DE19530531C2 - Hüftgelenksendoprothese mit bioresorbierbarem, axial gestütztem Mittelteil - Google Patents
Hüftgelenksendoprothese mit bioresorbierbarem, axial gestütztem MittelteilInfo
- Publication number
- DE19530531C2 DE19530531C2 DE19530531A DE19530531A DE19530531C2 DE 19530531 C2 DE19530531 C2 DE 19530531C2 DE 19530531 A DE19530531 A DE 19530531A DE 19530531 A DE19530531 A DE 19530531A DE 19530531 C2 DE19530531 C2 DE 19530531C2
- Authority
- DE
- Germany
- Prior art keywords
- hip joint
- bioresorbable
- connecting element
- joint endoprosthesis
- axially supported
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired - Fee Related
Links
- 210000004394 hip joint Anatomy 0.000 title claims 2
- 239000000463 material Substances 0.000 claims description 10
- 238000010521 absorption reaction Methods 0.000 claims description 2
- 238000005452 bending Methods 0.000 claims 2
- 210000000988 bone and bone Anatomy 0.000 description 9
- 239000007943 implant Substances 0.000 description 6
- JJTUDXZGHPGLLC-IMJSIDKUSA-N 4511-42-6 Chemical compound C[C@@H]1OC(=O)[C@H](C)OC1=O JJTUDXZGHPGLLC-IMJSIDKUSA-N 0.000 description 2
- 238000004873 anchoring Methods 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000000689 upper leg Anatomy 0.000 description 2
- RKDVKSZUMVYZHH-UHFFFAOYSA-N 1,4-dioxane-2,5-dione Chemical compound O=C1COC(=O)CO1 RKDVKSZUMVYZHH-UHFFFAOYSA-N 0.000 description 1
- 206010003694 Atrophy Diseases 0.000 description 1
- 208000006386 Bone Resorption Diseases 0.000 description 1
- 206010065687 Bone loss Diseases 0.000 description 1
- 208000005422 Foreign-Body reaction Diseases 0.000 description 1
- 206010020880 Hypertrophy Diseases 0.000 description 1
- 230000037444 atrophy Effects 0.000 description 1
- 230000010072 bone remodeling Effects 0.000 description 1
- 230000024279 bone resorption Effects 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 229920001577 copolymer Polymers 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 230000003412 degenerative effect Effects 0.000 description 1
- 238000006731 degradation reaction Methods 0.000 description 1
- 230000002757 inflammatory effect Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
Classifications
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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
- A61F2/3672—Intermediate 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
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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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- A61F2/3676—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
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- A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
- A61F2002/30032—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in absorbability or resorbability, i.e. in absorption or resorption time
-
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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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- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
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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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- 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
- 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
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/30387—Dovetail connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30649—Ball-and-socket joints
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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
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- A61F2002/3625—Necks
- A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
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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
- A61F2/3672—Intermediate parts of shafts
- A61F2002/3674—Connections of proximal parts to distal parts
-
- 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
-
- A—HUMAN NECESSITIES
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- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
- A61F2250/0031—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time made from both resorbable and non-resorbable prosthetic parts, e.g. adjacent parts
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- A—HUMAN NECESSITIES
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00005—The prosthesis being constructed from a particular material
- A61F2310/00011—Metals or alloys
- A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Description
Gelenkendoprothesen ersetzen durch degenerative,
entzündliche, traumatische oder tumoröse Ver
änderungen geschädigte Gelenke und ermöglichen es
dem Patienten so, ein weitgehend "normales" Leben zu
führen.
Es ist bekannt, daß das ideale Gelenkimplantat eine
physiologische, proximal-metaphysäre Lastübertragung in
das tragende Knochenlager ermöglichen sollte. Für eine
ausreichende Fixierung, insbesondere zur Primär
verankerung von zementfreien Implantaten, besitzen die
üblichen Implantate vor allem im Hüftbereich einen weit
in den Markraum des tragenden Knochens hinein
reichenden Prothesenstiel.
Es ist weiterhin bekannt, daß durch die herkömmlichen
langstieligen Prothesen die geforderte physiologische
Lasteinleitung derart geändert wird, daß anstelle der
proximal-metaphysären die distal-diaphysäre Kraftein
leitung begünstigt wird (Menge, M., 1994, Die
metaphysäre Prothesenverankerung - ein neues
Konzept für die Femurprothese.) Durch diese
Kraftumleitung in den distalen Bereich des tragenden
Knochens (Femur) entsteht eine mechanische
Schonung des Knochens im proximalen Bereich, das
"Stress-Shielding". Die Folge ist die oft zu beobachtende
Resorption des Knochens im proximalen Bereich, vor
allem des Kalkar (Kalkaratrophie). Zusätzlich kommt es
distal im Bereich der Stielspitze zu einer verstärkten
Krafteinleitung mit resultierender Kortikalishypertrophie
(Cohen, C., Rushton, N., 1995, Bone Remodelling in the
Proximal Femur After Charnley THA), (Kuiper, J. H., 1993,
Three-Dimensional Optimization of Hip Prosthetic
Design). Diese Mechanismen führen zur Lockerung der
Prothese im Knochenlager und somit zum Versagen des
Implantates.
Es ist weiterhin bekannt, daß der Knochen
substanzverlust im Falle einer Wechseloperation die
Fixation der Wechselprothese erheblich erschwert und
häufig die Verwendung von teuren Sonderimplantaten
erfordert.
Es ist weiterhin bekannt, daß sich als bioresorbierbare
Materialien bekannte Co-Polymere verwenden lassen,
die z. B. aus D,L-Lactid oder L-Lactid oder aus Glycolid
oder aus einer Mischung dieser Stoffe hergestellt
werden. Außerdem sind eigenverstärkte Materialien
entwickelt worden, die bezüglich ihrer mechanischen
Eigenschaften den bisherigen weit überlegen sind.
Diese kommen bereits bei der Herstellung von
Knochenschrauben, -stiften und -platten zur Anwendung.
Vergleiche z. B. Törmälä,P; 1993, Ultra-high Strength,
Self-Reinforced Absorbable Polymeric Composites for
Applications in Different Disciplines of Surgery, Clin. Mat.
pp. 35-40.
Es ist weiterhin bekannt, daß die Resorption zu großer
Mengen bioresorbierbaren Materials im Körper zu
unerwünschten Fremdkörperreaktionen führen kann.
Der im Patentanspruch angegebenen Erfindung liegt
das Problem zugrunde, die Vielzahl der
operationstechnisch komplizierten, teuren und für den
Patienten belastenden lockerungsbedingten Pro
thesenwechseloperationen zu minimieren.
Dieses Problem wird durch die im Patentanspruch
aufgeführten Merkmale gelöst.
Die mit der Erfindung erzielten Vorteile bestehen darin,
daß dieser Prothesentyp unmittelbar postoperativ durch
seinen langen Stiel eine ausreichende, den heutigen
Prothesenvarianten entsprechende Primärstabilität ge
währleistet. Durch den in den folgenden Wochen nach
der Operation ablaufenden Abbau des bioresobierbaren
Zwischenstückes wird eine stufenlose mechanische
Entkoppelung des distalen Stielteiles vom proximalen
Stielteil erreicht, die eine mech. Entlastung des distalen
Stielteiles zur Folge hat. Gleichzeitig kommt es zum
knöchernen Einwachsen des proximalen Stielteiles.
Dieser Prozeß führt dann zu einer ausschließlich
proximalen Verankerung und somit zu einer physio
logischen Lasteinleitung in das Knochenlager. Die
aseptische Implantatlockerung, die durch mechanisch
bedingte Knochenresorptionsvorgänge ausgelöst wird,
kann somit vermieden werden. So wird eine deutlich
erhöhte Standzeit der Prothese möglich.
Im Falle einer aus anderen Gründen trotzdem
notwendigen Wechseloperation wird durch den Erhalt
der proximalen Knochensubstanz eine solide
Ausgangsposition für die Fixation der Wechselprothese
geschaffen.
Die hier beschriebenen Funktionen der neuen Hüft
endoprothese werden mit einem kleinen
Materialvolumen des Zwischenstückes erreicht. Dies ist
deshalb von entscheidender Bedeutung, da größere
Mengen bioresorbierbaren Materials im Körper zu
unerwünschten Gewebereaktionen führen können.
Ein Ausführungsbeispiel der Erfindung ist in der
Zeichnung dargestellt und wird im folgenden näher
beschrieben.
Es zeigt
Fig. 1 einen Schnitt durch die erfindungsgemäße
Endoprothese.
Die Prothese besteht aus einem oberen Teil (1) und
einem unteren Teil (2). Zwischen diesem oberen Teil (1)
und dem unteren Teil (2) ist ein aus bioresorbierbarem
Material gefertigtes Verbindungselement (3) angeordnet,
das durch ein zusätzliches, nicht resorbierbares
Verbindungselement (4) mechanisch gestützt wird.
Claims (1)
- Hüftgelenksendoprothese, bestehend aus einem Stiel und einem Gelenkteil, dadurch gekennzeichnet, daß der obere Stielteil (1) und der untere Stielteil (2) mittels eines aus bioresobierbarem Material gefertigten Verbindungselementes (3) und eines aus nicht-resorbierbarem Material gefertigten Verbindungselementes (4) gekoppelt sind, derart, daß das aus nicht-resorbierbarem Material gefertigte Verbindungselement (4) einen Teil der auftretenden Axialkräfte und Biegemomente aufnimmt und daß bei zunehmender Resorption des aus bio resorbierbarem Material gefertigten Verbindungselementes (3) eine entscheidende Verringerung der Biegesteifigkeit des Gesamtsystems eintritt.
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19530531A DE19530531C2 (de) | 1995-08-19 | 1995-08-19 | Hüftgelenksendoprothese mit bioresorbierbarem, axial gestütztem Mittelteil |
US09/011,438 US6071312A (en) | 1995-08-16 | 1996-08-08 | Endoprosthesis, in particular an artificial hip joint |
DE59608020T DE59608020D1 (de) | 1995-08-16 | 1996-08-08 | Endoprothese, insbesondere hüftgelenkprothese |
EP96928429A EP0844855B1 (de) | 1995-08-16 | 1996-08-08 | Endoprothese, insbesondere hüftgelenkprothese |
PCT/EP1996/003506 WO1997006752A1 (de) | 1995-08-16 | 1996-08-08 | Endoprothese, insbesondere hüftgelenkprothese |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19530531A DE19530531C2 (de) | 1995-08-19 | 1995-08-19 | Hüftgelenksendoprothese mit bioresorbierbarem, axial gestütztem Mittelteil |
Publications (2)
Publication Number | Publication Date |
---|---|
DE19530531A1 DE19530531A1 (de) | 1997-02-20 |
DE19530531C2 true DE19530531C2 (de) | 1997-08-07 |
Family
ID=7769882
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19530531A Expired - Fee Related DE19530531C2 (de) | 1995-08-16 | 1995-08-19 | Hüftgelenksendoprothese mit bioresorbierbarem, axial gestütztem Mittelteil |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE19530531C2 (de) |
Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CS238282B1 (en) * | 1983-11-30 | 1985-11-13 | Rudolf Pavlansky | Hip endoprosthesis |
US5176712A (en) * | 1988-04-12 | 1993-01-05 | Tranquil Prospects Ltd. | Endoprostheses with resorption preventing means |
DE4141977C2 (de) * | 1991-12-19 | 1994-11-24 | S & G Implants Gmbh | Endoprothese zum Ersatz eines menschlichen Hüftgelenks |
US5571193A (en) * | 1992-03-12 | 1996-11-05 | Kampner; Stanley L. | Implant with reinforced resorbable stem |
-
1995
- 1995-08-19 DE DE19530531A patent/DE19530531C2/de not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
---|---|
DE19530531A1 (de) | 1997-02-20 |
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