This application is the National Stage of PCT/IB2008/001243 filed on May 9, 2008, which claims priority under 35 U.S.C. ยง119 of German Application No. 20 2007 009 620.8 filed on Jul. 9, 2007. The international application under PCT article 21(2) was not published in English.
The invention relates to a joint part prosthesis, particularly for a finger joint. It consists of either a proximal or a distal component, as well as a shaft that extends away from this component, to be mounted in a bone, the shaft having a fin-like anti-twist safety element.
Artificial finger joints consist essentially of two elements, namely a proximal and a distal component. A component has a convex joint head that interacts with the other part, which demonstrates a convex joint socket.
Artificial finger joints are inserted between the metacarpal bone and the finger bone, or between individual finger bones. Such joints have to be inserted if degenerative joint diseases such as osteoarthritis, post-traumatic arthritis, or rheumatoid arthritis of the joints in question are present. Another alternative that retains mobility of the individual finger members is a total joint replacement.
From the state of the art, particularly from EP 1203569 A (FINSBURY (DEVELOPMENT) LIMITED LEATHERHEAD) Mar. 3, 2000, finger joint implants are known in the configuration of so-called PIP shaft implants. They have a proximal or a distal component, which components interact accordingly, each having a shaft that points away from these components. The shaft is generally configured to be conical and is introduced into the bone marrow of a bone. In order to allow introduction, the interior of the bone is partly cleared out using a clearing tool, and the implant is driven into the bone using a hammer-like instrument. Fixation takes place in such a manner that the diameter of the cleared bore is smaller than the outside diameter of the shaft, so that a kind of press fit is formed between the shaft and the interior of the bone.
The implant itself consists of a material having a modulus of elasticity similar to bone. This modulus of elasticity similar to bone avoids so-called stress shielding and thus promotes bone build-up. Additionally, fixation of the implant in the medullary space of the bone is improved in this manner.
Furthermore, a joint part prosthesis is known from DE 101 30 796 Al (MUENDER ULRICH [DE]) 23.01.2003, which is particularly supposed to be used for diseased finger joints. Here, the artificial joint possesses so-called implant stems for its attachment to the adjacent bone, which stems have stabilization wings that run out very conically in their initial regions, to improve their rotation stability. Preferably, four stabilization wings are provided, in each instance, which are not only supposed to improve the production process when using a wax injection-molding technique, but also to take over the task of joint body stabilization against possible shrinkage or a change in geometrical shape.
Products according to the state of the art have disadvantages such as implant loosening due to insufficient fixation and insufficient connection with the bone, as well as high wear values, thereby causing corresponding friction wear. The shaft-like construction within the medullary space creates sufficient room for itself if loosened, so that an implant that was fixed in place previously is no longer functionally correct. The consequences of this are pain caused by migration or even fractures.
Furthermore, the disadvantage of the embodiments according to the state of the art consists in that the individual joint part prostheses cannot be disposed in a manner to reliably prevent twisting.
It is therefore the task of the invention to further develop a joint part prosthesis, particularly for finger joints, in such a manner that the likelihood of loosening of the implant is reduced, in contrast to the state of the art, and, at the same time, insertion of the prosthesis is simplified.
The core idea of the solution of the task is that at least two wing-like or fin-like anti-twist elements are disposed on the mantle surface of the shaft to be mounted in a bone, with rotation symmetry, and extend radially from the mantle surface and in the longitudinal direction, whereby the distance of the anti-twist elements from the mantle surface decreases slightly in the direction of the free end of the shaft.
One of the significant advantages of the invention is that because of the configuration of the joint part prosthesis according to the invention, it is no longer necessary to clear out the medullary space of the bone into which the implant is to be placed by means of working on it by hitting or hammering. Nevertheless, the joint part prosthesis can be fixed in place in simple and efficient manner. Since the shaft of the joint part prosthesis has rotation symmetry, it is sufficient to clear out the medullary space of the bone by means of rotational movements. In this way, damage to adjacent joints, in particular, caused by the hammering process required for clearing, is avoided.
One of the other significant advantages of the invention is that the joint part prosthesis can be inserted into the medullary space of a bone, with its shaft, and is also fixed in place there, in anti-twist manner, without additional steps being required.
The anti-twist device provided on the mantle surface of the shaft of the joint part prosthesis, according to the invention, which device comprises at least two fin-like elements, advantageously extends in a longitudinal expanse of the shaft. In this connection, the fin-like elements are preferably narrow, and advantageously configured to be somewhat thicker toward the shaft. This brings with it the advantage that for one thing, torques/torsions that occur can be absorbed by the anti-twist element. For another thing, it has the advantage, because of the fact that the free ends are configured to be narrower, that simple insertion into the prepared cleared medullary space is possible.
A preferred embodiment of this anti-twist security device provides that it/they increase in their reaches, proceeding from the free end, in the direction of the distal or proximal component, so that twisting is still possible at insertion of the implant, and the farther the implant is introduced into the medullary space, the more likely it is that twisting is configured to be restricted.
In order to be able to install such anti-twist devices together with the shaft of a component, it is provided to clear the cavity accordingly. Aside from the dimensions of the shaft, the spaces that project away laterally are also cleared by means of a gauge, so that the implant can be inserted with precise fit. Clearing preferably takes place by means of rotating and oscillating movements, so that no hammering movements, which put stress on the joints, are required.
In one exemplary embodiment, the joint part prosthesis consists of a material that is known from the state of the art.
Preferably, the anti-twist elements form a one-piece part with the shaft.
A preferred embodiment provides that the distance from the mantle surface of the shaft decreases toward the free end of the anti-twist element, in the direction of the free end of the shaft.
Furthermore, it is provided that a plastic can be used, particularly in order to achieve the modulus of elasticity similar to bone. This also brings with it the particular advantage that the joint part prostheses can be produced by means of injection-molding methods.
Other advantageous embodiments are evident from the following description, the drawings, as well as the claims.
The drawings show:
In
The free end 5 of the shaft 4 is preferably configured in ball-like manner, so that no sharp edges can be formed, which can injure any marrow of the bone during insertion of the prosthesis.
Furthermore, the wall of the shaft 4 is configured to be round, particularly in the region of the free end 5.
On the mantle surface 6, the anti-twist device 7 according to the invention is disposed. This anti-twist device 7 serves to fix a shaft 4, that has been introduced into a medullary space, in place in such a manner that turning of the joint part prosthesis 1 within the medullary space is no longer possible, whereby the medullary preferably has a cross section, which at least almost corresponds to a cross-section of the shaft 4 with its anti-twist device 7.
The anti-twist device 7 consists of at least two anti-twist elements 8 which expand in the longitudinal extension of the shaft 4 and have a fin-like construction.
Particularly in the region of the free end 5 of the shaft 4, it is provided to configure the anti-twist elements 8 very slightly, with regard to their distances from the mantle surface of the shaft 4, so that during introduction, corresponding positioning within the medullary space is still possible. The deeper the joint part prosthesis 1 is introduced into the medullary space, the more the fin-like anti-twist elements 8 penetrate into the medullary space and press themselves into the marrow of the bone. A corresponding wedge effect occurs.
The anti-twist elements 8 prevent a rotational movement of the joint part prosthesis 1 in or opposite to the arrow direction 9. They serve as a fixation of the joint part prosthesis 1 in the rotation direction, but also in the longitudinal direction.
The invention can be used for joint part prostheses in both the distal or the proximal region. Likewise, use for all types of prostheses that have a shaft-like configuration is possible, where it is important to prevent a rotational movement of the joint part prostheses from being possible.
1 joint part prosthesis
2 proximal component
3 -
4 shaft
5 free end
6 mantle surface
7 anti-twist device
8 anti-twist element
9 arrow direction
Number | Date | Country | Kind |
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20 2007 009 620 U | Jul 2007 | DE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB2008/001243 | 5/9/2008 | WO | 00 | 1/8/2010 |
Publishing Document | Publishing Date | Country | Kind |
---|---|---|---|
WO2009/007805 | 1/15/2009 | WO | A |
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