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WO2018139922A1 - Auxiliaire de positionnement destiné en particulier au positionnement d'un élément prothétique acétabulaire - Google Patents

Auxiliaire de positionnement destiné en particulier au positionnement d'un élément prothétique acétabulaire Download PDF

Info

Publication number
WO2018139922A1
WO2018139922A1 PCT/NL2018/050050 NL2018050050W WO2018139922A1 WO 2018139922 A1 WO2018139922 A1 WO 2018139922A1 NL 2018050050 W NL2018050050 W NL 2018050050W WO 2018139922 A1 WO2018139922 A1 WO 2018139922A1
Authority
WO
WIPO (PCT)
Prior art keywords
recesses
auxiliary body
recess
positioning aid
positioning
Prior art date
Application number
PCT/NL2018/050050
Other languages
English (en)
Inventor
Jan VERMAAT
Original Assignee
Orpidem B.V.
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 Orpidem B.V. filed Critical Orpidem B.V.
Publication of WO2018139922A1 publication Critical patent/WO2018139922A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4609—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of acetabular cups
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30079—Properties of materials and coating materials magnetic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30617—Visible markings for adjusting, locating or measuring
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30787—Plurality of holes inclined obliquely with respect to each other
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4687—Mechanical guides for implantation instruments

Definitions

  • Positioning aid in particular for positioning an acetabular prosthetic component
  • the invention relates to a positioning aid for all surgical procedures where direction and angle relative to the body are decisive, for example for positioning a bone in a human body during a surgical procedure. More particularly, the invention relates to a positioning aid for positioning a prosthesis of which the direction and angle relative to the body are decisive. Even more particularly, the invention relates to a positioning aid for positioning an acetabular prosthetic component of a prosthetic hip in an acetabulum of a patient.
  • the positioning aid compri sing:
  • auxiliary body to be fixed relative to a coupling element connected to the prosthetic acetabular component, which auxiliary body is provided with at least one cylindrical or conical recess, and
  • the coupling element is for example a straight, curved or angled rod.
  • Cups were placed in 49.7° ( SD 6.7) of abduction and 16.0° ( SD 8.1) of anteversion.
  • Estimation of placement was 46.3° ( SD 4.3 ) of abduction and 14.6° ( SD 5.9) of anteversion.
  • the mean inaccuracy of estimation was 4.1° ( SD 3.9) for abduction and 5.2° (SD 4.5 ) for antev ersion and for their residents this was respectiv ely, 6.3° (SD 4.6) and 5.7° ( SD 5.0).
  • Significant differences were found between orthopedic surgeons and residents for inaccuracy of estimation for abduction, not for anteversion.
  • Body mass index, sex, (un)cemented fixation and surgical approach were not significant factors. Based upon the inaccuracy of estimation, the group's chance on future cup placement within Lewinnek's safe zone (5-25° anteversion and 30-50° abduction) is 82.7 and 85.2% for anteversion and abduction separately. When both parameters are combined, the chance of accurate placement is only 70.5%. The chance of placement of the acetabular component within 5° of an intended position, for both abduction and anteversion is 21.5% this percentage decreases to just 2.9% when the tolerated error is 1°. There is a tendency to underestimate both abduction and anteversion. Orthopedic surgeons are superior to their residents in estimating abduction of the acetabular component. The results of this study indicate that freehand placement of the acetabular component is not a reliable method.
  • a positioning aid according to the preamble of claim 1 is known from EP2644164A1.
  • This known positioning aid for positioning an acetabular prosthetic component in a patient's surgically-prepared acetabulum comprises:
  • the position indicator of the positioning aid includes a housing having a gravity-based indicator secured thereto.
  • a "gravity-based indicator” is a sensor that indicates position based on gravity.
  • the gravity-based indicator is a bubble indicator including a vial that defines a chamber filled with a fluid.
  • the vial defines a dome- shaped chamber.
  • a bubble is trapped within the chamber. Gravity and the physical difference between the gas of the bubble and the fluid in the chamber control the function of the bubble indicator, with the bubble floating toward the side of the vial that constitutes the high side of the vial.
  • the vial has a face plate that is substantially transparent. In that way, a user may look through the face plate to determine the position of the bubble.
  • the bubble indicator has a plurality of markings etched into an outer surface of the face plate. Each of the markings indicates a predetermined position of the acetabular prosthetic component within the patient's surgically-prepared acetabulum.
  • the positioning aid according to the invention is characterized in that the auxiliary body is provided with a number of further cylindrical or conical recesses, the center lines of said recess and said further recesses are at angles relative to each other, wherein the position indicator with the coupling pin is inserted in one of the recess and further recesses, corresponding to the desired orientation in which the acetabular prosthetic component is to be mounted in the acetabulum.
  • the auxiliary body forms an interface between the position indicator and the coupling element and can be carried out in any desired size of choice. Because the position indicator can be coupled via the auxiliary body with the coupling element in a large number of different positions / orientations also a large number of pre-defined positions / orientations can be indicated on the auxiliary body.
  • the position indicator is a circular buble spirit level provided with a bubble indication.
  • This is a circular device with the liquid under a slightly convex transparent face with a circle at the center.
  • the spirit level has a convex surface window in the middle provided with two concentric circles, wherein the air bubble just fits within the innermost circle and in this position the spirit level is horizontally oriented, and when the air bubble touches the outer circle the spirit level is at a specified angle relative to the horizontal plane.
  • the position indicator is a circular bubble spirit level compass.
  • a circular bubble spirit level compass is meant a combination of a circular bubble spirit level and a compass. This enables the use of the positioning aid in situations the patient is lying on his/her back.
  • a position indicator that is both a circular bubble spirit level and a compass is still advantageous especially in case the patient is lying on his/her back to find the correct orientation of the cup.
  • the auxiliary body and coupling elements preferably have no ferromagnetic characteristics that could adversely influence the correct functioning of the compass.
  • the auxiliary body is provided with a surface in which the recess and the further recesses are present and which is provided with inscriptions indicating angles at which the recesses are relative to two vertical reference planes which are perpendicular to each other.
  • An embodiment of the positioning aid according to the invention is characterized in that the surface is curved along a spherical surface in which the center lines of the recesses are perpendicular to the surface.
  • a further embodiment of the positioning aid according to the invention is characterized in that the auxiliary body is detachabiy connected to the coupling element and is provided with a further surface opposite to the surface, which further surface is also provided with cylindrical or conical recesses in which the coupling pin of the position indicator can be inserted, each recess having an axis, the axes of the recesses are at angles relative to each other, wherein the auxiliary body can be connected to the coupling element in two different orientations, namely with the surface or the further surface facing up.
  • the positioning aid can be applied both for left and for the right-hand side of the patient.
  • Figure 3 shows the application of the positioning aid with a patient lying on his/her side
  • Figure 5 is a side view of a second embodiment of the auxiliary body with the circular bubble spirit level compass of the positioning aid.
  • Figure 1 shows an embodiment of the positioning aid 1 for positioning an acetabular prosthetic component 3 of an prosthetic hip in an acetabulum 5 of a patient according to the invention during use.
  • the positioning aid 1 comprises a coupling element 7 for coupling to the prosthetic acetabular component.
  • Figures 2 and 3 show the application of the positioning aid with a patient lying respectively on his/her back and on his/her side.
  • An auxiliary body 9 is fixed relative to the coupling element and is provided with a number of recesses 1 1, see figure 4.
  • the center lines 1 1A of said recesses are at angles relative to each other.

Landscapes

  • Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physical Education & Sports Medicine (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

Un auxiliaire de positionnement (1) présente un élément d'accouplement (7) destiné à être accouplé à l'élément acétabulaire prothétique, ainsi qu'un corps auxiliaire (9) qui est fixé par rapport à l'élément d'accouplement et qui est pourvu d'évidements. Les lignes centrales desdits évidements se trouvent à des angles donnés entre elles ; une boussole (13) sphérique est insérée dans l'un des évidements. Cet évidement correspond à l'orientation souhaitée dans laquelle l'élément prothétique acétabulaire (3) doit être monté dans l'acétabulum (5). Des inscriptions sont fournies sur le corps auxiliaire, à proximité de chaque évidement, indiquant deux angles auxquels l'évidement se trouve par rapport à deux plans de référence verticaux qui sont perpendiculaires l'un par rapport à l'autre. Lorsque le corps auxiliaire (9) est maintenu à un niveau, les angles indiqués à proximité de l'évidement dans lequel la boussole (13) à niveau à bulle d'air circulaire est insérée définissent la position dans laquelle est orienté l'élément prothétique acétabulaire.
PCT/NL2018/050050 2017-01-24 2018-01-24 Auxiliaire de positionnement destiné en particulier au positionnement d'un élément prothétique acétabulaire WO2018139922A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2018223 2017-01-24
NL2018223 2017-01-24

Publications (1)

Publication Number Publication Date
WO2018139922A1 true WO2018139922A1 (fr) 2018-08-02

Family

ID=61952938

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/NL2018/050050 WO2018139922A1 (fr) 2017-01-24 2018-01-24 Auxiliaire de positionnement destiné en particulier au positionnement d'un élément prothétique acétabulaire

Country Status (2)

Country Link
NL (1) NL2020309B1 (fr)
WO (1) WO2018139922A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111281623A (zh) * 2020-03-30 2020-06-16 北京市春立正达医疗器械股份有限公司 一种髋臼外杯安装定位器
EP4464265A1 (fr) * 2023-04-05 2024-11-20 Massmedica S.A. Dispositif de vérification de l'orientation pelvienne

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120330319A1 (en) * 2010-05-04 2012-12-27 Depuy International Limited Alignment guide with spirit level
EP2644164A1 (fr) 2012-03-29 2013-10-02 DePuy Synthes Products, LLC Instrument de positionnement d'un composant prothétique acétabulaire
DE102012104390A1 (de) * 2012-05-22 2013-11-28 Aesculap Ag Zielgerät zur Ausrichtung eines Implantats während des Implantiervorgangs

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120330319A1 (en) * 2010-05-04 2012-12-27 Depuy International Limited Alignment guide with spirit level
EP2644164A1 (fr) 2012-03-29 2013-10-02 DePuy Synthes Products, LLC Instrument de positionnement d'un composant prothétique acétabulaire
DE102012104390A1 (de) * 2012-05-22 2013-11-28 Aesculap Ag Zielgerät zur Ausrichtung eines Implantats während des Implantiervorgangs

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
ARCH ORTHOP TRAUMA SURG., vol. 127, no. 5, 13 February 2007 (2007-02-13), pages 375 - 379
BONE, JOINT J., vol. 97-B, no. 2, February 2015 (2015-02-01), pages 164 - 72

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111281623A (zh) * 2020-03-30 2020-06-16 北京市春立正达医疗器械股份有限公司 一种髋臼外杯安装定位器
EP4464265A1 (fr) * 2023-04-05 2024-11-20 Massmedica S.A. Dispositif de vérification de l'orientation pelvienne

Also Published As

Publication number Publication date
NL2020309A (en) 2018-08-01
NL2020309B1 (en) 2018-11-02

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