DE19925529A1 - Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted radially that can be inserted - Google Patents

Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted radially that can be inserted

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Publication number
DE19925529A1
DE19925529A1 DE19925529A DE19925529A DE19925529A1 DE 19925529 A1 DE19925529 A1 DE 19925529A1 DE 19925529 A DE19925529 A DE 19925529A DE 19925529 A DE19925529 A DE 19925529A DE 19925529 A1 DE19925529 A1 DE 19925529A1
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Germany
Prior art keywords
joint
proximal
shaft
endoprosthesis
joint part
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DE19925529A
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German (de)
Inventor
Hans-Juergen Moje
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MOJE HANS JUERGEN
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MOJE HANS JUERGEN
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Priority to DE29909740U priority Critical patent/DE29909740U1/en
Priority to DE19925529A priority patent/DE19925529A1/en
Publication of DE19925529A1 publication Critical patent/DE19925529A1/en
Withdrawn legal-status Critical Current

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    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • 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
    • 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
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30172—T-shaped
    • 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
    • A61F2002/30108—Shapes
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    • A61F2002/30224—Three-dimensional shapes cylindrical
    • 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
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    • A61F2002/30232—Half-cylinders
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30242—Three-dimensional shapes spherical
    • A61F2002/30245—Partial spheres
    • 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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4243—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for interphalangeal joints, i.e. IP joints
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
    • A61F2002/4251—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/0052—T-shaped
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0071—Three-dimensional shapes spherical
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00185—Ceramics or ceramic-like structures based on metal oxides
    • A61F2310/00239—Ceramics or ceramic-like structures based on metal oxides containing zirconia or zirconium oxide ZrO2
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds

Abstract

Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted 1 mm radially and up to 30 deg from the radial that can be inserted in bone, the proximal part being inserted in bone.

Description

Die Erfindung betrifft eine verbesserte nichtgeführte Endoprothese für Fingergelenke, die aus einem proximalen und einem distalen Endoprothesenkörper mit den entsprechenden Gelenkflächen besteht, die jeweils mit einem Schaft für die Befestigung im Knochen versehen sind. Diese Endoprothesen werden operativ anstelle der zerstörten Gelenke der Finger eingesetzt.The invention relates to an improved non-guided endoprosthesis for finger joints, the of a proximal and a distal endoprosthesis body with the corresponding Articular surfaces exist, each with a shaft for attachment to the bone are provided. These endoprostheses are operated on instead of the destroyed joints Fingers inserted.

In jüngster Zeit wurden die Endoprothesen, die mit Schrauben in den angrenzenden Knochen befestigt wurden, von Endoprothesen abgelöst, die mit einem Schaft, der einen Teil der Endoprothese bildet, in den angrenzenden Knochen eingepreßt werden. Bedingung dazu ist jedoch, dass die Endoprothesen aus einem biologisch verträglichen Material bestehen oder mit einem biologisch verträglichen Material beschichtet sind, da nur dann eine feste Verbindung mit dem Knochen erzeugt werden kann. Eine Endoprothese aus Titan oder einem Material mit ähnlichen Eigenschaften würde keinen festen Halt im Knochen finden und ist deshalb für solche Endoprothesen mit einem Schaft ungeeignet.More recently, the endoprostheses have been screwed into the adjacent ones Bones were attached, detached from endoprostheses with a shaft that one Forms part of the endoprosthesis into which adjacent bones are pressed. condition however, this means that the endoprostheses are made from a biologically compatible material exist or are coated with a biologically compatible material, because only then a firm connection to the bone can be created. An endoprosthesis Titanium or a material with similar properties would not hold firmly in place Find bones and is therefore unsuitable for such endoprostheses with a shaft.

Auch haben sich nichtgeführte Endoprothesen bewährt, da die natürlichen oder in komplizierten Fällen auch künstliche Bänder die Aufgabe der Gelenkhalterung und -führung voll übernehmen. Es wurde sogar nachgewiesen, dass nichtgeführte Endopro­ thesen einen besseren Gelenkersatz liefern als geführte Endoprothesen.Non-guided endoprostheses have also proven their worth, since the natural or in complicated cases also the task of the joint holder and artificial ligaments -full take over leadership. It has even been shown that non-guided Endopro theses provide a better joint replacement than guided endoprostheses.

Es wurde darüber hinaus versucht, die Endoprothese weitestgehend dem natürlichen Gelenkknochen nachzubilden, bzw. sie so zu gestalten, dass sie die natürliche Funktion des Gelenkes voll erfüllen. Eine Endoprothese, durch die die natürliche Funktion des Fingergrundgelenkes weitestgehend wieder hergestellt wird, hat der Erfinder der vorliegende Erfindung in DE 297 21 522.1 geschützt. Das proximale Gelenkteil besteht aus einer Kalotte, die bis 270° einer Kugelfläche darstellt, und das distale Gelenkteil bildet einen Teil einer Hohlkugel, die etwa 20% bis 25% der Kalotte des proximalen Gelenkteiles erfaßt. Dadurch kann das Gelenk über 90° bewegt werden, was etwa der natürlichen Bewegung des Fingergrundgelenkes entspricht. Die Endoprothese ist jedoch nicht zufriedenstellend, da sie im implantierten Zustand aufgrund der Konstruktion etwas unförmig ist und die Operation mit einigen Schwierigkeiten verbunden ist.In addition, attempts have been made to make the endoprosthesis largely natural To simulate articulated bones, or to design them in such a way that they function naturally Fully meet joint. An endoprosthesis, through which the natural function of the The inventor of the finger base joint is largely restored The present invention is protected in DE 297 21 522.1. The proximal joint part consists of a calotte, which represents a spherical surface up to 270 °, and forms the distal joint part part of a hollow sphere, which is about 20% to 25% of the calotte of the proximal Joint part detected. This allows the joint to be moved through 90 °, which is about the corresponds to natural movement of the basic finger joint. The endoprosthesis is however  not satisfactory as they are somewhat implanted due to their construction is misshapen and the operation is associated with some difficulties.

Die Aufgabe der Erfindung besteht nun darin, eine Endoprothese zu entwickeln, die die natürliche Funktion des Gelenkes besser erfüllt, als die bisher bekannten Endoprothesen.The object of the invention is now to develop an endoprosthesis that fulfills the natural function of the joint better than the previously known endoprostheses.

Die Lösung der Aufgabe wird mit den Merkmalen des Schutzanspruches 1 gelöst. Die nichtgeführte Endoprothese für Fingergelenke entsprechend der vorliegenden Erfindung, die aus einem proximalen und einem distalen Endoprothesenkörper mit den entsprechenden Gelenkflächen und einem Schaft zur Befestigung im Knochen bestehen, ist so gestaltet, dass der Schaft des proximalen Gelenkteiles um etwa 1 mm radial verschoben ist und um bis zu 30° entgegen der radialen Verschiebungsrichtung geneigt ist, und das proximale Gelenkteil so in den proximalen Knochen eingesetzt ist, dass die Neigung des Schaftes zur Handinnenseite weist.The solution to the problem is solved with the features of claim 1. The non-guided endoprosthesis for finger joints according to the present invention, which consists of a proximal and a distal endoprosthesis body with the corresponding articular surfaces and a shaft for attachment in the bone, is designed so that the shaft of the proximal joint part is radially displaced by approximately 1 mm is and is inclined by up to 30 ° against the radial direction of displacement, and that proximal joint part is inserted into the proximal bone so that the inclination of the Shaft pointing to the inside of the hand.

In einem Ausführungsbeispiel der Erfindung bildet die Gelenkfläche des proximalen Gelenkteiles eine etwa halbe Kugelfläche und die Gelenkfläche des distalen Endoprothesenkörpers einem Teil einer Hohlkugelfläche bildet, die nur etwa 20% bis 25% der Kugelfläche des proximalen Gelenkteiles erfaßt. Diese Endoprothese ist als Ersatz des Fingergrundgelenkes gedacht.In one embodiment of the invention, the articular surface of the proximal forms Joint part about half a spherical surface and the articular surface of the distal Endoprosthesis body forms part of a hollow spherical surface, which is only about 20% to 25% of the spherical surface of the proximal joint part is recorded. This endoprosthesis is called Replacement of the finger base joint thought.

Eine andere Endoprothese ist so gestaltet, dass die Gelenkfläche des proximalen Gelenkteiles aus einem Teil einer halben zylindrischen Fläche und die Gelenkfläche des distalen Gelenkteiles aus einem Teil einer Hohlzylinderfläche besteht, die nur etwa 15% bis 20% der zylindrischen Fläche des proximalen Gelenkteiles erfaßt. Diese Endoprothese ist als Ersatz der Fingermittelgelenke gedacht.Another endoprosthesis is designed so that the articular surface of the proximal Articulated part from part of a half cylindrical surface and the articular surface of the distal joint part consists of a part of a hollow cylindrical surface, which is only about 15% up to 20% of the cylindrical surface of the proximal joint part. This Endoprosthesis is intended to replace the middle finger joints.

Es ist vorteilhaft, wenn der Schaft eine aufgerauhte Oberfläche besitzt, da der Heilungsprozeß dann wesentlich beschleunigt wird. Die Gelenkteile bestehen vorteilhafterweise aus Zirkonkeramik oder der Schaft ist mit einer Biokeramik oder mit einer biokeramischen Beschichtung versehen. Es kann auch ein anderes biologisch verträgliches Material als Beschichtung verwendet werden. Die Verbindung mit dem Knochen wird mit Abschluß des Einheilungsprozesses dann so innig, dass praktisch keine Trennlinien mehr zwischen dem Knochen und dem Schaft erkennbar sind.It is advantageous if the shaft has a roughened surface because the Healing process is then accelerated significantly. The joint parts exist advantageously made of zirconium ceramic or the shaft is with a bio-ceramic or with provided with a bio-ceramic coating. It can also be another biological compatible material can be used as a coating. The connection with the  At the end of the healing process, bone becomes so intimate that practically none Separation lines are more recognizable between the bone and the shaft.

Mit dieser Endoprothese ist es erstmals gelungen, eine dem natürlichen Gelenk nachgebildete Endoprothese für kleine Gelenke zu schaffen, die in der Lage ist, die Funktion des Gelenkes exakt zu erfüllen. Durch die radiale Verschiebung des Schaftes des proximalen Gelenkteiles um etwa 1 mm, wobei diese Verschiebung im implantierten Zustand des proximalen Gelenkteiles in Richtung der Handoberseite liegt, erzeugt die Endoprothese einen exzentrischen Bewegungsablauf. Wenn die Finger nach unten gebeugt werden, werden die Bänder gespannt und das Gelenk kann eine größere Kraft aufnehmen. Das entspricht weitestgehend der natürlichen Funktion des Gelenkes.With this endoprosthesis it was possible for the first time to create a natural joint replica endoprosthesis for small joints that is able to create To perform the function of the joint exactly. Due to the radial displacement of the shaft of the proximal joint part by about 1 mm, this displacement in the implanted Condition of the proximal joint part in the direction of the top of the hand creates the Endoprosthesis an eccentric movement. When the fingers are bent down the ligaments are tensioned and the joint can absorb a greater force. This largely corresponds to the natural function of the joint.

Die Endoprothese kann sehr einfach unter örtlicher Betäubung implantiert werden und die Funktion kann bereits nach dem Einsetzen der Gelenkteile kontrolliert werden, bevor die Wunde verschlossen wird. Nach der ambulant vorgenommenen Operation vergehen nur wenige Tage der Wundheilung, bis der Patient das Gelenk wieder voll und vor allem schmerzfrei benutzen kann. Die Schrägstellung des Schaftes des proximalen Gelenkteiles garantiert einen sehr guten Halt im Knochen, da der Schaft dieses Gelenkteiles genau in der Mitte des Knochens eingesetzt werden kann.The endoprosthesis can be implanted very easily under local anesthesia Function can be checked after inserting the joint parts before the Wound is closed. After the outpatient operation, only pass few days of wound healing until the patient's joint is full again and above all can use painlessly. The inclination of the shaft of the proximal joint part guarantees a very good hold in the bone, because the shaft of this joint part is exactly in the Middle of the bone can be used.

Die Befestigung mit Hilfe des am Endoprothesenkörper angeformten Schaftes hat den Vorteil einer einfachen und unkomplizierten Operation. Das umständliche und zeitaufwendige Einsetzen der Schraube und das Verschrauben selbst entfallen. Außerdem heilt der biokeramische Schaft bedeutend schneller und besser in den Knochen ein, als die Titanschraube, die sich häufig lockert und eine erneute Operation erforderlich macht. Es ist bisher in keinem Fall bei Endoprothesen aus Zirkonkeramik eine allergische Reaktion bekannt geworden.The attachment with the aid of the shaft molded onto the endoprosthesis body has the The advantage of a simple and uncomplicated operation. The cumbersome and time-consuming insertion of the screw and the screwing itself are eliminated. Moreover the bio-ceramic shaft heals into the bone much faster and better than that Titanium screw that loosens frequently and requires another operation. It is So far, no allergic reaction to zirconium ceramic endoprostheses known.

Die Erfindung soll anhand eines Beispiels erläutert werden.The invention will be explained using an example.

Fig. 1 zeigt ein proximales Gelenkteil mit etwa einer halben Kugelfläche als Gelenkfläche und einem um etwa 30° geneigten Schaft; Fig. 1 shows a proximal hinge portion having about a half spherical surface as a joint surface and an inclined by about 30 ° stem;

Fig. 2A zeigt ein proximales Gelenkteil mit einem Teil einer zylindrischen Fläche als Gelenkfläche und einem um etwa 30° geneigten Schaft; Fig. 2A shows a proximal hinge portion with a part of a cylindrical surface as the joint surface and an inclined by about 30 ° stem;

Fig. 2B zeigt das proximale Gelenkteil entsprechend Fig. 2A in einer Ansicht von oben; FIG. 2B shows the proximal joint part corresponding to FIG. 2A in a view from above;

Fig. 3 A zeigt das distale Gelenkteil, das zusammen mit dem Gelenkteil entsprechend den Fig. 2A und 2B eine Endoprothese für ein Fingermittelgelenk bildet; und FIG. 3A shows the distal joint part which, together with the joint part according to FIGS. 2A and 2B, forms an endoprosthesis for a middle finger joint; and

Fig. 3B zeigt das Gelenkteil entsprechend Fig. 3 A in einer Ansicht von oben. FIG. 3B shows the joint part corresponding to FIG. 3A in a view from above.

Fig. 1 zeigt das proximale Gelenkteil einer nichtgeführten Endoprothese für Fingergrund­ gelenke, mit der entsprechenden Gelenkfläche 1 und einem Schaft 2 für die Befestigung im Knochen, der um etwa 1 mm radial verschoben ist und um bis zu 30° entgegengesetzt zur Richtung der Verschiebung des Schaftes 2 geneigt ist. Diese Form entspricht dem natürlichen Knochenersatz eines gesunden Fingergelenkes. In dem hier dargestellten Ausführungsbeispiel besteht die Gelenkfläche 1 des distalen Gelenkteiles (nicht gezeigt) aus einem Teil einer Hohlkugelfläche, die nur etwa 15% bis 20% der Kugelfläche des proximalen Gelenkteiles erfaßt. Fig. 1 shows the proximal joint part of a non-guided endoprosthesis for the base of the finger, with the corresponding joint surface 1 and a shaft 2 for attachment in the bone, which is radially displaced by about 1 mm and up to 30 ° opposite to the direction of displacement of the shaft 2 is inclined. This shape corresponds to the natural bone replacement of a healthy finger joint. In the exemplary embodiment shown here, the joint surface 1 of the distal joint part (not shown) consists of a part of a hollow spherical surface, which only covers approximately 15% to 20% of the spherical surface of the proximal joint part.

Fig. 2A zeigt ein proximales Gelenkteil mit einem Teil einer zylindrischen Fläche als Gelenkfläche 1 und einem Schaft 2 für die Befestigung im Knochen, der um etwa 1 mm radial verschoben ist und um bis zu 30° entgegengesetzt zur Richtung der Verschiebung des Schaftes 2 geneigt ist. Dieses Gelenkteil einer nichtgeführten Endoprothese ist dadurch gekennzeichnet, daß die Gelenkfläche 1 aus einer zylindrischen Fläche besteht und die Gelenkfläche des distalen Gelenkteiles, das in Fig. 3A gezeigt wird, einen Teil einer Hohlzylinderfläche darstellt, die nur etwa 15% bis 20% der zylindrischen Fläche des proximalen Gelenkteiles erfaßt. Die Fig. 2B und 3B zeigen das proximale bzw. distale Gelenkteil jeweils in einer Ansicht von oben. Aus der Draufsicht wird deutlich, dass der Schaft 2 jeweils um etwa 1 mm radial aus der Mittellage zur Gelenkfläche 1 verschoben ist. Das proximale Gelenkteil wird so im Knochen verankert, dass der Schaft 2 näher an der Handoberseite liegt. Der Schaft 2 kann dann zentral in den proximalen Knochen eingepreßt werden. Die Endoprothese bildet so das natürliche Gelenk vollständig nach. Fig. 2A shows a proximal hinge portion with a part of a cylindrical surface as a joint surface 1 and a shank 2 for fastening in the bone, the mm to about 1 is shifted radially and by up to 30 ° of the shaft 2 are oppositely inclined to the direction of displacement . This joint part of a non-guided endoprosthesis is characterized in that the joint surface 1 consists of a cylindrical surface and the joint surface of the distal joint part, which is shown in Fig. 3A, forms part of a hollow cylindrical surface, which is only about 15% to 20% of the cylindrical surface of the proximal joint part. Figs. 2B and 3B show the proximal and distal joint part in each case in a top view. From the top view it is clear that the shaft 2 is in each case shifted radially from the central position to the joint surface 1 by approximately 1 mm. The proximal joint part is anchored in the bone so that the shaft 2 is closer to the top of the hand. The shaft 2 can then be pressed centrally into the proximal bone. The endoprosthesis thus completely replicates the natural joint.

Claims (6)

1. Nichtgeführte Endoprothese für Fingergelenke, bestehend aus einem proximalen und einem distalen Gelenkteil, wobei die proximalen und distalen Gelenkteile aus Biokeramik mit den entsprechenden Gelenkflächen (1) und einem Schaft (2) zur Befestigung im Knochen bestehen, dadurch gekennzeichnet, dass der Schaft (2) des proximalen Gelenkteiles um etwa 1 mm radial verschoben ist und um bis zu 30° entgegen der radialen Verschiebungsrichtung geneigt ist und das proximale Gelenkteil so in den proximalen Knochen eingesetzt ist, dass die Neigung des Schaftes (2) zur Handinnenseite weist.1. Non-guided endoprosthesis for finger joints, consisting of a proximal and a distal joint part, the proximal and distal joint parts made of bioceramic with the corresponding joint surfaces ( 1 ) and a shaft ( 2 ) for fastening in the bone, characterized in that the shaft ( 2 ) the proximal joint part is displaced radially by approximately 1 mm and is inclined by up to 30 ° against the radial displacement direction and the proximal joint part is inserted into the proximal bone in such a way that the inclination of the shaft ( 2 ) points towards the inside of the hand. 2. Nichtgeführte Endoprothese nach Anspruch 1, dadurch gekennzeichnet, daß die Gelenkfläche des proximalen Gelenkteiles aus etwa einer halben Kugelfläche besteht und dass die Gelenkfläche (1) des distalen Gelenkteiles einen Teil einer Hohlkugelfläche darstellt, der nur etwa 15% bis 20% der Kugelfläche des proximalen Gelenkteiles erfaßt. 2. Non-guided endoprosthesis according to claim 1, characterized in that the joint surface of the proximal joint part consists of approximately half a spherical surface and that the joint surface ( 1 ) of the distal joint part is part of a hollow spherical surface, which only about 15% to 20% of the spherical surface of the proximal joint part detected. 3. Nichtgeführte Endoprothese nach Anspruch 1, dadurch gekennzeichnet, daß die Gelenkfläche des proximalen Gelenkteiles aus einer zylindrischen Fläche besteht und die Gelenkfläche (1) des distalen Gelenkteiles einen Teil einer Hohlzylinderfläche darstellt, der nur etwa 15% bis 20% der zylindrischen Fläche des proximalen Gelenkteiles erfaßt.3. Non-guided endoprosthesis according to claim 1, characterized in that the joint surface of the proximal joint part consists of a cylindrical surface and the joint surface ( 1 ) of the distal joint part is part of a hollow cylindrical surface, which only about 15% to 20% of the cylindrical surface of the proximal Joint part detected. 4. Nichtgeführte Endoprothese nach Anspruch 1, dadurch gekennzeichnet, dass der Schaft (2) eine aufgerauhte Oberfläche besitzt.4. Non-guided endoprosthesis according to claim 1, characterized in that the shaft ( 2 ) has a roughened surface. 5. Nichtgeführte Endoprothese nach Anspruch 2, dadurch gekennzeichnet, dass die aufgerauhte Oberfläche des Schaftes (2) eine Beschichtung mit einer Biokeramik darstellt.5. Non-guided endoprosthesis according to claim 2, characterized in that the roughened surface of the shaft ( 2 ) is a coating with a bioceramic. 6. Nichtgeführte Endoprothese nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, daß die Gelenkteile aus Zirkonkeramik bestehen und die Gelenkflächen (1) poliert sind.6. Non-guided endoprosthesis according to one of claims 1 to 5, characterized in that the joint parts consist of zirconium ceramic and the joint surfaces ( 1 ) are polished.
DE19925529A 1999-06-04 1999-06-04 Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted radially that can be inserted Withdrawn DE19925529A1 (en)

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DE29909740U DE29909740U1 (en) 1999-06-04 1999-06-04 Non-guided endoprosthesis for finger joints
DE19925529A DE19925529A1 (en) 1999-06-04 1999-06-04 Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted radially that can be inserted

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DE19925529A DE19925529A1 (en) 1999-06-04 1999-06-04 Endoprosthesis for finger joints comprises proximal and distal joint parts of bioceramic material with a shaft of material shifted radially that can be inserted

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FR2833156A1 (en) * 2001-12-12 2003-06-13 Bioprofile TRAPEZIAN OR TRAPEZO-METACARPIAN IMPLANT
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US8088168B2 (en) 2005-11-17 2012-01-03 Tornier Sas Implant, more particularly partial ulnar head implant
US8647390B2 (en) 2009-01-08 2014-02-11 Memometal Technologies Intramedullary anchoring stem for an orthopaedic implant head
US8858644B2 (en) 2009-01-08 2014-10-14 Memometal Technologies Orthopaedic implant for arthroplasty of the fingers

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EP0338715A1 (en) * 1988-04-12 1989-10-25 Bahaa Botros Seedhom Prosthetic finger joint
WO1991004718A1 (en) * 1989-10-09 1991-04-18 Neoligaments Limited Prosthetic finger joint
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* Cited by examiner, † Cited by third party
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US8088168B2 (en) 2005-11-17 2012-01-03 Tornier Sas Implant, more particularly partial ulnar head implant
US8647390B2 (en) 2009-01-08 2014-02-11 Memometal Technologies Intramedullary anchoring stem for an orthopaedic implant head
US8858644B2 (en) 2009-01-08 2014-10-14 Memometal Technologies Orthopaedic implant for arthroplasty of the fingers

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