L'invention se rattache au secteur technique des implants orthopédiques, notamment des prothèses d'épaules. The invention relates to the technical sector of orthopedic implants, including shoulder prostheses.
On connait différentes formes de réalisation de prothèses aptes å traiter les épaules détruites. Various embodiments of prostheses capable of treating destroyed shoulders are known.
La plupart d'entre elles sont conformées pour reproduire les surfaces anatomiques de l'articulation, mais ne donnent pas satisfaction lorsque la coiffe des rotateurs est détruite. Most of them are shaped to reproduce the anatomical surfaces of the joint, but are not satisfactory when the rotator cuff is destroyed.
La prothèse d'épaule définie dans la demande de brevet français N. 3710495 tend a remédier a ces inconvénients. The shoulder prosthesis defined in the French patent application No. 3710495 tends to remedy these drawbacks.
Cette prothèse est du type de celle comprenant une pièce malte sphérique destinée à être fixée à la glène de l'omoplate en étant apte à coopérer avec un élément humoral sous forme d'une cupule sphérique solidaire d'une tige apte a être implantée dans la diaphyse humérale.This prosthesis is of the type comprising a spherical malt piece intended to be fixed to the glene of the scapula being able to cooperate with a humoral element in the form of a spherical cup secured to a rod that can be implanted in the humeral diaphysis.
Cette forme de prothèse est plus particulièrement adaptée pour traiter les cas de rupture de coiffe susceptible de détruire complètement la stabilité de l'épaule. Son application est donc limitée et ne peut traiter tous les cas cliniques
Le problème que se propose de résoudre l'invention est de pouvoir traiter la plupart des traumatismes de l'articulation de l'épaule, à partir d'un ensemble prothétique composé d'éléments modulaires interchangeables soit au moment de l'opération soit ultérieurement au cours de l'évolution du cas Datllologique du patient.This form of prosthesis is more particularly adapted to treat cases of cuff rupture may completely destroy the stability of the shoulder. Its application is therefore limited and can not treat all clinical cases
The problem to be solved by the invention is to be able to treat most of the trauma of the shoulder joint, from a prosthetic assembly composed of interchangeable modular elements either at the time of the operation or later at the time of the operation. course of evolution of the Datllological case of the patient.
Le problème posé est résolu en ce qu'il a été conçus et mis au point un ensemble modulaire pour prothèse de l'épaule, qui comprend, en combinaison, un#élément apte à être implanté dans le fut huméral et dont la tête est conformée pour recevoir, d'une manière rapportée, des éléments interchan geables dont les formes et profils sont adaptés pour coopérer soii directement avec une partie de l'épaule, soit avec des éléments complémentaires conformés pour être implantés dans une partie de ladite épaule, en fonction de la nature de la fracture ou autre a traiter. The problem is solved in that it was designed and developed a modular assembly for shoulder prosthesis, which comprises, in combination, an element capable of being implanted in the humeral head and whose head is shaped to receive, in a reported manner, interchangeable elements whose shapes and profiles are adapted to co-operate directly with a portion of the shoulder, or with complementary elements shaped to be implanted in a part of said shoulder, according to of the nature of the fracture or other to be treated.
En fonction du choix et de la sélection des éléments, il est possible de traiter les fractures comminutives de la tête humérale, les omarthroses avec destruction de la glène et les différents cas de rupture de coiffe
Pour résoudre le problème posé du traitement des
Fractures communitîves de la tête humérale, les éléments interchangeables comprennent une sphère humérale apte à coopérer directement en appui sur la glène.Depending on the choice and the selection of the elements, it is possible to treat the comminuted fractures of the humeral head, the omarthroses with destruction of the glenoid and the different cases of rupture of the cap
To solve the problem of the treatment of
Common fractures of the humeral head, the interchangeable elements comprise a humeral sphere capable of cooperating directly in support on the glenoid.
Pour résoudre le problème posé du traitement des omarthroses avec destruction de la glène, les éléments interchangeables comprennent une sphère humérale apte a coopérer avec une cupule glênoidienne de forme complémentaire. To solve the problem of the treatment of omarthrosis with destruction of the glenoid, the interchangeable elements comprise a humeral sphere capable of cooperating with a glenoid cup of complementary shape.
Pour résoudre le problème posé des cas de rupture de coiffe, les éléments interchangeables comprennent une cupule sphérique apte coopérer avec une pièce male sphérique faisant office d'organe glénoidien. In order to solve the problem of cases of capping rupture, the interchangeable elements comprise a spherical cupule capable of cooperating with a spherical male part acting as a glenoid organ.
Un autre problème que se propose de résoudre l'invention est d'assurer une fixatIon sûre et efficace sans risque de descellement de la cupule glénoidienne et de l'organe glénoidien. Dans ce but, la cupule glénoidienne ou l'organe glénoidien sont conformés pour être fixés sur un support agencé pour être implantés dans la glène. Another problem to be solved by the invention is to ensure safe and effective fixation without risk of loosening of the glenoid cup and the glenoid organ. For this purpose, the glenoid cup or the glenoid organ are shaped to be fixed on a support arranged to be implanted in the glenoid.
Avantageusement, le problème posé est résolu en ce que le support est fixé dans la glène au moyen de vis divergentes disposées de manière à être en alignement ou ensiblement en alignement respectivement avec le pilier de l'omoplate, le pilier coracoidien et le pilier acromial. Les is étant à pas différentiel. Advantageously, the problem is solved in that the support is fixed in the glenoid by means of diverging screws arranged so as to be aligned or ensibly aligned respectively with the abutment of the scapula, the coracoidal abutment and the acromial abutment. The is being at differential pitch.
Dans une forme particulière de réalisation, le support présente un plateau circulaire recevant dans son épaisseur les vis, ledit plateau étant prolongé par une portée coaxiale creuse de centrage pour être engagée dans un trou formé dans la glène. In a particular embodiment, the support has a circular plate receiving in its thickness the screws, said plate being extended by a hollow coaxial centering surface to be engaged in a hole formed in the glenoid.
Pour assurer la fixation de la cupule glénoidienne sur le support, cette dernière présente une portée interne circulaire agencée pour être fixée sur le plateau du support. To ensure the fixing of the glenoid cup on the support, the latter has a circular inner surface arranged to be fixed on the support plate.
Pour assurer la fixation de l'organe glénoidien sur le support1 ledit organe présente une portée interne circulaire agencée pour être fixée sur le plateau du support et, d'une zanière coaxiale, une tige destinée a être engagée dans l'alésage de la portée de centrage dudit support, de manière à avoir le centre d'application de la résultante des efforts à l'intérieur de la glène
La tête sphérique de l'organe glénoidien peut, d'une manière connue, être exécutée en acier inoxydable, en céramique, en alliage a base de titane ou de cobalt ou autre produit biocompatible. Le support sur lequel est vissé l'organe glènoYdien ou la cupule glenoïdienne est en acier traité.Les cupules humérales et glénoidienne sont en polyéthylène.To ensure the fixation of the glenoidal member on the support1 said member has a circular internal surface arranged to be fixed on the support plate and, a coaxial zanière, a rod intended to be engaged in the bore of the scope of centering said support, so as to have the center of application of the resultant forces inside the glenoid
The spherical head of the glenoid organ may, in a known manner, be made of stainless steel, ceramic, titanium-based alloy or cobalt or other biocompatible product. The support on which the glenoid organ or the glenoid cup is screwed is made of treated steel. The humeral and glenoid cupules are made of polyethylene.
L'Invention est exposée, ci-après, plus en détail, a l'aide des dessins annexés, dans lesquels
La figure 1 est une vue en perspective montrant les principaux éléments de l'ensemble prothétique selon l'invention, lesdits éléments étant représentes avant montage.The invention is described below, in more detail, with the aid of the accompanying drawings, in which
Figure 1 is a perspective view showing the main elements of the prosthetic assembly according to the invention, said elements being shown before mounting.
Les figures 2 à 4 sont des vues à caractère schématique montrant les principales utilisations des éléments de prothèse, en jonction des fractures à traiter, notamment
- la figure 2 montre l'application de l'ensemble prothètique pour le traitement d'une fracture communitive de la tête humérale
- la figure 3 montre l'application de l'ensemble nothètique pour le traitement d'une omarthrose, avec destruction de la glène.FIGS. 2 to 4 are schematic views showing the main uses of the prosthesis elements, at the junction of the fractures to be treated, in particular
FIG. 2 shows the application of the prosthetic assembly for the treatment of a communitive fracture of the humeral head
- Figure 3 shows the application of the nothétique set for the treatment of omarthrosis, with destruction of the glenoid.
- la figure 4 montre l'application de l'ensemble prothètique dans le cas d'une rupture de coiffe. - Figure 4 shows the application of the prosthetic assembly in the case of a cap rupture.
La figure 5 est une vue en coupe longitudinale montrant l'ensemble prothètique adapté pour le traitement d'une fracture communîtive de la tète humérale. Figure 5 is a longitudinal sectional view showing the prosthetic assembly adapted for the treatment of a communitarian fracture of the humeral head.
La figure 6 est une vue en coupe longitudinale montrant le traitement d'une omarthrose, avec destruction de la glène. Figure 6 is a longitudinal sectional view showing the treatment of omarthrosis, with destruction of the glenoid.
La figure 7 est une vue partielle en coupe longitudinale montrant l'application de l'ensemble pr#othètique dans le cas d'une rupture de coiffe. FIG. 7 is a partial view in longitudinal section showing the application of the prosthetic assembly in the case of a cap rupture.
Comme le montre plus particulièrement la figure 1, l'ensemble modulaire pour prothèse de l'épaule comprend un élément de base (1), conformé pour être implanté dans la diaphyse de l'humérus CE). D'une manière connue, l'élément (1) comprend une tige d'ancrage Cla) prolongée dans sa partie supérieure, par une tête (lb) présentant un évidemment (ic) agencé pour recevoir, d'une manière rapportée, différents types d'éléments interchangeables, comme il sera indiqué dans la suite de la description. As shown more particularly in Figure 1, the modular assembly for shoulder prosthesis comprises a base member (1), shaped to be implanted in the diaphysis of the humerus CE). In a known manner, the element (1) comprises an anchoring rod Cla) extended in its upper part, by a head (Ib) having a recess (ic) arranged to receive, in a manner reported, different types interchangeable elements, as will be indicated in the following description.
Avantageusement, , la tête (1b) de l'élément huméral Cl) présente en débordement de sa périphérie externe, une ou plusieurs aspérités faisant office d'aileron (nid). Le nombre de ces ailerons est fonction de la dimension de la tête (lb). Dans l'exemple Illustré, l'élément huméral présente trois ailerons décalés angulalrement de 45 . Ces ailerons, après mise en place de l'élément huméral sont ancrés dans la corticale, en constituant des éléments stabilisateurs anti-rotatoire pour une implantation sans ciment. En outre# ces ailerons (ld) peuvent être percés de trous pour permettre au chirurgien d'y engager d'une manière connue, un fil de fixation. Advantageously, the head (1b) of the humeral element Cl) has overflowing its outer periphery, one or more asperities acting as aileron (nest). The number of these fins is a function of the size of the head (lb). In the Illustrated example, the humeral element has three fins angularly offset by 45. These fins, after placement of the humeral element are anchored in the cortex, constituting anti-rotator stabilizing elements for implantation without cement. In addition # these fins (ld) can be pierced with holes to allow the surgeon to engage in a known manner, a fixing wire.
D'une manière connue, la tige (ta) présente tout type d'agencement et/ou de profil pour permettre son ancrage dans le canal modulaire de l'humérus avec ou non l'apport d'un ciment. De même, la tête (lob) est orientée angulairement par rapport a la tige pour être convenablement positionnée après résection de l'extrémité supérieure de l'humérus. Cet élément huméral (1) est en outre, exécuté en tout matériaux connu et approprié. In a known manner, the rod (ta) has any type of arrangement and / or profile to allow its anchoring in the modular channel of the humerus with or without the contribution of a cement. Similarly, the head (lob) is angularly oriented relative to the stem to be properly positioned after resection of the upper end of the humerus. This humeral element (1) is furthermore made of any known and appropriate material.
Comme indiqué, la tête (lob) de l'élément Ci) est destinée à recevoir notamment d'une manière démontable, des éléments interchangeables, dont les formes et profils sont adaptés pour coopérer, soit directement avec une partie de l'épaule, soit avec des éléments complémentaires conformés pour être implantés dans une partie de ladite épaule. Le choix de ces éléments étant fonction de la nature de la fracture a traiter. As indicated, the head (lob) of the element Ci) is intended to receive in particular in a removable manner, interchangeable elements, whose shapes and profiles are adapted to cooperate, either directly with a part of the shoulder or with complementary elements shaped to be implanted in a portion of said shoulder. The choice of these elements being a function of the nature of the fracture to be treated.
Pour l'essentiel, ces éléments interchangeables comprennent une sphère humérale (2) ou une cupule sphérique (3). Essentially, these interchangeable elements comprise a humeral sphere (2) or a spherical cup (3).
La sphère humérale (2) est clipsée ou autrement centrée G l'intérieur de la tête (lb) de l'élément (1). Le rayon de courbure (2a) de cette sphère est déterminé pour correspondre, très sensiblement, au rayon de courbure de la glène, recevant normalement la tête humérale de l'os. The humeral sphere (2) is clipped or otherwise centered inside the head (1b) of the member (1). The radius of curvature (2a) of this sphere is determined to correspond, very substantially, to the radius of curvature of the glenoid, normally receiving the humeral head of the bone.
Dans le cas d'une fracture comminutive de la tête humérale, la sphère (2) coopère directement en appui avec la glène CG) (figures 2 et 5). Dans le cas d'un traitement d'une omarthrose avec destruction de la glène, la sphère (2) coopère en appui avec une cupule glénoïdienne C4) présentant un évidemment en forme de calotte sphérique dont le rayon de courbure correspond sensiblement à celui de la sphère humérale ( (figures s et 6)*
La cupule glénoïdienne (4) est agencée pour être solidaire d'un support (5), conformé pour être implanté au niveau de la glène de l'épaule. Avantageusement, le support (5) est fixé dans la glène au moyen de vis divérgentes C6) disposées en combinaison avec des agencements dudit support, de manière a être en alignement ou sensiblement en alignement, respectivement avec le pilier de l'omoplate, le pilier coracoidien et le pilier acromial.In the case of a comminuted fracture of the humeral head, the sphere (2) cooperates directly in support with the glenoid CG) (FIGS. 2 and 5). In the case of a treatment of an omarthrosis with destruction of the glenoid, the sphere (2) cooperates in support with a glenoid cup (C4) having an obviously spherical cap whose radius of curvature substantially corresponds to that of the humeral sphere ((figures s and 6) *
The glenoid cup (4) is arranged to be secured to a support (5), shaped to be implanted at the level of the glenoid of the shoulder. Advantageously, the support (5) is fixed in the glenoid by means of divisible screws C6) arranged in combination with arrangements of said support, so as to be aligned or substantially aligned with the abutment pillar, the abutment, respectively. coracoid and the acromial pillar.
Dans ce but, le support C5) présente un plateau circulaire (Sa) recevant dans son épaisseur les vis (6). En outre, ce plateau est prolongé par une portée coaxiale creuse de centrage C5b) destinée à être engagée dans un logement complémentaire formé dans la glène. For this purpose, the support C5) has a circular plate (Sa) receiving in its thickness the screws (6). In addition, this plate is extended by a hollow coaxial centering surface C5b) intended to be engaged in a complementary housing formed in the glenoid.
La fixation de la cupule glénoidienne (4) sur le support (5) peut s'effectuer par tout moyen connu et approprié, apte à rendre cette fixation démontable. Par exemple, la cupule (4) présente une portée interne taraudée C4a) pour être vissée sur la périphérie du plateau circulaire (Sa) du support filetée à cet effet. Fixing the glenoid cup (4) on the support (5) can be done by any known and appropriate means, adapted to make this attachment removable. For example, the cup (4) has a threaded inner surface C4a) to be screwed on the periphery of the circular plate (Sa) of the threaded support for this purpose.
Avantageusement, les vis C6) présentent d'une manière connue, un pas du type différentiel entre la tête de vis filetée et son corps, pour assurer une compression entre le support C5) et la glène. Advantageously, the screws C6) present, in a known manner, a pitch of the differential type between the threaded screw head and its body, to ensure compression between the support C5) and the glenoid.
Dans le cas d'une rupture de coiffe, la tête (1b) de l'élément huméral (1) reçoit la cupule sphérique (3). In the case of a cap rupture, the head (1b) of the humeral element (1) receives the spherical cup (3).
Cette cupule (3) présente un évidemment C3a) en forme de calotte sphérique. Avantageusement, la forme en calotte sphérique s'étend sur environ un tiers de sphère. De la même façon que pour la sphère humérale, la cupule (3) est positionnée et centrée à l'intérieur dé la tête (1b) de l'élément Ci), par tout moyen connu et approprié.This cup (3) has a recess C3a) shaped spherical cap. Advantageously, the spherical cap shape extends over approximately one-third of a sphere. In the same way as for the humeral sphere, the cup (3) is positioned and centered inside the head (1b) of the element Ci) by any known and appropriate means.
Comme le montre notamment la figure 7, la cupule (4) coopère avec une pièce male sphérique (7) faisant office d'organe glénoidien. Cette pièce sphérique est conformée de la même manière que la cupule glénoidienne (4) pour être fiwée sur le support C5). Par exemple, l'organe glénoidien (7) présente une portée circulaire interne C7a) agencée pour être fixée d'une manière démontable sur le support. Comme indiqué précédemment, cet agencement peut être constitué par un taraudage.En outre, la portée circulaire interne (7a) présente une tige coaxiale C7b) destinée à être engagée dans l'alésage de la portée de centrage (5b) du support (5) (figure 6), pour améliorer le temps opératoîr de pose. As shown in particular in Figure 7, the cup (4) cooperates with a spherical male part (7) acting as a glenoid organ. This spherical piece is shaped in the same way as the glenoid cup (4) to be fiwed on the support C5). For example, the glenoid organ (7) has an internal circular surface C7a) arranged to be removably attached to the support. As indicated above, this arrangement can be constituted by a tapping. In addition, the inner circular bearing (7a) has a coaxial rod C7b) intended to be engaged in the bore of the centering bearing surface (5b) of the support (5). (Figure 6), to improve the operating time of installation.
Le diamètre de la sphère de l'organe glénoidien est déterminé en combinaison avec la tige co=^iale (7b) pour que le centre d'application de la résultante des efforts soit situé à l'intérieur de la glène. D'une manière connue, la tête sphérique de l'organe glénoidien (7) peut être exécuté en acier ino-yda'Dle, en céramique, en alliage à base de titane ou de cobalt ou tout produit 'oio-comptatible. Le support (5) sur lequel peut être vissé soit l'organe glénoidien (7 > soit la cupule glénoidienne (4) est en acier traité. Les cupules humérale (2) et glénoidienne C3) sont en polyéthylène haute densité. The diameter of the sphere of the glenoid organ is determined in combination with the co-axial stem (7b) so that the center of application of the resultant of the forces is located inside the glenoid. In a known manner, the spherical head of the glenoid organ (7) can be made of stainless steel, ceramic, alloy based on titanium or cobalt or any oio-compatible product. The support (5) on which can be screwed either the glenoid organ (7> or the glenoid cup (4) is made of treated steel, the cups humeral (2) and Glenoid C3) are made of high density polyethylene.
Les avantages ressortent bien de la description, en particulier on souligne la possibilité de traiter la plupart des fractures de l'épaule a partir d'un même ensemble composé d'éléments modulaires interchangeables entre eus, soit au moment de l'opération, soit ultérieurement, en fonction de l'évolution du cas pathologique du patient On souligne également, la fixation sûre et efficace, de la cupule ou de l'organe glinoidien, en combinaison avec le support vissé dans la glène, évitant ainsi, l'emploi d'un ciment, avec les risques inhêrant à ce type de fixation. The advantages are apparent from the description, in particular the possibility of treating most of the fractures of the shoulder from the same set of modular elements interchangeable between them, either at the time of the operation or later , depending on the evolution of the pathological case of the patient It is also emphasized, the safe and effective fixation of the cup or the glinoidian organ, in combination with the support screwed into the glenoid, thus avoiding the use of a cement, with the risks inherent in this type of fixation.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR8913366AFR2652498B1 (en) | 1989-10-04 | 1989-10-04 | MODULAR ASSEMBLY FOR SHOULDER PROSTHESIS. |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR8913366AFR2652498B1 (en) | 1989-10-04 | 1989-10-04 | MODULAR ASSEMBLY FOR SHOULDER PROSTHESIS. |
| Publication Number | Publication Date |
|---|---|
| FR2652498A1true FR2652498A1 (en) | 1991-04-05 |
| FR2652498B1 FR2652498B1 (en) | 1997-12-26 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR8913366AExpired - LifetimeFR2652498B1 (en) | 1989-10-04 | 1989-10-04 | MODULAR ASSEMBLY FOR SHOULDER PROSTHESIS. |
| Country | Link |
|---|---|
| FR (1) | FR2652498B1 (en) |
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| Publication number | Publication date |
|---|---|
| FR2652498B1 (en) | 1997-12-26 |
| Publication | Publication Date | Title |
|---|---|---|
| FR2652498A1 (en) | Modular assembly for a shoulder prosthesis | |
| EP1064890B1 (en) | Prosthetic assembly for a shoulder joint | |
| EP1408886B1 (en) | Modular acetabular cup | |
| EP2965720B1 (en) | Anchoring base for orthopaedic joint implant | |
| FR2663838A1 (en) | Implant for an arthroplasty, in particular of a glenoid cavity | |
| EP2032082B1 (en) | Shoulder prosthesis and set of instruments for the implantation thereof | |
| EP0127503B1 (en) | Shoulder prosthesis | |
| EP1229872B1 (en) | Expansible acetabular prosthesis with double mobility | |
| EP3716916B1 (en) | Humeral anchor component without stem for humeral implant of shoulder prosthesis | |
| FR2746631A1 (en) | SET OF ELEMENTS FOR THE CONSTITUTION OF A TOTAL PROSTHESIS OF THE HIP | |
| FR2751868A1 (en) | ADJUSTED PROSTHESIS OF THE SUPERIOR END OF THE HUMERUS | |
| EP0259420A1 (en) | Prosthesis cupula. | |
| FR2699400A1 (en) | Artificial shoulder prosthesis | |
| FR2823662A3 (en) | TOTAL HIP PROSTHESIS | |
| FR2686503A1 (en) | Prosthesis for restoration of the femoral head | |
| FR2897527A1 (en) | CUPLE FOR COTYLOID IMPLANT | |
| FR2970411A1 (en) | Anchoring element for anchoring joint head of joint prosthesis with bone e.g. femur, has stud located at center of space defined by peripheral wall, where stud is intended to be inserted into bone from resected metaphyseal surface | |
| FR2819172A1 (en) | Replacement acetabular cup for hip prosthesis has angled fixed lug with fastening hole and hook to engage with pelvic aperture | |
| FR2669528A1 (en) | IMPLANT FOR THE OSTEOSYNTHESIS OF FRACTURES OF THE SUPERIOR END OF THE HUMERUS. | |
| FR2751528A1 (en) | Artificial hip joint prosthesis | |
| EP1824422A2 (en) | Acetabular prosthesis to be fixed without cement | |
| FR2709948A1 (en) | Total metatarso-phalangeal prosthesis for resurfacing without cement | |
| FR2644690A1 (en) | Femoral prosthesis having an anchoring system with screwed metaphysis and blocked diaphysis | |
| FR2890853A1 (en) | Prosthetic implant for the shoulder with a support element having a support and sliding surface able to cooperate with the joint head of the implant and the anatomical socket of the shoulder blade | |
| FR2972627A1 (en) | Shoulder prosthesis humeral rod for repair of fractured shoulder joint, has corolla delimited proximally by proximal face such that slope of corolla is perpendicular with proximal face and forms specific angle with diaphyseal portion axis |
| Date | Code | Title | Description |
|---|---|---|---|
| CA | Change of address | ||
| CD | Change of name or company name | ||
| CJ | Change in legal form | ||
| TP | Transmission of property | ||
| TP | Transmission of property |