U.S. patent number 3,648,294 [Application Number 05/008,647] was granted by the patent office on 1972-03-14 for endoprostheses, especially for hip joints.
Invention is credited to Esfandiar Shahrestani.
United States Patent |
3,648,294 |
Shahrestani |
March 14, 1972 |
ENDOPROSTHESES, ESPECIALLY FOR HIP JOINTS
Abstract
Disclosed are endoprostheses which include a piston forming a
joint head and mounted on a bone and a cylinder for receiving the
piston and mounted in the mating bone. The cylinder is divided into
two sections, the section for receiving the piston contains a
liquid, advantageously in bellows, which liquid is forced into the
other section of the cylinder to compress a gas, the compressed gas
therein thereby cushioning shocks. Flow of liquid between the
sections is controlled by back pressure valves.
Inventors: |
Shahrestani; Esfandiar
(Cologne, Sulz, DT) |
Family
ID: |
5724669 |
Appl.
No.: |
05/008,647 |
Filed: |
February 4, 1970 |
Foreign Application Priority Data
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Feb 8, 1969 [DT] |
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P 19 06 284.1 |
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Current U.S.
Class: |
623/23.42 |
Current CPC
Class: |
A61F
2/30742 (20130101); A61F 2/32 (20130101); A61F
2002/30563 (20130101); A61F 2002/30581 (20130101) |
Current International
Class: |
A61F
2/32 (20060101); A61F 2/30 (20060101); A61f
001/24 () |
Field of
Search: |
;3/1,1.2
;128/92R,92C,92CA |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
Having thus described my invention, I claim:
1. In endoprosthesis including an articial head joint adapted to be
fastened to a preselected bone and having first and second portions
axially movable relative to each other and a jointsocket receiving
said head, the improvement comprising: means for absorbing impact
disposed between said first and second portions, said impact
absorbing means comprising a piston including a piston rod
extending therefrom adapted to mount said piston to said
preselected bone; a cylinder having one portion defining a chamber
for closely receiving said piston and another portion forming a
dome; and, a partition separating said chamber and said dome from
each other, said partition including means transmitting a
cushioning liquid therethrough between said chamber and said dome
in response to axial movement of said piston within said
chamber.
2. In endoprosthesis described in claim 1, wherein said
transmitting means comprises intake and outlet channels in said
partition, said liquid filling at least said chamber such that
axial movement of said piston in said chamber toward said partition
forces said liquid into said dome through said intake channels,
said dome including means for forcing said liquid back into said
chamber through said outlet channels as said piston is moved
axially away from said partition in said chamber.
3. In endoprosthesis described in claim 2, said forcing means
comprising a closed and compressible bladder in the interior of
said dome which bladder is acted upon by the liquid entering said
dome.
4. In endoprosthesis described in claim 3, further including
back-pressure valves opening and closing said intake and outlet
channels in said partition.
5. In endoprosthesis described in claim 2, further including at
least one constantly open pressure-balance channel in said
partition interconnecting said chamber with said dome.
6. In endoprosthesis described in claim 4, wherein said valves are
elastic valve plates for closing said intake and outlet
channels.
7. In endoprosthesis described in claim 4, wherein said valves are
spring-loaded valve plates for closing said intake and outlet
channels.
8. In endoprosthesis described in claim 5, wherein the total cross
section of said intake channels is substantially larger than the
cross section of said pressure-balance channels.
9. In endoprosthesis described in claim 2, further including a
compressible pleated bag disposed in said chamber adjacent said
partition containing said liquid in said chamber, said piston
acting against said bag.
10. In endoprosthesis described in claim 9, further including a
plastic sealing cuff disposed adjacent the end of said cylinder
embracing said piston for enclosing and sealing said piston rod;
and, a ring plate surrounding said cuff adapted to clamp the free
edge of said cuff to the upper boundary of said preselected
bone.
11. In endoprosthesis described in claim 10, wherein said cylinder
is made of stainless steel and is coated with a wear-resistant
synthetic material which is connected with said cuff.
12. In endoprosthesis described in claim 11, said joint socket for
receiving said head is formed of a wear-resistant synthetic
material and is adapted to be fastened to a pelvic bone.
Description
The invention is concerned with an endoprosthesis, especially for
hip joints, consisting of an artificial joint head which is
fastened to the proper bone and fits into the joint socket.
Endoprostheses of this kind are already known which are inserted by
means of an operation in the case of fractures of the upper thigh
neck or injuries to the hip as a replacement for the destroyed
joint head or the joint ball, no longer able to grow together with
the femur, and which are connected with the upper thigh bone by
long pins. These known joint heads which are usually made of
corrosionproof metal transmit the jolts produced in the act of
walking directly to the joint socket.
If a partial prosthesis is involved, in the case of which the
natural joint socket is still preserved, the direct friction
between metal and bone leads in a relatively short time to the
destruction of the joint socket. Moreover, the continuous jolts and
frictional forces bring about a sensitization of the socket,
loosening of the prostheses in the shaft of the upper thigh, the
formation of excessive bone growth and eventually breaking through
of the socket into the pelvis.
In the case of complete prostheses in which also the joint socket
is lined with, or replaced by, a metal shell the jolts and the
compressive loads are introduced into the pelvic bone by way of the
artificial joint socket. By the continuous jolts in the act of
walking and running the joint socket is gradually loosened.
Friction leads to a sensitization of the pelvic bone and to a
progressive development of bone growth which cause pains,
increasing in intensity as time goes on, to the wearer of the
prostheses with each movement of the leg. The same process also
takes place in the shaft of the upper thigh. Although attempts were
made to overcome the foregoing difficulties and other
disadvantages, none, as far as I am aware, was entirely
satisfactory when practiced on a large scale.
It has now been discovered that these disadvantages can be avoided
and endoprostheses can be produced with which impacts in the joint
can be absorbed to a large extent and a sensitization of the joint
socket and the development of pain connected with it can either be
avoided or at least greatly reduced.
In accordance with the present invention, there is provided
endoprostheses, of the type described herebefore, including a joint
head which consists of two parts, movable against each other in an
axial direction, between which impact-absorbing spring elements are
arranged.
The direct transmission of jolts of the limbs over the joint head
upon the joint socket are avoided by this design, since the impact
energy is absorbed inside the joint head. Limbs provided with such
a prostheses display limited amounts of elasticity which makes
compression of the leg or the arm in an axial direction within
certain limits possible.
In accordance with a more limited aspect of the present invention,
one part of a joint head is formed by a piston which is firmly
connected with the bone and the other part by a cylinder, fitting
over the piston, which carries on its end away from the front
surface of the piston a dome the interior of which is separated
from the cavity of the cylinder by a partition. The cylinder is
filled with a liquid which can enter into the interior of the dome
through intake channels and return to the interior of the cylinder
through outlet channels in the partition.
In accordance with an even more limited aspect of the present
invention, there is included in endoprostheses of the type
described immediately hereinabove a closed elastic bladder
containing a compressible gas which bladder, placed within the
dome, is acted upon by the liquid entering the interior. If the
piston is pushed against the liquid, the liquid flows through the
intake channels into the interior of the dome, whereby the gas
contained in the elastic bladder is compressed until the forces are
balanced. The pressure transmission from the joint head to the
joint socket occurs therefore not fitfully but in a more uniform
manner than in the case of an artificial joint head which is
rigidly connected with the bone. When the load is then taken off
the limb provided with the prosthesis, the liquid which has forced
into the interior of the dome is pushed again into the interior of
the cylinder through the outlet channels by the pressure of the
expanding bladder, in which process piston, receding with the load
reduction, produces an underpressure in the cylinder which
facilitates the return flow of the liquid.
In accordance with another aspect of the present invention, the
intake channels and the outlet channels in the partition can be
closed by means of back pressure valves. Depending on the intensity
of the impact these back pressure valves open up a more or less
restricted cross section of passage. For closing the intake and
outlet channels elastic or spring-loaded valve plates are
appropriately provided. There is, in accordance with a further
aspect of the present invention, provided at least one constantly
open pressure-balance channel in the partition which connects the
interior of the cylinder with the interior of the dome. A complete
return flow of the liquid which has been forced into interior of
the dome is thereby achieved, even if the expansion of the elastic
bladder inside the dome does not provide sufficient pressure to
push the liquid back into the cylinder. Moreover, the
pressure-balance channel permits a gradual shifting of the piston
in the cylinder if the load on the limb provided with the
prosthesis is rather slowly applied, for instance, if the person is
standing and shifts the weight of his body from one leg to the
other.
In order to enable the piston in the case of severe jolts to shift
sufficiently and to press a large enough volume of the liquid into
the interior of the dome, the total cross section of passage of the
intake channels is substantially larger than the cross section of
passage of the pressure-balance channels. The displacement of the
piston in the case of only a slight load or small jolts can be
regulated by the initial stress in the springs of the valve
plates.
The liquid in the cylinder is advantageously contained in a
compressible pleated bag (bellows) which is acted upon by the
piston. This prevents the liquid necessary for the function of the
joint from leaking out of the joint in case of leaky piston rings.
For the same purpose, a sealing cuff of some elastic plastic
material is provided which is arranged on the end of the cylinder,
embracing the piston and enclosing as well as sealing, the piston
rod inserted into the bone, and which is clamped with its free edge
between the upper boundary of the bone and a doughnut-disk plate
fastened to it.
To prevent friction between the joint head and the joint socket,
the joint head, made of stainless steel, is covered by a cap of a
wear-resistant synthetic material which is connected with the
sealing cuff. The joint socket can be formed in a similar manner of
a wear-resistant synthetic material and fastened to the pelvic
bone.
It is a principal object of the present invention to provide
endoprostheses which minimize the pain associated with sudden jolts
encountered during use.
Another object of the present invention is to provide artificial
joints which minimize the discomfort associated with
sensitization.
Yet another object of the present invention is to provide
endoprostheses in which the effects of friction are minimized.
A still further object of the present invention is to provide
artificial joints which reduce the effects of shifting weight and
other gradual movements.
The invention may take physical form in certain elements and
arrangements of elements, a preferred embodiment which be described
in detail in this specification and illustrated in the accompanying
drawing which forms a part hereof and in which the Figure depicts
an artificial hip joint in vertical section.
Referring now to the drawing wherein the showings are for the
purpose of illustrating the preferred embodiment of the invention
only and not for the purpose of limiting same, the FIGURE shows an
artificial hip joint.
The artificial joint head 10 is constructed in two parts and
consists of a piston 11 of stainless steel whose piston rod 12 has
the shape of a pin with three lamellae and is inserted into the
bone 13 of the upper thigh and solidly cemented into it. The other
part of the joint head is the ball head 14 proper which consists of
a dome 15 of high-grade alloy steel to the base of which a cylinder
16 is joined in which the piston 11 is movably guided. The inside
17 of the cylinder is separated from the interior 18 of the dome 15
by a partition 19 which is provided with a number of intake
channels 20 and outlet channels 21 in an annular arrangement.
The intake channels 20 are closed in the interior 18 of the dome 15
by elastic valve plates 22 and the outlet channels 21 by elastic
valve plates 23. The valve plates 22 and 23 are ring-shaped and
slipped over a bolt 24. They are firmly clamped by spacer rings 25
which are held by nuts 26 screwed on to the bolts 24. The nuts 26
serve at the time as catch plates and limit the deflection of the
springy valve plates 22 and 23. In place of the spacer rings 25
coil springs or spring plates can also be used between the catch
plates and the valve plates 22 and 23.
Beside the intake and outlet channels 20 and 21 a few
pressure-balance channels 27 are also provided in the partition 19
which connect the interior 17 of the cylinder with the interior 18
of the dome and constantly open. However, their cross section of
passage is altogether substantially smaller than the cross section
of passage of the intake channels 20 and the outlet channels
21.
In the interior 17 of the cylinder is contained a liquid of
appropriate viscosity, for instance a mineral oil 28, which is
enclosed in a pleated bag 29 which is, however, open on its side
facing the partition 19 and which is acted upon by the piston 11.
Steel rings 36 inserted into the pleats of the bellows 29 prevent
jamming of the bellows 29 when the bag is compressed by the piston
11.
In the interior 18 of the dome 15 is arranged a completely closed
bladder 31 of a synthetic material or some other elastic material
resistant to aging which is filled with a compressible gas, such as
nitrous oxide (N.sub.2 O) and forms a closed and compressible gas
chamber which fills the inside 18 of the dome 15 almost
completely.
The piston 11 is sealed against the wall of the cylinder 17 by two
gaskets 32 of a self-lubricating synthetic material. It can also be
provided with a wear-resistant plastic coating.
The dome 15 and the cylinder 16 connected with it are covered by a
cap 33 of a wear-resistant synthetic material on whose lower end
embracing the rim of the cylinder 16 a sealing cuff 34 of an
elastic synthetic material is arranged which encloses and seals the
piston rod 12 embedded in the bone 13 and is clamped with its free
border between the upper boundary 35 of the bone and a ring plate
36 fastened to it. The ball head 14 joined together by the cap 33
fits into the joint socket 37 of the same wear-resistant synthetic
material of which the cap 33 is made. The joint socket 37 is
fastened to the pelvic bone (not shown in detail) by means of
appropriate fastening devices 38.
The mode of operation of the prostheses is as follows:
When the leg is weighted in the act of walking, the piston 11 is
displaced in the cylinder 16 in the direction towards the partition
19 and compresses the bellows 29. The liquid 28 enclosed in the
bellows is hereby pressed through the pressure-balance channels 27
into the interior 18 of the dome 15 and compresses there the gas
bladder 31.
With a heavier load and especially if it occurs as a shock, the
piston 11 exerts such a high pressure upon the liquid 28 that the
valve plate 22 is lifted from its seat and the liquid flows also
through the intake channels 20 into the interior 18 of the dome 15
and compresses the gas bladder 31, by which process the gas
enclosed in this bladder is compressed. The jolts are hereby
absorbed in the joint head 10 and not or only to a very slight
degree transmitted to the joint socket 37.
When the load is taken off the leg, the gas compressed in the
bladder 31 pushes the liquid which has penetrated into the interior
18 of the dome 15 through the outlet channels 21 and, with the gas
pressure subsiding, through the pressure-balance channels 27 back
into the membrane 29 in the interior 17 of the cylinder, whereby
the piston 11 is pushed back.
Polyurethanes or also polyethylenes of high molecular weight are
suitable as material for the cap 33 and the joint socket 37.
Although the present invention has been described in conjunction
with preferred embodiments, it is to be understood that
modifications and variations may be resorted to without departing
from the spirit and scope of the invention, as those skilled in the
art will readily understand. Such modifications and variations are
considered to be within the purview and scope of the invention and
appended claims.
* * * * *