DE10223474A1 - Cementless implant of the endoprosthetic replacement of the neck of the femur involves femur implant and bolts fitting though holes - Google Patents

Cementless implant of the endoprosthetic replacement of the neck of the femur involves femur implant and bolts fitting though holes

Info

Publication number
DE10223474A1
DE10223474A1 DE10223474A DE10223474A DE10223474A1 DE 10223474 A1 DE10223474 A1 DE 10223474A1 DE 10223474 A DE10223474 A DE 10223474A DE 10223474 A DE10223474 A DE 10223474A DE 10223474 A1 DE10223474 A1 DE 10223474A1
Authority
DE
Germany
Prior art keywords
implant
femoral
femoral neck
dynamic
femur
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Withdrawn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
DE10223474A
Other languages
German (de)
Inventor
Florian Krug
Ulrich Muender
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to DE10223474A priority Critical patent/DE10223474A1/en
Publication of DE10223474A1 publication Critical patent/DE10223474A1/en
Withdrawn legal-status Critical Current

Links

Classifications

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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
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
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    • A61F2/02—Prostheses implantable into the body
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
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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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Abstract

The endoprosthetic neck of the femur consists of several femur implant elements, the neck of the femur implant (4), the femur bolts (12) and the hip joint head (1). The hip joint head can preferably be adapted directly on an external neck of the femur implant cone (7) as a corresponding joint surface element (2) for an implanted or anatomical hip joint socket. The neck of the femur implant and femur bolts pass through elongated holes (5) in the neck of the femur implant.

Description

Die bekannten Ausführungen zum Stand der Technik, die als Schenkelhals-Implantat mit integrierter Druckscheibe und durchgehender, intramedullärer Sicherungsschraube (WO 00/72785 A2, WO 00/72785 A3), konisches Schenkelhals-Implantat mit integrierter Druckscheibe und nicht durchgehender, intramedullärer Sicherungsschraube im Trochanter major (DE 200 07 950 U1), Schenkelhals-Implantat mit integrierter Druckscheibe und separater Sicherungslasche zur lateralen Verschraubung (DE 27 24 234 C2), konisches Schenkelhals-Implantat mit separater Sicherungslasche zur lateralen Verschraubung (DE 196 01 340 C1), konisches Schenkelhals-Implantat mit integrierter, intramedullärer-caudaler Abstützung (EP 0 878 176 A2), Schenkelhals-Implantatschraube oder gekürzten Varianten von Standard-Hüftimplantate beschrieben werden können, weisen hinsichtlich der klinischen Anwendung bezüglich der OP-Techniken, der Revisionsmöglichkeiten, dem postoperativen Implantatverhalten und hinsichtlich der Belastungen des Femurs unterschiedliche Probleme auf. Die bestehenden Implantatausführungen bestehen alle aus den nach dem Stand der Technik hinreichend bekannten, implantierfähigen Kobalt-Chrom-Molybdän-Legierungen oder Titan-Legierungen. The known versions of the prior art, which as a femoral neck implant integrated thrust washer and continuous, intramedullary locking screw (WO 00/72785 A2, WO 00/72785 A3), conical femoral neck implant with integrated Thrust washer and non-continuous, intramedullary locking screw in the trochanter major (DE 200 07 950 U1), femoral neck implant with integrated pressure disc and separate securing tab for lateral screwing (DE 27 24 234 C2), conical Femoral neck implant with separate securing tab for lateral screwing (DE 196 01 340 C1), conical femoral neck implant with integrated, intramedullary-caudal Support (EP 0 878 176 A2), femoral neck implant screw or shortened variants of standard hip implants can be described in terms of clinical Application regarding surgical techniques, revision options, postoperative Implant behavior and different problems with regard to the loads on the femur on. The existing implant designs all consist of the state of the art Technically well known, implantable cobalt-chromium-molybdenum alloys or titanium alloys.

Die Aufgaben zur Neuentwicklung einer Schenkelhals-Endoprothese beziehen sich auf die aktuellen Probleme der am Markt befindlichen Schenkelhals-Endoprothesen:

  • 1. Berücksichtigung der indikationsabhängigen Größenauswahl bzw. einer intraoperativen Endoprothesenanpassung an die Femurgeometrie zur Rekonstruktion der ursprünglichen Femurgeometrie unter weitestgehender Erhaltung des Schenkelhalses.
  • 2. Berücksichtigung der Primärfixation der femoralen Implantate über eine Primärfixation durch eine makroporöse Oberfläche hinaus.
  • 3. Berücksichtigung der Implantationsweise bei Auslegung der femoralen Komponenten, die gegenwärtig hauptsächlich rotatorisch oder translatorisch-rotatorisch implantiert werden müssen, oder durch eine dauerhafte Perforation am lateralen Femur gesichert werden, was sich in der klinischen Praxis teilweise als problematisch darstellt.
  • 4. Berücksichtigung der Implantatrevision um eine Revision durch "Deckelung" des Femurs zu vermeiden, was eine schwerwiegende Beeinträchtigung des Patienten zur Folge hat.
The tasks for the new development of a femoral neck endoprosthesis relate to the current problems of the femoral neck endoprostheses on the market:
  • 1. Consideration of the indication-dependent size selection or an intraoperative endoprosthesis adaptation to the femoral geometry for the reconstruction of the original femoral geometry while largely preserving the femoral neck.
  • 2. Consideration of the primary fixation of the femoral implants beyond a primary fixation through a macroporous surface.
  • 3. Consideration of the type of implantation when designing the femoral components, which currently have to be mainly rotatory or translatory-rotatory implantation, or are secured by permanent perforation on the lateral femur, which is sometimes problematic in clinical practice.
  • 4. Consideration of the implant revision to avoid revision by "capping" the femur, which results in serious impairment of the patient.

Die innovative Aufgabe der vorliegenden Erfindung ist es, eine Schenkelhals-Endoprothese mit einem neuartigem Konzept, auf Basis der gegenseitigen geometrischen Durchdringung vorzugsweiss drei oder alternativ zwei oder mehrerer Femurimplantatkomponenten als Schenkelhalsimplantat (4) und Femurbolzen (12), zu schaffen, dass unter besonderer Berücksichtigung der operativen Technik und der Implantatstabilisation optimiert ist. Die vorliegende Patentanmeldung betrifft somit eine dynamische Schenkelhals-Endoprothese für das femorale Hüftgelenk zum alloplastischen Gelenkersatz, dessen Konzept, bei entsprechender, geometrischer Anpassung, auch bei anderen Gelenkimplantaten angewandt werden kann. Die Endoprothesenelemente bestehen vorzugsweise aus metallischen Implantatlegierungen und Al2O3-Keramik. Die anatomisch-technischen Ausführungen und die Möglichkeit der dynamischen Implantatfixation der vorliegenden, dynamische Schenkelhals-Endoprothese weisen im Gegensatz zu den nach dem Stand der Technik bekannten Hüftgelenkendoprothesen als Schenkelhalsendoprothesen entscheidende Vorteile auf. Die Erfindung berücksichtigt die besonderen Anforderungen der klinischen Anwender bezüglich der Implantationssicherheit und einer einfachen Revisionstechnik zum Implantataustausch. The innovative object of the present invention is to create a femoral neck endoprosthesis with a novel concept, based on the mutual geometric penetration, preferably three or alternatively two or more femoral implant components as femoral neck implant ( 4 ) and femoral bolt ( 12 ), with special consideration operational technology and implant stabilization is optimized. The present patent application thus relates to a dynamic femoral neck endoprosthesis for the femoral hip joint for alloplastic joint replacement, the concept of which, with appropriate geometric adaptation, can also be used for other joint implants. The endoprosthesis elements are preferably made of metallic implant alloys and Al2O3 ceramic. In contrast to the hip joint endoprostheses known from the prior art, the anatomical-technical designs and the possibility of dynamic implant fixation of the present dynamic femoral neck endoprosthesis have decisive advantages as femoral neck endoprostheses. The invention takes into account the special requirements of clinical users with regard to implantation security and a simple revision technique for implant replacement.

Die Innovationen zur Neuentwicklung einer dynamischen Schenkelhals-Endoprothese unter Berücksichtigung der nach dem Stand der Technik bekannten Entwicklungen können wie nachfolgend dargestellt beschrieben werden:

  • 1. Indikationsabhängige Größenauswahl bzw. intraoperative Endoprothesenanpassung an die Femurgeometrie durch die Verwendung eines modularen Femurimplantatsystemes bestehend aus verschiedenen großen Schenkelhalsimplantaten mit mehreren, vorzugsweise um 90° zueinander verdreht oder auch parallel positionierten, zur Implantatachse zentral oder dezentral liegenden, seitlich geschlossenen oder geöffneten Langlöchern, verschiedenen artigen und verschiedenen langen Femurbolzen und verschiedenen Hüftgelenkkopfvarianten zur Rekonstruktion der ursprünglichen Femurgeometrie unter Berücksichtigung des verbleibenden Schenkelhalses bzw. Femurknochengewebes.
  • 2. Dynamische Systemsicherung der femoralen Implantate durch Primärfixation auf Basis einer makroporöse Oberfläche mit oder ohne interkonnektierenden Räumen, in Einheit mit einer internen, dynamischen Verblockung durch die intraoperative, femurinterne Systemmontage des Schenkelhalsimplantates mit mehreren um 90° zueinander verdreht oder auch parallel positionierten, zur Implantatachse zentral oder dezentral liegenden, seitlich geschlossenen oder geöffneten Langlöchern mit den Femurbolzen, was mit den derzeitig bekannten Entwicklungen zu Schenkelhalsprothesen nicht möglich ist.
  • 3. Implantation des Schenkelhalsimplantates durch ausschließlich translatorische Einführbewegungen als Verbesserung zu den meisten gegenwärtigen Systemen, die teilweise rotatorisch oder translatorisch-rotatorisch implantiert werden müssen, was sich in der klinischen Praxis als problematisch darstellt.
  • 4. Einfache Möglichkeit der Implantatrevision durch Umkehr der Implantationstechnik nach der Entfernung der Femurbolzen und der Durchtrennung der eingewachsenen Knochentrabekeln an den Umfangsflächen des Schenkelhalsimplantates.
The innovations for the new development of a dynamic femoral neck endoprosthesis taking into account the developments known from the prior art can be described as follows:
  • 1.Selection-dependent size selection or intraoperative endoprosthesis adaptation to the femur geometry through the use of a modular femoral implant system consisting of various large femoral neck implants with several, preferably rotated by 90 ° to one another or also positioned parallel, centrally or decentrally, laterally closed or open oblong holes to the implant axis, various -like and various long femoral bolts and various femoral head variants for the reconstruction of the original femoral geometry, taking into account the remaining femoral neck or femoral tissue.
  • 2. Dynamic system security of the femoral implants by primary fixation based on a macroporous surface with or without interconnecting spaces, in unity with an internal, dynamic blocking through the intraoperative, femur-internal system assembly of the femoral neck implant with several rotated by 90 ° to each other or also positioned parallel to the implant axis centrally or decentrally located, laterally closed or open elongated holes with the femoral bolts, which is not possible with the currently known developments in femoral neck prostheses.
  • 3. Implantation of the femoral neck implant through only translatory insertion movements as an improvement to most current systems, which have to be implanted in part in a rotary or translatory-rotary manner, which is problematic in clinical practice.
  • 4. Easy possibility of implant revision by reversing the implantation technique after removing the femoral bolts and cutting through the ingrown bone trabeculae on the peripheral surfaces of the femoral neck implant.

Die einzelnen Endoprothesenelemente der dynamischen Schenkelhals-Endoprothese bestehen aus einem Hüftgelenkkopf (1) mit sphärisch-konvexer Gelenkfläche (2) und internem oder externen Hüftgelenkkopfkonus (3), einem optionalen Konusadapter mit Doppelkonus, sofern der Schenkelhalsimplantatkonus (7) zur Aufnahme des Hüftgelenkkopfes (1) nicht als externer Schenkelhalsimplantatkonus (7) an dem Schenkelhalsimplantat (4) oder als externer Hüftgelenkkopfkonus (3) an dem Hüftgelenkkopf (1) integriert ist, einem zementlos implantierbaren Schenkelhalsimplantat (4) mit mehreren, vorzugsweise um 90° zueinander verdreht oder auch parallel positionierten, zentral oder dezentral zur Implantatachse liegenden, seitlich geschlossenen oder geöffneten Langlöchern (5) und zementlos implantierbaren Femurbolzen (12) und einem optionalen Hüftpfannenimplantat in Anpassung an die Art des Hüftgelenkkopf (1). The individual endoprosthesis elements of the dynamic femoral neck endoprosthesis consist of a femoral head ( 1 ) with a spherical-convex articular surface ( 2 ) and internal or external femoral head cone ( 3 ), an optional cone adapter with double cone, provided that the femoral neck implant cone ( 7 ) for receiving the femoral head ( 1 ) is not integrated as an external femoral neck implant cone ( 7 ) on the femoral neck implant ( 4 ) or as an external femoral head cone ( 3 ) on the hip joint head ( 1 ), a femoral neck implant ( 4 ) that can be implanted without cement, with several, preferably rotated by 90 ° to each other or also positioned in parallel , centrally or decentrally to the implant axis, laterally closed or open elongated holes ( 5 ) and cementlessly implantable femur bolts ( 12 ) and an optional acetabular implant to match the type of hip joint head ( 1 ).

Das konische Schenkelhalsimplantat (4) weist vorzugsweise einen kreisrunden Querschnitt auf, der in seinen anatomisierten Varianten zwei seitliche, vorzugsweise parallele Flächen ausweist (Fig. 6, 7, 9, 10), alternativ aber auch vieleckig, oval, eioval oder elliptisch sein kann um durch den Formschluß verbessert Rotationskräfte aufnehmen zu können. Diese Querschnittsformgebung kann aus einem entsprechend ausgelegtem runden, vieleckigen, ovalen, eiovalen oder elliptischen Implantatkern mit einer konstanten makroporösen Oberfläche (11), vorzugsweise mit interkonnektierenden Räumen oder aus einem kreisrunden Implantatkern mit unterschiedlichen Oberflächenbauhöhen der makroporösen Oberfläche (11) entstehen. Die konische Formgebung des Schenkelhalsimplantates (4) wird vorzugsweise durch einen tatsächlichen Konus abgebildet, kann aber alternativ auch aus mehreren miteinander verbundenen, zylindrischen Elementen mit jeweils verringertem Durchmesser bestehen, die in ihrer Kombination einen "Stufenkonus" darstellen. The conical femoral neck implant ( 4 ) preferably has a circular cross-section which, in its anatomized variants, has two lateral, preferably parallel surfaces ( FIGS. 6, 7, 9, 10), but alternatively can also be polygonal, oval, oval or elliptical to be able to absorb improved rotational forces through the positive locking. This cross-sectional shape can result from a suitably designed round, polygonal, oval, ei-oval or elliptical implant core with a constant macroporous surface ( 11 ), preferably with interconnecting spaces, or from a circular implant core with different surface heights of the macroporous surface ( 11 ). The conical shape of the femoral neck implant ( 4 ) is preferably represented by an actual cone, but can alternatively also consist of a plurality of interconnected cylindrical elements, each with a reduced diameter, which in their combination constitute a "step cone".

Die femorale Implantatfixation des Schenkelhalsimplantates (4) im Schenkelhals (16) bzw. im proximalen Femur wird durch einen primären Preßfitt (21) auf Basis einer makroporösen Implantatoberfläche (11) mit oder ohne interkonnektierenden Räumen oder durch eine regelmäßige oder unregelmäßige Kerbung der Implantatoberfläche und einem Untermaß der im Schenkelhals operativ geschaffenen Knochenkaverne in Einheit mit einer dynamischen Implantatfixation des Schenkelhalsimplantates (4) durch die Verwendung von speziellen Femurbolzen (12) erzeugt. Die vorzugsweise um 90° zueinander verdrehten Femurbolzen (12), die in mehrere, vorzugsweise um 90° zueinander verdreht positionierten oder auch parallelen, zur Implantatachse zentral oder dezentral liegenden, seitlich geschlossenen oder geöffneten Langlöchern (5) des Schenkelhalsimplantates (4) eingreifen und die im gegenseitigen, geometrischen Durchdringungsbereich von Langloch (5) und Zentrierbolzenbereich (13) vorzugsweise eine Spielpassung oder alternativ eine Übergangspassung oder Presspassung aufweisen. Die primäre Implantatfixation durch Preßfitt wird postoperativ in eine Sekundärfixation durch knöcherne Integration des Schenkelhalsimplantates (4) umwandelt. Die Umwandlung wird durch das postoperative Gefäßwachstum und Trabekelwachstum bzw. einer allgemeinen Ossifikation in den interkonnektierenden Räumen bzw. Kerbungen erreicht. Die dynamische Implantatfixation wird durch vorzugsweise zwei oder mehrere vorzugsweise um 90° zueinander verdreht oder auch parallel positionierten, zur Implantatachse zentral oder auch dezentral liegenden, seitlich geschlossenen oder geöffneten Langlöcher (5) im Schenkelhalsimplantat (4) einschließlich der die Langlöcher (5) durchdringen Femurbolzen (12) erzielt, indem das Schenkelhalsimplantat (4) aufgrund der operativ lateral in die Langlöcher (5) eingebrachten Femurbolzen (12) eine postoperative Beweglichkeit bei einer Implantateinsinterung nach lateral/caudal aufweist, jedoch in proximaler/distaler und dorsaler/ventraler Richtung als auch hinsichtlich einer Rotationsbewegung durch die Femurbolzen (12) im Schenkelhals und im proximalen Femur fixiert wird. The femoral implant fixation of the femoral neck implant ( 4 ) in the femoral neck ( 16 ) or in the proximal femur is achieved by a primary press fit ( 21 ) based on a macroporous implant surface ( 11 ) with or without interconnecting spaces or by regular or irregular notching of the implant surface and one Undersize of the bone cavern surgically created in the femoral neck in unit with a dynamic implant fixation of the femoral neck implant ( 4 ) by the use of special femoral bolts ( 12 ). The femoral bolts ( 12 ), which are preferably rotated by 90 ° to one another, engage in a plurality of oblong holes ( 5 ) in the femoral neck implant ( 4 ) that are positioned laterally closed or open, preferably centrally rotated or 90 ° to one another, or parallel to the implant axis and which preferably have a clearance fit or alternatively a transition fit or press fit in the mutual, geometric penetration area of the elongated hole ( 5 ) and the centering pin area ( 13 ). The primary implant fixation by means of a press fit is converted postoperatively into a secondary fixation by means of the bony integration of the femoral neck implant ( 4 ). The transformation is achieved by postoperative vascular growth and trabecular growth or a general ossification in the interconnecting spaces or notches. The dynamic implant fixation is preferably rotated by two or more elongated holes ( 5 ) in the femoral neck implant ( 4 ), which are positioned parallel to the implant axis and are located parallel or parallel to the implant axis, including those that penetrate the elongated holes ( 5 ), femoral bolts ( 12 ) achieved by the fact that the femoral neck implant ( 4 ) has postoperative mobility with lateral / caudal implant sintering due to the femur bolts ( 12 ) inserted laterally into the elongated holes ( 5 ), but in the proximal / distal and dorsal / ventral direction as well is fixed in terms of a rotational movement by the femur bolts ( 12 ) in the femoral neck and in the proximal femur.

Das Schenkelhalsimplantat (4) weist an seinem medialen Ende vorzugsweise einen externen Schenkelhalsimplantatkonus (7) zur Aufnahme eines Hüftgelenkkopfes (1) mit einem internem Hüftgelenkkopfkonus (3) auf. Alternativ hierzu kann das Schenkelhalsimplantat (4) medial auch einen internen Schenkelhalsimplantatkonus (7) zur Aufnahme eines optionalen Konusadapters mit einem Doppelkonus oder eines Hüftkugelkopfes (1) mit einem externen Hüftgelenkkopfkonus (3) aufweisen. The femoral neck implant ( 4 ) preferably has an external femoral neck implant cone ( 7 ) at its medial end for receiving a femoral head ( 1 ) with an internal femoral head cone ( 3 ). As an alternative to this, the femoral neck implant ( 4 ) can also have an internal femoral neck implant cone ( 7 ) for receiving an optional cone adapter with a double cone or a femoral head ( 1 ) with an external femoral head cone ( 3 ).

Das Schenkelhalsimplantat (4) weist an seinem medialen Ende eine Bohrung (10) als Sacklochbohrung zur Ausrichtung eines, auf dem Konus adaptierten und mit dem Innengewinde (8) gesichertem, OP-Instrumentes zur Erstellung der Bohrungen für die speziellen Femurbolzen (12) auf. Alternativ hierzu kann das Schenkelhalsimplantat (4) zusätzlich auch eine zentrale, durchgehende Bohrung (10) aufweisen, die zur Aufnahme eines Kirschnerdrahtes dient, der am Beginn der Operation zur Orientierung eingebracht werden kann und über den alle chirurgischen Resektionen vorgenommen werden können. The femoral neck implant ( 4 ) has at its medial end a hole ( 10 ) as a blind hole for aligning an OP instrument adapted to the cone and secured with the internal thread ( 8 ) to create the holes for the special femoral bolts ( 12 ). As an alternative to this, the femoral neck implant ( 4 ) can also have a central, continuous bore ( 10 ) which serves to receive a Kirschner wire which can be inserted for orientation at the start of the operation and via which all surgical resections can be carried out.

Das Schenkelhalsimplantat (4) besteht vorzugsweise aus einer metallischen Implantatlegierung wie Kobalt-Chrom-Molybdän-Legierung, Titan-Legierung oder Implantatstahl-Legierung. The femoral neck implant ( 4 ) preferably consists of a metallic implant alloy such as cobalt-chromium-molybdenum alloy, titanium alloy or implant steel alloy.

Die systemspezifischen Femurbolzen (12) weisen vorzugsweise an beiden Enden selbstschneidende Gewinde (15) auf, können alternativ aber auch nur mit einem einseitigem selbstschneidenden Gewinde (15) ausgestattet sein, um postoperativ die Lage der Femurbolzen (12) zu gewährleisten. Alternativ können die Femurbolzen (12) beidseitig oder einseitig anstelle der selbstschneidenden Gewinde (15) auch mit einer makroporösen Implantatoberfläche (11) mit oder ohne interkonnektierenden Räumen zwecks postoperativer Lagesicherung versehen sein, wobei die Femurbolzen (12) in diesem Fall mit einem Innengewinde (8) zur Instrumentenadaption versehen sind. Die selbstschneidenden Gewinde (15) der Femurbolzen (12) bzw. die alternativen Bereiche mit einer makroporösen Implantatoberfläche (11) können zylindrisch oder auch konisch ausgeprägt sein. Die Femurbolzen (12) verfügen in ihrem mittigen Bereich über eine Zone, die als Zentrierbolzenbereich (13) vorzugsweisen mit einer Spielpassung oder alternativ auch mit einer Übergangspassung oder Presspassung zu den Langlöchern (5) im Schenkelhalsimplantat (4) ausgeprägt ist. Die Femurbolzen (12) in Einheit mit dem Schenkelhalsimplantat (4) sind derartig konzeptioniert, dass sie hauptsächlich auf Biegung belastet werden. Durch die Anlage einer möglichen Stirnfläche (14) an dem Femurbolzen (12), der vorzugsweise durch den Trochanter major (18) zum Adamschen Bogen (17) führt, auf dem Langlochrand (6) bzw. den Langlochrändern (6) in dem Schenkelhalsimplantat (4) kann eine zusätzliche, erweiterte Implantatstabilisierung erfolgen, indem die femurinternen Hebelkräfte, die durch Belastung des Hüftgelenkkopfes (1) und die Abstützung des Schenkelhalsimplantates (4) am Adamschen Bogen (17) entstehen, in den Trochanter major (18) als Druckkraft eingeleitet werden. The system-specific femoral bolts ( 12 ) preferably have self-tapping threads ( 15 ) at both ends, but can alternatively also only be equipped with a one-sided self-tapping thread ( 15 ) in order to ensure the position of the femoral bolts ( 12 ) postoperatively. Alternatively, the femoral bolts ( 12 ) can be provided on both sides or on one side instead of the self-tapping threads ( 15 ) with a macroporous implant surface ( 11 ) with or without interconnecting spaces for postoperative securing of position, the femoral bolts ( 12 ) in this case having an internal thread ( 8 ) are provided for instrument adaptation. The self-tapping threads ( 15 ) of the femoral bolts ( 12 ) or the alternative areas with a macroporous implant surface ( 11 ) can be cylindrical or conical. The femur bolts ( 12 ) have a zone in their central area, which is preferably designed as a centering bolt region ( 13 ) with a clearance fit or alternatively with a transition fit or press fit to the elongated holes ( 5 ) in the femoral neck implant ( 4 ). The femoral bolts ( 12 ) in unity with the femoral neck implant ( 4 ) are designed in such a way that they are mainly loaded on bending. By placing a possible end face ( 14 ) on the femoral bolt ( 12 ), which preferably leads through the greater trochanter ( 18 ) to the Adam's arch ( 17 ), on the elongated hole edge ( 6 ) or the elongated hole edges ( 6 ) in the femoral neck implant ( 4 ) an additional, expanded implant stabilization can be carried out by introducing the internal leverage forces, which result from the load on the hip joint head ( 1 ) and the support of the femoral neck implant ( 4 ) on the Adam's arch ( 17 ), into the greater trochanter ( 18 ) as a compressive force ,

Zur verbesserten Integration bzw. Gewebefixation der Femurbolzen (12) können die Femurbolzen (12) mit selbstschneidenden Gewinden (15) eine zementlose Oberfläche im Gewindebereich, die vorzugsweise aus einer Hydroxylapatit-Beschichtung besteht, aufweisen. Die Femurbolzen (12) bestehen vorzugsweise aus einer metallischen Implantatlegierung wie Kobalt-Chrom-Molybdän-Legierung, Titan-Legierung oder Implantatstahl-Legierung. Die Auswahl bzw. Festlegung zum Material ist von dem verwendeten Endoprothesenwerkstoff des Schenkelhalsimplantates (4) abhängig. For improved integration or tissue fixation of the femur bolts ( 12 ), the femur bolts ( 12 ) with self-tapping threads ( 15 ) can have a cementless surface in the thread area, which preferably consists of a hydroxyapatite coating. The femur bolts ( 12 ) preferably consist of a metallic implant alloy such as cobalt-chromium-molybdenum alloy, titanium alloy or implant steel alloy. The selection or determination of the material depends on the endoprosthesis material used for the femoral neck implant ( 4 ).

Der Hüftgelenkkopf (1) mit einer sphärisch-konvexen Gelenkfläche (2) korrespondiert mit der sphärisch-konkaven Gelenkfläche einer ebenfalls implantierten Hüftgelenkpfanne mit oder ohne im Inlay oder der anatomischen Hüftgelenkpfanne und ist über seinen internen oder externen Hüftgelenkkopfkonus (3) an das Schenkelhalsimplantat (4) direkt oder über einen optionalen Konusadapter mit Doppelkonus gekoppelt. Der Hüftgelenkkopf (1) besteht aus einem keramischen Werkstoff oder aus einer metallischen Implantatlegierung. The hip joint head (1) having a spherically convex joint surface (2) corresponds to the spherically concave joint surface of a likewise implanted acetabular cup, with or without the inlay or the anatomical acetabular cup and is connected via its internal or external femoral head cone (3) to the femoral neck implant (4 ) coupled directly or via an optional cone adapter with double cone. The hip joint head ( 1 ) consists of a ceramic material or a metallic implant alloy.

Zur Unterstützung des Operateurs liegt ein entsprechendes, systemspezifisches Operations- Instrumentarium vor, mit dem die Resektionen, Bohrungen und Fräsungen mit Hilfe der entsprechenden Lehren präzise durchgeführt werden können. Des weiteren beinhaltet das Instrumentenset die für Implantationen üblichen Bohrer, Probeimplantate, Fixateure etc.. A corresponding, system-specific operation Instrumentarium with which the resections, drilling and milling with the help of corresponding teachings can be carried out precisely. This also includes Instrument set for the usual drills, trial implants, fixators etc.

Die Einzelheiten der vorliegenden dynamischen Schenkelhals-Endoprothese für das Hüftgelenk gemäß der obrigen Beschreibung und den in den Patentansprüchen formulierten Neuerungen sind in den beigefügten Zeichnungen dargestellt: The details of the present dynamic femoral neck endoprosthesis for the Hip joint according to the above description and those formulated in the patent claims Innovations are shown in the attached drawings:

Fig. 1 Dynamische Schenkelhals-Endoprothese in implantierter Montagedarstellung im proximalen Femur (16, 17, 18, 19, 20, 21, 22) bestehend einem konischen Schenkelhalsimplantat (4) mit zwei zentralen, um 90° zueinander verdrehten Langlöchern (5) mit Langlochrand (6) für die Aufnahme der Femurbolzen (12), integriertem, externem Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenadaption, stumpf ausgeprägtem, lateralem Schenkelhalsprothesenende (9), Bohrung (10) zur Instrumentenausrichtung, einer makroporösen Implantatoberfläche (11) auf Basis interkonnektierender Räume sowie zwei Femurbolzen (12) mit Zentrierbolzenbereich (13), Stirnfläche (14) an dem Femurbolzen, zylindrischen, selbstschneidenden Gewinden (15) und einem Hüftgelenkkopf (1) zur Korrespondenz mit einem Hüftgelenkpfannen- Implantat mit konvexer Gelenkfäche (2) und internem Hüftgelenkkopfkonus (3), Vorderansicht im Längsschnitt Fig. 1 Dynamic femoral neck endoprosthesis in an implanted assembly view in the proximal femur ( 16 , 17 , 18 , 19 , 20 , 21 , 22 ) consisting of a conical femoral neck implant ( 4 ) with two central, elongated holes ( 5 ) rotated by 90 ° to each other with a slot edge ( 6 ) for receiving the femoral bolts ( 12 ), integrated, external femoral neck implant cone ( 7 ), internal thread ( 8 ) for instrument adaptation, bluntly pronounced, lateral femoral neck prosthesis end ( 9 ), hole ( 10 ) for instrument alignment, a macroporous implant surface ( 11 ) Basis of interconnecting spaces as well as two femoral bolts ( 12 ) with centering bolt area ( 13 ), end face ( 14 ) on the femoral bolt, cylindrical, self-tapping threads ( 15 ) and a hip joint head ( 1 ) for correspondence with an acetabular implant with a convex joint surface ( 2 ) and internal hip cone ( 3 ), front view in longitudinal section

Fig. 2 Dynamische Schenkelhals-Endoprothese in implantierter Montagedarstellung im proximalen Femur (16, 17, 18, 19, 20, 21, 22) bestehend einem konischen Schenkelhalsimplantat (4) mit zwei zentralen, um 90° zueinander verdrehten Langlöchern (5) für die Aufnahme der Femurbolzen (12), integriertem, externem Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixation, verrundetem, lateralem Schenkelhalsprothesenende (9), zwei Bohrungen (10) zur Instrumentenausrichtung, einer makroporösen Implantatoberfläche (11) auf Basis interkonnektierender Räume sowie zwei Femurbolzen (12) mit Zentrierbolzenbereich (13) Innengewinde (8) und einem konischen Bereich mit makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume sowie einem Hüftgelenkkopf (1) als Großkopfimplantat zur Korrespondenz mit der anatomischen Hüftgelenkpfanne mit konvexer Gelenkfäche (2) und internem Hüftgelenkkopfkonus (3), Vorderansicht im Längsschnitt Fig. 2 Dynamic femoral neck endoprosthesis in an implanted assembly view in the proximal femur ( 16 , 17 , 18 , 19 , 20 , 21 , 22 ) consisting of a conical femoral neck implant ( 4 ) with two central, by 90 ° to each other elongated holes ( 5 ) for The femoral bolts ( 12 ), integrated, external femoral neck implant cone ( 7 ), internal thread ( 8 ) for instrument fixation, rounded, lateral femoral neck prosthesis end ( 9 ), two holes ( 10 ) for instrument alignment, a macroporous implant surface ( 11 ) based on interconnecting spaces and two Femur pin ( 12 ) with centering pin area ( 13 ) internal thread ( 8 ) and a conical area with a macroporous implant surface ( 11 ) based on interconnecting spaces as well as a hip joint head ( 1 ) as a large head implant for correspondence with the anatomical acetabular cup with convex joint surface ( 2 ) and internal hip joint head cone ( 3 ), front view in length sschnitt

Fig. 3 Femorales Schenkelhalsimplantat (4) mit kreisrundem Querschnitt, zwei zentralen um 90° zueinander verdrehten Langlöchern (5) zur Aufnahme der Femurbolzen von denen ein Langloch (5) einen Langlochrand (6) zur erweiterten Kraftübertragung auf den Femurbolzen aufweist, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, lateralem Schenkelhalsimplantatende (9) in abgeschrägter Form, Bohrung zur Instrumentenausrichtung (10) und einer makroporösen Implantatoberfläche (11) auf Basis interkonnektierender Räume, Vorderansicht im Längsschnitt Fig. 3 Femoral femoral neck implant ( 4 ) with a circular cross-section, two central elongated holes ( 5 ) rotated by 90 ° with respect to one another for receiving the femoral bolts, of which one elongated hole ( 5 ) has an elongated hole edge ( 6 ) for extended power transmission to the femoral bolt, femoral neck implant cone ( 7 ), Internal thread ( 8 ) for instrument fixation, lateral femoral neck implant end ( 9 ) in beveled shape, hole for instrument alignment ( 10 ) and a macroporous implant surface ( 11 ) based on interconnecting spaces, front view in longitudinal section

Fig. 4 Femorales Schenkelhalsimplantat (4) mit kreisrundem Querschnitt, zwei zentralen um 90° zueinander verdrehten Langlöchern (5) zur Aufnahme der Femurbolzen von denen ein Langloch (5) einen Langlochrand (6) zur erweiterten Kraftübertragung auf den Femurbolzen aufweist, Schenkelhalsimplantatkonus (7), lateralem Schenkelhalsimplantatende (9) in abgeschrägter Form, Bohrung zur Instrumentenausrichtung (10) und einer makroporösen Implantatoberfläche (11) auf Basis interkonnektierender Räume, Seitensicht der Fig. 3 Fig. 4 Femoral femoral neck implant ( 4 ) with a circular cross-section, two central elongated holes ( 5 ) rotated by 90 ° to one another for receiving the femoral bolts, of which one elongated hole ( 5 ) has an elongated hole edge ( 6 ) for extended power transmission to the femoral bolt, femoral neck implant cone ( 7 ), lateral femoral neck implant end ( 9 ) in a beveled shape, drill hole for instrument alignment ( 10 ) and a macroporous implant surface ( 11 ) based on interconnecting spaces, side view of FIG. 3

Fig. 5 Femorales Schenkelhalsimplantat (4) mit kreisrundem Querschnitt, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, Bohrung zur Instrumentenausrichtung (10) und einer makroporösen Implantatoberfläche (11) auf Basis interkonnektierender Räume, Draufsicht der Fig. 3 Fig. 5 Femoral femoral neck implant ( 4 ) with a circular cross-section, femoral neck implant cone ( 7 ), internal thread ( 8 ) for instrument fixation, drilling for instrument alignment ( 10 ) and a macroporous implant surface ( 11 ) based on interconnecting spaces, top view of Fig. 3

Fig. 6 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, zwei zentralen um 90° zueinander verdrehten Langlöchern (5) zur Aufnahme der Femurbolzen von denen ein Langloch (5) einen Langlochrand (6) zur erweiterten Kraftübertragung auf den Femurbolzen aufweist, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, lateralem Schenkelhalsimplantatende (9) in stumpf ausgeprägter Form, zwei Bohrungen (10) zur Instrumentenausrichtung und einer makroporösen Implantatoberfläche (11) auf Basis von Kerbungen der Implantatoberfläche, Vorderansicht im Längsschnitt Fig. 6 Femoral femoral neck implant ( 4 ) with a partially circular cross-section and two parallel surfaces, two central elongated holes ( 5 ) rotated by 90 ° to each other for receiving the femoral bolt, of which an elongated hole ( 5 ) an elongated hole edge ( 6 ) for extended power transmission to the femoral bolt has, femoral neck implant cone ( 7 ), internal thread ( 8 ) for instrument fixation, lateral femoral neck implant end ( 9 ) in a blunt shape, two holes ( 10 ) for instrument alignment and a macroporous implant surface ( 11 ) based on notches in the implant surface, front view in longitudinal section

Fig. 7 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, zwei zentralen um 90° zueinander verdrehten Langlöchern (5) zur Aufnahme der Femurbolzen von denen ein Langloch (5) einen Langlochrand (6) zur erweiterten Kraftübertragung auf den Femurbolzen aufweist, Schenkelhalsimplantatkonus (7), lateralem Schenkelhalsimplantatende (9) in stumpf ausgeprägter Form und einer makroporösen Implantatoberfläche (11) auf Basis von Kerbungen der Implantatoberfläche, Seitensicht der Fig. 6 Fig. 7 Femoral femoral neck implant ( 4 ) with a partially circular cross-section and two parallel surfaces, two central elongated holes ( 5 ) rotated by 90 ° to each other for receiving the femoral bolt, of which an elongated hole ( 5 ) an elongated hole edge ( 6 ) for extended power transmission to the femoral bolt , femoral neck implant cone ( 7 ), lateral femoral neck implant end ( 9 ) in a blunt shape and a macroporous implant surface ( 11 ) based on notches in the implant surface, side view of FIG. 6

Fig. 8 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, zwei Bohrungen (10) zur Instrumentenausrichtung, Draufsicht der Fig. 6 Fig. 8 A femoral neck implant (4) with a partially circular cross-section and two parallel surfaces, femoral neck implant cone (7), inner thread (8) for tool fixing, two holes (10) for instrument alignment, top view of FIG. 6

Fig. 9 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, dezentralen um 90° zueinander verdrehten und parallelen, seitlich geöffneten Langlöchern (5) zur Aufnahme der Femurbolzen, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, lateralem Schenkelhalsimplantatende (9) in verrundeter Form, Bohrung zur Instrumentenausrichtung (10) und einer makroporösen Implantatoberfläche (11) auf Basis von Kerbungen der Implantatoberfläche, Vorderansicht im Längsschnitt Fig. 9 Femoral femoral neck implant ( 4 ) with a partially circular cross-section and two parallel surfaces, decentralized elongated holes ( 5 ) rotated by 90 ° to each other and parallel, laterally open elongated holes ( 5 ) for receiving the femoral bolts, femoral neck implant cone ( 7 ), internal thread ( 8 ) for instrument fixation, lateral Femoral neck implant end ( 9 ) in rounded shape, hole for instrument alignment ( 10 ) and a macroporous implant surface ( 11 ) based on notches in the implant surface, front view in longitudinal section

Fig. 10 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, dezentralen um 90° zueinander verdrehten und parallelen, seitlich geöffneten Langlöchern (5) zur Aufnahme der Femurbolzen von denen zwei Langlöcher (5) einen Langlochrand (6) zur erweiterten Kraftübertragung auf die Femurbolzen aufweisen, Schenkelhalsimplantatkonus (7), lateralem Schenkelhalsimplantatende (9) in verrundeter Form und einer makroporösen Implantatoberfläche (11) auf Basis von Kerbungen der Implantatoberfläche, Seitensicht der Fig. 9 Fig. 10 Femoral femoral neck implant ( 4 ) with a partially circular cross-section and two parallel surfaces, decentralized elongated holes ( 5 ) rotated by 90 ° to each other and parallel, laterally open elongated holes ( 5 ) for receiving the femoral bolts, of which two elongated holes ( 5 ) extend an elongated hole edge ( 6 ) Have transmission of force to the femoral bolts, femoral neck implant cone ( 7 ), lateral femoral neck implant end ( 9 ) in a rounded shape and a macroporous implant surface ( 11 ) based on notches in the implant surface, side view of FIG. 9

Fig. 11 Femorales Schenkelhalsimplantat (4) mit teilweise kreisrundem Querschnitt und zwei parallelen Flächen, Schenkelhalsimplantatkonus (7), Innengewinde (8) zur Instrumentenfixierung, Bohrung zur Instrumentenausrichtung (10), Draufsicht der Fig. 9 Fig. 11 A femoral neck implant (4) with a partially circular cross-section and two parallel surfaces, femoral neck implant cone (7), inner thread (8) for instrument fixation bore for instrument alignment (10), top view of FIG. 9

Fig. 12 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen und beidendigen, selbstschneidenden, zylindrischen Gewinden (15), Vorderansicht im Teilschnitt Fig. 12 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt and both ends, self-tapping, cylindrical threads ( 15 ), front view in partial section

Fig. 13 Femurbolzen (12) mit selbstschneidendem Gewinde (15), Draufsicht der Fig. 12 Fig. 13 Femurbolzen (12) with self-tapping thread (15), top view of FIG. 12

Fig. 14 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen und einseitigem, selbstschneidendem, zylindrischem Gewinde (15), Vorderansicht im Teilschnitt Fig. 14 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt and one-sided, self-tapping, cylindrical thread ( 15 ), front view in partial section

Fig. 15 Femurbolzen (12), Draufsicht der Fig. 14 Fig. Femurbolzen 15 (12), top view of FIG. 14

Fig. 16 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen, Stirnfläche (14) an dem Femurbolzen zur Krafteinleitung aus dem Schenkelhalsimplantat und beidendigen, selbstschneidenden, zylindrischen Gewinden (15), Vorderansicht im Teilschnitt Fig. 16 femur pin ( 12 ) with centering pin area ( 13 ) on the femur pin, end face ( 14 ) on the femur pin for applying force from the femoral neck implant and both ends, self-tapping, cylindrical threads ( 15 ), front view in partial section

Fig. 17 Femurbolzen (12) mit selbstschneidendem Gewinde (15), Draufsicht der Fig. 16 Fig. 17 Femurbolzen (12) with self-tapping thread (15), top view of FIG. 16

Fig. 18 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen und beidendigen, selbstschneidenden, zylindrischen und konischen Gewinden (15), Vorderansicht im Teilschnitt Fig. 18 femur pin ( 12 ) with centering pin area ( 13 ) on the femur pin and both ends, self-tapping, cylindrical and conical threads ( 15 ), front view in partial section

Fig. 19 Femurbolzen (12) mit selbstschneidendem Gewinde (15), Draufsicht der Fig. 18 FIG. 19 femur bolt ( 12 ) with self-tapping thread ( 15 ), top view of FIG. 18

Fig. 20 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen und einseitigem, selbstschneidendem, zylindrischem Gewinde (15), Vorderansicht im Teilschnitt Fig. 20 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt and one-sided, self-tapping, cylindrical thread ( 15 ), front view in partial section

Fig. 21 Femurbolzen (12) mit selbstschneidendem Gewinde (15), Draufsicht der Fig. 20 Fig. 21 Femurbolzen (12) with self-tapping thread (15), top view of FIG. 20

Fig. 22 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen, Innengewinde (8) zur Instrumentenadaption und beidendiger, zylindrischer, makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume, Vorderansicht im Längsschnitt Fig. 22 Femur pin ( 12 ) with centering pin area ( 13 ) on the femur pin, internal thread ( 8 ) for instrument adaptation and both ends, cylindrical, macroporous implant surface ( 11 ) based on interconnecting spaces, front view in longitudinal section

Fig. 23 Femurbolzen (12) mit Innengewinde (8) zur Instrumentenadaption und makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume, Draufsicht der Fig. 22 Fig. 23 Femurbolzen (12) with internal thread (8) for adaptation instrument and macroporous implant surface (11) on the basis interkonnektierender rooms, plan view of the Fig. 22

Fig. 24 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen, Innengewinde (8) zur Instrumentenadaption und einseitiger, zylindrischer, makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume, Vorderansicht im Längsschnitt Fig. 24 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt, internal thread ( 8 ) for instrument adaptation and one-sided, cylindrical, macroporous implant surface ( 11 ) based on interconnecting spaces, front view in longitudinal section

Fig. 25 Femurbolzen (12) mit Innengewinde (8) zur Instrumentenadaption, Draufsicht der Fig. 24 Fig. 25 Femurbolzen (12) with internal thread (8) for adaptation instrument, plan view of the Fig. 24

Fig. 26 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen, Innengewinde (8) zur Instrumentenadaption und einseitiger, konischer, makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume, Vorderansicht im Längsschnitt Fig. 26 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt, internal thread ( 8 ) for instrument adaptation and one-sided, conical, macroporous implant surface ( 11 ) based on interconnecting spaces, front view in longitudinal section

Fig. 27 Femurbolzen (12) mit Zentrierbolzenbereich (13) an dem Femurbolzen, Innengewinde (8) zur Instrumentenadaption und beidseitiger, zylindrischer und konischer, makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume Vorderansicht im Längsschnitt Fig. 27 Femur bolt ( 12 ) with centering pin area ( 13 ) on the femur bolt, internal thread ( 8 ) for instrument adaptation and bilateral, cylindrical and conical, macroporous implant surface ( 11 ) based on interconnecting spaces, front view in longitudinal section

Fig. 28 Femurbolzen (12) mit Innengewinde (8) zur Instrumentenadaption und makroporöser Implantatoberfläche (11) auf Basis interkonnektierender Räume, Draufsicht der Fig. 26 und 27 Bezeichnungsliste zu den Darstellungen der Fig. 1 bis 28 1 Hüftgelenkkopf
2 Konvexe Gelenkfläche am Hüftgelenkkopf
3 Hüftgelenkkopfkonus (intern/extern)
4 Schenkelhalsimplantat
5 Langlöcher im Schenkelhalsimplantat (zentral oder dezentral zur Implantatachse)
6 Langlochrand am Schenkelhalsimplantat zur Kraftübertragung auf den Femurbolzen
7 Schenkelhalsimplantatkonus (intern/extern)
8 Innengewinde für Instrumentenfixierung
9 Laterales Ende des Schenkelhalsimplantates
10 Bohrung für Instrumentenausrichtung im Schenkelhalsimplantat
11 Makroporöse Implantatoberfläche mit oder ohne interkonnektierenden Räumen
12 Femurbolzen
13 Zentrierbolzenbereich an dem Femurbolzen
14 Stirnfläche am Femurbolzen zur Abstützung des Schenkelhalsimplantates
15 Selbstschneidendes Gewinde am Femurbolzen
16 Schenkelhals
17 Adamscher Bogen
18 Trochanter major
19 Kortikalis
20 Spongiosa
21 Pressfittbereich
22 Markhöhle
 Fig. 28 Femurbolzen (12) with internal thread (8) to the instrument adaptation and macroporous implant surface (11) interkonnektierender based rooms, plan view of FIG. 26 and 27 name list to the representations of FIGS. 1 to 28 1 femoral head
2 Convex joint surface on the femoral head
3 femoral head cone (internal / external)
4 femoral neck implant
5 elongated holes in the femoral neck implant (central or decentral to the implant axis)
6 Slotted edge on the femoral neck implant for power transmission to the femoral bolt
7 femoral neck implant cone (internal / external)
8 internal threads for instrument fixation
9 Lateral end of the femoral neck implant
10 Bore for instrument alignment in the femoral neck implant
11 Macroporous implant surface with or without interconnecting spaces
12 femoral bolts
13 Centering pin area on the femur pin
14 end face on the femoral bolt to support the femoral neck implant
15 Self-tapping thread on the femoral bolt
16 femoral neck
17 Adam's bow
18 greater trochanter
19 cortex
20 Cancellous Cancer
21 press fit area
22 marrow cave

Claims (14)

1. Die vorzugsweise zementlos implantierbare, dynamische Schenkelhals-Endoprothese für den alloplastischen Ersatz des femoralen Hüftgelenkes mit einer anatomisch-technischen Geometrie ist dadurch gekennzeichnet, dass die Schenkelhals-Endoprothese aus mehreren, intraoperativ zu koppelnden Femurimplantatelementen, dem Schenkelhalsimplantat (4), den Femurbolzen (12) und einem Hüftgelenkkopf (1), der vorzugsweise direkt auf einem externen Schenkelhalsimplantatkonus (7) an dem Schenkelhalsimplantat (4) als korrespondierendes Gelenkflächenelement (2) zu einer implantierten Hüftgelenkpfanne oder der anatomischen Hüftgelenkpfanne adaptiert werden kann, besteht, von denen sich das Schenkelhalsimplantat (4) und die Femurbolzen (12) gegenseitig geometrisch mittels vorzugsweise zweier oder mehrerer vorzugsweise um 90° zueinander verdreht positionierten oder parallelen, zur Implantatachse zentral oder auch dezentral liegenden, seitlich geschlossenen oder geöffneten Langlöchern (5) im Schenkelhalsimplantat (4) durchdringen und eine dynamische Implantatstabilisation des Schenkelhalsimplantates (4) im proximalen Femur bewirken, indem das Schenkelhalsimplantat (4) aufgrund der intraoperativ lateral in die Langlöcher (5) eingebrachten Femurbolzen (12), die im gegenseitigen geometrischen Durchdringungsbereich von Langloch (5) und Zentrierbolzenbereich (13) vorzugsweise eine Spielpassung oder alternativ eine Übergangspassung oder Presspassung aufweisen, eine postoperative Bewegungsmöglichkeit bei einer Implantateinsinterung nach lateral/caudal aufweist, jedoch in proximaler/distaler und dorsaler/ventraler Richtung als auch hinsichtlich einer Rotation durch die Femurbolzen (12) fixiert wird. 1. The preferably cementless implantable, dynamic femoral neck endoprosthesis for the alloplastic replacement of the femoral hip joint with an anatomical-technical geometry is characterized in that the femoral neck endoprosthesis consists of several femoral implant elements to be coupled intraoperatively, the femoral neck implant ( 4 ), the femoral bolt ( 12 ) and a hip joint head ( 1 ), which can preferably be adapted directly on an external femoral neck implant cone ( 7 ) on the femoral neck implant ( 4 ) as a corresponding articular surface element ( 2 ) to an implanted acetabular cup or the anatomical acetabular cup, of which the femoral neck implant ( 4 ) and the femur bolts ( 12 ) mutually geometrically by means of preferably two or more Langlöc positioned or parallel to one another, preferably rotated by 90 ° relative to one another, centrally or also decentrally located to the implant axis Hern (5) penetrate the femoral neck implant (4) and a dynamic implant stabilization of the femoral neck implant (4) in the proximal femur cause by the femoral neck implant (4) due to the intraoperative laterally introduced into the elongated holes (5) Femurbolzen (12), the geometrical mutual The penetration area of the elongated hole ( 5 ) and the centering pin area ( 13 ) preferably have a clearance fit or alternatively a transition fit or press fit, has a postoperative movement possibility in the case of implant sintering laterally / caudally, but in the proximal / distal and dorsal / ventral direction as well as with respect to rotation the femur bolt ( 12 ) is fixed. 2. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass durch die femurinterne, intraoperativ vorzunehmende Verbindung von Schenkelhalsimplantat (4) und Femurbolzen (12), auf Basis der gegenseitigen geometrischen Durchdringung mittels der Langlöcher (5) im Schenkelhalsimplantat (4), vorzugsweise eine Kraftübertragung von Biegebelastungen von dem Schenkelhalsimplantat (4) auf die Femurbolzen (12) und von den Femurbolzen (12) in den Schenkelhals (16), den Trochanter major (18), die Femurkortikalis (19) und in die die Femurbolzen (12) umgebenden Spongiosa (20) erfolgen kann, wodurch die dynamische Implantatstabilisierung und die Rotationsstabilität bei gleichzeitiger Option einer Implantateinsinterung bzw. einem postoperativen Setzten des Implantates ermöglicht wird. 2. The dynamic total femoral neck endoprosthesis is characterized in that the internal femur, intraoperative connection of femoral neck implant ( 4 ) and femoral bolt ( 12 ), based on the mutual geometric penetration by means of the elongated holes ( 5 ) in the femoral neck implant ( 4 ) , preferably a force transmission of bending loads from the femoral neck implant ( 4 ) to the femoral bolts ( 12 ) and from the femoral bolts ( 12 ) into the femoral neck ( 16 ), the greater trochanter ( 18 ), the femoral cortex ( 19 ) and into which the femoral bolt ( 12 ) surrounding cancellous bone ( 20 ) can take place, which enables dynamic implant stabilization and rotational stability with simultaneous option of implant sintering or postoperative placement of the implant. 3. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass durch die femurinterne, intraoperativ vorzunehmende Verbindung vom Schenkelhalsimplantat (4) und dem Femurbolzen (12) der vorzugsweise durch den Trochanter major (18) eingeführt wird, eine Druckkrafteinleitung von dem Langlochrand (6) des entsprechenden Langloches (5) im Schenkelhalsimplantat (4) auf die Stirnfläche (14) des Femurbolzens und von dem Femurbolzen (12) in den Trochanter major (18) bzw. in die den Femurbolzen (12) umgebenden Spongiosa (20) erfolgen kann, wodurch eine erweiterte, dynamische Implantatstabilisierung ermöglicht wird. 3. The dynamic femoral neck total endoprosthesis is characterized in that the internal femur, intraoperative connection of the femoral neck implant ( 4 ) and the femoral bolt ( 12 ), which is preferably inserted through the greater trochanter ( 18 ), introduces compressive force from the edge of the elongated hole ( 6 ) of the corresponding elongated hole ( 5 ) in the femoral neck implant ( 4 ) onto the end face ( 14 ) of the femoral bolt and from the femoral bolt ( 12 ) into the greater trochanter ( 18 ) or into the cancellous bone ( 20 ) surrounding the femoral bolt ( 12 ) can take place, which enables an expanded, dynamic implant stabilization. 4. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das vorzugsweise konische Schenkelhalsimplantat (4) vorzugsweise einen kreisrunden Querschnitt (Fig. 3-5) aufweist, alternativ aber auch einen kreisrunden Querschnitt mit zwei seitlichen, vorzugsweise parallelen Flächen (Fig. 7, 8, 10, 11) oder einen vieleckigen, eiovalen, elliptischen oder einen anatomische ovalären Querschnitt aufweisen kann. 4. The dynamic femoral neck total endoprosthesis is characterized in that the preferably conical femoral neck implant ( 4 ) preferably has a circular cross-section ( Fig. 3-5), but alternatively also a circular cross-section with two lateral, preferably parallel surfaces ( Fig . 7, 8, 10, 11) or a polygonal, eio-oval, elliptical or an anatomical oval cross-section. 5. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das Schenkelhalsimplantat (4) in der lateralen-medialen Richtung vorzugsweise konisch gestaltet ist, alternativ aber auch aus mehreren miteinander verbundenen, zylindrischen Elementen mit jeweils verringertem Durchmesser bestehen kann, die in ihrer Kombination einen "Stufenkonus" darstellen. 5. The dynamic femoral neck total endoprosthesis is characterized in that the femoral neck implant ( 4 ) is preferably conical in the lateral-medial direction, but alternatively can also consist of several interconnected cylindrical elements, each with a reduced diameter, which in their combination represent a "step cone". 6. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das Schenkelhalsimplantat (4) zur zementlosen Implantation eine makroporöse Implantatoberfläche (11) mit oder ohne interkonnektierenden Räumen (Fig. 1-5) oder eine regelmäßige oder unregelmäßige Kerbung (11) der Implantatoberfläche (Fig. 6, 7, 9, 10) aufweisen kann, um eine Implantat-Primärfixation durch Preßfitt (21) im kortikalen und spongiösen Schenkelhalsgewebe bzw. im proximalen Femur zu realisieren. 6. The dynamic femoral neck total endoprosthesis is characterized according to claim 1, that the femoral neck implant ( 4 ) for cementless implantation, a macroporous implant surface ( 11 ) with or without interconnecting spaces ( Fig. 1-5) or a regular or irregular notch ( 11 ) of the implant surface (FIGS . 6, 7, 9, 10) in order to implement an implant primary fixation by means of a press fit ( 21 ) in the cortical and cancellous femoral neck tissue or in the proximal femur. 7. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass die makroporöse Oberfläche (11) mit interkonnektierenden Räumen an dem Schenkelhalsimplantat (4) veränderliche Raumtiefen bzw. Porengrößen aufweisen kann, um den äußeren Querschnitt des Schenkelhalsimplantates (4), das einen vorzugsweise kreisrunden Implantatkernquerschnitt aufweist, eckig, oval, eioval oder elliptisch zu gestalten. 7. The dynamic femoral neck total endoprosthesis is characterized in that the macroporous surface ( 11 ) with interconnecting spaces on the femoral neck implant ( 4 ) can have variable depths or pore sizes around the outer cross section of the femoral neck implant ( 4 ), the one preferably has a circular implant core cross section, angular, oval, eioval or elliptical. 8. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass die makroporöse Oberfläche (11) mit interkonnektierenden Räumen an dem Schenkelhalsimplantat (4) veränderliche Raumtiefen bzw. Porengrößen aufweisen kann, um einen von medial nach lateral zylindrischen Implantatkern konisch zu gestalten. 8. The dynamic femoral neck total endoprosthesis is characterized in that the macroporous surface ( 11 ) with interconnecting spaces on the femoral neck implant ( 4 ) can have variable depths or pore sizes in order to make a conical medial to lateral implant core. 9. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das laterale Ende (9) des Schenkelhalsimplantates (4) zur Anpassung an die interne Femurgeometrie stumpf ausgeprägt (Fig. 1, 6, 7), einseitig abgeschrägt (Fig. 3, 4), verrundet (Fig. 2, 9, 10), teilweise verrundet oder kegelförmig ausgeprägt sein kann. 9. The dynamic femoral neck total endoprosthesis is characterized according to claim 1, characterized in that the lateral end ( 9 ) of the femoral neck implant ( 4 ) is bluntly shaped to adapt to the internal femoral geometry ( Fig. 1, 6, 7), bevelled on one side ( Fig. 3rd , 4), rounded ( Fig. 2, 9, 10), partially rounded or conical. 10. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das Schenkelhalsimplantat (4) alternativ zu einem externen Schenkelhalsimplantatkonus (7) einen internen Schenkelhalsimplantatkonus (7) zur Adaption eines Hüftgelenkkopfes (1) mit einem externen Hüftgelenkkopfkonus (3) oder eines Konusadapters mit Doppelkonus zur Aufnahme des Hüftgelenkkopfes (1) mit internem Hüftgelenkkopfkonus (3) aufweisen kann. 10. The dynamic femoral neck total endoprosthesis is characterized in that the femoral neck implant ( 4 ) alternatively to an external femoral neck implant cone ( 7 ) an internal femoral neck implant cone ( 7 ) for adapting a femoral head ( 1 ) with an external femoral head cone ( 3 ) or one Cone adapter with double cone for receiving the femoral head ( 1 ) with an internal femoral head cone ( 3 ). 11. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass das Schenkelhalsimplantat (4) ein internes Innengewinde (8) für die Realisierung einer Instrumentenankopplung und eine oder alternativ zwei Bohrungen (10) zur Instrumentenausrichtung aufweisen kann. 11. The dynamic femoral neck total endoprosthesis according to claim 1, characterized in that the femoral neck implant ( 4 ) can have an internal internal thread ( 8 ) for realizing an instrument coupling and one or alternatively two bores ( 10 ) for instrument alignment. 12. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass die Femurbolzen (12) als Lagesicherungsapplikation vorzugsweise beidseitig, zumindest aber einseitig ein selbstschneidendes zylindrisches oder konisches Gewinde (15) oder alternativ eine zylindrisch oder konisch ausgeprägte makroporöse Implantatoberfläche (11) mit oder ohne interkonnektierenden Räumen aufweisen. 12. The dynamic femoral neck total endoprosthesis is characterized in that the femoral bolts ( 12 ) as a position securing application preferably on both sides, but at least on one side, a self-tapping cylindrical or conical thread ( 15 ) or alternatively a cylindrical or conical pronounced macroporous implant surface ( 11 ) or without interconnecting rooms. 13. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass ein Femurbolzen (12) eine Stirnfläche (14) zur Anlage auf dem Langlochrand (6) des Schenkelhalsimplantat (4) für die Druckkrafteinleitung aus dem Schenkelhalsimplantat (4) in den Femurbolzen (12) aufweisen kann. 13. The dynamic femoral neck total endoprosthesis is characterized according to claim 1, characterized in that a femoral bolt ( 12 ) has an end face ( 14 ) for abutment on the slot edge ( 6 ) of the femoral neck implant ( 4 ) for the introduction of pressure from the femoral neck implant ( 4 ) into the femoral bolt ( 12 ) can have. 14. Die dynamische Schenkelhals-Totalendoprothese ist nach Patentanspruch 1 dadurch gekennzeichnet, dass die Femurbolzen (12) im Bereich der Anlage in den Langlöchern (5) des Schenkelhalsimplantates (4) einen Abschnitt, der als Zentrierbolzenbereich (13) bezeichnet werden kann, aufweisen. 14. The dynamic femoral neck total endoprosthesis is characterized in that the femoral bolts ( 12 ) in the area of the system in the elongated holes ( 5 ) of the femoral neck implant ( 4 ) have a section that can be referred to as the centering pin area ( 13 ).
DE10223474A 2002-05-27 2002-05-27 Cementless implant of the endoprosthetic replacement of the neck of the femur involves femur implant and bolts fitting though holes Withdrawn DE10223474A1 (en)

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Cited By (6)

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Publication number Priority date Publication date Assignee Title
US8029573B2 (en) 2006-12-07 2011-10-04 Ihip Surgical, Llc Method and apparatus for total hip replacement
US8579985B2 (en) 2006-12-07 2013-11-12 Ihip Surgical, Llc Method and apparatus for hip replacement
US8974540B2 (en) 2006-12-07 2015-03-10 Ihip Surgical, Llc Method and apparatus for attachment in a modular hip replacement or fracture fixation device
CN105581833A (en) * 2015-12-28 2016-05-18 董耀武 Intramedullary fixed device and intramedullary nail
CN108578021A (en) * 2018-05-18 2018-09-28 苏州玄陶商务咨询有限公司 A kind of implanting instrument
CN113397766A (en) * 2021-06-17 2021-09-17 嘉思特华剑医疗器材(天津)有限公司 Bionic surface hip joint prosthesis with high long-term stability

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Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8029573B2 (en) 2006-12-07 2011-10-04 Ihip Surgical, Llc Method and apparatus for total hip replacement
US8211183B2 (en) 2006-12-07 2012-07-03 Ihip Surgical, Llc Methods and systems for total hip replacement
US8579985B2 (en) 2006-12-07 2013-11-12 Ihip Surgical, Llc Method and apparatus for hip replacement
US8795381B2 (en) 2006-12-07 2014-08-05 Ihip Surgical, Llc Methods and systems for hip replacement
US8974540B2 (en) 2006-12-07 2015-03-10 Ihip Surgical, Llc Method and apparatus for attachment in a modular hip replacement or fracture fixation device
US9237949B2 (en) 2006-12-07 2016-01-19 Ihip Surgical, Llc Method and apparatus for hip replacement
CN105581833A (en) * 2015-12-28 2016-05-18 董耀武 Intramedullary fixed device and intramedullary nail
CN108578021A (en) * 2018-05-18 2018-09-28 苏州玄陶商务咨询有限公司 A kind of implanting instrument
CN108578021B (en) * 2018-05-18 2024-03-15 苏州黑桃医疗科技有限公司 Implantation tool
CN113397766A (en) * 2021-06-17 2021-09-17 嘉思特华剑医疗器材(天津)有限公司 Bionic surface hip joint prosthesis with high long-term stability
CN113397766B (en) * 2021-06-17 2022-08-05 嘉思特华剑医疗器材(天津)有限公司 Bionic surface hip joint prosthesis with high long-term stability

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