TW487568B - Modular Hip prosthesis - Google Patents
Modular Hip prosthesis Download PDFInfo
- Publication number
- TW487568B TW487568B TW090105689A TW90105689A TW487568B TW 487568 B TW487568 B TW 487568B TW 090105689 A TW090105689 A TW 090105689A TW 90105689 A TW90105689 A TW 90105689A TW 487568 B TW487568 B TW 487568B
- Authority
- TW
- Taiwan
- Prior art keywords
- segment
- patent application
- distal
- metaphyseal
- proximal
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
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- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
-
- 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
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
-
- 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
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/367—Proximal or metaphyseal 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
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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
- 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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- A61F2002/30316—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
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- 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
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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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
- A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
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- A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
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- A61F2/30—Joints
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- A61F2/02—Prostheses implantable into the body
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Description
487568 五、發明說明(1 ) 主明之背景和槪述 本發明一般係關於全體臀關節造形術之領域’較詳言 之,係關於三分段模組臀幹其容許各組成部份間之全尺寸 可交換性,尙提供在使用期間對於組成部份脫離之優良抵 抗性。 全體臀關節造形術設計方面之模塊性是一種進化槪念’ 在臨床文獻中正得到增加之引用。此等系統的優點包括隔 離棚架彎曲性以便定做近側和遠側管塡充以及適應近側變 形和骨損耗之困難情勢。然而,此等設計引起各種問題包 括由於應力和組成部份間之脫離,在金屬-金屬互連時之 結構「折衷」。 爲了解決此等問題,槪括而言,本發明提供一種模組臀 彌補物包含下列組件··(a)具有一個軸向孔通經其中之近側 分段,該近側分段包括與股骨之前部組成部份可鎖緊接合 之一個頸部,並另外包括自該頸部遠側延伸之一個陽錐形 部份;(b)具有一個近側端和一個遠側尖之遠側分段,另外 形成該遠側分段而具有接鄰其近側端之一個陽錐形部份; 及(c)具有一個近側端和一個遠側端之幹骺端的分段,該幹 骺端的分段包括一個接合骨之外表面部份,並另外包括通 經其中之一個軸向孔,該軸向孔包括第一和第二陰錐形部 份,該第一陰錐形部份位於接鄰幹骺端的分段之近側端並 予以因次構型以便鎖緊接合近側分段的陽錐形部份,第二 陰錐形部份位於接鄰幹骺端的分段之遠側端並予以因次構 487568 五、 發 -明說明 (2) 型 以 便 鎖 緊 接合遠側分段的陽錐形部份。 相 對 應 之 近側、幹骺端及遠側等分段的 陽 和 陰 錐 形 部 份 每 —* 者 含混合入通常拋物線形狀截面中 之 一 個 錐 形 截 面 〇 每 — 錐 形部份的混合之圓錐形錐形/拋 物 線 錐 形 幾 何 學 保 證 充 分 之錐形接觸面積。並減少在陽/ 陰 錐 形 連 接 處 的 彎 曲 載 荷 下,界面之接觸應力和內部身體 應 力 〇 各 錐 形 之 錐 形 部 份 每一者具有範圍自大約Γ至大約 2.: 5° 之 錐 形 角 度 而 提 供在錐形連接處之加強扭轉抵抗性 〇 近 側 分 段 與 幹 骨后 丄UJ 贿 分 段 之近側端可鎖緊接合而使通過近 側 和 幹 骺 端 各 分 段 所 形 成 之軸向孔對齊。遠側分段之近側 端 與 幹 骺 丄山 分 段 的 遠 側 端 可鎖緊接合而使通過遠側和幹 端 各分 段 所 形 成 之 軸 向 孔 對齊。 視 需 要 將 一個通孔形成在近側分段中,形 成 遠 側 分 段 具 有 一 個 刻 有 螺紋之孔接鄰其近側端。此等孔 與 幹 骺 端 的 分 段 之 軸 向 孔 可對齊。若需要,將一個螺釘(成 構 型 尺 寸 而 可 通 經 各 對 齊之孔)與經形成在遠側分段中 之 刻 有 螺 紋 之 孔 可 螺 紋 式 接合,來更進一步加強各彌補物 組 件 的 鎖 緊 接 合 〇 本 發 明 提 供下列優點:(a)經由增加錐形接 觸 面 積 及 減 少 由 於 彎 曲 和 在錐形連接處之扭轉負載所產生 之 接 觸 應 力 而 具 有 優 良 之 對於組成部份分離之抵抗性;(b)通 過 其 模 塊 性 之 手 術 期 內 彈性;(〇任何分段與任何其他分 段 之 兀 全 可 交 換 性 ⑷每 :一分段的可調整性以便前轉和後 - 4- 傾 而 與 其 他 分 487568 五、發明說明(:b) 段之位置無關,因此容許適合左與右臀應用之共通設計; (e)獨立選擇彌補物的支架長度和補償;(f)使用相同系統 之主要和修正應用;(g)容許外科醫師修改設備來適合病患 之解剖學甚至面臨可能留下骨短缺之修正外科手術;及(h) 使用所有試樣和尺寸的股骨前部組成部份。 經倂合入本說明書中並構成其一部份之附隨圖式舉例說 明本發明之詳述和較佳具體實施例,並連同該詳細敘述充 作解釋本發明的原理。然而,應了解:圖式及敘述兩者僅 是舉例說明而並非限制本發明。 圖式之簡述 第1圖是本發明之模組臀彌補物之一個具體實施例之 分_透視圖。 第2圖是本發明之近側組成部份之一個具體實施例之 截面側視圖。 第3圖是本發明之幹骺端組成部份之一個具體實施例之 截面側視圖。 第4圖是沿第3圖的A - A線所取之本發明之幹骺端組成 部份之具體實施例橫向截面圖。 第5圖是本發明之遠側組成部份之一個具體實施例之截 面側視圖。 第6圖是沿第5圖的B-B線所取之本發明之遠側組成部 份之具體實施例橫向截面圖。 第7圖是本發明之模組臀彌補物之一個具體實施例的接 487568 五、發明說明(4) 合之近側、幹骺端和遠側等組成部份的截面側視圖。 第8圖是第7圖之近側、幹骺端和遠側等組成部份之截 面側視圖顯示:舉例說明之錐形和摻合物等因次。 本發明之詳細敘述 現在參照第1-8圖,使用相同參考數字來指示遍及各圖 之相同組件,本發明之模組臀彌補物的第一具體實施例通 常以數字10表示。如第1圖中所示,臀彌補物10 —般包 括:(a)近側分段12 ; (b)幹骺端之分段14和遠側分段 1 6。可視需要使用一個刻有螺紋之螺釘〗8來加強各個分 段1 2,1 4和1 6的鎖緊接合如下述。如此處所具體表現, 近側分段1 2,幹骺端之分段1 4和遠側分段1 6每一者係被 構成爲分開之部件。其結果是,可將每一個分段相互無關 而訂定大小。此種獨立定訂大小之能力產生彌補物模塊性 即:它提供外科醫師,廣泛選擇的彌補物構型來實際上適 應在外科手術室所遇到之每一種血管吻合狀況。有利地, 可將本發明之模組彌補物1 0使用眾所周知之骨膠合植入 法技術予以植入’或在另外方法中,可以一種非膠合之模 式,使用爲精於該項技藝之人士眾所周知之骨接合表面應 用法予以植入。 現在參照第2圖,近側分段12包括以下列(a)、(b)、(c) 三組件所形成之一個頸剖20 : (a)終端在陽錐形柱22中之 一個角向補償臂2 1 ; (b)以一個陽錐形部份25所形成之頸 2 〇的遠側延伸之一個延伸構件2 4,並終止在圓柱形螺紋 487568 五、發明說明(5) 接套26中;及(c)通過頸部20,延伸構件24和螺紋接套 26所形成之分段鑽孔27。近側分段1 2宜自生物可相容之 局強度鈦合金所構成。然而,近側分段1 2可自其他生物 可相容之材料所構成例如鈷鉻合金、不銹鋼和複合材料。 宜將近側分段1 2的外表面表面處理拋光而具有平均32微 英寸或更小之表面粗糙度,如經由面形測定器所測定者。 外部表面表面處理亦可能是平滑無光或使用該項技藝中眾 所周知之表面製備技術予以機製。 將近側分段1 2的錐形柱22因次上構型以便與股骨的前 端組成部份的互補陰錐形部份(未顯示)鎖緊接合。精於該 項技藝之人士可容易認知:可構成近側分段1 2來適應股 骨的前端組成部份的所有樣式和材料。將一個下部凹陷23 形成在近側分段1 2的每一邊上之臂2 1和柱22中來增加 頸部20與整個臀接合置換系統的髖白之組成部份間活動 之範圍,並便利於接合股骨之前部移除工具(未顯示),係 當在修理或校正臀彌補物1 0期間,必須自近側分段1 2上 拆開股骨之前部時。 作爲較佳之所具體表現,延伸構件24的錐形部份25包 括混合入一個通常拋物線形狀之陽錐形段25b中之一個陽 錐形段25a(具有大約0.25英寸之混合半徑,見第2和8 圖)。錐形段25b的拋物線幾何學減少界面之接觸應力及 在錐形部份25與幹骺端分段14的互補陰錐形段33間之 彎曲載荷下之內部身體應力(下述)。作爲較佳之具體表 487568 五、發明說明(6) 現,錐形段25a具有範圍自大約Γ至大約2.5°之一個錐 形角度而提供加強之抗扭轉性在近側/幹骺端之錐形連接 處上。在第8圖中所示之本發明的舉例說明之具體實施例 中,錐形之錐形段25a具有大約0.43英寸之長度而拋物線 錐形段25b具有大約0.09英寸之長度。關於此等舉例說 明之錐形長度,拋物線錐形長度:圓錐錐形長度之比是大 約2 1 %。作爲較佳之具體表現,拋物線錐形/圓錐形長度 比其範圍應係自大約5%至大約30%。此範圍保證充分之 錐形接觸面積,及將存在在拋物線錐形段25b上之尖銳角 落減至最少,當使彌補物歷經彎曲應力時,其可導致高點 接觸應力在近側/幹骺端錐形連接處上。作爲較佳之具體 表現,圓錐形之錐形段25a具有大約0.09英寸之混合半徑 R1 (見第8圖)。陰錐形分段33之互補圓錐錐形段33a具 有大約0.0 5英寸的混合半徑R3。此等不同半徑創造一種 減小應力狀況在接鄰間隙G(見第7圖)之近側/幹骺端錐形 連接處上,此間隙G係當連合近側分段和幹骺端分段時所 造成。有利地,可使用錐形部份2 5和3 3之相同幾何學和 半徑於所有尺寸的近側分段1 2和幹骺端分段1 4,藉以增 加尺寸可互換性而因此近側分段與幹骺端分段間之模塊 性。 作爲較佳之具體表現,螺紋接套26具有大約0.18英寸 之長度來增加延伸構件24的力矩臂(見第2和8圖)而藉以 於誘導彎曲之應力入彌補物中時,協助將近側/幹骺端錐 487568 五、發明說明(7) 形連接處卸載負荷。關於上述之錐形幾何學和混合半徑, 可使用螺紋接套26之相同長度於所有尺寸的近側分段 1 2。將螺紋接套26因次上構型小於幹骺端分段1 4中通孔 32的各截面32a,32b與32c的直徑(下述)以便,當於組 合彌補物組件時(見第7圖和下文討論),將近側分段1 2的 延伸構件24滑動式容納在通孔32中時,螺紋接套26不 會起始接合孔3 2之側壁。於應用充分負載至彌補物的股 骨前端(圖中未示)時,螺紋接套26可接觸孔32的中間孔 分段3 2 b之側壁而藉以,轉移一部份的所誘發之彎曲應力 遠離近側/幹骺端錐形連接處。 再參照第2圖,近側分段1 2的分段之孔2 7包括第一直 線段27a,錐形之中間段27b和第二直段27c。作爲較佳 之具體表現,段27b以大約60°之一個角度向內向著孔段 2 7c漸變細。將各孔段27a,27b與27c大小作成容許螺釘 1 8通經近側分段1 2。孔段27a亦充作螺釘1 8頭部之鑽孔 裝埋且應訂定充分大之大小以便輕鬆容納機械式驅動器例 如螺絲起子或鑽頭,當使用螺釘1 8作爲彌補物1 〇組合體 之一部份時,來刻有螺紋式曬合螺釘1 8與經形成在近側 分段1 6中之刻有螺紋之孔42(下文中將予詳細討論)。 現在述及第3圖,幹骺端之分段1 4具有近側端1 4和遠 側端1 4b並予以構型而具有與錐形截面3 1成整體之梯形 截頭錐形角錐截面3 0。如弟4圖中所不,此輪廊以橫截面 呈現其本身爲自通常圓形截面35分出之通常梯形截面 五、發明說明(8) 3 6。另種方式可構造角錐截面3 0以便幹骺端分段丨4具有 自通常圓形橫截面分出之通常長方形橫截面。幹骺端分段 1 4宜自生物可相容之高強度鈦合金所構成,但是亦可自其 他生物可相容之材料所構成例如鈷鉻合金、不銹鋼和複合 材料。 幹骺端分段1 4亦包括一個鑽孔3 2其包含近側孔截面 3 2a、中間孔截面32b和遠側孔截面32c。參照第3圖和第 8圖,形成孔分段32a而具有一個陰錐形部份33其包含混 合入通常拋物線形狀之錐形截面3 3 b中之圓錐形錐形截面 3 3a。陰錐形截面3 3a和3 3b各自與圓柱形截面24之陽錐 形截面25a與25b呈互補。如此處所具體表現,圓錐形錐 形截面33a具有範圍自大約Γ至大約2·5°之錐形角,大 約0.50英寸之長度和大約0.05英寸之混合半徑R3(上 述)。拋物線錐形截面33b具有大約0.09英寸長度,大約 0.25英寸之混合半徑R4(見第8圖)。關於前述舉例說明之 錐形長度,拋物線錐形長度:圓錐形錐形長度之比是大約 18%。將錐形之截面33a與33b之大小作成可嵌入圓柱形 截面24入孔32中時,各自鎖緊接合錐形截面25a和 2 5b。關於圓柱形截面24之錐形截面25 a與25b,錐形截 面33a與33b之拋物線錐形/圓錐錐形長度比其範圍應係自 大約5%至大約30%來保證減少接觸應力及近側/幹骺端錐 形連接處的區域中之內部應力。又,如上文關於近側分段 12所討論,可使用錐形截面33a與33b之相同錐形幾何學 -10- 五、發明說明(9) 和混合半徑於所有尺寸的幹骺端分段1 4來加強近側和幹 端各組成部份的互換性而藉以,彌補物1 0之模塊性。 再參照第3圖與第8圖,形成幹骺端之孔32的孔分段 3 2 c而具有錐形部份3 4包含圓錐錐形截面3 4 a和通常拋物 線形狀錐形截面34b。將錐形截面34a與34b大小作成可 嵌入遠側分段1 6之近側端1 6a入幹骺端之分段1 4的孔3 2 中時鎖緊式接合各自之速側分段1 6的相對應陽錐形截面 43a與43b(如下文中更完全討論)。作爲本文中之具體表 現,圓錐形錐形截面3 4a具有大約〇. 5 1英寸之長度,範圍 自大約1°至大約2.5°之錐形角度及大約〇.5英寸之混合 半徑R5。拋物線錐形截面34b具有大約0.09英寸之長度 和大約0.25英寸之混合半徑R6(見第8圖)。關於前述舉 例說明之錐形長度,拋物線之錐形長度··圓錐形錐形長度 的比是大約18%。關於上文中所討論之彌補物1〇的其他 錐形部分,拋物線錐形/圓錐形之錐形長度比其範圍應自 大約5%至大約30%來保證充分之錐形接觸面積和將近側/ 幹骺端之錐形連接處之高點接觸應力減至最小。又,關於 上述之其他錐形部份,可使用錐形截面34a與34b之相同 錐形幾何學和混合半徑於所有尺寸之幹骺端分段1 4來加 強各組件之互換性而藉以,彌補物1 0之模塊性。 幹骺端之分段1 4的幾何學增加使用於身體期間,組件 的扭轉穩定性並提供較佳塡充近側骨髓腔內管。可將幹骺 端之分段1 4的外表面整理拋光,而具有平均大約3 2微英 -11- 487568 五、發明說明(1〇) 寸或更小之表面粗糙度。如經由面形測定器所測定。外表 面整理亦可能是平滑無光或使用該項技藝中眾所周知之表 面製備技術予以機製。作爲較佳之具體表現,幹骺端之分 段1 4的外表面含有接合骨之表面塗料、舉例而言,例如 砂礫噴淨之表面;電漿噴射塗料、燒結之金屬珠塗料、羥 基磷灰石塗料、或其他生物活性塗料例如生物玻璃陶瓷, 脫礦質之骨和載體及生長因素和載體。應用此等塗料至金 屬之植件表面在所項技藝中係眾所周知。視需要,幹骺端 之分段1 4可被構成而具有一個遠側環3 7。遠側環3 7是隆 起材料的一個區域其厚度等於經施加至幹骺端分段的外表 面上之接合骨塗料的最小厚度。遠側環3 7增加幹骺端分 段1 4的圓錐形截面3 1之壁厚度。此現象復可經由增加局 部壁厚度及屏障它免於凹痕(其可能自多孔塗覆過程所產 生)而增加圓錐形截面31之疲勞強度。作爲較佳之具體表 現,應將遠側環37使用在較小尺寸的幹骺端之分段14 中,其中在遠側端14b附近的圓錐形截面31之側壁可能 相當的薄。圓錐形截面3 1上之局部應力程度(其可能爲適 合特別尺寸之幹骺端分段14之遠側環37必須使用)可經 由精於該項技藝之人士容易決定。 現在述及第5圖,形成遠側分段16而具有一個遠側端 1 6a,一個遠側尖1 6b並包括沿著其外表面的增量長度所 形成之許多尖銳縱向溝槽40。溝槽40的尖邊緣深入脊髓 內管的皮質的骨壁中而增加在使用彌補物於身體中期間遠 1 487568 五、 發明說明 ( 11) 側 分 段 1 6之扭轉穩定性。亦視需要形成遠側分段 16 具 有 在 遠 側 尖1 6 開始之冠的狹縫41並近側 進行 歷 其 增 量 長 度 〇 冠 的狹 縫 4 1增加遠側分段1 6之彎曲 性。 此 增 加 之 彎 曲 性 抑 制: 當 將彌補物負載時,遠側尖 16b 上 之 應 力 強 度 並 容許 彌 補物較佳適應脊髓內管之彎 曲。 精 於 該 技 藝 之 人 士 應認 知 :視需要按照全體彌補物設 計臀 計 劃 可 容 易 調 整 縱向 溝 槽40之長度而便利於彌補 物上 之 扭 轉 負 載 之 抵 抗性。 在各圖中所示之遠側分段1 6 之舉 例 說 明 具 體 實 施 例 中, 縱 向溝槽4 0的長度是遠側分段1 6 全 長 的 大 約 8 0% Ο / 有利 地 ,可使用溝槽長度:遠側分 段長 度 的 相 同 比 於 所 有 尺寸 的 遠側分段1 6。精於該項技 藝之 人 士 亦 應 認 知 : 可 容易 調 整冠的狹縫41之長度而提 供所 需 要 之 彎 曲 程 度 在 遠側 分 段16中而不須過度「折衷 」遠 側 分 段 之 疲 勞 強 度 〇 作 爲 較佳 之 具體表現,遠側尖1 6 b具有 一個 通 常 拋 物 線 軸 向 截 面其 亦 充作減少遠側分段1 6與遠 側尖 附 近 之 骨 間 的 接 觸 應力 〇 如第6圖中所示,遠側分段 16 具 有 一 個 通 常 圓 橫 截面 , 但是亦可構成而具有其他截 面之 幾 何 學 1 舉 例 而 :' 例如 六邊形或橢圓形。視需要, 可形成 遠 側 分 段 1 6 •具有縱商 ]通過而代替尖的縱向溝槽來便 利於 增 加 之幹 彎 曲 性 和 脊髓 內 管中皮質的骨之接合。雖然 各圖 中 所 示 之 遠 側分 段 16 具 有直的輪廓,但是亦可將它 彎曲 以 便 較 佳 匹 配 病 患 之脊 髓 內管的自然彎曲。遠側分段 -13- 16 宜 白 種 生 487568 五、發明說明(12) 物可相容之高強度鈦合金所構成,但是亦可自其他生物可 相容之材料所構成例如鈷鉻合金、不銹鋼和複合材料。另 外,宜提供遠側分段1 6,一個經拋光之外表面整理(其具 有平均32微英寸或更小之表面粗糙度如經由面形測定器 所測定)。亦可提供遠側分段,一個平滑無光表面或使用 該項技藝中眾所周知之表面製備技術予以機製。爲了便利 於固定遠側分段1 6至脊髓內管的皮質骨壁,若需要,亦 可構成遠側分段1 6沒有縱向溝槽而代替以一個多孔接合 骨之表面塗料,舉例而言,例如砂礫噴淨之表面;電漿噴 射塗料,燒結之適屬珠塗料、羥基磷灰石塗料或其他生物 活性塗料例如生物玻璃陶瓷、脫礦質之骨和載體及生長因 素和載體。 現在參照第5圖和第8圖,亦形成遠側分段1 6具有接 鄰其近側端1 6a之一個刻有螺紋鑽孔42。將孔42因次構 型以便於嵌入通過近側分段1 2,幹骺端之分段1 4和遠側 分段1 6的各個經對齊之各孔時,以螺紋接合螺釘1 8 (見下 面討論)。亦形成遠側分段1 6具有接接近側端1 6 a之一個 陽錐形部份43。錐形分段43包括一個圓錐錐形截面43a 和一個通常拋物線形狀錐形截面43b。將陽錐形截面43 a 和43b的大小作成便於將遠側分段1 6的近側端1 6a嵌入 幹骺端之分段14的孔32中時’鎖緊接合幹骺端分段14 的各自相對應陰錐形截面3 4a和3 4b。作爲此處之具體表 現,圓錐錐形截面43a具有大約0·48英寸之長度,範圍自 -14- 五、發明說明(13) 大約1°至大約2.5°之一個錐形角度及大約0.09英寸的 混合半徑R7。拋物線錐形截面43b具有大約0.09英寸之 長度和大約0.25英寸的混合半徑R8(見第8圖)。關於前 述舉例說明之錐形長度,拋物線錐形長度:圓錐形錐形長 度之比是大約1 9%。拋物線/圓錐形錐形長度比其範圍應 自大約5%至大約30%來保證充分之錐形接觸面積和將幹 端/遠側錐形連接處之高點接觸應力減至最小。又,關於 上述之其他錐形部份,可使用錐形截面43a與43b之相同 錐形幾何學和混合半徑於所有尺寸之遠側分段1 6來加強 遠側和幹骺端各組件的互換性而藉以,彌補物1 0之模塊 性。 現在參照第7圖與第8圖,顯示近側分段12,幹骺端分 段1 4和遠側分段1 6的截面圖來更爲淸楚地舉例說明於組 合時此等組件間之內部關係。如各圖中所示,將近側分段 12之延伸構件24容納在幹骺端分段14的孔截面32a中呈 緊配合之滑動關係,並將延伸部24的錐形截面25a與25b 各自與孔分段32a之錐形截面33a與33b鎖緊接合。相似 地,將遠側分段1 6之近側端1 6a容納在幹骺端分段1 4的 孔截面32c中呈緊配合之滑動關係,並將遠側分段16的 錐形截面43a與43b各自與孔分段32c之錐形截面34a與 3 4b鎖緊接合。在將錐形鎖緊關係建立在近側分段1 2與幹 骺端分段1 4間之前,建立近側分段1 2之臂2 1和柱22的 角向定向來放置柱22在所需要之位置以便接受習見之股 -15- 抑 7568 五、發明說明(14 ) 骨的前面組成部份(圖中未示)。於將近側、幹骺端和遠側 等分段的互補之錐形部份鎖緊接合時,各孔27,32和42 將呈軸向對齊。於是,將螺針1 8嵌入通過各對齊之孔而 成爲與孔42的互補刻有螺紋之截面螺紋接合。螺釘1 8具 有一個埋頭孔頭1 9而可容納在經形成在幹骺端之孔27的 截面27a中之埋頭孔28中。若需要將螺釘18緊固旋緊以 便更進一步加強近側,幹骺端和遠側等分段之鎖緊接合。 只要不脫離本發明之要旨或基本特性,可將本發明以除 去本發明的詳述中所揭示形式以外之其他形式予以具體表 現。因此,在各方面,將所述之本發明具體實施例視爲舉 例說明而非限制性。因此,本發明之範圍係由下文所特舉 出之申請專利範圍予以指示而非經由本發明之前述所有變 更(其形成申請專利範圍主題)的意義和同義語之範圍均被 認爲係包括在申請專利之範圍以內。 符號之說明 10 臀彌補物 12 近側分段 14 幹骺端之分段 16 遠側分段 16a 近側端 16b 遠側尖 18 刻有螺紋之螺釘 19 埋頭孔頭 -16- 487568 五、發明說明(15) 20 頸部 21 角向補償臂 22 陽錐形柱 23 下部凹陷 24 延伸構件 25,4 3 陽錐形部份 26 圓錐形螺紋接套 27 分段之鑽孔 25a , 43a 圓錐之錐形截面 25b , 43b 拋物線錐形截面 30 梯形截頭錐形角錐截面 3 1 錐形截面 32 孔 32a 孔截面 33 錐形部份 33a 錐形截面 33b 錐形截面 34 錐形部份 37 遠側環 40 溝槽 41 冠的狹縫 42 刻有螺紋之鑽孔 -17-
Claims (1)
- 487568 六、申請專利範圍 1. 一種模組臀彌補物,包括: 一個近側分段,該近側分段包括與一個股骨之前組 成部份鎖緊可接合之頸部,該近側分段另外包括自該 頸部遠側延伸之一個陽錐形部份; 具有一個近側端和一個遠側尖之遠側分段,該遠側 分段包括接鄰於其近側端之一個陽錐形部份; 具有一個近側端和一個遠側端之幹骺端分段,該幹 端分段包括一個接合骨之外表面部份,該幹骺端分段 另外包括通經其中之一個軸向孔,該軸向孔包括第一 和第二陰錐形部份,將第一陰錐形部份定位接鄰於幹 骺端分段之近側端其大小作成可鎖緊接合近側分段的 陽錐形部份,將第二陰錐形部份定位接鄰於幹骺端分 段之遠側端,其大小作成可鎖緊接合遠側分段的陽錐 形部份。 2 .如申請專利範圍第1項之模組臀彌補物,其中近側分 段另外包括通經其中之一個軸向孔,該近側分段與幹 骺端分段之近側端可接合而使通過近側和幹骺端等分 段所形成之各個軸向孔對齊,該遠側分段另外包括一 個刻有螺紋之軸向孔接鄰其近側端,遠側分段之近側 端與幹骺端分段之遠側端可接合而使通過遠側和幹骺 端等分段所形成之各個軸向孔對齊,該模組臀彌補物 另外包括一個螺釘其大小作成可通經近側、幹骺端和 遠側等分段的已對齊之各孔而與遠側分段之刻有螺紋 -18- 487568 六、申請專利範圍 之軸向孔以螺紋接合。 3.如申請專利範圍第1項之模組臀彌補物,其中遠側分 段包括一個接合骨之外表面部份。 4 .如申請專利範圍第3項之模組臀彌補物,其中遠側分 段之接合骨之表面包含沿著其增量長度所形成之各個 縱向溝槽。 5 ·如申請專利範圍第1項之模組臀彌補物,其中遠側分 段另外包含沿著其增量長度之冠的狹縫。 6 .如申請專利範圍第3項之模組臀彌補物,其中遠側分 段之接合骨之表面係選自下列所構成之族群:砂礫噴 淨之表面、經燒結之金屬珠塗料、羥基磷灰石塗料、 電漿噴射塗料、生物玻璃陶瓷塗料、脫礦質之骨和載 體及生長因素和載體。 7 .如申請專利範圍第1項之模組臀彌補物,其中近側分 段具有一個通常圓形橫截面。 8 .如申請專利範圍第3項之模組臀彌補物,其中遠側分 段的遠側尖具有一個通常拋物線形軸向截面。 9 .如申請專利範圍第1項之模組臀彌補物,其中遠側分 段係由選自下列所構成之族群的一種材料所構成:鈦 金屬合金、姑絡合金和不誘鋼。 1 〇 .如申請專利範圍第1項之模組臀彌補物,其中遠側分 段的陽錐形部份及幹骺端分段的第二陰錐形部份每一 者包含混合入一個通常拋物線截面中之圓錐錐形截面 -19- 487568 六、申請專利範圍 0 1 1 .如申請專利範圍第1 0項之模組臀彌補物, 錐形長度與圓錐錐形長度之比其範圍自大,彳 30% 0 1 2 .如申請專利範圍第1 1項之模組臀彌補物, 段的各圓錐錐形截面及幹骺端分段的第二 之錐形角其範圍自大約1 °至大約2 . 5° 。 1 3 .如申請專利範圍第1項之模組臀彌補物, 分段的陽錐形截面形成在自頸部遠側延伸 i 4 .如申請專利範圍第1 3項之模組臀彌補物, 件包括自其遠側分段之一個螺紋接套構件。 i 5 .如申請專利範圍第丨項之模組臀彌補物, 段的陽錐形部份及幹骺端分段的第一陰錐 者包含混合入一個通常拋物線截面中之一 截面。 1 6 .如申請專利範圍第1 5項之模組臀彌補物, 錐形長度與圓錐錐形長度之比其範圍自大| 3 0% 〇 1 7 .如申請專利範圍第1 6項之模組臀彌補物, 段的各圓錐錐形截面及幹骺端分段的第一 之錐形角其範圍自大約1°至大約2.5° 。 1 8 ·如申請專利範圍第1項之模組臀彌補物, 其中拋物線 :勺5%至大約 其中遠側分 陰錐形部份 其中將近側 之延伸構件 其中延伸構 其中近側分 形部份每一 個圓錐錐形 其中拋物線 与5%至大約 其中近側分 陰錐形部份 其中近側分 -20- 487568 六、申請專利範圍 段係由選自下列所構成之族群的一種材料所構成:鈦 金屬合金、姑絡合金和不誘鋼。 1 9 .如申請專利範圍第1項之模組臀彌補物,其中幹骺端 分段之接合骨之表面係選自下列所構成之族群:砂礫 噴淨之表面處理、經燒結之金屬珠塗料、羥基磷灰石 塗料、電漿噴射塗料、生物玻璃陶瓷塗料、脫礦質之 骨和載體及生長因素和載體。 2〇 .如申請專利範圍第1項之模組臀彌補物,其中幹骺端 分段係由選自下列所構成之族群的一種材料所構成: 鈦金屬合金、銘鉻合金和不銹鋼。 2 1 .如申請專利範圍第1項之模組臀彌補物,其中幹骺端 分段具有與一個通常錐形截面成整體之梯形截頭錐形 角錐截面。 22 .如申請專利範圍第2 1項之模組臀彌補物,其中幹骺端 分段具有自一個通常圓形橫截面所補償之一個通常梯 形橫截面。 23 .如申請專利範圍第2 1項之模組臀彌補物,其中幹骺端 分段包括環繞至少一部份的通常錐形截面所形成之一 個外部環。 24.—種模組臀彌補物,包括: 一個近側分段,該近側分段包括與一個股骨之前組 成部份鎖緊可接合之頸部,該近側分段另外包括自該 頸部遠側延伸之一個陽錐形部份; -21 - 487568 六、申請專利範圍 具有一個近側端和一個遠側尖之遠側分段,該遠側 分段包括接鄰於其近側端之一個陽錐形部份及一個接 合骨之外表面部份;及 具有一個近側端和一個遠側端之幹骺端分段,該幹 骺骺端分段另外包括通經其中之一個軸向孔,該軸向 孔包括第一和第二陰錐形部份,將第一陰錐形部份定 位接鄰於幹骺端分段之近側端,其大小作成可鎖緊接 合近側分段之陽錐形部份,將第二陰錐形部份定位接 鄰於幹骺端分段之遠側端,其大小作成可鎖緊接合遠 側分段之陽錐形部份。 25.如申請專利範圍第24項之模組臀彌補物,其中近側分 段另外包括通經其中之一個軸向孔,該近側分段與幹 骺端分段之近側端可接合而使通過近側和幹骺端等分 段所形成之各個軸向孔對齊,該遠側分段另外包括一 個刻有螺紋之軸向孔接鄰其近側端,遠側分段之近側 端與幹 端分段之遠側端可接合而使通過遠側和幹骺端等分 段所形成之各個軸向孔對齊,該模組臀彌補物另外包 括一個螺釘其大小作成可通經近側、幹骺端和遠側等 分段的已對齊之各孔而與遠側分段之刻有螺紋之軸向 孔以螺紋接合。 26 .如申請專利範圍第24項之模組臀彌補物,其中近側分 段的陽錐形部份及幹骺端分段的第一陰錐形部份每一 -22- 487568 六、申請專利範圍 者包含混合入一個通常拋物線截面中之圓錐錐形截面 〇 27 .如申請專利範圍第26項之模組臀彌補物,其中拋物線 錐形長度與圓錐錐形長度之比其範圍自大約5%至大約 30% ° 28 .如申請專利範圍第27項之模組臀彌補物,其中近側分 段的各圓錐錐形截面及幹骺端分段之第一陰錐形部份 之錐形角其範圍自大約厂至大約2.5° 。 29 .如申請專利範圍第24項之模組臀彌補物,其中近側分 段係由選自下列所構成之族群的一種材料所構成:鈦 金屬合金、銘鉻合金和不銹鋼。 3〇.如申請專利範圍第24項之模組臀彌補物,其中將近側 分段之陽錐形部份形成在自頸部遠側延伸之一個延伸 構件上。 3 !.如申請專利範圍第30項之模組臀彌補物,其中該延伸 構件包括自其遠側分段之一個螺紋接套構件。 32 .如申請專利範圍第24項之模組臀彌補物,其中近側分 段具有一個通常圓形橫截面。 33 .如申請專利範圍第24項之模組臀彌補物,其中遠側分 段的陽錐形部份及幹骺端分段之第二陰錐形部份每一 者包含混合入一個通常拋物線截面中之一個圓錐錐形 截面。 34.如申請專利範圍第33項之模組臀彌補物,其中拋物線 -23- 487568 六、申請專利範圍 錐形長度與圓錐錐形長度之比其範圍自大約5%至大約 30%。 35. 如申請專利範圍第34項之模組臀彌補物,其中遠側分段的 各圓錐錐形截面及幹骺端分段的第二陰錐形部份之錐形角 其範圍自大約1°至大約2.5° 。 36. 如申請專利範圍第24項之模組臀彌補物,其中遠側分段的 接合骨之表面包含沿著其增量長度所形成之縱向溝槽。 37. 如申請專利範圍第24項之模組臀彌補物,其中遠側分段另 外包含沿著其增量長度之冠的狹縫。 3 8_如申請專利範圍第24項之模組臀彌補物,其中遠側分段之 接合骨之表面係選自下列所構成之族群:砂礫噴淨之表面 處理、經燒結之金屬珠塗料、羥基磷灰石塗料、電漿噴射 塗料、生物玻璃陶瓷塗料、脫礦質之骨和載體及生長因素 和載體。 39. 如申請專利範圍第24項之模組臀彌補物,其中遠側分段係 由選自下列所構成之族群的一種材料所構成:鈦金屬合 金、鈷鉻合金和不銹鋼。 40. 如申請專利範圍第24項之模組臀彌補物,其中幹骺端分段 包括接合骨之表面係選自下列所構成之族群:砂礫噴淨之 表面、經燒結之金屬珠塗料、羥基磷灰石塗料、電漿噴射 塗料、生物玻璃陶瓷塗料、脫礦質之骨和載體及生長因素 和載體。 41·如申請專利範圍第24項之模組臀彌補物,其中幹骺端分段 具有與一個通常錐形截面成整體之梯形截頭錐形角錐截 __ -24- 487568 六、申請專利範圍 面。 42·如申請專利範圍第41項之模組臀彌補物,其中幹骺端分段 具有自一個通常圓形橫截面所補償之一個通常梯形橫截 面。 43·如申請專利範圍第41項之模組臀彌補物,其中幹骺端分段 包括環繞至少一部份的通常錐形截面所形成之一個外部 環。 44申請專利範圍第24項之模組臀彌補物,其中幹骺端分段係 由選自下列所構成之族群的一種材料所構成:鈦金屬合 金、鈷鉻合金和不銹鋼。 45·—種模組臀彌補物,包括: 具有通經其中之一個軸向孔之近側分段,該近側分段包 括與一個股骨之前組成部份鎖緊可接合之頸部,該近側分 段另外包括自該頸部遠側延伸之一個陽錐形部份; 具有一個近側端和一個遠側尖之遠側分段,形成該遠側 分段而具有接鄰於其近側端之一個刻有螺紋之軸向孔,另 外形成該遠側分段而具有接鄰於其近側端之一個陽錐形部 份; 具有一個近側端和一個遠側端之幹骺端分段,該幹 端 分段包括一個接合骨之外表面部份,該幹骺端分段另外包 括通經其中之一個軸向孔,該軸向孔包括第一和第二陰錐 形部份,將第一陰錐形部份定位接鄰幹骺端分段之近側 端,其大小作成可鎖緊接近側分段之陽錐形部份,將第二 陰錐形部份定位接鄰於幹骺端分段之遠側端,其大小作成 -25- 4^7568 六、申請專利範圍 來鎖緊接合遠側分段之陽錐形截面;及 該近側分段與幹骺端分段的近側端可接合而將通過近側 和幹骺端等分段所形成之各軸向孔對齊,遠側分段之近俱ij 端與幹骺端分段的遠側端可接合而將通過遠和幹骺端等分 段所形成之各軸向孔對齊;及 該模組臀彌補物另外包括一支螺釘其大小作成可通經近 側、幹骺端和遠側等分段的經對齊之各孔並與遠側分段的 刻有螺紋之軸向孔以螺紋接合。 46. 如申請專利範圍第45項之模組臀彌補物,其中近側分段之 陽錐形部份和幹骺端分段之第一陰錐形部份每一者包含混 合入一個通常拋物線截面中之一個圓錐錐形截面。 47. 如申請專利範圍第46項之模組臀彌補物,其中拋物線錐形 長度與圓錐錐形長度之比其範圍自大約5 %至大約30%。 48·如申請專利範圍第47項之模組臀彌補物,其中近側分段的 各圓錐截面及幹骺端分段的第一陰錐形部份之錐形角其範 圍自大約1°至大約2.5°。 49·如申請專利範圍第45項之模組臀彌補物,其中近側分段係 由選自下列所構成之族群的一種材料所構成:鈦金屬合 金、鈷鉻合金和不銹鋼。 5〇·如申請專利範圍第45項之模組臀彌補物,其中將近側分段 的陽錐形部份形成在自頸部遠側延伸之一個延伸構件上。 5 1 ·如申請專利範圍第45項之模組臀彌補物,其中延伸構件包 括自其遠側延伸之一個螺紋接套構件。 52·如申請專利範圍第45項之模組臀彌補物,其中遠側分段另 _ -26- 487568 六、申請專利範圍 外包括沿著其增量長度之縱向溝槽。 5 3·如申請專利範圍第45項之模組臀彌補物,其中遠側分段另 外包括沿著其增量長度之冠的狹縫。 54·如申請專利範圍第45項之模組臀彌補物,其中遠側分段之 陽錐形部份及幹骺端分段之第二陰錐形部份每一者包含混 合入一個通常拋物線截面中之圓錐錐形截面。 5 5·如申請專利範圍第54項之模組臀彌補物,其中拋物線錐形 長度與圓錐錐形長度之比其範圍自大約5 %至大約30%。 5 6·如申請專利範圍第55項之模組臀彌補物,其中遠側分段的 各圓錐截面及幹骺端分段的第二陰錐形截面之錐形角其範 圍自大約1°至大約2.5°。 57.如申請專利範圍第45項之模組臀彌補物,其中遠側分段係 由選自下列所構成之族群的一種材料所構成:鈦金屬合 金、鈷鉻合金和不銹鋼。 5 8·如申請專利範圍第45項之模組臀彌補物,其中遠側分段包 括接合骨之外表面其係選自下列所構成之族群:砂礫噴淨 之表面、經燒結之金屬珠塗料、羥基磷灰石塗料、電漿噴 射塗料、生物玻璃陶瓷塗料、脫礦質之骨和載體及生長因 素和載體。 5 9.如申請專利範圍第45項之模組臀彌補物,其中幹骺端分段 具有與一個通常錐形截面成整體之梯形截頭錐形截面。 60.如申請專利範圍第59項之模組臀彌補物,其中幹骺端分段 具有自一個通常圓形橫截面所補償之一個通常梯形橫截 面。 -27- 48^568 六、申請專利範圍 δ 1·如申請專利範圍第59項之模組臀彌補物,其中幹骺端分段 包括環繞至少一部份之通常圓錐截面所形成之一個外部 環。 62. 如申請專利範圍第45項之模組臀彌補物,其中幹骺端分段 的接合骨之表面係選自下列所構成之族群:砂礫噴淨之表 面、經燒結之金屬珠塗料、羥基磷灰石塗料、電漿噴射塗 料、生物玻璃陶瓷塗料、脫礦質之骨和載體及生長因素和 載體。 63. 如申請專利範圍第45項之模組臀彌補物,其中幹骺端分段 係由選自下列所構成之族群的一種材料所構成:鈦金屬合 金、鈷鉻合金和不銹鋼。 -28-
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-
2000
- 2000-03-13 US US09/524,341 patent/US6319286B1/en not_active Expired - Lifetime
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2001
- 2001-03-12 TW TW090105689A patent/TW487568B/zh not_active IP Right Cessation
- 2001-03-13 JP JP2001566467A patent/JP3834510B2/ja not_active Expired - Fee Related
- 2001-03-13 DE DE60111703T patent/DE60111703T2/de not_active Expired - Lifetime
- 2001-03-13 CN CNB018009247A patent/CN1203819C/zh not_active Expired - Lifetime
- 2001-03-13 PT PT01918624T patent/PT1191906E/pt unknown
- 2001-03-13 AT AT01918624T patent/ATE298547T1/de not_active IP Right Cessation
- 2001-03-13 CA CA002374072A patent/CA2374072C/en not_active Expired - Fee Related
- 2001-03-13 WO PCT/US2001/008033 patent/WO2001067997A1/en active IP Right Grant
- 2001-03-13 ES ES01918624T patent/ES2240435T3/es not_active Expired - Lifetime
- 2001-03-13 EP EP01918624A patent/EP1191906B1/en not_active Expired - Lifetime
- 2001-03-13 AU AU45677/01A patent/AU771968B2/en not_active Expired
- 2001-11-01 US US10/004,207 patent/US6911048B2/en not_active Expired - Lifetime
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AU4567701A (en) | 2001-09-24 |
US20020038148A1 (en) | 2002-03-28 |
JP3834510B2 (ja) | 2006-10-18 |
HK1048584A1 (en) | 2003-04-11 |
ES2240435T3 (es) | 2005-10-16 |
AU771968B2 (en) | 2004-04-08 |
ATE298547T1 (de) | 2005-07-15 |
DE60111703T2 (de) | 2005-12-08 |
CN1203819C (zh) | 2005-06-01 |
JP2003526454A (ja) | 2003-09-09 |
US6911048B2 (en) | 2005-06-28 |
WO2001067997A1 (en) | 2001-09-20 |
CA2374072C (en) | 2008-12-02 |
DE60111703D1 (en) | 2005-08-04 |
PT1191906E (pt) | 2005-10-31 |
EP1191906A1 (en) | 2002-04-03 |
EP1191906B1 (en) | 2005-06-29 |
HK1048584B (zh) | 2006-01-27 |
CA2374072A1 (en) | 2001-09-20 |
CN1366457A (zh) | 2002-08-28 |
EP1191906A4 (en) | 2003-04-16 |
US6319286B1 (en) | 2001-11-20 |
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