(19)
(11)EP 3 457 992 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
06.09.2023 Bulletin 2023/36

(21)Application number: 17734455.3

(22)Date of filing:  10.05.2017
(51)International Patent Classification (IPC): 
A61F 2/38(2006.01)
(52)Cooperative Patent Classification (CPC):
A61F 2/3836; A61F 2230/0006
(86)International application number:
PCT/IB2017/052719
(87)International publication number:
WO 2017/199131 (23.11.2017 Gazette  2017/47)

(54)

CONSTRAINED SPACER DEVICE FOR THE KNEE

EINGESCHRÄNKTE ABSTANDSHALTERVORRICHTUNG FÜR DAS KNIE

DISPOSITIF D'ESPACEMENT CONTRAINT POUR LE GENOU


(84)Designated Contracting States:
AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

(30)Priority: 16.05.2016 IT UA20163486

(43)Date of publication of application:
27.03.2019 Bulletin 2019/13

(73)Proprietor: Tecres S.P.A.
37066 Sommacampagna (VR) (IT)

(72)Inventors:
  • FACCIOLI, Giovanni
    37066 Sommacampagna (Verona) (IT)
  • SOFFIATTI, Renzo
    37066 Sommacampagna (Verona) (IT)

(74)Representative: Feltrinelli, Secondo Andrea 
APTA S.r.l. Patent Department Via Ca' di Cozzi, 41
37124 Verona
37124 Verona (IT)


(56)References cited: : 
DE-A1-102014 204 326
US-A- 4 224 697
US-A- 5 282 867
US-A- 4 216 549
US-A- 5 123 928
  
      
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description

    TECHNICAL FIELD OF THE INVENTION.



    [0001] The present invention refers to a constrained spacer device adapted to be implanted at a knee j oi nt.

    STATE OF THE PRIOR ART



    [0002] As is known, joint prostheses, after having been implanted in the human body, can be removed, for example due to an infection that arose at the implant site.

    [0003] In order to treat the infection, it is possible to temporarily substitute the infected prosthesis with a spacer device provided with suitable antibiotic medications, so to be able to proceed with a new prosthetic implant once the site in question has healed. Such spacer device is capable of maintaining the articular space necessary for the implant of a new prosthesis, so as to prevent the shortening of the tissues, the atrophying of the articulation and the loss of muscle tone, in addition to - as stated - containing medical agents capable of treating the tissues surrounding it.

    [0004] However, when the implant site is particularly weak or damaged, or when the substitution of an infected prosthesis occurs for a second time, it is necessary to use a constrained spacer device, in which its femoral and tibial components are connected or constrained to each other. Document US 5282867 discloses an example of a hinged prosthesis.

    [0005] It is therefore necessary to arrange a preformed spacer device, capable of providing the aforesaid constraint between the components thereof.

    OBJECTS OF THE INVENTION



    [0006] One object of the present i nventi on is to improve the state of the prior art.

    [0007] A further object of the present invention is to provide a constrained spacer device, possibly also secondary, adapted to treat an infection that arose at the implant site, in particular for the knee joint.

    [0008] A still further object of the present invention is to provide a constrained spacer device that is pre-formed and simultaneously able to allow a good mobility for the patient.

    [0009] A further object of the present invention is to provide a constrained spacer device that ensures a high stability for the knee joi nt.

    [0010] In accordance with one aspect of the present invention, a constrained spacer device for a knee is provided according to the enclosed claim 1.

    [0011] The present invention further refers to a method for the assembly of a constrained spacer device for a knee according to the enclosed claim 20.

    [0012] The dependent claims refer to preferred and advantageous embodiments of the invention.

    BRIEF DESCRIPTION OF THE DRAWINGS



    [0013] Further characteristics and advantages of the present invention will be more evident from the detailed description of a preferred but not exclusive embodiment of a constrained spacer device for a knee, illustrated as a non-limiting example in the enclosed drawing tables in which:

    figure 1 and figure 2 are perspective views of the spacer device according to the present invention that illustrate two mutual positions of a femoral component with respect to a tibial component;

    figures 3 to 5 are respectively a lateral perspective view, a top view and a bottom perspective view of the tibial component of the spacer device according to the present invention;

    figures 6 to 9 are respectively a lateral perspective view, a top view, a bottom front view and a bottom rear view of the femoral component of the spacer device according to the present invention;

    figures 10 and 11 are front views of the spacer device according to the present invention, respectively not provided or provided with a further closure or locking element;

    figures 12 and 13 are side views of the spacer device according to the present invention that illustrate two mutual positions of the femoral component with respect to the tibial component;

    figures 14 and 15 are sectional side views of the spacer device according to the present invention pursuant to figures 12 and 13, taken along the trace plane XIV-XIV of figure 11;

    figure 16 is a rear side perspective view of the femoral component, partially sectioned, according to one version of the invention, in which its internal core is visible;

    figures 17 and 19 are front side perspective views, partially transparent, respectively of the femoral component and of the tibial component of the spacer device according to one version of the invention;

    figures 18 and 20 are front side perspective views respectively of the internal core of the femoral component and of the tibial component of the spacer device according to one version of the invention;

    figure 21 is a front side perspective view of the internal core of the spacer device according to one version of the invention, in which the further closure or locking element is visible;

    figure 22 is a front side view of the further closure or locking component of the spacer device according to the present invention.


    EMBODIMENTS OF THE INVENTION



    [0014] With reference to the enclosed figures, reference number 1 generically indicates a constrained spacer device.

    [0015] Such spacer device is temporary, preformed, and adapted to be implanted at the knee joint.

    [0016] Such spacer device is during use adapted to be implanted at the knee joint in substitution of a preceding prosthesis, and it is during use adapted to treat an infection underway in the knee joint itself.

    [0017] By constrained spacer device it is intended a spacer device whose tibial and femoral components are joined together, i.e. they are hinged, or it is not possible to modify the relative distance from one to the other.

    [0018] In substance, the femoral component is capable of rotating and translating with respect to the tibial component (and vice versa) but the two components cannot be separated from each other. This serves so that, once the two components are fixed to the bone of the patient during implant, the knee joint cannot undergo dislocations, or that tibia and femur do not have irregular relative rotation.

    [0019] The femoral component and the tibial component of the spacer device 1 according to the present invention, according to that defined now and as will be better understood in the course of the present description, are constrained to each other in an articulated manner, and they are both adapted to be stably fixed to the respective bone of the patient.

    [0020] The spacer device 1 according to the present invention comprises a tibial component 2 and a femoral component 3.

    [0021] The tibial component 2 is adapted to be fixed to the end of the tibial bone at the knee joint while the femoral component 3 is adapted to be fixed to the end of the femoral bone in proximity to the knee joint.

    [0022] In one version of the invention, only the femoral component 3 and the tibial component 2 are present, constrained to each other, while no patellar component is present, since it is not necessary for the operation of the spacer device, and since it is desirable that the latter be as simple as possible.

    [0023] The tibial component 2 comprises a tibial plate 20, on which the femoral component 3 is adapted to abut, roll and/or slide and with which it is articulated.

    [0024] The tibial plate 20 comprises two condylar articular bases 21, 22.

    [0025] The condylar articular bases 21, 22 are substantially concave and have a curvature radius R2.

    [0026] The tibial component 2 further comprises, between the condylar articular bases 21, 22, a rib 23.

    [0027] Such rib 23 is in relief with respect to the surface of the tibial plate 20 and/or of the condylar articular bases 21, 22.

    [0028] At its front portion, the tibial component 2 and/or the rib 23 has a protrusion 25.

    [0029] Such protrusion 25 has a substantially curved and/or C-shaped or swan-neck projection and during use is projected upward or towards the femoral component 3.

    [0030] The protrusion 25 has a head or end 26 that is substantially T-shaped.

    [0031] Specifically, the protrusion 25 comprises, as stated, a substantially curved shape and/or C shape comprising a first section that corresponds with at least part of the rib 23, a second section, with substantially vertical section, and a third section, raised with respect to the rib 23, but which is substantially parallel to the latter.

    [0032] Such third section departs from the second section and terminates with the head or end 26, shaped as a T.

    [0033] In one version of the invention, the rib 23 is not present and therefore the protrusion 25 only has a section with substantially vertical progression, from which a further section departs, substantially parallel to the tibial plate 20 and which terminates with the head or end 26.

    [0034] The third section or the further section of the protrusion 25 is extended towards the rear part of the tibial component 2.

    [0035] Therefore, the head or end 26 of the protrusion 25 comprises two sections 26', 26" that are extended on opposite sides with respect to the third section (and/or to the protrusion 25). In one version of the invention, the two sections 26', 26" are lateral bulges of the protrusion 25 or of its third section.

    [0036] The sections 26', 26" have a progression that is lateromedial or parallel to the transverse axis of the human body.

    [0037] The transverse axis of the human body is an axis of the human body that goes from right to left.

    [0038] Due to the shape of the protrusion 25, the head or end 26 thereof comes to be situated in raised position substantially at the center of the tibial plate 20 and/or of the rib 23.

    [0039] In particular, as visible in figure 15, the head or end 26 is situated at a distance D from the rib 23 or at a distance B from the most-front part of the tibial plate 20 and/or of the tibial component 2.

    [0040] As visible in figure 4, the head or end 26, including the sections 26', 26", has a size or width, calculated according to the transverse axis of the human body, equal to F.

    [0041] In particular, F is greater than the width F1 of the rib 23 (or of the protrusion 25).

    [0042] The width of the first and/or second and/or third section or of the section with substantially vertical progression and/or of the further section of the protrusion 25 also have a width substantially corresponding to F1.

    [0043] The tibial component 2, along a surface adapted to come into contact with the tibial bone of the patient or in any case opposite the condylar articular bases 21, 22, has a hole 24.

    [0044] The hole 24 is adapted to house and fix, through for example a screw-nut screw coupling, at least one pin 28.

    [0045] The at least one pin 28, possibly threaded, is a pin adapted for the connection, the fixing and/or the centering or the orientation of the tibial component 2 with respect to the bone end of the tibial bone of the patient.

    [0046] The at least one pin 28 is extended from the face of the tibial component 2 opposite that which has the two condylar articular bases 21, 22.

    [0047] The protrusion 25, during use, is adapted to be inserted in the femoral component 3, in a manner such to create a guided articulation or a constraint articulation between the femoral component 3 and the tibial component 2.

    [0048] The femoral component 3 has a shape that generally reproduces the condylar articulation surfaces of the femur.

    [0049] In particular, the femoral component 3 has, as is visible for example in figures 12 and 13, a substantially U-shaped form - in cross section according to a plane parallel to the sagittal plane of the human body.

    [0050] The femoral component 3 comprises an internal surface 31, substantially concave, adapted to be positioned in contact with the bone seat, and an external surface 32, substantially convex, adapted to come into contact and be articulated with the tibial component 2.

    [0051] The femoral component 3 is symmetric, with respect to a plane of symmetry parallel to the sagittal plane of the human body.

    [0052] More in detail, the femoral component 3 comprises a first condylar portion 33 placed laterally and a second condylar portion 34 medially placed with respect to the sagittal plane of the human body, each having a shape similar to that of the condyles of the knee.

    [0053] The condylar portions 33, 34 in turn have a substantially U-shaped form - in cross section according to a plane parallel to the sagittal plane of the human body.

    [0054] The condylar portions 33, 34, in their front during use portion of the spacer device 1 according to one version of the present invention, converge towards each other and are joined together to form a joining portion or surface adapted to come into contact with the patella or to be arranged substantially in the zone where it is usually situated from the anatomical standpoint.

    [0055] The condylar portions 33, 34 are articulated on the condylar articular bases 21, 22 of the tibial component 2.

    [0056] The condylar portions 33, 34 are separated from each other by an intercondylar space 50. The intercondylar space 50 is extended at least along the rear and central during use portion of the femoral component 3 and/or of the condylar portions 33, 34. In one version of the invention, the intercondylar space 50 is also extended for a portion of the front part of the femoral component 3, e.g. the portion which, during use, is placed downward and towards the central portion thereof.

    [0057] The femoral component 3 comprises a box element 35, placed on the internal surface 31.

    [0058] The box element 35 is connected to the internal surface 31 and, in one version of the invention, is integrally made therewith and/or with the femoral component 3.

    [0059] The box element 35 has two lateral walls and one connector wall, which connects and joins the lateral walls. The connector wall is placed above the lateral walls of the box element. The lateral walls have a progression parallel to the sagittal plane of the human body. During use, they are extended therefore from the front portion to the rear portion of the internal surface 31 of the tibial component 3.

    [0060] The box element 35 has a substantially overturned U shape - in cross section according to a plane parallel to the front plane of the human body.

    [0061] Between the lateral walls and the connector wall of the box element 35, a seat or cavity is comprised or enclosed, corresponding to the abovementioned intercondylar space 50. At the connector wall of the box element 35, a hole 36 and/or a cylindrical protrusion or stem 38 (possibly threaded) can be present, for the connection, the fixing and/or the centering or the orientation of the femoral component 3 with respect to the bone end of the femoral bone.

    [0062] The condylar portions 33, 34 have, in at least one portion of their profile, a curvature radius R1, as is visible for example in figures 12 and 13.

    [0063] The radius R1 is present at least in the rear portion of the condylar portions 33, 34.

    [0064] In a further version of the invention, the condylar portions 33, 34 have, in at least one portion of their profile, a curvature radius R3, as is visible for example in figures 12 and 13.

    [0065] The radius R3 is present at least in the central portion of the condylar portions 33, 34. The curvature radius R1, in one version of the invention, is smaller than the curvature radius R2.

    [0066] In a further version, the curvature radius R3 is substantially equal to the curvature radius R2.

    [0067] The box element 35 comprises an external surface 42 and an internal surface 43. The internal surface 43 faces towards the intercondylar space 50.

    [0068] The internal surface 43 in turn comprises two internal lateral walls and one internal connector wall, which delimit the intercondylar space 50.

    [0069] The internal connector wall is placed above the internal lateral walls of the box element. The internal lateral walls have a progression parallel to the sagittal plane of the human body. During use, therefore, they depart from the front portion to the rear portion of the internal surface 31 of the tibial component 3.

    [0070] Each or at least one of the internal lateral walls of the internal surface 43 have a step 44. Such step 44 is projecting with respect to the internal lateral surface of the internal surface 43. Therefore, the step 44 is extended towards the intercondylar space 50.

    [0071] Such step 44 constitutes a kind of guide for the head or end 26 of the tibial component 2. Indeed, such head or end 26, during the articulation of the femoral component 3 on the tibial component 2, slides and/or can rotate along such step 44, allowing the articulation of the knee of the patient in which the spacer device 1 has been implanted.

    [0072] Simultaneously, the step 44 determines the constraint of the femoral component 3 with the tibial component 2, since the head or end 26 of the latter abuts against (particularly due to the sections 26', 26") and is substantially prevented - regarding its movements from right to left - from exiting from the seat determined by the box element 35 and/or, hence, from the intercondylar space 50.

    [0073] In one version of the invention, such step 44 has a substantially overturned S shape. Regarding such overturned S, during use: the upper horizontal section coincides with the internal connector wall, the concavity is placed at the rear part of the tibial component 3, the convexity is placed at the front part of the tibial component 3 and the lower horizontal second section coincides with the (central) external surface 42 of the femoral component 3.

    [0074] The overturned S shape of the step 44 and/or the presence of the step 44 allows creating an opening, in the femoral component 3 and in particular between its two condylar portions 33, 34, comprising two portions and/or having two widths. By width, in this case, it is intended the size of the opening along a direction that goes from right to left, hence considered along the front plane of the human body or parallel to the same. Such direction is horizontal, i.e. also parallel to the abutment surface of the human body.

    [0075] The opening determined by the box element 35 and by the step 44 coincides with the intercondylar space 50.

    [0076] In particular, as is visible for example in figure 8, for example in proximity to the front zone of the femoral component 3, a first opening 48 is present having a width L.

    [0077] In proximity instead to the central and lower zone of the femoral component 3, a second opening 49 is present which has a width N, in which N is smaller than L.

    [0078] In particular, as will be better described hereinbelow, the width L corresponds substantially or is slightly greater than the width F of the head or end 26 of the femoral component 2. In such a manner, it is possible to insert such head or end 26 inside the intercondylar space 50, through such first opening 48.

    [0079] Then, once the protrusion 25 is inserted, by means of its head or end 26, into the femoral component 3, the latter is engaged with, or at least abutted against, the step 44 and is unable to exit from the second opening 49 having width N.

    [0080] Indeed, the width N is smaller than the width F and substantially corresponds to the width F1, or is slightly greater than the latter.

    [0081] According to a section taken along a plane parallel to the front plane of the human body, therefore, the opening has a substantially T shape, substantially corresponding to the T shape of the protrusion 25 and/or of the head or end 26 of the protrusion 25.

    [0082] The spacer device 1, according to at least one version of the invention, then comprises a closure or locking element 46.

    [0083] The closure or locking element 46 has size substantially corresponding to that of the first opening 48 or at least of its initial part. In particular, such closure or locking element 46 is capable of closing the first opening 48 and preventing the exit of the head or end 26 from the intercondylar space 50 delimited by the box component 35 of the femoral component 3.

    [0084] The closure or locking element 46 can be provided with a pin 47, adapted to be inserted, e.g. snap-inserted, in at least one hole 36b suitably made in the femoral component 3. The hole 36b is placed at the front portion of the femoral component 3, in a manner so as to maintain the closure or locking element 46 in the front or frontal portion thereof.

    [0085] The closure or locking element 46 has an internal face 46d (during use directed towards the bottom wall 35d of the box element 35) that is substantially concave. In such a manner, the sections 26', 26" can also rotate into such position of contact with the internal face 46d, and hence the femoral component 3 can also be articulated in this position with respect to the tibial component 2.

    [0086] The closure or locking element 46 substantially has a prism shape, e.g. with triangular base, as visible in figure 22.

    [0087] Seen in cross section, i.e. in a section parallel to the sagittal plane of the human body, as illustrated in the figures 14 and 15, the first opening 48 has a substantially wedge-like shape while the second opening 49 has a progression that is substantially wedge-shaped or L-shaped. In the latter version, for example, the sections of the L affect (the longer one) the central portion towards the bottom and (the shorter one) the rear portion of the femoral component 3, at its external surface 32.

    [0088] In particular, the second opening 49 is a through opening, from front to rear of the femoral element 3.

    [0089] The first opening 48, instead, is open at its front part. In the rear part, however, it is closed by the bottom wall 35d of the box element 35.

    [0090] The bottom wall 35d, therefore, acts as a block for the sliding of the head or end 26 on the steps 44 and hence as a block for the maximum articulation of the femoral component 3 with respect to the tibial component 2.

    [0091] The bottom wall 35d has a curvature substantially corresponding to that of the sections 26', 26" of the protrusion 25, in a manner so as to allow the rotation thereof - and hence the rotation of the femoral component 3 on the tibial component 2 - even in such position.

    [0092] The first and the second opening 48, 49 identify corresponding portions in the internal lateral walls of the box element 35.

    [0093] Such portions are delimited, on each side, by the step 44.

    [0094] In particular, the internal lateral walls have a first portion or surface 51 and a second portion or surface 52.

    [0095] Both such portions have a progression substantially parallel to the sagittal plane of the human body. The first portion or surface 51, nevertheless, is placed more in proximity to the internal connector wall of the box element 35. In such a manner, it is situated more internally with respect thereto.

    [0096] Such first portion or surface 51 has a progression that is substantially rectangular with smoothed edges. The height of such first portion or surface 51 is substantially equal to the bulk of each of the sections 26', 26".

    [0097] The sections 26' and 26", in one version of the invention, are small cylinders which depart laterally from the protrusion 25. In a further version, the sections 26', 26" have a shape adapted to allow the rotation of the femoral component 3 on the tibial component 2, e.g. small balls, etcetera.

    [0098] The sections 26', 26", in fact, act as a rotation hinge or axis around which a relative rotation occurs between the tibial component 2 and the femoral component 3.

    [0099] The second portion or surface 52 is instead more external with respect to the internal connector wall of the box element 35. In particular, such second portion or surface 52 is closer to the tibial component 2, with respect to the first 51.

    [0100] This second portion or surface 52 has a substantially L-shaped progression, in which its larger section is substantially parallel to the progression of the first portion or surface 51, while its shorter section continues upward in a substantially perpendicular manner, considering the spacer device 1 during use.

    [0101] The distance between the first portions or surfaces 51 is equal to L while the distance between the two second portions or surfaces 52 is equal to N.

    [0102] As is visible in figures 16 to 20, the spacer device 1 according to the present invention can comprise an internal core, having shape substantially corresponding to that of the tibial 2 and femoral 3 components.

    [0103] The spacer device 1 according to the present invention can be porous and comprise at least one medical substance, such as an antibiotic, adapted to be released in the tissues surrounding the spacer device, in order to combat the infection.

    [0104] The closure or locking element 46, at least in one version of the invention, determines the front wall of the box element 35.

    [0105] As is seen, the present invention allows attaining the pre-established objects, since it allows treating the infection underway at the surgical site, simultaneously allowing a rotational-translational movement of the femoral component on the tibial component.

    [0106] For such reason, therefore, the spacer device 1 comprises means for sliding and rotating the femoral component 3 on the tibial component 2 and vice versa. The rotation and sliding or translation movement is a relative movement of the femoral component 3 on the tibial component 2.

    [0107] Such means, in at least one version of the invention, are constituted by the protrusion 25, with its head or end 26 and by the opening or intercondylar space 50 of the femoral component 3, possibly defined by the presence of the step 44.

    [0108] Such rotational-translational or sliding and rotation movement cannot laterally translate, but only in front-rear direction, since the femoral component is constrained in an articulated manner to the tibial component.

    [0109] The device according to the present invention, therefore, follows the physiological movement of the knee joint.

    [0110] The closure or locking element 46 can be removed from the spacer device 1, for example when the latter must be removed from the human body in order to allow the implant of a new permanent prosthesis.

    [0111] The spacer device 1, according to a non-limiting version of the invention, is assembled according to the following method: arranging a tibial component 2 and a femoral component 3 as described above and inserting or housing the protrusion 25 of the tibial component inside an opening present in the femoral component 3.

    [0112] In particular, the head or end 26 of the tibial component 2 is inserted in the first opening 48 of the femoral component 3. Then, the sections 26', 26" abut against a step 44 placed on both sides of the opening of the femoral component 3, and they can slide on the step itself.

    [0113] In this manner, the protrusion 25 can slide and traverse the second opening 49 of the femoral component 3. Simultaneously, the latter is articulated with the tibial component by rotating and/or translating thereon.

    [0114] Finally, the closure or locking element 46 is inserted in the femoral component 3, for example in a hole 36b thereof, in a manner so as to prevent the protrusion 25 from exiting from the femoral component 3. In such a manner, the femoral component 3 and the tibial component 2 are constrained to each other in an articulated manner.

    [0115] The at least one pin 28 and/or the cylindrical protrusion or stem 38 can then be inserted or screwed, in a manner so as to stabilize (during use) the application respectively of the tibial component 2 on the tibial bone and/or of the femoral component 3 on the femoral bone.

    [0116] Finally, it is possible to block the closure or locking element 46 by means of bone cement.

    [0117] Once it is desired to extract the spacer device 1, it will suffice to remove the bone cement that locks and fixes the closure or locking element 46 in position, for example by means of a small scalpel, so to be able to remove it and free the passage for the protrusion 25. By making the latter exit from the first opening 48, it will be possible to release tibial and femoral component and then remove both the components (or at least one) from the infection site without having to overly compromise the residual tissues of the articulation of the patient.

    [0118] As was seen above, the spacer device 1, even if implanted in situations of serious bone loss and loosening of the ligaments as well as in less damaged situations, is constrained, thus ensuring good stability to the knee joint.

    [0119] In addition, the spacer device according to the present invention can therefore, during use, be implanted in the two affected bone ends and be constrained after implant of the femoral and tibial components. Indeed, once the femoral component and tibial component are implanted, it is possible to insert the protrusion 25 in the suitable space or opening of the femoral component. The access point of the protrusion in the femoral element is then closed by the presence of the closure or locking element.

    [0120] A facilitated method is thus obtained, with advantages in terms of reduction of time and pain, both for the patient and for the doctor.

    [0121] In addition, due to this the patient can lead a self-sufficient life for the entire period of use of the constrained spacer device according to the present invention.

    [0122] The spacer component 1 according to the present invention is made of biologically compatible manner.

    [0123] Such biologically compatible manner can be selected from among metals, metal alloys and organometallic compounds.

    [0124] Alternatively, the biologically compatible manner can be selected from among ceramics, resins with high porosity, plastic materials and/or a combination thereof. Specifically, the aforesaid plastic materials can be selected from among thermoplastic polymers, such as acrylic resins, polyethylene, polypropylene, polyester, thermoformable polymers and other similar materials.

    [0125] In one version of the present invention, the biologically compatible manner is a bone cement, e.g. polymethylmethacrylate (PMMA).

    [0126] The presence of an internal core, e.g. metallic, can be particularly useful when the spacer device 1 is made of plastic or ceramic material.

    [0127] In such a manner, it is possible to confer a greater stability to the implant, a higher load strength, etcetera.

    [0128] In one version of the invention, the spacer device 1 is made of PMMA or the internal core is metallic and covered with PMMA.

    [0129] As stated, the aforesaid biologically compatible manner, due to its porosity, can be impregnated with pharmaceutical and/or therapeutic products, such as antibiotics, before its use, by the producer and/or by the doctor before implant.

    [0130] The invention thus conceived is susceptible to numerous modifications and variations, all falling within the scope of the invention as defined by the claims.


    Claims

    1. Temporary spacer device (1), suitable during use to be implanted at the knee joint replacing a previous prosthesis and suitable during use to treat an infection arose at the knee joint itself, comprising a tibial component (2), adapted to be fixed to one end of the tibial bone in proximity to the knee joint, and a femoral component (3), adapted to be fixed to one end of the femoral bone in proximity to the knee joint, wherein said tibial component (2) is adapted to come into contact and be articulated with said femoral component (3), wherein said tibial component (2) comprises a protrusion (25) adapted to be inserted in an opening present in said femoral component (3), in order to allow the sliding and the rotation of said femoral component (3) on said tibial component (2), wherein said protrusion (25) has a substantially C-shaped conformation, characterized in that said protrusion (25) has a head or end (26) provided with two sections (26', 26") which are extended on opposite sides with respect to said protrusion (25) and in that said opening comprises a first opening (48) having a first width (L) and a second opening (49) having a second width (N), wherein said first width (L) is greater than said second width (N).
     
    2. Spacer device (1) according to claim 1, comprising means for the relative sliding and rotation of said femoral component (3) on said tibial component (2), wherein said means for the sliding and rotation of said femoral component (3) on said tibial component (2) comprise at least said protrusion (25).
     
    3. Spacer device (1) according to claim 1 or 2, wherein said tibial component (2) comprises a tibial plate (20) provided with two condylar articular bases (21, 22) and a rib (23) placed between said condylar articular bases (21, 22), wherein said condylar articular bases (21, 22) are adapted to come into contact and be articulated with said femoral component (3).
     
    4. Spacer device (1) according to any one of the preceding claims, wherein said femoral component (3) has a substantially U-shaped form in cross section according a plane parallel to the sagittal plane of the human body and comprises a substantially concave internal surface (31) in contact with the femoral bone seat, and a substantially convex external surface (32) adapted to come into contact with said tibial component (2).
     
    5. Spacer device (1) according to any one of the preceding claims, wherein said femoral component (3) comprises a first and a second condylar portion (33, 34), said first condylar portion (33) being laterally placed and said second condylar portion (34) being medially placed with respect to the sagittal plane of the human body, said condylar portions (33, 34) having a substantially U-shaped conformation in cross section according to a plane parallel to the sagittal plane of the human body, wherein said first condylar portion (33) and said second condylar portion (34) are separated from each other by an intercondylar space (50).
     
    6. Spacer device (1) according to any one of the preceding claims, wherein said femoral component (2) comprises a box element (35), placed on the internal surface (31) of said femoral component (3), wherein said box element (35) comprises two lateral walls, a connector wall connected to said lateral walls, wherein said walls identify an internal connector wall and two internal lateral walls which delimit said opening or said intercondylar space (50).
     
    7. Spacer device (1) according to any one of the preceding claims, wherein said one head or end (26) provided with two sections (26', 26") has a width (F) and wherein said protrusion (25) has a width (F1), wherein said width (F) substantially corresponds to or is slightly smaller than said width (L) and wherein said width (F1) substantially corresponds to or is slightly smaller than said width (N).
     
    8. Spacer device (1) according to any one of the preceding claims when dependent on claim 6, wherein said means for the relative sliding and rotation of said femoral component (3) on said tibial component (2) comprise at least a step (44) placed on each internal lateral wall of said box element (35) and/or wherein each internal lateral wall of said box element (35) comprises a step (44), wherein said step (44) delimits a first portion or surface (51) and a second portion or surface (52) of said internal lateral wall, wherein said first portion or surface (51) is placed in proximity to the internal connector wall of the box element while said second portion or surface (52) is placed in proximity to said tibial component (2).
     
    9. Spacer device (1) according to the preceding claim, wherein said first portions or surfaces (51) are separated by a distance (L) while the second portions or surfaces (52) are separated by a distance (N) of said intercondylar space (50) or of said respective first opening (48) and said second opening (49).
     
    10. Spacer device (1) according to any one of the preceding claims, wherein said step (44) has an overturned S conformation and/or wherein said first opening (48) is delimited on the rear by a bottom wall (35d) of said box element (35).
     
    11. Spacer device (1) according to any one of the preceding claims, comprising a closure or locking element (46) adapted to close said first opening (48) and to prevent the exit of said protrusion (25) from said opening of said femoral component (3).
     
    12. Spacer device (1) according to any one of the preceding claims, wherein said first portion or surface (51) has a substantially rectangular progression with smoothed edges, and/or wherein said first portion or surface (51) has a height substantially equal to the bulk of said sections (26', 26").
     
    13. Spacer device (1) according to any one of the preceding claims, wherein said second portion or surface (52) has a substantially L-shaped progression, wherein its greater segment is substantially parallel to the progression of said first portion or surface (51), while its shortest section continues upward in a substantially perpendicular manner, considering the arrangement of said spacer device (1) during use.
     
    14. Spacer device (1) according to any one of the preceding claims, wherein said sections (26', 26") have a conformation adapted to allow the rotation of said femoral component (3) on said tibial component (2) and/or have a cylinder, ball conformation, or the like.
     
    15. Spacer device (1) according to any one of the preceding claims, wherein said femoral component (3) and/or said tibial component (2) have an internal core, possibly made of metal.
     
    16. Spacer device (1) according to any one of the preceding claims, wherein said spacer device (1) is made of biologically compatible material selected from among a metal, a metal alloy, an organometallic compound
     
    17. Spacer device (1) according to any one of the preceding claims, wherein said spacer device (1) is made of biologically compatible material selected from among ceramics, resins with high porosity, plastic materials and/or a combination thereof, thermoplastic polymers, acrylic resins, polyethylene polypropylene, polyester, thermoformable polymers and other similar materials, bone cement, polymethylmethacrylate (PMMA).
     
    18. Spacer device (1) according to any one of the preceding claims, wherein said spacer device (1) is porous and comprises at least one pharmaceutical or medical substances, such as at least one antibiotic.
     
    19. Method for the assembly of a spacer device (1) for the articulation of the knee comprising a tibial component (2), adapted to be fixed to one end of the tibial bone in proximity to the knee joint, and a femoral component (3), adapted to be fixed to one end of the femoral bone in proximity to the knee joint, wherein said femoral component (3) is adapted to come into contact and be articulated with said tibial component (2), comprising the steps of:

    providing a tibial component (2), provided with a tibial plate (20) and with a protrusion (25), and a femoral component (3), provided with an opening, wherein said protrusion (25) has a substantially C-shaped conformation and a head or end (26) provided with two sections (26', 26") which are extended on opposite sides with respect to said protrusion (25) and wherein said opening comprises a first opening (48) having a first width (L) and a second opening (49) having a second width (N), wherein said first width (L) is greater than said second width (N),

    inserting said protrusion (25) in said opening of said femoral component (3), in a manner such as to constrain said femoral component (3) to said tibial component (2) in a rotary manner and allow the sliding and rotation of said femoral component (3) on said tibial component (2), wherein said inserting step comprises inserting said head or end (26) provided with two sections (26', 26") of said protrusion (25) in said first opening (48) having said first width (L).


     
    20. Method according to claim 19, wherein said femoral component (3) has a box element (35) having two internal lateral walls and one internal connector wall, wherein each internal lateral wall comprises a step (44), with substantially overturned S-shaped conformation, wherein said method comprises the steps of sliding and/or rolling said sections (26', 26") on said step (44) in a manner so as to allow the sliding and the rotation of said femoral component (3) on said tibial component (2).
     
    21. Method according to any one of the claims 19 or 20, comprising a step of providing a closure or locking element (46) and closing said first opening (48) by means of said closure or locking element (46), so as to prevent the exit of said protrusion (25) from said opening of said femoral component (3).
     


    Ansprüche

    1. Temporäre Abstandsvorrichtung (1), die während der Verwendung geeignet ist, am Kniegelenk implantiert zu werden, um eine bisherige Prothese zu ersetzen, und die während der Verwendung geeignet ist, eine an dem Kniegelenk selbst entstandene Infektion zu behandeln, umfassend eine Tibiakomponente (2), die dazu ausgelegt ist, an einem Ende des Tibia-Knochens in der Nähe des Kniegelenks befestigt zu werden, und eine Femurkomponente (3), die dazu ausgelegt ist, an einem Ende des Femurknochens in der Nähe des Kniegelenks befestigt zu werden, worin die besagte Tibiakomponente (2) dazu ausgelegt ist, mit der besagten Femurkomponente (3) in Berührung zu kommen und gelenkig damit verbunden zu sein, worin die besagte Tibiakomponente (2) einen Vorsprung (25) umfasst, der dazu ausgelegt ist, in eine in der besagten Femurkomponente (3) vorhandene Öffnung eingeführt zu werden, um das Gleiten und das Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) zu ermöglichen, worin der besagte Vorsprung (25) eine im Wesentlichen C-förmige Form aufweist, dadurch gekennzeichnet, dass der besagte Vorsprung (25) einen Kopf oder ein Ende (26) aufweist, der bzw. das mit zwei Abschnitten (26', 26") versehen ist, die sich jeweils auf gegenüberliegenden Seite in Bezug auf den besagten Vorsprung (25) erstrecken, und dadurch, dass die besagte Öffnung eine erste Öffnung (48) mit einer ersten Breite (L) und eine zweite Öffnung (49) mit einer zweiten Breite (N) umfasst, worin die besagte erste Breite (L) größer als die besagte zweite Breite (N) ist.
     
    2. Abstandsvorrichtung (1) nach Anspruch 1, umfassend Mittel für das relative Gleiten und Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2), worin die besagten Mittel zum Gleiten und Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) mindestens den besagten Vorsprung (25) umfassen.
     
    3. Abstandsvorrichtung (1) nach Anspruch 1 oder 2, worin die besagte Tibiakomponente (2) eine Tibiaplatte (20) umfasst, die mit zwei kondylären Gelenkbasen (21, 22) und einer Rippe (23) versehen ist, die zwischen den besagten kondylären Gelenkbasen (21, 22) angeordnet ist, worin die besagten kondylären Gelenkbasen (21, 22) dazu ausgelegt sind, mit der besagten Femurkomponente (3) in Berührung zu kommen und gelenkig damit verbunden zu sein.
     
    4. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Femurkomponente (3) eine im Wesentliche U-förmigen Form im Querschnitt gemäß einer Ebene parallel zur Sagittalebene des menschlichen Körpers aufweist und eine im Wesentlichen konkave Innenfläche (31) in Berührung mit dem Femurknochensitz und eine im Wesentlichen konvexe Außenfläche (32), die dazu ausgelegt ist, mit der besagten Tibiakomponente (2) in Berührung zu kommen, umfasst.
     
    5. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Femurkomponente (3) einen ersten und einen zweiten kondylären Abschnitt (33, 34) umfasst, wobei der besagte erste kondyläre Abschnitt (33) seitlich angeordnet ist und der besagte zweite kondyläre Abschnitt (34) medial in Bezug auf die Sagittalebene des menschlichen Körpers angeordnet ist, wobei die besagten kondylären Abschnitte (33, 34) eine im Wesentlichen U-förmige Form im Querschnitt gemäß einer Ebene parallel zur Sagittalebene des menschlichen Körpers aufweisen, worin der besagte erste kondyläre Abschnitt (33) und der besagte zweite kondyläre Abschnitt (34) durch einen interkondylären Raum (50) voneinander getrennt sind.
     
    6. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Femurkomponente (2) ein Gehäuseelement (35) umfasst, das auf der Innenfläche (31) der besagten Femurkomponente (3) angeordnet ist, worin das besagte Gehäuseelement (35) zwei Seitenwände, eine mit den besagten Seitenwänden verbundene Verbindungswand umfasst, worin die besagten Wände eine innere Verbindungswand und zwei innere Seitenwände bestimmen, die die besagte Öffnung oder den besagten interkondylären Raum (50) begrenzen.
     
    7. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin der besagte eine Kopf oder das besagte eine Ende (26), der bzw. das mit zwei Abschnitten (26', 26") versehen ist, eine Breite (F) aufweist und worin der besagte Vorsprung (25) eine Breite (F1) aufweist, worin die besagte Breite (F) im Wesentlichen der Breite (L) entspricht oder geringfügig kleiner als diese ist und worin die besagte Breite (F1) im Wesentlichen der besagten Breite (N) entspricht oder geringfügig kleiner als diese ist.
     
    8. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, wenn abhängig von Anspruch 6, worin die besagten Mittel zum relativen Gleiten und Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) mindestens eine Stufe (44) umfassen, die auf jeder inneren Seitenwand des besagten Gehäuseelements (35) angeordnet ist und/oder worin jede innere Seitenwand des besagten Gehäuseelements (35) eine Stufe (44) umfasst, worin die besagte Stufe (44) einen ersten Abschnitt oder eine erste Oberfläche (51) und einen zweiten Abschnitt oder eine zweite Oberfläche (52) der besagten inneren Seitenwand begrenzt, worin der besagte erste Abschnitt oder die erste Oberfläche (51) in der Nähe der inneren Verbindungswand des Gehäuseelements angeordnet ist, während der besagte zweite Abschnitt oder die zweite Oberfläche (52) in der Nähe der besagten Tibiakomponente (2) angeordnet ist.
     
    9. Abstandsvorrichtung (1) nach dem vorangegangenen Anspruch, worin die besagten ersten Abschnitte oder Oberflächen (51) durch einen Abstand (L) getrennt sind, während die zweiten Abschnitte oder Oberflächen (52) durch einen Abstand (N) des besagten interkondylären Raums (50) oder der besagten jeweiligen ersten Öffnung (48) und der besagten zweiten Öffnung (49) getrennt sind.
     
    10. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Stufe (44) eine umgekehrte S-Form aufweist und/oder worin die besagte erste Öffnung (48) auf der Rückseite durch eine Bodenwand (35d) des besagten Gehäuseelements (35) begrenzt ist.
     
    11. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, umfassend ein Verschluss- oder Verriegelungselement (46), das dazu ausgelegt ist, die besagte erste Öffnung (48) zu verschließen und den Austritt des besagten Vorsprungs (25) aus der besagten Öffnung der besagten Femurkomponente (3) zu verhindern.
     
    12. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin der besagte erste Abschnitt oder die besagte erste Oberfläche (51) einen im Wesentlichen rechteckigen Verlauf mit abgerundeten Kanten aufweist und/oder worin der besagte erste Abschnitt oder die besagte erste Oberfläche (51) eine Höhe aufweist, die im Wesentlichen gleich der Masse der besagten Abschnitte (26', 26") ist.
     
    13. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin der besagte zweite Abschnitt oder die besagte zweite Oberfläche (52) einen im Wesentlichen L-förmigen Verlauf aufweisen, wobei ihr größeres Segment im Wesentlichen parallel zum Verlauf des besagten ersten Abschnitts oder der besagten ersten Oberfläche (51) ist, während sich ihr kürzester Abschnitt in einer im Wesentlichen senkrechten Weise weiter nach oben fortsetzt, wobei die Anordnung der besagten Abstandsvorrichtung (1) während der Verwendung berücksichtigt wird.
     
    14. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagten Abschnitte (26', 26") eine Form aufweisen, die dazu ausgelegt ist, die Drehung der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) zu ermöglichen und/oder eine Zylinder-, Kugelform oder dergleichen aufweisen.
     
    15. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Femurkomponente (3) und/oder die besagte Tibiakomponente (2) einen inneren Kern aufweisen, der möglichst aus Metall gefertigt ist.
     
    16. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Abstandsvorrichtung (1) aus biologisch verträglichem Material, ausgewählt aus einem Metall, einer Metalllegierung, einer metallorganischen Verbindung, gefertigt ist.
     
    17. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Abstandsvorrichtung aus biologisch verträglichem Material, ausgewählt aus Keramik, Harzen mit hoher Porosität, Kunststoffmaterialien und/oder einer Kombination derselben, thermoplastischen Polymeren, Acrylharzen, Polyethylen, Polypropylen, Polyester, thermoformbaren Polymeren und anderen ähnlichen Materialien, Knochenzement, Polymethylmethacrylat (PMMA), gefertigt ist.
     
    18. Abstandsvorrichtung (1) nach irgendeinem der vorangegangenen Ansprüche, worin die besagte Abstandsvorrichtung (1) porös ist und mindestens eine pharmazeutische oder medizinische Substanz, wie z.B. mindestens ein Antibiotikum, umfasst.
     
    19. Verfahren zum Zusammenbau einer Abstandsvorrichtung (1) für das Gelenk eines Knies, umfassend eine Tibiakomponente (2), die dazu ausgelegt ist, an einem Ende des Tibia-Knochens in der Nähe des Kniegelenks befestigt zu werden, und eine Femurkomponente (3), die dazu ausgelegt ist, an einem Ende des Femurknochens in der Nähe des Kniegelenks befestigt zu werden, worin die besagte Femurkomponente (3) dazu ausgelegt ist, mit der besagten Tibiakomponente (2) in Berührung zu kommen und gelenkig damit verbunden zu sein, umfassend die Schritte des: Bereitstellens einer Tibiakomponente (2), die mit einer Tibiaplatte (20) und mit einem Vorsprung (25) versehen ist, und einer Femurkomponente (3), die mit einer Öffnung versehen ist, worin der besagte Vorsprung (25) eine im Wesentlichen C-förmige Form und einen Kopf oder ein Ende (26) aufweist, der bzw. das mit zwei Abschnitten (26', 26") versehen ist, die sich jeweils von dem besagten Vorsprung (25) oder einer gegenüberliegenden Seite in Bezug auf den besagten Vorsprung (25) an dem besagten Kopf oder Ende (26) erstrecken, und worin die besagte Öffnung eine erste Öffnung (48) mit einer ersten Breite (L) und eine zweite Öffnung (49) mit einer zweiten Breite (N) umfasst, worin die besagte erste Breite (L) größer als die besagte zweite besagte Breite (N) ist, des Einführens des besagten Vorsprungs (25) in die besagte Öffnung der besagten Femurkomponente (3) auf derartige Weise, dass die besagte Femurkomponente (3) an der besagten Tibiakomponente (2) in einer drehbaren Weise festgehalten wird und das Gleiten und Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) ermöglicht wird, worin der besagte Einführschritt das Einführen des besagten Kopfes oder Endes (26), versehen mit zwei Abschnitten (26', 26") des besagten Vorsprungs (25), in die besagte erste Öffnung (48) mit der besagten ersten Breite (L) umfasst.
     
    20. Verfahren nach Anspruch 19, worin die besagte Femurkomponente (3) ein Gehäuseelement (35) mit zwei inneren Seitenwänden und einer inneren Verbindungswand aufweist, worin jede innere Seitenwand eine Stufe (44) mit im Wesentlichen umgekehrter S-förmiger Form umfasst, worin das besagte Verfahren die Schritte des Gleitens und/oder Rollens der besagten Abschnitte (26', 26") auf der besagten Stufe (44) in einer Weise umfasst, die das Gleiten und das Drehen der besagten Femurkomponente (3) auf der besagten Tibiakomponente (2) ermöglicht.
     
    21. Verfahren nach irgendeinem der Ansprüche 19 oder 20, umfassend einen Schritt des Bereitstellens eines Verschluss- oder Verriegelungselements (46) und des Verschließens der besagten ersten Öffnung (48) mittels des besagten Verschluss- oder Verriegelungselements (46), um den Austritt des besagten Vorsprungs (25) aus der besagten Öffnung der besagten Femurkomponente (3) zu verhindern.
     


    Revendications

    1. Dispositif d'espacement temporaire (1), adapté pendant l'utilisation pour être implanté dans l'articulation du genou en remplacement d'une prothèse précédente et adapté pendant l'utilisation pour traiter une infection survenue sur l'articulation du genou même, comprenant un composant tibial (2), adapté pour être fixé à une extrémité de l'os tibial à proximité de l'articulation du genou, et un composant fémoral (3), adapté pour être fixé à une extrémité de l'os fémoral à proximité de l'articulation du genou, dans lequel ledit composant tibial (2) est adapté pour entrer en contact et être articulé avec ledit composant fémoral (3), dans lequel ledit composant tibial (2) comprend une protubérance (25) adaptée pour être insérée dans une ouverture présente dans ledit composant fémoral (3), afin de permettre le coulissement et la rotation dudit composant fémoral (3) sur ledit composant tibial (2), dans lequel ladite protubérance (25) a une forme sensiblement en C, caractérisé en ce que ladite protubérance (25) a une tête ou une extrémité (26) dotée de deux sections (26', 26") qui s'étendent sur des côtés opposés par rapport à ladite protubérance (25) et en ce que ladite ouverture comprend une première ouverture (48) ayant une première largeur (L) et une deuxième ouverture (49) ayant une deuxième largeur (N), dans lequel ladite première largeur (L) est supérieure à ladite deuxième largeur (N).
     
    2. Dispositif d'espacement (1) selon la revendication 1, comprenant des moyens pour le coulissement et la rotation relatifs dudit composant fémoral (3) sur ledit composant tibial (2), dans lequel lesdits moyens pour le coulissement et la rotation dudit composant fémoral (3) sur ledit composant tibial (2) comprennent au moins ladite protubérance (25).
     
    3. Dispositif d'espacement (1) selon la revendication 1 ou 2, dans lequel ledit composant tibial (2) comprend une plaque tibiale (20) dotée de deux bases articulaires condyliennes (21, 22) et une nervure (23) placée entre lesdites bases articulaires condyliennes (21, 22), dans lequel lesdites bases articulaires condyliennes (21, 22) sont adaptées pour entrer en contact et être articulées avec ledit composant fémoral (3).
     
    4. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit composant fémoral (3) a une forme sensiblement en U en section transversale selon un plan parallèle au plan sagittal du corps humain et comprend une surface intérieure sensiblement concave (31) en contact avec le siège de l'os fémoral, et une surface extérieure sensiblement convexe (32) adaptée pour entrer en contact avec ledit composant tibial (2).
     
    5. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit composant fémoral (3) comprend une première et une deuxième partie condylienne (33, 34), ladite première partie condylienne (33) étant positionnée latéralement et ladite deuxième partie condylienne (34) étant positionnée moyennement par rapport au plan sagittal du corps humain, lesdites parties condyliennes (33, 34) ayant une forme sensiblement en U en section transversale selon un plan parallèle au plan sagittal du corps humain, dans lequel ladite première partie condylienne (33) et ladite deuxième partie condylienne (34) sont séparées l'une de l'autre par un espace intercondylien (50).
     
    6. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit composant fémoral (2) comprend un élément en boîte (35), placé sur la surface intérieure (31) dudit composant fémoral (3), dans lequel ledit élément en boîte (35) comprend deux parois latérales, une paroi de raccordement raccordée auxdites parois latérales, dans lequel lesdites parois identifient une paroi de raccordement intérieure et deux parois latérales intérieures qui délimitent ladite ouverture ou ledit espace intercondylien (50).
     
    7. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ladite une tête ou extrémité (26) dotée de deux sections (26', 26") a une largeur (F) et dans lequel ladite protubérance (25) a une largeur (F1), dans lequel ladite largeur (F) correspond sensiblement ou est légèrement inférieure à ladite largeur (L) et dans lequel ladite largeur (F1) correspond sensiblement ou est légèrement inférieure à ladite largeur (N).
     
    8. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes quand elle dépend de la revendication 6, dans lequel lesdits moyens pour le coulissement et la rotation relatifs dudit composant fémoral (3) sur ledit composant tibial (2) comprennent au moins un cran (44) placé sur chaque paroi latérale intérieure dudit élément en boîte (35) et/ou dans lequel chaque paroi latérale intérieure dudit élément en boîte (35) comprend un cran (44), dans lequel ledit cran (44) délimite une première partie ou surface (51) et une deuxième partie ou surface (52) de ladite paroi latérale intérieure, dans lequel ladite première partie ou surface (51) est placée à proximité de la paroi de raccordement intérieure de l'élément en boîte alors que ladite deuxième partie ou surface (52) est placée à proximité dudit composant tibial (2).
     
    9. Dispositif d'espacement (1) selon la revendication précédente, dans lequel lesdites premières parties ou surfaces (51) sont séparées par une distance (L) alors que les deuxièmes parties ou surfaces (52) sont séparées par une distance (N) dudit espace intercondylien (50) ou de ladite première ouverture (48) et ladite deuxième ouverture (49) respectives.
     
    10. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit cran (44) a une forme en S retourné et/ou dans lequel ladite première ouverture (48) est délimitée à l'arrière par une paroi inférieure (35d) dudit élément en boîte (35).
     
    11. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, comprenant un élément de fermeture ou de verrouillage (46) adapté pour fermer ladite première ouverture (48) et pour empêcher la sortie de ladite protubérance (25) de ladite ouverture dudit composant fémoral (3).
     
    12. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ladite première partie ou surface (51) a une progression sensiblement rectangulaire avec des bords lisses, et/ou dans lequel ladite première partie ou surface (51) a une hauteur sensiblement égale à la masse desdites sections (26', 26").
     
    13. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ladite deuxième partie ou surface (52) a une progression sensiblement en L, dans lequel son segment le plus grand est sensiblement parallèle à la progression de ladite première partie ou surface (51), alors que sa section la plus courte continue vers le haut de manière sensiblement perpendiculaire, en considérant l'agencement dudit dispositif d'espacement (1) pendant l'utilisation.
     
    14. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel lesdites sections (26', 26") ont une forme adaptée pour permettre la rotation dudit composant fémoral (3) sur ledit composant tibial (2) et/ou ont une forme cylindrique, sphérique, ou analogue.
     
    15. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit composant fémoral (3) et/ou ledit composant tibial (2) ont un noyau interne, éventuellement fait de métal.
     
    16. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit dispositif d'espacement (1) est constitué de matériau biologiquement compatible sélectionné parmi un métal, un alliage métallique, un composé organométallique.
     
    17. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit dispositif d'espacement (1) est constitué de matériau biologiquement compatible sélectionné parmi les céramiques, les résines à porosité élevée, les matières plastiques et/ou une combinaison de celles-ci, les polymères thermoplastiques, les résines acryliques, le polyéthylène, le polypropylène, le polyester, les polymères thermoformables et d'autres matières similaires, le ciment osseux, le polyméthylméthacrylate (PMMA) .
     
    18. Dispositif d'espacement (1) selon l'une quelconque des revendications précédentes, dans lequel ledit dispositif d'espacement (1) est poreux et comprend au moins une substance pharmaceutique ou médicale, comme au moins un antibiotique.
     
    19. Procédé pour le montage d'un dispositif d'espacement (1) pour l'articulation du genou comprenant un composant tibial (2), adapté pour être fixé à une extrémité de l'os tibial à proximité de l'articulation du genou, et un composant fémoral (3), adapté pour être fixé à une extrémité de l'os fémoral à proximité de l'articulation du genou, dans lequel ledit composant fémoral (3) est adapté pour entrer en contact et être articulé avec ledit composant tibial (2), comprenant les étapes de : fourniture d'un composant tibial (2), doté d'une plaque tibiale (20) et d'une protubérance (25), et un composant fémoral (3), doté d'une ouverture, dans lequel ladite protubérance (25) a une forme sensiblement en C et une tête ou extrémité (26) dotée de deux sections (26', 26") qui s'étendent sur des côtés opposés par rapport à ladite protubérance (25) et dans lequel ladite ouverture comprend une première ouverture (48) ayant une première largeur (L) et une deuxième ouverture (49) ayant une deuxième largeur (N), dans lequel ladite première largeur (L) est supérieure à ladite deuxième largeur (N), insertion de ladite protubérance (25) dans ladite ouverture dudit composant fémoral (3), de telle manière que ledit composant fémoral (3) soit maintenu sur ledit composant tibial (2) de manière rotative et le coulissement et la rotation dudit composant fémoral (3) soient possibles sur ledit composant tibial (2), dans lequel ladite étape d'insertion comprend l'insertion de ladite tête ou extrémité (26) dotée de deux sections (26', 26") de ladite protubérance (25) dans ladite première ouverture (48) ayant ladite première largeur (L).
     
    20. Procédé selon la revendication 19, dans lequel ledit composant fémoral (3) comporte un élément en boîte (35) ayant deux parois latérales intérieures et une paroi de raccordement intérieure, dans lequel chaque paroi latérale intérieure comprend un cran (44) de forme en S sensiblement retourné, dans lequel ledit procédé comprend les étapes de coulissement et/ou roulement desdites sections (26', 26") sur ledit cran (44) de manière à permettre le coulissement et la rotation dudit composant fémoral (3) sur ledit composant tibial (2).
     
    21. Procédé selon l'une quelconque des revendications 19 ou 20, comprenant une étape de fourniture d'un élément de fermeture ou de verrouillage (46) et fermeture de ladite première ouverture (48) au moyen dudit élément de fermeture ou de verrouillage (46), de façon à empêcher la sortie de ladite protubérance (25) de ladite ouverture dudit composant fémoral (3).
     




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    Cited references

    REFERENCES CITED IN THE DESCRIPTION



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    Patent documents cited in the description