Source: https://patents.google.com/patent/WO1996015738A1/en
Timestamp: 2019-10-17 22:03:57
Document Index: 263423168

Matched Legal Cases: ['art 3', 'arts 2', 'art 3', 'art 2', 'art 3', 'art 2', 'art 3', 'art 3', 'art 3', 'art 2', 'art 3', 'art 3', 'art. 2', 'art 2', 'art 3', 'art 2']

WO1996015738A1 - Modular artificial hip joint - Google Patents
WO1996015738A1
WO1996015738A1 PCT/DE1995/001653 DE9501653W WO9615738A1 WO 1996015738 A1 WO1996015738 A1 WO 1996015738A1 DE 9501653 W DE9501653 W DE 9501653W WO 9615738 A1 WO9615738 A1 WO 9615738A1
PCT/DE1995/001653
1994-11-19 Priority to DEP4442205.9 priority Critical
1994-11-19 Priority to DE19944442205 priority patent/DE4442205A1/en
1996-05-30 Publication of WO1996015738A1 publication Critical patent/WO1996015738A1/en
210000004394 hip joint Anatomy 0 abstract description title 3
The invention concerns a modular artificial hip joint having a head part and at least one shank part. The shank part, which can be driven into the bone and forms the distal region, is connected to the distal end of the head part by insertion, preferably by means of an insert cone. A first screw means, guided through an axial bore in the head part, can be screwed into a threaded bore in the shank part. In order to guide a second screw means for separating the conical insert connection between the individual components (2, 3) of the artificial joint (1), the bore (5) in the head part (3) is threaded and has a diameter (D1) which is greater than the diameter (D2) of the threaded bore (6) in the shank part (2).
The invention relates to a modular joint prosthesis of the type specified in the preamble of claim l.
Such joint prostheses are manufactured in various shapes and sizes to allow the most accurate adaptation to the bone shape and the aktu¬ economic condition of the bone tissue in consideration of the disease.
Through multi-part design with friction Verbin¬ the corresponding items dung in the proximal region can be made to adapt optimally. In this case, a positioning of the joint head, regardless of the shaft diameter is gleichzei¬ tig possible.
From EP-0243298 Bl a kit for a shank prosthesis is known having a versehba¬ with a joint ball res head portion, an end portion anchored in the bone and a positionable between two intermediate part. All parts have conical bores or matching pin, whereby the prosthesis can be assembled by preparing koni¬ shear connectors. Head and intermediate portion each have an axial to Durch¬-bore.
The end part is provided with means for releasable engagement for the purpose of transmitting a force in the axial direction. When joining of components, the corresponding holes are axially aligned in the direction of the shaft. The individual parts of the prosthesis are transmitted in the axial direction using a ei¬ ne power tie rod zusam¬ amount added, which penetrates both the head part and nachfol¬ constricting shaft parts and is einschraubar into the threaded hole of the end part. Thereby, the head in part, or tightened zusammen¬ the intermediate part and the end part, so that a loosening of the individual Prothesentei- le by the mechanical load, in use, is not to be feared.
The solution described above has the disadvantage that with such a prosthesis, the plug-in connection zwi¬ rule the items in the implanted condition can not be ge triggers, although this medical reasons - is sometimes necessary - in part, for example for repositioning or replacement of the Kopf¬ , The conical plug connections hold even after prior removal of the tie rod provided inside the shaft together so tightly that when the necessary disassembly, to the detriment of the patient damage to the door or Fe, at least one unwanted loosening of the stem, under certain circumstances can not be avoided.
Based on the deficiencies of the prior art the invention has the object of providing a odularen Gelenk¬ prosthesis of the type mentioned to provide that allows in a simple way a release of the individual elements unterein¬ other externally.
The invention includes the recognition that with a bolt considerable compressive forces can be generated in the axial direction when the bolt end is supported on an abutment. For this purpose also the edge of the hole of a subsequent shaft member under the condition is ge is that the outer diameter of a tion in the threaded hole to be screwed bolt is larger than the inside diameter of the subsequent element. Since an exchange is preferably used (for advanced disease, or due ande rer indications) for the head element in loading tracht, the following elements can have a constant diameter Boh¬ tion, in which case optionally the ge (distal) last element a thread (comprising elements a tie rod for connecting the Schaftele¬ or having to set the cone members. the force for releasing two consecutive Elemen¬ te can to be so comfortable reached, the lower its slope is selected.
, Is particularly advantageous in the invention that the removed without bones remain in the space lower part of the shaft to ent remote near the joint head part and can be replaced if necessary. Thus a much lower load on the patient is connected to conventional prostheses. Also, if you remove the head of the corresponding bone interior can be achieved for other purposes Behandlungs¬. are meant by "head" in the present context near the joint portion of the prosthesis, which can be used advantageously in other parts of the body in the event of joint replacement.
Prosthesis designed as a modular system, at least as the top part and end part of a system verschiede¬ ne individual elements of different size on which vor¬ preferably by mating their corresponding conical see stud or recess having proximal and distal ends are joined together. The required Liehe stability of the connector is - secured screw - preferred wise designed as tie rods. The end part is designed as a hollow shaft, wherein the axially extending longitudinal bore of the carrier part carries a thread at its proximal end portion. The tie rod is guided through a lying on the same axis as the longitudinal bore in the support part cylindrical channel in the head part and screwed into the threaded end portion.
According to the preferred embodiment of the invention, the cylindrical channel in the head part of the modular hip prosthesis stem is at least partially designed as a threaded bore. This threaded hole in this case has a diameter which is larger than the diameter of the tie rod receiving threaded bore in the following shaft part. This diameter design ensures on, advantageous manner that, when mated Prothesentei¬ len on the proximal provided frustoconical En- de of the following shaft part, a free, annular in wesentli chen surface area of ​​the top surface of the truncated cone remains. This surface area is available as an abutment for a screw bolt provided which can be screwed into the head portion after removal of the tension rod. The screwed into the bolt head portion is supported on said substantially circular ring ausge¬ formed abutment. In a further screwing in a favorable manner, an axial pressure force is generated, which the extent dissolves (in spite of the absence of tie rods) fixed conical plug connection between the head and subsequent Schaft¬ part, that the head part for replacement corresponds taken or with respect to the following shank portion in ge wünschtem dimensions can be pivoted on dessem at the proximal end provided frusto-conical pin. To secure the transmission of force when releasing the connection between the head and the succeeding shaft part derlagerfläche sufficiently large Wi¬ a, a diameter ratio of the holes in the head or following shaft part is in the range of 1.5 to 2.5 is favorable.
According to another advantageous development of the dung Erfin extends for the screw bolt the threads provided in the head part of the modular hip prosthesis shaft over the entire length of the existing cylindrical Ka¬ Nals. Both for the threaded bore in the head part of the hip prosthesis stem as well as the threaded portion at the proximal end of the following shaft part a me¬ tric thread is provided. Preferably, the thread in the head part a lower pitch than the threads on the proximal end of the following shaft part, thereby facilitating the generation of the time required for dissolving the most fe¬ conical Steckverbinduung pressure force by the bolts.
According to a further advantageous embodiment of the inventions fertil the measures described can be used several times in aufeinander¬ following elements of the same modular shaft using various gradations. When performed here illustration, only the word "head" with "towards distally advanced continuous shaft element" here would be to replace. It can be seen that the gradations of the diameter of the bores thereby enlarge each distal direction. According to an additional further development of Erfin dung, the proximal end of the foreseen in the subsequent Schaft¬ partially threaded bore a recess, which is formed as arranged symmetrically to the longitudinal axis of the bore chamfer in a favorable manner. It is thus achieved in an advantageous manner that the Schraubbol¬ zen, the free end also overall the same angle is almost formed, can not engage the threads of the rich provided for in this Working threaded bore in operative contact when supporting on the proximal end of the supporting part and when generating the to release the conical Steck¬ connection between the head and the succeeding shaft part required pressure force er¬ a deformation of the first Gewin¬ degänge is avoided. A deformed thread would fit on or re-screwing the tie rod into the proximal end of the following shaft part to make Aus¬ exchange of the head impossible. For the Kraftein¬ line in the abutment is an inclination angle of Anfa¬ solution low in the range of 45 ° in respect to the central axis of the corresponding threaded hole.
The head part has, on its medial side below the cone for the joint connection legs groove on forming in a favorable manner a recognition and support region for a tool that is used for tilting or withdrawing of the head portion after the conical connection between the head and the succeeding shaft part , as described vorste¬ starting been solved.
In order to ensure greatest possible adjustment of the hinge shaft to the anatomical conditions of a patient, for the manufacture of a customizing shaft is a kit with differently shaped head and stem portions following advantage. The individual parts of the hip joint shaft with different diameters, of length and curvature. They can be combined with each other under prerequisite of a coordinated outer diameter.
1 shows the preferred embodiment of the invention in a schematic partial sectional view,
Figure la is a sectional view taken along line A ... A as shown in FIG 1,
2 shows a simplified representation of the preferred embodiment of the invention according to Figure 1 as a view from the left and Seiten¬
3 shows an enlarged view of detail E in FIG. 1
The view in the figures 1, la and 2 in the form of a Seitenan¬, a cut or a partial cut darge presented modular joint prosthesis l consists of a shaft portion 2 and a head part 3, each of which has a profiling in the longitudinal direction. The parts 2 and 3 of the shaft 1 are connected lying on the same axis and relative to each other by means of a conical connection Steck¬ 10th a (not shown) is tie rods provided for the "setting" of the cone and to secure these plug-in connection against axial disengagement, which is guided through the form of a threaded bore channel 5 of the head part 3 and ausge¬ in a threaded bore 6 formed proximal region of the subsequent Schaft¬ part 2 provided for channel 4 is screwed. screw the input data takes place that abuts the proximal end of the tie rod in the recess 7 and thereby the Ein¬ individual parts are moved axially towards each other 2 and 3 of the modular hip prosthesis shaft 1 until the conical Steck¬ having connection 10 the desired strength.
To the position of a joint connection cone 9 aufwei¬ send head part 3 with respect to the following Schaft¬ part 2 to be able to change or replace the entire head part 3, the conical plug-in connection 10 has to be solved again. After releasing and unscrewing the (not shown) Zu¬ ganker a (also not shown) is Schraub¬ bolt into the threaded hole 5 of the head part 3 einge¬ screwed. Since the diameter D * j _ the threaded hole 5 in the head part 3 has a larger value than the diameter D 2 of the proximal, threaded certain sections 6 of the central bore 4 of the following shaft part 2, the screw bolt is supported on a in its square measure by the difference in diameter D l ~ D 2 fixed circular ring on the top surface 8 of the formed as a truncated cone proximal end of the Kopf¬ part 3, and is thus able to generate an axially directed compressive force. This force overcomes the after "setting" of the cone very strong connector 10 and er¬ enables in a convenient manner, a further adjustment of the hip prosthesis shaft 1 to changing physical loading conditions of a patient.
The provided on the medial side of the head portion 3 below the joint-connecting cone 9 groove 9a is 10 zwi¬'s head and the succeeding shaft part se pivoted on the same Ach¬ as a starting point for a tool, with which the head portion 3 after re-dissolution of the conical plug-in connection or in case of need can be subtracted from the following shank part.
In this context it has proved to be favorable for the handling of the means for generating the force required to detachment of the conical Steck¬ connection-pressure force, a diameter ratio of the holes 4, 5 to provide in the range of 1.5 to 2.5 and the bore 5 to be provided over the entire length with a thread. Are used vorzugt metric thread, the thread of the threaded bore 5 has a lower pitch in the head part 3 and the threads in the proximal portion 6 of the bore 4 of the following shaft part. 2
The increases shown in Figure 3 detail E of Figure 1 shows an advantageous development of the invention shown in Figures 1, la and 2. FIG. In order to prevent damage to the provided therein threaded portion 6 is made possible by the effect of engagement of the bolt (not shown) at the top of the proximal end of the following shaft part 2, a recess 11 formed aus¬ as a chamfer is provided at the proximal end of the threaded bore , The inclination of the Flan¬ ken 12 is 45 ° and corresponds to the inclination of the flank chamfer on the threaded end of the (not shown) Schraub¬ bolt. Characterized can be made an optimum force into the following shaft portion 2 to allow the disengagement of the conical plug-in connection 10 between succeeding shaft part 3 and the head part 2 set with a relatively small force introduction. In this way, the Kopf¬ can partially remove without significant effort and with only minor reaction forces with Implanted stem at a potentially er¬ ford variable reoperation. In order for a dissolution or loosening of the remaining is the stem part with great certainty avoided in the bone.
It can be seen that: - by the er¬ aimed modularity in a system of shaft prostheses to achieve different individually based Prot¬ various elements sizes hesenformen combined - at dar¬ not identified in the drawing - to further embodiments. The graduation of the present invention the thread diameter may also be provided between each of the different aufein¬ other following elements. This makes it possible, for example a separation - if desired - to effect not only between the headboard and the di¬ stal subsequent toward shank portion, but also between the shaft parts together. For targeted "dialing" of a compound for releasing then toward gradual vergröpßernden with them toward the headend size of thread, a bolt which in the gele¬ on the proximal side of the intended dividing point antigenic shaft element would have to be chosen diameters whose outer thread engages the inner thread engaging engages. He then supported with the edge of its end on the edge of the hole of the distal adjacent element and separates the ausge¬ selected connection.
1. Modular joint prosthesis having a head portion and minde- least a shank part, which - preferably by means of a cone connection - plug are connected to each other, wherein a set or securing the plug-in connection traversal by means of a substantially coaxial with the longitudinal axis of the shaft part coaxially by both parts drilling can be carried extending first screw means,
that in the head part (3) or one end in the direction of the shank preceding shaft part provided bore (5) is provided with a thread for a screw means which for releasing the plug-in connection with the subsequent Ele¬ ment an outer diameter (D ^) comprises which is greater than the inner diameter (D 2) arranged in the subsequent the shank part (2) bore.
2. A joint prosthesis according to claim 1, dadurchge ¬ indicates that the ratio of the larger diameter (D ^ to the smaller diameter (D 2) is between 1.5 and 2.5.
3. A joint prosthesis according to claim 1, dadurchge - indicates that the thread in the in
(3) head part or in the proximal direction in vorangehen- arranged the shaft part bore (5) extending over its entire length.
, A joint prosthesis according to claim 1, dadurchge ¬ indicates that the shaft in the downstream part (2) provided in the bore (4) is provided only in the region ih¬ res proximal end (6) with a thread.
5. A joint prosthesis according to one of the preceding che Ansprü¬, characterized in that the proximal end of the threaded bore (6) of the downstream shaft part (2) has a chamfer (11).
to the central axis of the threaded bore (6) has an angle of inclination of which 6. A joint prosthesis according to claim 5, dadurchge ¬ indicates that the chamfer (11) based substantially 45 °.
che 7. Joint prosthesis according to one of the preceding Ansprü¬, characterized in that on the medial side of the head part (3) below the joint-connecting cone (9) a groove (9a) with sentlichen in we¬ arcuate limitation is provided.
8. kit for producing a joint prosthesis according to ei¬ nem of the preceding claims, gekennzeich - netdurch a selection of head parts (3) unter¬ different lengths and / or different diameter as well as a selection of shaft parts (2) of differing length, differing diameter and / or of different curvature.
9. A kit according to claim 8, dadurchgekenn ¬ characterized in that for the head parts (3) a Durchmes- ser in the range of 12 to 17 mm and for the shaft parts (2) a length ranging from 200 to 320 mm and a Durchmes¬ diameter range of 10 is provided to 14 mm.
PCT/DE1995/001653 1994-11-19 1995-11-20 Modular artificial hip joint WO1996015738A1 (en)
DEP4442205.9 1994-11-19
DE1995508177 DE59508177D1 (en) 1994-11-19 1995-11-20 Modulare hüftgelenkprothese
AU39229/95A AU3922995A (en) 1994-11-19 1995-11-20 Modular artificial hip joint
JP51645696A JP3548579B2 (en) 1994-11-19 1995-11-20 Modular artificial hip joint
US08/836,707 US6238436B1 (en) 1994-11-19 1995-11-20 Modular artificial hip joint
AT95936971T AT191633T (en) 1994-11-19 1995-11-20 Modular hip prosthesis
EP19950936971 EP0792128B1 (en) 1994-11-19 1995-11-20 Modular artificial hip joint
WO1996015738A1 true WO1996015738A1 (en) 1996-05-30
US6238436B1 (en) 2001-05-29
Ref document number: 1995936971
Ref document number: 08836707