DE3522196A1 - Method of producing joint endoprostheses and osteosynthesis material or other bone substitute adapted to the patient's bone dimensions - Google Patents

Method of producing joint endoprostheses and osteosynthesis material or other bone substitute adapted to the patient's bone dimensions

Info

Publication number
DE3522196A1
DE3522196A1 DE19853522196 DE3522196A DE3522196A1 DE 3522196 A1 DE3522196 A1 DE 3522196A1 DE 19853522196 DE19853522196 DE 19853522196 DE 3522196 A DE3522196 A DE 3522196A DE 3522196 A1 DE3522196 A1 DE 3522196A1
Authority
DE
Germany
Prior art keywords
bone
patient
dimensions
computer
joint endoprostheses
Prior art date
Legal status (The legal status 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 status listed.)
Withdrawn
Application number
DE19853522196
Other languages
German (de)
Inventor
Martin Wilhelm Dr. Dr. 6072 Dreieich Happel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Happel martin Wilhelm drdr
Original Assignee
Happel martin Wilhelm drdr
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 Happel martin Wilhelm drdr filed Critical Happel martin Wilhelm drdr
Priority to DE19853522196 priority Critical patent/DE3522196A1/en
Publication of DE3522196A1 publication Critical patent/DE3522196A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/28Bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2/30942Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30952Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using CAD-CAM techniques or NC-techniques

Abstract

According to the invention, the geometrical data of the bone dimensions are to be recorded - assisted by a computer - from radiographs and/or computed tomographs, and the requisite moulds for metallic or other joint endoprostheses are to be produced by numerically controlled production facilities. Osteosynthesis plates and other bone substituting prostheses can be made directly or re-worked by this method.

Description

Verfahren zur Fertigung von Gelenkendoprothesen und Osteosyn-Process for the production of joint endoprostheses and osteosyn-

thesematerial oder anderem Knochenersatz nach den Knochendi -mensionen des Patienten.thesis material or other bone substitute according to the bone dimensions of the patient.

Der Ersatz von Hüft-und Kniegelenken hat in- den letzten Dezennien eine explosionsartige Entwicklung genommen Trotzdem ist der Kompromiß gegenüber dem natürlichen Gelenk noch erheblich.The replacement of hip and knee joints has taken place in the last few decades Nevertheless, the compromise is up against the natural joint still considerably.

Bei den mit sogen. Knochenzement am Knochen verankerten Prothesenschäften hat sich die Rate der septischen Implantatlocker -ungen stark vermindert. Dadurch wurde die relativ große Rate der infektfreien Tjockerungen recht augenfällig, die durch folgende Ursachen entstehen: der am geringsten tragfähige Partner des Verbundes Knochen - Knochenzement - Metall, nämlich der Hnochenzement, ist den auftretenden Last- und Spannungssp durch den hohen Unterschied der Elastizitätsmoduli beeinflußt) auf Dauer nicht gewachsen und zerrüttet. Hierdurch korim- es .s-z unphysiologisch hohen oder niedrigen Beanspruchungen des Knochens der mit Resorption darauf reagiert. Ebenso kann es auch zur k£-scr -tion durch Stoffwechselstörungen im Knochen kommen, die dadurch ausgelöst werden, daß der Knochenzement und Implantatschaft den Markraum verstopfen. In diesem Zusammenhang muß angefügt erden, daß die Ernährung des Knochens größtenteils durch den Markraiiir erfolgt. Diese Probleme führten zur Entwicklung der zementfreien Prothesen mit Tragrippen oder einer Oberflächenstruktur, in die der Knochen hineinwachsen soll. Im Zuge dieser Entwicklung id dem Operateur jetzt zementfreie Prothesen verschiedeiier Formen und Dimensionen anhand gegeben. Allerdings muß der Markraum je -weils durch umfangreiche Knochenresektionen dem Implantat a^^e -paßt werden. Oftmals gelingt dies nur in einer Ebene, sodaC Lo nen mit unphysiologischer Beanspruchung des Knochens infolge @@ spitzen entstehen, in denen der Knochen dann resorbiert. Die le erdung des Prothesenschaftes ist die Folge.With the so-called Prosthetic shafts anchored to the bone by bone cement the rate of septic implant loosening has decreased significantly. Through this the relatively high rate of infection-free jokers became quite obvious caused by the following causes: the least sustainable partner in the network Bone - bone cement - metal, namely the bone cement, is the occurring Load and tension sp influenced by the large difference in the moduli of elasticity) not grown in the long run and shattered. As a result, korim- es .s-z is unphysiological high or low stresses on the bone, which reacts to it with resorption. It can also lead to k £ -scr -tion due to metabolic disorders in the bones, which are triggered by the fact that the bone cement and implant shaft enter the medullary canal clog. In this connection it must be added that the nutrition of the bones largely done through the Markraiiir. These problems led to the development of cementless prostheses with support ribs or a surface structure into which the bone should grow into it. In the course of this development, the surgeon id now cement-free prostheses based on various shapes and dimensions. However the medullary canal must be attached to the implant a ^^ e -be adjusted. Often this only works on one level, so that it is unphysiological Stress on the bone as a result of @@ sharp points, in which the bone then absorbed. The result is that the prosthesis stem becomes empty.

Der Erfindung liegt die Aufgabe zugrunde, diese Nachteile größtmöglichst zu vermeiden. Die Lösung dieser Aufgabe besteht in der dem Patienten individuell angepaßten Prothese.The invention is based on the task of addressing these disadvantages as much as possible to avoid. The solution to this task consists in the individual patient adapted prosthesis.

Nach einem Stereoröntgenbild oder dem Röntgenbild der Beckenübersicht und Computertomographien des coxalen Femurendes wird.After a stereo x-ray or the x-ray of the pelvic overview and computed tomography of the coxal end of the femur.

kannter Weise, computerunterstützt das Netz scjmtlicher geometri ist der Koordinatenpunkte (ähnlich wie bei der Vermessung der Erdobenff in der erforderlichen Dichte für die jeweilige Zone, augenorrer und gespeichert. Diese Daten werden vom Computer mit deren der vohandenen oder vom Handel bereitgehaltenen Prothesen verglichen.As is known, the network of all geometries is computer-aided of the coordinate points (similar to the measurement of the earth in the required Density for the respective zone, augenorrer and saved. These data are from Computer with their existing or kept by the trade Prostheses compared.

Ist keine passende Prothese verfügbar, übernimmt eine numerisch gesteuerte rräs- oder Schleifmaschine die Daten und fertigt nach diesen ein modells nach dem eine Negativform aus Ton oder der£leicnen oder anderem Material hergestellt werden kann. Unter Berficksichtigung der Ausschußquote bei der Fertigung (Materialprüfung, Fertigungstoleranzen) können dann beliebig viele Kokillen maßgeau für die Produktion der Prothese, die in bekannter Weise erfolgt.If no suitable prosthesis is available, a numerically controlled one takes over milling or grinding machine takes the data and produces a model according to the a negative mold can be made from clay or the leicnen or other material can. Taking into account the reject rate in production (material testing, Manufacturing tolerances), any number of molds can be made to measure for production the prosthesis, which is done in a known manner.

hergestellt werden.getting produced.

Eine Nachbearbeitung vorhandener Prothesen, zwecks Anpassung Knochendimensionen, ist nach dieser Methode ebenfalls möglich.Post-processing of existing prostheses for the purpose of adapting bone dimensions, is also possible using this method.

Bas gleiche Verfahren, mit dem die Kokillen für patientenindivi -duel angepaßte metallische Gelenkprothesen gefertigt werden, kann auch zur Herstellung von Formen für biokeramische oder Faserver -bundprothesen eingesetzt werden. Ebenso sind mit dem gleichen Verfahren Osteosyntheseplatten und anderer Knochenersatz nach den Knochendimensionen nachzubearbeiten.Bas the same process with which the molds for patient-specific duel Customized metallic joint prostheses can also be used to manufacture of forms for bio-ceramic or fiber composite prostheses are used. as well osteosynthesis plates and other bone substitutes are done using the same procedure rework the bone dimensions.

Claims (3)

Patent- und Schutzansprüche 1.) Patienten-individuell angepaßte Gelenkendoprotnesen östeosynthesematerial und anderer Knochenersatz, dadurch gekennzeichnet, daß computergesteuert von Röntgenbildern, oder dergleichen, Formen für den Abguß metallischer Implantate nach den Knochendimensionen des betreffenden patienten srefertigt werden.Patent and protection claims 1.) Joint endoproteses that are individually adapted to the patient osteosynthesis material and other bone substitutes, characterized in that they are computer-controlled X-rays or the like, molds for casting metallic implants according to the bone dimensions of the patient concerned. 2.) Patientenindividuell angepaßte Gelenkendoprothesen, Ostersynthesematerial und anderer Knochenersatz nach Anspruch jedoch aus anderem Itaterial, so auch aus keramischem und ähnlichem Material, oder aus Faserverbundmaterial, oder --u~ Kohle, dadurch gekennzeichnet, daß com.putergesteuert von Röntgenbildern, oder dergleichen, Formen fir die Fertigung dieser Impalntate nach den Knochendimension des betreffen den Patienten gefertigt werden.2.) Joint endoprostheses adapted to the individual patient, Easter synthesis material and other bone substitutes according to the claim, however, made from other Itaterial, including from ceramic and similar material, or made of fiber composite material, or --u ~ carbon, characterized in that computer-controlled X-ray images or the like, Molds for the production of these implants according to the bone dimension of the concern made for the patient. 3.) Patientenindividuell angepaßte Gelenkprothesen , Osteosynthesematerial oder anderer Knochenersatz nach Anspruch 1,dadurch gekennzeichnet, daß diese computergesteuert aus vorhandenen Implantaten nachgearbeitet werden und so den Knochen -dimensionen des Patienten angepaßt werden.3.) Joint prostheses, osteosynthesis material adapted to the individual patient or other bone substitute according to claim 1, characterized in that it is computer-controlled can be reworked from existing implants and thus the bone dimensions of the patient.
DE19853522196 1985-06-21 1985-06-21 Method of producing joint endoprostheses and osteosynthesis material or other bone substitute adapted to the patient's bone dimensions Withdrawn DE3522196A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE19853522196 DE3522196A1 (en) 1985-06-21 1985-06-21 Method of producing joint endoprostheses and osteosynthesis material or other bone substitute adapted to the patient's bone dimensions

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19853522196 DE3522196A1 (en) 1985-06-21 1985-06-21 Method of producing joint endoprostheses and osteosynthesis material or other bone substitute adapted to the patient's bone dimensions

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DE3522196A1 true DE3522196A1 (en) 1986-02-20

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Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4800639A (en) * 1985-02-07 1989-01-31 Sulzer Brothers Limited Method of making a metal bone implant
DE3844592A1 (en) * 1988-05-28 1990-04-05 Marc Amler Artificial joint element for attachment to a bone section of a hinge joint
EP0479257A1 (en) * 1990-10-03 1992-04-08 Board Of Regents, The University Of Texas System Process for making custom joint replacements
WO1992006654A1 (en) * 1990-10-23 1992-04-30 Ian Leonard Prostheses and methods and apparatus for making same
EP0574098A1 (en) * 1992-06-10 1993-12-15 AMEI TECHNOLOGIES Inc. Method and apparatus for making customized fixation devices
EP0669115A1 (en) * 1994-02-25 1995-08-30 Fehling Medical Ag Total hip endoprothesis
DE4434539A1 (en) * 1994-09-27 1996-04-25 Luis Dr Med Schuster Process for the production of an endoprosthesis as a joint replacement for knee joints
DE19952550A1 (en) * 1999-11-02 2001-05-03 Tutogen Medical Gmbh Bone implant
DE19936682C1 (en) * 1999-08-04 2001-05-10 Luis Schuster Process for the production of an endoprosthesis as a joint replacement for knee joints
FR2813780A1 (en) * 2000-09-08 2002-03-15 Biomet Merck France Procedure and instrument for determining theoretical articulation interline of knee joint for prosthesis
US6510334B1 (en) 2000-11-14 2003-01-21 Luis Schuster Method of producing an endoprosthesis as a joint substitute for a knee joint
WO2003059211A1 (en) * 2001-12-20 2003-07-24 Matts Andersson Method and arrangement at implants preferably for a human intervertebral and such implant
DE10341187A1 (en) * 2003-09-06 2005-03-31 Bernhard Linnekogel Human or animal artificial bone or cartilage joint substitute production procedure uses three dimensional virtual computer model from infrared or tomography imaging
EP1982652A1 (en) * 2007-04-20 2008-10-22 Medicim NV Method for deriving shape information
US8419741B2 (en) 2000-03-17 2013-04-16 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US8521492B2 (en) 2008-09-19 2013-08-27 Smith & Nephew, Inc. Tuning implants for increased performance

Cited By (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4800639A (en) * 1985-02-07 1989-01-31 Sulzer Brothers Limited Method of making a metal bone implant
DE3844592A1 (en) * 1988-05-28 1990-04-05 Marc Amler Artificial joint element for attachment to a bone section of a hinge joint
EP0479257A1 (en) * 1990-10-03 1992-04-08 Board Of Regents, The University Of Texas System Process for making custom joint replacements
US5274565A (en) * 1990-10-03 1993-12-28 Board Of Regents, The University Of Texas System Process for making custom joint replacements
US5448489A (en) * 1990-10-03 1995-09-05 Board Of Regents, The University Of Texas System Process for making custom joint replacements
WO1992006654A1 (en) * 1990-10-23 1992-04-30 Ian Leonard Prostheses and methods and apparatus for making same
EP0574098A1 (en) * 1992-06-10 1993-12-15 AMEI TECHNOLOGIES Inc. Method and apparatus for making customized fixation devices
US5365996A (en) * 1992-06-10 1994-11-22 Amei Technologies Inc. Method and apparatus for making customized fixation devices
EP0669115A1 (en) * 1994-02-25 1995-08-30 Fehling Medical Ag Total hip endoprothesis
US5735277A (en) * 1994-09-27 1998-04-07 Schuster; Luis Method of producing an endoprosthesis as a joint substitute for knee-joints
DE4434539A1 (en) * 1994-09-27 1996-04-25 Luis Dr Med Schuster Process for the production of an endoprosthesis as a joint replacement for knee joints
DE4434539C2 (en) * 1994-09-27 1998-06-04 Luis Dr Med Schuster Process for the production of an endoprosthesis as a joint replacement for knee joints
DE19936682C1 (en) * 1999-08-04 2001-05-10 Luis Schuster Process for the production of an endoprosthesis as a joint replacement for knee joints
DE19952550A1 (en) * 1999-11-02 2001-05-03 Tutogen Medical Gmbh Bone implant
US6988015B1 (en) 1999-11-02 2006-01-17 Tutogen Medical Gmbh Bone implant
US8419741B2 (en) 2000-03-17 2013-04-16 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US9393032B2 (en) 2000-03-17 2016-07-19 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US8961529B2 (en) 2000-03-17 2015-02-24 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US8936602B2 (en) 2000-03-17 2015-01-20 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US8936601B2 (en) 2000-03-17 2015-01-20 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
US8771281B2 (en) 2000-03-17 2014-07-08 Kinamed, Inc. Marking template for installing a custom replacement device for resurfacing a femur and associated installation method
FR2813780A1 (en) * 2000-09-08 2002-03-15 Biomet Merck France Procedure and instrument for determining theoretical articulation interline of knee joint for prosthesis
US6510334B1 (en) 2000-11-14 2003-01-21 Luis Schuster Method of producing an endoprosthesis as a joint substitute for a knee joint
WO2003059211A1 (en) * 2001-12-20 2003-07-24 Matts Andersson Method and arrangement at implants preferably for a human intervertebral and such implant
DE10341187A1 (en) * 2003-09-06 2005-03-31 Bernhard Linnekogel Human or animal artificial bone or cartilage joint substitute production procedure uses three dimensional virtual computer model from infrared or tomography imaging
CN101720204B (en) * 2007-04-20 2013-11-06 麦迪西姆有限公司 Method for deriving shape information
CN101720204A (en) * 2007-04-20 2010-06-02 麦迪西姆有限公司 Method for deriving shape information
WO2008128720A3 (en) * 2007-04-20 2009-03-19 Medicim Nv Method for deriving shape information
WO2008128720A2 (en) * 2007-04-20 2008-10-30 Medicim Nv Method for deriving shape information
EP1982652A1 (en) * 2007-04-20 2008-10-22 Medicim NV Method for deriving shape information
US9439608B2 (en) 2007-04-20 2016-09-13 Medicim Nv Method for deriving shape information
US8521492B2 (en) 2008-09-19 2013-08-27 Smith & Nephew, Inc. Tuning implants for increased performance
US10600515B2 (en) 2008-09-19 2020-03-24 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US11488721B2 (en) 2008-09-19 2022-11-01 Smith & Nephew, Inc. Operatively tuning implants for increased performance

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