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DE102004043294A1 - Drainage system for implanting an endoprosthesis comprises protective tube surrounding the drainage cannula over its whole length and connected to a cement snorkel on its upper end - Google Patents

Drainage system for implanting an endoprosthesis comprises protective tube surrounding the drainage cannula over its whole length and connected to a cement snorkel on its upper end Download PDF

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Publication number
DE102004043294A1
DE102004043294A1 DE102004043294A DE102004043294A DE102004043294A1 DE 102004043294 A1 DE102004043294 A1 DE 102004043294A1 DE 102004043294 A DE102004043294 A DE 102004043294A DE 102004043294 A DE102004043294 A DE 102004043294A DE 102004043294 A1 DE102004043294 A1 DE 102004043294A1
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Prior art keywords
cement
snorkel
protective tube
medullary
drainage system
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DE102004043294A
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German (de)
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Merete Medical GmbH
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Merete Medical GmbH
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Priority to DE102004043294A priority Critical patent/DE102004043294A1/en
Publication of DE102004043294A1 publication Critical patent/DE102004043294A1/en
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Classifications

    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8822—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
    • 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
    • A61F2/30721—Accessories
    • A61F2/30723—Plugs or restrictors for sealing a cement-receiving space
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B2050/005—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover
    • A61B2050/0062—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover closable by a combination of rotation and translation
    • A61B2050/0063—Bayonet coupling
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30062—(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
    • 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
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30235—Three-dimensional shapes cylindrical tubular, e.g. sleeves
    • 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
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • 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
    • A61F2002/30691—Drainage means, e.g. for evacuating blood or other fluids
    • 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
    • A61F2/30721—Accessories
    • A61F2/30724—Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
    • A61F2002/30726—Centering or guiding rods, e.g. for insertion of femoral shafts
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00353—Bone cement, e.g. polymethylmethacrylate or PMMA
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00365—Proteins; Polypeptides; Degradation products thereof
    • A61F2310/00383—Gelatin

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Prostheses (AREA)

Abstract

Drainage system comprises protective tube (3) surrounding the drainage cannula (4) over its whole length and connected to a cement snorkel (2) on its upper end. Preferred Features: A stopper (1) and/or the protective tube are detachedly connected together on one side and the cement snorkel on the other side so that separation occurs with increasing cement pressure. The cement snorkel encloses the drainage cannula and protective tube in a ring-like manner. The cement snorkel and the protective tube form one component.

Description

Die Erfindung betrifft ein Markraumdrainagesytem für die Implantatation einer Endoprothese, wobei die Verankerung des Prothesenschaftes mittels Zement erfolgt.The The invention relates to a medullary canal drainage system for the implantation of a Endoprosthesis, whereby the anchoring of the prosthesis stem by means of cement he follows.

Die Verwendung künstlicher Implantate für verschiedene Indikationen der verschiedenen Gelenke, und deren Fixation mittels Zement ist ein seit Jahren allgemein anerkanntes und bewährtes Verfahren.The Use artificial Implants for different Indications of various joints, and their fixation by means of Cement has been a widely recognized and proven process for years.

Für eine moderne Zementierungstechnik d.h., für den Zeitraum des Einfüllens des Zementes in den Markraum, ist eine wirkungsvolle Drainage der Markhöhle notwendig, da anderenfalls eine gefährliche Druckerhöhung im Markraum die Folge sein kann, was wiederum zu bereits erkannten Embolisationen führen könnte. Ein in den Markraum plazierter Drainageschlauch, an den auch ein sogenannter Markraumstopper angebracht ist, kann hier Abhilfe schaffen.For a modern one Cementing technique, i.e., for the period of filling of the cement in the medullary cavity, an effective drainage of the medullary cavity is necessary, otherwise a dangerous one pressure increase in the medullary canal may be the result, which in turn already recognized Embolizations lead could. A drainage tube placed in the medullary cavity, to which also a so-called medullary stopper attached, can remedy this situation.

Es ist bekannt, diese Druckerhöhung im Markraum dadurch zu vermeiden, dass der Femurschaft über eine separate Incision distal des Prothesenlagers aufgebohrt und dort gegebenenfalls eine Saugkanüle eingesetzt wird (WO 88/06 023). Diese Maßnahme ist jedoch wegen der zusätzlichen Weichteilschädigung, der zusätzlichen Knochenbohrung und der schwierigen Positionierung der Endoprothese nachteilig.It is known, this pressure increase in the medullary cavity by avoiding the femoral shaft over a Separate incision bored distal to the prosthesis bearing and there optionally a suction cannula is used (WO 88/06 023). This measure, however, is because of additional Soft tissue damage, the additional Bone hole and the difficult positioning of the endoprosthesis disadvantageous.

Eine weitere Möglichkeit zur Vermeidung der Druckerhöhung im Markraum wird in der DE 41 36 317 A1 und der entsprechenden EP 0565 680 beschrieben. Hier ist die Prothese in Richtung der Schaftachse mit einer Mittelbohrung versehen, so dass der Prothesenschaft über ein Drainagerohr geschoben werden kann. Der Zement kann dabei durch Vakuumapplikation eingebracht. Auch das Einsetzen des Prothesenschaftes erfolgt hierbei gegebenfalls unter Vakuum. Die Zementierung unter Vakuum hat sich jedoch in der operativen Praxis als wenig Praktikabel erwiesen. Das Vakuum ist nur sehr schwer aufrecht zu erhalten, da immer wieder Blut und Gewebe angesaugt werden und die Schlauchleitungen verstopfen.Another way to avoid the pressure increase in the medullary cavity is in the DE 41 36 317 A1 and the corresponding EP 0565 680 described. Here, the prosthesis is provided in the direction of the shaft axis with a central bore, so that the prosthesis socket can be pushed over a drainage tube. The cement can be introduced by vacuum application. Also, the insertion of the prosthesis shaft takes place under vacuum if necessary. However, cementation under vacuum has proven to be less practical in operative practice. The vacuum is very difficult to maintain, as again and again blood and tissue are sucked in and clog the tubing.

Der Erfindung liegt die Aufgabe zu Grunde, ein Markraumdrainagesystem der eingangs genannten Gattung zu schaffen, mit dem die nachteilige Druckerhöhung im Markraum ohne die Notwendigkeit zusätzlicher operativer Maßnahmen vermieden, eine Zementierung ohne Hohlräume oder Lufteinschlüsse gesichert wird und die Positionierung des Prothesenschaftes während der Operation ohne Druckerhöhung oder Vakuum möglichst schnell und zentriert erfolgen kann.Of the Invention is based on the object, a medullary canal drainage system to create the type mentioned, with the disadvantageous pressure increase in the medullary cavity without the need for additional operational measures avoided, a cementation without cavities or air pockets secured is and the positioning of the prosthesis shaft during the Operation without pressure increase or vacuum as possible can be done quickly and centered.

Erfindungsgemäß wird diese Aufgabe mit den im kennzeichnenden Teil des Anspruchs 1 angegebenen Maßnahmen gelöst. Ein Markraumdrainagesystem, bestehend aus Markraumstopper, Zentrierkanüle, Schutzrohr und Zementschnorchel, ist dabei so ausgebildet, dass ein retrogrades Zementieren ohne Schwierigkeiten erfolgen kann. An seinem distalen Ende ist das Markraumdrainagesystem als Markraumstopper ausgebildet, welcher nach der Operation im Körper verbleibt.According to the invention this Task with the specified in the characterizing part of claim 1 activities solved. A medullary canal drainage system, consisting of medullary block, centering cannula, protective tube and cement snorkel, is designed to be a retrograde Cementing can be done without difficulty. At his distal At the end, the medullary canal drainage system is designed as medullary stoppers, which after surgery in the body remains.

Der Markraumstopper ist an seinem proximalen Ende über die Zentrier- und Drainagekanüle mit einem Zementschnorchel verbunden. In der Mitte des Markraumdrainagesystems befindet sich die Zentrierkanüle, die eine sichere zentrierte Positionierung der Prothese sichert. Die Zentrierkanüle ist von einem Schutzrohr umgeben, dadurch wird ein retrogrades Zementieren gesichert, das heißt, der distale Teil der Femurhöhle wird als erstes mit Zement gefüllt. Durch den Druck mit dem der Zement eingebracht wird, lösen sich Zementschnorchel und Schutzrohr vom Markraumstopper und werden in proximaler Richtung aus der Femurhöhle geschoben. Nach der gewünschten blasenfreien Applikation des Zements in der Femurhöhle werden Zementschnorchel mit Schutzrohr entfernt und die Prothese über die Zentrierkanüle bis zum Markraumstopper eingeschoben.Of the Markraumstopper is at its proximal end via the centering and drainage cannula with a Connected cement snorkel. In the middle of the medullary canal drainage system is the centering cannula, which ensures a secure centered positioning of the prosthesis. The centering cannula is surrounded by a protective tube, this is a retrograde cementing secured, that is, the distal part of the femoral cavity is first filled with cement. The pressure with which the cement is introduced dissolves Cement snorkel and protective tube from the medullary plug and become more proximal Direction out of the femoral cavity pushed. After the desired bladder-free application of cement in the femoral cavity Cement snorkel with protective tube removed and the prosthesis over the Zentrierkanüle inserted to the medullary stopper.

Die Erfindung schließt dabei die Erkenntnis ein, dass durch das Schutzrohr, welches eine derart glatte Oberfläche aufweist, der Zement nicht an daran anhaftet, in Gegenrichtung zu dem sich aufbauenden Knochenzement gleichmäßig entfernt werden kann, ohne dass es zu Inhomogenitäten im Zementaufbau kommt.The Invention includes thereby the knowledge that through the protective tube, which a such a smooth surface the cement does not adhere to it in the opposite direction the building up bone cement can be removed evenly, without that it is inhomogeneities comes in cement construction.

Besonders vorteilhaft ist dabei, dass es bei dem erfindungsgemässen System zu einem kontinuierlichen Aufbau des Zements von unten nach oben, ohne störende Verwirbelungen oder Lufteinschlüsse kommt. Das System arbeitet zuverlässig und sicher, ohne dass es dabei besonderer Aufmerksamkeit seitens des Chirurgen bedarf. Insbesondere muss das Drainagerohr nicht mehr genau mit der Einfüllhöhe des Zements nachgeführt werden, um störende Unterbrechungen des Zementaufbaus oder den Aufbau von Überdruck zu verhindern.Especially It is advantageous that it is in the inventive system to a continuous construction of the cement from bottom to top, without disturbing Turbulence or air bubbles comes. The system works reliably and sure, without paying special attention the surgeon needs. In particular, the drainage pipe does not need more exactly with the filling height of the cement tracked become disturbing Interruptions of the cement structure or the build-up of overpressure to prevent.

Die Erfindung wird an Hand der Zeichnungen und der Beschreibung eines Ausführungsbeispiels, näher erläutert.The Invention will be with reference to the drawings and the description of a Embodiment, explained in more detail.

Es zeigen:It demonstrate:

1 Den oberen Teil des an eine Zementkartusche angeschlossenen Drainagesystems und 1 The upper part of the connected to a cement cartridge drainage system and

2 den unteren Teil der Vorrichtung mit dem Markraumstopper. 2 the lower part of the device with the medullary stopper.

1 zeigt nunmehr den oberen Teil des erfindungsgemäßen Markraumdrainagesystems, mit einem Zementschnorchel 2, der einen abgewinkelten Teil 2a und einen Anschluss 2b besitzt. Der Zementschnorchel 2 kann mittels des Anschluss 2b an eine vorher gefüllte oder anderweitig vorbereitete Zementkartusche 20 angekoppelt werden, beispielsweise ist der Anschluss 2b ein sog. Bajonettverschluss. 1 now shows the upper part of the medullary canal drainage system according to the invention, with a cement snorkel 2 , the angled part 2a and a connection 2 B has. The cement snorkel 2 can by means of the connection 2 B to a previously filled or otherwise prepared cement cartridge 20 be coupled, for example, is the connection 2 B a so-called bayonet lock.

Eine Drainage- bzw. Zentrierkanüle 4 befindet sich mittig des senkrechten Teiles des Zementschnorchels 2 und ragt aus dem abgewinkelten Teil 2a heraus. Fast über die gesamte Länge der Zentrierkanüle 4 befindet sich ein Schutzrohr 3, dass an der Stelle 7 mit dem abgewinkelten Teil 2a des Zementschnorchels 2a fest verbunden ist. Das Schutzrohr 3 wirkt an der Stelle 8 mit der Zentrierkanüle 4 nur abdichtend als leichte Gleitdichtung.A drainage or centering cannula 4 is located in the middle of the vertical part of the cement snorkel 2 and sticks out of the angled part 2a out. Almost the entire length of the centering cannula 4 there is a protective tube 3 that at the point 7 with the angled part 2a of the cement snorkel 2a is firmly connected. The protective tube 3 works in the place 8th with the centering cannula 4 only sealing as a light sliding seal.

Die Pfeile 6 geben die Flussrichtung des Zementes an.The arrows 6 indicate the flow direction of the cement.

In 1 ist der Femur 30 eines Oberschenkels strichpunktiert angedeutet, um die Lage und die Verwendung deutlicher darzustellen.In 1 is the femur 30 a thigh indicated by dash-dotted lines to illustrate the location and use more clearly.

Den unteren Teil des erfindungsgemäßen Markraumdrainagesystem wird in 2 gezeigt und besteht aus dem Markraumstopper 1, dem Zementschnorchel 2, der Zentrier- und Drainagekanüle 4 und dem Schutzrohr 3.The lower part of the medullary canal drainage system according to the invention is in 2 shown and consists of the medullary block 1 , the cement snorkel 2 , the centering and drainage cannula 4 and the protective tube 3 ,

Die Außenkontur des Markraumstopper 1 kann nach seiner distalen Seite hin konisch gearbeitet, so dass ein konischer Presssitz in der Markhöhle erreicht wird. Der Bereich der Überlappung 4a des Markraumstopper 1 mit der Zentrier- und Drainagekanüle 4 ist als kraftschlüssige Verbindung, beispielsweise als Gewindebereich vorgesehen.The outer contour of the medullary stopper 1 can be conically worked towards its distal side, so that a conical press fit in the medullary cavity is achieved. The area of the overlap 4a the medullary stopper 1 with the centering and drainage cannula 4 is intended as a non-positive connection, for example as a threaded area.

Beim operativen Vorgehen wird zunächst die Femurhöhle bzw. der Markraum in üblicher Weise mit einem entsprechenden Instrument nach Durchmesser und Tiefe vorbereitet, damit der Markraumstopper 1 in die geplanten Tiefe eingebracht werden kann. Hier können vorzugsweise Markraumstopper 1 mit 10 bis 18 mm Durchmesser Verwendung finden. Anschließend wird das erfindungsgemäße Markraumdrainagesystem eingesetzt. Über den Zementschnorchel 2 wird nun der Zement in angedeuteter Füllrichtung 6 ringförmig bis zum Markraumstopper 1 gedrückt. Ist der Hohlraum über dem proximalen Ende des Markraumstoppers 1 ausgefüllt, lösen sich Zementschnorchel 2 und Schutzrohr 3 an der Trennstelle 5 vom Markraumstopper und werden zusammen aus der Femurhöhle gedrückt.In the surgical procedure, the femoral cavity or the medullary cavity is prepared in the usual way with a suitable instrument according to diameter and depth, so that the medullary block 1 can be brought into the planned depth. Here can preferably medullary stoppers 1 be used with 10 to 18 mm diameter. Subsequently, the medullary canal drainage system according to the invention is used. About the cement snorkel 2 Now the cement is in indicated filling direction 6 annular to the medullary stopper 1 pressed. Is the cavity above the proximal end of the medullary plug 1 filled in, solve cement snorkel 2 and protective tube 3 at the separation point 5 from the medullary stopper and are pressed together out of the femoral cavity.

Mit dem allmählichen Entfernen von Zementschnorchel 2 und Schutzrohr 3 kann sich der Zement retrograd in alle Richtungen der distalen Markhöhle ausbreiten.With the gradual removal of cement snorkel 2 and protective tube 3 The cement may spread retrograde in all directions of the distal medullary cavity.

Es leuchtet ein, das die vorhandene Luft im Markraum beim steigenden Einbringen des Zements gleichmäßig und ohne den Aufbau eines Überdrucks durch die Drainagekanüle 4 direkt nach oben außen entweichen kann.It is clear that the existing air in the medullary cavity evenly with the increasing introduction of cement and without the build-up of an overpressure through the drainage cannula 4 can escape directly to the top.

Nach dem vollständigen Entfernen von Zementschnorchel 2 und Schutzrohr 3 entlang der zunächst verbleibenden Drainagekanüle 4, wird über die noch mit dem Markraumstopper verbundene Zentrier- und Drainagekanüle 4 die in ihrer Längsrichtung kanülierte Endoprothese in die mit Zement ausgefüllte Femurhöhle eingesetzt.After complete removal of cement snorkel 2 and protective tube 3 along the first remaining drainage cannula 4 , is via the centering and drainage cannula still connected to the medullary plug 4 the endoprosthesis cannulated in its longitudinal direction is inserted into the cemented femoral cavity.

Die Zentrier- und Drainagekanüle 4 erfüllt dabei einmal die Aufgabe der ungehinderten Markraumdrainage während und nach der Operation und des weiteren die Aufgabe der exakten zentrierten Positionierung der Endoprothese.The centering and drainage cannula 4 fulfills the task of unobstructed medullary canal drainage during and after surgery and the task of exact centered positioning of the endoprosthesis.

Nach der Implantation der Endoprothese wird die Zentrier- und Drainagekanüle 4 durch Herausdrehen am Gewindebereich 4a vom Markraumstopper 1 getrennt.After implantation of the endoprosthesis becomes the centering and drainage cannula 4 by unscrewing at the threaded area 4a from the medullary stopper 1 separated.

Der Markraumstopper 1, bekannt auch unter der Bezeichnung "Femur-Zementrestriktor", kann aus einer Gelatine/Glycerin Verbindung, aus einer bioresorbierbaren Kunststoff PE-Verbindung oder aus implantierbaren Polyethylen bzw. PMMA bestehen und ist als solcher bereits bekannt.The medullary stopper 1 , also known under the name "femoral cement restrictor", may consist of a gelatin / glycerol compound, a bioresorbable plastic PE compound or implantable polyethylene or PMMA and is already known as such.

Der Zementschnorchel 2 und das Schutzrohr 3 bestehen ebenfalls aus einer Kunststoff- PE Verbindung. Die Drainagekanüle 4 besteht vorzugsweise aus einer bioverträglichen Metallverbindung.The cement snorkel 2 and the protective tube 3 also consist of a plastic PE connection. The drainage cannula 4 preferably consists of a biocompatible metal compound.

Das gesamte montierte Markraumdrainagesystem kann steril verpackt geliefert und erst im OP nach dem Auspacken an die entsprechende Zementkartusche 20 angesetzt werden.The entire mounted medullary canal drainage system can be supplied sterile packed and only in the operating room after unpacking to the appropriate cement cartridge 20 be set.

Claims (9)

Markraumdrainagesystem für die Implantation einer Endoprothese mittels Zementierung mit einem eine Drainagekanüle aufweisenden Zementschnorchel und einem Markraumstopper, wobei der Markraumstopper und die Endoprothese in Richtung der Schaftachse jeweils mit einer Mittelbohrung versehen sind, dadurch gekennzeichnet, dass ein die Drainagekanüle (4) im wesentlichen über ihre gesamte Länge umschließendes Schutzrohr (3) vorgesehen ist, das an seinem oberen Ende mit dem Zementschnorchel (2) verbunden ist.Markraumdrainagesystem for the implantation of an endoprosthesis by cementation with a drainage cannula having a cement snorkel and a medullary block, wherein the medullary plug and the endoprosthesis verses in the direction of the shaft axis in each case with a central bore hen, characterized in that a drainage cannula ( 4 ) substantially over its entire length enclosing protective tube ( 3 ) provided at its upper end with the cement snorkel ( 2 ) connected is. Markraumdrainagesystem nach Anspruch 1, dadurch gekennzeichnet, dass der Markraumstopper (1) und/oder das Schutzrohr (3) einerseits und der Zementschnorchel (2) andererseits derart lösbar miteinander verbunden sind, dass bei sich aufbauendem Zementdruck eine Trennung erfolgt.Medullary canal drainage system according to claim 1, characterized in that the medullary cavity stopper ( 1 ) and / or the protective tube ( 3 ) on the one hand and the cement snorkel ( 2 ) On the other hand, are detachably connected to each other so that when building up cement pressure separation occurs. Markraumdrainagesystem nach einem der Ansprüche 1 oder 2, dadurch gekennzeichnet, dass der Zementschnorchel (2) die Drainagekanüle (4) und das Schutzrohr (3) ringförmig umschließt.Medullary canal drainage system according to one of claims 1 or 2, characterized in that the cement snorkel ( 2 ) the drainage cannula ( 4 ) and the protective tube ( 3 ) encloses annularly. Markraumdrainagesystem nach Anspruch 3 dadurch gekennzeichnet, dass der Zementschnorchel (2) und das Schutzrohr (3) eine Baugruppe bilden.Markraumdrainagesystem according to claim 3, characterized in that the cement snorkel ( 2 ) and the protective tube ( 3 ) form an assembly. Markraumdrainagesystem nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass der Zementschnorchel (2) und/oder das Schutzrohr (3) aus einem biokompatiblen Kunststoff besteht.Medullary canal drainage system according to one of the preceding claims, characterized in that the cement snorkel ( 2 ) and / or the protective tube ( 3 ) consists of a biocompatible plastic. Markraumdrainagesystem, nach Anspruch 5, dadurch gekennzeichnet, dass das Schutzrohr mit einer glatten Oberfläche mit geringem Reibungsbeiwert versehen ist.Medullary canal drainage system, according to claim 5, characterized characterized in that the protective tube with a smooth surface with low coefficient of friction is provided. Markraumdrainagesystem nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass der Zementschnorchel (2) einen Bajonettanschluss (2b) aufweist.Medullary canal drainage system according to one of the preceding claims, characterized in that the cement snorkel ( 2 ) a bayonet connection ( 2 B ) having. Markraumdrainagesystem nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass das Drainagesystem( 2, 3, 4) steril verpackt ist.Medullary canal drainage system according to one of the preceding claims, characterized in that the drainage system ( 2 . 3 . 4 ) is packed sterile. Markraumdrainagesystem nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, dass die Durchmesser von Zementschnorchel (2) mit dem Markraumstopper (1) übereinstimmen. Medullary canal drainage system according to one of the preceding claims, characterized in that the diameter of cement snorkel ( 2 ) with the medullary stopper ( 1 ) to match.
DE102004043294A 2004-09-08 2004-09-08 Drainage system for implanting an endoprosthesis comprises protective tube surrounding the drainage cannula over its whole length and connected to a cement snorkel on its upper end Withdrawn DE102004043294A1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2010266A4 (en) * 2006-04-07 2010-07-14 Commercialisation Des Produits INTEGRATED ACRYLIC CEMENT DELIVERY SYSTEM FOR BONE INCREASE PROCEDURES AND METHODS
US9867646B2 (en) 2006-04-07 2018-01-16 Gamal Baroud Integrated cement delivery system for bone augmentation procedures and methods

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2010266A4 (en) * 2006-04-07 2010-07-14 Commercialisation Des Produits INTEGRATED ACRYLIC CEMENT DELIVERY SYSTEM FOR BONE INCREASE PROCEDURES AND METHODS
US8409211B2 (en) 2006-04-07 2013-04-02 Societe De Commercialisation Des Produits De La Recherche Appliquee Socpra Sciences Et Genie S.E.C. Integrated cement delivery system for bone augmentation procedures and methods
US9204913B2 (en) 2006-04-07 2015-12-08 Sociéte de Commercialisation Des Produits de la Recherche Appliquée SOCPRA Sciences et Génie S.E.C. Integrated cement delivery system for bone augmentation procedures and methods
US9867646B2 (en) 2006-04-07 2018-01-16 Gamal Baroud Integrated cement delivery system for bone augmentation procedures and methods
US10004549B2 (en) 2006-04-07 2018-06-26 Gamal Baroud Integrated cement delivery system for bone augmentation procedures and methods

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