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FR2821545A1 - Prosthetic shoulder joint assembly has head and shank of humeral component connected by movable peg to vary their relative positions - Google Patents

Prosthetic shoulder joint assembly has head and shank of humeral component connected by movable peg to vary their relative positions Download PDF

Info

Publication number
FR2821545A1
FR2821545A1 FR0103062A FR0103062A FR2821545A1 FR 2821545 A1 FR2821545 A1 FR 2821545A1 FR 0103062 A FR0103062 A FR 0103062A FR 0103062 A FR0103062 A FR 0103062A FR 2821545 A1 FR2821545 A1 FR 2821545A1
Authority
FR
France
Prior art keywords
head
humeral
rod
holes
prosthetic assembly
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
FR0103062A
Other languages
French (fr)
Other versions
FR2821545B1 (en
Inventor
Emmanuel Baulot
Martin Gonzalvez
Didier Capon
Wilde Lieven De
Frank Handelberg
Dany Stoffelen
Pierre Trouilloud
Christophe Alepee
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.)
Dany Stoffelen Be
Didier Capon Fr
Emmanuel Baulot Fr
Frank Handelberg Be
Lieven De Wilde Be
MARTIN GONZALVEZ, FR
Pierre Trouilloud Fr
Aston Medical SAS
Original Assignee
ASTON MEDICAL Ltd
ASTON MEDICAL Ltd
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 ASTON MEDICAL Ltd, ASTON MEDICAL Ltd filed Critical ASTON MEDICAL Ltd
Priority to FR0103062A priority Critical patent/FR2821545B1/en
Publication of FR2821545A1 publication Critical patent/FR2821545A1/en
Application granted granted Critical
Publication of FR2821545B1 publication Critical patent/FR2821545B1/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4081—Glenoid components, e.g. cups
    • A—HUMAN NECESSITIES
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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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    • A61F2/4059—Humeral shafts
    • A—HUMAN NECESSITIES
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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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    • A61F2/00—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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    • 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
    • A—HUMAN NECESSITIES
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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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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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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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    • 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
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    • 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
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  • 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 shoulder joint assembly, comprising humeral and glenoid components, has the humeral component made with a head (1) and shank (2) connected by a movable peg (3) that can be fixed to the head in at least two different positions to allow the the head to be fitted to the shank in different planes. The peg (3) has a truncated conical shape and a threaded projection (3a) to fix into one of two holes (1a, 1b) in the head before engaging with a matching tapering socket (2c) in the shank. Auxiliary elements in the form of a stud (2e) and holes (1d1, 1d2) provide for angular indexation of the of the head and shank.

Description

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ENSEMBLE PROTHETIQUE POUR L'ARTICULATION
DE L'EPAULE
L'invention se rattache au secteur technique des implants orthopédiques, notamment des prothèses d'épaule. JOINT PROSTHETIC ASSEMBLY
SHOULDER
The invention relates to the technical sector of orthopedic implants, in particular shoulder prostheses.

D'une manière parfaitement connue pour un homme du métier, ce type de prothèse comprend essentiellement un élément huméral et un élément glénoïdien. L'élément huméral est destiné à être fixé dans la diaphyse humérale, tandis que l'élément glénoïdien est destiné à être fixé au niveau de la glène de l'omoplate.  In a manner perfectly known to a person skilled in the art, this type of prosthesis essentially comprises a humeral element and a glenoid element. The humeral element is intended to be fixed in the humeral shaft, while the glenoid element is intended to be fixed at the level of the glenoid of the scapula.

Généralement, l'élément huméral présente une tige agencée pour être fixée et ancrée avec ou non du ciment, dans la diaphyse humérale. Cette tige présente angulairement une tête hémisphérique destinée à coopérer avec une partie complémentaire de forme hémisphérique concave que présente l'élément glénoïdien. Le plus souvent l'élément glénoïdien présente un plateau en polyéthylène fixé sur une embase support présentant tout type d'agencement pour être ancré au niveau de la glène de l'omoplate.  Generally, the humeral element has a rod arranged to be fixed and anchored with or without cement, in the humeral shaft. This rod angularly has a hemispherical head intended to cooperate with a complementary part of concave hemispherical shape which has the glenoid element. Most often the glenoid element has a polyethylene plate fixed to a support base having any type of arrangement to be anchored at the glenoid of the scapula.

On a également proposé une conception inverse de ce type de prothèse, en ce sens que la tête d'articulation, sous forme d'un élément hémisphérique mâle, est fixée au niveau de la glène pour coopérer avec une cupule de forme complémentaire que présente l'élément huméral.  A reverse design of this type of prosthesis has also been proposed, in the sense that the articulation head, in the form of a male hemispherical element, is fixed at the level of the glenoid to cooperate with a cup of complementary shape which presents l humeral element.

Quel que soit le type de prothèse utilisé, il est important d'avoir une congruence parfaite entre l'humérus et la glène, en ayant pour objectif de respecter la physiologie de l'épaule, qui est variable en fonction du patient.  Whatever type of prosthesis is used, it is important to have perfect congruence between the humerus and the glenoid, with the aim of respecting the physiology of the shoulder, which is variable depending on the patient.

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Ainsi, l'analyse de paramètres biomécaniques de l'épaule, a mis en avant la nécessité de recomposer la définition des implants pour le positionnement de la glène et pour le positionnement du centre de la tête sphérique par rapport à l'axe médulaire huméral. Notamment, des travaux ont démontré que, par rapport à l'axe diaphysaire, le décalage postérieur du centre de la tête d'articulation varie de 1 à 5 mm environ, tandis que le décalage médial varie de 5 à 9 mm environ. Cette variation n'est pas propre à la taille de l'humérus obligeant ainsi de combiner ces différents paramètres.  Thus, the analysis of biomechanical parameters of the shoulder, highlighted the need to recompose the definition of implants for the positioning of the glenoid and for the positioning of the center of the spherical head relative to the medial humeral axis. In particular, studies have shown that, with respect to the diaphyseal axis, the posterior offset of the center of the articulation head varies from 1 to 5 mm approximately, while the medial offset varies from 5 to 9 mm approximately. This variation is not specific to the size of the humerus, thus forcing these different parameters to be combined.

Le problème posé est donc de pouvoir, à partir d'une même tête humérale, faire varier ces différents paramètres.  The problem is therefore to be able, from the same humeral head, to vary these different parameters.

Pour résoudre un tel problème, selon l'invention : - l'élément huméral présente une tête et une tige constituant deux parties distinctes ; - la tête et la tige sont accouplées par un pion amovible susceptible d'être fixé à la tête selon au moins deux positions différentes pour permettre un réglage dans différents plans par rapport à ladite tige ; - la tête et la tige présentent des moyens complémentaires d'indexation angulaire.  To solve such a problem, according to the invention: - the humeral element has a head and a rod constituting two distinct parts; - The head and the rod are coupled by a removable pin capable of being fixed to the head in at least two different positions to allow adjustment in different planes relative to said rod; - The head and the rod have complementary angular indexing means.

Compte tenu de ces dispositions, le décalage postérieur est obtenu par décalage de la tête autour du pion faisant office d'axe de pivotement, tandis que le décalage médial est obtenu par décalage du pion fixé dans l'une ou l'autre des positions préétablies que présente la tête humérale.  In view of these provisions, the posterior offset is obtained by offset of the head around the pin acting as a pivot axis, while the medial offset is obtained by offset of the pin fixed in one or the other of the preset positions. presented by the humeral head.

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Pour résoudre le problème posé d'assurer l'accouplement de la tête humérale par rapport à la tige, en fonction de l'une quelconque des positions du pion, ce dernier est de forme générale tronconique et présente des agencements de fixation dans l'un quelconque de deux trous formés selon le diamètre d'une face d'appui de la tête humérale, le pion étant apte à être emmanché dans un chambrage complémentaire formé dans l'épaisseur de la tige humérale, à partir d'une face d'appui correspondante.  To solve the problem posed of ensuring the coupling of the humeral head with respect to the rod, as a function of any one of the positions of the pin, the latter is of generally frustoconical shape and has fixing arrangements in one any of two holes formed along the diameter of a bearing face of the humeral head, the pin being able to be fitted into a complementary recess formed in the thickness of the humeral rod, from a bearing face corresponding.

Pour résoudre le problème posé de permettre un réglage postérieur et/ou médian de la tête par rapport à la tige, les deux trous de fixation du pion sont décalés d'une valeur irrégulière par rapport au centre de la tête humérale.  To solve the problem posed of allowing posterior and / or median adjustment of the head relative to the rod, the two fixing holes of the pin are offset by an irregular value relative to the center of the humeral head.

Pour résoudre le problème posé d'assurer le positionnement angulaire de la tête humérale par rapport à la face d'appui de la tige humérale, les moyens d'indexation angulaire sont constitués par un ergot cylindrique formé en débordement de la face d'appui de la tige humérale et apte à coopérer avec l'un quelconque d'une pluralité de trous formés dans l'épaisseur de la face d'appui de la tête humérale.  To solve the problem posed of ensuring the angular positioning of the humeral head relative to the bearing face of the humeral rod, the angular indexing means are constituted by a cylindrical lug formed in overflow from the bearing face of the humeral rod and able to cooperate with any one of a plurality of holes formed in the thickness of the bearing face of the humeral head.

Les trous sont positionnés selon des courbes dont les centres correspondent respectivement aux deux trous de fixation du plot.  The holes are positioned according to curves whose centers correspond respectively to the two fixing holes of the stud.

Avantageusement, la tête humérale est de forme générale hémisphérique convexe.  Advantageously, the humeral head is generally hemispherical convex.

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Un autre problème que se propose de résoudre l'invention est d'avoir une congruence parfaite et une très bonne stabilité entre la tête humérale et l'élément glénoïdien, en évitant tout effet de cisaillement.  Another problem which the invention proposes to solve is to have perfect congruence and very good stability between the humeral head and the glenoid element, while avoiding any shearing effect.

Pour résoudre un tel problème, l'élément glénoïdien est constitué d'une embase support présentant, d'une part, des agencements de fixation au niveau de la glène de l'omoplate et, d'autre part, des agencements aptes à assurer le montage avec capacité de mobilité, d'une cupule hémisphérique concave coopérant avec la tête humérale.  To solve such a problem, the glenoid element consists of a support base having, on the one hand, fixing arrangements at the level of the glenoid of the scapula and, on the other hand, arrangements capable of ensuring the mounting with mobility capacity, of a concave hemispherical cup cooperating with the humeral head.

D'une manière générale et connue, pour faire varier l'angle d'antéversion entre la tête humérale et la tige humérale, l'ensemble prothétique selon l'invention présente plusieurs tiges humérales avec des faces d'appui inclinées selon différentes valeurs angulaires pour faire varier, d'une manière correspondante, l'angulation de la tête humérale.  In general and known manner, in order to vary the anteversion angle between the humeral head and the humeral rod, the prosthetic assembly according to the invention has several humeral rods with bearing faces inclined according to different angular values for vary, in a corresponding manner, the angulation of the humeral head.

L'invention est exposée ci-après plus en détail à l'aide des figures des dessins annexés dans lesquels : - la figure 1 est une vue en perspective, avant montage, des principaux composants de l'élément huméral ; - la figure 2 est une vue de face de la tige humérale ; - la figure 3 est une vue de côté correspondant à la figure 2 ; - la figure 4 est une vue en coupe transversale considérée selon la ligne 4.4 de la figure 2 ; - la figure 5 est une vue en coupe longitudinale montrant le montage de la tête humérale par rapport à la tige ;  The invention is set out below in more detail with the aid of the figures of the appended drawings in which: - Figure 1 is a perspective view, before assembly, of the main components of the humeral element; - Figure 2 is a front view of the humeral rod; - Figure 3 is a side view corresponding to Figure 2; - Figure 4 is a cross-sectional view taken along line 4.4 of Figure 2; - Figure 5 is a longitudinal sectional view showing the mounting of the humeral head relative to the rod;

<Desc/Clms Page number 5><Desc / Clms Page number 5>

- la figure 6 est une vue correspondant à la figure 5 montrant le réglage de la tête humérale par rapport à la tige ; - la figure 7 est une vue montrant la face d'appui de la tête humérale et les orientations angulaires de la tige par rapport à ladite tête ; - la figure 7a est une vue semblable à la figure 7 montrant différentes orientations angulaires possibles de la tête humérale par rapport à la tige ; - la figure 8 est une vue en coupe longitudinale, à caractère schématique, d'une forme de réalisation de l'élément glénoïdien ; - la figure 9 est une vue semblable à la figure 8 d'une autre forme de réalisation pour le montage, avec capacité de mobilité, de la cupule glénoïdienne ; - la figure 10 est une vue en plan correspondant à l'une quelconque des figures 8 et 9 ; - la figure 11 est une vue en coupe montrant l'impaction de l'ensemble prothétique.  - Figure 6 is a view corresponding to Figure 5 showing the adjustment of the humeral head relative to the rod; - Figure 7 is a view showing the bearing face of the humeral head and the angular orientations of the rod relative to said head; - Figure 7a is a view similar to Figure 7 showing different possible angular orientations of the humeral head relative to the rod; - Figure 8 is a schematic longitudinal sectional view of an embodiment of the glenoid element; - Figure 9 is a view similar to Figure 8 of another embodiment for mounting, with mobility capacity, the glenoid cup; - Figure 10 is a plan view corresponding to any of Figures 8 and 9; - Figure 11 is a sectional view showing the impaction of the prosthetic assembly.

D'une manière connue, l'ensemble prothétique d'articulation de l'épaule comprend un élément huméral désigné dans son ensemble par (A) et un élément glénoïdien désigné dans son ensemble par (B).  In known manner, the prosthetic joint assembly of the shoulder comprises a humeral element designated as a whole by (A) and a glenoid element generally designated by (B).

Selon l'invention, l'élément huméral (A) est établi en deux parties distinctes, à savoir, une tête humérale (1) et une tige humérale (2). La tête (1) est de forme générale hémisphérique de profil externe convexe. D'une manière connue, la tige (2) présente une partie (2a) de section transversale déterminée pour être correctement stabilisée dans la diaphyse humérale, en combinaison ou non avec du ciment. La figure 4 montre un exemple de la section transversale. Ainsi, cette section transversale peut former des  According to the invention, the humeral element (A) is established in two distinct parts, namely, a humeral head (1) and a humeral rod (2). The head (1) is of generally hemispherical shape with a convex external profile. In a known manner, the rod (2) has a part (2a) of cross section determined to be correctly stabilized in the humeral shaft, in combination or not with cement. Figure 4 shows an example of the cross section. So this cross section can form

<Desc/Clms Page number 6><Desc / Clms Page number 6>

ailerons de stabilisation anti-rotation. Cette tige peut également présenter des trous (2b) de réinsertion musculaire.  anti-rotation stabilization fins. This rod may also have holes (2b) for muscle reinsertion.

Selon l'invention, la tête humérale (1) est accouplée à la tige (2) au moyen d'un pion amovible (3) susceptible d'être fixé à la tête selon au moins deux positions différentes pour permettre un réglage dans différents plans par rapport à ladite tige (2). Le pion (3) est de forme générale tronconique et présente une portée filetée (3a) apte à être vissée dans l'un quelconque de deux trous taraudés (la) et (Ib) formés dans l'épaisseur de la tête humérale (1) à partir d'une face d'appui plane (be).  According to the invention, the humeral head (1) is coupled to the rod (2) by means of a removable pin (3) capable of being fixed to the head in at least two different positions to allow adjustment in different planes relative to said rod (2). The pin (3) is of generally frustoconical shape and has a threaded seat (3a) capable of being screwed into any one of two tapped holes (la) and (Ib) formed in the thickness of the humeral head (1) from a flat bearing face (be).

Comme le montre la figure 7, les deux trous taraudés (la) et (lb) sont formés selon le diamètre de la face d'appui (lc) qui est circulaire, en étant décalés d'une valeur inégale par rapport au centre de la tête humérale. Par exemple, le trou (la) est décalé d'une valeur (x) supérieure à la valeur de décalage (xl) du trou (db).  As shown in Figure 7, the two threaded holes (la) and (lb) are formed according to the diameter of the support face (lc) which is circular, being offset by an unequal value relative to the center of the humeral head. For example, the hole (la) is offset by a value (x) greater than the offset value (xl) of the hole (db).

La portée tronconique (3b) du pion (3) est conformée pour être emmanchée à force dans un chambrage (2c) dont la forme complémentaire est établie dans l'épaisseur de la tige humérale à partir d'une face d'appui plane (2d) destinée à coopérer avec la face (lc) de la tête humérale.  The frustoconical bearing surface (3b) of the pin (3) is shaped to be force fitted into a recess (2c) whose complementary shape is established in the thickness of the humeral rod from a plane bearing face (2d ) intended to cooperate with the face (lc) of the humeral head.

Suivant une autre caractéristique, la tête (1) et la tige humérale (2) présentent des moyens complémentaires d'indexation angulaire.  According to another characteristic, the head (1) and the humeral rod (2) have complementary angular indexing means.

Ces moyens sont formés par au moins un ergot cylindrique (2e) formés en débordement de la face d'appui (2d) de la tige humérale. Cet ergot (2e) est susceptible de coopérer avec l'un quelconque d'une pluralité  These means are formed by at least one cylindrical lug (2e) formed in overflow from the bearing face (2d) of the humeral rod. This lug (2e) is capable of cooperating with any one of a plurality

<Desc/Clms Page number 7><Desc / Clms Page number 7>

de trous (ldl) et (ld2) formés dans l'épaisseur de la face d'appui (lc) de la tête humérale. Cette série de trous (Idl) est établie selon une courbe (C) dont le centre correspond au trou taraudé (la), tandis que la série de trous (ld2) est établie selon une courbe (CI) dont le centre correspond au trou taraudé (db).  holes (ldl) and (ld2) formed in the thickness of the bearing face (lc) of the humeral head. This series of holes (Idl) is established according to a curve (C) whose center corresponds to the tapped hole (la), while the series of holes (ld2) is established according to a curve (CI) whose center corresponds to the tapped hole (db).

Compte tenu de ces dispositions, il est possible d'obtenir, d'une manière simple et efficace, un réglage latéral et angulaire de la tête humérale (1) par rapport à la tige (2). En fonction du positionnement et de la fixation du plot (3) dans l'un quelconque des trous (la) ou (db), on obtient un réglage latéral de la tête permettant de tenir compte du décalage médian de l'axe diaphysaire de l'humérus par rapport au centre de la tête (figures 5 et 6). En outre, quelle que soit l'une de ces positions, la tige humérale peut être orienter angulairement par rapport à la face d'appui de la tête humérale (figure 7).

Figure img00070001
Given these provisions, it is possible to obtain, in a simple and effective manner, a lateral and angular adjustment of the humeral head (1) relative to the rod (2). Depending on the positioning and fixing of the stud (3) in any one of the holes (la) or (db), a lateral adjustment of the head is obtained making it possible to take account of the median offset of the diaphyseal axis of the humerus in relation to the center of the head (Figures 5 and 6). In addition, whatever one of these positions, the humeral rod can be angularly oriented relative to the bearing face of the humeral head (Figure 7).
Figure img00070001

A noter que pour assurer la fixation du plot d'accouplement (3) dans l'un quelconque des trous (la) et (db), la portée tronconique (3b) peut présenter une empreinte en creux (3c) de section polygonale apte à coopérer avec un organe d'entraînement. Note that to ensure the attachment of the coupling stud (3) in any of the holes (la) and (db), the frustoconical bearing (3b) may have a recessed imprint (3c) of polygonal section capable of cooperate with a drive member.

De même, d'une manière connue, la face d'appui (2d) de la tige humérale est inclinée par rapport à l'axe de la partie d'ancrage (2a). Pour assurer le réglage de l'inclinaison de la tête humérale par rapport à l'axe médullaire huméral et ceci en fonction de configuration articulaire choisie inversée ou anatomique, l'ensemble prothétique selon l'invention met en oeuvre plusieurs tiges humérales conformes aux caractéristiques définies,  Likewise, in a known manner, the bearing face (2d) of the humeral rod is inclined relative to the axis of the anchoring part (2a). To ensure the adjustment of the inclination of the humeral head relative to the humeral medullary axis and this according to the joint configuration chosen inverted or anatomical, the prosthetic assembly according to the invention implements several humeral rods conforming to the defined characteristics. ,

<Desc/Clms Page number 8><Desc / Clms Page number 8>

mais susceptibles de présenter une face d'appui (2b) avec différentes orientations angulaires par rapport à l'axe de la partie d'ancrage (2a).  but likely to have a bearing face (2b) with different angular orientations relative to the axis of the anchoring part (2a).

L'élément glénoïdien (B) est constitué d'une embase support (4) présentant des agencements pour assurer le montage, avec capacité de mobilité, d'une cupule hémisphérique concave (5) apte à coopérer avec la tête humérale (1). En outre, l'embase support (4) présente des agencements de fixation (4a) au niveau de la glène de l'omoplate.  The glenoid element (B) consists of a support base (4) having arrangements for mounting, with mobility capacity, a concave hemispherical cup (5) capable of cooperating with the humeral head (1). In addition, the support base (4) has fixing arrangements (4a) at the level of the glenoid of the scapula.

Comme indiqué, la cupule glénoïdienne (5) est montée avec capacité de déplacement multidirectionnel par rapport à l'embase support (4). Pour obtenir cette fonction, différentes solutions techniques peuvent être envisagées.  As indicated, the glenoid cup (5) is mounted with multidirectional displacement capacity relative to the support base (4). To obtain this function, different technical solutions can be envisaged.

Par exemple, l'embase support (4) peut présenter une rainure débouchante (4b) formant glissière, établie à partir de sa face supérieure.  For example, the support base (4) may have a through groove (4b) forming a slide, established from its upper face.

Cette glissière (4b) coopère avec une tête profilée (5a) formée en débordement de la cupule (5) à l'opposé de sa face d'appui hémisphérique convexe (5b) (figure 9). This slide (4b) cooperates with a profiled head (5a) formed in overflow from the cup (5) opposite its convex hemispherical bearing face (5b) (Figure 9).

Dans la forme de réalisation simplifiée de la figure 8, la face de dessous de la cupule (5) présente en débordement un plot (5c), notamment de forme cylindrique, et apte à être engagé librement dans une ouverture de plus grande dimension, telle qu'une lumière (4c) formée dans l'épaisseur de l'embase support (4).  In the simplified embodiment of Figure 8, the underside of the cup (5) has an overhang a stud (5c), in particular of cylindrical shape, and capable of being freely engaged in a larger opening, such that a lumen (4c) formed in the thickness of the support base (4).

<Desc/Clms Page number 9> <Desc / Clms Page number 9>

On renvoie à la figure 10 qui montre, par des traits interrompus, les différentes possibilités de réglage et de positionnement de la cupule glénoïdienne (5) par rapport à l'embase support (4).  Reference is made to FIG. 10 which shows, by dashed lines, the various possibilities for adjusting and positioning the glenoid cup (5) relative to the support base (4).

Bien évidemment, les différents éléments prothétiques huméral et glénoïdien sont réalisés dans différentes tailles et en tous matériaux appropriés.  Obviously, the various humeral and glenoid prosthetic elements are produced in different sizes and in all appropriate materials.

Les avantages ressortent bien de la description, en particulier on souligne et on rappelle la possibilité, à partir d'une même tête humérale, de faire varier les différents paramètres aptes à tenir compte des décalages postérieur et médian notamment, de l'axe diaphysaire de l'humérus par rapport au centre de l'articulation de la tête. The advantages emerge clearly from the description, in particular it underlines and recalls the possibility, from the same humeral head, of varying the various parameters able to take into account the posterior and median shifts in particular, of the diaphyseal axis of the humerus in relation to the center of the head joint.

Claims (4)

(1 dl-ld2) d'indexation angulaire.  (1 dl-ld2) of angular indexing.
Figure img00100003
Figure img00100003
 -1-Ensemble prothétique pour l'articulation de l'épaule comprenant un élément huméral (A) et un élément glénoïdien (B), caractérisé en ce que : - l'élément huméral présente une tête (1) et une tige (2) constituant deux parties distinctes ; - la tête (1) et la tige (2) sont accouplées par un pion amovible (3) susceptible d'être fixé à la tête (1) selon au moins deux positions différentes (x) et (xl) pour permettre un réglage dans différents plans de la tête par rapport à ladite tige (2) ; - la tête (1) et la tige (2) présentent des moyens complémentaires (2e) et  -1-Prosthetic assembly for the shoulder joint comprising a humeral element (A) and a glenoid element (B), characterized in that: - the humeral element has a head (1) and a rod (2) constituting two distinct parts; - the head (1) and the rod (2) are coupled by a removable pin (3) capable of being fixed to the head (1) in at least two different positions (x) and (xl) to allow adjustment in different planes of the head with respect to said rod (2); the head (1) and the rod (2) have complementary means (2e) and
Figure img00100002
Figure img00100002
 REVENDICATIONS -2-Ensemble prothétique selon la revendication 1, caractérisé en ce que le pion (3) est de forme générale tronconique et présente des agencements de fixation dans l'un quelconque de deux trous (la) et (Ib) formés selon le diamètre d'une face d'appui (le) de la tête humérale (1), le pion (3) étant apte à être emmanché dans un chambrage complémentaire (2c) formé dans l'épaisseur de la tige humérale (1), à partir d'une face d'appui correspondante (2d). -2- prosthetic assembly according to claim 1, characterized in that the pin (3) is of generally frustoconical shape and has fixing arrangements in any of two holes (la) and (Ib) formed according to the diameter d '' a bearing face (le) of the humeral head (1), the pin (3) being able to be fitted into a complementary recess (2c) formed in the thickness of the humeral stem (1), from d 'a corresponding bearing face (2d). -3-Ensemble prothétique selon la revendication 2, caractérisé en ce que les deux trous de fixation (la) et (1b) du pion (3) sont décalés d'une valeur (x) et (xl) irrégulière par rapport au centre la tête humérale (1). -3- Prosthetic assembly according to claim 2, characterized in that the two fixing holes (la) and (1b) of the pin (3) are offset by a value (x) and (xl) irregular relative to the center la humeral head (1). <Desc/Clms Page number 11><Desc / Clms Page number 11> formés dans l'épaisseur de la face d'appui (lc) de la tête humérale, lesdits trous étant positionnés sur des courbes (CI) et (C2) dont les centres correspondent aux deux trous de fixation du plot. -5-Ensemble prothétique selon la revendication 1, caractérisé en ce que la tête humérale (1) est de forme générale hémisphérique convexe.  formed in the thickness of the bearing face (lc) of the humeral head, said holes being positioned on curves (CI) and (C2) whose centers correspond to the two fixing holes of the stud. -5- Prosthetic assembly according to claim 1, characterized in that the humeral head (1) is of generally hemispherical convex shape.
Figure img00110001
Figure img00110001
 -4-Ensemble prothétique selon la revendication 1, caractérisé en ce que les moyens d'indexation angulaire sont constitués par un ergot cylindrique (2e) formé en débordement de la face d'appui (2d) de la tige humérale (2) et apte à coopérer avec l'un quelconque d'une pluralité de trous (Idl) et (ld2)  -4- Prosthetic assembly according to claim 1, characterized in that the angular indexing means are constituted by a cylindrical lug (2e) formed in overflow from the bearing face (2d) of the humeral rod (2) and suitable to cooperate with any one of a plurality of holes (Idl) and (ld2) -6-Ensemble prothétique selon la revendication 1, caractérisé en ce que l'élément glénoïdien est constitué d'une embase support (4) présentant, d'une part, des agencements de fixation, au niveau de la glène de l'omoplate et, d'autre part, des agencements aptes à assurer le montage avec capacité de mobilité, d'une cupule hémisphérique concave (5) coopérant avec la tête humérale (1). -6- Prosthetic assembly according to claim 1, characterized in that the glenoid element consists of a support base (4) having, on the one hand, fixing arrangements, at the level of the glenoid of the scapula and , on the other hand, arrangements capable of ensuring the mounting with mobility capacity, of a concave hemispherical cup (5) cooperating with the humeral head (1). -7-Ensemble prothétique selon la revendication 6, caractérisé en ce que la cupule hémisphérique concave (5) coopère avec la tête transversale (1), d'une manière congruente.-7- Prosthetic assembly according to claim 6, characterized in that the concave hemispherical cup (5) cooperates with the transverse head (1), in a congruent manner.
FR0103062A 2001-03-02 2001-03-02 PROSTHETIC ASSEMBLY FOR THE ARTICULATION OF THE SHOULDER Expired - Fee Related FR2821545B1 (en)

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US11229522B2 (en) 2004-10-25 2022-01-25 DePuy Synthes Products, Inc. Modular humeral prosthesis for an inverted shoulder prosthesis
US9622869B2 (en) 2004-10-25 2017-04-18 Cecile Nerot Modular humeral prosthesis for an inverted shoulder prosthesis
US9610165B2 (en) 2005-10-01 2017-04-04 Cecile Nerot Humeral component of a shoulder joint prosthesis
US8152855B2 (en) 2006-11-03 2012-04-10 Howmedica Osteonics Corp. Method and apparatus for hip femoral resurfacing tooling
FR2955248A1 (en) * 2010-01-21 2011-07-22 Tornier Sa Shoulder prosthesis glenoidal component for use on coil of scapula, has fixation base provided with anchoring unit, and plate defining articular surface on plate opposed face, where articular surface cooperates with humeral head
US8998994B2 (en) 2012-02-07 2015-04-07 Biomet Manufacturing, Llc Humeral implant having a floating bearing
US9642710B2 (en) 2012-02-07 2017-05-09 Biomet Manufacturing, Llc Humeral implant having a floating bearing
US10405985B2 (en) 2012-02-07 2019-09-10 Biomet Manufacturing, Llc Humeral implant having a floating bearing
WO2013119378A1 (en) * 2012-02-07 2013-08-15 Biomet Manufacturing Corporation Humeral implant having a floating bearing
US9155626B2 (en) * 2012-09-10 2015-10-13 Acumed Llc Radial head prosthesis with floating articular member
US9707084B2 (en) 2012-09-10 2017-07-18 Acumed Llc Radial head prosthesis with floating articular member
US20140074246A1 (en) * 2012-09-10 2014-03-13 Acumed Llc Radial head prosthesis with floating articular member
US9763792B2 (en) 2015-10-01 2017-09-19 Acumed Llc Radial head prosthesis with rotate-to-lock interface
EP4166115A1 (en) * 2021-10-15 2023-04-19 Howmedica Osteonics Corp. Mobile bearing anatomic glenoid

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