Orthopaedic implant for arthroplasty of the fingers
View Patent ↗An orthopaedic implant used in arthroplasty of the fingers comprises a first element for a proximal phalanx and a second element for an adjacent distal phalanx, each element having a respective stem for implantation in the bone and an interphalangeal articulation head, the head of the first element having a biconvex surface of articulation, with a central valley, and the head of the second element having a biconcave surface of articulation designed to cooperate with said convex surface and comprising a central crest. At rest, the surfaces are congruent in the frontal plane of the articulation in the area of the condyles and non-congruent in the sagittal plane.
1. An orthopedic implant used in arthroplasty of the fingers, comprising a first element for implantation in a proximal phalanx and a second element for implantation in an adjacent distal phalanx, each element having a respective stem sized for implantation in the respective phalanx and an interphalangeal pivot head, a head of the first element having a biconvex condylar pivot surface including a central valley having a radius of curvature R 5 in the frontal plane, and a head of the second element having a biconcave condylar pivot surface designed to fit generally complementarily with the biconvex condylar pivot surface including a central ridge having a radius of curvature R 6 in the frontal plane,
wherein the biconcave and biconvex condylar pivot surfaces at rest are congruent in the frontal plane and are not congruent in the sagittal plane, and
wherein radii of curvature R 1 , R′ 1 of the biconvex condylar pivot surface of the first element are identical to respective radii of curvature R 2 , R′ 2 of the biconcave condylar pivot surface of the second element in the frontal plane, and
wherein the central valley of the biconvex condylar pivot surface and the central ridge of the biconcave condylar pivot surface define an intercondylar space along a length of the central valley, the intercondylar space having a volume between 15 mm 3 and 30 mm 3 .
2. The orthopedic implant according to claim 1 , wherein a radius of curvature of the biconvex condylar pivot surface of the first element is less than or equal to a radius of curvature of the biconcave condylar pivot surface of the second element in the sagittal plane.
3. The implant according to claim 1 , wherein the radii of curvature are such that R 1 =R′ 1 =R 2 =R′ 2 .
4. The implant according to claim 1 , wherein the surfaces and the material of the heads are designed to cooperate by friction along a line of friction in the frontal plane in the absence of longitudinal pressure and along a crush zone in the frontal plane in the event of longitudinal pressure.
5. The implant according to claim 4 , wherein the material of the biconvex condylar pivot surface of the head of the first element is a flexible polymer material having a modulus of elasticity E, wherein E≦30 GPa.
6. The implant according to claim 5 , wherein the material of the biconvex bicondylar pivot surface has a modulus of elasticity E, wherein E≦2 GPa.
7. The implant according to claim 1 , wherein facing surfaces of the heads of the two elements placed in contact define an intercondylar space of a volume greater than zero along the entire length of the central valley, allowing improved lubrication of the joint between the heads.
8. The implant according to claim 7 , wherein the radius of curvature R 5 of the central valley of the head of the first element is less than the radius of curvature R 6 of the central ridge of the second element.
9. The implant according to claim 1 , wherein each of the respective implantation stems has a shape of a polygonal post that is proportioned so as to be received inside the medullary cavity of the respective phalanx and is provided with a stop to prevent it from being excessively pushed in.
10. The implant according to claim 1 , wherein at least one of the respective implantation stems has a shape that is at least partially open in a dorsal-palmar plane.
11. The implant according to claim 10 , wherein at least one of the respective implantation stems has one of a U-shaped, an H-shaped, and a V-shaped cross-section.
12. The implant according to claim 10 , wherein at least one of the respective implantation stems has a recessed semicylindrical shape on the palmar side or a half-tube shape.
13. The implant according to claim 1 , wherein at least one of the respective implantation stems of the first and second elements includes a means for attachment to the respective head of the first and second elements such that the at least one respective implantation stem is removable relative to the respective head.
14. The implant according to claim 13 , wherein the attachment means are formed by a conical fitting of a post secured to the head into a recess formed in the at least one respective implantation stem.
15. The implant according to claim 14 , wherein the conical fitting has a Morse taper.
16. The implant according to claim 13 wherein the biconcave surface includes a base provided with an attachment post of predetermined thickness.
17. The implant according to claim 13 , wherein the attachment means includes a recess or a groove formed in one of a stem and a respective head able to receive a plate of complementary shape that is secured to the other of the stem and the respective head.
18. The implant according to claim 1 , wherein the biconvex condylar pivot surface and the respective biconcave condylar pivot surface have uniform radii of curvature in the frontal plane and variable radii of curvature in the sagittal plane.
19. A set of implants according to claim 13 , the set of implants including a plurality of heads and a plurality of stems, each head and each stem corresponding to one of the first and second elements,
wherein the plurality of heads includes heads of different sizes and the plurality of stems includes substantially identical or different stems, and
wherein the attachment means of each implant of the set of implants is substantially identical between each head of the plurality of heads and each stem of the plurality of stems corresponding to the first element and each head of the plurality of heads and each stem of the plurality of stems corresponding to the second element.
20. The implant according to claim 2 , wherein a radius of curvature of the biconvex condylar pivot surface of the first element is less than 1.2 times smaller than a radius of curvature of the biconcave condylar pivot surface of the second element in the sagittal plane.