WO1997007754A1 - Kugelgelenk-endoprothese - Google Patents

Kugelgelenk-endoprothese Download PDF

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Publication number
WO1997007754A1
WO1997007754A1 PCT/EP1996/003685 EP9603685W WO9707754A1 WO 1997007754 A1 WO1997007754 A1 WO 1997007754A1 EP 9603685 W EP9603685 W EP 9603685W WO 9707754 A1 WO9707754 A1 WO 9707754A1
Authority
WO
WIPO (PCT)
Prior art keywords
ring
endoprosthesis
joint
covered
protective ring
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/EP1996/003685
Other languages
English (en)
French (fr)
Inventor
Arnold Keller
Philipp Lubinus
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.)
Waldemar Link GmbH and Co KG
Original Assignee
Waldemar Link GmbH and Co KG
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 Waldemar Link GmbH and Co KG filed Critical Waldemar Link GmbH and Co KG
Priority to DE59609825T priority Critical patent/DE59609825D1/de
Priority to EP96929301A priority patent/EP0957833B1/de
Priority to AT96929301T priority patent/ATE226419T1/de
Priority to US09/029,024 priority patent/US6096083A/en
Priority to JP50982197A priority patent/JP3698729B2/ja
Publication of WO1997007754A1 publication Critical patent/WO1997007754A1/de
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
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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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    • 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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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30563—Special structural features of bone or joint prostheses not otherwise provided for having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • 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
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2310/00179—Ceramics or ceramic-like structures

Definitions

  • This guard ring is normally not subject to wear. However, it can happen that the neck supporting the joint head strikes the polyethylene ring during a strongly sweeping movement. This can lead to harmful abrasion. It has also been shown that the protective ring can be deformed, so that its protective function for the ceramic part is impaired.
  • the end face of the protective ring is covered by a cover ring made of resistant material.
  • This material can be metal or a resistant plastic. So that in the event of subluxation the surface of the joint head cannot hit the cover ring and be damaged, the
  • FIG. 1 shows an enlarged longitudinal section through a hip joint endoprosthesis and FIG. 2 shows an even further enlarged partial section through the edge of the
  • the acetabular cup 1 comprises a socket 2, a polyethylene body 3 and a ceramic insert 4.
  • the socket 2 is designed externally so that it can be anchored easily and permanently in the bone. For this purpose, it is provided with projections 5, for example.
  • projections 5 for example.
  • the polyethylene body 3 has a frustoconical inner shape 8, 9, which corresponds to the outer shape of the ceramic insert 4 without play, possibly with a little oversize.
  • This consists of a physiologically compatible, highly wear-resistant ceramic material, for example highly pure aluminum oxide ceramic.
  • It forms a spherical sliding surface 10 which corresponds to the spherical shape of the joint head 11 mounted therein.
  • the spherical sliding surface 10 extends in each direction over approximately 180 °; the equator of the spherical surface forming the sliding surface 10 lies somewhere between the beginning of the rounded edge 12 and the end surface 13.
  • a protective ring 14 made of high-density polyethylene or similar resilient, preferably sufficiently elastic material is placed on the end face 13 of the ceramic insert, which in turn is largely covered by a protective ring 15 made of suitable metal, for example titanium.
  • this is designed as a threaded ring which interacts with the polyethylene body 3 via a thread 16 in order to secure the ceramic insert 4 and the protective ring 14 in place.
  • a fuse not shown, can be provided which prevents the cover ring 15 from being unintentionally unscrewed.
  • the polyethylene body 13 causes a uniformly distributed force transmission from the ceramic body 4 to the holder 2 and thereby prevents harmful stress concentrations on the ceramic body 4.
  • the protective ring 14 distributes the holding force originating from the cover ring 15 while avoiding stress peaks on the end face 13 of the Ceramic body 4.
  • the protective ring 14 as seen from the sliding surface 10 of the ceramic body 4, preferably located on the other side of the equator, protrudes on the inside up to approximately the imaginary spherical surface that continues the sliding surface 10 on the opening side.
  • it expediently has a little play with respect to the joint head 11 when it rests properly on the sliding surface 10 so that polyethylene wear is avoided and the joint fluid has free access to the sliding gap.
  • it is expedient if its inside diameter is a little smaller than the maximum diameter of the joint head 11 in order to form a force threshold against the joint head sliding out of the joint socket. Most subluxations can be prevented in this way.
  • the force threshold should, however, be less than the force at which the joint head 11 can detach from the cone pin 17 in the bearing.
  • the cover ring 15 protects the protective ring 14 from possibly damaging impacts on the part of the head neck 18. Because of this protection, it can be produced with greatly reduced dimensions. Its thickness is, for example, on the order of one millimeter.
  • the collar 19 can even protrude slightly beyond the edge of the cover ring 15 on the opening side.
  • One accepts that the neck 18 of the head can strike the collar 19. As long as it can dodge elastically, this is harmless.
  • the elastic evasion is possible for him that a wedge gap opens between the opening-side edge rounding 12 of the ceramic insert and the protective ring 14, into which the inner edge of the protective ring can elastically recede in such a case.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Photometry And Measurement Of Optical Pulse Characteristics (AREA)
  • Sealing Devices (AREA)

Abstract

Bei einer Kugelgelenk-Endoprothese, deren Gelenkkopf und Gelenkpfanne (4) aus keramischem Werkstoff bestehen, wobei die Öffnungskante (12) der Gelenkpfanne (4) von einem Schutzring (14) aus Polyethylen abgedeckt ist, ist die Stirnseite des Schutzrings (14) durch einen Abdeckring (15) aus widerstandsfähigem Material abgedeckt. Zweckmässigerweise ist der Innenrand (20) des Abdeckrings (15) von dem Schutzring (14, 19) überdeckt.

Description

Kugelgelenk-Endoprothese
Es ist bekannt (EP-A 53794), die Gelenkpfanne einer Kugelgelenk-Endoprothese, beispielsweise einer Hüftprothese, mit einer Gleitfläche aus keramischem Werkstoff auszurüsten. Wenn der darin geführte Gelenkkopf im Falle einer sogenannten Subluxation sich teilweise aus der vorgesehenen Lagerposition entfernt, kann es zu Linienkontakt mit der Gleitflächenkante kommen, was zu Schäden sowohl am Ge¬ lenkkopf als auch an der Kante der Gelenkpfanne führen kann. Es wurde deshalb vorgeschlagen, der Kante der Gelenkgleitfläche einen Schutzring aus plastisch ver¬ formbarem Polyethylen vorzuschalten (EP-A 53794).
Dieser Schutzring ist normalerweise keinem Verschleiß unterworfen. Jedoch kann es geschehen, daß der den Gelenkkopf tragende Hals bei stark ausladender Bewegung an dem Polyethylenring anschlägt. Dies kann zu schädlichem Abrieb führen. Auch hat sich gezeigt, daß der Schutzring dabei verformt werden kann, so daß seine Schutz¬ funktion für den Keramikteil beeinträchtigt wird.
Diese Nachteile werden erfindungsgemäß dadurch vermieden, daß die Stirnseite des Schutzrings durch einen Abdeckring aus widerstandsfähigem Material abgedeckt ist. Bei diesem Material kann es sich um Metall handeln oder auch um einen wider¬ standsfähigen Kunststoff. Damit im Falle einer Subluxation die Oberfläche des Ge- ι lenkkopfs nicht an dem Abdeckring anschlagen und beschädigt werden kann, ist der
I Schutzring zweckmäßigerweise so ausgebildet, daß er den Innenrand des Abdeck¬ rings überdeckt. Die Erfindung wird im folgenden näher unter Bezugnahme auf die Zeichnung erläu¬ tert, die ein vorteilhaftes Ausführungsbeispiel veranschaulicht. Darin zeigen: Fig. 1 einen vergrößerten Längsschnitt durch eine Hüftgelenk-Endoprothese und Fig. 2 einen noch weiter vergrößerten Teilschnitt durch den Rand der
Gelenkpfanne.
Die Hüftpfanne 1 umfaßt eine Fassung 2, einen Polyethylenkörper 3 und einen Kera¬ mikeinsatz 4. Die Fassung 2 ist äußerlich so gestaltet, daß sie sich leicht und dauer¬ haft im Knochen verankern läßt. Zu diesem Zweck ist sie beispielsweise mit Vor¬ sprüngen 5 versehen. Wegen der Einzelheiten kann auf den Stand der Technik ver¬ wiesen werden.
Sie weist eine kegelstumpfförmige Innenform 6, 7 auf, der die Außenform des Polye- thylenkörpers 3 entspricht. Diese kann nach Implantation der Fassung 2 im wesentli¬ chen spielfrei darin eingesetzt und verankert werden. Auch dies ist bekannt.
Der Polyethylenkörper 3 hat eine kegelstumpfförmige Innenform 8, 9, der spielfrei, ggf. mit etwas Übermaß die Außenform des Keramikeinsatzes 4 entspricht. Dieser besteht aus einem physiologisch verträglichen, hochverschleißfesten Keramikmateri¬ al, beispielsweise hochreiner Aluminiumoxydkeramik. Er bildet eine sphärische Gleit¬ fläche 10, die der sphärischen Gestalt des darin gelagerten Gelenkkopfs 11 ent¬ spricht. Die sphärische Gleitfläche 10 erstreckt sich in jeder Richtung über etwa 180°; der Äquator der die Gleitfläche 10 bildenden sphärischen Fläche liegt irgenwo zwi¬ schen dem Beginn der Kantenrundung 12 und der Stirnfläche 13.
Auf die Stirnfläche 13 des keramischen Einsatzes ist ein Schutzring 14 aus hoch¬ dichtem Polyethylen oder ähnlichem nachgiebigem, vorzugsweise hinreichend elasti¬ schem Material aufgelegt, der wiederum größtenteils von einem Schutzring 15 aus geeignetem Metall, beispielsweise Titan, abgedeckt ist. Dieser ist im dargestellten Beispiel als Gewindering ausgebildet, der über ein Gewinde 16 mit dem Polyethylen¬ körper 3 zusammenwirkt, um den Keramikeinsatz 4 und den Schutzring 14 an Ort und Stelle zu sichern. Eine nicht dargestellte Sicherung kann vorgesehen sein, die das ungewollte Herausdrehen des Abdeckrings 15 verhindert. Der Polyethylenkörper 13 bewirkt eine gleichmäßig verteilte Kraftübertragung von dem Keramikkörper 4 auf die Fassung 2 und verhütet dadurch schädliche Span¬ nungskonzentrationen am Keramikkörper 4. Desgleichen verteilt der Schutzring 14 die von dem Abdeckring 15 herrührende Haltekraft unter Vermeidung von Spannungs¬ spitzen auf die Stirnfläche 13 des Keramikkörpers 4.
Der - von der Gleitfläche 10 des Keramikkörpers 4 her gesehen - vorzugsweise jen¬ seits des Äquators gelegene Schutzring 14 ragt innen bis etwa an diejenige gedachte sphärische Fläche vor, die die Gleitfläche 10 öffnungsseitig fortsetzt. Einerseits hat er zweckmäßigerweise ein wenig Spiel gegenüber dem Gelenkkopf 11 , wenn dieser ordnungsgemäß an der Gleitfläche 10 anliegt, damit Polyethylenabrieb vermieden wird und die Gelenkflüssigkeit freien Zugang zum Gleitspalt hat. Andererseits ist es zweckmäßig, wenn sein Innendurchmesser ein wenig kleiner ist als der Maximal¬ durchmesser des Gelenkkopfs 11 , um eine Kraftschwelle gegen das Herausgleiten des Gelenkkopfs aus der Gelenkpfanne zu bilden. Die meisten Subluxationen können auf diese Weise verhindert werden. Die Kraftschwelle soll aber geringer sein als die Kraft, bei der sich der Gelenkkopf 11 von dem in tragenden Konuszapfen 17 lösen kann.
Der Abdeckring 15 schützt den Schutzring 14 vor möglicherweise schädigenden Stö¬ ßen seitens des Kopfhalses 18. Aufgrund dieses Schutzes kann er mit stark redu¬ zierten Maßen hergestellt werden. Seine Dicke liegt beispielsweise in der Größenord¬ nung von einem Millimeter. An seinem inneren Rand weist er einen sich achsparallel nach außen erstreckenden Kragen 19 auf, der vor dem Innenrand 20 des Abdeck¬ rings 15 liegt und dadurch verhütet, daß der Gelenkkopf 11 unmittelbar mit dem aus härterem Material bestehenden Abdeckring 15 in möglicherweise schädigenden Kontakt treten kann. Der Kragen 19 kann, wie man in Fig. 2 sieht, öffnungsseitig so¬ gar etwas über den Rand des Abdeckrings 15 hinausragen. Zwar nimmt man dadurch in Kauf, daß der Kopfhals 18 an dem Kragen 19 anschlagen kann. Solange dieser elastisch ausweichen kann, ist dies jedoch unschädlich. Das elastische Ausweichen ist ihm dadurch möglich, daß zwischen der öffnungsseitigen Kantenrundung 12 des Keramikeinsatzes und dem Schutzring 14 ein Keilspalt sich öffnet, in den hinein der innere Rand des Schutzrings in einem solchen Fall elastisch zurückweichen kann.

Claims

Patentansprüche
1. Endoprothese, die einen Gelenkkopf (11) und eine Gelenkpfanne (1) umfaßt, deren Gelenkgleitfläche (10) von einem Teil (4) aus keramischem Werkstoff gebildet ist und deren Öffnungskante (12) von einem Schutzring (14) aus nachgiebigem Material wie Polyethylen abgedeckt ist, dadurch gekennzeich¬ net, daß die Stirnseite des Schutzrings (14) durch einen Abdeckring (15) aus widerstandsfähigem Material abgedeckt ist.
2. Endoprothese nach Anspruch 1 , dadurch gekennzeichnet, daß der Innenrand (20) des Abdeckrings (15) von dem Schutzring (14, 19) überdeckt ist.
3. Endoprothese nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß die Öffnungskante (12) des keramischen Teils (4) abgerundet ist.
4. Endoprothese nach Anspruch 3, dadurch gekennzeichnet, daß die Abrundung (12) einen Keilspalt zwischen dem keramischen Einsatz (4) und dem Schutz¬ ring (14) bildet.
PCT/EP1996/003685 1995-08-25 1996-08-21 Kugelgelenk-endoprothese Ceased WO1997007754A1 (de)

Priority Applications (5)

Application Number Priority Date Filing Date Title
DE59609825T DE59609825D1 (de) 1995-08-25 1996-08-21 Kugelgelenk-endoprothese
EP96929301A EP0957833B1 (de) 1995-08-25 1996-08-21 Kugelgelenk-endoprothese
AT96929301T ATE226419T1 (de) 1995-08-25 1996-08-21 Kugelgelenk-endoprothese
US09/029,024 US6096083A (en) 1995-08-25 1996-08-21 Endoprosthesis with a ball-and-socket joint
JP50982197A JP3698729B2 (ja) 1995-08-25 1996-08-21 ボール−ソケット連結部を備える内部人工補綴物

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE29513694.4 1995-08-25
DE29513694U DE29513694U1 (de) 1995-08-25 1995-08-25 Gelenkpfanne für eine Endoprothese

Publications (1)

Publication Number Publication Date
WO1997007754A1 true WO1997007754A1 (de) 1997-03-06

Family

ID=8012232

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1996/003685 Ceased WO1997007754A1 (de) 1995-08-25 1996-08-21 Kugelgelenk-endoprothese

Country Status (8)

Country Link
US (1) US6096083A (de)
EP (1) EP0957833B1 (de)
JP (1) JP3698729B2 (de)
KR (1) KR100380594B1 (de)
AT (1) ATE226419T1 (de)
DE (2) DE29513694U1 (de)
ES (1) ES2185799T3 (de)
WO (1) WO1997007754A1 (de)

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Also Published As

Publication number Publication date
JP3698729B2 (ja) 2005-09-21
US6096083A (en) 2000-08-01
ATE226419T1 (de) 2002-11-15
EP0957833B1 (de) 2002-10-23
DE29513694U1 (de) 1997-01-02
KR100380594B1 (ko) 2004-02-11
DE59609825D1 (de) 2002-11-28
JPH11511342A (ja) 1999-10-05
KR19990044114A (ko) 1999-06-25
EP0957833A1 (de) 1999-11-24
ES2185799T3 (es) 2003-05-01

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