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WO2003011133A1 - Systeme d'implant medical - Google Patents

Systeme d'implant medical Download PDF

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Publication number
WO2003011133A1
WO2003011133A1 PCT/EP2002/007927 EP0207927W WO03011133A1 WO 2003011133 A1 WO2003011133 A1 WO 2003011133A1 EP 0207927 W EP0207927 W EP 0207927W WO 03011133 A1 WO03011133 A1 WO 03011133A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant system
implant
radiation
glass fiber
measuring device
Prior art date
Application number
PCT/EP2002/007927
Other languages
German (de)
English (en)
Inventor
Thomas Grupp
Josef Kozak
Original Assignee
Aesculap Ag & 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 Aesculap Ag & Co. Kg filed Critical Aesculap Ag & Co. Kg
Priority to AT02791457T priority Critical patent/ATE282358T1/de
Priority to DE50201594T priority patent/DE50201594D1/de
Priority to EP02791457A priority patent/EP1424937B1/fr
Publication of WO2003011133A1 publication Critical patent/WO2003011133A1/fr
Priority to US10/765,724 priority patent/US20040204647A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0031—Implanted circuitry
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A61B17/7208—Flexible pins, e.g. ENDER pins
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/07—Endoradiosondes
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/75—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated
    • G01N21/77—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator
    • G01N21/7703—Systems in which material is subjected to a chemical reaction, the progress or the result of the reaction being investigated by observing the effect on a chemical indicator using reagent-clad optical fibres or optical waveguides
    • 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
    • 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
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02—Operational features
    • A61B2560/0204—Operational features of power management
    • A61B2560/0214—Operational features of power management of power generation or supply
    • A61B2560/0219—Operational features of power management of power generation or supply of externally powered implanted units
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4504—Bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30965—Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • 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
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30668—Means for transferring electromagnetic energy to implants
    • 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
    • A61F2250/0001—Means for transferring electromagnetic energy to implants

Definitions

  • the invention relates to a medical implant system with an implant made of a composite material, in which glass fibers are embedded.
  • Medical implants for example bone plates, intramedullary nails, endoprostheses, osteosynthesis systems for the spine, etc. are usually made of metallic materials, but implants are also known which consist of a composite material in which glass fibers are embedded for reinforcement, in particular such medical implants consist of sterilizable, selected plastics such as polyether ether ketone, polyamides etc.
  • these implants When these implants are inserted into the body, they are exposed to different influences, for example different strains and stresses, temperature developments or chemical environments. It would be of interest to the treating type to experience these different parameters, since they provide information about the healing process or about any problems that may arise.
  • the object of the invention is to improve a generic medical implant system in such a way that information about physical properties in the implant and in its surroundings can be obtained.
  • This object is achieved according to the invention in a medical implant of the type described in the introduction in that a sensor element embedded in the implant and comprising at least one of the glass fibers is connected to a measuring device which determines a physical property of the sensor element or its environment and its change.
  • At least one glass fiber embedded in the composite material of the implant is therefore used for the transmission of signals which provide information about the physical properties of the implant or the surroundings of the implant.
  • glass fiber is understood to mean all fibrous substances which can be embedded in the composite material and are capable of carrying and transmitting electromagnetic radiation, these fibers preferably being made of quartz glass, but other substances can also be used, for example fibers Plastic, so-called plastic optical fibers (POF).
  • fibers Plastic so-called plastic optical fibers (POF).
  • glass fibers are embedded in the composite material as mechanical reinforcement.
  • the glass fibers are arranged in the form of a woven fabric, a knitted fabric or a fleece, that is to say form a network which is embedded overall in the composite material and thereby reinforces it.
  • the glass fibers can be concentrated in certain areas of the implant or distributed over the entire extent of the implant.
  • the measuring device is preferably designed in such a way that it feeds electromagnetic radiation into the sensor element and determines physical properties of the sensor element or its surroundings from the type of continuous and / or reflected radiation.
  • the glass fiber of the sensor element is provided with a radiation-reflecting coating.
  • the sensor element essentially consists of the glass fiber that forms a sensor fiber.
  • the glass fiber embedded in the composite material is simultaneously a sensor and a transmission element for the electromagnetic radiation.
  • the glass fiber acts as a sensor fiber; for example, at least one region acting as a Bragg grating can be incorporated into the sensor fiber.
  • a region which has periodic changes in the refractive index in the longitudinal direction of the sensor fiber, radiation is reflected which is superimposed on reflection and is only amplified in the reverse direction for very specific wavelengths. This wavelength depends on the periodicity of the Bragg grating region and changes with this periodicity. Any length Changes in the sensor fiber or any change in the periodicity of the Bragg grating that occurs due to external influences can be determined in this way in the form of a wavelength shift.
  • a substance which is excited to fluorescence by the electromagnetic radiation fed in and whose fluorescence properties undergo changes under the influence of the environment outside the sensor fiber is embedded in the sensor fiber.
  • These changes can be mechanical changes, but in particular the fluorescence property of the embedded substance can be influenced by the chemical environment of the sensor fiber, for example the fluorescence can be quenched by certain substances in the environment.
  • the radiation-reflecting coating consists of a substance which, under the influence of the surroundings outside the sensor fiber, changes the reflection behavior for the electromagnetic radiation in the sensor fiber. This alters the amount of radiation reflected and reflected through the sensor fiber, and this can be determined.
  • any change in the properties of the radiation can be detected; these can be changes in the wavelength, the phase position, the polarization, etc. It is only essential that these changes are clearly recognizable in connection with changes in the properties in the vicinity of the sensor fiber , so- for example with changes in mechanical tension, temperature or material composition.
  • the sensor element comprises the glass fiber and a further sensor element which is connected to the measuring device via the glass fiber.
  • the glass fiber essentially acts as a transmission element between the sensor element and the measuring device.
  • the sensor element can be a pressure sensor with a flexible membrane and a mirror element which can be moved by it and which reflects the electromagnetic radiation fed into the glass fiber differently depending on the position.
  • the sensor element can be a Fabry-Perot interferometer.
  • the Fabry-Perot interferometer is designed as a thin-layer interferometer which is contacted on the end of the glass fiber and whose active layer experiences dimensional changes under the influence of the environment.
  • Such an active layer can, for example, be porous and swell when it comes into contact with a liquid, in this way it can be determined, for example, whether an implant is still sealed or has a desired or undesired opening to the surroundings.
  • the Fabry-Perot interferometer comprises two glass fibers with polished end faces, whose distance can be changed by environmental influences. This configuration is particularly advantageous when strains or displacements are to be determined within an implant.
  • the glass fiber of the sensor element can be connected directly to the measuring device, wherein the measuring device can be worn inside the body, but also outside. In the latter case, the glass fiber is guided out of the implant through the body tissue to the outside, so that a connection to the measuring device can be made there.
  • the measuring device is a microcontroller that can be implanted in the body.
  • the glass fiber is connected to a transmitter which exchanges signals with the measuring device without a physical connection.
  • This transmitter can in particular be implantable in the body, for example it can be a transponder.
  • the transmitter is a light source to which a light receiver is assigned. It has been found that light of different wavelengths can penetrate body tissue to a certain extent, so that light can transmit radiation energy between a light receiver and a light source, part of which are arranged in the body and part outside, in particular if if the light source emits electromagnetic radiation in the range between 650 and 1000 nm.
  • the measuring device is assigned a radiation transmitter which transports radiation into the interior of the implant via a glass fiber in the implant.
  • a radiation transmitter can be used to act on the implant in addition to determining the physical properties of the implant by means of the injected radiation and to change the implant, for example by heating in certain areas or the like.
  • the radiation is transported via a glass fiber which is embedded in the implant in addition to the glass fiber of a sensor element, but it can also be provided that the radiation is transported via the glass fiber of a sensor element.
  • appropriate switching elements are used which optionally connect the glass fiber to the measuring device and to the radiation transmitter.
  • a particularly advantageous embodiment is one in which the wavelength and intensity of the transported radiation are selected such that the radiation in the composite material of the implant causes mechanical and / or material changes. For example, this makes it possible to carry out an additional curing of a polymer composite in certain areas or, conversely, to weaken it by destroying the composite, so that the mechanical properties of the implant can be changed in larger areas or else locally.
  • a control is assigned to the measuring device and the radiation transmitter, which activates the radiation transmitter as a function of the measured variables of the measuring device.
  • Figure 1 is a schematic view of an implant in the form of a bone plate with a wireless connection to a measuring device
  • Figure 2 is a schematic view of a plate-shaped
  • FIG. 3 a schematic view of an implant in the form of a bone plate with one of several glass fibers tern connected measuring device and with a radiation source for introducing radiation into a glass fiber not connected to the measuring device;
  • Figure 4 a view similar to Figure 3 with a switching device for the optional connection of glass fibers in the implant with the measuring device or with the radiation source;
  • Figure 5 a schematic side view of an optical fiber with
  • FIG. 6 a schematic side view of a glass fiber with embedded fluorescent dye particles
  • FIG. 7 a schematic side view of a glass fiber with a sheathing with variable transmission properties
  • Figure 8 is a schematic side view of one with a
  • Figure 9 a view similar to Figure 8 with a dimensionally variable active layer and Figure 10: a schematic side view of a glass fiber with a membrane pressure sensor.
  • the invention is explained below using the example of a bone plate, but it goes without saying that the invention can generally be used for medical implants that can be inserted into the body and is not restricted to bone plates.
  • An implant 1 in the form of a bone plate with openings 2 for receiving bone screws is connected in a known manner by means of bone screws to two bone fragments 3, 4 in such a way that they are fixed in a certain relative position to one another, so that, for example, a fracture point 5 can heal ( Figure 1).
  • the implant 1 consists of a plastic material, for example a resorbable plastic such as polylactide (PLLA, PL DLLA), polyglycolite (PGA) or trimethylene carbonate (TMC), and glass fibers 7 are embedded in this plastic material 6.
  • PLLA polylactide
  • PGA polyglycolite
  • TMC trimethylene carbonate
  • a large number of glass fibers 7 are indicated in the form of a network which is embedded overall in the plastic material 6,
  • the glass fibers reinforce the plastic material 6 through this embedding, and accordingly different distributions in the implant are selected, depending on the mechanical strength requirements.
  • the glass fibers 7 in the exemplary embodiment in FIG. 1 are connected to a transmission element 8, for example a conventional transponder, which can be arranged on the implant 1 itself or at a distance from the implant 1 inside the patient's body or else on the surface of the patient's body , It can also be an optical element that can receive and emit light, for example a small parabolic mirror, a lens or the like.
  • a transmission element 8 for example a conventional transponder
  • all the glass fibers 7 arranged in the implant 1 are connected to the transmission element 8, in the exemplary embodiment in FIG. 2 only a few, while other glass fibers serve exclusively to reinforce the implant 1. This can be selected differently from case to case, in extreme cases it is sufficient to connect a single glass fiber 7 in the implant 1 to such a transmission element 8.
  • a corresponding transmission element 9 is assigned to the transmission element 8 and is connected to a measuring device 11 via a line 10.
  • Signals can be exchanged between the transmission elements 8 and 9, it can be electrical signals, optical signals, mechanical signals (ultrasound), it is only essential that from the transmission element 8 into the glass fiber and possibly from the glass fiber into the Transmission element 8 is transmitted electromagnetic energy, which is converted into signals in the transmission element 8, which can then be passed in any way to the transmission element 9 and thus to the measuring device 11.
  • the transmission elements 8 and 9 can have an electromagnetic see exchanging radiation with a wavelength between 650 and 1000 nanometers, this electromagnetic radiation can penetrate the body tissue to a certain depth and can therefore establish a signal connection between the two transmission elements 8 and 9, both in the direction of radiation and in the direction of radiation.
  • the radiation thus coupled into the glass fiber 7 is guided in the glass fiber 7 and changed by the latter itself or by a sensor element 12 connected to it, depending on the physical status data of the glass fiber 7, the sensor element 12 or the surroundings thereof.
  • the radiation then supplied from the glass fiber 7 to the transmission element 8 in the reverse direction is changed accordingly, and this change can be determined by the measuring device 11, which thus receives feedback about changes in the physical state of the glass fiber, the sensor element 12 and / or the environment thereof ,
  • the possibilities for influencing the electromagnetic radiation fed into the glass fiber 7 are numerous, in this way length changes, deformations, mechanical tensile stresses, forces, vibrations, pressures, angles of rotation, electric or magnetic field strengths, currents, temperatures, humidity, ionizing radiation or determine the concentration or presence of chemical substances, this is just a selection of the possible physical states that can be determined in this way.
  • Some examples of influencing the electromagnetic radiation in a glass fiber are discussed below with reference to FIGS. 5 to 10.
  • a section of a glass fiber 7 is shown in FIG. 5, different regions 13, 14, 15 are provided in this glass fiber in the longitudinal direction at a distance from one another, in which periodic changes in the refractive index occur in the longitudinal direction of the fiber.
  • These can be produced, for example, by irradiating a quartz glass fiber, for example doped with germanium dioxide, through a microlithographic mask with ultraviolet light of a wavelength of 240 nm. This creates an arrangement of a Bragg grating in each area 13, 14, 15, the periodicity and thus the grating constant being selected differently in different areas 13, 14, 15.
  • a very specific wavelength is reflected on each of these Bragg gratings by interference radiation, this wavelength depends on the periodicity of the grating and therefore also changes when the latter changes the periodicity.
  • Such a change in the periodicity or lattice constant can be caused by external influences, for example by stretching the glass fiber, by bending the glass fiber, by heating etc. Since only radiation of a certain wavelength is reflected in each area 13, 14, 15, one can use the wavelength The reflected radiation can be read off immediately at which area a reflection has occurred.
  • the shift in the wavelength provides information about changes in the grating spacing in these areas, for example about the elongation of the glass fiber in certain areas.
  • the measuring device can use the reflected radiation to make statements about how great an expansion is in each of the areas 13, 14, 15. This gives you especially when using several Such glass fibers provide precise information about the deformation of the implant 1 in the body and thus, for example, about the progress of healing when bone fragments grow together. The stretch due to the forces exerted will be greatest when the bone fragments have not yet grown together, and will decrease continuously as the healing progresses.
  • 16 dye particles 17 are embedded in the glass fiber 7 in a specific region and are excited to fluorescence by electromagnetic radiation entering the glass fiber 7.
  • the radiation emitted in this way can be determined by the measuring device.
  • Environmental influences, for example certain chemical substances in the vicinity of the area 16 can influence the fluorescence, for example the fluorescence intensity can be reduced or the fluorescence can be completely extinguished. In this way, the measuring device receives information about the presence of certain chemical substances in the vicinity of area 16.
  • the glass fiber 7 is coated with a coating 18 which prevents the electromagnetic radiation guided through the glass fiber 7 from escaping.
  • This coating can react with chemical substances 19 in the environment and thereby react in such a way that the exit properties of the electromagnetic radiation are changed in the area in which the chemical substance 19 is located, and in this way a change in the reflected radiation is obtained again depending on certain chemical substances 19 in the vicinity of the glass fiber 7.
  • the flat-ground end 20 of the glass fiber 7 is opposite a likewise flat-ground end 21 of a glass fiber piece 22, a very narrow gap 23 being formed between the ends 20 and 21, the gap width A being, for example, of the order of 50 mm.
  • This arrangement forms a Fabry-Perot interferometer and reflects radiation of a very specific wavelength, this depends on the gap width A. If the two ends 20 and 21 move relative to one another, there is also a shift in the wavelength of the reflected radiation, and this can be determined very sensitively. In this way too, for example, stretching of the implant, which is transmitted to the glass fiber 7 and the glass fiber piece 22, can be determined without further notice.
  • an active layer 24 is inserted in the gap 23, which changes its dimension, for example its volume, as a function of environmental influences.
  • it can be a porous structure that swells when liquid enters the pores.
  • the gap width B changes as a result, and this leads to a change in the wavelength of the radiation reflected at the Fabry-Perot arrangement.
  • FIGS. 8 and 9 thus form a sensor element 12, which is connected to the measuring device 11 via the glass fiber 7, whereas in the exemplary embodiments of FIGS. 5 to 7 the glass fiber 7 itself is a sensor element So here are glass fibers that are themselves sensor fibers.
  • a sensor element 12 in the form of a pressure sensor 25 is assigned to the glass fiber 7. This comprises a flexible membrane 26, which is provided on one side with a mirror layer 27. If this pressure sensor 25 is arranged at the end of a glass fiber 7, the electromagnetic radiation reflected back into the glass fiber 7 changes with the deformation of the membrane 26, which takes place as a function of pressure, and this again gives a measure of the pressure at the end of the glass fiber 7 ,
  • glass fibers 7 which are led out of the implant 1 are connected directly or indirectly to the measuring device 11.
  • connection of the transmission element 8 to the measuring device 11 is via a line 10 symbolizes, it can be a physical line or a wireless transmission link.
  • a radiation source 29 is provided which is connected to one or more glass fibers 30 which are embedded in the plastic material 6 of the implant 1.
  • a radiation source 29 is provided which is connected to one or more glass fibers 30 which are embedded in the plastic material 6 of the implant 1.
  • only one such glass fiber 30 is shown, which is connected directly to the radiation source 29; this is only to be understood as a schematic representation.
  • several glass fibers 30 can be provided, which are similar How the glass fibers 7 are connected to the measuring device, in turn are connected to the radiation source 29, that is to say via transmission elements which could be arranged inside or outside, etc.
  • the radiation source 29 can feed an electromagnetic radiation into the glass fibers 30, which emerges in the interior of the implant 1 and there has a direct influence on the environment, for example a warming-up of the surrounding plastic material 6 or an additional hardening by increased polymerization or a dissolution of polymerization compounds etc.
  • a variety of effects are conceivable here, which depend on the nature of the plastic material 6 used and on the nature of the electromagnetic radiation fed in.
  • the effect of this fed-in electromagnetic radiation is in any case an influencing of the physical data of the plastic material 6 and possibly the surroundings of the implant 1, for example the strength of the implant can be increased or decreased locally or across the board.
  • the location of the action can be determined by appropriate arrangement of the glass fibers 30 in the implant 1, the type of action by a corresponding selection of a specific radiation.
  • the radiation source 29 can be activated completely independently of the measuring device 13, but it is particularly advantageous if, as shown in FIG. 3, a control 31 is assigned to the radiation source 29, which controls the radiation source 29 depending on the measurement data of the measuring device 11. and turns off.
  • the measuring device 11 is connected to the controller 31 via a line 28. If, for example, the measuring device 11 detects that the stretch of the implant 1 decreases in a certain area, this is a sign that part of the force transmission has been taken over by healing bone fragments, it can then be fed into the glass fibers 30 by feeding electromagnetic radiation Strength of the implant 1 can be reduced by dissolving part of the plastic material 6, so that the supporting function of the implant 1 decreases in accordance with the increase in the stability of the bone connection. This makes it possible to optimally adapt these sizes to one another, and it is also conducive to healing if the bone connection is increasingly stressed in accordance with the healing process.
  • the radiation generated by the radiation source 29 is introduced via glass fibers 30, which are different from the glass fibers 7 of the measuring device.
  • FIG. 7 It is also possible to carry out both the measurement of the physical state data and the feeding of electromagnetic radiation via the same glass fibers 7, this is shown schematically in FIG.
  • an optical switch 33 is switched on, which optionally enables a connection of the glass fibers 7 to the measuring device 11 or the radiation source 29.
  • this is symbolically indicated by the double arrow C.
  • Switches of this type are available in various ways. These can be mechanical switches that, for example, move an optical fiber between two coupling points, or also switches that are electrically work magnetically, piezoelectrically or thermally, a large number of different switches are known to the person skilled in the art which can be used for this purpose.
  • the optical switch 33 can optionally also be actuated automatically, so that it is ensured that, for example, measurement of the physical condition is carried out alternately via the glass fiber 7 and radiation energy is irradiated to influence the glass fiber environment.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Neurology (AREA)
  • Biophysics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Chemical & Material Sciences (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Plasma & Fusion (AREA)
  • Analytical Chemistry (AREA)
  • Biochemistry (AREA)
  • General Physics & Mathematics (AREA)
  • Immunology (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un système d'implant médical comprenant un implant réalisé en matériau composite dans lequel sont incorporées des fibres de verre. Pour obtenir des informations sur l'état physique de l'implant dans son environnement, un élément capteur est incorporé dans l'implant et contient au moins une fibre de verre. Cet élément capteur est relié à un dispositif de mesure qui détermine une propriété physique de l'élément capteur ou de son environnement et sa modification.
PCT/EP2002/007927 2001-07-28 2002-07-17 Systeme d'implant medical WO2003011133A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
AT02791457T ATE282358T1 (de) 2001-07-28 2002-07-17 Medizinisches implantatsystem
DE50201594T DE50201594D1 (de) 2001-07-28 2002-07-17 Medizinisches implantatsystem
EP02791457A EP1424937B1 (fr) 2001-07-28 2002-07-17 Systeme d'implant medical
US10/765,724 US20040204647A1 (en) 2001-07-28 2004-01-26 Medical implant system

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10137011A DE10137011C2 (de) 2001-07-28 2001-07-28 Medizinisches Implantatsystem
DE20112482U DE20112482U1 (de) 2001-07-28 2001-07-28 Medizinisches Implantatsystem
DE10137011.3 2001-07-28

Related Child Applications (1)

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US10/765,724 Continuation US20040204647A1 (en) 2001-07-28 2004-01-26 Medical implant system

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WO2003011133A1 true WO2003011133A1 (fr) 2003-02-13

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004110272A1 (fr) * 2003-06-19 2004-12-23 Integration Diagnostics Ltd Procede et agencement destines a tester des objets
US8391958B2 (en) 2003-06-19 2013-03-05 Osstell Ab Method and arrangement relating to testing objects

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004006501A1 (de) * 2004-02-10 2005-09-01 Charité-Universitätsmedizin Berlin Bauteil und Verfahren zum Zusammenbau einer Implantatanordnung
KR101189732B1 (ko) 2004-06-07 2012-10-11 신세스 게엠바하 센서를 구비한 정형외과용 임플란트
WO2006032362A2 (fr) * 2004-09-17 2006-03-30 Michael Buhr Produits d'osteosynthese partiellement resorbables

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DE3914164C1 (fr) * 1989-04-28 1991-01-03 Aesculap Ag, 7200 Tuttlingen, De
WO1996017223A1 (fr) * 1994-11-29 1996-06-06 United Technologies Corporation Detection de l'enlevement du revetement d'un reseau de diffraction de bragg a fibre optique
US5792076A (en) * 1995-01-17 1998-08-11 Smith & Nephew, Inc. Fracture consolidation measuring apparatus
WO1999045352A1 (fr) * 1998-03-06 1999-09-10 Leiv Eiriksson Nyfotek As Capteur de pression optique
US6005242A (en) * 1997-08-15 1999-12-21 Alconi Sensline Environmental media and pressure sensor
WO2001022880A1 (fr) * 1999-09-30 2001-04-05 Uab Research Foundation Detecteur de force mecanique implantable

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JPS61135671A (ja) * 1984-12-04 1986-06-23 三菱鉱業セメント株式会社 インプラント材
US4834757A (en) * 1987-01-22 1989-05-30 Brantigan John W Prosthetic implant

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DE3914164C1 (fr) * 1989-04-28 1991-01-03 Aesculap Ag, 7200 Tuttlingen, De
WO1996017223A1 (fr) * 1994-11-29 1996-06-06 United Technologies Corporation Detection de l'enlevement du revetement d'un reseau de diffraction de bragg a fibre optique
US5792076A (en) * 1995-01-17 1998-08-11 Smith & Nephew, Inc. Fracture consolidation measuring apparatus
US6005242A (en) * 1997-08-15 1999-12-21 Alconi Sensline Environmental media and pressure sensor
WO1999045352A1 (fr) * 1998-03-06 1999-09-10 Leiv Eiriksson Nyfotek As Capteur de pression optique
WO2001022880A1 (fr) * 1999-09-30 2001-04-05 Uab Research Foundation Detecteur de force mecanique implantable

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JIE L ET AL: "Sol-gel glass as a matrix for chemical and biochemical sensing", TRAC, TRENDS IN ANALYTICAL CHEMISTRY, ANALYTICAL CHEMISTRY. CAMBRIDGE, GB, vol. 16, no. 4, 1 April 1997 (1997-04-01), pages 200 - 211, XP004064451, ISSN: 0165-9936 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004110272A1 (fr) * 2003-06-19 2004-12-23 Integration Diagnostics Ltd Procede et agencement destines a tester des objets
US8391958B2 (en) 2003-06-19 2013-03-05 Osstell Ab Method and arrangement relating to testing objects

Also Published As

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DE10137011A1 (de) 2003-02-20
DE10137011C2 (de) 2003-12-04
DE20112482U1 (de) 2001-10-31

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