WO1994001063A1 - Implant et son procede de production - Google Patents

Implant et son procede de production Download PDF

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Publication number
WO1994001063A1
WO1994001063A1 PCT/EP1993/001800 EP9301800W WO9401063A1 WO 1994001063 A1 WO1994001063 A1 WO 1994001063A1 EP 9301800 W EP9301800 W EP 9301800W WO 9401063 A1 WO9401063 A1 WO 9401063A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
hollow body
implant according
hollow
another
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.)
Ceased
Application number
PCT/EP1993/001800
Other languages
German (de)
English (en)
Inventor
Klaus Draenert
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to EP93915863A priority Critical patent/EP0649296A1/fr
Priority to JP6502975A priority patent/JPH07508673A/ja
Publication of WO1994001063A1 publication Critical patent/WO1994001063A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/56—Porous materials, e.g. foams or sponges
    • 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
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
    • A61L27/16—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
    • A61L27/22—Polypeptides or derivatives thereof, e.g. degradation products
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28—Materials for coating prostheses
    • A61L27/30—Inorganic materials
    • A61L27/32—Phosphorus-containing materials, e.g. apatite
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8822—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive
    • 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
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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
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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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4614—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of plugs for sealing a cement-receiving space
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • 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
    • A61F2002/30011—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 porosity
    • 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
    • A61F2002/30003—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
    • 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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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/302—Three-dimensional shapes toroidal, e.g. rings
    • A—HUMAN NECESSITIES
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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
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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
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    • A61F2002/30593—Special structural features of bone or joint prostheses not otherwise provided for hollow
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    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2250/0023—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 porosity
    • A61F2250/0024—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 porosity made from both porous and non-porous parts, e.g. adjacent 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
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063—Nested prosthetic 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
    • 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
    • A61F2310/00353—Bone cement, e.g. polymethylmethacrylate or PMMA
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00—Materials or treatment for tissue regeneration
    • A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants

Definitions

  • the invention relates to an implant, in particular a marrow stopper or marrow blocker, a method for its manufacture and its use in a method for sealing a medullary cavity.
  • the so-called bone cement for example made of polymethyl methacrylate (PMMA), which is introduced into the bony bed by means of a syringe.
  • PMMA polymethyl methacrylate
  • the so-called vacuum application by means of a vacuum cannula, as described for example in WO 88/06023, the bone cement can also be sucked into the bone by applying a vacuum.
  • the plastic cement mass is advanced from the prosthesis shaft in front of the tip of the prosthesis component into the depth of the medullary cavity and the desired transverse compression of the bone cement into the bone marrow spaces does not occur, which results in a slight "interlocking"; an early loosening of the prosthesis component is thus preprogrammed.
  • the second problem is that, in the vacuum application, a suction is exerted on the bone cavity by means of a vacuum cannula inserted into the bone and the bone cement is sucked into the bone cavity, the bone cement being able to displace or block the vacuum cannula in direct flow.
  • a filter is therefore required which, on the one hand, can stop the cement at a certain height of the long bone and prevent further penetration and, on the other hand, ensures that the cannula can suck and is not blocked by cement, abrasion material or blood.
  • an implant or marrow stopper was already proposed in WO 92/06718. Under unfavorable circumstances, however, this marrow stopper can be used to prevent problems in sealing the marrow cavity in the depth of the femoral marrow cavity, for example at a depth of about 17 to 21 cm occur.
  • the medullary cavity resembles a blunt cone cone with an ellipsoidal cross section in the sagittal direction. With cylindrical implants, given the dimensions of the medullary cavity, it is difficult to seal the medullary cavity, even if the implants are deformable.
  • the invention is therefore based on the object of providing an implant, in particular in the form of a medullary space stopper or medullary space block, which solves both the problem of the filter and the problem of sealing the femoral marrow space.
  • the implant according to the invention consists of at least one hollow body which can be deformed elastically, viscoelastically or plastically.
  • the hollow body can be at least partially porous.
  • the pores of the hollow body are preferably continuously connected to one another and form an open-pore structure.
  • the hollow body preferably has the shape of a hollow ball.
  • the wall of at least part of the hollow sphere, for example a half shell, is preferably porous.
  • the implant according to the invention can be inserted occlusively into a long bone and seal the medullary cavity.
  • the hollow body may also not have an exact, but only approximately the shape of a hollow sphere or the shape of a hollow ellipsoid, preferably a rotational ellipsoid, i.e. the shape of a rotationally symmetrical body, the longitudinal axis of which is longer than its transverse diameter, approximately in a ratio of 1: 1 to 2: 1.
  • the surface of the hollow body can also be profiled in a ring shape, the envelope of these rings preferably having the shape of a sphere or an ellipsoid.
  • the hollow body can be constructed from several, for example 5 to 9, bead-shaped rings.
  • the hollow body can also be constructed with two walls and have an outer permeable wall and an inner impermeable wall which encloses a closed cavity.
  • the cavity can be filled with liquid and filled, for example, via a valve.
  • Such a hollow body filled with water is plastically deformable in an ideal manner and adapts perfectly to every contour of the medullary cavity when it is introduced into the medullary cavity, so that a seal of the medullary cavity is ensured.
  • the hollow body can also be designed such that it becomes deformable by heating and in this way adapts to the inner contour of the medullary cavity when inserted into the bone.
  • the implant can consist of a resorbable or non-resorbable material.
  • the implant can preferably consist of a polyamic acid, a derivative of a polyamino acid, a collagen, a chitin derivative or chitosan, keratin or another resorbable polymer.
  • the hollow body can be produced in a simple manner from two preferably identical half-shells.
  • the half-shells are preferably made of a resorbable material and can be pressed from a felt, for example.
  • the two half-shells are then glued to form the hollow body, preferably a spherical hollow body.
  • the hollow body according to the invention can be pressed in a simple manner from resorbable thread material, for example from textures, preferably layered textures, or in the form of a felt.
  • the thread material is preferably made of polymethyl ethacrylate.
  • two half-shells are first produced, which are glued to one another. In this way, hollow bodies, for example hollow spheres, of different diameters can be produced.
  • the hollow body can also either be coated on its surface or consistently equipped in the entire hollow body, for example in the form of particles.
  • the coating or assembly can consist, for example, of tricalcium phosphate, hydroxylapatite or another calcium phosphate or calcium carbonate.
  • the implant according to the invention preferably consists of two hollow bodies.
  • one of the two hollow bodies is preferably at least partially porous, while the other hollow body body is at least not porous to the outside.
  • the two hollow bodies can be connected to one another, for example connected or glued to one another on their surface, or connected to one another via a connecting piece, for example a web.
  • the web preferably consists of the same material as the two hollow bodies.
  • the diameter of the hollow sphere or the diameter of the long or short semiaxis of the ellipsoid of revolution is preferably approximately 14 mm.
  • a series of hollow bodies with different diameters can also be provided in order to be able to reliably seal all individual medullary cavities; in this case the diameters are preferably approximately 10 to 18 mm, particularly preferably 12 to 16 mm.
  • WO 92/06718 discloses a medullary space block with continuously porous structures and a method for its production.
  • This method can be modified according to the invention in such a way that the soluble substances are glued in the center of the implant according to the invention, then the implant is injected and the content of the continuously porous implant, ie the soluble substances, is washed out.
  • a hollow body with a porous outer wall can also be produced with this method. This can be done, for example, as follows: Sugar balls are glued to a conglomerate in water vapor. The outer layers are then glued on in such a way that the core is glued more firmly than the balls on the outer layer.
  • the resulting body is placed in an injection mold and injected with a bone cement, for example a conventional bone cement such as PMMA.
  • a bone cement for example a conventional bone cement such as PMMA.
  • the bead polymer of any conventional bone cement can be used.
  • the hardened composite body is then washed, the sugar is dissolved out, and the implant is finished with it.
  • the implant can either be uncoated or inserted after coating.
  • the coating can be carried out with tricalcium phosphate or hydroxyapatite, which can be sputtered on, for example, or by spraying the polymer powder with tricalcium phosphate.
  • the implant produced in this way is then placed in water at about 80 ° C. shortly before it is used in the operating room.
  • the implant according to the invention can furthermore also be filled with a filler material, for example an antibiotic, as is known from the bone cements containing antibiotics.
  • the implant according to the invention is preferably used in a vacuum application method, as described, for example, in WO 88/06023.
  • the implant is removed from the hot water using an applicator and inserted into the medullary cavity.
  • the implant is filled with, for example, water at about 80 ° C. and is plastically deformable, and therefore ideally adapts to the inner contour of the medullary cavity.
  • the applicator can be, for example, a conical thread on a flexible metal rod.
  • the implant according to the invention is with the applicator in the medullary cavity up to the level of the drill hole of the drainage cannula.
  • the procedure here is that the borehole is created based on the x-ray image after planning, normally at a height of between 17 and 21 cm, starting from the greater trochanter.
  • the thread is then cut and, if necessary, the cannula is screwed in at the same time.
  • a Kirschner wire is pushed through the cannula.
  • the medullary cavity is then opened, preferably with a diamond hollow loop or a diamond hollow loop instrument, and the femoral neck is osteotomized along a guide instrument.
  • the bony opening pin is then twisted off and removed with an extractor, and the medullary cavity is probed. Subsequently, the bone marrow is aspirated proximally and the marrow cavity is carefully washed out.
  • a hollow body implant (plug) according to the invention is then inserted into the medullary cavity with a guide instrument or applicator up to the height of the Kirschner wire. This wobbles when the plug is pushed and is then pulled back.
  • the hollow body implant can then be advanced even further, for example by approximately 10 mm.
  • the vacuum cannula is then further screwed on, for example about 1 1/2 turns, as a result of which the hollow body implant is clamped in and the mouth of the cannula presses against the material, for example the felt, of the hollow body implant.
  • a vacuum then develops during suction, both in the hollow body implant and above the implant in the medullary cavity. If the material of the hollow body implant is selected appropriately, a vacuum drop cannot be measured, so that the material, for example the felt, does not impair the formation of the vacuum and represents practically no resistance to the vacuum.
  • FIG. 2 shows an implant according to the invention after insertion into the medullary cavity of a femur.
  • FIG. 1A shows the view of an implant 10 according to the invention, which consists of two hollow bodies 12 and 14.
  • Line 16 shows schematically that the two hollow bodies 12, 14 can either be connected to one another or separated.
  • Each of the two hollow bodies is annularly profiled, the individual rings in the lower hollow body 14 of FIG. 1A being provided with the reference symbol 18.
  • the overall shape of each hollow body 12, 14 is essentially a sphere, the sphere being the envelope of the individual rings.
  • the upper hollow body 12 has a bore 20 for receiving an applicator.
  • FIG. 1B shows the upper hollow body 12 in an exploded view with a section along the line B-B of FIG. 1A. It can be seen from FIG. 1B that the upper hollow body 12 has a continuously porous structure, while the lower hollow body 14, which is shown schematically as a sphere, is not porous.
  • the hollow bodies 12, 14 shown in FIGS. 1A and 1B can be produced in a simple manner.
  • the annularly profiled, essentially spherical and continuously porous hollow body 12 is produced using the principle of the lost shape, sugar balls first being glued to a conglomerate, then sprayed in an injection mold, for example with PMMA, and then detached .
  • the hollow body 14 can be produced, for example, in the hollow injection molding process. It is also possible to use a solid body, for example a solid ball, instead of the lower hollow body 14.
  • 2 shows the application of an implant 10 according to the invention into a femur 30 with an inner contour 34.
  • the porous bone structure is shown schematically in the upper part of the Fe 30 and also the so-called load triangle 32 is indicated by line structures.
  • FIG. 2 shows a cannula 40 for vacuum application with a continuous inner channel 42 and a thread 44.
  • the non-porous body 14 and the continuously porous spherical hollow body 12 are either placed one after the other or, if they are connected to one another, by means of an applicator which is brought into engagement with the bore 20, from proximal to the medullary cavity . Due to the deformation of the lower body 14, it comes into full engagement with the inner contour 34 of the medullary cavity and seals the medullary cavity distally.
  • the continuously porous hollow body 12 can be somewhat larger in diameter than the body 14, and also comes into full engagement with the inner contour 34 of the medullary cavity.
  • the cannula 40 is then placed between the two bodies 12, 14, for example using a target device (not shown), as shown in FIG. 2.

Landscapes

  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Public Health (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Veterinary Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Medicinal Chemistry (AREA)
  • Dermatology (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Inorganic Chemistry (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Dispersion Chemistry (AREA)
  • Prostheses (AREA)

Abstract

Un implant (10), notamment un bouchon ou un obturateur du canal médullaire, comprend au moins un corps creux (12) dont la paroi est au moins partiellement poreuse, élastiquement, visco-élastiquement ou plastiquement déformable et pouvant être introduit dans un os long de manière à l'obturer. L'implant a l'avantage d'être adaptable à différents diamètres de canal médullaire, ce qui permet de fermer hermétiquement pratiquement tous les canaux médullaires.
PCT/EP1993/001800 1992-07-10 1993-07-09 Implant et son procede de production Ceased WO1994001063A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP93915863A EP0649296A1 (fr) 1992-07-10 1993-07-09 Implant et son procede de production
JP6502975A JPH07508673A (ja) 1992-07-10 1993-07-09 インプラントおよびその製造方法

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP4222763.1 1992-07-10
DE4222763A DE4222763A1 (de) 1992-07-10 1992-07-10 Implantat und Verfahren zu seiner Herstellung

Publications (1)

Publication Number Publication Date
WO1994001063A1 true WO1994001063A1 (fr) 1994-01-20

Family

ID=6462958

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1993/001800 Ceased WO1994001063A1 (fr) 1992-07-10 1993-07-09 Implant et son procede de production

Country Status (4)

Country Link
EP (1) EP0649296A1 (fr)
JP (1) JPH07508673A (fr)
DE (1) DE4222763A1 (fr)
WO (1) WO1994001063A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0968690A1 (fr) * 1998-07-02 2000-01-05 Sulzer Orthopädie AG Système d'obturation pour le canal médullaire d'un os tubulaire
US9907884B2 (en) 2011-05-31 2018-03-06 Curasan Ag Biodegradable composite material

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19508647C2 (de) * 1994-06-29 1999-06-02 Biovision Gmbh Markraumsperre
DE19542351C2 (de) * 1995-11-14 1998-07-02 Jansson Volkmar Priv Doz Dr Me Markraumstopper zum Abdichten von Knochenöffnungen
US5932552A (en) 1997-11-26 1999-08-03 Keraplast Technologies Ltd. Keratin-based hydrogel for biomedical applications and method of production
US6371984B1 (en) 1999-09-13 2002-04-16 Keraplast Technologies, Ltd. Implantable prosthetic or tissue expanding device
US6783546B2 (en) 1999-09-13 2004-08-31 Keraplast Technologies, Ltd. Implantable prosthetic or tissue expanding device

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH648477A5 (de) * 1981-02-18 1985-03-29 Sulzer Ag Spreizbare markraumsperre.
DE3413596A1 (de) * 1984-04-11 1985-11-07 Hermann Heinrich M. Dauerer Markraum-verriegelungsnaegel und anwendungsverfahren
WO1992006653A1 (fr) * 1990-10-19 1992-04-30 Klaus Draenert Materiau et son procede de production

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CH648477A5 (de) * 1981-02-18 1985-03-29 Sulzer Ag Spreizbare markraumsperre.
DE3413596A1 (de) * 1984-04-11 1985-11-07 Hermann Heinrich M. Dauerer Markraum-verriegelungsnaegel und anwendungsverfahren
WO1992006653A1 (fr) * 1990-10-19 1992-04-30 Klaus Draenert Materiau et son procede de production

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0968690A1 (fr) * 1998-07-02 2000-01-05 Sulzer Orthopädie AG Système d'obturation pour le canal médullaire d'un os tubulaire
US6179842B1 (en) 1998-07-02 2001-01-30 Sulzer Orthopaedie Ag Blocking system for the medullary canal of a tubular bone
US9907884B2 (en) 2011-05-31 2018-03-06 Curasan Ag Biodegradable composite material

Also Published As

Publication number Publication date
EP0649296A1 (fr) 1995-04-26
JPH07508673A (ja) 1995-09-28
DE4222763A1 (de) 1994-01-13

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