WO2001005335A1 - Oberschenkelstumpf-endoprothese für eine exoprothetische versorgung - Google Patents

Oberschenkelstumpf-endoprothese für eine exoprothetische versorgung Download PDF

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Publication number
WO2001005335A1
WO2001005335A1 PCT/EP2000/004552 EP0004552W WO0105335A1 WO 2001005335 A1 WO2001005335 A1 WO 2001005335A1 EP 0004552 W EP0004552 W EP 0004552W WO 0105335 A1 WO0105335 A1 WO 0105335A1
Authority
WO
WIPO (PCT)
Prior art keywords
thigh
stump
thigh stump
exoprosthetic
leg
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/EP2000/004552
Other languages
English (en)
French (fr)
Inventor
Hans Grundei
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.)
Eska Implants GmbH and Co KG
Original Assignee
Eska Implants 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
Priority claimed from DE1999132388 external-priority patent/DE19932388C1/de
Application filed by Eska Implants GmbH and Co KG filed Critical Eska Implants GmbH and Co KG
Priority to US09/913,036 priority Critical patent/US6709466B1/en
Priority to JP2001510395A priority patent/JP2003504153A/ja
Priority to AT00936758T priority patent/ATE229775T1/de
Priority to EP00936758A priority patent/EP1119319B1/de
Priority to DE50000961T priority patent/DE50000961D1/de
Priority to HK02100810.6A priority patent/HK1039741B/zh
Publication of WO2001005335A1 publication Critical patent/WO2001005335A1/de
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

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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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical

Definitions

  • the present invention relates to a thigh stump endoprosthesis for an exoprosthetic care of a leg amputated in the thigh area.
  • the thigh stump can be pulled into a shaft, which is followed by the replica of a knee, lower and foot part of the prosthesis.
  • the endoprosthesis has a proximal stem part that can be placed in a femoral stump, the stem part being at least partially covered with an open-mesh, three-dimensional spatial network structure and having a conical adapter at its distal end, by means of which a condyle replacement, which is in the form of natural condyles of a knee joint is reproduced, is coupled to the stem part.
  • the object of the present invention is to further increase the patient's sense of perception.
  • a wedge-shaped base is connected to the condyle replacement, which restores the natural valgity, ie the angular position of the femoral stump in the medial direction.
  • the force distributions are modeled on the corresponding distributions in a healthy leg.
  • the wedge can create a parallelism between the underside of the wedge and the sliding surfaces of an artificial knee joint while largely maintaining the natural CCD Angle. This achieves an equalization of the load along the axis of the prosthesis.
  • An implant is already known from the field of surgery (US Pat. No. 5,766,251), which is designed as a wedge-shaped compensation piece, which allows corrections, for example, with regard to the valgity angle.
  • the wedge-shaped implant is used, among other things, in the joint area of the tibia, with which the tibial plateau is raised on one side in accordance with the angle of inclination of the wedge-shaped implant.
  • this publication does not refer to the use of this implant in the care of a leg amputee.
  • the wedge angle is in a range between 5 and 9 °.
  • the 5 ° are preferably used for male patients, the 9 ° maximum for female patients.
  • the pad is preferably connected to the shock-absorbing layer of the femoral stump endoprosthesis.
  • the formation of the base from a shock-absorbing cushion is particularly preferred, so that loads are not introduced directly into the femoral stump.
  • the base is preferably made of silicone.
  • the only drawing figure schematically shows a thigh stump 1 with a thigh stump endoprosthesis implanted in the femoral stump 5.
  • An intramedullary stem 4 forms the proximal stem part, which is placed in the medullary canal of the femoral stump.
  • the surface of the stem part 4 is covered with an open-mesh, three-dimensional network structure 6, through which bone trabeculae can grow, so that the stem part 4 has become part of the natural bone after a certain healing phase, as far as the substrate flow is concerned.
  • the stem part 4 is followed by a conical adapter 7 on the distal side.
  • the condyle replacement 11 is coupled to the stem part 4 on the distal side.
  • the condyle replacement part 8 is designed so that it emulates the shape 11 of natural condyles of a knee joint.
  • the condyle replacement 8 is coated with a shock-absorbing layer 10 made of silicone.
  • the base 16 is connected to the condyle replacement 8 or to the covering shock-absorbing layer.
  • the base 16 is wedge-shaped and has a wedge angle to the horizontal in the range of 5 ° ⁇ a ⁇ 9 °.
  • the pad 16 in the present case consists of a cushioning cushion and thus supports the absorption of shock loads on the knee, lower leg and foot parts 3 in the exemplary embodiment shown.
  • the wedge angle of the pad 16 is determined individually for the patient, so that the underside 17 of the pad 16 essentially runs parallel to the plane of the slideways of the artificial condyles of a coupled artificial knee joint. This achieves a high degree of uniform distribution of the loads in the overall prosthesis.

Landscapes

  • Health & Medical Sciences (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)
  • Orthopedic Medicine & Surgery (AREA)
  • Prostheses (AREA)

Abstract

Es wird eine Oberschenkelstumpf-Endoprothese für eine exoprothetische Versorgung eines im Oberschenkelbereich beinamputierten Patienten beschrieben, wobei der Oberschenkelstumpf in einen Schaft ziehbar ist, dem sich die Nachbildung eines Unterschenkel- und Fussteils der Prothese anschliesst. Sie weist ein proximales Stielteil (4) auf, das in einen Femurstumpf (5) setzbar ist, wobei das Stielteil zumindest teilweise mit einer offenmaschigen dreidimensionalen Raumnetzstruktur (6) bedeckt ist und an seinem distalen Ende einen konischen Adapter (7) aufweist, mittels dessen ein Kondylenersatz (8), der die Form (11) natürlicher Kondylen eines Kniegelenks nachempfindet, an das Stielteil (4) koppelbar ist. Mit dem Kondylenersatz (8) ist eine keilförmige Unterlage (16) mit einem Keilwinkel alpha verbindbar, der die natürliche Valgität des Beines wiederherstellt.

Description

OBERSCHENKELSTUMPF-ENDOPROTHESE FÜR EINE EXOPROTHETISCHE VERSORGUNG
Beschreibung
Die vorliegende Erfindung betrifft eine Oberschenkelstumpf-Endoprothese für eine exoprothetische Versorgung eines im Oberschenkelbereich beinamputierten Patienten. Dabei ist der Oberschenkelstumpf in einen Schaft ziehbar, dem sich die Nachbildung eines Knie-, Unter- und Fußteils der Prothese anschließt. Die Endoprothese weist einen proximalen Stielteil auf, das in einen Femurstumpf setzbar ist, wobei das Stielteil zumindest teilweise mit einer offenmaschigen, dreidimensionalen Raumnetzstruktur bedeckt ist und an seinem distalen Ende einen konischen Adapter aufweist, mittels dessen ein Kondylenersatz, der der Form natürlicher Kondylen eines Kniegelenks nachgebildet ist, an das Stielteil gekoppelt ist.
Der vorliegenden Erfindung liegt die Aufgabe zugrunde, das Wahrnehmungsgefühl des Patienten noch weiterhin zu steigern.
Diese Aufgabe wird mit dem Gegenstand des Anspruchs 1 gelöst.
Erfindungsgemäß ist mit dem Kondylenersatz eine keilförmige Unterlage verbunden, welche die natürliche Valgität, d. h. also die Winkelstellung des Femurstumpfes in Richtung medial, wiederherstellt. Hierdurch werden die Kräfteverteilungen den entsprechenden Verteilungen in einem gesunden Bein nachempfunden. Dies bedeutet, daß mit dem Keil eine Parallelität zwischen der Unterseite des Keiles und den Gleitflächen eines künstlichen Kniegelenkes hergestellt werden kann unter weitgehender Beibehaltung des natürlichen CCD- Winkels. Eine Vergleichmäßigung der Belastung entlang der Prothesenachse wird hierdurch erzielt.
Aus dem Bereich der Chirurgie ist zwar bereits ein Implantat bekannt (US-A- 5,766,251), welches als keilförmiges Ausgleichsstück ausgebildet ist, welches Korrekturen beispielsweise hinsichtlich des Valgitätswinkels gestattet. Der Einsatz des keilförmigen Implantates findet unter anderem statt im Gelenkbereich der Tibia, womit das Tibiaplateau dem Neigungswinkel des keilförmigen Implantates entsprechend einseitig angehoben wird. Einen Hinweis auf die Verwendung dieses Implantates bei der Versorgung eines beinamputierten Patienten ist dieser Druckschrift allerdings nicht zu entnehmen.
Gemäß einer bevorzugten Ausführungsform liegt der Keilwinkel in einem Bereich zwischen 5 und 9°. Die 5° werden vorzugsweise bei männlichen Patienten, die 9° maximal bei weiblichen Patienten zur Anwendung kommen.
Bevorzugt ist die Unterlage mit der stoßdämpfenden Schicht der Oberschenkelstumpf- Endoprothese verbunden .
Besonders bevorzugt wird die Ausbildung der Unterlage aus einem stoßdämpfenden Kissen, so daß Belastungen nicht direkt in den Femurstumpf eingeleitet werden. Zu diesem Zwecke ist die Unterlage bevorzugt aus Silikon hergestellt.
Die Erfindung wird anhand eines Ausführungsbeispiels gemäß der einzigen Zeichnungsfigur beispielhaft näher erläutert.
Die einzige Zeichnungsfigur zeigt schematisch einen Oberschenkelstumpf 1 mit einer in dem Femurstumpf 5 implantierten Oberschenkelstumpf-Endoprothese. Ein intramedullärer Stiel 4 bildet das proximale Stielteil, welches in den Markraum des Femurstumpfes gesetzt ist. Die Oberfläche des Stielteils 4 ist mit einer ofienmaschigen, dreidimensionalen Raumnetzstruktur 6 belegt, durch welche hindurch Knochentrabekel wachsen können, so daß das Stielteil 4 nach einer gewissen Einheilphase, was den Substratfluß betrifft, quasi Bestandteil des natürlichen Knochens geworden ist.
Dem Stielteil 4 schließt sich distalseitig ein konischer Adapter 7 an. Mittels dieses konischen Adapters 7 ist distalseitig der Kondylenersatz 11 mit dem Stielteil 4 gekoppelt.
Das Kondylenersatzteil 8 ist so ausgebildet, daß es die Form 11 natürlicher Kondylen eines Kniegelenks nachempfindet.
Der Kondylenersatz 8 ist vorliegend mit einer stoßdämpfenden Schicht 10 aus Silikon beschichtet.
Mit dem Kondylenersatz 8 bzw. mit der deckenden stoßdämpfenden Schicht verbunden ist die Unterlage 16. Die Unterlage 16 ist keilförmig ausgebildet und weist einen Keilwinkel zur Horizontalen im Bereich von 5° < a < 9° auf.
Die Unterlage 16 besteht vorliegend aus einem dämpfenden Kissen und unterstützt somit im gezeigten Ausführungsbeispiel die Abdämpfung von Stoßbelastungen auf die Knie-, Unterschenkel- und Fußteile 3. Der Keilwinkel der Unterlage 16 wird patientenindividuell bestimmt, so, daß die Unterseite 17 der Unterlage 16 im wesentlichen parallel verläuft zu der Ebene der Gleitbahnen der künstlichen Kondylen eines angekoppelten künstlichen Kniegelenks. Hierdurch wird ein hohes Maß an einer Gleichverteilung der Belastungen in der Gesamtprothese erreicht.

Claims

Patentansprüche
1. Oberschenkelstumpf-Endoprothese für eine exoprothetische Versorgung eines im Oberschenkelbereich beinamputierten Patienten, wobei der Oberschenkelstumpf (1) in einen Schaft (2) ziehbar ist, dem sich die Nachbildung eines Knie-, Unterschenkel- und Fußteils (3) der Prothese anschließt, aufweisend ein proximales Stielteil (4), das in einen Femurstumpf (5) setzbar ist, wobei das Stielteil (4) zumindest teilweise mit einer offenmaschigen, dreidimensionalen Raumnetzstruktur (6) bedeckt ist und an seinem distalen Ende einen konischen Adapter (7) aufweist, mittels dessen ein Kondylenersatz (8), der der Form (11) natürlicher Kondylen eines Kniegelenks nachgebildet ist, an das Stielteil (4) gekoppelt ist, mit einer keilförmigen Unterlage (16), die mit dem Kondylenersatz (8) verbunden ist.
2. Oberschenkelstumpf-Endoprothese nach Anspruch 1, bei der der Keilwinkel a der Unterlage (16) im Bereich 5° < α< 9° liegt.
3. Oberschenkelstumpf-Endoprothese nach Anspruch 1 oder 2, bei der die Unterlage (16) mit der stoßdämpfenden Schicht (10) verbunden ist.
4. Oberschenkelstumpf-Endoprothese nach einem der Ansprüche 1 bis 3, bei der die Unterlage (16) aus einem stoßdämpfenden Kissen besteht.
5. Oberschenkelstumpf- Endoprothese nach Anspruch 4, bei der die Unterlage aus Silikon besteht.
PCT/EP2000/004552 1999-07-14 2000-05-20 Oberschenkelstumpf-endoprothese für eine exoprothetische versorgung Ceased WO2001005335A1 (de)

Priority Applications (6)

Application Number Priority Date Filing Date Title
US09/913,036 US6709466B1 (en) 1999-07-14 2000-05-20 Thigh stump endoprosthesis for an exoprosthetic treatment
JP2001510395A JP2003504153A (ja) 1999-07-14 2000-05-20 エキソプロテーゼ用の大腿断端エンドプロテーゼ
AT00936758T ATE229775T1 (de) 1999-07-14 2000-05-20 Oberschenkelstumpfendoprothese für eine exoprothetische versorgung
EP00936758A EP1119319B1 (de) 1999-07-14 2000-05-20 Oberschenkelstumpfendoprothese für eine exoprothetische versorgung
DE50000961T DE50000961D1 (de) 1999-07-14 2000-05-20 Oberschenkelstumpfendoprothese für eine exoprothetische versorgung
HK02100810.6A HK1039741B (zh) 1999-07-14 2000-05-20 用於外部修復治療的大腿根部內部修復術

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE1999132388 DE19932388C1 (de) 1998-12-16 1999-07-14 Oberschenkelstumpf-Endoprothese
DE19932388.7 1999-07-14

Publications (1)

Publication Number Publication Date
WO2001005335A1 true WO2001005335A1 (de) 2001-01-25

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US (1) US6709466B1 (de)
EP (1) EP1119319B1 (de)
JP (1) JP2003504153A (de)
AT (1) ATE229775T1 (de)
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ES (1) ES2186650T3 (de)
HK (1) HK1039741B (de)
WO (1) WO2001005335A1 (de)

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WO2003065938A1 (en) * 2002-01-18 2003-08-14 Cypromed As Prosthesis set
EP3257474A1 (de) 2016-06-13 2017-12-20 René Daniel Boesch Endoprothese für einen röhrenknochen

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SE529762C2 (sv) * 2005-06-28 2007-11-20 Gramtec Innovation Ab Osseointegrerad ben- eller armprotes
US20070162150A1 (en) * 2006-01-12 2007-07-12 Fago John R Modular prosthetic implant for upper and lower extremity amputees
EP2468216B1 (de) * 2010-12-23 2014-05-14 Baumgart, Rainer, Dipl.-Ing. Dr. med. Implantierbare Prothese zum Ersatz des menschlichen Hüft- oder Kniegelenks und der angrenzenden Knochenabschnitte
US8979945B2 (en) * 2011-06-20 2015-03-17 Gordon Maniere Implantable end pad
US8882851B2 (en) 2011-09-20 2014-11-11 Larry Nelson Smith Implantable prosthetic device for distribution of weight on amputated limb and method of use with an external prosthetic device
EP2759281A1 (de) * 2013-01-29 2014-07-30 Les Hôpitaux Universitaires de Genève Implantat für die Amputation einer unteren Gliedmaße
US8932367B2 (en) 2013-02-13 2015-01-13 Larry N. Smith Shock absorbing implantable limb prosthetic

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US3947897A (en) * 1975-03-17 1976-04-06 Owens Lester J Apparatus for connecting a prosthesis to a bone
US4158895A (en) * 1978-02-09 1979-06-26 Nasa Prosthesis coupling
DE3125268A1 (de) * 1981-06-24 1983-01-13 C. Nicolai GmbH & Co KG, 3000 Hannover Implantat
GB2231271A (en) * 1988-09-21 1990-11-14 Krasnod Kraevoi Sovet V Obsche Device for a limb prosthetic appliance
WO1991007932A1 (en) * 1989-11-30 1991-06-13 Ab Volvo Artificial hip-joint
US5766251A (en) 1992-03-13 1998-06-16 Tomihisa Koshino Wedge-shaped spacer for correction of deformed extremities
EP0577178A1 (de) * 1992-06-20 1994-01-05 ESKA Implants GmbH & Co. Implantat mit offenzelliger oder offenporiger Metallstruktur
EP0639351A2 (de) * 1993-08-20 1995-02-22 ULRICH, Heinrich Implantat zum Ersatz von Wirbelkörpern und/oder zur Stabilisierung und Fixierung der Wirbelsäule
DE4338746A1 (de) * 1993-11-12 1995-05-18 Otmar Dr Behr Amputationsstumpf-Endoprothese
US5549682A (en) * 1994-06-16 1996-08-27 Roy; Stephen C. Shoulder joint prosthesis with angular adjustment
DE19630298A1 (de) * 1996-07-26 1998-01-29 Basim A Dr Fleega Schulter-Totalendoprothese
DE19826638A1 (de) * 1998-06-17 1999-12-30 Eska Implants Gmbh & Co Adapter für ein exoprothetisches Standardteil
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003065938A1 (en) * 2002-01-18 2003-08-14 Cypromed As Prosthesis set
US7223293B2 (en) 2002-01-18 2007-05-29 Otto Bock Healthcare Products Gmbh Prosthesis set
KR100929694B1 (ko) * 2002-01-18 2009-12-03 오토 복 헬스케어 프로덕츠 게엠베하 보철물 세트
EP3257474A1 (de) 2016-06-13 2017-12-20 René Daniel Boesch Endoprothese für einen röhrenknochen
WO2017215975A1 (de) 2016-06-13 2017-12-21 Boesch René Endoprothese für einen röhrenknochen

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DE50000961D1 (de) 2003-01-30
JP2003504153A (ja) 2003-02-04
EP1119319A1 (de) 2001-08-01
ATE229775T1 (de) 2003-01-15
HK1039741B (zh) 2003-06-06
HK1039741A1 (en) 2002-05-10
ES2186650T3 (es) 2003-05-16
US6709466B1 (en) 2004-03-23
EP1119319B1 (de) 2002-12-18

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