The invention relates to a joint prosthesis implant. More specifically, the invention relates to a joint prosthesis implant whose joint outer surface is made of ceramic.
The state of the art already describes several types of joint prosthesis, for example shoulder prostheses, hip prostheses, and knee prostheses.
These joint prostheses all comprise two implants, each having a joint outer surface intended to come into contact with each other, thus reproducing the joint. To reproduce the best possible joint quality, it is known to use pairs of favorable materials for these joint outer surfaces in contact, these pairs possibly consisting of two “hard” materials or one “hard” material and one “soft” material. The “hard” materials known and used in joint prosthesis implants are the cobalt-chromium alloy, titanium-stainless steel alloy and ceramic. The “soft” materials may be plastic, for example ultra-high-molecular-weight polyethylene (UHMWPE) and its cross-linked and vitamin-stabilized derivatives or polyetheretherketone (PEEK) or polyetherketoneketone (PEKK) and their derivatives.
The cobalt-chromium alloy is particularly appreciated by joint prosthesis implant manufacturers since it offers exceptional tribological and mechanical properties which allowed in particular the implant concerned to be impacted (using a suitable element) either directly into the patient's bone, or in an element itself attached to the patient's bone (for example a metaglene for a reverse total shoulder prosthesis), with no risk of damaging the implant.
However, the latest applicable standards (and in particular the updated standard of the delegated regulation (UE) 2020/217 of 4 Oct. 2019 REACH) tend to prohibit the use of chromium cobalt as material for the joint prosthesis implants since cobalt is considered to be a potentially carcinogenic, mutagenic or toxic substance for the patient. Alternative hard materials must therefore be considered.
One known hard material is ceramic. This material offers the advantage of being biocompatible and especially suitable for rubbing due to its hardness properties. However, ceramic is a material with very low ductility and the very high, localized mechanical stresses caused by the step of the surgeon gripping the implant could create cracks in the ceramic, or even break it. Such a risk is not acceptable, whether for the surgeon during the operation or for the patient who could need to have the prosthesis replaced too quickly. In addition, it is not currently authorized to install another ceramic implant when the ceramic of a first implant has broken. In this case therefore, another pair of materials must be chosen.
The invention aims in particular to allow the use of such a ceramic implant which overcomes all the above-mentioned disadvantages.
The invention therefore relates to a joint prosthesis implant comprising:
Thus, it is possible to produce a joint prosthesis implant made of ceramic (or mainly of ceramic) that is also functional, since it is particularly adapted to be assembled to a gripping device that is itself adapted to grip an implant in a fragile ceramic portion. Consequently, the risks of cracking or breaking are eliminated.
According to other optional characteristics of the implant taken alone or in combination:
The invention also relates to an assembly of a joint prosthesis implant according to the invention and a gripping device, the assembly comprising a guiding portion protruding from the main body of the implant, from a side of the main body opposite the joint outer surface.
According to other optional characteristics of the assembly taken alone or in combination:
The invention also relates to a joint prosthesis comprising an implant according to the invention.
The invention also relates to a use of an assembly according to the invention to form a joint prosthesis.
The invention also relates to a method for attaching an implant of the invention to form a joint prosthesis.
The invention will be better understood on reading the following description, given solely by way of example and with reference to the accompanying drawings in which:
For the two embodiments shown, as well as for those not shown, the joint prosthesis implant 1 comprises:
In addition, and for all the embodiments shown, as well as for those not shown, the assembly 100 according to the invention comprises a joint prosthesis implant 1 according to one of the possible variants of the invention and a gripping device 20. Furthermore, the assembly 100 comprises a guiding portion 12 protruding from the main body 2 of the implant 1, from a side of the main body 2 opposite the joint outer surface 8.
Note that the various examples shown of the invention concern a glenoid implant 1 for reverse shoulder prosthesis but that the invention applies to any prosthesis comprising a joint implant having a ceramic joint surface and being assembled by the surgeon, on the patient's bone or on an intermediate element attached to said bone, by using a gripping device. It could be a hip prosthesis or a knee prosthesis (obviously, with an adaptation of the shape of the various elements forming this prosthesis). Thus, in all these examples, the main body 2 corresponds to a glenosphere 2.
Any type of ceramic known by those skilled in the art can be used for the main body. For example, it could be alumina, zirconia or a composite material. Since ceramic is a hard material, it can be used with pairs of “hard/hard” or “hard/soft” materials. In this second example, the “soft” material can be ultra-high-molecular-weight polyethylene (UHMWPE) or polyetheretherketone (PEEK) or polyetherketoneketone (PEKK) or their derivatives.
In the two embodiments of the implant 1, the main body 2 therefore corresponds to a glenosphere 2 intended to be impacted inside a metaglene 3, itself attached beforehand in the bone of the patient (not shown) who will receive surgery.
The glenosphere 2 and the metaglene 3 are assembled together by any means known by those skilled in the art, for example using a Morse cone (not shown) between the glenosphere 2 and the metaglene 3.
The ceramic glenosphere 2 can have a diameter from 30 to 46 mm, it can be centered or off-centered and can be lateralized with respect to the metaglene, if necessary.
In all the embodiments shown, the housing 4 and the part of the assembly member 21 intended to be installed in said housing 4 have an oblong shape. Thus, such an association of complementary oblong shape allows an assembly integral in rotation between the glenosphere 2 and the gripping device 20. Note that any other association of complementary geometric shape known by those skilled in the art and allowing such an assembly integral in rotation can be considered in the framework of the invention. The surgeon therefore has a safe gripping means presenting no risk of cracking or breaking the ceramic of the glenosphere 2 during surgery. This non-pivoting link between the glenosphere 2 and the assembly member 21 allows the surgeon to index the position of the glenosphere 2, during surgery, using the gripping device 20. Such a possibility of positioning the glenosphere 2 is particularly advantageous if the glenosphere is off-centered with respect to the metaglene 3, which may happen when the bone of the patient who will receive surgery does not allow the metaglene to be attached in the most natural position possible for the joint.
In addition, the housing 4 provided on the joint outer surface 8 comprises either a blind hole (
The guiding portion 12 protruding from the glenosphere 2, from one side of the glenosphere 2 opposite its joint outer surface 8, guides the glenosphere using the gripping device 20 into the correct final position ready to be impacted inside the metaglene 3. According to the first embodiment of the implant 1 (referring to
The gripping device 20, forming part of the assembly 100 of the invention, comprises the assembly member 21 and a main portion 22. More precisely, the assembly member 21 is located at one of the two ends of the main portion 22. In the examples shown on
Alternatively, and as shown on
The invention is not limited to the embodiments described. As mentioned previously, the invention can be applied to any type of joint implant having a ceramic joint surface and being assembled by the surgeon, on the patient's bone or on an intermediate element attached to said bone, by using a gripping device.
Number | Date | Country | Kind |
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FR2203270 | Apr 2022 | FR | national |