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DE19530531C2 - Hip joint endoprosthesis with bioresorbable, axially supported middle part - Google Patents

Hip joint endoprosthesis with bioresorbable, axially supported middle part

Info

Publication number
DE19530531C2
DE19530531C2 DE19530531A DE19530531A DE19530531C2 DE 19530531 C2 DE19530531 C2 DE 19530531C2 DE 19530531 A DE19530531 A DE 19530531A DE 19530531 A DE19530531 A DE 19530531A DE 19530531 C2 DE19530531 C2 DE 19530531C2
Authority
DE
Germany
Prior art keywords
hip joint
bioresorbable
connecting element
joint endoprosthesis
axially supported
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
DE19530531A
Other languages
German (de)
Other versions
DE19530531A1 (en
Inventor
Frank Dr Med Lampe
Roman Dipl Ing Nassutt
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to DE19530531A priority Critical patent/DE19530531C2/en
Priority to DE59608020T priority patent/DE59608020D1/en
Priority to EP96928429A priority patent/EP0844855B1/en
Priority to US09/011,438 priority patent/US6071312A/en
Priority to PCT/EP1996/003506 priority patent/WO1997006752A1/en
Publication of DE19530531A1 publication Critical patent/DE19530531A1/en
Application granted granted Critical
Publication of DE19530531C2 publication Critical patent/DE19530531C2/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3672—Intermediate parts of 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
    • 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
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/367—Proximal or metaphyseal parts of 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
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3676—Distal or diaphyseal parts of 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
    • 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
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30032—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in absorbability or resorbability, i.e. in absorption or resorption time
    • 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
    • A61F2002/30316—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
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection
    • 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
    • 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
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30649—Ball-and-socket 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A61F2002/3631—Necks with an integral complete or partial peripheral collar or bearing shoulder at its base
    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2/3672—Intermediate parts of shafts
    • A61F2002/3674—Connections of proximal parts to distal parts
    • 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
    • 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
    • A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
    • A61F2250/0031—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time made from both resorbable and non-resorbable prosthetic parts, e.g. adjacent parts
    • 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
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel

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)
  • Materials For Medical Uses (AREA)

Description

Gelenkendoprothesen ersetzen durch degenerative, entzündliche, traumatische oder tumoröse Ver­ änderungen geschädigte Gelenke und ermöglichen es dem Patienten so, ein weitgehend "normales" Leben zu führen.Replace joint endoprostheses with degenerative, inflammatory, traumatic or tumorous ver changes damaged joints and make it possible the patient to a largely "normal" life to lead.

Es ist bekannt, daß das ideale Gelenkimplantat eine physiologische, proximal-metaphysäre Lastübertragung in das tragende Knochenlager ermöglichen sollte. Für eine ausreichende Fixierung, insbesondere zur Primär­ verankerung von zementfreien Implantaten, besitzen die üblichen Implantate vor allem im Hüftbereich einen weit in den Markraum des tragenden Knochens hinein­ reichenden Prothesenstiel.It is known that the ideal joint implant is one physiological, proximal metaphyseal load transfer in that should enable load-bearing bone. For one sufficient fixation, especially to the primary anchoring of cementless implants, the usual implants, especially in the hip area into the medullary cavity of the supporting bone reaching prosthetic handle.

Es ist weiterhin bekannt, daß durch die herkömmlichen langstieligen Prothesen die geforderte physiologische Lasteinleitung derart geändert wird, daß anstelle der proximal-metaphysären die distal-diaphysäre Kraftein­ leitung begünstigt wird (Menge, M., 1994, Die metaphysäre Prothesenverankerung - ein neues Konzept für die Femurprothese.) Durch diese Kraftumleitung in den distalen Bereich des tragenden Knochens (Femur) entsteht eine mechanische Schonung des Knochens im proximalen Bereich, das "Stress-Shielding". Die Folge ist die oft zu beobachtende Resorption des Knochens im proximalen Bereich, vor allem des Kalkar (Kalkaratrophie). Zusätzlich kommt es distal im Bereich der Stielspitze zu einer verstärkten Krafteinleitung mit resultierender Kortikalishypertrophie (Cohen, C., Rushton, N., 1995, Bone Remodelling in the Proximal Femur After Charnley THA), (Kuiper, J. H., 1993, Three-Dimensional Optimization of Hip Prosthetic Design). Diese Mechanismen führen zur Lockerung der Prothese im Knochenlager und somit zum Versagen des Implantates.It is also known that the conventional long-stemmed prostheses the required physiological Load introduction is changed so that instead of proximal metaphyseal the distal diaphyseal force line is favored (Menge, M., 1994, Die Metaphyseal prosthetic anchorage - a new one Concept for the femoral prosthesis.) Through this Force redirection into the distal area of the bearing Bone (femur) creates a mechanical Protection of the bone in the proximal area, the "Stress shielding". The result is the one that can often be observed Resorption of the bone in the proximal area, before all of the kalkar (calcar atrophy). In addition, it comes distally in the area of the stem tip to a reinforced Force application with resulting cortical hypertrophy (Cohen, C., Rushton, N., 1995, Bone Remodeling in the Proximal Femur After Charnley THA), (Kuiper, J.H., 1993, Three-Dimensional Optimization of Hip Prosthetic Design). These mechanisms lead to loosening Prosthesis in the bone bed and thus to failure of the Implants.

Es ist weiterhin bekannt, daß der Knochen­ substanzverlust im Falle einer Wechseloperation die Fixation der Wechselprothese erheblich erschwert und häufig die Verwendung von teuren Sonderimplantaten erfordert.It is also known that the bone loss of substance in the event of a change operation Fixation of the replacement prosthesis considerably more difficult and often the use of expensive special implants required.

Es ist weiterhin bekannt, daß sich als bioresorbierbare Materialien bekannte Co-Polymere verwenden lassen, die z. B. aus D,L-Lactid oder L-Lactid oder aus Glycolid oder aus einer Mischung dieser Stoffe hergestellt werden. Außerdem sind eigenverstärkte Materialien entwickelt worden, die bezüglich ihrer mechanischen Eigenschaften den bisherigen weit überlegen sind. It is also known to be bioabsorbable Let materials use known copolymers, the z. B. from D, L-lactide or L-lactide or from glycolide or made from a mixture of these substances will. In addition, are self-reinforced materials have been developed in terms of their mechanical Properties are far superior to previous ones.  

Diese kommen bereits bei der Herstellung von Knochenschrauben, -stiften und -platten zur Anwendung. Vergleiche z. B. Törmälä,P; 1993, Ultra-high Strength, Self-Reinforced Absorbable Polymeric Composites for Applications in Different Disciplines of Surgery, Clin. Mat. pp. 35-40.These come during the manufacture of Bone screws, pins and plates for use. Compare e.g. B. Törmälä, P; 1993, ultra-high strength, Self-Reinforced Absorbable Polymeric Composites for Applications in Different Disciplines of Surgery, Clin. Mat. pp. 35-40.

Es ist weiterhin bekannt, daß die Resorption zu großer Mengen bioresorbierbaren Materials im Körper zu unerwünschten Fremdkörperreaktionen führen kann.It is also known that the absorption is too great Amounts of bioabsorbable material in the body can lead to undesired foreign body reactions.

Der im Patentanspruch angegebenen Erfindung liegt das Problem zugrunde, die Vielzahl der operationstechnisch komplizierten, teuren und für den Patienten belastenden lockerungsbedingten Pro­ thesenwechseloperationen zu minimieren.The invention specified in the claim lies the problem underlying the multitude of technically complicated, expensive and for the Loosening-related pro stressing patients to minimize thesis change operations.

Dieses Problem wird durch die im Patentanspruch aufgeführten Merkmale gelöst.This problem is caused by the claim listed features solved.

Die mit der Erfindung erzielten Vorteile bestehen darin, daß dieser Prothesentyp unmittelbar postoperativ durch seinen langen Stiel eine ausreichende, den heutigen Prothesenvarianten entsprechende Primärstabilität ge­ währleistet. Durch den in den folgenden Wochen nach der Operation ablaufenden Abbau des bioresobierbaren Zwischenstückes wird eine stufenlose mechanische Entkoppelung des distalen Stielteiles vom proximalen Stielteil erreicht, die eine mech. Entlastung des distalen Stielteiles zur Folge hat. Gleichzeitig kommt es zum knöchernen Einwachsen des proximalen Stielteiles. Dieser Prozeß führt dann zu einer ausschließlich proximalen Verankerung und somit zu einer physio­ logischen Lasteinleitung in das Knochenlager. Die aseptische Implantatlockerung, die durch mechanisch bedingte Knochenresorptionsvorgänge ausgelöst wird, kann somit vermieden werden. So wird eine deutlich erhöhte Standzeit der Prothese möglich.The advantages achieved by the invention are that this type of prosthesis immediately after surgery its long stem is adequate, today's Primary stability corresponding to prosthesis variants ensures. By following in the following weeks the operation of the degradation of the bioabsorbable The intermediate piece is a stepless mechanical Decoupling of the distal part of the stem from the proximal part Stalk part reached, the one mech. Relief of the distal Part of the stem results. At the same time it comes to bony ingrowth of the proximal part of the stem. This process then leads to an exclusive one proximal anchoring and thus to a physio logical load transfer into the bone bed. The aseptic implant loosening by mechanical conditional bone resorption processes is triggered, can thus be avoided. So one becomes clear increased service life of the prosthesis possible.

Im Falle einer aus anderen Gründen trotzdem notwendigen Wechseloperation wird durch den Erhalt der proximalen Knochensubstanz eine solide Ausgangsposition für die Fixation der Wechselprothese geschaffen.In case of any other reason anyway necessary exchange operation is obtained through receipt the proximal bone is solid Starting position for the fixation of the replacement prosthesis created.

Die hier beschriebenen Funktionen der neuen Hüft­ endoprothese werden mit einem kleinen Materialvolumen des Zwischenstückes erreicht. Dies ist deshalb von entscheidender Bedeutung, da größere Mengen bioresorbierbaren Materials im Körper zu unerwünschten Gewebereaktionen führen können.The functions of the new hip described here endoprosthesis with a small Material volume of the intermediate piece reached. This is therefore crucial since larger Amounts of bioabsorbable material in the body can lead to undesirable tissue reactions.

Ein Ausführungsbeispiel der Erfindung ist in der Zeichnung dargestellt und wird im folgenden näher beschrieben.An embodiment of the invention is in the Drawing shown and will be described in more detail below described.

Es zeigtIt shows

Fig. 1 einen Schnitt durch die erfindungsgemäße Endoprothese. Fig. 1 shows a section through the endoprosthesis according to the invention.

Die Prothese besteht aus einem oberen Teil (1) und einem unteren Teil (2). Zwischen diesem oberen Teil (1) und dem unteren Teil (2) ist ein aus bioresorbierbarem Material gefertigtes Verbindungselement (3) angeordnet, das durch ein zusätzliches, nicht resorbierbares Verbindungselement (4) mechanisch gestützt wird.The prosthesis consists of an upper part ( 1 ) and a lower part ( 2 ). Between this upper part ( 1 ) and the lower part ( 2 ) there is a connecting element ( 3 ) made of bioresorbable material, which is mechanically supported by an additional, non-absorbable connecting element ( 4 ).

Claims (1)

Hüftgelenksendoprothese, bestehend aus einem Stiel und einem Gelenkteil, dadurch gekennzeichnet, daß der obere Stielteil (1) und der untere Stielteil (2) mittels eines aus bioresobierbarem Material gefertigten Verbindungselementes (3) und eines aus nicht-resorbierbarem Material gefertigten Verbindungselementes (4) gekoppelt sind, derart, daß das aus nicht-resorbierbarem Material gefertigte Verbindungselement (4) einen Teil der auftretenden Axialkräfte und Biegemomente aufnimmt und daß bei zunehmender Resorption des aus bio­ resorbierbarem Material gefertigten Verbindungselementes (3) eine entscheidende Verringerung der Biegesteifigkeit des Gesamtsystems eintritt.Hip joint endoprosthesis, consisting of a stem and a joint part, characterized in that the upper stem part ( 1 ) and the lower stem part ( 2 ) are coupled by means of a connecting element ( 3 ) made of bioabsorbable material and a connecting element ( 4 ) made of non-resorbable material are such that the connecting element ( 4 ) made of non-absorbable material absorbs part of the axial forces and bending moments that occur and that with increasing absorption of the connecting element ( 3 ) made of bio-absorbable material there is a decisive reduction in the bending stiffness of the overall system.
DE19530531A 1995-08-16 1995-08-19 Hip joint endoprosthesis with bioresorbable, axially supported middle part Expired - Fee Related DE19530531C2 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
DE19530531A DE19530531C2 (en) 1995-08-19 1995-08-19 Hip joint endoprosthesis with bioresorbable, axially supported middle part
DE59608020T DE59608020D1 (en) 1995-08-16 1996-08-08 ENDOPROTHESIS, ESPECIALLY HIP JOINT PROSTHESIS
EP96928429A EP0844855B1 (en) 1995-08-16 1996-08-08 Endoprosthesis, in particular an artificial hip joint
US09/011,438 US6071312A (en) 1995-08-16 1996-08-08 Endoprosthesis, in particular an artificial hip joint
PCT/EP1996/003506 WO1997006752A1 (en) 1995-08-16 1996-08-08 Endoprosthesis, in particular an artificial hip joint

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Application Number Priority Date Filing Date Title
DE19530531A DE19530531C2 (en) 1995-08-19 1995-08-19 Hip joint endoprosthesis with bioresorbable, axially supported middle part

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DE19530531C2 true DE19530531C2 (en) 1997-08-07

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Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CS238282B1 (en) * 1983-11-30 1985-11-13 Rudolf Pavlansky Hip endoprosthesis
US5176712A (en) * 1988-04-12 1993-01-05 Tranquil Prospects Ltd. Endoprostheses with resorption preventing means
DE4141977C2 (en) * 1991-12-19 1994-11-24 S & G Implants Gmbh Endoprosthesis to replace a human hip joint
US5571193A (en) * 1992-03-12 1996-11-05 Kampner; Stanley L. Implant with reinforced resorbable stem

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