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FR2663838A1 - Implant for an arthroplasty, in particular of a glenoid cavity - Google Patents

Implant for an arthroplasty, in particular of a glenoid cavity Download PDF

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Publication number
FR2663838A1
FR2663838A1 FR9008646A FR9008646A FR2663838A1 FR 2663838 A1 FR2663838 A1 FR 2663838A1 FR 9008646 A FR9008646 A FR 9008646A FR 9008646 A FR9008646 A FR 9008646A FR 2663838 A1 FR2663838 A1 FR 2663838A1
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France
Prior art keywords
head
implant according
implant
medullary
bone
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.)
Withdrawn
Application number
FR9008646A
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French (fr)
Inventor
Berger Michel
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Individual
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Individual
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Publication date
Application filed by Individual filed Critical Individual
Priority to FR9008646A priority Critical patent/FR2663838A1/en
Publication of FR2663838A1 publication Critical patent/FR2663838A1/en
Withdrawn legal-status Critical Current

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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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3804—Joints for elbows or knees for elbows
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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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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    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4606—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of wrists or ankles; of hands, e.g. fingers; of feet, e.g. toes
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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
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30143—Convex polygonal shapes hexagonal
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    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap 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
    • A61F2002/30316—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
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30767—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
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • 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
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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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    • A61F2002/4233—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes for metatarso-phalangeal joints, i.e. MTP joints
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/4631—Special tools for implanting artificial joints the prosthesis being specially adapted for being cemented
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    • A—HUMAN NECESSITIES
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    • 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

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  • 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)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

The implant for an arthroplasty, in particular of a glenoid cavity, is distinguished by the fact that it comprises an element (1) shaped in order to be fixed in the medullary cavity of the bone in question, the said element (1) having an end part (1a) capable of receiving, with a capacity for rotation, a profiled head (2) designed to cooperate in a sliding manner with the articular surface of the bone corresponding to the glenoid cavity in question.

Description

Implant pour la réalisation d'une arthroplastie, notamment d'une cavité glénoïde
Plus particulièrement, mais non limitativement, l'invention concerne l'arthroplastie de la tête radiale, pour le remplacement de l'extrémité proximale du radius, sans pour cela elre les arthroplasties des articulations métatarso-pllalangiennes, de l'extrémité distale du radius et d'extremité distale du tibia.Implant for performing arthroplasty, including a glenoid cavity
More particularly, but not exclusively, the invention relates to the arthroplasty of the radial head, for the replacement of the proximal end of the radius, without it being the arthroplasty of the metatarsophalangeal joints, the distal end of the radius and distal end of the tibia.

Actuellement, il existe pratiquement aucune solution permettant de résoudre ce problème. La solution la plus utilisée met en oeuvre un élément prothétique a base de silicone. Les résultats obtenus ne sont pas satisfaisants, l'emploi du silicone étant générateur d'allergies. Currently, there is virtually no solution to this problem. The most used solution uses a prosthetic element based on silicone. The results obtained are not satisfactory, the use of silicone being allergenic.

L'invention s'est donc fie pour but de remédier a ces inconvenients. The invention is therefore intended to remedy these drawbacks.

Le problème que se propose de résoudre l'invention est de concevoir un implant pour la realisation d'une arthroplastie, notamment dans le cas de fractures polyframentaires de la tête radiale, avec une grande stabilité primaire autorisant une mobilisation post-opératoire immédiate. Tous les mouvements peuvent être travaillés dans leur amplitude maximale. The problem to be solved by the invention is to design an implant for performing arthroplasty, particularly in the case of polyframentary fractures of the radial head, with a high primary stability allowing immediate postoperative mobilization. All movements can be worked in their maximum amplitude.

Un tel problème est résolu en ce que l'implant comprend un élément conformé pour être fixé dans le canal médullaire de l'ors considéré, ledit élément présentant une partie d'extrémité apte a recevoir, avec capacité de rotation, une tête profilée conformée pour coopérer å glissement avec la surface articulaire de l'os correspondant a la cavité glénoïde considérée.  Such a problem is solved in that the implant comprises an element shaped to be fixed in the medullary canal of the gold considered, said element having an end portion adapted to receive, with rotational capacity, a profiled head shaped for to cooperate with the articular surface of the bone corresponding to the glenoid cavity considered.

Pour résoudre le problème posé d'avoir un degré de liberté supplémentaire au niveau de l'articulation et de diminuer les contraintes en torsion et en cisaillement An niveau de la prothèse, lors des mouvements de pronosupination, la partie d'extrémité de 1'élément et la tête profilée, présentent des agencements complémentaires aptes à assurer leur accouplement par clipsage et le montage tournant de ladite tête par rapport à ladite partie. To solve the problem of having an additional degree of freedom at the joint and to reduce the torsional and shear stresses at the level of the prosthesis, during pronosupination movements, the end portion of the element and the profiled head, have complementary arrangements adapted to ensure their clipping coupling and the rotational mounting of said head relative to said portion.

Avantageusement, les agencements de la partie de l'élément recevant la tête, sont constitués par une calotte hémisphérique et une gorge circulaire coopérant respectivement avec un chambrage interne complémentaire et une collerette formée dans la tête profilée. Advantageously, the arrangements of the portion of the element receiving the head are constituted by a hemispherical cap and a circular groove respectively cooperating with a complementary internal recess and a flange formed in the profiled head.

Pour résoudre le problème posé d'assurer l'articulation avec le condyle de l'os correspondant (condyle huméral dans le cas de l'arthroplastie de la tête radiale), la partie de la tête profilée recevant å glissement la surface articulaire de l'os, comporte une face concave. To solve the problem of ensuring the articulation with the condyle of the corresponding bone (humeral condyle in the case of arthroplasty of the radial head), the part of the profiled head receiving å slip the articular surface of the bone, has a concave face.

Le problème posé de permettre, essentiellement dans les mouvements de pronosupination, la rotation et la translation par rapport à la surface articulaire proximale du cubitus, dans le cas de la tête radiale, est résolu en ce que la tête profilée a un profil tronconique de section dégressive depuis la surface concave de glissement. The problem of allowing, essentially in the movements of pronosupination, rotation and translation with respect to the proximal articular surface of the ulna, in the case of the radial head, is solved in that the profiled head has a frustoconical section profile. degressive from the concave sliding surface.

Pour résoudre le problème posé d'assurer la fixation de l'implant, l'élément présente une portée filetée dont le profil du filet est déterminé pour assurer son ancrage dans le canal médullaire, avec ou sans ciment. To solve the problem posed to ensure the attachment of the implant, the element has a threaded surface whose net profile is determined to ensure its anchoring in the medullary canal, with or without cement.

Dans le cas de fractures étendues et complexes, la partie vissée de l'élément présente une gorge pour permettre le cimentage. In the case of extensive and complex fractures, the screwed part of the element has a groove to allow cementing.

Le problème pose d'assurer l'impaction de l'implant, est résolu en ce qu'au-dessus de la portée filetée et sous la gorge circulaire, l'élément présente une portée polygonale apte à coopérer avec un organe de manoeuvre. The problem poses to ensure the impaction of the implant, is solved in that above the threaded surface and under the circular groove, the element has a polygonal bearing adapted to cooperate with an actuator.

L'implant tel que défini est réalisé en matériaux stables et biocompatibles. The implant as defined is made of stable and biocompatible materials.

L'élément est en acier inoxydable tel que le 316 LVN, tandis que la tête est en polyéthylène ultra-haute- densité. The element is made of stainless steel such as 316 LVN, while the head is made of ultra-high density polyethylene.

L'invention est exposee ci-après plus en détail a l'aide des dessins annexés, dans lesquels
La figure 1 est une vue en perspective avant montage des éléments de l'implant selon l'invention.The invention is described below in more detail with the aid of the accompanying drawings, in which
Figure 1 is a perspective view before mounting elements of the implant according to the invention.

La figure 2 est une vue montrant une application de l'implant dans le cas d'une arthroplastie de la tête radiale. Figure 2 is a view showing an application of the implant in the case of arthroplasty of the radial head.

La figure 3 est une vue en coupe longitudinale de l'implant. Figure 3 is a longitudinal sectional view of the implant.

La figure 4 est une vue en coupe selon la ligne 4-4 de la figure 3. Figure 4 is a sectional view along the line 4-4 of Figure 3.

La figure 5 est une vue de dessus de l'élément métallique. Figure 5 is a top view of the metal element.

La figure 6 est une vue en coupe transvservale selon la ligne 6-6 de la figure 3.  FIG. 6 is a transvserval sectional view along the line 6-6 of FIG. 3.

La figure 7 est, å une échelle plus importante, une vue partielle et en coupe montrant le montage de la tête sur la partie correspondante de l'élément. Figure 7 is a larger scale, a partial view in section showing the mounting of the head on the corresponding part of the element.

Comme le montre la figure 1, l'implant comprend un élément (1) conformé pour être fixé dans le canal médullaire de l'os considéré. Cet élément (1) présente une partie d'extrémité (la) apte à recevoir, avec capacité de rotation, une tête profilée (2). Cette tête t2) est conformée pour coopérer à glissement avec la surface articulaire ou osseuse correspondante. As shown in Figure 1, the implant comprises an element (1) shaped to be fixed in the medullary canal of the bone in question. This element (1) has an end portion (la) adapted to receive, with rotational capacity, a profiled head (2). This head t2) is shaped to cooperate sliding with the corresponding articular or bone surface.

D'une manière préférée, mais non limitative, l'implant selon l'invention trouve une application particulièrement avantageuse dans le cas de fractures polyfragmentaires de la tête radiale. Dans ce cas, l'élément médullaire llj est fixé dans la diaphyse radiale, tandis que la tête (2) coopère avec le condyle huméral
La partie d'extrémité (la) de l'élément medullaire (1) et la tête profilée (2) présentent en combinaison des agencements complémentaires aptes à assurer leur accouplement par clipsage notamment, et le montage tournant de la tête (2) par rapport à l'élément (1) au niveau de son extrémité (la). Dans ce but, la partie (la) de l'élément médullaire (1) est constituée par une calotte hémispbérique (lai) formée en débordement d'une gorge circulaire (la2). In a preferred way, but not limited to, the implant according to the invention finds a particularly advantageous application in the case of polyfragmentary fractures of the radial head. In this case, the medullary element 11j is fixed in the radial diaphysis, while the head 2 co-operates with the humeral condyle
The end portion (la) of the medullary element (1) and the profiled head (2) have in combination complementary arrangements adapted to ensure their clipping coupling in particular, and the rotational mounting of the head (2) relative to the element (1) at its end (la). For this purpose, the part (la) of the medullary element (1) is constituted by a hemispherical cap (lai) formed in overflow of a circular groove (la2).

Comme le montrent notamment les figures 3 et 7, la calotte hémisphérique (lai) coopère avec un chambrage interne (2a) de la tête (2). L'entrée du chambrage (2a) présente une collerette (2b) apte a coopérer avec la gorge (la2) de l'élément médullaire (1). Dans l'exemple illustré, la tète (2) présente d'une manière coaxiale au chambrage (2a) un évidement circulaire (2c) déterminé pour prendre appui sur une portée (1a3 > de l'élément medullaire (1).  As shown in particular in Figures 3 and 7, the hemispherical cap (lai) cooperates with an internal recess (2a) of the head (2). The inlet of the recess (2a) has a flange (2b) adapted to cooperate with the groove (la2) of the medullary element (1). In the illustrated example, the head (2) has a coaxial recess (2a) a circular recess (2c) determined to bear on a bearing (1a3> of the medullary element (1).

Bien évidemment, les formes et dimensions notamment au niveau de la calotte hémisphérique (lal) et du chambrage (2a), en combinaison avec la collerette (2b) et la gorge (1a2), sont convenablement déterminées pour assurer un parfait positionnement coaxial entre la tête (2) et l'élément médullaire (1) tout en permettant la libre rotation de la tête (2) par rapport au grand axe dudit élément médullaire. Of course, the shapes and dimensions in particular at the level of the hemispherical cap (lal) and recess (2a), in combination with the flange (2b) and the groove (1a2), are suitably determined to ensure perfect coaxial positioning between the head (2) and the medullary element (1) while allowing free rotation of the head (2) relative to the major axis of said medullary element.

La portée (1a3) de l'élément médullaire (1) est de section polygonale notamment hexagonale pour coopérer avec un organe de manoeuvre en vue de la mise en place dudit élément dans la partie correspondante de l'os considéré. The scope (1a3) of the medullary element (1) is of polygonal section including hexagonal to cooperate with an actuator for the introduction of said element in the corresponding part of the bone.

La partie d'extrémité (la) de l'élément médullaire (1) est prolongée coaxialement par une tige (lb > présentant tout agencement en vue de la fixation et de l'ancrage de l'ensemble de l'élément (1) dans le canal médullaire. Avantageusement, cette tige (lb) présente un filetage cortical (obi) dont le profil peut être de tout type connu et approprié. La figure 6 illustre un exemple de profil du filet (1b1). En outre, d'une manière connue, la tige filetée (lb > peut présenter trois rainures (1b2) décalées angulairement, par exemple de 120 degrés. The end portion (1a) of the medullary element (1) is extended coaxially by a rod (1b) having any arrangement for securing and anchoring the entire member (1) in advantageously, this rod (1b) has a cortical thread (obi), the profile of which can be of any known and appropriate type, and Figure 6 illustrates an example of a profile of the thread (1b1). In known manner, the threaded rod (lb> may have three grooves (1b2) angularly offset, for example 120 degrees.

La partie de la tête profilée (2) recevant à glissement la surface articulaire, comporte une face d'appui concave (2d). La concavité est déterminée pour assurer l'articulation avec le condyle huméral dans le cas de l'arthroplastie de la tête radiale. En outre, cette tête (2j présente un profil tronconique de section dégressive depuis la surface concave (2d > de glissement. The portion of the profiled head (2) slidably receiving the articular surface has a concave bearing surface (2d). The concavity is determined to ensure articulation with the humeral condyle in the case of arthroplasty of the radial head. In addition, this head (2j has a frustoconical profile of degressive section from the concave surface (2d> sliding.

Ce profil tronconique permet la rotation et la translation eu égard à la surface articulaire proximale du cubitus (figure 2)
'implant, tel que décrit et illustré, est réalisé en tout type de matériaux stables et biocompatibles
L'élément (i) est réalisé en axier inoxydable, tel que le 316 LVM, tandis que la tête (2) est réalisée en polyéthylène ultra-haute-densité.This frustoconical profile allows rotation and translation with respect to the proximal articular surface of the ulna (FIG. 2)
implant, as described and illustrated, is made of any type of stable and biocompatible materials
The element (i) is made of stainless steel, such as 316 LVM, while the head (2) is made of ultra-high density polyethylene.

A noter que l'élément médullaire (l) et la tête glénoïde (2) sont réalisés suivant plusieurs tailles, toutes adaptables les unes aux autres, conférant ainsi une parfaite modularité et adaptation anatomique et biomecanique.  Note that the medullary element (l) and the glenoid head (2) are made in several sizes, all adaptable to each other, thus conferring a perfect modularity and anatomical and biomechanical adaptation.

La technique opératoire pour la mise en place de l'implant n'est pas décrite car elle ne fait pas partie de l'objet spécifique de l'invention. The operative technique for implant placement is not described because it is not part of the specific object of the invention.

Les avantages ressortent bien de la description. The advantages are apparent from the description.

En particulier, on souligne - une grande stabilité primaire autorisant une mobilisation post-opèratoire immédiate F tous les mouvements peuvent être travaillés dans leur amplitude maximale ; - en cas de problème septique l'implant est facilement extractible ; - la libre rotation de la tête glénoïde par rapport au grand axe de l'élément médullaire donne un degré de liberté supplémentaire, ce qui diminue les contraintes en torsion et en cisaillement, notamment dans les mouvements de pronosupination ; - le profil tronconique latéral de la tête permet la rotation et la translation par rapport à la surface articulaire proximale de l'os considéré ; ; - la diminution des risques de fracture de fatigue de l'implant - la facilité de pose au moyen d'un ancillaire simple et précis - l'accouplement de la tête sur l'élément médullaire par simple clipsage ;
A noter que la tige filetée peut comporter une gorge pour permettre le cimentage dans le cas de fractures étendues et complexes.In particular, it is emphasized - a high primary stability allowing immediate postoperative mobilization F all movements can be worked in their maximum amplitude; - in case of septic problem the implant is easily extractable; the free rotation of the glenoid head with respect to the major axis of the medullary element gives an additional degree of freedom, which reduces the torsional and shear stresses, especially in the movements of pronosupination; - The lateral frustoconical profile of the head allows rotation and translation relative to the proximal articular surface of the bone considered; ; - the reduction of the risk of fatigue fracture of the implant - the ease of installation by means of a simple and precise ancillary - the coupling of the head on the medullary element by simple clipping;
Note that the threaded rod may have a groove to allow cementing in the case of extensive and complex fractures.

Enfin, la tête glénoïde (2) peut présenter des fils à radio (3) disposés par exemple d'une manière radiale en étant décalés angulairement de 120 degrés (figure 1),  Finally, the glenoid head (2) may have radio son (3) arranged for example in a radial manner being angularly offset by 120 degrees (Figure 1),

Claims (1)

REVENDICATIONS -l- Implant pour la réalisation d'une arthroplastie, notamment d'une cavité génoïde, caractérisé en ce qu'il comprend un élément (1) conformé pour être fixé dans le canal médullaire de l'os considéré, ledit élément (1) présentant une partie d'extrémité (la) apte à recevoir, avec capacité de rotation, une tête profilée (2) conformée pour coopérer à glissement avec la surface articulaire de l'os correspondant à la cavité glénoïde considéré. CLAIMS Implant for carrying out an arthroplasty, in particular a genoid cavity, characterized in that it comprises an element (1) shaped to be fixed in the medullary canal of the bone in question, said element (1 ) having an end portion (la) adapted to receive, with rotational capacity, a profiled head (2) shaped to cooperate slidably with the articular surface of the bone corresponding to the glenoid cavity considered. -2- Implant selon la revendication 1, caractérisé en ce que la partie d'extrémité (la) de l'élément médullaire (l) et la tête profilée (2), présentent des agencements complémentaire (lai - la2) et (2a - 2b) aptes à assurer leur accouplement par clipsage et le montage tournant de ladite tête (2) par rapport a ladite partie (la) -3- Implant selon la revendication 1, caractérisé en ce que les agencements de la partie (la) de l'élément (l) recevant la tête (2), sont constitués par une calotte hérnisphérique (lai) et une gorge circulaire (la2) coopérant respectivement avec un chambrage interne complémentaire (2a > et une collerette (2b) formée dans la tête profilée.-2- Implant according to claim 1, characterized in that the end portion (la) of the medullary element (1) and the profiled head (2), have complementary arrangements (lai - la2) and (2a - 2b) adapted to ensure their coupling by clipping and the rotational mounting of said head (2) relative to said portion (la) -3- Implant according to claim 1, characterized in that the arrangements of the part (la) of the element (1) receiving the head (2), are constituted by a shell (lai) and a circular groove (la2) cooperating respectively with a complementary internal recess (2a> and a flange (2b) formed in the profiled head. -4- Implant selon la revendication 1, caractérisé en ce que la partie de la tête profilée (2) recevant à glissement la surface articulaire de l'os, comporte une face concave (2d). Implant according to claim 1, characterized in that the portion of the profiled head (2) slidably receiving the articular surface of the bone has a concave face (2d). -5- Implant selon les revendications 1 et 4, caractérisé en ce que la tête profilée (2) a un profil tronconique de section dégressive depuis la surface concave (2d) de glissement.-5- Implant according to claims 1 and 4, characterized in that the profiled head (2) has a frustoconical profile of degressive section from the concave surface (2d) sliding. -6- Implant selon la revendication 1, caractérisé en ce que l'élément médullaire (1) présente une portée filetée (lb) dont le profil du filet est déterminé pour assurer son ancrage dans le canal médullaire, avec ou sans ciment. -6- Implant according to claim 1, characterized in that the medullary element (1) has a threaded surface (1b) whose net profile is determined to ensure its anchoring in the medullary canal, with or without cement. -7- Implant selon la revendication 5, caractérisé en ce qu'au-dessus de la portée filetée (lb) et sous la gorge circulaire (la2), l'élément (l) présente une portée polygonale (la3) apte a coopérer avec un organe de manoeuvre.-7- Implant according to claim 5, characterized in that above the threaded surface (Ib) and under the circular groove (la2), the element (1) has a polygonal surface (la3) adapted to cooperate with an actuator. -8- Implant selon la revendication l, caractérisé en ce que l'élément médullaire (ï) est en métal, notamment en acier inoxydable.-8- Implant according to claim 1, characterized in that the medullary element (I) is metal, in particular stainless steel. -9- Implant selon la revendication 1, caractérisé en ce que la tête (2) est en polyétvlène. Implant according to claim 1, characterized in that the head (2) is made of polyethylene.
FR9008646A 1990-06-29 1990-06-29 Implant for an arthroplasty, in particular of a glenoid cavity Withdrawn FR2663838A1 (en)

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