• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    This preparation assembly comprises a piercing guide (31) comprising a bearing surface (33) intended to bear against a glenoid, a passage opening (35) intended for the passage of a guide pin (36) implanted in the glenoid, and first and second guide openings (37, 38) each opening into the bearing surface (33) and each intended to guide a drill bit (38) capable of producing a bony bore in the glenoid, the first and second guide openings (37, 38) being inclined with respect to the axis of extension of the passage opening (35) and converging towards the bearing surface (33); and a compactor (42) comprising a compaction portion (45) having a generally trapezoidal shape and adapted to be impacted against the glenoid to provide a bone housing in the glenoid, the compactor (42) further comprising a through hole (49) extending at least in part in the compaction portion (45) and for the passage of the guide pin (36) implanted in the glenoid.
    公开号:FR3057454A1
    申请号:FR1660114
    申请日:2016-10-19
    公开日:2018-04-20
    发明作者:Bruce Miller；James Hoffmann；Guillaume Rouyer
    申请人:Fournitures Hospitalieres Industrie SAS；FH Orthopedics SAS；Durham Valley Orthopedic Consultants LLC；
    IPC主号:
    专利说明:

    Holder (s): FOURNITURES HOSPITALIERES INDUSTRIE Simplified joint stock company, FH ORTHOPEDICS Simplified joint stock company, MILLER BRUCE, DURHAM VALLEY ORTHOPEDIC CONSULTANTS LLC.
    Extension request (s)
    Agent (s): CABINET GERMAIN & MAUREAU.
    ASSEMBLY FOR THE BONE PREPARATION OF A GLEN FOR THE INSTALLATION OF A SHOULDER PROSTHESIS, AND METHOD FOR IMPLANTING A SHOULDER PROSTHESIS.
    FR 3 057 454 - A1
    This preparation assembly comprises a drilling guide (31) comprising a bearing surface (33) intended to bear against a glenoid, a passage orifice (35) intended for the passage of a guide pin (36) implanted in the glenoid, and first and second guide holes (37, 38) each opening into the bearing surface (33) and each intended to guide a drilling drill (38) capable of producing a bone bore in the glenoid, the first and second guide holes (37, 38) being inclined relative to the extension axis of the passage opening (35) and converging towards the bearing surface (33); and a compactor (42) comprising a compaction part (45) having a generally trapezoidal shape and intended to be impacted against the glenoid so as to provide a bone housing in the glenoid, the compactor (42) further comprising a passage hole (49) extending at least partly in the compaction part (45) and intended for the passage of the guide pin (36) implanted in the glenoid.
    i
    The present invention relates to an assembly for bone preparation of a glenoid for the placement of a shoulder prosthesis, and more particularly for the placement of a glenoid base of such a prosthesis.
    A glenoid base for shoulder prosthesis and cementless fixation, comprises in known manner:
    a support part configured to be fixed, by means of bone anchoring screws, to a glenoid previously prepared with a scapula, the support part comprising a bearing face intended to come to bear against the glenoid, and a support face opposite to the support face and on which is intended to be fixed an insert capable of cooperating with a humeral head or a humeral implant, and
    - An anchoring element, also called a keel or anchoring stud, extending from the bearing face and intended to be anchored in a bone housing previously formed in the glenoid.
    The anchoring element advantageously has a trapezoidal shape in order to ensure a stable and robust anchoring of the glenoid base in the glenoid.
    However, such a configuration of the anchoring element involves a complex, risky, long and tedious preparation of the glenoid bone, and which calls upon the dexterity of the surgeon. Indeed, the realization of the bone housing intended to receive the anchoring element requires in particular the installation of a cutting guide on the glenoid, the realization of pre-drilling in the glenoid by freehand using '' a drilling tool guided by the cutting guide, making incisions in the glenoid using an osteotome guided by the cutting guide, and finalizing the bone housing using the osteotome and one or more compactors.
    The present invention aims to remedy these drawbacks.
    The technical problem underlying the invention therefore consists in providing a set of bone preparation which is of simple structure and which simplifies and secures the operative gesture, while ensuring optimal stability of the glenoid base in the bone.
    To this end, the present invention relates to an assembly for bone preparation of a glenoid for the placement of a shoulder prosthesis, comprising:
    - a drilling guide comprising:
    - a bearing surface intended to bear against a glenoid previously prepared with a scapula,
    a passage orifice opening into the bearing surface of the drilling guide and intended for the passage of a guide pin implanted in the glenoid, and
    - A first guide hole and a second guide hole each opening into the bearing surface of the drilling guide and each intended to guide a drilling drill capable of producing a bone bore in the glenoid, the first and second guide holes being inclined with respect to the axis of extension of the hole for passage of the drilling guide and converging in the direction of the bearing surface of the drilling guide,
    - A compactor comprising a compaction part having a generally trapezoidal shape and intended to be impacted against the glenoid so as to provide a bony housing in the glenoid, the compactor further comprising a passage hole extending at least partially in the compaction part and intended for the passage of the guide pin implanted in the glenoid.
    Such a configuration of the drilling guide, and in particular the presence of the passage orifice, makes it possible to guarantee an optimal positioning of the drilling guide relative to the guide pin, and therefore relative to the concave surface previously prepared in the glenoid , and to facilitate and secure the production of bone bores in the glenoid using at least one drill bit guided by the first and second guide holes. Thus, the drilling guide according to the present invention makes it possible to easily and precisely carry out the first removals of bone material in the glenoid, and this in the strict size of the anchoring element of the glenoid base.
    In addition, the configuration of the compactor, and in particular the presence of the through hole, guarantees optimal positioning of the compactor relative to the guide pin, and therefore relative to the concave surface previously prepared in the glenoid, and thus facilitates the realization bone accommodation by compacting the cancellous bone of the glenoid.
    The assembly may also have one or more of the following characteristics, taken alone or in combination.
    According to one embodiment of the invention, the drilling guide comprises a guide body comprising the bearing surface, the passage orifice and the first and second guide orifices.
    According to one embodiment of the invention, the bearing surface is convex.
    According to one embodiment of the invention, the drilling guide comprises a gripping handle in order to facilitate its manipulation by a surgeon.
    According to an embodiment of the invention, each of the first and second guide orifices extends, relative to the extension axis of the passage orifice, at an angle of inclination less than 45 °.
    According to one embodiment of the invention, the first and second guide orifices are arranged on either side of the passage orifice.
    According to one embodiment of the invention, the first and second guide orifices are arranged symmetrically with respect to the extension axis of the passage orifice.
    According to one embodiment of the invention, the extension axes of the first and second guide orifices and of the passage orifice extend in the same extension plane.
    According to one embodiment of the invention, the compacting part is of generally isosceles trapezoidal shape.
    According to one embodiment of the invention, the compacting part is of truncated pyramidal shape, and for example of rectangular base.
    According to one embodiment of the invention, the compacting part has a rectangular cross section.
    According to one embodiment of the invention, the compacting part extends in a direction of extension.
    According to one embodiment of the invention, the extension axis of the through hole is substantially parallel to the direction of extension.
    According to one embodiment of the invention, the through hole is centered relative to the base and the top of the compacting part.
    According to one embodiment of the invention, the compacting part has a base and a top opposite to the base, the through hole opening into the top of the compacting part.
    According to an embodiment of the invention, the compacting part comprises a plurality of compacting ribs extending transversely to the axis of extension of the through hole. These provisions make it possible to push the compacted bone parts to the bottom of the bone housing while limiting the wedge effects and therefore the risks of fracture of the glenoid during the production of the bone housing.
    According to one embodiment of the invention, the compacting part comprises four opposite side faces two by two, each side face being provided with a plurality of substantially parallel compacting ribs.
    According to an embodiment of the invention, each compaction rib has a triangular cross section.
    According to one embodiment of the invention, the compactor includes a gripping handle in order to facilitate its handling by a surgeon.
    According to one embodiment of the invention, the handle for gripping the compactor comprises a striking surface on which an impact force can be transmitted to the compactor.
    According to one embodiment of the invention, the compactor comprises an abutment part comprising an abutment surface intended to abut against the glenoid, the compaction part extending from the abutment surface.
    According to one embodiment of the invention, the stop part comprises at least one viewing light opening into the stop surface. Such a configuration of the abutment part allows the surgeon to view the glenoid through the abutment part when the guide pin is received in the passage hole, which facilitates the operating gesture.
    According to one embodiment of the invention, the compactor comprises two viewing lights arranged on either side of the through hole.
    According to an embodiment of the invention, the abutment part comprises at least one anterior guide surface which is substantially planar and which is configured to guide a cutting tool capable of making an anterior cut on the glenoid.
    According to one embodiment of the invention, the compactor comprises at least one angular orientation mark making it possible to orient the compactor angularly with respect to the guide pin.
    According to one embodiment of the invention, the at least one angular orientation mark is placed on the stop part, and for example on a peripheral surface of the stop part.
    According to one embodiment of the invention, the compactor comprises two angular orientation marks diametrically opposite with respect to the through hole.
    According to one embodiment of the invention, the at least one angular orientation mark is formed by a notch or an imprint made on the abutment part.
    According to one embodiment of the invention, the assembly further comprises an immobilizing element configured to extend in one of the first and second guide orifices and to be inserted into a bone bore formed in the glenoid.
    According to one embodiment of the invention, the assembly further comprises at least one drilling drill comprising a drilling portion configured to be guided in at least one of the first and second guide holes and to provide at least one bone bore in the glenoid, and an abutment portion configured to abut against the drilling guide so as to limit the insertion depth of the at least one drill bit in the glenoid when the au minus a bone bore.
    According to one embodiment of the invention, the abutment portion of the at least one drill bit is configured to abut against the guide body.
    The present invention further relates to a method of implanting a shoulder prosthesis comprising the following steps:
    - provide a preparation unit according to the present invention,
    - implant a guide pin in a central portion of the glenoid,
    - insert the guide pin into the hole for the drilling guide,
    - position the bearing surface of the drilling guide against the glenoid,
    - introduce and guide a drilling bit into the first guide hole provided on the drilling guide so as to make a first bone bore in the glenoid,
    - introduce and guide a drill bit into the second guide hole provided on the drill guide so as to make a second bone bore in the glenoid,
    - remove the drilling guide from the guide pin,
    - insert the guide pin into the through hole of the compactor,
    - compact the cancellous bone of the glenoid using the compaction part of the compactor so as to form a bony housing.
    According to an embodiment of the invention, the implantation method comprising the following steps:
    - provide a glenoid base for shoulder prosthesis, the glenoid base comprising:
    a support part comprising a support face intended to come into abutment against the glenoid, and a support face opposite to the support face and on which is intended to be fixed an insert capable of cooperating with a humeral head or a humeral implant, and
    an anchoring element extending from the bearing face and intended to be anchored in the bone housing formed in the glenoid, the anchoring element having a generally trapezoidal shape,
    - anchor the anchoring element of the glenoid base in the bone housing.
    According to an embodiment of the invention, the implantation method comprises a step consisting in fixing the glenoid base in the glenoid using bone anchoring screws.
    According to one embodiment of the invention, the support part of the glenoid base is provided with two through-passage openings arranged on either side of the anchoring element, and the fixing step of the glenoid base in the glenoid consists of introducing the bone anchor screws through the through-passage holes provided on the glenoid base.
    According to one embodiment of the invention, each through passage orifice is intended to receive the head of the respective bone anchoring screw.
    According to one embodiment of the invention, the two through-passage openings are inclined with respect to each other, and are for example inclined with respect to the axis of extension of the anchoring element.
    According to one embodiment of the invention, the glenoid base includes a fixing part extending from the bearing face and from an edge of the support part, the fixing part comprising a passage orifice .
    According to one embodiment of the invention, the implantation method comprises a step carried out before the step of producing the second bone bore and consisting in introducing an immobilizing element, such as an immobilizing rod, in the first guide hole provided on the drilling guide and in the first bone bore so as to immobilize in rotation the drilling guide.
    According to an embodiment of the invention, the implantation method comprises a step carried out before the compaction step and consisting in angularly orienting the compactor relative to the guide pin using orientation marks angle provided on the compactor.
    According to an embodiment of the invention, the implantation method comprises a step consisting in guiding a cutting tool using an anterior guide surface provided on the compactor so as to make an anterior bone cut in the glenoid. Such a cut is more particularly intended to receive an anterior fixing tab provided on the glenoid base.
    According to one embodiment of the invention, the implantation method comprises a step carried out before the implantation step of the guide pin and consisting of milling the glenoid so as to provide a concave bearing surface.
    According to an embodiment of the invention, the implantation method comprises a step consisting in providing a first insert of a first type configured to be fixed on the support part of the glenoid base, the first insert comprising a joint part having a general hemispherical shape and being able to cooperate with a humeral implant, and a second insert of a second type configured to be fixed on the support part of the glenoid base, the second insert comprising a part An articulation comprising a concave articulation surface intended to cooperate with a humeral head or a humeral implant.
    According to an embodiment of the invention, the implantation method comprises a step consisting in fixing one of the first and second inserts on the support part of the glenoid base.
    According to one embodiment of the invention, the glenoid base includes first fixing means intended to cooperate with complementary fixing means provided on a first insert of a first type, and second fixing means intended to cooperate with additional fixing means provided on a second insert of a second type.
    According to one embodiment of the invention, the second fixing means comprise a latching housing opening into the support face and intended to cooperate with a latching part provided on the second insert.
    According to one embodiment of the invention, the first fixing means comprise a fixing housing delimited internally at least in part by a frustoconical surface widening in the direction of the support face, the fixing housing being intended to receive by complementarity of form a frustoconical fixing part provided on the first insert.
    According to one embodiment of the invention, the fixing housing opens into the latching housing.
    According to one embodiment of the invention, the latching housing and the fixing housing are coaxial.
    According to one embodiment of the invention, the fixing housing extends at least partially in the anchoring element.
    According to one embodiment of the invention, the first insert is metallic, and is for example made of stainless steel.
    According to one embodiment of the invention, the first insert comprises a support portion intended to bear against the support part.
    According to one embodiment of the invention, the first insert comprises a fixing element comprising a fixing portion of generally frustoconical shape intended to be fixed in the fixing housing of the glenoid base.
    According to one embodiment of the invention, the first insert comprises a through bore opening into the pole of the convex articulation part of the first insert, the through bore of the first insert being intended for the passage of a suitable fixing screw to cooperate with a threaded bore provided on the glenoid base. The threaded bore is for example formed in the extension of the fixing housing, and advantageously extends substantially coaxially with the fixing housing
    According to one embodiment of the invention, the through orifice has a first end opening into the pole of the convex articulation part of the first insert, and a second end opposite the first end and opening into the free end of the fixing part.
    According to one embodiment of the invention, the second insert is made of polyethylene.
    According to one embodiment of the invention, the articulation part of the second insert has a general form of plate.
    According to one embodiment of the invention, the second insert comprises a latching portion configured to cooperate with the latching housing provided on the glenoid base. Advantageously, the latching part comprises at least one latching rib capable of cooperating with the at least one latching groove delimited by the latching housing.
    In any case, the invention will be clearly understood with the aid of the description which follows with reference to the appended schematic drawing representing, by way of nonlimiting example, an embodiment of this glenoid base.
    Figure 1 is a perspective view of a glenoid base and a first insert adapted to be fixed on the glenoid base.
    FIG. 2 is a perspective view from below of a second insert able to be fixed to the glenoid base of FIG. 1.
    Figure 3 is a perspective view showing the second insert fixed to the glenoid base of Figure 1.
    Figures 4 to 18 are perspective views showing different stages of a method of implanting the glenoid base of Figure 1 in a glenoid of a scapula using a preparation assembly according to the invention.
    FIG. 1 represents a glenoid base 2 configured to be fixed on a glenoid previously prepared with a scapula. The glenoid base 2 comprises a support part 3 having a general shape of a plate. The support part 3 more particularly comprises a support face 4 intended to come into abutment against the glenoid, and a support face 5 opposite to the support face 4 and on which is intended to be fixed an insert capable of cooperating with a humeral head or a humeral implant. According to the embodiment shown in the figures, the support face 4 is convex and the support face 5 is concave.
    The glenoid base 2 further comprises an anchoring element 6, for example produced in the form of an anchoring stud, extending from the bearing face 4 and in a direction of extension. The anchoring element 6 is intended to be anchored in a bone housing previously formed in the glenoid 3. The anchoring element 6 has a general trapezoidal shape, and more particularly a truncated pyramidal shape with a rectangular base.
    According to the embodiment shown in the figures, the anchoring element 6 further comprises a through bore 7 inclined relative to the direction of extension of the anchoring element 6 and intended for the passage of a screw d bone anchor 8.
    As shown more particularly in FIG. 1, the support part 3 comprises two through-passage openings 9 arranged on either side of the anchoring element 6, and each intended for the passage of a bone anchoring screw 11. The two through-passage openings 9 are advantageously inclined relative to one another, and also relative to the direction of extension of the anchoring element 6. Each through-passage opening 9 is more particularly intended to receive and accommodate the head of the respective bone anchor screw 11.
    The glenoid base 2 also comprises a latching housing 12 centered with respect to the anchoring element 6 and opening into the support face
    5. The latching housing 12 is substantially cylindrical in shape, and delimits a latching groove 13.
    ίο
    The glenoid base 2 further comprises a fixing housing 14 opening into the latching housing 12, and having an oblong shape. The fixing housing 14 extends in the extension of the latching housing 12 so that the latching housing 12 and the fixing housing 14 are coaxial. Advantageously, the fixing housing 14 partly extends in the anchoring element 6.
    The glenoid base 2 also includes a fixing part 15, for example in the form of a fixing lug, extending from the bearing face 4 and from an edge of the support part 3. The fixing part 15 comprises a passage orifice 16 of axis coincident with the axis of the through bore 7 formed on the anchoring element 6. The passage orifice 16 is more particularly intended to serve as a stop for the head of the anchor screw 8 intended to pass through the through bore 7.
    It should be noted that the glenoid base 2 exists in a so-called standard version, in which the anchoring element 6 is short, and in a so-called elongated version, in which the anchoring element 6 is long.
    FIG. 1 also represents a first insert 17, of a first type, intended to be fixed on the support part 3 of the glenoid base 2. The first insert 17 is advantageously metallic, and can for example be made of steel stainless.
    The first insert 17 comprises a convex articulation part 18 having a general hemispherical shape, and being able to cooperate with a humeral implant. The articulation part 18 comprises in particular a support portion 19 intended to bear against the support face 5 of the support part 3.
    The first insert 17 further comprises a fixing element 21 extending from the articulation part 18. The fixing element 21 more particularly comprises a fixing portion 22 of oblong section intended to be fixed, by fitting in force, in the fixing housing 14 of the glenoid base 2.
    The first insert 17 also includes a through bore 23 comprising a first end opening into the pole of the articulation part 18, and a second end opposite the first end and opening into the free end of the fixing portion 22. L the through bore 23 of the first insert 17 is intended for the passage of a fixing screw capable of cooperating with a tapped bore 20 provided on the glenoid base 2 so as to secure the fixing of the first insert 17 on the glenoid base 2. The threaded bore 20 advantageously extends in the extension of the fixing housing 14, and coaxially with the fixing housing 14.
    Figures 2 and 3 show a second insert 24, of a second type, intended to be fixed on the support part 3 of the glenoid base 2. The second insert 24 is advantageously made of plastic, such as polymer , and can for example be made of polyethylene.
    The second insert 24 comprises an articulation part 25 having a general shape of a plate, and comprising a concave articulation surface 26 intended to cooperate with a humeral head or a humeral implant.
    The second insert 24 further includes a snap-in portion 27 configured to cooperate with the snap-fit housing 12 provided on the glenoid base 2. Advantageously, the snap-in portion 27 has a snap-in rib 28 adapted to cooperate by latching with the latching groove 13 delimited by the latching housing 12.
    According to the embodiment shown in the figures, the second insert 24 includes a fixing part 29 of oblong section intended to be fixed, by force fitting, in the fixing housing 14 of the glenoid base 2.
    FIGS. 4 to 11 represent a drilling guide 31 comprising a guide body 32 comprising a support surface 33 (see FIG. 11) which is convex and intended to bear against a glenoid 34 of a shoulder blade 35.
    The guide body 32 further comprises a central passage orifice 35 opening into the bearing surface 33 and intended for the passage of a guide pin 36 implanted in the glenoid 34.
    The guide body 32 also includes a first guide hole 37 and a second guide hole 38 each opening into the bearing surface 33 and each intended to guide a drilling bit 39 capable of producing bone bores in the glenoid 34. The drill bit 39 more particularly comprises a drilling portion 39.1 configured to be guided in each of the first and second guide holes 37, 38, and an abutment portion 39.2 configured to abut against the guide body 32 so as to limit the insertion depth of the drill bit 39 in the glenoid 34 when producing the bone bores.
    The first and second guide orifices 37, 38 are arranged on either side of the passage orifice 35 and symmetrically with respect to the extension axis of the passage orifice 35. In addition, the first and second guide holes 37, 38 are inclined with respect to each other and with respect to the extension axis of the passage orifice 35. In addition, the first and second guide holes 37, 38 converge towards the bearing surface 33. Advantageously, each of the first and second guide orifices 38, 39 extends, relative to the extension axis of the passage orifice 35, at an angle d '' tilt less than 45 °.
    Advantageously, the extension axes of the first and second guide orifices 37, 38 and of the passage orifice 35 extend in the same extension plane P (see FIG. 5).
    The drilling guide 31 also includes a grip handle 41 to facilitate its manipulation by a surgeon. The gripping handle 41 is more particularly secured to the guide body 32.
    FIGS. 12 to 17 show a compactor 42 comprising an abutment part 43 comprising a convex abutment surface 44 intended to abut against the glenoid 34, and a compaction part 45 extending from the abutment surface 44 and intended to be impacted against the glenoid 34 so as to provide bone accommodation in the glenoid 34.
    The compaction part 45 more particularly has a truncated pyramidal shape with a rectangular base. Thus, the compaction part 45 has four lateral faces 45.1, 45.2 opposite two by two, as well as a base 46 and a top 47 opposite the base 44.
    According to the embodiment shown in FIG. 13, the compaction part 45 further comprises a plurality of compaction ribs 48 extending perpendicular to the direction of extension of the compaction part 45. Each lateral face 45.1, 45.2 of the compaction part 45 is more particularly provided with a plurality of compaction ribs 48 which are substantially parallel and axially offset from one another. Advantageously, each compaction rib 48 has a triangular cross section.
    According to an alternative embodiment shown in FIG. 14, each lateral face 45.1, 45.2 of the compaction part 45 could comprise, in place of the compaction ribs 48, compaction pins 50, for example diamond-coated.
    The compactor 42 further comprises a passage hole 49, for example in the form of a passage channel, intended for the passage of the guide pin 36 located in the glenoid 34. The passage hole 49 extends to the less partly in the compaction part 45 and substantially parallel to the direction of extension of the compaction part 45. Advantageously, the through hole 49 is centered relative to the base 46 and to the top 47 of the compaction part 45 , and opens into the top 47 of the compaction part 45.
    Advantageously, the abutment portion 43 also includes one or more viewing lights 51 opening into the abutment surface 44. Such a configuration of the abutment portion 43 allows the surgeon to view the glenoid 34 through the abutment portion 43 when the guide pin 36 is received in the through hole 49, which facilitates the operating gesture. According to the embodiment of the invention shown in the figures, the compactor 42 includes two viewing lights 51 arranged on either side of the through hole 49.
    The compactor 42 also includes one or more angular orientation marks 52 making it possible to angularly orient the compactor 42 relative to the guide pin 36. According to the embodiment shown in the figures, the compactor 42 comprises two orientation marks angular 52 diametrically opposite with respect to the through hole 49 and formed on a peripheral surface of the abutment part 43.
    According to the embodiment shown in the figures, the abutment part 43 further comprises an anterior guide surface 53 which is substantially planar and which is configured to guide a cutting tool capable of making an anterior cut on the glenoid 34.
    The compactor 42 further comprises a gripping handle 54 in order to facilitate its handling by a surgeon. The gripping handle 54 advantageously includes a striking surface 55 on which an impact force can be transmitted to the compactor 42.
    Advantageously, the through hole 49 extends at least partially over the grip handle 54.
    A method for implanting a glenoid base will now be described with particular reference to FIGS. 4 to 18.
    Such an implantation process comprises the following steps:
    - implant the guide pin 36 in a central portion of the glenoid 34,
    insert the guide pin 36 into the passage orifice 35 of the drilling guide 31,
    sliding the guide body 32 along the guide pin 36 in the direction of the glenoid 34,
    position the bearing surface 33 of the drilling guide 31 against the glenoid 34 (see FIG. 4),
    insert and guide the drilling bit 39 into the first guide hole 37 provided on the drilling guide 31 so as to produce a first bone bore 55 in the glenoid 34 (see FIGS. 6, 7 and 16),
    - extract the drill bit 39 from the first guide hole 37,
    - Introduce an immobilization element 56, such as an immobilization rod, in the first guide hole 37 provided on the drilling guide 31 and in the first bone bore 55 so as to immobilize the rotation guide drilling 31 (see FIG. 8),
    introduce and guide the drilling bit 39 into the second guide hole 38 provided on the drilling guide 31 so as to produce a second bone bore 56 in the glenoid 34 (see FIGS. 9, 10 and 16),
    - extract the drill bit 38 from the second guide hole 38,
    - remove the immobilizing element 56 from the first guide orifice 37,
    - remove the drilling guide 31 by sliding the guide body 32 along the guide pin 36,
    - insert the guide pin 36 into the through hole 49 of the compactor 42 (see Figure 16),
    slide the compaction part 45 along the guide pin 36 in the direction of the glenoid 34,
    - angularly orient the compactor 42 relative to the guide pin 36 using the angular orientation marks 52 so that the angular orientation marks 52 are aligned with the first and second bone bores 55, 56 (see Figure 14),
    - compact the cancellous bone of the glenoid 34 using the compaction part 45 so as to form a bone housing 57 in the glenoid 34 (see FIGS. 16 and 17),
    guide a cutting tool using the anterior guide surface 53 so as to make an anterior bone cut in the glenoid 34 to allow the fixing of the fixing part 15 of the glenoid base 2,
    - remove the compactor 42 by sliding the compaction part 45 along the guide pin 36,
    - remove the guide pin 36,
    - anchor the anchoring element 6 of the glenoid base 2 in the bone housing 57 (see FIG. 18),
    - fix the glenoid base 2 using the bone anchor screws 8,11,
    - fix one of the first and second inserts 17, 24 to the support part 3 of the glenoid base 2.
    As it goes without saying, the invention is not limited to the sole embodiment of this preparation assembly, described above by way of example, on the contrary it embraces all the variant embodiments thereof.
    权利要求:
    Claims (12)
    [1" id="c-fr-0001]
    1. Set of bone preparation of a glenoid (34) for the installation of a shoulder prosthesis, comprising:
    - a drilling guide (31) comprising:
    a support surface (33) intended to bear against a glenoid (34) previously prepared with a scapula,
    a passage orifice (35) opening into the bearing surface (33) of the drilling guide (31) and intended for the passage of a guide pin (36) implanted in the glenoid, and
    - A first guide hole (37) and a second guide hole (38) each opening into the bearing surface (33) of the drilling guide and each intended to guide a drilling bit (38) capable of producing a bore bone in the glenoid, the first and second guide holes (37, 38) being inclined relative to the axis of extension of the passage hole (35) of the piercing guide and converging towards the surface of support (33) of the drilling guide (31),
    - A compactor (42) comprising a compaction part (45) having a generally trapezoidal shape and intended to be impacted against the glenoid (34) so as to provide a bone housing in the glenoid, the compactor (42) further comprising a passage hole (49) extending at least partly in the compacting part (45) and intended for the passage of the guide pin (36) implanted in the glenoid.
    [2" id="c-fr-0002]
    2. The assembly of claim 1, wherein the first and second guide holes (37, 38) are arranged on either side of the passage opening (35).
    [3" id="c-fr-0003]
    3. The assembly of claim 1 or 2, wherein the extension axes of the first and second guide holes (37, 38) and the through hole (35) extend in the same extension plane ( P).
    [4" id="c-fr-0004]
    4. Assembly according to any one of claims 1 to 3, in which the compacting part (45) comprises a base (46) and an apex (47) opposite the base (46), the through hole (49) opening into the top (47) of the compacting part (45).
    [5" id="c-fr-0005]
    5. Assembly according to any one of claims 1 to 4, in which the compaction part (45) comprises a plurality of compaction ribs (48) extending transversely to the axis of extension of the through hole (49 ).
    [6" id="c-fr-0006]
    6. The assembly of claim 5, wherein the compaction part (45) has four side faces (45.1, 45.2) opposite in pairs, each side face (45.1, 45.2) being provided with a plurality of compaction ribs ( 48) substantially parallel.
    [7" id="c-fr-0007]
    7. Assembly according to any one of claims 1 to 6, in which the compactor (42) comprises an abutment part (43) comprising an abutment surface (44) intended to abut against the glenoid (34), the compaction part (45) extending from the abutment surface (44).
    [8" id="c-fr-0008]
    8. The assembly of claim 7, wherein the abutment portion (43) comprises at least one viewing light (51) opening into the abutment surface (44).
    [9" id="c-fr-0009]
    9. The assembly of claim 7 or 8, wherein the abutment portion (43) comprises at least one front guide surface (53) which is substantially planar and which is configured to guide a cutting tool capable of making an anterior cut. on the glenoid (34).
    [10" id="c-fr-0010]
    10. Assembly according to any one of claims 1 to 9, in which the compactor (42) comprises at least one angular orientation mark (52) making it possible to orient the compactor (42) angularly with respect to the guide pin. (36).
    [11" id="c-fr-0011]
    11. An assembly according to any one of claims 1 to 10, which further comprises an immobilizing element (56) configured to extend in one of the first and second guide holes (37, 38) and to be inserted into a bone bore in the glenoid.
    [12" id="c-fr-0012]
    12. An assembly according to any one of claims 1 to 11, which further comprises at least one drilling drill (39) comprising a drilling portion (39.1) configured to be guided in at least one of the first and second orifices guide (37, 38) and to provide at least one bone bore in the glenoid, and an abutment portion (39.2) configured to abut against the drilling guide (31) so as to limit the insertion depth of the at least one drill bit (39) in the glenoid during the production of the at least one bone bore.
    1/5
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    同族专利:
    公开号 | 公开日
    FR3057454B1|2018-10-26|
    US20180103967A1|2018-04-19|
    US10188408B2|2019-01-29|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    WO2020058633A1|2018-09-20|2020-03-26|Shoulder Friends Institute|Guide for positioning an orthopaedic guide pin on a bone structure|DE2247168A1|1971-11-22|1973-05-24|Galvanische Elemente K Veb|PROCESS FOR PRODUCING ALKALINE ROUND CELLS|
    US8506569B2|2009-12-31|2013-08-13|DePuy Synthes Products, LLC|Reciprocating rasps for use in an orthopaedic surgical procedure|
    FR2955250B1|2010-01-15|2012-02-03|Tornier Sa|SURGICAL ASSISTANCE ASSEMBLY FOR THE IMPLANTATION OF A GLENOIDAL COMPONENT OF SHOULDER PROSTHESIS|
    FR2996114B1|2012-10-02|2015-02-13|Sem Sa|DRILLING GUIDE FOR ANTERIOR SHOULDER STOOL|
    US9320527B2|2013-01-18|2016-04-26|Biomet Manufacturing, Llc|Quick-connect anti-rotation peg/drill bit component|CN112584791A|2018-06-19|2021-03-30|托尼尔公司|Neural network for diagnosing shoulder disorders|
    US10583012B1|2018-09-07|2020-03-10|Raphael S. F. Longobardi|Universal shoulder prosthesis system|
    法律状态:
    2017-09-07| PLFP| Fee payment|Year of fee payment: 2 |
    2018-04-20| PLSC| Search report ready|Effective date: 20180420 |
    2018-10-26| PLFP| Fee payment|Year of fee payment: 3 |
    2019-08-30| PLFP| Fee payment|Year of fee payment: 4 |
    2020-08-27| PLFP| Fee payment|Year of fee payment: 5 |
    2021-02-12| TQ| Partial transmission of property|Owner name: FOURNITURES HOSPITALIERES INDUSTRIE, FR Effective date: 20210104 Owner name: BRUCE MILLER, US Effective date: 20210104 Owner name: FH ORTHO, FR Effective date: 20210104 Owner name: DURHAM VALLEY ORTHOPEDIC CONSULTANTS LLC, US Effective date: 20210104 |
    2021-08-31| PLFP| Fee payment|Year of fee payment: 6 |
    优先权:
    申请号 | 申请日 | 专利标题
    US15/296,828|US10188408B2|2016-10-18|2016-10-18|Glenoid cavity bone preparation set for setting a shoulder prosthesis, and method for implanting a shoulder prosthesis|
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