WO1997027828A1 - Procede et appareil de positionnement d'un element prothetique par rapport a un os permettant d'obtenir l'orientation desiree - Google Patents

Procede et appareil de positionnement d'un element prothetique par rapport a un os permettant d'obtenir l'orientation desiree Download PDF

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Publication number
WO1997027828A1
WO1997027828A1 PCT/US1997/001754 US9701754W WO9727828A1 WO 1997027828 A1 WO1997027828 A1 WO 1997027828A1 US 9701754 W US9701754 W US 9701754W WO 9727828 A1 WO9727828 A1 WO 9727828A1
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WO
WIPO (PCT)
Prior art keywords
implant
bone
prosthetic element
desired orientation
structural
Prior art date
Application number
PCT/US1997/001754
Other languages
English (en)
Inventor
Michael A. Masini
Original Assignee
Masini Michael A
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 Masini Michael A filed Critical Masini Michael A
Priority to US09/029,457 priority Critical patent/US6267785B1/en
Priority to AU18565/97A priority patent/AU1856597A/en
Publication of WO1997027828A1 publication Critical patent/WO1997027828A1/fr
Priority to US10/996,415 priority patent/US7229478B2/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
    • A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
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    • 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
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    • 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
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    • 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
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    • 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
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    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
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    • 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
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    • 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
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30131—Rounded shapes, e.g. with rounded corners horseshoe- or crescent- or C-shaped or U-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
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    • 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
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    • 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
    • A61F2002/30565—Special structural features of bone or joint prostheses not otherwise provided for having spring elements
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    • 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
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    • A61F2002/30726—Centering or guiding rods, e.g. for insertion of femoral shafts
    • A—HUMAN NECESSITIES
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    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
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    • 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
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    • A61F2002/3625—Necks
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Definitions

  • This invention relates generally to arthroplasty and, more particularly to devices and techniques for positioning a prosthesis prior to fixation through the injection of a bonding agent.
  • the present invention resides m apparatus and methods for maintaining the proper positioning of a prosthetic implant having proximal and distal ends within a prepared bone cavity during cement injection and curing.
  • the invention provides first stabilization means, implantable within the bone cavity, for minimizing lateral movement of the distal end of the implant, and second stabilization means, physically separate from the means for minimizing lateral movement of the distal end of the implant, for minimizing both the lateral movement of the proximal end of the implant and the rotational movement of the implant overall .
  • the second stabilization means includes an apertured cap removably securable to the end of a bone having the prepared cavity through which the implant is inserted and held in place.
  • FIGURE IA illustrates, in skeletal form, the first step of a prior-art implantation sequence involving host bed preparation;
  • FIGURE IB depicts an intermediate step in the prior-art sequence wherein the cavity prepared according to Figure IA is filled with cement;
  • FIGURE IC illustrates the final phase of this prior-art sequence wherein a femoral prosthesis is inserted into the injected cement prior to hardening
  • FIGURE 2A illustrates a prior-art improvement over the sequence shown n Figures IA through IC, wherein a distal plug s used for distal centering of the implant;
  • FIGURE 2B illustrates yet another prior-art improvement over the approach of Figure 2A wherein a vertically oriented rod is attached to the distal plug over which an implant may be slid after cement injection to further inhibit movement during curing;
  • FIGURE 3 is an arrangement according to this invention showing the use of a proximal cap which may be used either with a specially prepared prosthetic device or commercially available unit;
  • FIGURE 4 illustrates two independently usable alternative embodiments according to the invention, including a multiple degree-of-freedom proximal retainment structure and a distal plug including leaf springs;
  • FIGURE 5 is a drawing which shows, from an oblique perspective, an alternative embodiment of the invention which clamps around the femur below the area of resection, and attaches to an elongated fastener oriented generally lengthwise with respect to the implant.
  • Figure 1 of U.S. Patent 5,340,362 shows an existing, prior-art procedure for inserting and cementing a prosthesis into a bone cavity, and this figure has been reproduced herein.
  • the canal is reamed or broached as shown in Figure IA, and a trial is typically inserted thereinto to ensure that the final prosthetic component will be properly received.
  • cement is injected into the excavated area as shown in Figure IB, and the prosthesis is inserted as shown in Figure IC, and left in position while the cement hardens .
  • the technique just described is deficient in that, although the prosthesis may be optimally oriented during the trial procedure, the position of the actual implant may shift upon insertion into the cemented host or thereafter, resulting in a misaligned final fixation.
  • a distal centralizer 16 is inserted beforehand into the intramedullary cavity 13 to which the distal tip 17a of the implant 17 engages at point 16a. This, at least, stabilizes the relative position of the distal tip 17a, resulting in a narrower range of angles (A to B) through which the implant 17 may move within the cement-filled cavity prior to final curing.
  • the final implant includes a cement canal along its longitudinal axis.
  • a bone-cement injector is threaded onto the proximal portion of this cement canal, causing the cement to subsequently travel down and through the implant, eventually exiting through openings in and around its distal tip.
  • a restrictor plug halts downward cement travel, thus initiating an upward, retrograde filling of the void in between the prosthesis and the cancellous bone wall .
  • side ports may also be included, as shown in U.S.
  • Patent 4,274,163 and various other prior-art references exhibit various shortcomings.
  • the point of substantial stability remains at the distal tip of the implant, enabling a certain level of proximal misalignment to continue, as no true proximal stabilization is provided.
  • the centering rod and bore through the specialized component are both circular, the final implant is still subject to up-and-down and/or rotational variation, resulting in potential misalignment upon fixation.
  • the present invention improves upon the prior art by providing a simplified apparatus and associated installation methods whereby an implant may be oriented both proximally and distally prior to the injection of cement, while, at the same time, providing means for guarding against rotational and up/down movement of the implant as well during such injection and subsequent curing.
  • configurations according to the invention provide a simple means for expelling over- pressurized cement, thereby yielding a simple, but satisfactory indication that sufficient cement has been injected to an acceptable level.
  • the invention makes advantageous use of a longitudinal bore through the implant, in another embodiment, all of the above improvements and advantages are realized in conjunction with standard, currently available prostheses, thus resulting in an approach which is both straightforward and economical .
  • FIG. 3 is an oblique drawing of an arrangement according to this invention depicting various independent embodiments.
  • an implant 310 is shown inserted into a prepared cavity 312, in this case the implant 310 being a femoral hip prosthesis and the cavity 312 being the intramedullary canal, though, as will be apparent to those of skill in the art of orthopaedics, the general principles disclosed herein are not restricted to this application, and may be used in other joint situations, including the knee, shoulder and other situations.
  • a resection not visible in this figure has been performed on at least a portion of the proximal end of the femur along with reaming and other preparation of the medullary canal itself to accept the implant 310.
  • an apertured proximal sealing cap is installed over the resection portion of the femoral shaft, the prosthesis 310 is inserted through the proximal opening 320 of the seal, and cement is injected through an injection port 322.
  • this proximal seal includes a horseshoe-shaped collar 330 having one or more means such as thumb screws 332 for releasably securing the collar 330 over the bone, and a preferably pliable gasket 334 made from rubber or other suitable polymeric materials through which the aperture 320 is formed.
  • a flap valve 336 wherein the material forming the gasket 334 is adjusted to flap open or rupture at a predetermined pressure level, preferably on the order of 25 mm of mercury, which has shown to be advantageous for such orthopaedic purposes.
  • this flap valve 336 is formed either by scoring the material of the gasket 334 in a manner conducive to such rupture, or, alternatively, the material may be thinned in this area to break under load.
  • the embodiment of the proximal seal just described is that preferred for use in conjunction with standard, commercially available implants.
  • the aperture 320 formed in the gasket 334 may take the form of a slit, an oval, or another shape appropriate to the stem of the implant, enabling the device to be inserted therethrough and retained in place by the surrounding material of the gasket 334 against the stem, either through friction or high-tolerance.
  • the material 334 may be of a more rigid composition, and may, in fact, be integrally formed to the collar 330, in which case the injection port 322 and valve 336 may be more elaborate and substantial.
  • the port 322 may be threaded for a more solid connection to commercially available injector nozzles, and the valve 336 may take advantage of more sophisticated pressure-release techniques available in the art, including adjustability for a particular pressure or range of pressures.
  • a distal spacer 340 is preferably utilized for distal centering.
  • a longitudinal rod 342 may optionally be added to, or installed on the plug 340, requiring a specialized implant having a longitudinal bore 344 akin to that described in the '085 patent referred to above, the exception being that, according to this invention, the implant 310 would be monorailed onto the optional rod 342 prior to the injection of cement into the cavity formed between the walls of the implant and the prepared medullary canal.
  • the present invention may either be used with a specially prepared implant having this longitudinal bore and/or convenient wall geometries or, alternatively, and unlike the prior art, a standard prosthesis may be used.
  • the prosthesis includes an arrangement to assist in installation or removal such as ring 350
  • the alternative proximal stabilization configuration of Figure 4 may be used.
  • a multiple degree-of-freedom clamp arrangement illustrated generally at 404 may be attached to a proximal cover 406 secured to femoral end or attached to a portion of available bone material by whatever means .
  • a first rod 408 securely affixed to the member 406 at point 409, onto which there is disposed a slidable collar 412 which may be locked into position with a suitable device such as thumb screw 414.
  • a second rod 420 and collar 422 contains two thumb screws, one to lock the collar 422 in position along rod 420, and a different thumb screw 430 for positive engagement with the prosthesis proper. It will be understood to those of skill that various other approaches may be utilized in accordance with the general principle contained herein to grasp and hold any portion or aperture of a standard implant without requiring its modification.
  • Figure 4 also shows an alternative distal plug according to the invention which may be used in combination with any of the embodiments previously described.
  • an inventive plug it is first seated distally at an appropriate distance within the intermedullary canal, and includes a plurality of deformable upwardly oriented leaf springs 490.
  • leaf springs 490 Accordingly, with the plug 480 installed in place as shown, an even more generalized type of implant, and not requiring an actual, solid connection to such a distal spacer, may be inserted down and into the medullary canal and held in place while resisting distal side-to-side motion as the distal tip of the implant is retained within these leaf springs 490.
  • This also allows adjustments in a longitudinal direction enabling fine tuning at the effective length of the implant.
  • the aperture through which the implant is inserted is quite a bit larger than that shown in Figure 4 and, in fact, does not include a seal per se.
  • cement may, in fact, be injected prior to or after the implant is held in place both proximally and distally.
  • a standard distal plug may be used in conjunction with the mechanism shown generally at 404 even without a cap or collar as shown.
  • this mechanism 404 may simply attach to an existing bone surface or structure instead of the point 409, thereby holding the implant in place proximally and distally while preventing motion in all dimensions as the cement cures, regardless of when it was injected.
  • proximal and distal stabilizers may be used in conjunction with a trial then, upon achieving a desired orientation, a single manual fastener may be loosened, and the actual implant installed in the exact configuration of the trial to guarantee proper positioning.
  • FIG. 5 illustrates an alternative embodiment of the invention, seen generally at 502 from an oblique perspective.
  • a prosthesis 504 which may have a threaded bore along an axis 508 to receive a threaded fastener such as a bolt 506, is physically coupled to a first structural element 520 which slidably engages with a collar 530, and which may be tightened in place with a manual fastener such as thumb screw 532.
  • Other types of fasteners including those requiring tools such as set screws, may alternatively be utilized for this purpose.
  • the prosthesis 504 may be rotated about the axis 508 with the bolt 506 in a slightly loosened condition, and then tightened when a desired angular rotation is achieved.
  • a score mark 522 may be used in conjunction with score marks 524 to provide an indication of this desired angular rotation for future reference.
  • score marks are provided on the underside of member 520 as well in the vicinity of the attachment to the prosthesis, to assist in maintaining the desired rotational configuration once the bolt 506 is tightened.
  • Prosthetic devices having a threaded bore along axis 508 are available from the Zimmer Company, though in the event that such a feature is not provided for, connection may be made to the prosthetic element itself as disclosed elsewhere herein, rendering this threaded bore convenient but not necessary to the invention.
  • a set of score marks 526 are also provided on the member 520, such that with the member 520 being moved back and forth to adjust the lateral or transverse positioning of the implant, the fastener 532 may be used to lock the configuration in place, with the marks 526 being used to maintain a visual indication of the desired lateral configuration.
  • Attached to collar 530 is a downwardly extending member 540, which is received by a collar 544 having a manual adjustment device 546.
  • the member 540 may also include markings 542, such that, as the element 540 is moved up and down to adjust for the axial length of the prosthesis, fastener 546 may be locked with the score marks 542 providing a visual indication.
  • the collar 544 is attached to a clamp 550, which is rigidly attached to the outer surface of the femur through manual fasteners 552 and 554.
  • the collar 544 may be rotationally variable, and locked into place along with member 540 with manual fastener 546, with optional score marks 560 being used as a visual indication of this configuration, if so desired.
  • the various embodiments of this invention may be used to properly position a trial implant prior to the positioning of a final prosthetic element, it should be apparent that in all cases, the device such as 504 in Figure 5 is assumed to be the final implant itself, thereby eliminating the need for a trial. Particularly if the various positioning elements of the invention are sufficiently low in profile, the entire assembly, including those shown in the figures, joint reduction may be carried out, with the various fasteners being adjustably and rigidly clamped, with the final implant positioned in place and rigidly connected thereto. Following this procedure, the properly positioned implant may be removed from its reduced configuration and cemented.
  • the prosthesis may be cemented in si tu , with the various positioning members according to the invention remaining locked in place, or, alternatively, one or more of the fasteners may be loosened, with the implant and, perhaps, other fasteners attached thereto, removed and repositioned once cement has been injected into the intramedullary canal.
  • fastener 546 may be slightly loosened, with the prosthesis 504 and members 520 and 540 rigidly attached thereto being temporarily removed, the cavity filled with cement, and the prosthesis with members 520 and 540 reinserted, with member 540 being reinstalled into collar 544, utilizing the score marks 542 to ensure that fixation will take place at a proper and desired orientation upon re-tightening of the fastener 546.

Abstract

Appareil et procédé permettant de maintenir le positionnement adéquat d'un implant (310, 504) à l'intérieur d'une cavité osseuse préparée (312) au cours de l'injection et du séchage du ciment. Un premier dispositif de stabilisation (340, 480), implantable à l'intérieur de la cavité osseuse, réduit au minimum le déplacement latéral de l'extrémité distale de l'implant, alors qu'un deuxième dispositif de stabilisation (330, 334, 406, 404), physiquement séparé du premier dispositif de stabilisation (340, 480) réduit au minimum à la fois le déplacement latéral de l'extrémité proximale de l'implant et le déplacement de l'ensemble de l'implant en rotation. Suivant le mode de réalisation préféré, le deuxième dispositif de stabilisation (330, 334) comporte une capsule d'ouverture (334) fixée de façon amovible à l'extrémité d'un os préparé. Cette capsule (334) comporte de préférence un premier et un deuxième orifice (322, 336) servant, respectivement, à l'injection de ciment et à l'application d'une surpression sur le ciment. Suivant un autre mode de réalisation, le deuxième dispositif de stabilisation (406, 404) comporte un mécanisme à actionnement manuel (404) permettant de fixer temporairement, mais de façon rigide, l'implant (504) à celui-ci conformément à une orientation voulue, de préférence en procédant à des réglages sur de multiples degrés de jeu avant la fixation rigide.
PCT/US1997/001754 1996-02-01 1997-01-31 Procede et appareil de positionnement d'un element prothetique par rapport a un os permettant d'obtenir l'orientation desiree WO1997027828A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US09/029,457 US6267785B1 (en) 1996-02-01 1997-01-31 Apparatus for positioning a prosthetic element to achieve a desired orientation for cementation
AU18565/97A AU1856597A (en) 1996-02-01 1997-01-31 Method and apparatus for positioning a prosthetic element relative to a bone to achieve a desired orientation
US10/996,415 US7229478B2 (en) 1997-01-31 2004-11-23 Shoulder prosthesis with anatomic reattachment features

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US59527796A 1996-02-01 1996-02-01
US08/595,277 1996-02-01

Related Child Applications (3)

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US09029457 A-371-Of-International 1997-01-31
US09/029,457 A-371-Of-International US6267785B1 (en) 1996-02-01 1997-01-31 Apparatus for positioning a prosthetic element to achieve a desired orientation for cementation
US09/396,576 Continuation US6379391B1 (en) 1996-02-01 1999-09-15 Method and apparatus for positioning a prosthetic element relative to a bone to achieve a desired orientation

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1022001A1 (fr) * 1998-12-24 2000-07-26 Johnson & Johnson Professional, Inc. Guide d'alignement pour introduire des tiges de prothèse
EP0940128A3 (fr) * 1998-03-02 2000-10-25 Benoist Girard Et Cie Dispositif d'insertion de prothèse
EP1082943A2 (fr) * 1999-09-10 2001-03-14 Depuy Orthopaedics, Inc. Dispositif pour positionner une prothèse
EP0962198A3 (fr) * 1998-06-04 2001-09-12 Benoist Girard Sas Dispositif d'obturation et de centralisation pour positionner la tige d'une prothèse
DE10221273A1 (de) * 2002-05-14 2003-12-04 Peter Brehm Intramedulläre Führung
WO2004026191A1 (fr) * 2002-09-19 2004-04-01 Flinders Technologies Pty. Ltd. Attache pour implant et procede associe
CN109171939A (zh) * 2018-08-02 2019-01-11 重庆市华港科技有限公司 骨水泥假体一体化3d打印成型模具及其成型方法

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US4357716A (en) * 1980-07-09 1982-11-09 Brown Byron L Device and method for cementing a hip prosthesis in a femoral canal
US4404692A (en) * 1981-09-14 1983-09-20 Eftekhar Nas S Centering system for hip replacement
US5047061A (en) * 1989-01-20 1991-09-10 Brown Byron L Prosthesis holder
US5078746A (en) * 1989-01-25 1992-01-07 Richards Medical Company Femoral stem distal centralizer

Patent Citations (4)

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Publication number Priority date Publication date Assignee Title
US4357716A (en) * 1980-07-09 1982-11-09 Brown Byron L Device and method for cementing a hip prosthesis in a femoral canal
US4404692A (en) * 1981-09-14 1983-09-20 Eftekhar Nas S Centering system for hip replacement
US5047061A (en) * 1989-01-20 1991-09-10 Brown Byron L Prosthesis holder
US5078746A (en) * 1989-01-25 1992-01-07 Richards Medical Company Femoral stem distal centralizer

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0940128A3 (fr) * 1998-03-02 2000-10-25 Benoist Girard Et Cie Dispositif d'insertion de prothèse
EP0962198A3 (fr) * 1998-06-04 2001-09-12 Benoist Girard Sas Dispositif d'obturation et de centralisation pour positionner la tige d'une prothèse
EP1022001A1 (fr) * 1998-12-24 2000-07-26 Johnson & Johnson Professional, Inc. Guide d'alignement pour introduire des tiges de prothèse
US6165177A (en) * 1998-12-24 2000-12-26 Depuy Orthopaedics, Inc. Alignment guide for insertion of stem prosthesis
EP1082943A2 (fr) * 1999-09-10 2001-03-14 Depuy Orthopaedics, Inc. Dispositif pour positionner une prothèse
EP1082943A3 (fr) * 1999-09-10 2001-03-21 Depuy Orthopaedics, Inc. Dispositif pour positionner une prothèse
US6277123B1 (en) 1999-09-10 2001-08-21 Depuy Orthopaedics, Inc. Prosthesis positioning apparatus and method for implanting a prosthesis
US6702824B2 (en) 1999-09-10 2004-03-09 Depuy Orthopaedics, Inc. Prosthesis positioning apparatus
DE10221273A1 (de) * 2002-05-14 2003-12-04 Peter Brehm Intramedulläre Führung
WO2004026191A1 (fr) * 2002-09-19 2004-04-01 Flinders Technologies Pty. Ltd. Attache pour implant et procede associe
CN109171939A (zh) * 2018-08-02 2019-01-11 重庆市华港科技有限公司 骨水泥假体一体化3d打印成型模具及其成型方法

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