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FR2897527A1 - Cup for cotyloidal implant, has tapered part and recess cooperating with outer and inner surfaces of different types of inserts by friction and by detent, respectively, where cap is made of osteo-conductor metal such as titanium alloy - Google Patents

Cup for cotyloidal implant, has tapered part and recess cooperating with outer and inner surfaces of different types of inserts by friction and by detent, respectively, where cap is made of osteo-conductor metal such as titanium alloy Download PDF

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Publication number
FR2897527A1
FR2897527A1 FR0601599A FR0601599A FR2897527A1 FR 2897527 A1 FR2897527 A1 FR 2897527A1 FR 0601599 A FR0601599 A FR 0601599A FR 0601599 A FR0601599 A FR 0601599A FR 2897527 A1 FR2897527 A1 FR 2897527A1
Authority
FR
France
Prior art keywords
cup
insert
intended
implant
cavity
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.)
Granted
Application number
FR0601599A
Other languages
French (fr)
Other versions
FR2897527B1 (en
Inventor
Christophe Bussiere
Francois Guillaume Chalencon
Franck Cladiere
Philippe Forgeois
Christophe Fornasieri
Tristan Meusnier
Pascal Moreau
Claude Schwartz
Alain Aaron
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.)
Fournitures Hospitalieres Industrie SAS
Original Assignee
Fournitures Hospitalieres Industrie SAS
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 Fournitures Hospitalieres Industrie SAS filed Critical Fournitures Hospitalieres Industrie SAS
Priority to FR0601599A priority Critical patent/FR2897527B1/en
Publication of FR2897527A1 publication Critical patent/FR2897527A1/en
Application granted granted Critical
Publication of FR2897527B1 publication Critical patent/FR2897527B1/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/34—Acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/30721—Accessories
    • A61F2/30744—End caps, e.g. for closing an endoprosthetic cavity
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
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    • A61F2002/30385—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 the rib and groove having non-parallel, e.g. conically-tapered, cooperating sides, e.g. having a trapezoidal front cross-section
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    • A61F2002/30387—Dovetail connection
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—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
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
    • A61F2310/00796—Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

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 cup (2) has an inner cavity (3) in which an insert is mounted in a removable manner, where the insert receives a prosthetic femoral head. A tapered part cooperates with outer surface of a type of insert by friction, and a recess (5) cooperates with inner surface of another type of insert by detent, where the cup is made of osteo-conductor metal such as titanium alloy and is coated with hydroxyapatite. The inserts are rigid and are made of ceramic, alumina or metallic alloy.

Description

La présente invention concerne une cupule pour implant cotyloïdien et unThe present invention relates to a cup for acetabular implant and a

implant cotyloïdien comprenant cette cupule. Le traitement des hanches arthrosiques ou les traitements des fractures du col du fémur peut être réalisé en utilisant divers implants 5 prothétiques, notamment des implants cotyloïdiens. Les chirurgiens disposent de différents types d'implants cotyloïdiens adaptés selon l'anatomie et la qualité osseuse du fémur ou de l'os iliaque du patient à traiter. II existe des implants cotyloïdiens comportant une cupule 10 hémisphérique destinée à être fixée dans une cavité cotyloïdienne et délimitant une cavité intérieure destinée à recevoir une tête fémorale prothétique. Cette fixation peut être réalisée par cimentage ou par impaction. Selon le type d'implant utilisé, la cupule peut être monobloc et réalisée en polyéthylène à très haut poids moléculaire ou elle peut comprendre une enveloppe métallique 15 sensiblement hémisphérique dans laquelle est fixé un insert réalisé en polyéthylène à très haut poids moléculaire, en céramique ou en alliage métallique tel qu'un alliage de chrome-cobalt. Il existe également des implants cotyloïdiens dits implants à double mobilité . Ce type d'implant cotyloïdien comprend une cupule 20 métallique destinée à être fixée dans une cavité cotyloïdienne et délimitant une cavité hémisphérique dans laquelle s'articule un insert réalisé en polyéthylène à très haut poids moléculaire, en céramique ou en un alliage métallique. Cet insert délimite lui-même une cavité hémisphérique, de même centre que celle délimitée par la cupule, dans laquelle est destinée être articulée une tête 25 fémorale prothétique. Généralement, le chirurgien choisit en phase pré-opératoire le type d'implant cotyloïdien qui est le mieux adapté à la pathologie et à l'anatomie du patient à traiter. Le chirurgien doit parfois modifier son choix d'implant cotyloïdien 30 en phase per-opératoire, notamment lorsqu'il constate que la qualité mécanique osseuse du fémur ou de l'os iliaque est différente de celle prévue ou lorsqu'il constate qu'il existe un risque d'instabilité de l'implant. Cependant, l'instabilité de l'implant n'est pas toujours détectée en phase per-opératoire, et dans ce cas le chirurgien doit réintervenir pour mettre 35 en place sur le patient un implant cotyloïdien capable d'assurer une stabilité que les parties musculaires n'assurent plus.  cotyloid implant comprising this cup. The treatment of osteoarthritic hips or the treatment of femoral neck fractures can be accomplished using a variety of prosthetic implants, including cotyloid implants. Surgeons have different types of cotyloid implants adapted to the anatomy and bone quality of the femur or the iliac bone of the patient to be treated. There are cotyloid implants comprising a hemispherical cup 10 intended to be fixed in an acetabulum and delimiting an internal cavity intended to receive a prosthetic femoral head. This fixing can be done by cementing or by impaction. Depending on the type of implant used, the cup may be monobloc and made of very high molecular weight polyethylene or it may comprise a substantially hemispherical metal casing in which is fixed an insert made of very high molecular weight polyethylene, ceramic or in a metal alloy such as a chromium-cobalt alloy. There are also cotyloid implants called implants with dual mobility. This type of cotyloid implant comprises a metal cup intended to be fixed in an acetabular cavity and delimiting a hemispherical cavity in which is articulated an insert made of very high molecular weight polyethylene, ceramic or a metal alloy. This insert itself delimits a hemispherical cavity, of the same center as that defined by the cup, in which is intended to be articulated a prosthetic femoral head 25. Generally, the surgeon chooses in the preoperative phase the type of cotyloid implant that is best suited to the pathology and anatomy of the patient to be treated. The surgeon must sometimes modify his choice of acetabular implant 30 in the intraoperative phase, especially when he finds that the mechanical bone quality of the femur or the pelvic bone is different from that expected or when he finds that there is a risk of instability of the implant. However, the instability of the implant is not always detected in the intra-operative phase, and in this case the surgeon must re-intervene to put in place on the patient an acetabular implant capable of ensuring a stability that the muscular parts. do not insure anymore.

Cette réintervention chirurgicale nécessite parfois l'extraction complète de l'implant cotyloïdien pour le remplacer par un autre mieux adapté à la pathologie du patient. Ce remplacement complet de l'implant engendre d'importantes pertes osseuses qui sont très néfastes pour le patient.  This surgical reoperation sometimes requires the complete extraction of the cotyloid implant to replace it with another better adapted to the pathology of the patient. This complete replacement of the implant causes significant bone loss which is very harmful for the patient.

Dans certains cas, la réintervention chirurgicale consiste uniquement à remplacer un des éléments constitutifs de l'implant. En effet, lorsque l'implant cotyloïdien comporte une enveloppe métallique fixée dans l'os iliaque dans laquelle est fixé un insert réalisé en polyéthylène à très haut poids moléculaire ou en céramique, il est possible de remplacer cet insert par un insert en polyéthylène à très haut poids moléculaire dit insert anti-luxation ou insert semi-retentif sans retirer l'enveloppe métallique de l'os iliaque et donc sans engendrer de pertes osseuses. Bien que ces inserts anti-luxation ou semi-retentifs permettent de réduire le risque de luxation et donc de corriger l'instabilité de l'articulation prothétique, ils diminuent toutefois la mobilité du patient. En effet, ces deux types d'inserts consistent à plus envelopper la tête fémorale prothétique fixée sur la tige fémorale prothétique, ce qui a pour conséquence de limiter la mobilité de la prothèse totale de hanche et donc du patient. La présente invention vise donc à remédier à ces inconvénients.  In some cases, the surgical reoperation is only to replace one of the components of the implant. Indeed, when the cotyloid implant comprises a metal casing fixed in the iliac bone in which is fixed an insert made of polyethylene with a very high molecular weight or ceramic, it is possible to replace this insert by a polyethylene insert to very high molecular weight said anti-dislocation insert or semi-retentive insert without removing the metal shell of the pelvic bone and therefore without generating bone loss. Although these anti-dislocation or semi-retentive inserts reduce the risk of dislocation and thus correct the instability of the prosthetic joint, they reduce the mobility of the patient. Indeed, these two types of inserts consist of more wrap the prosthetic femoral head fixed on the femoral stem prosthetic, which has the effect of limiting the mobility of the total hip prosthesis and therefore the patient. The present invention therefore aims to remedy these drawbacks.

Le problème technique à la base de l'invention est donc la réalisation d'une cupule pour implant cotyloïdien destinée à être fixée dans une cavité cotyloïdienne qui soit de structure simple et qui n'engendre pas de pertes osseuses et une diminution de la mobilité du patient lorsqu'il est nécessaire de remplacer l'implant cotyloïdien durant une réintervention chirurgicale. A cet effet, l'invention concerne une cupule pour implant cotyloïdien, de forme sensiblement hémisphérique et destinée à être fixée dans une cavité cotyloïdienne, la cupule délimitant une cavité intérieure dans laquelle est destiné à être monté de manière amovible un insert recevant une tête fémorale prothétique, caractérisée en ce qu'elle comporte : - des premiers moyens de fixation par frottement destinés à coopérer avec la surface extérieure d'un premier type d'insert, et - des seconds moyens de fixation par encliquetage destinés à coopérer avec la surface extérieure d'un second type d'insert.  The technical problem underlying the invention is therefore the realization of an acetabular implant cup intended to be fixed in an acetabular cavity which is of simple structure and which does not cause bone loss and a decrease in the mobility of the acetabulum. patient when it is necessary to replace the cotyloid implant during a surgical reoperation. For this purpose, the invention relates to a cup for acetabular implant, of substantially hemispherical shape and intended to be fixed in an acetabular cavity, the cup delimiting an internal cavity in which is intended to be removably mounted an insert receiving a femoral head prosthetic, characterized in that it comprises: - first friction fixing means intended to cooperate with the outer surface of a first type of insert, and - second snap fastening means for cooperating with the outer surface a second type of insert.

Ainsi, des inserts possédant des propriétés tribologiques (coefficient de frottement, fluage, etc.) permettant une fixation par frottement peuvent être fixés dans la cupule par l'intermédiaire des premiers moyens de fixation par frottement. Avantageusement, ces inserts sont rigides et sont réalisés par exernple en céramique, en alumine ou en un alliage métallique. Des inserts ne possédant pas de propriétés tribologiques permettant une fixation par frottement peuvent également être fixés dans la cupule par l'intermédiaire des seconds moyens de fixation par encliquetage. Avantageusement, ces inserts sont déformables élastiquement et sont réalisés par exemple en polyéthylène à très haut poids moléculaire. La cupule est également agencée pour recevoir des inserts permettant d'obtenir un implant cotyloïdien à double mobilité. Dans ce cas, l'insert comporte avantageusement une coque rigide extérieure dont la surface extérieure permet une fixation par frottement dans la cupule. Cette coque délimite une cavité sensiblement hémisphérique dans laquelle est monté articulé un noyau réalisé en polyéthylène à très haut poids moléculaire, le noyau étant destiné à recevoir de manière articulée une tête fémorale prothétique. La fixation de ces différents inserts étant réalisée de manière amovible, le chirurgien peut, si nécessaire, remplacer, en phase pré-opératoire ou per-opératoire, l'insert choisi par un autre insert permettant d'obtenir un implant cotyloïdien plus adapté à la pathologie du patient. En outre, en cas de réintervention chirurgicale, le chirurgien peut également remplacer l'insert utilisé par un autre insert capable d'assurer la stabilité de l'articulation prothétique. Le remplacement de l'insert étant réalisé sans retirer la cupule fixée dans l'os iliaque, une création d'importantes pertes osseuses est évitée. De plus, en cas d'instabilité de l'implant cotyloïdien, le chirurgien peut remplacer l'insert utilisé par un insert permettant d'obtenir un implant cotyloïdien à double mobilité qui, contrairement aux inserts antiluxation ou semi-retentif, ne limite pas la mobilité du patient.  Thus, inserts having tribological properties (coefficient of friction, creep, etc.) enabling friction fixing can be fixed in the cup via the first friction fixing means. Advantageously, these inserts are rigid and are made for example ceramic, alumina or a metal alloy. Inserts having no tribological properties for frictional attachment may also be secured in the cup via the second snap-fastening means. Advantageously, these inserts are elastically deformable and are made for example of very high molecular weight polyethylene. The cup is also arranged to receive inserts for obtaining a cotyloid implant with dual mobility. In this case, the insert advantageously comprises an outer rigid shell whose outer surface allows frictional attachment in the cup. This shell delimits a substantially hemispherical cavity in which is mounted articulated a core made of very high molecular weight polyethylene, the core being adapted to receive in a hinged manner a prosthetic femoral head. The fixation of these different inserts being carried out in a removable manner, the surgeon can, if necessary, replace, in the preoperative or perioperative phase, the insert chosen by another insert making it possible to obtain an acetabular implant more adapted to the pathology of the patient. In addition, in case of surgical reoperation, the surgeon can also replace the insert used by another insert capable of ensuring the stability of the prosthetic joint. The replacement of the insert being performed without removing the cup fixed in the pelvic bone, a creation of significant bone loss is avoided. Moreover, in the event of instability of the acetabular implant, the surgeon can replace the insert used with an insert that makes it possible to obtain an acetabular implant with dual mobility which, unlike anttiluxation or semi-retentive inserts, does not limit the patient mobility.

La cupule selon l'invention permet donc d'obtenir, selon l'insert utilisé, différents types d'implants cotyloïdiens et permet également d'éviter la création d'importantes pertes osseuses et la diminution de la mobilité du patient s'il y a nécessité de remplacer l'implant cotyloïdien implanté dans l'os iliaque.  The cup according to the invention therefore makes it possible, according to the insert used, to obtain different types of cotyloid implants and also makes it possible to avoid the creation of significant bone loss and the reduction of the patient's mobility if there is need to replace the cotyloid implant implanted in the iliac bone.

Avantageusement, les premiers moyens de fixation par frottement comportent une partie tronconique ménagée dans la cavité intérieure délimitée par la cupule, la partie tronconique s'étendant sur au moins une portion de la cavité intérieure à partir de l'ouverture de la cupule, la partie tronconique étant destinée à coopérer par frottement avec une portion de forme complémentaire ménagée sur la surface extérieure du premier type d'insert.  Advantageously, the first friction fixing means comprise a frustoconical portion formed in the internal cavity delimited by the cup, the frustoconical portion extending over at least a portion of the internal cavity from the opening of the cup, the portion frusto-conical being intended to cooperate by friction with a portion of complementary shape formed on the outer surface of the first type of insert.

De ce fait, lorsque les inserts utilisés sont réalisés par exemple en céramique, en alumine ou en un alliage métallique, la portion tronconique ménagée sur la surface extérieure de ces derniers coopère avec la partie tronconique de la cupule afin de réaliser un emmanchement tronconique de l'insert dans la cupule qui assure un parfait maintien de l'insert dans cette dernière. Selon une autre caractéristique de l'invention, les seconds moyens de fixation par encliquetage comportent au moins une encoche ménagée dans la cupule et débouchant du côté de l'ouverture de la cupule, dans laquelle est destinée à être encliquetée au moins une dent ménagée sur l'insert.  Therefore, when the inserts used are made for example of ceramic, alumina or a metal alloy, the frustoconical portion formed on the outer surface of the latter cooperates with the frustoconical portion of the cup to achieve a frustoconical fitting of the insert in the cup which ensures a perfect fit of the insert in the latter. According to another characteristic of the invention, the second snap fastening means comprise at least one notch formed in the cup and opening on the side of the opening of the cup, in which is intended to be snapped at least one tooth formed on the insert.

Ainsi, lorsque les inserts utilisés sont réalisés par exemple en polyéthylène à très haut poids moléculaire, la dent ménagée sur l'insert coopère avec l'encoche ménagée sur la cupule pour obtenir un asservissement en rotation mais aussi en translation de l'insert par rapport à la cupule. II est à noter que la mise en place de l'insert se fait grâce à une déformation élastique de la dent ménagée sur l'insert qui est réalisé en un matériau déformable élastiquement. Avantageusement, la ou chaque encoche ménagée dans la cupule ne débouche pas dans la surface extérieure de la cupule tournée vers la cavité cotyloïdienne.  Thus, when the inserts used are made for example of very high molecular weight polyethylene, the tooth formed on the insert cooperates with the notch provided on the cup to obtain a control in rotation but also in translation of the insert relative to at the cup. It should be noted that the insertion of the insert is done through an elastic deformation of the tooth formed on the insert which is made of an elastically deformable material. Advantageously, the or each notch in the cup does not open into the outer surface of the cup facing the acetabulum.

Ainsi, lors de la fixation de l'insert sur la cupule, il n'y a aucun risque que des tissus mous s'introduisent entre l'encoche et la dent. La mise en place de l'insert est donc considérablement facilitée. Selon une autre caractéristique de l'invention, la ou chaque encoche ménagée dans la cupule est de forme trapézoïdale, son extrémité de plus grande largeur étant tournée vers le fond de la cavité intérieure délimitée par la cupule. De ce fait, les encoches agissent comme des queues d'aronde et garantissent une immobilisation totale de l'insert par rapport à la cupule. Avantageusement, la cupule comprend une succession d'encoches 35 régulièrement réparties sur la circonférence de son ouverture.  Thus, when fixing the insert on the cup, there is no risk that soft tissue is introduced between the notch and the tooth. The introduction of the insert is therefore greatly facilitated. According to another characteristic of the invention, the or each notch formed in the cup is trapezoidal in shape, its end of greater width being turned towards the bottom of the interior cavity delimited by the cup. As a result, the notches act as dovetails and guarantee total immobilization of the insert relative to the cup. Advantageously, the cup comprises a succession of notches 35 regularly distributed over the circumference of its opening.

Selon une autre caractéristique de l'invention, la cupule comporte un trou polaire pour la fixation d'un outil d'impaction et au moins un trou de passage de vis pour la fixation de la cupule dans l'os iliaque, ces différents trous étant obturables afin d'éviter la migration de particules d'usure.  According to another characteristic of the invention, the cup comprises a polar hole for fixing an impaction tool and at least one screw hole for fixing the cup in the pelvic bone, these different holes being closable to prevent migration of wear particles.

Avantageusement, la surface extérieure de la cupule comprend, sensiblement au niveau de son ouverture, des aspérités d'ancrage, ceci afin d'améliorer la fixation de la cupule dans l'os iliaque. Selon une autre caractéristique de l'invention, la cupule est réalisée dans un métal ostéo-conducteur, tel qu'un alliage de titane, et est revêtue d'hydroxyapatite. L'utilisation d'un tel métal pour réaliser la cupule permet une fixation biologique de cette dernière dans l'os iliaque. Le fait que la cupule soit revêtue d'hydroxyapatite permet d'accélérer la fixation biologique de la cupule et de créer rapidement un barrage à la migration d'éventuelles particules d'usure de la cupule.  Advantageously, the outer surface of the cup comprises, substantially at its opening, anchoring asperities, in order to improve the attachment of the cup in the pelvic bone. According to another characteristic of the invention, the cup is made of an osteoconductive metal, such as a titanium alloy, and is coated with hydroxyapatite. The use of such a metal to make the cup allows a biological fixation of the latter in the pelvic bone. The fact that the cup is coated with hydroxyapatite accelerates the biological fixation of the cup and quickly create a barrier to the migration of any wear particles of the cup.

La présente invention concerne également un implant cotyloïdien comprenant une cupule selon l'invention, et comprenant en outre un insert réalisé dans un matériau rigide, tel que de la céramique, de l'alumine ou un alliage métallique, l'insert présentant une surface extérieure destinée à coopérer avec les premiers moyens de fixation par frottement ménagés sur la cupule. Avantageusement, la surface extérieure de l'insert présente une portion tronconique de forme complémentaire de celle de la partie tronconique ménagée dans la cavité intérieure délimitée par la cupule. Selon une autre caractéristique de l'invention, l'insert comporte une coque extérieure rigide destinée à être assemblée à la cupule, la coque délimitant une cavité sensiblement hémisphérique dans laquelle est monté articulé un noyau de forme complémentaire délimitant une cavité sensiblement hémisphérique destinée à recevoir de manière articulée une tête fémorale prothétique. Le noyau est avantageusement réalisé en polyéthylène à très haut poids moléculaire. La présente invention concerne également un implant cotyloïdien comprenant une cupule selon l'invention, et comprenant en outre un insert réalisé dans un matériau non rigide, tel que le polyéthylène à très haut poids moléculaire, l'insert présentant une surface extérieure destinée à coopérer avec les seconds moyens de fixation par encliquetage ménagés sur la cupule.  The present invention also relates to an acetabular implant comprising a cup according to the invention, and further comprising an insert made of a rigid material, such as ceramic, alumina or a metal alloy, the insert having an outer surface intended to cooperate with the first friction fixing means provided on the cup. Advantageously, the outer surface of the insert has a frustoconical portion of complementary shape to that of the frustoconical portion formed in the interior cavity defined by the cup. According to another characteristic of the invention, the insert comprises a rigid outer shell intended to be assembled to the cup, the shell delimiting a substantially hemispherical cavity in which is articulated a complementary shaped core delimiting a substantially hemispherical cavity intended to receive in an articulated manner a prosthetic femoral head. The core is advantageously made of very high molecular weight polyethylene. The present invention also relates to an acetabular implant comprising a cup according to the invention, and further comprising an insert made of a non-rigid material, such as polyethylene with a very high molecular weight, the insert having an outer surface intended to cooperate with the second snap fastening means provided on the cup.

Avantageusement, l'insert comporte au moins une dent destinée à être encliquetée dans l'encoche respective ménagée dans la cupule, la ou chaque dent s'étendant radialement depuis la surface extérieure de l'insert. De toute façon l'invention sera bien comprise à l'aide de la description qui suit en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme d'exécution de cette cupule pour implant cotyloïdien et trois formes d'exécution d'un implant cotyloïdien comportant une cupule selon l'invention. La figure 1 est une vue en perspective d'une cupule selon 10 l'invention. La figure 2 est une vue en coupe de la cupule. La figure 3 est une vue en coupe d'une première forme d'exécution d'un implant cotyloïdien comportant la cupule selon l'invention. La figure 4 est une vue dessus d'une seconde forme d'exécution 15 d'un implant cotyloïdien comportant la cupule selon l'invention. La figure 5 est une vue en perspective éclatée de l'implant cotyloïdien de la figure 4. La figure 6 est une vue en perspective éclatée d'une troisième forme d'exécution d'un implant cotyloïdien comportant la cupule selon 20 l'invention. Les figures 1 et 2 représentent une cupule métallique 2 pour implant cotyloïdien. La cupule 2 est réalisée dans un métal ostéo-conducteur, tel qu'un alliage de titane, et est revêtue d'hydroxyapatite afin de favoriser sa fixation biologique dans l'os iliaque et pour créer un barrage à la migration 25 d'éventuelles particules d'usure de la cupule. Comrne montré à la figure 2, la cupule 2 est de forme sensiblement hémisphérique et est destinée à être fixée par impaction dans une cavité cotyloïdienne. La cupule 2 délimite une cavité intérieure 3 dans laquelle est destiné à être rnontée de manière amovible un insert recevant une tête 30 fémorale prothétique. Afin de permettre la fixation de différents types d'inserts, la cupule comportent des premiers moyens de fixation 4 par frottement destinés à coopérer avec la surface extérieure d'un premier type d'insert, et des seconds moyens de fixation 5 par encliquetage destinés à coopérer avec la surface 35 extérieure d'un second type d'insert.  Advantageously, the insert comprises at least one tooth intended to be snapped into the respective notch formed in the cup, the or each tooth extending radially from the outer surface of the insert. In any case, the invention will be better understood with the aid of the description which follows with reference to the appended schematic drawing showing, by way of non-limiting example, one embodiment of this cup for acetabular implant and three forms of execution of an acetabular implant comprising a cup according to the invention. Figure 1 is a perspective view of a cup according to the invention. Figure 2 is a sectional view of the cup. Figure 3 is a sectional view of a first embodiment of an acetabular implant comprising the cup according to the invention. FIG. 4 is a view of a second embodiment of an acetabular implant comprising the cup according to the invention. Fig. 5 is an exploded perspective view of the cotyloid implant of Fig. 4. Fig. 6 is an exploded perspective view of a third embodiment of an acetabular implant having the cup according to the invention. Figures 1 and 2 show a metal cup 2 for cotyloid implant. The cup 2 is made of an osteoconductive metal, such as a titanium alloy, and is coated with hydroxyapatite in order to promote its biological fixation in the pelvic bone and to create a barrier to the migration of any particles. wear of the cup. As shown in FIG. 2, the cup 2 is of substantially hemispherical shape and is intended to be impregnated in an acetabular cavity. The cup 2 delimits an interior cavity 3 into which is removably mounted an insert receiving a prosthetic femoral head. In order to allow the fixing of different types of inserts, the cup comprises first friction fixing means 4 intended to cooperate with the outer surface of a first type of insert, and second snap-fastening means 5 intended to cooperate with the outer surface of a second type of insert.

Les premiers moyens de fixation par frottement comportent une partie tronconique 4 ménagée dans la cavité intérieure 3 délimitée par la cupule 2. La partie tronconique 4 s'étend sur une portion de la cavité intérieure à partir de l'ouverture de la cupule et elle est prolongée par une partie en forme 5 de calotte sphérique 6 qui forme le fond de la cavité intérieure. La partie tronconique 4 est destinée à coopérer par frottement avec une portion tronconique ménagée sur la surface extérieure d'un d'insert du premier type afin de réaliser une fixation par emmanchement tronconique de l'insert dans la cupule. 10 Les seconds moyens de fixation par encliquetage comportent douze encoches 5 ménagées dans la cupule et débouchent du côté de son ouverture, dans lesquelles sont destinée à être encliquetées des dents ménagées sur un insert du second type. Comme montré sur la figure 1, les encoches 5 sont régulièrement 15 réparties sur la circonférence de l'ouverture de la cupule et sont de forme trapézoïdale en queue d'aronde, l'extrémité de plus grande largeur de chaque encoche 5 étant tournée vers le fond de la cavité intérieure 3 délimitée par la cupule. Chaque encoche 5 ne débouche pas dans la surface extérieure de 20 la cupule 2 tournée vers la cavité cotyloïdienne, ceci afin d'éviter tout risque d'introduction de tissus mous entre la cupule et l'insert lors de leur assemblage. La cupule 2 comporte également un trou taraudé polaire 7 pour la fixation d'un outil d'impaction (non représenté aux figures) afin de faciliter sa fixation dans la cavité cotyloïdienne de l'os iliaque. La cupule comporte en 25 outre trois trous 8 de passage de vis orientés radialement pour la fixation de la cupule dans l'os iliaque. Il est à noter que ces différents trous sont obturables afin d'éviter la migration de particules d'usure de la cupule vers l'os iliaque qui pourraient conduire à une réaction de l'organisme nécessitant parfois une réintervention 30 chirurgicale. Pour améliorer sa fixation dans la cavité cotyloïdienne, la cupule 2 comprend également sur sa surface extérieure tournée vers l'os iliaque, sensiblement au niveau de son ouverture, une aspérité d'ancrage formée par un cran circulaire 9. 35 Il va maintenant être décrit trois formes d'exécution d'implants cotyloïdiens comprenant chacun une cupule 2 selon l'invention.  The first friction fixing means comprise a frustoconical portion 4 formed in the interior cavity 3 delimited by the cup 2. The frustoconical portion 4 extends over a portion of the interior cavity from the opening of the cup and is extended by a shaped spherical cap portion 6 which forms the bottom of the inner cavity. The frustoconical portion 4 is intended to cooperate by friction with a frustoconical portion formed on the outer surface of an insert of the first type in order to achieve attachment by frustoconical fitting of the insert in the cup. The second snap-fastening means comprise twelve notches 5 in the cup and open on the side of its opening, in which are intended to be snapped teeth arranged on an insert of the second type. As shown in FIG. 1, the notches 5 are regularly distributed over the circumference of the opening of the cup and are trapezoidal dovetail-shaped, the wider end of each notch 5 being turned towards the bottom of the interior cavity 3 delimited by the cup. Each notch 5 does not open into the outer surface of the cup 2 facing the acetabular cavity, this to avoid any risk of introduction of soft tissue between the cup and the insert during assembly. The cup 2 also comprises a polar threaded hole 7 for attaching an impaction tool (not shown in the figures) in order to facilitate its fixation in the acetabular cavity of the pelvic bone. The cup further comprises three radially oriented screw holes 8 for securing the cup to the pelvic bone. It should be noted that these different holes are closable in order to avoid the migration of wear particles from the cup to the iliac bone which could lead to a reaction of the body sometimes requiring a surgical reoperation. To improve its fixation in the acetabular cavity, the cup 2 also comprises on its outer surface turned towards the pelvic bone, substantially at the level of its opening, an anchoring asperity formed by a circular notch 9. It will now be described three embodiments of cotyloid implants each comprising a cup 2 according to the invention.

La figure 3 représente une vue en coupe d'un premier implant cotyloïdien 10 comprenant une cupule 2 et un insert 11 réalisé dans un matériau rigide, tel que de la céramique, de l'alumine ou un alliage métallique. L'insert 11 présente une surface extérieure destinée à coopérer avec les premiers moyens de fixation 4 par frottement ménagés sur la cupule. Ainsi, la surface extérieure de l'insert 11 présente une portion tronconique 12 de forme complémentaire de celle de la partie tronconique 4 ménagée dans la cavité intérieure 3 délimitée par la cupule 2. L'insert 11 délimite une cavité sensiblement hémisphérique 13 destinée à recevoir de manière articulée une tête fémorale prothétique. Les figures 4 et 5 représentent un second implant cotyloïdien 20 comprenant une cupule 2 et un insert 21 comportant une coque extérieure rigide 22 réalisée par exemple en acier inoxidable ou en alliage chrome-cobalt et présentant sur sa surface extérieure une portion tronconique 23 complémentaire de celle de la partie tronconique 4 de la cupule 2 afin de permettre un emmanchement tronconique de la coque dans la cupule. La coque 22 délimite une cavité sensiblement hémisphérique 24 dans laquelle est monté articulé un noyau 25 de forme complémentaire réalisé en polyéthylène à très haut poids moléculaire, le noyau 25 délimitant une cavité sensiblement hémisphérique 26, de même centre que celle délimitée par la cupule 2, destinée à recevoir de manière articulée une tête fémorale prothétique. L'association de la cupule 2 avec la coque 22 et le noyau 25 permet d'obtenir un implant cotyloïdien 20 à double mobilité . Il est à noter que lorsque des vis de fixation sont utilisées pour fixer la cupule 2 dans la cavité cotyloïdienne, la tête de ces vis se situe entre la cupule et la coque rigide 22 et non entre la cupule et la cavité hémisphérique où a lieu l'articulation du noyau 25 réalisé en polyéthylène à très haut poids moléculaire. De ce fait, contrairement aux implants cotyloïdiens à double mobilité de l'art antérieur, les risques de génération de particules d'usure du noyau sont limités. La figure 6 représente un troisième implant cotyloïdien 30 comprenant une cupule 2 et un insert 31 réalisé en polyéthylène à très haut poids moléculaire. L'insert 31 présente une surface extérieure destinée à coopérer avec les seconds moyens de fixation 5 par encliquetage ménagés sur la cupule.  FIG. 3 represents a sectional view of a first acetabular implant 10 comprising a cup 2 and an insert 11 made of a rigid material, such as ceramic, alumina or a metal alloy. The insert 11 has an outer surface intended to cooperate with the first friction fixing means 4 formed on the cup. Thus, the outer surface of the insert 11 has a frustoconical portion 12 of complementary shape to that of the frustoconical portion 4 formed in the interior cavity 3 delimited by the cup 2. The insert 11 defines a substantially hemispherical cavity 13 intended to receive in an articulated manner a prosthetic femoral head. Figures 4 and 5 show a second acetabular implant 20 comprising a cup 2 and an insert 21 having a rigid outer shell 22 made for example of stainless steel or chromium-cobalt alloy and having on its outer surface a frustoconical portion 23 complementary to that of the frustoconical portion 4 of the cup 2 to allow a frustoconical fitting of the shell in the cup. The shell 22 delimits a substantially hemispherical cavity 24 in which is mounted articulated a core 25 of complementary shape made of very high molecular weight polyethylene, the core 25 delimiting a substantially hemispherical cavity 26, of the same center as that defined by the cup 2, intended to articulately receive a prosthetic femoral head. The combination of the cup 2 with the shell 22 and the core 25 makes it possible to obtain a cotyloid implant 20 with dual mobility. It should be noted that when fixing screws are used to fix the cup 2 in the acetabulum, the head of these screws is located between the cup and the rigid shell 22 and not between the cup and the hemispherical cavity where the cup is located. core joint 25 made of very high molecular weight polyethylene. Therefore, unlike the cotyloidal implants with dual mobility of the prior art, the risk of generation of wear particles of the core are limited. Figure 6 shows a third acetabular implant 30 comprising a cup 2 and an insert 31 made of very high molecular weight polyethylene. The insert 31 has an outer surface intended to cooperate with the second snap-fastening means 5 provided on the cup.

Ainsi, l'insert 31 comporte douze dents quadrangulaires 32 destinées à être encliquetées dans les encoches 5 ménagées dans la cupule, chaque dent 32 s'étendant radialement depuis la surface extérieure de l'insert, sensiblement au niveau de son ouverture.  Thus, the insert 31 has twelve quadrangular teeth 32 intended to be snapped into the notches 5 in the cup, each tooth 32 extending radially from the outer surface of the insert, substantially at its opening.

II est à noter que la hauteur des dents 32 est égale à celle des encoches 5 et que la largeur des dents 32 est supérieure à l'ouverture des encoches 5 afin de permettre un maintien de l'insert 31 dans la cupule, la mise en place de l'insert se faisant grâce à une déformation élastique du polyéthylène à très haut poids moléculaire constitutif de l'insert.  It should be noted that the height of the teeth 32 is equal to that of the notches 5 and that the width of the teeth 32 is greater than the opening of the notches 5 to allow maintenance of the insert 31 in the cup, the setting place of the insert being made thanks to an elastic deformation of the very high molecular weight polyethylene constituting the insert.

Comme il ressort de ce qui précède, l'invention apporte une grande amélioration à la technique existante en fournissant une cupule pour implant cotyloïdien et un implant cotyloïdien comprenant cette cupule qui sont de structure simple et qui n'engendrent pas de pertes osseuses et une diminution de la mobilité du patient lorsqu'il est nécessaire de remplacer l'implant cotyloïdien durant une réintervention chirurgicale. Comme il va de soi l'invention ne se limite pas à la forme d'exécution de cette cupule pour implant cotyloïdien décrite ci-dessus à titre d'exemple, elle embrasse au contraire toutes les variantes de réalisation.  As can be seen from the foregoing, the invention brings a great improvement to the existing technique by providing an acetabular implant cup and an acetabular implant comprising this cup which are of simple structure and which do not cause bone loss and decrease mobility of the patient when it is necessary to replace the acetabular implant during a surgical reoperation. It goes without saying that the invention is not limited to the embodiment of this cup for acetabular implant described above by way of example, it embraces all variants.

Claims (14)

REVENDICATIONS 1. Cupule (2) pour implant cotyloïdien, de forme sensiblement hémisphérique et destinée à être fixée dans une cavité cotyloïdienne, la cupule délimitant une cavité intérieure (3) dans laquelle est destiné à être monté de manière amovible un insert (11, 21, 31) recevant une tête fémorale prothétique, caractérisée en ce qu'elle comporte : - des premiers moyens de fixation (4) par frottement destinés à coopérer avec la surface extérieure d'un premier type d'insert (11, 21), et - des seconds moyens de fixation (5) par encliquetage destinés à coopérer avec la surface extérieure d'un second type d'insert (31).  1. Cup (2) for acetabular implant, of substantially hemispherical shape and intended to be fixed in an acetabular cavity, the cup delimiting an internal cavity (3) in which is intended to be removably mounted an insert (11, 21, 31) receiving a prosthetic femoral head, characterized in that it comprises: first friction fixing means (4) intended to cooperate with the outer surface of a first type of insert (11, 21), and second snap-fastening means (5) for cooperating with the outer surface of a second type of insert (31). 2. Cupule selon la revendication 1, caractérisée en ce que les premiers moyens de fixation par frottement comportent une partie tronconique (4) ménagée dans la cavité intérieure (3) délimitée par la cupule (2), la partie tronconique s'étendant sur au moins une portion de la cavité intérieure à partir de l'ouverture de la cupule, la partie tronconique (4) étant destinée à coopérer par frottement avec une portion de forme complémentaire ménagée sur la surface extérieure du premier type d'insert (11, 21).  2. Cup according to claim 1, characterized in that the first friction fixing means comprise a frustoconical portion (4) formed in the inner cavity (3) defined by the cup (2), the frustoconical portion extending over at at least a portion of the interior cavity from the opening of the cup, the frustoconical portion (4) being intended to cooperate by friction with a portion of complementary shape formed on the outer surface of the first type of insert (11, 21 ). 3. Cupule selon l'une des revendications 1 et 2, caractérisée en ce que les seconds moyens de fixation par encliquetage comportent au moins une encoche (5) ménagée dans la cupule (2) et débouchant du côté de l'ouverture de la cupule, dans laquelle est destinée à être encliquetée au moins une dent (32) ménagée sur l'insert (31).  3. Cup according to one of claims 1 and 2, characterized in that the second snap fastening means comprise at least one notch (5) formed in the cup (2) and opening on the side of the opening of the cup , in which is intended to be snapped at least one tooth (32) formed on the insert (31). 4. Cupule selon la revendication 3, caractérisée en ce que la ou chaque encoche (5) ménagée dans la cupule ne débouche pas dans la surface extérieure de la cupule (2) tournée vers la cavité cotyloïdienne.  4. Cup according to claim 3, characterized in that the or each notch (5) formed in the cup does not open into the outer surface of the cup (2) facing the acetabulum. 5. Cupule selon l'une des revendications 3 et 4, caractérisée en ce que la ou chaque encoche (5) ménagée dans la cupule est de forme trapézoïdale, son extrémité de plus grande largeur étant tournée vers le fond de la cavité intérieure (3) délimitée par la cupule.  5. Cup according to one of claims 3 and 4, characterized in that the or each notch (5) formed in the cup is trapezoidal in shape, its end of greater width being turned towards the bottom of the inner cavity (3). ) delimited by the cup. 6. Cupule selon l'une des revendications 3 à 5, caractérisée en ce qu'elle comprend une succession d'encoches (5) régulièrement réparties sur la circonférence de son ouverture.  6. Cup according to one of claims 3 to 5, characterized in that it comprises a succession of notches (5) regularly distributed over the circumference of its opening. 7. Cupule selon l'une des revendications 1 à 6, caractérisée en ce que la cupule comporte un trou polaire (7) pour la fixation d'un outil d'impactionet au moins un trou (8) de passage de vis pour la fixation de la cupule dans l'os iliaque, ces différents trous étant obturables afin d'éviter la migration de particules d'usure.  7. Cup according to one of claims 1 to 6, characterized in that the cup comprises a pole hole (7) for fixing an impaction tool and at least one hole (8) for the screw fixing for fixing of the cup in the iliac bone, these different holes being closable to prevent the migration of wear particles. 8. Cupule selon l'une des revendications 1 à 7, caractérisée en ce 5 que la surface extérieure de la cupule comprend, sensiblement au niveau de son ouverture, des aspérités d'ancrage (9).  8. Cup according to one of claims 1 to 7, characterized in that 5 the outer surface of the cup comprises, substantially at its opening, anchoring asperities (9). 9. Cupule selon l'une des revendications 1 à 8, caractérisée en ce que la cupule est réalisée dans un métal ostéo-conducteur, tel qu'un alliage de titane, et est revêtue d'hydroxyapatite. 10  9. Cup according to one of claims 1 to 8, characterized in that the cup is made of an osteoconductive metal, such as a titanium alloy, and is coated with hydroxyapatite. 10 10. Implant cotyloïdien comprenant une cupule selon l'une des revendications 1 à 9, caractérisé en ce qu'il comprend en outre un insert (11, 21) réalisé dans un matériau rigide, tel que de la céramique, de l'alumine ou un alliage métallique, l'insert présentant une surface extérieure destinée à coopérer avec les premiers moyens de fixation (4) par frottement ménagés sur 15 la cupule (2).  10. cotyloid implant comprising a cup according to one of claims 1 to 9, characterized in that it further comprises an insert (11, 21) made of a rigid material, such as ceramic, alumina or a metal alloy, the insert having an outer surface for cooperating with the first friction fixing means (4) provided on the cup (2). 11. Implant cotyloïdien selon la revendication 10, caractérisé en ce que la surface extérieure de l'insert (11, 21) présente une portion tronconique (12) de forme complémentaire de celle de la partie tronconique (4) ménagée dans la cavité intérieure (3) délimitée par la cupule. 20  11. cotyloid implant according to claim 10, characterized in that the outer surface of the insert (11, 21) has a frustoconical portion (12) of complementary shape to that of the frustoconical portion (4) formed in the inner cavity ( 3) delimited by the cup. 20 12. Implant cotyloïdien selon l'une des revendication 10 ou 11, caractérisé en ce que l'insert (21) comporte une coque extérieure rigide (22) destinée à être assemblée à la cupule (2), la coque délimitant une cavité sensiblement hémisphérique (24) dans laquelle est monté articulé un noyau (25) de forme complémentaire délimitant une cavité sensiblement 25 hémisphérique (26) destinée à recevoir de manière articulée une tête fémorale prothétique.  12. cotyloid implant according to one of claims 10 or 11, characterized in that the insert (21) comprises a rigid outer shell (22) intended to be assembled to the cup (2), the shell defining a substantially hemispherical cavity (24) in which is mounted articulated a core (25) of complementary shape delimiting a substantially hemispherical cavity (26) for hingedly receiving a prosthetic femoral head. 13. Implant cotyloïdien comprenant une cupule selon l'une des revendications 1 à 9, caractérisé en ce qu'il comprend en outre un insert (31) réalisé dans un matériau élastiquement déformable, tel que le polyéthylène à 30 très haut poids moléculaire, l'insert présentant une surface extérieure destinée à coopérer avec les seconds moyens de fixation (5) par encliquetage ménagés sur la cupule.  13. cotyloid implant comprising a cup according to one of claims 1 to 9, characterized in that it further comprises an insert (31) made of an elastically deformable material, such as polyethylene with a very high molecular weight, insert having an outer surface for cooperating with the second fastening means (5) snap on the cup. 14. Implant cotyloïdien selon la revendication 13, caractérisé en ce que l'insert (31) comporte au moins une dent (32) destinée à être encliquetée 35 dans l'encoche (5) respective ménagée dans la cupule (2), la ou chaque dent s'étendant radialement depuis la surface extérieure de l'insert.  14. cotyloid implant according to claim 13, characterized in that the insert (31) comprises at least one tooth (32) intended to be snapped into the respective notch (5) formed in the cup (2), the or each tooth extending radially from the outer surface of the insert.
FR0601599A 2006-02-23 2006-02-23 CUPLE FOR COTYLOID IMPLANT Active FR2897527B1 (en)

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CN102113924A (en) * 2009-12-31 2011-07-06 北京爱康宜诚医疗器材股份有限公司 Acetabular bone deformity filler
WO2011158213A1 (en) * 2010-06-17 2011-12-22 Thomas Gradel Method for producing a ceramic acetabulum
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9125744B2 (en) 2009-09-28 2015-09-08 Inventorio Sa Method for manufacturing a prosthetic hip acetabulum
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EP0927548A2 (en) * 1997-12-29 1999-07-07 Johnson & Johnson Professional, Inc. Acetabular prosthesis
FR2788685A1 (en) * 1999-01-22 2000-07-28 Jean Louis Dore Cotyloidal implant cup has radial slot has slot extending from central bore to edge and recess to maintain elasticity of cup
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Publication number Priority date Publication date Assignee Title
US9445903B2 (en) 2008-11-24 2016-09-20 Biomet Manufacturing, Llc Multi-bearing acetabular prosthesis
US8123815B2 (en) 2008-11-24 2012-02-28 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US8308810B2 (en) 2009-07-14 2012-11-13 Biomet Manufacturing Corp. Multiple bearing acetabular prosthesis
US9445904B2 (en) 2009-07-14 2016-09-20 Biomet Manufacturing, Llc Multiple bearing acetabular prosthesis
US9125744B2 (en) 2009-09-28 2015-09-08 Inventorio Sa Method for manufacturing a prosthetic hip acetabulum
US9987139B2 (en) 2009-09-28 2018-06-05 Inventorio Sa Method for manufacturing a prosthetic hip acetabulum
CN102113924A (en) * 2009-12-31 2011-07-06 北京爱康宜诚医疗器材股份有限公司 Acetabular bone deformity filler
CN102946826B (en) * 2010-06-17 2015-06-17 因韦托里奥有限公司 Method for producing a ceramic acetabulum
US9173740B2 (en) 2010-06-17 2015-11-03 Inventorio Sa Method for producing a ceramic acetabulum
CN102946826A (en) * 2010-06-17 2013-02-27 托马斯·格拉德尔 Method for producing ceramic acetabulum
FR2961387A1 (en) * 2010-06-17 2011-12-23 Thomas Gradel CERAMIC COTYL WITH EXTERNAL FASTENING
WO2011158213A1 (en) * 2010-06-17 2011-12-22 Thomas Gradel Method for producing a ceramic acetabulum
RU2589612C1 (en) * 2015-04-07 2016-07-10 Денис Игоревич Варфоломеев Hip joint endoprosthesis

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