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WO2003013398A1 - Joint prosthesis, in particular finger joint - Google Patents

Joint prosthesis, in particular finger joint Download PDF

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Publication number
WO2003013398A1
WO2003013398A1 PCT/FR2002/002815 FR0202815W WO03013398A1 WO 2003013398 A1 WO2003013398 A1 WO 2003013398A1 FR 0202815 W FR0202815 W FR 0202815W WO 03013398 A1 WO03013398 A1 WO 03013398A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
shell
prosthesis according
joint prosthesis
rod
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.)
Ceased
Application number
PCT/FR2002/002815
Other languages
French (fr)
Inventor
Philippe Valenti
Christophe Mathoulin
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
Publication of WO2003013398A1 publication Critical patent/WO2003013398A1/en
Anticipated expiration legal-status Critical
Ceased 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • 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
    • A61F2002/30362—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 with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
    • 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
    • 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
    • A61F2002/3039—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 with possibility of relative movement of the rib within the groove
    • A61F2002/30392—Rotation
    • 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
    • A61F2002/30601—Special structural features of bone or joint prostheses not otherwise provided for telescopic
    • 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
    • A61F2002/3065—Details of the ball-shaped head
    • A61F2002/30652—Special cut-outs, e.g. flat or grooved cut-outs
    • 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
    • A61F2002/30662—Ball-and-socket joints with rotation-limiting means
    • 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
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • A61F2002/30738—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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4243—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for interphalangeal joints, i.e. IP 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4251—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4256—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints
    • A61F2002/4258—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for carpo-metacarpal joints, i.e. CMC joints for trapezo-metacarpal joints of thumbs
    • 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

Definitions

  • the present invention relates to a joint prosthesis, in particular of a finger, of the type comprising a joint body which comprises on the one hand a shell having an internal cavity and on the other hand a ball joint received in rotation in this cavity, and means for connecting the articulation body to two adjacent bones, said cavity being formed by the assembly of two shell parts adapted to trap the patella.
  • US-A-5,147,386 brings into play an additional element for retaining the ball joint, for example produced under the appearance of a retaining bar which passes through the ball joint, or else a retaining cover. of the ball joint placed on the shell at the end of assembly. Although the dislocation phenomenon is then detrimentally detrimentally, at least one degree freedom of articulation is suppressed, the latter therefore being unable to reproduce a natural movement.
  • the object of the invention is to provide a dismountable joint prosthesis which, while being easy to assemble, retains the natural degrees of freedom of the biological joint, and which allows a high folding amplitude as well as the use of sleeves. anchor.
  • FIG. 1 is a side view of a joint prosthesis according to the invention implanted in the finger of a patient;
  • FIG. 2 is an exploded perspective view of the articulation prosthesis of Figure 1 without the anchoring sleeves;
  • Figure 3 is a side view in axial section of the same prosthesis;
  • Figure 4 is a top view in axial section of the shell portion forming the ring;
  • Figure 5 is a top view in axial section of the proximal shell portion;
  • Figure 6 is a bottom view of the articulation prosthesis, without the anchoring sleeves.
  • Figure 1 shows the implantation of a joint prosthesis 1 between the first phalanx and the second phalanx of the index finger of a hand.
  • This articulation prosthesis 1 comprises an articulation body 2 guided essentially by sliding in two anchoring sleeves 3 and 4 fixedly arranged in the bones of each adjacent phalanx. It can be seen in FIG. 2 that the articulation body consists of three metal parts: a shell in two parts, and a spherical ball joint 5 secured to a projecting distal rod 6 and received in rotation in an interior cavity of the shell .
  • This shell comprises a shell part forming a ring 7 and a proximal shell part 8 externally integral with a projecting proximal rod 9.
  • the two rods 6 and 9 are cylindrical, and have an identical current diameter.
  • the rod 6 carries at one of its ends the ball 5, and has a part of rod 10 of larger diameter adjacent to the ball 5.
  • a circular shoulder 11 delimits the part 10.
  • the shell part 7 has the general shape of a hollow hemisphere, comprising a cylindrical proximal extension 12 with a flat end edge 13a. It further comprises at its distal end a radial flat 13b, provided with a clover-shaped opening allowing a lateral movement of the rod 6 of approximately 2 X 11 ° degrees when the latter is aligned along the general axis XX of the prosthesis, in its metacarpophalangeal version, which is the only one requiring such lateral movement.
  • the external surface of the shell part 7 is smooth and devoid of sharp edges so as not to traumatize, once implanted, the ligaments of the natural joint.
  • the shell part 7 has a flattened lower face 13c to reduce the size of the articulation body.
  • the rod 9 has two transverse projecting lugs 14, diametrically opposite on the rod 9.
  • the shell part 7 and 8 respectively comprise internal cavities 15a and 15b which, once assembled, form a spherical cavity 15 conjugate with the ball 5, greater than a half-sphere, adapted to trap the ball. Furthermore, the shell part 7 has a radial notch 16a which cuts the lower face 13c and enters the flat 13b ( Figure 2), while the shell part 8 has a notch 16b provided in its hemispherical cavity 15b. These notches 16a and 16b are adapted to form a single notch 16 once the two shell parts 7 and 8 are assembled.
  • the two anchoring sleeves 3 and 4 have a converging outer surface of roughly triangular section intended to improve the anchoring forces of these sleeves in the bones where they are implanted.
  • the interior surfaces of these sleeves are cylindrical and smooth to ensure good sliding of the rods 6 and 9 inside said sleeves.
  • the distal rod 6 can slide and pivot freely in the distal sheath 3, while the proximal rod 9 can only slide along two longitudinal grooves 17 provided in the inner surface of the proximal sheath 4, and diametrically opposite to cooperate in guiding with the lugs 14 of the proximal rod 9.
  • any rotation of the rod 9 in the sheath 4 is limited to a small angular play provided between the lugs 14 and the corresponding grooves 17.
  • FIG. 3 is a section in the plane of symmetry of the joint, the two extreme positions can be occupied by the distal rod 6 (in dotted lines).
  • the notch 16 formed by the two notches 16a and 16b assembled is adapted to obtain maximum extension and bending positions of the joint, corresponding respectively to the upper and lower positions of the rod 6.
  • the upper position is of the order of a few degrees, for example 10 °, above the axis XX, obtained by abutment of the rod part 10 against the circular upper end of the notch 16.
  • the low position of the rod 6 forms a obtuse angle with the axis XX, for example 105 °, which is obtained when the part 10 abuts with the circular lower bottom of the notch 16.
  • the articulation therefore has a scanning angle of the order of 115 ° .
  • the width of the notch is such that the portion 10 of the distal rod has a freedom of lateral movement in a direction normal to the plane of the Figure, in an inclined position on the axis XX, this in the metacarpo version -phalangeal prosthesis.
  • Figure 3 also shows the two anchor sleeves 3 and 4, having identical external shapes.
  • the end edge 18a of the distal sheath 3 abuts against the shoulder 11 of the rod 6, while that 18b of the proximal sheath 4 abuts both against a flat proximal annular face 19 of the shell part 8 and against the flat end edge 13c.
  • the surfaces of parts 13c and 19 are coplanar.
  • Figure 4 shows the shell part 7 and shows the bottom of the notch 16a, which has a circular shape to accommodate the rod portion 10 in abutment in the low position.
  • Figure 6 shows the prosthesis assembled seen from below and shows that the notches 16a and 16b of the shell parts 7 and 8 form a single notch bottom in which the rod part 10 abuts in the low position.
  • the shell part 7, not assembled comprises a cylindrical interior cavity 20a oriented longitudinally along the axis XX.
  • An annular shoulder 21 ( Figure 4) delimits the cylindrical interior cavities 20a and spherical 15a, the cylindrical cavity having the largest diameter.
  • Figure 5 shows the shell part 8 integral with the proximal rod 9, on which are visible the projecting lugs 14 diametrically opposite.
  • the shell part 8 has a cylindrical outer surface oriented longitudinally along the axis X-X, and of a diameter barely greater than that of the cylindrical cavity 20a.
  • Figures 4 and 5 further show that the interior cavity 15a has a surface less than a hemisphere, while the interior cavity 15b is hemispherical, while the total surface of the resulting cavity 15 of the shell once the two parts of assembled shell is greater than a half sphere.
  • the articulation prosthesis being removable, the assembly of the shell parts and the ball joint is done in the factory.
  • the ball 5 is first disposed in the internal cavity 15a of the shell part 8, then the shell parts 7 and 8 are fitted one into the other until a stop position delimited by the contact of the distal face of the shell part 8 against the shoulder 21.
  • This assembly is preferably carried out by shrinking: the shell part 8 is cooled while the shell part 7 is heated, just before being nested one inside the other.
  • the surfaces 20a and 20b due to their respective expansion and contraction, are then in a state allowing easy interlocking.
  • the blocking of said parts is quickly obtained after homogenization of the temperature.
  • the joint prosthesis described with reference to the appended Figures is preferably a digital prosthesis which applies to the metacarpophalangeal joint as to the first inter-phalangeal joint.
  • the procedure is as follows: first positioning the two sheaths 3 and 4 respectively in medullary cavities previously formed in the distal and proximal bones of the natural joint to replace. Then, insert the rod 9 comprising the lugs 14 up to a stop position in the proximal sheath 4, following the guidance offered by the grooves 17. Finally, fold the articulation body 2 until the rod 6 is in its low position and this rod is inserted into the distal sheath 3. The articulation prosthesis 1 is then unfolded and the operation is completed.
  • the articulation body described below has two projecting rods, one of which is integral with a ball joint.
  • the invention is not limited to this type of prosthesis.
  • prostheses comprising only one rod are known for applications different from those mentioned above.
  • the articulation body is formed of a shell, preferably comprising a rough surface, implanted directly into the trapezium, and a projecting distal rod inserted into a sheath disposed in the adjacent metacarpus.
  • Such a joint prosthesis can be envisaged on the basis of the characteristics of the present invention. Indeed, the invention refers to a method of imprisonment of a ball joint in a shell, by means of several parts of shells assembled in particular by shrinking.

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

The invention concerns a prosthesis comprising an articulating body (2) which includes a shell in two halves having an inner cavity (15) and a ball joint (5) locked in rotation in said cavity, and means for linking (3, 4, 6, 9) the articulating body (2) to two adjacent bones. The shell parts (7, 8) comprise cylindrical conjoined surfaces interlocked with each other up to an abutting position and assembled in a tight fit. The invention is useful for repairing a trapezo-metacarpal, metacarpo-phalangeal or interphalangeal articulation.

Description

Prothèse d'articulation, notamment digitale Joint prosthesis, especially digital

La présente invention concerne une prothèse d'articulation, notamment d'un doigt, du type comprenant un corps d'articulation qui comporte d'une part une coque possédant une cavité intérieure et d'autre part une rotule reçue à rotation dans cette cavité, et des moyens de liaison du corps d'articulation à deux os adjacents, ladite cavité étant formée par l'assemblage de deux parties de coque adaptées pour emprisonner la rotule.The present invention relates to a joint prosthesis, in particular of a finger, of the type comprising a joint body which comprises on the one hand a shell having an internal cavity and on the other hand a ball joint received in rotation in this cavity, and means for connecting the articulation body to two adjacent bones, said cavity being formed by the assembly of two shell parts adapted to trap the patella.

Il est parfois nécessaire, en raison de polyarthrites rhumatoïdes, de rhumatismes déformants ou bien encore d'accidents, de remplacer une articulation par une prothèse munie de moyens articulés. On connaît, par exemple par les brevets FR-A-It is sometimes necessary, due to rheumatoid arthritis, deforming rheumatism or even accidents, to replace a joint with a prosthesis provided with articulated means. We know, for example from the patents FR-A-

2.692.776 et FR-A-2.717.071 , des prothèses d'articulation dans lesquelles l'assemblage du corps d'articulation se fait par encliquetage de la rotule dans un insert en matière plastique disposé dans la cavité intérieure de la coque. Ces prothèses, une fois implantées, soulèvent le problème de la stabilité de l'articulation. En effet, certaines contraintes exercées sur la prothèse peuvent entraîner un phénomène inverse de désolidarisation de la rotule et de la coque. Ces accidents se traduisent sur le plan physiologique par une luxation de l'articulation et sur le plan mécanique par une usure prématurée de la prothèse.2,692,776 and FR-A-2,717,071, articulation prostheses in which the assembly of the articulation body is done by snap-fastening of the ball joint in a plastic insert placed in the interior cavity of the shell. These prostheses, once implanted, raise the problem of the stability of the joint. Indeed, certain stresses exerted on the prosthesis can cause an inverse phenomenon of separation of the patella and the shell. These accidents translate physiologically by dislocation of the joint and mechanically by premature wear of the prosthesis.

Pour éviter ces phénomènes, des dispositifs de retenue de la rotule dans la cavité de la coque sont connus. Ainsi, le brevet US-A-5.147.386 , met en jeu un élément supplémentaire de retenue de la rotule, par exemple réalisé sous l'aspect d'une barre de maintien qui traverse la rotule, ou encore d'un capot de retenue de la rotule disposé sur la coque en fin d'assemblage. Bien que le phénomène de luxation soit alors enrayé, de manière préjudiciable, au moins un degré de liberté de l'articulation est supprimé, cette dernière se trouvant de ce fait dans l'incapacité de reproduire un mouvement naturel .To avoid these phenomena, devices for retaining the ball joint in the shell cavity are known. Thus, US-A-5,147,386, brings into play an additional element for retaining the ball joint, for example produced under the appearance of a retaining bar which passes through the ball joint, or else a retaining cover. of the ball joint placed on the shell at the end of assembly. Although the dislocation phenomenon is then detrimentally detrimentally, at least one degree freedom of articulation is suppressed, the latter therefore being unable to reproduce a natural movement.

Les prothèses décrites dans DE 195 12 854-C et US 3 638 243 -A, du type indiqué au début, évitent ces inconvénients. Cependant, la conception du DE-C, avec deux demi-coques assemblées par vissage, limite l'amplitude du pliage de l'articulation, tandis que celle du US-A nécessite l'emploi de rivets, ce qui rend très difficile l'utilisation des fourreaux d'ancrage dans les os et est délicat à mettre en oeuvre .The prostheses described in DE 195 12 854-C and US 3 638 243 -A, of the type indicated at the beginning, avoid these drawbacks. However, the design of the DE-C, with two half-shells assembled by screwing, limits the amplitude of the folding of the joint, while that of the US-A requires the use of rivets, which makes it very difficult to use of the anchoring sleeves in the bones and is difficult to implement.

L'invention a pour but de fournir une prothèse d'articulation indémontable qui, tout en étant facile à assembler, conserve les degrés de liberté naturels de l'articulation biologique, et qui permette une amplitude de pliage élevée ainsi que l'utilisation de fourreaux d'ancrage.The object of the invention is to provide a dismountable joint prosthesis which, while being easy to assemble, retains the natural degrees of freedom of the biological joint, and which allows a high folding amplitude as well as the use of sleeves. anchor.

A cet effet, l'invention a pour objet une prothèse d'articulation du type précité, caractérisée par la partie caractérisante de la revendication 1. Certains modes de réalisation de l'invention sont décrits dans les revendications 2 à 13.To this end, the subject of the invention is a joint prosthesis of the aforementioned type, characterized by the characterizing part of claim 1. Certain embodiments of the invention are described in claims 2 to 13.

Un exemple de réalisation de l'invention va maintenant être décrit en regard des dessins annexés, sur lesquels : - la Figure 1 est une vue de côté d'une prothèse d'articulation selon l'invention implantée dans le doigt d'un patient ;An embodiment of the invention will now be described with reference to the accompanying drawings, in which: - Figure 1 is a side view of a joint prosthesis according to the invention implanted in the finger of a patient;

- la Figure 2 est une vue en perspective éclatée de la prothèse d'articulation de la Figure 1 sans les fourreaux d'ancrage ;- Figure 2 is an exploded perspective view of the articulation prosthesis of Figure 1 without the anchoring sleeves;

- la Figure 3 est une vue de côté en coupe axiale de la même prothèse ; la Figure 4 est une vue de dessus en coupe axiale de la partie de coque formant bague ; la Figure 5 est une vue de dessus en coupe axiale de la partie de coque proximale ; et la Figure 6 est une vue de dessous de la prothèse d'articulation, sans les fourreaux d'ancrage.- Figure 3 is a side view in axial section of the same prosthesis; Figure 4 is a top view in axial section of the shell portion forming the ring; Figure 5 is a top view in axial section of the proximal shell portion; and Figure 6 is a bottom view of the articulation prosthesis, without the anchoring sleeves.

La Figure 1 montre l'implantation d'une prothèse d'articulation 1 entre la première phalange et la deuxième phalange de l'index d'une main.Figure 1 shows the implantation of a joint prosthesis 1 between the first phalanx and the second phalanx of the index finger of a hand.

Cette prothèse d'articulation 1 comprend un corps d'articulation 2 guidé essentiellement en coulissement dans deux fourreaux d'ancrage 3 et 4 disposés fixement dans les os de chaque phalange adjacente. On voit sur la Figure 2 que le corps d'articulation est constitué de trois pièces métalliques : une coque en deux pièces, et une rotule sphérique 5 solidaire d'une tige distale en saillie 6 et reçue à rotation dans une cavité intérieure de la coque. Cette coque comporte une partie de coque formant bague 7 et une partie de coque proximale 8 solidaire extérieurement d'une tige proximale 9 en saillie. Les deux tiges 6 et 9, sont cylindriques, et possèdent un diamètre courant identique.This articulation prosthesis 1 comprises an articulation body 2 guided essentially by sliding in two anchoring sleeves 3 and 4 fixedly arranged in the bones of each adjacent phalanx. It can be seen in FIG. 2 that the articulation body consists of three metal parts: a shell in two parts, and a spherical ball joint 5 secured to a projecting distal rod 6 and received in rotation in an interior cavity of the shell . This shell comprises a shell part forming a ring 7 and a proximal shell part 8 externally integral with a projecting proximal rod 9. The two rods 6 and 9 are cylindrical, and have an identical current diameter.

La tige 6 porte à l'une de ses extrémités la rotule 5, et présente une partie de tige 10 de plus grand diamètre adjacente à la rotule 5. Un épaulement circulaire 11 délimite la partie 10.The rod 6 carries at one of its ends the ball 5, and has a part of rod 10 of larger diameter adjacent to the ball 5. A circular shoulder 11 delimits the part 10.

La partie de coque 7 présente la forme générale d'une demi-sphère creuse, comportant un prolongement proximal cylindrique 12 à tranche d'extrémité plane 13a. Elle comprend en outre à son extrémité distale un méplat radial 13b, doté d'une ouverture en forme de trèfle autorisant un débattement latéral de la tige 6 d'environ 2 X 11° degrés lorsque celle- ci est alignée selon l'axe général X-X de la prothèse, dans sa version métacarpo-phalangienne, qui est la seule nécessitant un tel débattement latéral. De plus, la surface externe de la partie de coque 7 est lisse et dépourvue d'arête vive pour ne pas traumatiser, une fois implantée, les ligaments de l'articulation naturelle. Enfin, la partie de coque 7 présente une face inférieure aplatie 13c pour diminuer l'encombrement du corps d'articulation.The shell part 7 has the general shape of a hollow hemisphere, comprising a cylindrical proximal extension 12 with a flat end edge 13a. It further comprises at its distal end a radial flat 13b, provided with a clover-shaped opening allowing a lateral movement of the rod 6 of approximately 2 X 11 ° degrees when the latter is aligned along the general axis XX of the prosthesis, in its metacarpophalangeal version, which is the only one requiring such lateral movement. In addition, the external surface of the shell part 7 is smooth and devoid of sharp edges so as not to traumatize, once implanted, the ligaments of the natural joint. Finally, the shell part 7 has a flattened lower face 13c to reduce the size of the articulation body.

La tige 9 comporte deux ergots transversaux en saillie 14, diamétralement opposés sur la tige 9. Sur la Figure 3, on voit que les parties de coqueThe rod 9 has two transverse projecting lugs 14, diametrically opposite on the rod 9. In Figure 3, we see that the shell parts

7 et 8 comportent respectivement des cavités intérieures 15a et 15b qui, une fois assemblées, forment une cavité sphérique 15 conjuguée de la rotule 5, supérieure à une demi -sphère, adaptée pour emprisonner la rotule. Par ailleurs, la partie de coque 7 comporte une encoche radiale 16a qui coupe la face inférieure 13c et pénètre dans le méplat 13b (Figure 2) , tandis que la partie de coque 8 possède une encoche 16b prévue dans sa cavité hémisphérique 15b. Ces encoches 16a et 16b sont adaptées pour ne former qu'une seule encoche 16 une fois les deux parties de coque 7 et 8 assemblées.7 and 8 respectively comprise internal cavities 15a and 15b which, once assembled, form a spherical cavity 15 conjugate with the ball 5, greater than a half-sphere, adapted to trap the ball. Furthermore, the shell part 7 has a radial notch 16a which cuts the lower face 13c and enters the flat 13b (Figure 2), while the shell part 8 has a notch 16b provided in its hemispherical cavity 15b. These notches 16a and 16b are adapted to form a single notch 16 once the two shell parts 7 and 8 are assembled.

En outre, les deux fourreaux d'ancrage 3 et 4 possèdent une surface extérieure convergente à section grossièrement triangulaire destinée à améliorer les forces d'ancrage de ces fourreaux dans les os où ils sont implantés. Les surfaces intérieures de ces fourreaux sont cylindriques et lisses pour assurer un bon coulissement des tiges 6 et 9 à l'intérieur desdits fourreaux. La tige distale 6 peut coulisser et pivoter librement dans le fourreau 3 distal, tandis que la tige proximale 9 ne peut que coulisser le long de deux rainures longitudinales 17 prévues dans la surface intérieure du fourreau proximal 4, et diamétralement opposées pour coopérer en guidage avec les ergots 14 de la tige proximale 9. Ainsi, toute rotation de la tige 9 dans le fourreau 4 est limitée à un faible jeu angulaire prévu entre les ergots 14 et les rainures correspondantes 17.In addition, the two anchoring sleeves 3 and 4 have a converging outer surface of roughly triangular section intended to improve the anchoring forces of these sleeves in the bones where they are implanted. The interior surfaces of these sleeves are cylindrical and smooth to ensure good sliding of the rods 6 and 9 inside said sleeves. The distal rod 6 can slide and pivot freely in the distal sheath 3, while the proximal rod 9 can only slide along two longitudinal grooves 17 provided in the inner surface of the proximal sheath 4, and diametrically opposite to cooperate in guiding with the lugs 14 of the proximal rod 9. Thus, any rotation of the rod 9 in the sheath 4 is limited to a small angular play provided between the lugs 14 and the corresponding grooves 17.

On voit également à la Figure 3, qui est une coupe dans le plan de symétrie de l'articulation, les deux positions extrêmes pouvant être occupées par la tige distale 6 (en traits pointillés). L'encoche 16 formée par les deux encoches 16a et 16b assemblées est adaptée pour obtenir des positions d'extension et de pliure maximales de l'articulation, correspondant respectivement à des positions haute et basse de la tige 6. La position haute est de l'ordre de quelques degrés, par exemple 10°, au-dessus de l'axe X-X, obtenue par butée de la partie de tige 10 contre l'extrémité supérieure circulaire de l'encoche 16. La position basse de la tige 6 forme un angle obtus avec l'axe X-X, par exemple 105°, qui est obtenu lorsque la partie 10 vient en butée avec le fond inférieur circulaire de l'encoche 16. L'articulation possède donc un angle de balayage de l'ordre de 115°. Par ailleurs, la largeur de l'encoche est telle que la partie 10 de la tige distale a une liberté de débattement latéral selon une direction normale au plan -de la Figure, en position inclinée sur l'axe X-X, ce dans la version métacarpo-phalangienne de la prothèse .We also see in Figure 3, which is a section in the plane of symmetry of the joint, the two extreme positions can be occupied by the distal rod 6 (in dotted lines). The notch 16 formed by the two notches 16a and 16b assembled is adapted to obtain maximum extension and bending positions of the joint, corresponding respectively to the upper and lower positions of the rod 6. The upper position is of the order of a few degrees, for example 10 °, above the axis XX, obtained by abutment of the rod part 10 against the circular upper end of the notch 16. The low position of the rod 6 forms a obtuse angle with the axis XX, for example 105 °, which is obtained when the part 10 abuts with the circular lower bottom of the notch 16. The articulation therefore has a scanning angle of the order of 115 ° . Furthermore, the width of the notch is such that the portion 10 of the distal rod has a freedom of lateral movement in a direction normal to the plane of the Figure, in an inclined position on the axis XX, this in the metacarpo version -phalangeal prosthesis.

La Figure 3 montre également les deux fourreaux d'ancrage 3 et 4 , possédant des formes extérieures identiques. Lorsque les tiges 6 et 9 sont respectivement disposées à l'intérieur des fourreaux 3 et 4 , la tranche d'extrémité 18a du fourreau distal 3 vient en butée contre l'épaulement 11 de la tige 6, tandis que celle 18b du fourreau proximal 4 vient en butée à la fois contre une face annulaire proximale plane 19 de la partie de coque 8 et contre la tranche d'extrémité plane 13c. En effet, les surfaces des pièces 13c et 19 sont coplanaires.Figure 3 also shows the two anchor sleeves 3 and 4, having identical external shapes. When the rods 6 and 9 are respectively disposed inside the sheaths 3 and 4, the end edge 18a of the distal sheath 3 abuts against the shoulder 11 of the rod 6, while that 18b of the proximal sheath 4 abuts both against a flat proximal annular face 19 of the shell part 8 and against the flat end edge 13c. Indeed, the surfaces of parts 13c and 19 are coplanar.

La Figure 4 montre la partie de coque 7 et fait apparaître le fond inférieur de l'encoche 16a, qui possède une forme circulaire pour accueillir la partie de tige 10 en butée dans la position basse. La Figure 6 montre la prothèse assemblée vue de dessous et fait apparaître que les encoches 16a et 16b des parties de coque 7 et 8 forment un seul fond d'encoche dans lequel vient en butée la partie de tige 10 en position basse. De plus, la partie de coque 7, non assemblée, comprend une cavité intérieure cylindrique 20a orientée longitudinalement selon l'axe X-X. Un épaulement annulaire 21 (Figure 4) délimite les cavités intérieures cylindrique 20a et sphérique 15a, la cavité cylindrique ayant le plus grand diamètre .Figure 4 shows the shell part 7 and shows the bottom of the notch 16a, which has a circular shape to accommodate the rod portion 10 in abutment in the low position. Figure 6 shows the prosthesis assembled seen from below and shows that the notches 16a and 16b of the shell parts 7 and 8 form a single notch bottom in which the rod part 10 abuts in the low position. In addition, the shell part 7, not assembled, comprises a cylindrical interior cavity 20a oriented longitudinally along the axis XX. An annular shoulder 21 (Figure 4) delimits the cylindrical interior cavities 20a and spherical 15a, the cylindrical cavity having the largest diameter.

La Figure 5 montre la partie de coque 8 solidaire de la tige proximale 9, sur laquelle sont visibles les ergots en saillie 14 diamétralement opposés. La partie de coque 8 possède une surface extérieure cylindrique orientée longitudinalement selon l'axe X-X, et d'un diamètre à peine supérieur à celui de la cavité cylindrique 20a.Figure 5 shows the shell part 8 integral with the proximal rod 9, on which are visible the projecting lugs 14 diametrically opposite. The shell part 8 has a cylindrical outer surface oriented longitudinally along the axis X-X, and of a diameter barely greater than that of the cylindrical cavity 20a.

Les Figures 4 et 5 montrent en outre que la cavité intérieure 15a a une surface inférieure à une demi-sphère, tandis que la cavité intérieure 15b est hémisphérique, alors que la surface totale de la cavité résultante 15 de la coque une fois les deux parties de coque assemblées est supérieure à une demi - sphère .. La prothèse d'articulation étant indémontable, l'assemblage des parties de coque et de la rotule se fait en usine. Ainsi, la rotule 5 est d'abord disposée dans la cavité interne 15a de la partie de coque 8, puis les parties de coque 7 et 8 sont emboîtées l'une dans l'autre jusqu'à une position de butée délimitée par le contact de la face distale de la partie de coque 8 contre l' épaulement 21. Cet assemblage est de préférence réalisé par frettage : la partie de coque 8 est refroidie tandis que la partie de coque 7 est chauffée, juste avant d'être emboîtées l'une dans l'autre. Les surfaces 20a et 20b, en raison de leurs dilatation et contraction respectives, sont alors dans un état permettant un emboîtement facile. Le blocage desdites pièces est rapidement obtenu après homogénéisation de la température. Par ailleurs, les trois pièces métalliques 5, 7 etFigures 4 and 5 further show that the interior cavity 15a has a surface less than a hemisphere, while the interior cavity 15b is hemispherical, while the total surface of the resulting cavity 15 of the shell once the two parts of assembled shell is greater than a half sphere. The articulation prosthesis being removable, the assembly of the shell parts and the ball joint is done in the factory. Thus, the ball 5 is first disposed in the internal cavity 15a of the shell part 8, then the shell parts 7 and 8 are fitted one into the other until a stop position delimited by the contact of the distal face of the shell part 8 against the shoulder 21. This assembly is preferably carried out by shrinking: the shell part 8 is cooled while the shell part 7 is heated, just before being nested one inside the other. The surfaces 20a and 20b, due to their respective expansion and contraction, are then in a state allowing easy interlocking. The blocking of said parts is quickly obtained after homogenization of the temperature. Furthermore, the three metal parts 5, 7 and

8, sont constituées d'un même acier inoxydable. Pour diminuer le frottement direct métal/métal, les surfaces sphériques de la rotule 5 et des cavités internes 15a et 15b sont nitrurées . La prothèse d'articulation décrite en regard des Figures annexées est de préférence une prothèse digitale qui s'applique à l'articulation métacarpo-phalangienne comme à la première articulation inter-phalangienne . Pour sa mise en place au cours d'une intervention chirurgicale, on procède de la manière suivante : on positionne d'abord les deux fourreaux 3 et 4 respectivement dans des cavités médullaires préalablement ménagées dans les os distal et proximal de l'articulation naturelle à remplacer. Ensuite, on insère la tige 9 comportant les ergots 14 jusqu'à une position de butée dans le fourreau proximal 4, en suivant le guidage offert par les rainures 17. Enfin on plie le corps d'articulation 2 jusqu'à ce que la tige 6 soit dans sa position basse et l'on insère cette tige dans le fourreau distal 3. On déplie alors la prothèse d'articulation 1 et on termine l'opération.8, are made of the same stainless steel. To reduce direct metal / metal friction, the spherical surfaces of the ball 5 and of the internal cavities 15a and 15b are nitrided. The joint prosthesis described with reference to the appended Figures is preferably a digital prosthesis which applies to the metacarpophalangeal joint as to the first inter-phalangeal joint. For its implementation during a surgical procedure, the procedure is as follows: first positioning the two sheaths 3 and 4 respectively in medullary cavities previously formed in the distal and proximal bones of the natural joint to replace. Then, insert the rod 9 comprising the lugs 14 up to a stop position in the proximal sheath 4, following the guidance offered by the grooves 17. Finally, fold the articulation body 2 until the rod 6 is in its low position and this rod is inserted into the distal sheath 3. The articulation prosthesis 1 is then unfolded and the operation is completed.

Le corps d'articulation décrit ci-dessous comporte deux tiges en saillie dont l'une est solidaire d'une rotule. Cependant, l'invention ne se limite pas à ce type de prothèses. En effet, des prothèses ne comportant qu'une seule tige sont connues pour des applications différentes de celles précitées. Par exemple, dans le cas d'une application à l'articulation trapézo-métarcarpienne, la faible dimension longitudinale du trapèze interdit l'implantation d'un fourreau d'ancrage trop long, mais autorise l'implantation directe d'une coque compacte. Ainsi le corps d'articulation est formé d'une coque, comportant de préférence une surface rugueuse, implantée directement dans le trapèze, et d'une tige distale en saillie insérée dans un fourreau disposé dans le métacarpe adjacent. Une telle prothèse d'articulation est envisageable à partir des caractéristiques de la présente invention. En effet l'invention se réfère à un mode d'emprisonnement d'une rotule dans une coque, au moyen de plusieurs parties de coques assemblées notamment par frettage. The articulation body described below has two projecting rods, one of which is integral with a ball joint. However, the invention is not limited to this type of prosthesis. In fact, prostheses comprising only one rod are known for applications different from those mentioned above. For example, in the case of an application to the trapezo-metarcarpal joint, the small longitudinal dimension of the trapezium prohibits the implantation of an excessively long anchoring sheath, but allows the direct implantation of a compact shell. Thus the articulation body is formed of a shell, preferably comprising a rough surface, implanted directly into the trapezium, and a projecting distal rod inserted into a sheath disposed in the adjacent metacarpus. Such a joint prosthesis can be envisaged on the basis of the characteristics of the present invention. Indeed, the invention refers to a method of imprisonment of a ball joint in a shell, by means of several parts of shells assembled in particular by shrinking.

Claims

REVENDICATIONS 1. Prothèse d'articulation (1), comprenant un corps d'articulation (2) qui comporte d'une part une coque possédant une cavité intérieure (15) et d'autre part une rotule (5) reçue à rotation dans cette cavité, et des moyens de liaison (3, 4, 6, 9) du corps d'articulation (2) à deux os adjacents, ladite cavité (15) étant formée par l'assemblage de deux parties de coque (7, 8) adaptées pour emprisonner la rotule (5) , caractérisée en ce que les parties de coque (7, 8) comportent des surfaces conjuguées cylindriques (20a, 20b) emboîtées l'une dans l'autre jusqu'à une position de butée et assemblées à jeu négatif . 1. Joint prosthesis (1), comprising a joint body (2) which comprises on the one hand a shell having an interior cavity (15) and on the other hand a ball joint (5) rotatably received in this cavity , and connecting means (3, 4, 6, 9) of the articulation body (2) to two adjacent bones, said cavity (15) being formed by the assembly of two shell parts (7, 8) adapted for trapping the ball joint (5), characterized in that the shell parts (7, 8) have cylindrical conjugate surfaces (20a, 20b) fitted one into the other as far as a stop position and assembled together negative. 2. Prothèse d'articulation selon la revendication2. Joint prosthesis according to claim 1, caractérisée en ce que les surfaces conjuguées cylindriques (20a, 20b) sont assemblées par frettage.1, characterized in that the cylindrical conjugate surfaces (20a, 20b) are assembled by shrinking. 3. Prothèse d'articulation selon la revendication 1 ou 2, caractérisée en ce que chaque partie de coque (7, 8) comporte une encoche radiale (16a, 16b) , les deux encoches étant adaptées pour ne former qu'une seule encoche (16) de guidage d'une tige (6) solidaire de la rotule (5) après assemblage des deux parties de coque.3. Joint prosthesis according to claim 1 or 2, characterized in that each shell part (7, 8) has a radial notch (16a, 16b), the two notches being adapted to form only one notch ( 16) for guiding a rod (6) integral with the ball joint (5) after assembly of the two shell parts. 4. Prothèse d'articulation selon la revendication 3, caractérisée en ce que la coque présente la forme générale d'une demi-sphère creuse comportant un prolongement cylindrique (12), l'encoche (16) étant située dans son plan de symétrie.4. Joint prosthesis according to claim 3, characterized in that the shell has the general shape of a hollow hemisphere comprising a cylindrical extension (12), the notch (16) being located in its plane of symmetry. 5. Prothèse d'articulation selon la revendication 4, pour articulation de doigt, caractérisée en ce que l'encoche (16) est adaptée pour obtenir un angle de balayage de l'ordre de 115° compris entre des positions de pliure maximale et d'extension maximale de 1 ' articulation. 5. Joint prosthesis according to claim 4, for finger joint, characterized in that the notch (16) is adapted to obtain a scanning angle of the order of 115 ° comprised between maximum fold positions and d 'maximum extension of the joint. 6. Prothèse d'articulation selon l'une quelconque des revendications 3 à 5, caractérisée en ce que la largeur de l'encoche (16) est supérieure au diamètre de la tige solidaire de la rotule (6) en regard de cette encoche .6. Joint prosthesis according to any one of claims 3 to 5, characterized in that the width of the notch (16) is greater than the diameter of the rod integral with the ball joint (6) opposite this notch. 7. Prothèse d'articulation selon l'une quelconque des revendications précédentes, caractérisée en ce que la rotule (5) possède une forme spherique, et en ce que la cavité intérieure (15) de la coque possède une surface formant une portion de sphère supérieure à une demi- sphère, tandis que chacune desdites parties de coque (7, 8) comporte une partie de cavité (15a, 15b) dont la surface est au plus égale à une demi-sphère.7. Joint prosthesis according to any one of the preceding claims, characterized in that the ball joint (5) has a spherical shape, and in that the interior cavity (15) of the shell has a surface forming a portion of a sphere greater than a half-sphere, while each of said shell parts (7, 8) comprises a cavity part (15a, 15b) whose surface is at most equal to a half-sphere. 8. Prothèse d'articulation selon l'une quelconque des revendications précédentes, caractérisée en ce que la rotule (5) et la cavité (15) de la coque possèdent des surfaces adaptées pour coopérer directement l'une avec 1' autre .8. Joint prosthesis according to any one of the preceding claims, characterized in that the ball joint (5) and the cavity (15) of the shell have surfaces adapted to cooperate directly with one another. 9. Prothèse d'articulation selon l'une quelconque des revendications précédentes, caractérisée en ce que chaque partie de coque (7, 8) est réalisée en un matériau rigide, notamment métallique.9. Joint prosthesis according to any one of the preceding claims, characterized in that each shell part (7, 8) is made of a rigid material, in particular metallic. 10. Prothèse d'articulation selon la revendication10. Joint prosthesis according to claim 9, caractérisée en ce que chaque partie de coque (7, 8) est réalisée en acier inoxydable.9, characterized in that each shell part (7, 8) is made of stainless steel. 11. Prothèse d'articulation selon la revendication11. Joint prosthesis according to claim 10, caractérisée en ce que la cavité (15) de la coque et la rotule (5) possèdent des surfaces nitrurées.10, characterized in that the cavity (15) of the shell and the ball joint (5) have nitrided surfaces. 12. Prothèse d'articulation selon l'une quelconque des revendications précédentes, caractérisée en ce que lesdits moyens de liaison comprennent une tige en saillie (6) solidaire de la rotule (5), et éventuellement une tige proximale en saillie (9) solidaire d'une partie de coque (8) , et en ce que la prothèse comprend en outre au moins un fourreau (3, 4) destiné à être ancré dans un os et adapté pour recevoir la ou chaque tige à coulissement .12. Joint prosthesis according to any one of the preceding claims, characterized in that said connecting means comprise a projecting rod (6) integral with the ball joint (5), and optionally a proximal projecting rod (9) integral of a shell part (8), and in that the prosthesis further comprises at at least one sheath (3, 4) intended to be anchored in a bone and adapted to receive the or each sliding rod. 13. Prothèse d'articulation selon la revendication 12, caractérisée en ce qu'une tige et une seule (9) comporte au moins un ergot (14) en saillie latérale, reçu dans une rainure de guidage longitudinale (17) du fourreau associé (4), notamment avec un jeu angulaire. 13. Joint prosthesis according to claim 12, characterized in that a rod and only one (9) comprises at least one lug (14) projecting from the side, received in a longitudinal guide groove (17) of the associated sleeve ( 4), in particular with an angular play.
PCT/FR2002/002815 2001-08-06 2002-08-06 Joint prosthesis, in particular finger joint Ceased WO2003013398A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0110514 2001-08-06
FR0110514A FR2828092B1 (en) 2001-08-06 2001-08-06 PROSTHESIS OF ARTICULATION, ESPECIALLY DIGITAL

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WO2003013398A1 true WO2003013398A1 (en) 2003-02-20

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PCT/FR2002/002815 Ceased WO2003013398A1 (en) 2001-08-06 2002-08-06 Joint prosthesis, in particular finger joint

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FR (1) FR2828092B1 (en)
WO (1) WO2003013398A1 (en)

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DE10354601B3 (en) * 2003-11-21 2005-06-23 Chiropro Gmbh Finger joint prosthesis comprises a ball-and-socket joint in which the rotatable part is a ball-like disk with a peripheral opening in which a distal shaft extension is borne in a movable manner
GB2477397A (en) * 2010-01-28 2011-08-03 Biomet Mfg Corp Interphalangeal joint implant

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EP1632200A1 (en) * 2004-09-02 2006-03-08 ESKA Implants GmbH & Co. Carpometacarpal thumb joint prosthesis
FR2912051B1 (en) * 2007-02-07 2010-03-12 Jean Pierre Pequignot TRAPEZO-METACARPIAN IMPLANT
GB2506634A (en) * 2012-10-04 2014-04-09 William Duncan Robertson A joint consolidator
US11123196B1 (en) * 2020-05-07 2021-09-21 Thomas Zink Stand alone metatarsophalangeal (MTP) joint fusion device

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US5147386A (en) 1988-08-22 1992-09-15 Techmedica, Inc. Securable pistoning finger prosthesis
FR2692776A1 (en) 1992-06-30 1993-12-31 Impact Total replacement prosthesis for bone joint esp. in hand or foot - has cotylar portion implanted into bone surface, cooperating with shaft implanted in medullary canal of second bone via intermediate pin
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FR2717071A1 (en) 1994-03-11 1995-09-15 Procerati Joint prosthesis esp. for finger
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DE10354601B3 (en) * 2003-11-21 2005-06-23 Chiropro Gmbh Finger joint prosthesis comprises a ball-and-socket joint in which the rotatable part is a ball-like disk with a peripheral opening in which a distal shaft extension is borne in a movable manner
GB2477397A (en) * 2010-01-28 2011-08-03 Biomet Mfg Corp Interphalangeal joint implant
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GB2477397B (en) * 2010-01-28 2016-02-24 Biomet Mfg Corp Modular proximal interphalangeal joint

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FR2828092B1 (en) 2004-07-09

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