WO1989006946A1

WO1989006946A1 - Device at artificial joints

Info

Publication number: WO1989006946A1
Application number: PCT/SE1989/000025
Authority: WO
Inventors: Anders Berggren; Håkan ROHMAN
Original assignee: Unilink Inc
Priority date: 1988-01-28
Filing date: 1989-01-27
Publication date: 1989-08-10
Also published as: SE466237B; EP0400035B1; JPH03502287A; USRE34632E; SE8800274L; ATE109648T1; EP0400035A1; SE8800274D0; US5061288A; DE68917464T2; DE68917464D1

Abstract

Fastening means for artificial joint including two titanium wires (5) that are wound to a spiral and that the wires between them clamp a number of bristles (6) that extend essentially radially outwards towards the inner of the bone. The bristles are a little bit too long for the undisturbed insertion into the cavity of the bone and this means that they will be slightly turned backwards on insertion which secures a very steady grip once inserted.

Description

Device at artificial joints

To replace worn or in other way for instance as a result of rheumatism damaged joints it is since considerably long time known to remove a joint end from a bone and re- place this end with an artificial part. These artificial parts include a joint part and a connection part that is inserted into the cavity of the remaining bone. The faste¬ ning in the bone has been carried out in different ways for instance the connection part has been threaded and/or cemented into the bone.

To start with this is comparatively complicated and time consumeing and secondly great loads as for instance in the vicinity of knee joints and tigh bones with time give an increasing play between artificial part and bone, which in turn result in a necessary change of the artificial part, which also normally includes the shortening of the bone to obtain sufficiently good material to fasten the artificial part in. After a few changes of the artificial part so little of the bone will remain that the joint has to be made ridgid due to the lack of bone material.

A further drawback of the known artificial part this far is that the inner cavity of the bone is not available for the formation of vessels in a natural way, which presumably further reduces the life spann of the mounting of a artificial part and thus of the artificial part itself.

The invention has as it's object to solve the above mentioned problem and provide a simply useable artificial part fastening or mounting that is easy to apply, that does not need to be exchanged and that allows an improved bleed- ing. This is in accordance with the invention achieved by means of a supporting structure that is inserted into the axial cavity of the bone and by this supporting structure beeing provided with bristles, fibres, loops or the like with such length that the combined dia etre of the device is somewhat larger than the cavity in the bone so that at least some of the bristles, fibres or loops or the like retain a certain pretension at mounting. In other words when the fastening element is inserted into the hollow of the bone the bristles are bent somewhat which will give a greater resistance against withdrawal than against the insertion. It will in fact be practically impossible to withdraw the fastening element. Preferably the number of bristles, fibres or the corresponding is very great. In this way a very great contact surface between bone and artificial part fastening element is obtained simultaneously as an adaption is automatically made to possible irregularities on the inside of the bone.

By furthermore fabricating the bristles, fibres or loops in titanium the bone and the artificial part fastening element will grow together and will so to say be integrated with time. Bleeding and the development of vessels can take place between the bristles or loops and it is furthermore possible to make the supporting structure more or less porous or open. Since the tensions are less further in the bone the fastening element can there be more open or be provided with less bristles. The length of the bristles and the density thereof are above all ruled by the forces that has to be transferred and the density of the bristles need not necessarily be the same over the entire length of the fastening element.

If bristles of titanium is used, thin but many bristles can be used in view of the hard and stiff character of titanium. Instead of titanium however titanium containing alloys coated by titanium can be used and it is also possible to consider plastic materials coated with titanium.

The bristles can from the start be directed radially or possibly somewhat rearwards or it is of course possible that omly some of them are.

The supporting structure need not necessary be rigid but may allow a certain elasticity that may preferably be calculated to coincide with that of the bone so that no tension peaks are developed in the force transfer forth and back.

By means of the invention an immediate sturdy grip is obtained in the bone preventing the mounted artificial part from loosening. With the use of titanium the device is prevented from working loose with time since the contact surface is great and thus the specific load small.

It should be observed that the fastening means descri- bed above can also be used for the jointing of brooken bones .

Further details and advantages of the invention are apparent from the following description of a prefered embo¬ diment and the claims. Fig 1 shows a joint seen from the front and fig 2 the same joint seen from the side, both in a longitudinal section.

The artificial joint shown in the drawings includes a bowl or concave joint part 4 and a ball concave joint part 3 each fastened in a bone 1 and 2 respectively. The lower part, the ball part 3 is welded to two wires 5 of titanium which from diametrical pheriferial fastening points extend towards each other, then to continue in a winding around each other. Between the windings of these two wires 5 thin threadlike bristles 6, also of titanium are clamped. The bristles 6 have such a length that they on inser¬ tion into the bone 2 will be bent somewhat upwards. This means that they will not excert any particular resistance against the intruducing into the bone. However the resist¬ ance against possible attempts to withdraw the artificial joint part from the bone will be very great. By useing a great number of bristles a good fastening against a turning of the artificial joint part relative the bone is achieved.

The ball joint part 3 has a circumferencial downwards protruding flange 7 gripping around the bone 2 on it's cor- respondingly shaped end 8. In this way the artificial joint part will be locked against possible tilting, with the bristles and the titanium wires pressing the ball joint part against the bone 2.

Possibly the inner of the ball joint part 5 can be filled with silicon at the mounting alternatively can the inner be entirely empty. By useing pure titanium or titanium alloys or other materials coated with titanium or perhaps even other materials which can grow together with the bone an integration is achieved with time. In this way not only the immediate sturdy fixing is obtained but also a long time fixing.

The upper joint bowl part or concave part 4 has a shape corresponding to the shape of the ball joint part 5 so that an angular movement is possible. The surfaces turned against each other has principly the shape of cylinder or sphere surfaces where the lower ball joint part 5 has a waist or groove 9 into which a protrusion or ridge 10 on the upper bowl joint part can grip to provide an increased resistance against turning and dislocation sidewise. By di- mensioning the interrelated length of groove and ridge angle stops for the joint can be achieved. The upper bowl joint part 4 is not made of titanium but is made of a synthetic material that against titanium gives a low friction. An example of this is HDP (high density polyetylen) that has shown itself to be a material that work well with human tissues. In the bowl part 4 a dove tail groove 12 extends sidew^τise and into this -grips an correspondingly shaped dove tail 14 that in turn is a part of a titanium plate 13. Preferably the titanium plate and the joint bowl part 3 of HDP are provided with snap means so that the lateral location when well achieved is secured. To the plate 13 is then welded wires 15 which are then wound to a spiral that holds bristles 16 in the same way as has been described above for the lower ball shaped joint part. Also the titanium disk or plate 15 is provided with a flange 17 gripping around a corresponding shaping 18 of the bone 1.

By use of a dove tail joint to join the joint ball part with it's fastening means the advantage is obtained that with comparatively simple means the joint bowl part can easily be exchanged if it for instance after many years of use becomes too worn and this with an operation that is far easier and less complicated and time consu eing than would be the case if one would have to exchange the entire artificial joint or artificial joint part. Of course also the lower ball joint part can be made in a corresponding way to allow a change of the part subjected to wear. This can for instance take place by means of a dove tail joint with the interl ocation of a plastic part. By useing plastic for one half of the joint and possibly as a joining element in the lower part a certain elasticity against shock is achieved which reduce tensions in other joints as well as in the fastening of the artificial joint.

It should be observed that the flanges 7, 17 and the corresponding shaping of the bone ends respectively need not necessarily be exactly after the outer shape of the bone, but to fasciliate working it is of course also possible to use flanges that are circular for instance concentric wi h the axis of the wound titanium wires.

The joint has on each side a ligament 19. By means of the invention an artificial joint or joint parts is achieved for big as well as small joints that are very similiar to the desired relationships of the original joint .

Since the fastening according to the invention in prin¬ ciple is or can be made elastic over it's entire length there will be no tension peaks where the artificial part ends which is a regretful case with many known artificial joint parts.

Due to the improved fastening characteristics and the soft transferring of forces from the artificial part to the bone it is actually possible to make replacements of another character that has previously been possible. Due to the pre¬ viously poor fastening characteristics the artificial part has always had to be comparatively short in order not to have too great torques excerted on the remaining bone part. With the invention the remaining bone w^τill not be subjected to forces greater than the bone originally could take. The¬ refore an artificial joint part according to the invention can be longer which in turn means that the previous shorte- ning of bones will become unnecessary.

In the drawings has been shown the use of two wires for fastening the bristles. More wires than two can of course be used and it is also possible to use a supporting structure carrying the bristles that is shaped in another way. For in- stance the bristles could be fastened in a cast plastic structure.

If the supporting structure has a stiffness that re¬ duces towards the _inner of the cavity the transferring of forces from and to the joint will take place without signi- ficant tension peaks.

In the above example two wires have been used to clamp or fasten the bristles, of course a greatur number o britles can also be used. Furthermore if an other type of supporting structure of for instance plastic is used a porous or open structure can also be employed.

Claims

1. Fastening means for fastening an artificial joint part or another bone part characterized in that from an into the bone insertable supporting structure extends bristles, fibres, loops or the like with such a length that a greater outer diameter is achieved than that of the cavity in the bone into which the device is intended to be inserted so that the bristles, fibres or loopes or some of them receive a certain pretens ioning at the mounting angling these away from the direction of insertion.

2. Means according to claim 1, characterized in that the number of bristles, fibres, or loops is great.

3. Means according to claim 1 or 2, characterized in that the bristles, fibres or loops are made of titanium.

4. Means according to claim 1 or 2, characterized in that the bristles, fibres or loops are made of titanium alloys or other materials coated with titanium.

5. Means according to claim 1 characterized in that the supporting structure is fastened to a disk that on mounting of the fastening means is to be located against the end of the bone.

6. Means according to claim 5 characterized in that the disk has flanges or protrusions extending towards the bone and intended to cooperate with a corresponding shaping of the end of the bone.

7. Means according to claim 5 or 6 , characterized in that via a dove tail joint is an artificial joint part directly or indirectly secureable to the disk or plate.

8. Means according to claim 7, characterized in that the dove tail joint extend perpendicular to the bending plane of the joint.