• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:

    公开号:ES2686847T9
    申请号:ES13818367T
    申请日:2013-10-24
    公开日:2019-05-30
    发明作者:Michele Pressacco
    申请人:Limacorporate SpA；
    IPC主号:
    专利说明:

    [0001] Acetabular prosthesis and corresponding method for its production and assembly
    [0002] Field of the invention
    [0003] The present invention relates to an acetabular prosthesis associable to a natural acetabular hip seat to function as the positioning and rotation seat for the head of a femoral prosthesis.
    [0004] The present invention also relates to the method for producing and assembling the acetabular prosthesis.
    [0005] BACKGROUND OF THE INVENTION
    [0006] In the field of orthopedic hip prostheses, it is known how to produce acetabular prostheses consisting of an insert with a hemispherical cavity, which acts as a positioning and rotation seat for the head of the femoral prosthesis.
    [0007] The insert, in turn, is normally disposed inside a mating mold, or acetabular cup, with an internal cavity, made of an osteo-compatible metallic material, for example, with a titanium base or a cobalt base. , which joins in an acetabular hip seat.
    [0008] In this context, resurfacing prostheses are known, suitable for joining at the head of the femur, leaving it substantially intact.
    [0009] Resurfacing systems have been used for many years in hip reconstruction surgery in order to:
    [0010] - preserve the neck and a part of the head of the femur in active and young patients;
    [0011] - use head diameters that are closer to the anatomical diameter, compared to traditional implants, in order to restore joint biomechanics and at the same time to guarantee a lower risk of dislocation;
    [0012] - facilitate possible future revisions with a traditional implant, since the proximal part of the femur is intact, rather than with revision implants.
    [0013] The systems of resurfacing in the market traditionally provide couplings of the metalmetal type.
    [0014] Recently, some resurfacing systems have shown a higher failure rate than traditional implants. More generally, a possible drawback has arisen in the case of metalmetal couplings, due to the release of metal ions, which have developed after the wear of the components in the human body. These ions have different side effects, including the deterioration of the tissues surrounding the implant, the loss of the implant itself and, in some cases, systemic effects (heart, nervous system, etc.). The development of these phenomena of wear is more evident in cases in which the acetabular implant is not perfectly placed in terms of inclination and rotation. Accordingly, although, using metal-metal couplings, very limited thicknesses are obtained which are well adapted to the production of resurfacing prostheses, it is better to avoid this type of coupling due to the drawbacks described above. From DE-A-19616059, it is known how to manufacture a prosthesis having a cylindrical coupling, in particular, which provides the possibility of an insert with a diameter larger than that of the cup. This technique is used, in general, in mechanical cylindrical forced couplings. More specifically, the coupling provided achieves a congruence between the two spherical surfaces, in order to have a better distribution of the contact.
    [0015] DE-A-19701536 discloses a hinge prosthesis of known type, which provides a conical coupling of ceramic manufactured inserts, but without providing a mechanical force in the vicinity of the coupling plane between the acetabular cup and the defined insert as length of the coupling shaft.
    [0016] EP-A-1,712,206 describes an acetabular prosthesis that provides a conical coupling similar to that of DE-A-19701536.
    [0017] WO-A-2004/017870 discloses an acetabular expandable cavity, or acetabular cup, which is elastically manufactured by means of radial sections and which provides a throat inside which a flange or tooth of the insert engages in a manner under pressure, to prevent it from coming out. In essence, the coupling is produced by connecting the tooth in the throat and the posterior conical coupling.
    [0018] WO-A-2006/125711 discloses a prosthesis provided with recesses made only directly below the surface, which are connected to the outside through transverse openings.
    [0019] US-A-2012/095569 discloses a prosthetic joint comprising a contact member made of metal or ceramic with an osteointegration of resurfacing surface, such as trabecular metal, textured metal, sintered or extruded integration textures, which they are manufactured only on the surface, not completely on the entire component without interruption of continuity.
    [0020] Therefore, one of the purposes of the present invention is to produce an acetabular prosthesis that on the one hand can be manufactured with reduced thicknesses and on the other hand is compatible and has a good mechanical resistance, in particular, to wear, and therefore avoids the release of ions.
    [0021] Another objective of the present invention is to produce an acetabular prosthesis of a total hip prosthesis that can be configured as a resurfacing prosthesis, thus obtaining the typical advantages of this type of prosthesis, but without the drawbacks of the metal-metal coupling described. previously.
    [0022] Another objective of the present invention is to produce an acetabular prosthesis of a total hip prosthesis, whose insert, once arranged inside the acetabular cup or mold, maintains, during normal use, the position determined during the insertion operation. the acetabular cup inside the acetabular seat and the prosthesis of the femoral head, inside the insert, avoiding rotation with respect to the axis of common symmetry.
    [0023] Another objective of the present invention is to improve a production method that optimizes the assembly and installation of the acetabular prosthesis.
    [0024] The applicant has devised, tested and performed the present invention to overcome the drawbacks of the state of the art and to obtain these and other purposes and advantages.
    [0025] Summary of the invention
    [0026] The present invention is set forth and characterized by the independent claims, while the dependent claims describe other characteristics of the invention or variants of the main inventive idea.
    [0027] In accordance with the above purposes, an acetabular prosthesis according to the present invention, which exceeds the limits of the state of the art and eliminates the defects thereof, can be inserted inside a natural acetabular hip seat to act as a placement and rotation seat for the head of a femoral prosthesis.
    [0028] The acetabular prosthesis comprises an acetabular cup, which in turn comprises an internal surface defining a coupling cavity, and an insert capable of being inserted into the interior of the coupling cavity and which in turn comprises an external surface.
    [0029] The acetabular cup and the insert have a common coupling shaft and comprise corresponding clamping means for reciprocal clamping in an assembled state.
    [0030] According to the present invention, in a disassembled state of the coupling cavity of the acetabular cup there is an internal diameter that is smaller than the largest external diameter of the insert; furthermore, in the assembled state, the largest external diameter of the insert is equal to the internal diameter of the coupling cavity of the acetabular cup. In some embodiments, the internal diameter of the coupling cavity of the acetabular cup is considered in correspondence with a coupling plane between the acetabular cup and the insert, defined along the coupling axis.
    [0031] The fastening means comprise a first clamping surface, made on the inner surface of the acetabular cup, and a second clamping surface, made on the external surface of the insert and cooperating with the first clamping surface.
    [0032] The first and second clamping surfaces have a truncated cone shape with a different inclination therebetween with respect to the coupling axis.
    [0033] A conical coupling is made between the insert and the acetabular cup, with imposed interference, variable along the axis of symmetry.
    [0034] In particular, unlike in the state of the art, the insert can be coupled to the acetabular cup by means of a forced conical coupling.
    [0035] In fact, the present invention achieves a conical coupling by forcing the insert and the acetabular cup that it obtains, in particular, said force in the vicinity of the coupling plane defined above.
    [0036] According to another possible function of the present invention, the variable interference during use is maximum in the vicinity of the maximum cones diameters and minimum in the vicinity of the minimum diameters of the cones defining the first and second clamping surfaces .
    [0037] The variable interference is able to compensate for the deformations that the insert experiences during the assembly stages of the acetabular prosthesis.
    [0038] In this way, it is maintained that the present invention is adequate to preserve the advantages derived from the production of resurfacing prostheses, but also provides greater primary stability to the prosthesis itself.
    [0039] In different embodiments, the first clamping surface has a smaller inclination in comparison with the inclination of the second clamping surface.
    [0040] According to another function of the present invention, at least one of the acetabular cup or the insert is made of a ceramic material.
    [0041] In the exemplary embodiments, the insert is made of a ceramic material.
    [0042] The choice of ceramic material allows to adopt relatively thin thicknesses and, at the same time, obtain optimum mechanical and anti-wear characteristics, avoiding the release of metal ions. The ceramic material is also biocompatible.
    [0043] Ceramic-ceramic couplings have a reduced wear rate, do not release metal ions and are less sensitive to implant placement compared to metal-metal systems. In particular, with the present invention it is possible to obtain reduced thicknesses of the acetabular prosthesis, to maintain the necessary mechanical properties and, in addition, to avoid the problem of wear and ion release.
    [0044] The acetabular cup is shaped so as to comprise a through opening, in correspondence with its polar region.
    [0045] The insert is shaped to comprise, in a polar region thereof, a centering element capable of being inserted into the interior of the through opening.
    [0046] The centering element and the through opening are capable of enabling the centering of the acetabular cup and the insert during the assembly step.
    [0047] The present invention also relates to a method for assembling an acetabular prosthesis as described above, such assembly normally being performed during an industrial production stage.
    [0048] The method provides:
    [0049] - making available an acetabular cup comprising an internal surface defining a coupling cavity,
    [0050] - making available an insert capable of being inserted inside the coupling cavity and comprising an external surface,
    [0051] - coupling the acetabular cup and the insert along a common coupling shaft and holding them reciprocally in an assembled state using respective securing means.
    [0052] According to the present invention, prior to coupling, in a disassembled state, the coupling cavity of the acetabular cup has an internal diameter that is smaller than the largest external diameter of the insert while, after coupling, in the Assembled, the internal diameter of the coupling cavity of the acetabular cup is equal to the largest external diameter of the insert.
    [0053] The internal diameter of the coupling cavity of the acetabular cup is considered in correspondence with a plane of coupling between the acetabular cup and the insert defined along the coupling axis.
    [0054] In addition, the fastening of the acetabular cup and the insert is achieved by means of the fastening means comprising:
    [0055] - a first clamping surface, manufactured on the inner surface of the acetabular cup,
    [0056] - a second clamping surface, made on the external surface of the insert, and cooperating with the first clamping surface.
    [0057] The first clamping surface and the second clamping surface have a truncated cone shape, with an inclination different from each other with respect to the coupling axis, in order to obtain a conical coupling of the insert and the acetabular cup, with a variable interference , along the coupling axis.
    [0058] The method for assembling the acetabular prosthesis comprises at least one step in which the acetabular cup is grasped by elastic gripping means in correspondence with a through opening, a step in which the insert is placed on a support and centering member, a step in which the elastic grasping means move and the acetabular cup engages, through variable interference, with the insert, causing the first clamping surface and the second clamping surface to work together with each other, and a step in that the elastic grip means release the acetabular cup coupled with the insert.
    [0059] In some embodiments, the method includes a preliminary step of aligning and centering the elastic grasping means and the insert, positioned on the support and centering element, which move the elastic grasping means downwardly.
    [0060] In some embodiments, after alignment and centering of the elastic grasping means and the insert, the elastic grasping means are raised, the insert is removed from the support and centering element, the acetabular cup is placed on the element of support and centering, the elastic grasping means move downwards to grasp the acetabular cup, the elastic grasping means associated with the acetabular cup are raised and the insert is once again placed on the support element and centered for the purpose to proceed with the conical coupling.
    [0061] In some variants, the assembly can be obtained by applying a thermal load, or a thermal deformation. In other variants, the assembly can be obtained mechanically, or by means of a mechanical force.
    [0062] Other variants can provide an assembly manufactured by combining the application of a thermal load with a mechanical assembly.
    [0063] BRIEF DESCRIPTION OF THE DRAWINGS
    [0064] These and other features of the present invention will be apparent from the following description of some embodiments, provided as a non-restrictive example with reference to the accompanying drawings in which:
    [0065] Figure 1 is a perspective view of an acetabular prosthesis according to some embodiments of the present invention;
    [0066] - Figure 2 is another perspective view of the acetabular prosthesis of Figure 1;
    [0067] - Figure 3 is a side view of the acetabular prosthesis of Figure 1;
    [0068] Figure 4 is a cross section of the acetabular prosthesis of Figure 3;
    [0069] - figure 5 is a part of figure 4;
    [0070] - figure 6 is an enlarged detail of figure 5;
    [0071] - figure 7 is another part of figure 4;
    [0072] - Figure 8 is an enlarged detail of Figure 7;
    [0073] - Figure 9 is an enlarged detail of Figure 4;
    [0074] - Figure 10 is another enlarged detail of Figure 4;
    [0075] - Figure 11 is a schematic representation of a part of the present invention;
    [0076] - Figure 12 schematically shows a variant of the method for assembling the acetabular prosthesis of figure 1.
    [0077] Detailed description of some embodiments
    [0078] Reference will now be made in detail to the various embodiments of the present invention, of which one or more examples are shown in the accompanying drawing. Each example is provided by way of illustration of the invention and should not be understood as a limitation thereof. For example, features shown or described as being part of an embodiment may be adopted in, or in association with, other embodiments to produce another embodiment. It is understood that the present invention will include all modifications and variants of this type.
    [0079] Referring to Figures 1 and 2, an acetabular prosthesis 10 according to the present invention is capable of being inserted into an acetabular seat, not shown in the drawings, of the hip bone of a patient, acting as a seat of placement and rotation for the head of a femoral prosthesis, is also not shown in the drawings. In the non-restrictive exemplary embodiments of the present invention, it is held that the acetabular prosthesis 10 can be effectively applied to achieve a resurfacing prosthesis.
    [0080] In some embodiments, the acetabular prosthesis 10 can be substantially formed as a cap hemi-spherical or hemispherical, which is hollow in its interior and, in this case is shown by way of example, axial symmetric with respect to an axis of symmetry Y (figures 3 and 4), also called coupling axis.
    [0081] According to the present invention, the acetabular prosthesis 10 comprises mainly two elements, ie, an acetabular cup 11 and a mating insert 12, both of substantially hemispherical shape which are pressed and assembled reciprocally by conical coupling with an interference that it is variable and imposed along a common coupling axis which in this case is represented by said Y axis.
    [0082] In particular, in some embodiments, the acetabular cup or mold 11 can be inserted into the interior of the acetabular hip seat, and the mating insert 12 can be inserted into the interior of the acetabular cup 11.
    [0083] The configuration of the acetabular prosthesis 10 defines, in general, a hemispherical cavity 13.
    [0084] The acetabular cup 11 can in this case be made of titanium, titanium alloys, or in any case a material with a titanium base.
    [0085] The acetabular cup 11 may comprise an internal surface 14 (FIG. 5), which may define a coupling cavity 15, in this case hemispherical, and an external surface 16 which, in use, faces the bone of the acetabular seat. The acetabular cup 11 can comprise or be defined by an equatorial band 17, a polar region 18 and an intermediate zone 19, the latter provided between the equatorial band 17 and the polar region 18, with a greater extension and a hemispherical shape.
    [0086] According to some embodiments of the present invention, in a disassembled state of the coupling cavity 15 of the acetabular cup 11 there is an inner diameter Dc (FIG. 5) that is smaller than a larger outer diameter Di (FIG. 7) of the insert 12.
    [0087] Furthermore, according to the present invention, in the assembled state the largest external diameter, indicated by Di 'in FIG. 4, of the insert 12 is equal, after the mechanical and / or thermal deformation, that the internal diameter, indicated by Dc 'in FIG. 4, of the coupling cavity 15 of the acetabular cup 11.
    [0088] In particular, in some embodiments of the invention, an interference "i" can be identified provided by the difference between the values of the diameters Di and Dc, external and internal, respectively, of the insert 12 and the acetabular cup 11, in the disassembled state: i = Di - Dc
    [0089] Without being limited by theory, in practice it is maintained that the stable coupling of the insert 12 and the acetabular cup 11 is largely provided by the deformation of the material of the acetabular cup 11 which, after forced, mechanical and / or mechanical coupling. thermal, with the insert 12, has a deformation that increases the internal diameter of Dc to Dc '.
    [0090] In possible embodiments, the "i" values of the diameter interference may be equal to or larger than 0.01 mm, for example, it may vary in a range between 0.01 and 0.25 mm, and may include all the possible subintervals. Examples of embodiments of lower limits of the diametric interference values "i" may be 0.01 mm, 0.0125 mm or 0.025 mm or 0.05 mm. Examples of embodiments of upper limits of the diametric interference values "i", which can be combined with cited exemplary embodiments of lower limits of the diametric interference values "i", can be 0.25 mm, 0.20 mm or , again, 0.15 mm. For example, a subinterval of diametric interference values "i" may be between 0.025 mm and 0.20 mm, or another example of subinterval of diametric interference values "i" may be between 0.05 mm and 0.15 mm.
    [0091] For the sake of integrity, it is maintained that the shape or size of the insert 12 can also be minimally deformed, and that as a consequence, the outer diameter of the insert 12 varies slightly from Di to the value Di 'after coupling with the acetabular cup 11. However, it is maintained that in most cases the difference in absolute value between Di and Di 'is negligible, that is, the deformation of the material constituting the insert 12 is negligible, while the difference between Dc and Dc' is meaningful In fact, as has been said, the greatest deformation occurs in the acetabular cup 11, whose internal diameter increases from Dc to Dc '.
    [0092] In some embodiments, the inner diameter Dc, Dc 'of the coupling cavity 15 of the acetabular cup 11 is considered, both in the disassembled state and in the assembled state, in correspondence with a coupling plane P of the acetabular cup. 11 and the insert 12, defined along the coupling axis Y.
    [0093] In some embodiments, in correspondence with the equatorial band 17, the inner surface 14 can be shaped so as to comprise a first clamping surface 20, in the form of a truncated cone, with an inclination α with respect to the Y axis (FIG. 6) and capable of achieving reciprocal bonding with the insert 12, as will be seen below in the present document. In addition, the equatorial band 17 can be shaped so as to comprise an outer ring 21. In some embodiments, the outer ring 21 is a solid part and compact acetabular cup 11.
    [0094] The external ring 21 can have the function of modulating the stiffness of the entire acetabular cup 11. As an example, it is maintained that the greater the height of the outer ring 21, the greater the total stiffness of the acetabular cup 11. In some embodiments, the desired stiffness can be obtained, in the design stage, according to the sizes of the prosthesis to be manufactured, by varying the height of the outer ring 21. The polar region 18 can be shaped in order to have a through opening. of circular shape, delimited by an upper ring 24, configured, for example, as a protruding annular projection.
    [0095] The acetabular cup 11 may comprise, in the space between the outer ring 21 and the upper ring 24 of the equatorial band 17, a solid and compact internal part 22 and a trabecular part, or a trabecular reticular structure 25, in this case external, associated with the external surface 16. The trabecular part 25 can be defined by a network which, for example, acts as a bone-engaging and bone-engaging element during the new growth stage after the operation experienced by the patient. patient.
    [0096] In other embodiments, the trabecular part 25 can be in a single body with the solid and compact inner part 22 and with the outer ring 21, that is, from the inside to the outside, the material constituting the acetabular cup 11 is solid, in correspondence with the outer ring 21 and, continuous with the material, varies in order to subsequently define the structure of the trabecular part 25.
    [0097] In other embodiments, the acetabular cup 11 may consist entirely of the trabecular part 25. The structure of the trabecular part 25 may be a network of cells, which achieve a plurality of three-dimensional cavities arranged, open and in intercommunication, connected to each other . The network can be solid with the solid and compact inner part 22 and with the outer ring 21. In some embodiments, at least part of the network of the trabecular part 25 can be formed, without interruption of continuity, by one or more models of a plurality of geometric meshes that are repeated in space throughout the trabecular part 25, having a cellular geometry with open and contiguous elementary cells, in order to define a plurality of polygons, such as hexagons, with non-coplanar vertices, with a spatial development that delimits the cavities, in such a way that the network is able to promote osteo-integration.
    [0098] In some embodiments, the structure of the trabecular part 25 mentioned above, possibly in continuity with the solid and compact internal part 22, can be obtained using techniques such as electron beam fusion (EBM) or selective laser fusion (SLM). . Exemplary embodiments are described in the international application WO-A-2008/146141 in the name of the applicant.
    [0099] In some embodiments, the acetabular cup 11 may also comprise a plurality, in this case for example four, of niches 26 on the outer surface 16 of the equatorial band 17, to facilitate orientation and placement of the acetabular cup 11 in the acetabular seat.
    [0100] The insert 12, in this case made of a ceramic material, can comprise an internal surface 27 (FIG. 7), which can define a hemispherical cavity 28, and an external surface 29, which during use faces towards the internal surface 14 of the acetabular cup 11. Also in this case, the insert 12 can be defined, for example, by an equatorial band 30, a polar region 31 and an intermediate zone 32.
    [0101] The insert 12 made of ceramic material allows to adopt relatively thin thicknesses and, at the same time, obtain optimum mechanical characteristics, wear resistance, biocompatibility and avoid the risk of metal ions.
    [0102] The outer surface 29, in correspondence with the equatorial band 30, can be shaped to comprise a second clamping surface 33, formed as a truncated cone and with a tilt p (FIG. 8) larger than the tilt a of the first clamping surface 20 of the acetabular cup 11.
    [0103] Accordingly, according to some embodiments of the present invention, the first clamping surface 20 and the second clamping surface 33 can be a truncated cone shaped with an inclination to p different from each other with respect to the coupling axis Y, in order to achieve a coupling of the insert 12 and the acetabular cup 11 with the interference "i" which varies along the axis of symmetry Y.
    [0104] In essence, some embodiments define that said larger external diameter Di, Di 'of the insert 12 is the larger base diameter of the truncated cone shape of the second fastening surface 33.
    [0105] Therefore, some embodiments define that said larger inner diameter Dc, Dc 'of the acetabular cup 11 is the diameter of the truncated cone shape of the first clamping surface 20 in correspondence with the ring band of joint operation and coupling with the second clamping surface 33 of the insert 12, along the coupling plane P.
    [0106] Having previously defined the interference "i" as the difference between the diameters Di and Dc, it is clear that this size refers to the base diameters of the truncated cones of the clamping surfaces 20 and 33. Referring to the interference "i ", In figure 11 its variability is shown schematically, in particular decreasing along the coupling axis Y going from the outside to the inside, where it has a maximum value (imax) in correspondence with the larger diameters Dc, Di, internal and external respectively, in the disassembled state of the acetabular cup 11 and of the insert 12, and a minimum value (imine), equal to zero, where the two diameters Dc, Di, which vary in height along the coupling axis And, they would assume the same value. In this case, said coupling plane P can therefore be defined as the plane of passage for the annular region of contact and coupling of the acetabular cup 11 and of the insert 12 in the assembled state, in correspondence with the position for which the interference "i" assumes the value (imax) that would exist in the disassembled state.
    [0107] In some embodiments, the insert 12 can be shaped so as to comprise, in the polar region 31, a centering pin 34 capable of being inserted into the interior of the through opening 23, with a diameter a little smaller than that of the through opening 23.
    [0108] As stated above, the two different inclination values, ie the conicity, a and p of the clamping surfaces 20 and 33 with respect to the Y axis, ensure that the coupling of the insert 12 and the acetabular cup 11 is produced by the "i" interference (figure 9). In particular, there is a maximum variable interference "i" in the maximum diameter of the cone, and a minimum, in this case zero, in the minimum diameter of the cone (figures 9 and 11). This configuration is able to compensate the deformations in the monitoring stage and guarantee a solid coupling.
    [0109] Furthermore, the presence of the centering pin 34 can facilitate, in the assembly step, the centering of the insert 12 with respect to the acetabular cup 11.
    [0110] The acetabular cup 11 and the insert 12 can be configured so as to work together, during assembly, using only the clamping surfaces 20 and 33, which define an interspace 35 in correspondence with the intermediate zones 19 and 32 and the polar regions 18 and 31 (figure 10). The interspace 35, during the assembly, has the function of guaranteeing that the tightening is caused by the conical coupling. During normal use, the insert 12 and the acetabular cup 11 can work together in contact with each other.
    [0111] The acetabular prosthesis 10, in its entirety, confers optimum stability to the insert 12 and the acetabular cup 11, both in the step of inserting the acetabular prosthesis 10 into the acetabular seat, as well as in the step of inserting the head of the acetabular prosthesis. femoral prosthesis, or the natural femoral head, inside the insert 12.
    [0112] According to some embodiments, the coupling of the acetabular cup 11 and the insert 12 can be produced as described hereinafter in relation to the schematic representation in figure 12, which shows respectively two variants of a possible assembly .
    [0113] For assembly, the present invention may use elastic gripping means actuated by a press 42 configured to apply a desired vertical thrust. In variants of the embodiments, the elastic gripping means are, for example, elastic lugs 37 vertically movable by means of the press 42. The elastic lugs 37 are equipped with an elastic pusher 38 with a piston having elastic grip ends. 39 of the flexible type capable of elastically deforming during opening and closing. The elastic grip ends 39 protrude from a stop surface 46 of the elastic pusher 38 of a curvilinear shape, which is matched with a contact portion 47 of the polar region of the acetabular cup 11 surrounding the through opening 23.
    [0114] The elastic lugs 37 may comprise a containment chamber 43 for displacement of the elastic pusher 38, in which resilient damping means are provided, such as, for example, a spring 44. The elastic pusher 38 may be normally in one position inactive at the bottom of the containment chamber 43, as can be seen in figure 12, stage A.
    [0115] In some embodiments, the assembly method, normally performed during the industrial production stage, may include a preliminary centering step and the alignment of the insert 12 and the elastic lugs 37 (Figure 12 step A). The insert 12 can be placed in a support and centering element 40 arranged, in turn, in a support block 48. The support and centering element 40 has the profile, in negative, of the internal surface 27 of the insert 12. The centering is carried out by moving the elastic lugs 37 downwards and aligning them with the centering pin 34, until they come into contact with the latter. In this case, a clamping element 41 is provided which cooperates with the elastic pusher 38, holding its displacement, to prevent the elastic pusher 38 from returning upwards (FIG. 12, step A).
    [0116] Subsequently, it is necessary to assemble the acetabular cup 11 in the elastic lugs 37. To do this, as seen in figure 12, the elastic lugs 37, once aligned with the insert 12, are raised and the insert 12 is removed from the element of support and centering 40.
    [0117] The acetabular cup 11 is then positioned in the latter and the elastic lugs 37 are lowered again, keeping the fastening element 41 inserted, until the joint operation between the elastic gripping end 39 and the through opening 23 of the acetabular cup 11 (figure 12 stage B). It is maintained that the removal of the insert 12 from the support and centering element 40 facilitates the assembly of the acetabular cup 11 on the elastic lugs 37, since otherwise the through opening 23 would be occupied by the centering pin 34 and could not be engaged. by the elastic grip ends 39.
    [0118] Subsequently, the elastic lugs 37, and the solid acetabular cup 11 with them, are raised again, in order to place the insert 12 once more on the support and centering element 40 (figure 12, stage C). The clamping element 41 can be removed in order to allow the displacement of the elastic pusher 38 as explained below.
    [0119] Next, the elastic lugs 37 move once more downwardly and the acetabular cup 11 is placed in the insert 12, applying a suitable thrust using the press 42, causing the first gripping surface 20 and the second gripping surface 33 work together with each other, in order to obtain the conical coupling by the variable interference as described above (figure 12 step D): the joint operation between the first clamping surface 20 and the second clamping surface 33 starts when the surface stop 46 of the elastic pusher 38 makes contact with the contact part 47 of the polar region 18 of the acetabular cup 11. In fact, at this point, the displacement of the elastic pusher 38 is caused backwards with respect to its inactive position in the bottom of the containment chamber 43, until the elastic grip ends 39 are placed in the containment chamber 43, disengaging the aber intern course 23 (figure 12, stage D). This movement is controlled and elastically damped by the spring 44, which is consequently progressively compressed (FIG. 12, step D). The elastic pusher 38 is retracted until the elastic grip ends 39 are uncoupled from the through opening 23, also following the insertion of the centering pin 34. Thus, in addition, the through opening 23 is positioned around the centering pin 34. , guaranteeing the centering of the acetabular cup 11 in the insert 12 (figure 12, step D).
    [0120] In some embodiments, in step D, the assembly of the acetabular cup 11 and of the insert 12 can be obtained only mechanically, by means of said conical coupling, or by applying a thermal load, so that the thermal expansion of the material of the acetabular cup 11 due to heating facilitates the conical coupling of the acetabular cup 11 and of the insert 12, or by means of a combination of these techniques. In any case, the selected technique is suitable to obtain the forced coupling of the insert 12, which in the disassembled state has a larger external diameter Di larger than the internal diameter Dc of the acetabular cup 11, so that, in the assembled state, the largest external diameter Di 'is equal to the internal diameter Dc' of the acetabular cup 11.
    [0121] Subsequently, the elastic lugs 37 are raised, separating from the acetabular cup 11 which remains coupled to the insert 12 by the variable interference (figure 12, step E). As it rises, the elastic pusher 38 is pushed back outwards by the extension of the spring 44 (figure 12, step E).
    [0122] It is clear that modifications and / or additions of parts can be made to the acetabular prosthesis and to the corresponding method as described heretofore, without departing from the scope and scope of the present invention. It is also clear that, although the present invention has been described with reference to a specific example, a person skilled in the art will certainly be able to achieve many other equivalent forms of acetabular prostheses and the corresponding method, having the characteristics as set forth in claims.
    权利要求:
    Claims (11)
    [1]
    1. Acetabular prosthesis comprising:
    - an acetabular cup (11) comprising an internal surface (14) defining a coupling cavity (15),
    - an insert (12) which can be inserted inside said coupling cavity (15) and which comprises an external surface (29),
    said acetabular cup (11) and said insert (12) having a common coupling shaft (Y) and comprising respective clamping means (20, 33) for reciprocal clamping in an assembled state, wherein in a disassembled state the cavity coupling (15) of the acetabular cup (11) has an internal diameter (Dc) that is smaller than the largest external diameter (Di) of said insert (12), wherein in the assembled state the largest external diameter (Di ') of said insert (12) is equal to the largest internal diameter (Dc') of the coupling cavity (15) of the acetabular cup (11), wherein the internal diameter (Dc, Dc ') of the The coupling cavity (15) of the acetabular cup (11) is considered in correspondence with a coupling plane (P) between the acetabular cup (11) and the insert (12) defined along said coupling axis (Y) , wherein further, said securing means comprise:
    - a first clamping surface (20) made on said internal surface (14) of said acetabular cup (11), - a second clamping surface (33) made on said external surface (29) of said insert (12) and cooperates with said first clamping surface (20),
    said first clamping surface (20) and said second clamping surface (33) having a truncated cone shape with an inclination (a, P), different from one another, with respect to said coupling axis (Y), with the so as to obtain a conical coupling between said insert (12) and said acetabular cup (11), with a variable interference (i), along said coupling axis (Y), characterized in that said acetabular cup (11) comprises a trabecular reticular structure (25), said trabecular reticular structure (25) being a network of cells, obtaining a plurality of three-dimensional cavities arranged, open and interconnected, connected to each other;
    wherein said acetabular cup (11) is shaped to comprise a through opening (23) in correspondence with a polar region (18) thereof,
    wherein said insert (12) is shaped to comprise, in a polar region (31) thereof, a centering element (34) capable of being inserted into said interior through opening (23).
    [2]
    Acetabular prosthesis as in claim 1, characterized in that said variable interference (i), during use, is maximum (i max ) in the vicinity of the maximum diameters of the cones, and minimum (i min ) in the vicinity to the minimum diameters of the cones defining said first clamping surface (20) and said second clamping surface (33).
    [3]
    3. Acetabular prosthesis as in claims 1 or 2, characterized in that said first clamping surface (20) has a smaller inclination (a) than an inclination (P) of said second clamping surface (33).
    [4]
    Acetabular prosthesis as in any of the preceding claims, characterized in that at least one of said acetabular cup (11) and said insert (12) is made of a ceramic material.
    [5]
    Acetabular prosthesis as in any of the previous claims, characterized in that said acetabular cup (11) comprises a plurality of recesses (26) that allow to place said acetabular prosthesis in an acetabular seat.
    [6]
    Acetabular prosthesis as in any of the preceding claims, characterized in that the trabecular meshwork (25) constitutes all or part of the acetabular cup (11).
    [7]
    7. Acetabular prosthesis as in any of the preceding claims, characterized in that at least part of the trabecular mesh structure (25) is formed, without interruption of continuity, by one or more models of a plurality of geometric meshes that are repeated in the space in the entire trabecular reticular structure (25) and have a cellular geometry with open and contiguous elementary cells, in order to define a plurality of polygons, with non-coplanar vertices, with a spatial development that delimits the cavities.
    [8]
    8. Acetabular prosthesis as in any of the previous claims, characterized in that the trabecular reticular structure (25) is obtained using electron beam fusion (EBM) or selective laser fusion (SLM).
    [9]
    9. Method to assemble an acetabular prosthesis, providing said method:
    - making available an acetabular cup (11) comprising an internal surface (14) defining a coupling cavity (15),
    - making available an insert (12) capable of being inserted inside said coupling cavity (15) and comprising an external surface (29),
    - coupling said acetabular cup (11) and said insert (12) along a common coupling shaft (Y) and reciprocally holding said acetabular cup (11) and said insert (12) in an assembled state by means of a means (20, 33), wherein before the coupling, in a disassembled state, the coupling cavity (15) of the acetabular cup (11) has an internal diameter (Dc) that is smaller than the outer diameter large (Di) of said insert (12) and where, after coupling, in the assembled state, the internal diameter (Dc ') of the coupling cavity (15) of the acetabular cup (11) is equal to the outer diameter larger (Di ') of said insert (12), wherein the internal diameter (Dc, Dc') of the coupling cavity (15) of the acetabular cup (11) is considered in correspondence with a coupling plane (P) ) between the acetabular cup (11) and the insert (12) defined along said coupling axis (Y), as in addition, the clamping between said acetabular cup (11) and said insert (12) is carried out using clamping means comprising:
    - a first clamping surface (20), made on said internal surface (14) of said acetabular cup (11), - a second clamping surface (33), made on said external surface (29) of said insert (12) and cooperating with said first clamping surface (20),
    said first clamping surface (20) and said second clamping surface (33) having a truncated cone shape with an inclination (a, P), different from one another, with respect to said coupling axis (Y), with the In order to obtain a conical coupling between said insert (12) and said acetabular cup (11), with a variable interference (i) along said coupling axis (Y), characterized in that
    said acetabular cup (11) comprises a trabecular reticular structure (25), said trabecular reticular structure (25) being a network of cells, achieving a plurality of three-dimensional cavities arranged, open and interconnected, connected to each other; because said acetabular cup (11) is shaped so as to comprise a through opening (23) in correspondence with a polar region (18) thereof, because said insert (12) is formed in order to understand, in a polar region (31) thereof, a centering element (34) capable of being inserted inside said through-hole (23),
    and in that said method comprises at least one step in which said acetabular cup (11) is grasped by elastic gripping means (37) in correspondence with a through opening (23), a step in which said insert (12) it is placed in a support and centering element (40), a step in which the elastic grasping means (37) move and said acetabular cup (11) engages by variable interference with said insert (12), making it cooperate between said first clamping surface (20) and said second clamping surface (33), and a step in which said elastic grasping means (37) release said acetabular cup (11) coupled with said insert (12), where the assembly of said acetabular cup (11) and said insert (12) is obtained by applying a thermal load, or mechanically, or a combination of applying a thermal load and a mechanical assembly.
    [10]
    Method as in claim 9, characterized in that it comprises a preliminary stage of alignment and centering of said elastic gripping means (37) and said insert (12) placed in said support and centering element (40) that moves downwards said elastic grip means (37).
    [11]
    Method as in claim 10, characterized in that , after alignment and centering of said elastic gripping means (37) and said insert (12), said elastic gripping means (37) are lifted, said insert is removed ( 12) of the support and centering element (40), said acetabular cup (11) is placed on the support and centering element (40), the elastic grasping means (37) are moved down to grip the acetabular cup (11). ), the elastic gripping means (37) associated with the acetabular cup (11) are raised and the insert (12) is again placed on the support and centering element (40) in order to proceed with the conical coupling.
    类似技术:
    公开号 | 公开日 | 专利标题
    JP5671106B2|2015-02-18|Method for manufacturing an artificial acetabular external assembly
    US3848272A|1974-11-19|Artificial hip joint
    ES2254068T3|2006-06-16|HIP ARTICULATION PROTESIS.
    JP2013521864A|2013-06-13|Interlocking reverse hip joint and revision prosthesis
    EP1293179A1|2003-03-19|Resilient thimble for ball head of prosthetic joint
    US20080262626A1|2008-10-23|Femoral sleeve for hip resurfacing
    JP5758392B2|2015-08-05|Acetabular cup with high holding ability
    US9867710B2|2018-01-16|Modular humeral prosthesis
    JP2005511142A|2005-04-28|Ball / socket joint prosthesis acetabular cup assembly for hip joints, etc.
    WO2008087415A2|2008-07-24|Reverse shoulder prosthesis
    ES2891276T3|2022-01-26|Prosthetic element for bony extremities such as fingers or toes, or for teeth, and corresponding manufacturing method
    ES2829910T3|2021-06-02|Prosthesis
    JP4243060B2|2009-03-25|Tool for adjusting the mutual angle between the parts of the hip prosthesis
    ES2686847T3|2018-10-22|Acetabular prosthesis and corresponding method for its production and assembly
    CN101917936B|2013-06-26|Acetabular prosthesis
    US20090248168A1|2009-10-01|Prosthesis
    JP2009160300A|2009-07-23|Resurfacing femoral head component
    CN214967163U|2021-12-03|Forged titanium alloy acetabular cup
    JP2022502215A|2022-01-11|Implants, systems and how to use them
    同族专利:
    公开号 | 公开日
    ES2686847T8|2019-01-18|
    ES2686847T3|2018-10-22|
    US10092406B2|2018-10-09|
    EP2911615A1|2015-09-02|
    EP2911615B1|2018-08-01|
    JP2015535188A|2015-12-10|
    WO2014064515A1|2014-05-01|
    AU2013336331B2|2018-03-22|
    ITUD20120179A1|2014-04-25|
    AU2013336331A1|2015-06-04|
    EP2911615B9|2019-01-23|
    US20150257887A1|2015-09-17|
    JP6437919B2|2018-12-12|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US5314487A|1991-02-14|1994-05-24|Smith & Nephew Richards Inc.|Acetabular prosthesis with anchoring pegs|
    US5405392A|1992-06-10|1995-04-11|Deckner; Andre G.|Articular prosthetic device|
    US5443519A|1993-04-22|1995-08-22|Implex Corporation|Prosthetic ellipsoidal acetabular cup|
    US5480448A|1993-09-20|1996-01-02|Mikhail; W. E. Michael|Acetabular cup groove insert|
    DE19616059A1|1996-04-23|1997-10-30|Cerasiv Gmbh|Method for renewing prosthetic joint cup|
    DE19701536A1|1996-08-24|1998-02-26|Cerasiv Gmbh|Joint prosthesis|
    AU783205C|2000-03-15|2006-08-17|Depuy Orthopaedics, Inc.|Prosthetic cup assembly which includes components possessing self-locking taper|
    US6626947B2|2000-10-03|2003-09-30|Depuy Orthopaedics, Inc.|Press fit acetabular cup and associated method for securing the cup to an acetabulum|
    FR2827154B1|2001-07-16|2004-04-30|Jean Yves Lazennec|COTYLOID IMPLANT FOR HIP PROSTHESIS|
    GB0122002D0|2001-09-11|2001-10-31|Benoist Girard Sas|Acetabular cup|
    US6682567B1|2001-09-19|2004-01-27|Biomet, Inc.|Method and apparatus for providing a shell component incorporating a porous ingrowth material and liner|
    US7326253B2|2001-11-16|2008-02-05|Depuy Products, Inc.|Prosthetic cup assembly having increased assembly congruency|
    ITUD20020037A1|2002-02-14|2003-08-14|Lima Lto Spa|HIP ACETABULAR PROSTHESIS|
    US6916342B2|2002-04-01|2005-07-12|Smith & Nephew, Inc.|Liner assembly for prosthetic components|
    CA2400955A1|2002-08-22|2004-02-22|Roger Bacon|Expandable prosthetic cotyle|
    GB0321582D0|2003-09-15|2003-10-15|Benoist Girard Sas|Prosthetic acetabular cup and prosthetic femoral joint incorporating such a cup|
    US20060190089A1|2005-02-18|2006-08-24|Howmedica Osteonics Corp.|Internal adaptor for hip acetabular cage|
    US20060229731A1|2005-04-12|2006-10-12|Zimmer Technology, Inc.|Acetabular implant with a tapered bearing-locking flange|
    CH698608B1|2005-05-02|2009-09-15|Mariasal Invest Nv|prosthetic element with recesses formed below the outer surface.|
    US8728387B2|2005-12-06|2014-05-20|Howmedica Osteonics Corp.|Laser-produced porous surface|
    EP2007318B8|2006-03-20|2014-03-12|Smith & Nephew, Inc.|Acetabular cup assembly for multiple bearing materials|
    US8308811B2|2006-04-11|2012-11-13|Zimmer, Inc.|Acetabular cup conversion ring|
    US20070239283A1|2006-04-11|2007-10-11|Berger Richard A|Acetabular cup conversion ring|
    US8308812B2|2006-11-07|2012-11-13|Biomedflex, Llc|Prosthetic joint assembly andjoint member therefor|
    FR2911062B1|2007-01-08|2009-07-03|Thomas Gradel|COTYL WITH STERILE INTERFACE|
    ITUD20070088A1|2007-05-25|2008-11-26|Lima Lto S P A|INSERT FOR AN ACETABULAR CUP|
    ITUD20070092A1|2007-05-29|2008-11-30|Lima Lto S P A|PROSTHETIC ELEMENT AND RELATIVE PROCEDURE FOR IMPLEMENTATION|
    DE102008058153A1|2008-11-20|2010-05-27|Aesculap Ag|acetabulum|
    US8123815B2|2008-11-24|2012-02-28|Biomet Manufacturing Corp.|Multiple bearing acetabular prosthesis|
    WO2010091995A1|2009-02-11|2010-08-19|Ceramtec Ag|Ceramic ball socket insert having inverse-conical guide pins|
    US8308810B2|2009-07-14|2012-11-13|Biomet Manufacturing Corp.|Multiple bearing acetabular prosthesis|
    GB0922339D0|2009-12-21|2010-02-03|Mcminn Derek J W|Acetabular cup prothesis and introducer thereof|
    US8585769B2|2011-01-14|2013-11-19|Zimmer, Inc.|Acetabular liner system|
    US8771367B2|2011-09-30|2014-07-08|DePuy Synthes Products, LLC|Self centering, anti-seizing acetabular liner|
    US20140343682A1|2013-05-17|2014-11-20|Zimmer, Inc.|Convertible acetabular bearing|FR3039440B1|2015-07-30|2017-08-11|Soc D'etudes De Rech Et De Fabrication |PROCESS FOR PRODUCING A CUPULE|
    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    ITUD20120179|2012-10-24|
    IT000179A|ITUD20120179A1|2012-10-24|2012-10-24|ACETABULAR PROSTHESIS AND ITS PROCESS OF MANUFACTURING AND ASSEMBLY|
    PCT/IB2013/002378|WO2014064515A1|2012-10-24|2013-10-24|Acetabular prosthesis and corresponding method for production and assembly|
    [返回顶部]