000011084 recovery Methods 0.000 claims description 10
- 230000002035 prolonged effect Effects 0.000 claims 1
- 239000007943 implant Substances 0.000 description 9
- 239000000463 material Substances 0.000 description 5
- 239000004568 cement Substances 0.000 description 4
- 238000002271 resection Methods 0.000 description 4
- 230000015556 catabolic process Effects 0.000 description 3
- 238000004140 cleaning Methods 0.000 description 3
- 238000006731 degradation reaction Methods 0.000 description 3
- 230000004064 dysfunction Effects 0.000 description 3
- 206010020649 Hyperkeratosis Diseases 0.000 description 2
- 230000004075 alteration Effects 0.000 description 2
- 230000004323 axial length Effects 0.000 description 2
- 239000011230 binding agent Substances 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 238000000605 extraction Methods 0.000 description 2
- 210000002436 femur neck Anatomy 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 229910000831 Steel Inorganic materials 0.000 description 1
- 229910001069 Ti alloy Inorganic materials 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 238000007596 consolidation process Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 238000005242 forging Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 230000007257 malfunction Effects 0.000 description 1
- 238000013508 migration Methods 0.000 description 1
- 230000005012 migration Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000000399 orthopedic effect Effects 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
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
- A61F2/36—Femoral heads ; Femoral endoprostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
- A61B17/1753—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for fixing pins through femoral hip prostheses
-
- 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
- A61F2/30721—Accessories
- A61F2/30739—Devices connected to the proximal part of an endoprosthetic femoral shaft for reinforcing or replacing the trochanters, e.g. the greater trochanter
-
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- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
- A61B17/175—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for preparing the femur for hip prosthesis insertion
-
- A—HUMAN NECESSITIES
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- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1796—Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
-
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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
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/842—Flexible wires, bands or straps
-
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
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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
- A61B17/88—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
- A61B17/8847—Equipment for handling bone cement or other fluid fillers for removing cement from a bone cavity
-
- 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
- A61F2/30721—Accessories
- A61F2/30749—Fixation appliances for connecting prostheses to 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
- A61F2/30—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
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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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/3676—Distal or diaphyseal parts of shafts
-
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
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- A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
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- A61F2002/30205—Three-dimensional shapes conical
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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
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
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-
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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
- 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
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
-
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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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- A61F2002/30682—Means for preventing migration of particles released by the joint, e.g. wear debris or cement particles
-
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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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- 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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- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30784—Plurality of holes
- A61F2002/30785—Plurality of holes parallel
-
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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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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30795—Blind bores, e.g. of circular cross-section
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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
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Description
DESCRIZIONE dell’Invenzione industriale dal titolo:
«PROTESI D’ANCA»
La presente invenzione riguarda il campo degli impianti ortopedici e, più particolarmente, delle protesi impiegate per la riabilitazione delle articolazioni del corpo umano.
Lo scopo deirinvenzione è più particolarmente rivolto verso le protesi d’anca che sono posizionate dopo resezione del collo del femore, negli interventi previsti per riabilitare l’articolazione coxofemorale.
Nel campo tecnico precedente, è ora abituale impiantare protesi d’anca che hanno costituito l’oggetto di numerose proposte tecniche, al fine di garantire una riabilitazione nelle migliori condizioni per durate quanto più lunghe possibili.
Sarebbe vano tentare di stabilire una "'recensione esauriente di tutte le proposte attualmente note, a causa del loro grande numero. Si può semplicemente ricordare che le protesi d’anca possono essere generalmente classificate in due categorie, a seconda del fatto che esse siano impiantate in presenza, o sen za presenza, di un agente legante intermedio, come un cemento.
Il rigetto, attualmente correlato all’impianto di queste protesi, consente di constatare che l’impianto o gli impianti effettuati per un medesimo femore determinano una necessità di revisionare, prima o poi, rimpianto realizzato che presenta inconvenienti richiedenti l’estrazione e la sostituzione della protesi. Le cause di questi inconvenienti sono numerose e possono provenire da un impianto iniziale non ottimale, da un degrado dell’agente legante, dalla comparsa di una infezione, da uno stacco o da un degrado naturale del materiale osseo proteggente la protesi.
In queste situazioni, e per ristabilire l’integrità funzionale della articolazione coxofemorale, è necessario procedere al posizionamento di una nuova protesi, chiamata di ripresa, che deve, naturalmente, essere impiantata nel femore il cui stato è stato alterato dalle disfunzioni precedenti.
In una simile situazione, conviene, naturalmente, tener conto dello stato del materiale osseo, in particolare delle deformazioni del femore o, inoltre, del degrado della sua estremità superiore d’appoggio derivante dalla resezione del collo del femore.
E’ pure necessario, generalmente, tener conto dell’obbligo di procedere ad una pulitura preliminare del cemento di fissaggio della protesi anteriore quando quest’ultima è del tipo cementato o, inoltre, ad un ripristino del canale midollare la cui parte interna ha potuto essere degradata in caso di spostamento di una protesi non cementata o di stacco di una protesi cementata.
E’ quindi necessario poter disporre di una protesi che possa soddisfare i requisiti precedenti, in modo da eliminare le disfunzioni, le complicazioni o le difficoltà di estrazione correlate ad una protesi esistente, per consentire il reimpianto di una protesi di ripresa ristabilente rintegrità della articolazione coxofemorale.
Lo scopo dell’invenzione è quello di soddisfare tale esigenza proponendo una protesi di ripresa consentente di tener conto delle alterazioni di integrità o delle modificazioni di potenzialità fisiche e strutturali del femore preliminarmente impiantato.
Lo scopo dell'invenzione è quello di proporre una protesi di ripresa, adattata alle esigenze di re-installazione o di re-instaurazione delle integrità, a causa delle difficoltà di estrazione della protesi precedente o, anche, dei danni ossei o delle deformazioni naturali del femore.
Inoltre, le operazioni di pulitura e di riparazione del femore possono richiedere il taglio di una porzione o aletta nella parte metafisaria esterna del femore al fine di definire, da un lato, un accesso alla parte interna metafisaria e, dall’altro lato, un accesso in profondità del canale midollare.
E’ quindi necessario poter disporre di una protesi consentente un ri-posizionamento della menzionata porzione o aletta dopo reimpianto della protesi di ripresa.
Lo scopo dell’invenzione è quello di soddisfare tale esigenza proponendo una protesi di ripresa fornente i mezzi necessari per un ri-posizionamento della menzionata porzione o aletta in una posizione stabile consentente una formazione rapida di un callo osseo suscettibile di ristabilire l’integrità tra il femore e l’aletta.
Per raggiungere tutti gli scopi precedenti, la protesi d’anca, denominata di ripresa, è caratterizzata dal fatto che:
- la parte metafìsaria presenta due facce piane, situate da entrambi i lati di un piano di simmetria, chiamato perpendicolare al piano di riferimento sagittale anatomico,
- la parte metafìsaria possiede, arretrati dal suo bordo esterno, fori passanti aprentisi nelle due facce piane e riservati per il passaggio di elementi di collegamento previsti per cerchiare un’aletta ossea tagliata nella parte esterna metafìsaria di un femore in cui detta protesi è impiantata,
- il codolo è cilindrico, di superficie liscia e di lunghezza uguale ad almeno il 65% della lunghezza totale della protesi, - il codolo presenta, a distanza dalla sua estremità, due fori trasversali, passanti, praticati nel piano di simmetria e previsti per il passaggio di due viti di fissaggio.
Varie altre caratteristiche risulteranno chiare dalla descrizione in seguito fornita con riferimento ai disegni acclusi che illustrano, a titolo di esempi non limitativi, forme di realizzazione dell’oggetto dell’invenzione.
Nei disegni:
La Fig. 1 è una vista prospettica della protesi secondo l’invenzione;
La Fig. 2 è ima vista laterale, parzialmente in spaccato, corrispondente alla Fig. 1,
La Fig. 3 è una vista trasversale presa secondo la linea III-III della Fig. 2;
La Fig. 4 è una vista in alzato in sezione illustrante rimpianto della protesi di ripresa in un femore; e
La Fig. 5 è una vista in alzato illustrante uno sviluppo deU’invenzione.
Com’è rappresentato nelle Fig. da 1 a 3, la protesi d’anca comprende uno stelo 1 che è collegato ad un collo 2 formante una testa protesica 3.
Dal punto di vista dell’invenzione, può essere considerato indifferente che la testa 3 formi parte integrante della protesi o sia costituita da una testa sferica riportata come illustrato dai disegni.
La protesi è realizzata in modo tale che lo stelo 1 comprende una parte spessa o massiccia 4, chiamata metafìsaria, estendentesi a partire da una base 5 di collegamento con il collo 2 prolungantesi mediante un codolo 6.
La parte massiccia metafisaria 4 è definita da due facce piane 7a e 7b che sono disposte da entrambi i lati di un piano di simmetria P-P’, il cui riferimento geometrico deve essere considerato con riferimento ad un piano sagittale anatomico S. Benché lo stelo 1 possa essere conformato per presentare una curvatura appropriata al femore in cui esso deve essere impiantato, è considerato, per i fini inventivi, che il riferimento P-P’ sia di tipo piano, generalmente parlando.
Le facce piane 7a e 7b sono, a partire dalla base 5, leggermente convergenti nella direzione del piano di riferimento sagittale S e presentano, ciascuna, rigature, scanalature o simili 8, realizzate longitudinalmente e parallelamente tra loro, in modo da favorire ulteriore ancoraggio della massa ossea di ricostituzione. A tale proposito, la parte metafisaria può, vantaggiosamente, costituire l’oggetto di un apporto di un rivestimento di idrossia patite. Le rigature 8 sono del tipo non sboccante alla estremità trasversale sul collo, per evitare qualsiasi migrazione di particelle verso l’alto. Viceversa, nella estremità distale, le rigature 8 sono "sfuggenti” vale a dire che esse tendono a raccordarsi alla superficie delle facce 7a, 7b, in modo da facilitare un arretramento futuro, in caso di bisogno.
La parte metafisaria 4 è delimitata, trasversalmente alle facce 7a e 7b, da un bordo interno 9, di forma concava, estendentesi nel prolungamento del collo 2 per raccordarsi al codolo 6. Analogamente, la parte metafisaria è delimitata trasversalmente da un bordo 10, chiamato esterno, che prende origine a partire da uno spallamene 11 formato dalla base del collo 2 e raccordantesi, direttamente o tramite una successione di segmenti piani rettilinei, al codolo 6.
In ogni caso, l’asse generale A-A’ dello stelo 1 forma, con l’asse B-B’ del collo 2, un angolo a compreso tra 135° e 140°, e la base 5 di detto collo è orientata perpendicolarmente all’asse B-B’.
Può essere previsto, come si nota in Fig. 2, di prolungare la base 5 del collo 2, e a partire dal bordo interno 9, mediante una patta o collarino d’appoggio 12 la cui funzione sarà illustrata successivamente.
La parte metafisaria 4 presenta, inoltre, arretrati dal suo bordo esterno 10, fori passanti 13 aprentesi sulle due facce 7a e 7b e praticati, preferibilmente, in modo rettilineo e parallelamente l’uno all’altro, secondo due direzioni che possono essere considerate come perpendicolari al piano P.P’.
Secondo un’altra disposizione dell’invenzione, il codolo 6 presenta una forma cilindrica di superficie liscia e di lunghezza tale che essa conferisce, alla protesi di ripresa secondo l’invenzione, una lunghezza assiale compresa tra 160 e 350 mm. Questa lunghezza è, ogni volta, scelta per corrispondere a circa 65% della lunghezza totale della protesi. La lunghezza assiale del codolo 6 è considerata come presa tra lo spallamento Il e l’estremità 14 del codolo 6. Tale estremità 14, di forma generalmente arrotondata, corrisponde, preferibilmente, ad una parte terminale 15 generalmente troncoconica o a forma di ogiva.
In posizione arretrata dalla parte terminale 15, il codolo 6 presenta due fori passanti 16, paralleli fra loro e che sono praticati secondo direzioni perpendicolari a quelle dei fori 13 per essere, conseguentemente, orientati perpendicolarmente al piano di riferimento sagittale anatomico S.
A titolo di esempio, la protesi di ripresa secondo l’invenzione può essere realizzata in lega di titanio TAGV secondo ISO 5832-3 o d’acciaio impiantabile tipo acciaio inossidabile Z6 CNM 21-09 forgiabile (M30NW) secondo ISO 5832-9.
La protesi d’anca descritta precedentemente è prevista per essere impiantata in un femore F il cui canale midollare 20 ha costituito l’oggetto di una rimessa nello stato naturale o di una pulitura prevista per eliminare le tracce di materiale legante o di cemento corrispondenti ad un impianto precedente.
Il canale midollare 20 è trattato a tale proposito su una lunghezza largamente superiore a quella delle protesi abituali e, per accedere alla parte diafisaria del canale midollare, è previsto di tagliare, nella parte metafìsaria esterna del femore, una porzione o aletta V (Fig. 4) consentente un accesso alla parte interna metafìsaria svasata o configurata a tulipano e sopratutto un accesso in profondità al canale midollare 20.
Quando le operazioni preliminari di rimessa in stato sono state garantite, è pure previsto di conferire al canale midollare una sezione retta trasversale superiore a quella del codolo 6, e anche adattare, mediante resezione, la faccia interna della corticale interna della parte metafisaria del femore, per consentire un appoggio distribuito di cooperazione con il bordo interno concavo 9. Può pure essere previsto di ritagliare il piano di resezione iniziale, in modo da conferire ad esso uno stato favorente un appoggio eventuale con il collarino d’appoggio 12 che costituisce in tal caso un riscontro limitante l’impegno dell’asta nel canale midollare e consentente di trasmettere sollecitazioni al-l’osso al fine di consentire a quest’ultimo di ridinamizzarsi.
La protesi secondo l’invenzione è impiantata, come è illustrato dalla Fig. 4, senza presenza di cemento, ma prevedendo un collegamento o un bloccaggio distale consistente nell’eseguire, nella parte distale esterna del femore, fori di passaggio di due viti 21, che sono impegnate, tramite questi fori, all’interno dei fori passanti 16 del codolo 6 per essere avvitate direttamente nella corticale interna del femore.
Come risulta da Fig. 4, la protesi secondo l’invenzione è quindi impiantata direttamente nel canale midollare, essendo bloccata nella parte distale con appoggio simultaneo del bordo interno concavo 9 sulla faccia interna della corticale interna della parte metafisaria, appoggio eventualmente completato dall’arresto o dal riscontro garantito dal collarino 12.
L’aletta V preliminarmente tagliata è quindi ri-posizionata e legata, per un ulteriore consolidamento osseo, mediante due elementi di collegamento impegnati nei fori passanti 13, in modo a stabilire, tramite passaggio attraverso il tratto di taglio avente consentito lo stacco dell’aletta V, due cinture o cerchiature 22 unenti in modo solidale l’aletta o porzione V alla parte metafisa -ria 4 in una posizione stabile che è conferita dalla cooperazione tra il bordo interno e la corticale interna del femore e mediante il bloccaggio realizzato mediante le viti 21.
In questa posizione stabile, la formazione del callo osseo ristabilisce rapidamente l’integrità tra il femore e l’aletta V.
Le disposizioni strutturali richiamate, associate alla protesi di ripresa precedente, consentono di realizzare la riabilitazione di un impianto protesico precedente soggetto ad alterazioni o a disfunzioni, senza che un simile reimpianto abbia a risentire delle disfunzioni dell’impianto precedente. Infatti, mediante il taglio dell’aletta V è possibile raggiungere un materiale osseo di buona qualità nella parte distale profonda del femore F e realizzare un bloccaggio mantenente, grazie alla grande lunghezza del codolo 6, un collegamento saldo e resistente favorente l’appoggio del bordo 9 sulla faccia interna della corticale interna della parte metafisaria del femore.
In questo modo, una ricostituzione del materiale osseo intemo al canale midollare può aver luogo nelle migliori condizioni, analogamente allo ristabilimento della integrità della parte metafisaria del femore mediante riconsolidamento dell’aletta V immobilizzata in posizione stabile sulla parte metafisaria della protesi mediante cerchiature 22.
Claims (8)
- RIVENDICAZIONI 1. Protesi d’anca, denominata di ripresa, del tipo comprendente uno stelo (1), collegato mediante un collo (2) ad una testa (3), detto stelo comprendendo, a partire dal collo, una parte massiccia (4) chiamata metafisaria, prolungata mediante un codolo (6) e lo stelo presentando un asse generale (A-A’) formante un angolo (a) con l’asse (B-B’) del collo, caratterizzata dal fatto che: - la parte metafisaria (4) presenta due facce piane (7 a, 7b), situate da entrambi i lati di un piano di simmetria (P-P’), denominato perpendicolare al piano di riferimento sagittale anatomico (S), - la parte metafisaria (4) possiede, arretrati dal suo bordo esterno (10), fori passanti (13) aprentisi nelle due facce piane e riservati al passaggio di elementi di collegamento (22) previsti per cerchiare un’aletta ossea (V) tagliata nella parte esterna metafisaria di un femore (F) in cui detta protesi è impiantata, - il codolo (6) è cilindrico, di superficie liscia e di lunghezza almeno uguale al 65% della lunghezza totale della protesi, - il codolo presenta, a distanza dalla sua estremità (14), due fori trasversali (16), passanti praticati nel piano di simmetria e previsti per il passaggio di due viti di fissaggio (21).
- 2. Protesi d’anca secondo la rivendicazione 1, caratterizzata dal fatto che gli assi dei fori passanti (13) sono perpendicolari a quelli dei fori (16) del codolo (6).
- 3. Protesi d'anca secondo la rivendicazione 1 o 2, caratterizzata dal fatto che la parte metafìsaria (4) comprende: - due facce piane (7a, 7b), leggermente convergenti in direzione del piano di riferimento sagittale (S), - un bordo (9), denominato interno, concavo, collegante il collo al codolo, - e un bordo (10), denominato esterno, originantesi a partire da uno spallamento (11) del collo e raccordantesi al codolo.
- 4. Protesi d’anca secondo una delle rivendicazioni da 1 a 3, caratterizzata dal fatto che la parte metafìsaria (4) è raccordata, mediante il suo bordo interno (9), al collo con la presenza intermedia di un collarino d’appoggio (12) estendentesi nel piano della base (5) di raccordo tra il collo e la parte metafìsaria.
- 5. Protesi d’anca secondo una delle rivendicazioni da 1 a 4, caratterizzata dal fatto che la parte metafìsaria (4) comprende due facce piane (7a, 7b) presentanti scanalature longitudinali parallele (8) non sboccanti nella estremità prossimale della parte metafìsaria.
- 6. Protesi d’anca secondo una delle rivendicazioni da 1 a 5, caratterizzata dal fatto che la parte metafìsaria comprende due facce piane (7a e 7b) che sono, a partire dalla base (5) conver genti nella direzione del codolo.
- 7. Protesi secondo una delle rivendicazioni da 1 a 6, caratterizzata dal fatto che la parte metafisaria comprende, in sue facce (7a, 7b), rigature che sono raccordate in modo sfuggente mediante la loro estremità distale a dette facce.
- 8. Protesi d’anca secondo una delle rivendicazioni da 1 a 7, caratterizzata dal fatto che la parte metafisaria almeno definisce un asse longitudinale (A-A’) formante, con l’asse (B- B’) del collo, un angolo (a) compreso tra 135° e 140°.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9609601A FR2751528B1 (fr) | 1996-07-24 | 1996-07-24 | Prothese de hanche |
Publications (2)
Publication Number | Publication Date |
---|---|
ITTO970665A1 true ITTO970665A1 (it) | 1999-01-23 |
IT1293642B1 IT1293642B1 (it) | 1999-03-08 |
Family
ID=9494648
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
IT97TO000665 IT1293642B1 (it) | 1996-07-24 | 1997-07-23 | Protesi d'anca |
Country Status (4)
Country | Link |
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DE (1) | DE29713206U1 (it) |
ES (1) | ES2121563B1 (it) |
FR (1) | FR2751528B1 (it) |
IT (1) | IT1293642B1 (it) |
Families Citing this family (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6200350B1 (en) | 1999-10-01 | 2001-03-13 | Medidea, Llc | Anti-impingement femoral prostheses |
FR2855395B1 (fr) * | 2003-05-27 | 2006-02-24 | Faher Mohcine | Implant femoral de prothese de hanche |
FR2865382B1 (fr) * | 2004-01-23 | 2007-01-05 | Sem Sa | Tige femorale pour prothese de hanche et ensemble d'outils pour son ablation |
FR2868688A1 (fr) * | 2004-04-09 | 2005-10-14 | Ct Pulse France Sa Sa | Tige femorale impactable pour prothese de la hanche |
FR2875397B1 (fr) * | 2004-09-23 | 2007-11-02 | Genie Medical Sgm Sa Soc D | Tige femorale de reprise impactee sans ciment pour prothese de hanche |
FR2911265B1 (fr) * | 2007-01-16 | 2009-07-24 | Fournitures Hospitalieres Ind | Tige femorale prothetique |
FR2941863B1 (fr) * | 2009-02-10 | 2011-03-18 | Fournitures Hospitalieres Ind | Gamme de tiges femorales prothetiques |
DE102010012462B4 (de) | 2010-03-24 | 2011-12-15 | Manssur Arbabian | Gelenkendoprothese |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB1442990A (en) * | 1972-10-19 | 1976-07-21 | English T A | Prosthesis |
ZA771690B (en) * | 1977-04-21 | 1978-06-28 | C Grobbelaar | Improved hip joint |
FR2501998B1 (fr) * | 1981-03-17 | 1985-09-13 | Babin Chevaye Jean | Prothese de hanche comportant notamment une queue femorale dont la zone metaphysaire est sensiblement cylindrique |
EP0135755B1 (de) * | 1983-08-29 | 1987-02-04 | Protek AG | Schaft für eine Hüftgelenkprothese |
US4871369A (en) * | 1987-11-23 | 1989-10-03 | Pfizer Hospital Products Group, Inc. | Long stem hip implant |
US4895572A (en) * | 1988-11-25 | 1990-01-23 | Ira Chernoff | Interlocking femoral prosthesis device |
FR2639821B1 (fr) * | 1988-12-07 | 1997-10-03 | Implants Instr Ch Fab | Element femoral pour prothese de hanche |
IT1250907B (it) * | 1990-06-22 | 1995-04-21 | Cremascoli G Srl | Stelo protesico da revisione a bloccaggio variabile |
FR2687306B1 (fr) * | 1992-02-13 | 1996-04-05 | Prolig Sa | Implant femoral pour protheses de hanches. |
FR2705884B1 (fr) * | 1993-06-03 | 1995-07-28 | Rech Fabrication Et | Ensemble de tiges fémorales pour prothèse totale de la hanche. |
-
1996
- 1996-07-24 FR FR9609601A patent/FR2751528B1/fr not_active Expired - Lifetime
-
1997
- 1997-07-22 ES ES9701633A patent/ES2121563B1/es not_active Expired - Fee Related
- 1997-07-23 IT IT97TO000665 patent/IT1293642B1/it active IP Right Grant
- 1997-07-24 DE DE29713206U patent/DE29713206U1/de not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
ES2121563A1 (es) | 1998-11-16 |
DE29713206U1 (de) | 1997-10-02 |
IT1293642B1 (it) | 1999-03-08 |
ES2121563B1 (es) | 1999-07-16 |
FR2751528A1 (fr) | 1998-01-30 |
FR2751528B1 (fr) | 1999-04-09 |
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