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WO2008146124A2 - Prothèse humérale destinée à l'articulation de l'épaule - Google Patents

Prothèse humérale destinée à l'articulation de l'épaule Download PDF

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Publication number
WO2008146124A2
WO2008146124A2 PCT/IB2008/001298 IB2008001298W WO2008146124A2 WO 2008146124 A2 WO2008146124 A2 WO 2008146124A2 IB 2008001298 W IB2008001298 W IB 2008001298W WO 2008146124 A2 WO2008146124 A2 WO 2008146124A2
Authority
WO
WIPO (PCT)
Prior art keywords
prosthesis
rod
cap
prosthetic
humerus
Prior art date
Application number
PCT/IB2008/001298
Other languages
English (en)
Other versions
WO2008146124A3 (fr
Inventor
Paolo Dalla Pria
Original Assignee
Lima - Lto Spa
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 Lima - Lto Spa filed Critical Lima - Lto Spa
Publication of WO2008146124A2 publication Critical patent/WO2008146124A2/fr
Publication of WO2008146124A3 publication Critical patent/WO2008146124A3/fr

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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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4003—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30171—Concave polygonal shapes rosette- or star-shaped
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30179—X-shaped
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30448—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • A61F2002/30449—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives the adhesive being cement
    • 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
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
    • 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
    • A61F2002/3097—Designing or manufacturing processes using laser
    • 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
    • A61F2/40—Joints for shoulders
    • A61F2/4003—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft
    • A61F2002/4007—Replacing only the epiphyseal or metaphyseal parts of the humerus, i.e. endoprosthesis not comprising an entire humeral shaft implanted without ablation of the whole natural humeral head
    • 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
    • A61F2002/4631—Special tools for implanting artificial joints the prosthesis being specially adapted for being cemented
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • 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
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • 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
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
    • A61F2310/00407—Coating made of titanium or of Ti-based alloys
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Definitions

  • the present invention concerns a humeral prosthesis for the articulation of a shoulder, of the so-called covering type, that is, a prosthesis suitable to be fixed to the head of a humerus, leaving it substantially intact.
  • the humeral prosthesis is able on the one hand to articulate in a corresponding glenoid seating of the shoulder, and on the other hand to be inserted and clamped in the upper part of the humerus.
  • glenoid seating we mean both a natural glenoid seating of the shoulder, and also a corresponding glenoid prosthesis which replaces the natural glenoid seating of the shoulder.
  • a humeral prosthesis is known, or so-called covering prosthesis, for the articulation of a humerus in a shoulder.
  • the prosthesis comprises, as its essential parts, a prosthetic cap, which is able to articulate in the glenoid seating of the shoulder and a metal rod, made in a single piece with the prosthetic cap, which is inserted and fixed through the humerus, in a suitable seating made in the meta- epiphyseal part of the humerus.
  • This type of prosthesis is called a covering prosthesis because, once implanted, the prosthetic cap covers the natural humeral head, and the humerus is not sectioned.
  • humeral prostheses are made in different sizes, that is, with directly correlated sizes of the prosthetic cap and the rod, so as to adapt to the sizes both on the meta-epiphyseal part of the humerus, where the seating for the rod is made, and also on the head of the humerus, which normally vary greatly, in a manner directly correlated, both according to sex and also according to the build of the patient who will receive the prosthesis.
  • humeral prostheses are not always easy to use for the surgeon, nor optimum with regard to effective articulation, if the size of the meta-epiphyseal part where the seating of the rod is made, or meta-epiphyseal seating, and the head of the humerus are not directly correlated, that is, if a humeral head with limited size corresponds to a very large seating for the rod, or vice versa, or in any case if said sizes are not regularly coordinated.
  • One purpose of the present invention is to achieve a humeral prosthesis which can be used both if the size of the meta-epiphyseal part where the seating of the rod is made, or meta-epiphyseal seating, and the humeral head are directly correlated to each other, and also if the seating of the rod and the humeral head are irregularly coordinated in size with each other, that is, if the seating of the rod is very large and the humeral head is small, and vice versa.
  • Another purpose is to facilitate the operations to implant the humeral prosthesis by the surgeon.
  • a covering humeral prosthesis for the articulation of a head of a humerus in a mating glenoid seating of a shoulder comprises a prosthetic cap which is able to articulate in the glenoid seating and which, to cover the humeral head, has a cavity into which the humeral head is able to be inserted, and a rod able to be positioned in a suitable seating in the humerus, to connect the prosthetic cap to the humerus.
  • said rod is a distinct component with respect to the prosthetic cap and is able to be coupled with the prosthetic cap, in its cavity.
  • the rod is a distinct component and removable from the prosthetic cap. This allows to combine several prosthetic caps, one at a time, of different shape and/or size, with the same rod, and vice versa.
  • the prosthesis according to the present invention comprises coupling means able to determine the selectively releasable coupling of the rod and the prosthetic cap.
  • the coupling means allows a direct and stable coupling of the rod and cap.
  • the covering humeral prosthesis according to the present invention can be used both when the size of the meta-epiphyseal seating into which the rod is inserted and the humeral head are directly correlated, and also when the meta- epiphyseal seating and the humeral head are of irregularly coordinated sizes, that is, when the meta-epiphyseal seating is very large and the humeral head is small, and vice versa.
  • the rod can be implanted through the humerus in a first operating step, ensuring the coupling means is accessible, and in a second step the prosthetic cap can be easily applied by the surgeon who can orientate and position it as necessary.
  • the rod can be shaped like a cone, a truncated cone or cylindrical. Furthermore, the rod can be substantially straight, or curvilinear or a combination of the two, according to specific applications.
  • the rod can be positioned with its longitudinal axis aligned with the axis of symmetry of the cap, or with its longitudinal axis inclined with respect to said axis.
  • the rod can be coupled with the prosthetic cap in a polar position, that is, axial to the axis of symmetry of the cap, or in an eccentric position, according to needs.
  • Another variant provides to position the rod in a central position with respect to the axis of symmetry of the cap, or displaced from the center, parallel or inclined to the axis of symmetry.
  • the coupling means comprises an open housing seating, made longitudinally in the rod, into which a mating constraining - A -
  • an insertion cone or truncated cone solid with the internal surface of the prosthetic cap.
  • the housing seating can be made in the prosthetic cap and instead the constraining element can be provided at the end of the rod.
  • the prosthetic cap and the rod are constrained to each other by means of conical coupling, which confers stability and security to the coupling.
  • the rod has, at least on part of its length, a cross- or star-shaped cross section.
  • the rod has a plurality of longitudinal ribs, able to increase the surface of contact with the humeral bone.
  • ribs instead of ribs there are corresponding grooves, or there are no ribs and no grooves, in both cases the rod being attached by means of bone cement or bioactive linings, such as porous titanium or hydroxyl apatite.
  • the present invention allows to combine rod and prosthetic cap of different materials.
  • the prosthetic cap can advantageously be made of a cobalt-based alloy, for example cobalt-chrome-molybdenum, or titanium or titanium alloy with suitable surface treatments, or of ceramic or other material with high mechanical resistance
  • the rod can be made of titanium or titanium alloy, thanks to its high capacity for bone integration.
  • the rod and/or the internal surface of the prosthetic cap are made so as to optimize their bone integration with the humeral head.
  • these components can be made of bioactive linings, such as porous titanium or hydroxyl apatite, or with an at least partly trabecular or reticular structure, of the three-dimensional type.
  • This type of at least partly trabecular structure achieves a plurality of open and intercommunicating cavities, connected both toward the inside and also toward the outside, and advantageously consists of a plurality of meshes that are repeated in space according to a predefined model and each consisting of contiguous elementary cells in polygons.
  • This reticular structure is advantageously obtained by melting metal powders, titanium- or cobalt-based, according to a predefined geometry, for example exploiting the known electronic-ray melting technologies of EBM (Electric Beam
  • FIG. 2 is a front view of a humeral prosthesis according to the present invention.
  • - fig. 3 is a plane view from below of the prosthesis in fig. 2;
  • - fig. 4 is a perspective view of the prosthesis in fig. 2;
  • - fig. 5 is a view of separate parts of the prosthesis in fig. 2;
  • - fig. 6 is a section of the prosthesis in fig. 2;
  • - fig. 7 shows part of a variant of a humeral prosthesis according to the present invention
  • - fig. 8 is a section of the variant in fig. 7; - fig. 9 shows a part of another variant of a humeral prosthesis according to the present invention.
  • - fig. 10 is a section of the variant in fig. 9.
  • a covering humeral prosthesis 10 comprises a prosthetic cap 20, axial-symmetrical with respect to an axis Y, having a semi- spherical external surface 24 and a mating semi-spherical internal surface 26, so as to define a semi-spherical cavity 27 to accommodate a head 14 of a humerus 12.
  • a rod 22 is mounted inside the cavity 27, protruding from the internal surface 26, to attach the cap 20 to the head 14 of the humerus 12.
  • the rod 22 is coaxial with said axis Y, that is, substantially in correspondence with the angular position of the pole of the cap 20 (fig. 4).
  • the rod 22 has a length sufficient to allow it to be inserted through the humerus 14 into the meta-epiphyseal part 15, and to be stably positioned therein. According to the size, the rod 22 may or may not protrude from the cavity 27.
  • the prosthesis 10 is able to be mounted on the head 14 of a humerus 12, so as to be positioned between the head 14 and the mating glenoid seating 16 of a shoulder 18 (fig. 1). As we said, the cavity 27 is able to accommodate the head
  • the rod 22 is able to be inserted into the bone of the meta-epiphyseal part 15 that makes up the head 14, previously holed to make a suitable meta-epiphyseal seating.
  • the external surface 24 is able to be geometrically coupled with the glenoid seating 16, whether it is anatomical or prosthetic.
  • the cap 20 and the rod 22 are two distinct elements and able to be coupled together, according to operating necessities (fig. 5).
  • the rod 22 is able to be selectively positioned in the cap 20, and different shapes and sizes of rod 22 can be combined with different types of cap 20, according to needs.
  • a preferential embodiment of the present invention provides to make, in a single piece with the cap 20, an insertion cone, or insertion truncated cone, or similar constraining element 28,protmding from the surface 26, coaxial with the axis Y, that is, disposed in an angular position in correspondence with the pole of the cap 20 (fig. 6).
  • the rod 22 has a conical seating, or axial cavity 30, of size and shape mating with those of the insertion cone 28.
  • the insertion of the insertion cone 28 into the seating 30 determines said coupling of the rod 22 and cap 20.
  • the insertion cone 28 and the seating 30 are shaped so as to allow a conical coupling between them, which determines an effective clamping ofthe rod 22 and cap 20.
  • the insertion cone 28 has a much smaller length, or in any case not comparable, with the length of the rod 22, since it has a different function from the latter.
  • the insertion cone 28 is fixed to the seating 30 of the rod 22 by screwing, nailing or cement.
  • Another alternative provides to make the seating 30 in the cap 20 and the cone 28 at the end of the rod 22.
  • the rod 22 is conical, advantageously to give a stable insertion into the corresponding meta- epiphyseal seating of the head 14 of the humerus 12, and has a plurality of longitudinal ribs 32, made over the whole lateral surface and equidistant from each other (fig. 3), which are able to increase the contact surface with the bone of the head 14 of the humerus 16.
  • the internal surface 26 and the cavity 27 defined thereby can be shaped like a truncated cone.
  • Another variant shown in figs. 7 and 8, provides to position the insertion cone 28 displaced with respect to the center of the cap 20 and with its longitudinal axis Y' in an inclined position with respect to the axis of symmetry Y of the prosthetic cap, for example inclined in a radial direction.
  • the cap 20 is used in case of Cuff Tear Arthropathy, or in cases of massive rotator cuff tear.

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)

Abstract

L'invention concerne une prothèse humérale (10) destinée à articuler une tête de l'humérus dans une cavité glénoïde homologue de l'épaule. La prothèse humérale comprend: une coiffe prothétique (20) pouvant s'articuler dans la cavité glénoïde et qui, pour coiffer la tête de l'humérus, présente un logement (27) dans lequel l'humérus vient s'insérer; une tige (22) pouvant être positionnée à l'intérieur de l'humérus pour relier la coiffe prothétique (20) à la tête de l'humérus. La tige (22) est un élément distinct de la coiffe prothétique (20) à laquelle elle peut s'accoupler à l'intérieur du logement (27).
PCT/IB2008/001298 2007-05-25 2008-05-23 Prothèse humérale destinée à l'articulation de l'épaule WO2008146124A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITUD2007A000089 2007-05-25
IT000089A ITUD20070089A1 (it) 2007-05-25 2007-05-25 Protesi omerale per l'articolazione della spalla

Publications (2)

Publication Number Publication Date
WO2008146124A2 true WO2008146124A2 (fr) 2008-12-04
WO2008146124A3 WO2008146124A3 (fr) 2009-03-19

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IT (1) ITUD20070089A1 (fr)
WO (1) WO2008146124A2 (fr)

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WO2012035265A1 (fr) 2010-09-17 2012-03-22 Marc Duport Cupule de prothèse d'épaule pourvue de nervures de fixation
WO2012035264A1 (fr) 2010-09-17 2012-03-22 Marc Duport Cupule modulable de prothèse d'épaule
WO2013103499A1 (fr) * 2012-01-04 2013-07-11 Biomet Manufacturing Corp. Prothèse pour épaule
US20130190881A1 (en) * 2006-03-20 2013-07-25 Biomet Manufacturing Corp. Modular center pegged glenoid
US8506638B2 (en) 2011-07-13 2013-08-13 Biomets Manufacturing, LLC Shoulder prosthesis
US8876908B2 (en) 2011-07-13 2014-11-04 Biomet Manufacturing, Llc Shoulder prosthesis
USD745678S1 (en) 2010-07-06 2015-12-15 Tornier, Inc. Prosthesis anchor
IT201600080874A1 (it) * 2016-08-01 2018-02-01 Alfonso Sciarrabone Impianto protesico artroscopico di spalla
US10213243B2 (en) 2011-07-19 2019-02-26 Tornier, Inc. Osteotome extractor
CN109730760A (zh) * 2019-01-24 2019-05-10 丁伟 一种肩关节骨性修复重建装置
US10456264B2 (en) 2014-01-24 2019-10-29 Tornier, Inc. Humeral implant anchor system
US10463499B2 (en) 2016-03-25 2019-11-05 Tornier, Inc. Stemless shoulder implant with fixation components
US11129724B2 (en) 2016-07-28 2021-09-28 Howmedica Osteonics Corp. Stemless prosthesis anchor component
RU210322U1 (ru) * 2021-09-05 2022-04-07 Андрей Юрьевич Худошин Бесстержневой эндопротез плечевого сустава
USD951449S1 (en) 2019-10-01 2022-05-10 Howmedica Osteonics Corp. Humeral implant
RU211694U1 (ru) * 2021-09-05 2022-06-17 Андрей Юрьевич Худошин Бесстержневой эндопротез плечевого сустава
US11364127B2 (en) 2018-10-02 2022-06-21 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
US11399948B2 (en) 2017-12-11 2022-08-02 Howmedica Osteonics Corp. Stemless prosthesis anchor components and kits
US11547572B2 (en) 2007-01-30 2023-01-10 Tornier Sas Intra-articular joint replacement
US11642223B2 (en) 2019-10-01 2023-05-09 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
US11974925B2 (en) 2017-09-25 2024-05-07 Howmedica Osteonics Corp. Patient specific stemless prosthesis anchor components
US12023253B2 (en) 2014-01-24 2024-07-02 Howmedica Osteonics Corp. Humeral implant anchor system

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WO2006002476A1 (fr) * 2004-07-01 2006-01-12 Orthoplan Pty Ltd Composant de resurfaçage de hanche
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Cited By (44)

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US20130190881A1 (en) * 2006-03-20 2013-07-25 Biomet Manufacturing Corp. Modular center pegged glenoid
US11547572B2 (en) 2007-01-30 2023-01-10 Tornier Sas Intra-articular joint replacement
USD965150S1 (en) 2010-07-06 2022-09-27 Howmedica Osteonics Corp. Prosthesis anchor
USD840539S1 (en) 2010-07-06 2019-02-12 Tornier, Inc. Prosthesis anchor
USD745678S1 (en) 2010-07-06 2015-12-15 Tornier, Inc. Prosthesis anchor
CN103108612A (zh) * 2010-09-17 2013-05-15 马克·杜波 可适应的肩关节假体托座
WO2012035265A1 (fr) 2010-09-17 2012-03-22 Marc Duport Cupule de prothèse d'épaule pourvue de nervures de fixation
WO2012035264A1 (fr) 2010-09-17 2012-03-22 Marc Duport Cupule modulable de prothèse d'épaule
US20130173006A1 (en) * 2010-09-17 2013-07-04 Marc Duport Adaptable shoulder prosthesis cup
US20130173007A1 (en) * 2010-09-17 2013-07-04 Marc Duport Shoulder prosthesis cup including securing ribs
FR2964857A1 (fr) * 2010-09-17 2012-03-23 Marc Duport Cupule modulable de prothese d'epaule
FR2964856A1 (fr) * 2010-09-17 2012-03-23 Marc Duport Cupule de prothese d'epaule pourvue de nervures de fixation
US8506638B2 (en) 2011-07-13 2013-08-13 Biomets Manufacturing, LLC Shoulder prosthesis
US9364334B2 (en) 2011-07-13 2016-06-14 Biomet Manufacturing, Llc Shoulder prosthesis
US9326865B2 (en) 2011-07-13 2016-05-03 Biomet Manufacturing, Llc Shoulder prosthesis
US8876908B2 (en) 2011-07-13 2014-11-04 Biomet Manufacturing, Llc Shoulder prosthesis
US11278428B2 (en) 2011-07-19 2022-03-22 Howmedica Osteonics Corp. Osteotome extractor
US10213243B2 (en) 2011-07-19 2019-02-26 Tornier, Inc. Osteotome extractor
WO2013103499A1 (fr) * 2012-01-04 2013-07-11 Biomet Manufacturing Corp. Prothèse pour épaule
US10456264B2 (en) 2014-01-24 2019-10-29 Tornier, Inc. Humeral implant anchor system
US12023253B2 (en) 2014-01-24 2024-07-02 Howmedica Osteonics Corp. Humeral implant anchor system
US11628067B2 (en) 2014-01-24 2023-04-18 Howmedica Osteonics Corp. Humeral implant anchor system
US11432933B2 (en) 2014-01-24 2022-09-06 Howmedica Osteonics Corp. Humeral implant anchor system
US11389300B2 (en) 2016-03-25 2022-07-19 Howmedica Osteonics Corp. Stemless shoulder implant with fixation components
US11660200B2 (en) 2016-03-25 2023-05-30 Howmedica Osteonics Corp. Stemless shoulder implant with fixation components
US10463499B2 (en) 2016-03-25 2019-11-05 Tornier, Inc. Stemless shoulder implant with fixation components
US11766335B2 (en) 2016-07-28 2023-09-26 Howmedica Osteonics Corp. Stemless prosthesis anchor component
US11129724B2 (en) 2016-07-28 2021-09-28 Howmedica Osteonics Corp. Stemless prosthesis anchor component
US12109121B2 (en) 2016-07-28 2024-10-08 Howmedica Osteonics Corp. Stemless prosthesis anchor component
IT201600080874A1 (it) * 2016-08-01 2018-02-01 Alfonso Sciarrabone Impianto protesico artroscopico di spalla
US11974925B2 (en) 2017-09-25 2024-05-07 Howmedica Osteonics Corp. Patient specific stemless prosthesis anchor components
US11399948B2 (en) 2017-12-11 2022-08-02 Howmedica Osteonics Corp. Stemless prosthesis anchor components and kits
US12232969B2 (en) 2018-10-02 2025-02-25 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
US12167966B2 (en) 2018-10-02 2024-12-17 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
US11364127B2 (en) 2018-10-02 2022-06-21 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
CN109730760A (zh) * 2019-01-24 2019-05-10 丁伟 一种肩关节骨性修复重建装置
US11642223B2 (en) 2019-10-01 2023-05-09 Howmedica Osteonics Corp. Shoulder prosthesis components and assemblies
USD985125S1 (en) 2019-10-01 2023-05-02 Howmedica Osteonics Corp. Humeral implant
USD951449S1 (en) 2019-10-01 2022-05-10 Howmedica Osteonics Corp. Humeral implant
USD1058810S1 (en) 2019-10-01 2025-01-21 Howmedica Osteonics Corp. Humeral implant
USD1060677S1 (en) 2019-10-01 2025-02-04 Howmedica Osteonics Corp. Humeral implant
RU211694U1 (ru) * 2021-09-05 2022-06-17 Андрей Юрьевич Худошин Бесстержневой эндопротез плечевого сустава
RU210322U1 (ru) * 2021-09-05 2022-04-07 Андрей Юрьевич Худошин Бесстержневой эндопротез плечевого сустава
RU218669U1 (ru) * 2023-03-27 2023-06-05 Федеральное государственное бюджетное образовательное учреждение высшего образования "Самарский государственный медицинский университет" Министерства здравоохранения Российской Федерации Эндопротез проксимальной части головки плечевой кости

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