Note: Within nine months of the publication of the mention of the grant of the European patent in the European Patent
3 609 439 B1
*EP003609439B1*
(11)
EP 3 609 439 B1
(12)
EUROPEAN PATENT SPECIFICATION
(45) Date of publication and mention of the grant of the patent:
06.01.2021 Bulletin 2021/01 (21) Application number: 18717604.5 (22) Date of filing: 12.04.2018
(51) Int Cl.:
A61F 2/40(2006.01)
(86) International application number:
PCT/EP2018/059444
(87) International publication number:
WO 2018/189322 (18.10.2018 Gazette 2018/42) (54) SCAPULAR ANCHOR FOR FIXING A GLENOID COMPONENT OF A SHOULDER JOINT
PROSTHESIS TO A SCAPULA WITH COMPROMISED ANATOMY AND RELATED METHOD FOR MANUFACTURING SAID SCAPULAR ANCHOR
SCHULTERBLATTANKER ZUR BEFESTIGUNG EINES GLENOIDKOMPONENTEN EINER SCHULTERGELENKENPROTHESE AN EINER SCHULTERBLATT MIT KOMPROMIERTER ANATOMIE UND VERWANDTE VERFAHREN ZUR HERSTELLUNG DIESES
SCHULTERBLATTANKERS
ANCRAGE SCAPULAIRE PERMETTANT DE FIXER UN COMPOSANT GLÉOÏDE D’UNE PROTHÈSE D’ARTICULATION D’ÉPAULE À UNE SCAPULE À ANATOMIE COMPROMIS ET PROCÉDÉ ASSOCIÉ DE FABRICATION DE CET ANCRE SCAPULAIRE
(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: 13.04.2017 IT 201700041420 (43) Date of publication of application:
19.02.2020 Bulletin 2020/08 (73) Proprietor: Limacorporate S.p.A.
33038 San Daniele Del Friuli (UD) (IT) (72) Inventors:
• SBAIZ, Fausto
33033 Codroipo (UD) (IT)
• PRESSACCO, Michele 33035 Martignacco (UD) (IT) (74) Representative: Botti, Mario
Botti & Ferrari S.r.l.
Via Cappellini, 11 20124 Milano (IT) (56) References cited:
EP-A1- 2 929 861 US-A- 4 919 669 US-A1- 2006 079 963 US-A1- 2007 179 624 US-A1- 2014 364 953 US-B1- 8 532 806
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Description Field of application
[0001] The present invention relates to a scapular an- chor for fixing a glenoid component of a shoulder joint prosthesis to a patient’s scapula, in particular a scapula with a compromised anatomy.
[0002] The invention also relates to a method for man- ufacturing said scapular anchor.
Prior art
[0003] As it is well known, the total shoulder prostheses provide a glenoid prosthetic component and a humeral component, which articulate with each other.
[0004] In the clinical practice two types of total shoulder prostheses are used.
[0005] A first type of prosthesis, defined anatomic and aimed at reproducing the natural anatomy of the gleno- humeral joint, provides a humeral component with con- vex end that articulates on a concave end of a glenoid component. On the contrary, a second type of prothesis, defined inverse, provides a convex glenoid component that articulates on a concave humeral component. This latter prosthesis is used in critical situations of rotator cuff instability.
[0006] The glenoid component, be it of anatomic or inverse prosthesis, is fixed to an anchor element or scapular insert, which in turn is placed in contact and anchored to the scapular glenoid cavity. The humeral component is instead fixed at the top of the humerus by means of a fixing stem that is inserted in the humerus itself.
[0007] The anchor element or scapular insert usually comprises a pin for fixing the glenoid component, which is inserted into a hole formed at the glenoid cavity, and a flange having a curved shape with a convex side in- serted in a seat previously formed in the glenoid cavity.
[0008] Though advantageous under various aspects and substantially satisfying the purpose, the anchor ele- ments have a common drawback since they are not able to ensure a correct and lasting fixing of the anchor ele- ment to the scapula in case of compromised bone anat- omy, with obvious serious loosening and/or detachment problems.
[0009] In particular, the known anchor elements have a standardized shape structure that is used for any pa- tient. During the preparation step to the implant, the bone surface of the glenoid cavity is processed by removing part of the bone so as to create the seat that will then receive the anchor element. Once the anchor element has been positioned in the seat, it is stabilized by inserting stabilization bone screws.
[0010] In this way an optimal fixing of the anchor ele- ment is guaranteed in case of patients having a substan- tially physiologic scapular anatomy.
[0011] However, as a skilled person may well under-
stand, the scapular anatomy of some patients may result compromised due to, for instance, resorption, deforma- tion or poor quality of the bone tissue. In other words, the scapular bone tissue undergoes a shape and/or compo- sition pathological alteration that varies from patient to patient. A surgeon could also face a compromised scapu- lar anatomy in case of a revision surgery of a shoulder joint prosthesis.
[0012] In case of important alterations of the scapular anatomy, the surgeon may have serious difficulties in obtaining the seat for the application of the anchor ele- ment and in the stabilization of the latter to the bone. As a consequence, the anchor element does not adequately match the below bone surface with the consequent im- pairment of the implant stability.
[0013] A solution adopted to ensure the stabilization of the glenoid element under conditions of compromised anatomy is to use stabilization screws that are long enough to reach the healthy bone deep in the glenoid.
[0014] Though advantageous under various aspects and substantially responding to the purpose, this solution is not always feasible due to the inter-patient heteroge- neity of the pathological scapular anatomy. In fact, the standard structure of the anchor element does not allow the screws to reach the healthy bone tissue in case of particularly compromised anatomies.
[0015] An alternative solution is described in the doc- ument US 2007/01799624 that discloses a modular an- atomical shoulder joint prosthesis wherein two tubular support members extend superiorly from the glenoid sup- port and are fixed to the coracoid and acromial process, respectively, by fasteners passing therethrough. These two support members are however strut structures that does not allow a simpler insertion of fasteners or screws.
[0016] An attempt to achieve a suitable fixation of the scapular anchor in scapular anatomies of a specific pa- tient is provided by the US patent 8,532,806. Said patent described a method of manufacturing a glenoid support that matches the contour of a fractured glenoid cavity.
[0017] Though advantageous under various aspects for threating fractured glenoid cavities, this solution can- not provide adequate fixation in case of scapular anato- mies in which the morphology of the glenoid cavity and/or the quality of the below bone are particularly altered.
[0018] The purpose of the present invention is to pro- vide a scapular anchor for fixing a glenoid component of a shoulder joint prosthesis to a patient’s scapula with compromised anatomy having structural and functional features such as to overcome the above drawbacks with reference to the prior art and to allow adaptability to the compromised scapular anatomies of the different pa- tients, even with morphology of the glenoid cavity and/or the quality of the below bone particularly altered, thus ensuring a stable and lasting fixing of the anchor element to the bone.
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Summary of the invention
[0019] The solution idea underlying the present inven- tion is to customize the scapular anchor, in particular a coracoid support of said scapular anchor, according to the pathological scapular anatomy of the single patient.
[0020] The customization can be implemented while manufacturing the anchor based on a faithful reconstruc- tion of the patient’s anatomy or possibly in the implanta- tion step.
[0021] Based on such a solution idea, the previously identified technical problem is solved by a scapular an- chor according to claim 1.
[0022] The customized portion of the implant is directly made to match the bone surface in the implantation step and does not need a reception seat. Obtaining the re- ception seat can be a task difficult to perform in case of severely compromised scapular anatomy due to defor- mation, reabsorption or poor quality of the pathological bone tissue.
[0023] By making the anchor perfectly match the bone surface, the stability of the anchor to the pathological scapular anatomy is promoted.
[0024] The customized portion can advantageously be the flange of the glenoid support, namely the distal sur- face of the flange having a substantially convex and wavy shape such as to shape to the bone morphology of the glenoid cavity.
[0025] Further customized portions can advanta- geously be represented by a coracoid support projection arranged to shape to the bone morphology of a coracoid process of the scapula and/or by at least one acromial support projection arranged to shape to the bone mor- phology of an acromial process of the scapula.
[0026] In case of scapular anatomies in which the mor- phology of the glenoid cavity and/or the quality of the below bone are particularly altered, the sole fixing of the scapular anchor to the glenoid cavity does not ensure a stable and lasting fixing. The presence of at least one coracoid support projection and/or at least one acromial support projection allows fixing the scapular anchor to other bone components of the scapula in order to obtain a proper fixing.
[0027] The coracoid support projection can have a sub- stantially tubular shape with a proximal end integral with the glenoid support and a second distal end adapted to abut to the coracoid process of the scapula; a through- hole can advantageously extend between the proximal end and the distal end for inserting a stabilization bone screw to the coracoid process of the scapula.
[0028] Likewise, the acromial support projection can have a substantially tubular shape with a proximal end integral with the glenoid support and a second distal end adapted to abut to the acromial process of the scapula;
a through-hole can advantageously extend between the proximal end and the distal end for inserting a stabiliza- tion bone screw to the acromial process of the scapula.
[0029] The distal surface of the glenoid support, the
coracoid and acromial support projections can therefore be directly designed based on a faithful reconstruction of the compromised scapular anatomy of the single pa- tient.
[0030] In particular, the at least one coracoid and/or acromial support projection can advantageously be se- lected from a plurality of different modules, which can have for instance a length and/or a specific orientation with respect to the glenoid support in order to adapt to the bone morphology and to allow the fixing to the cora- coid and acromial process of the scapula, respectively.
In this case the support projections are assembled to the glenoid support in the implantation step, thus also facil- itating the implantation process and a possible revision.
[0031] Alternatively, the coracoid and/or acromial sup- port projection can be made in one piece with said glenoid support for instance by means of EBM sintering or SLM manufacturing.
[0032] Advantageously, the distal surface of the gle- noid support and/or the distal end of the coracoid support projection and/or the distal end of the acromial support projection can have an at least partially irregular or trabecular structure to promote osteogenesis and bone integration.
[0033] Furthermore, the glenoid support can comprise at least one hole for inserting stabilization bone screws to the glenoid cavity and have the pin element made in one piece with the flange.
[0034] Anyway, the above said does not exclude the chance to have a glenoid support made of a pin and a flange, which can be assembled in the implantation step of the anchor.
[0035] The above identified technical problem is also solved by the method for manufacturing the scapular an- chor according to claim 11.
[0036] Said method can advantageously comprise a preliminary step of acquiring a bone morphology of a pa- tient’s scapula, for instance by means of computerized tomography.
[0037] The features and advantages of the scapular anchor according to the present invention will become clear from the following description of a preferred em- bodiment given as a non-limiting example with reference to the appended drawings.
Brief description of the drawings [0038]
- Figure 1 shows a proximal view of a scapular anchor for an artificial prosthesis of the shoulder manufac- tured according to the present invention;
- figure 2 shows a first side view of the scapular anchor of figure 1;
- figure 3 shows a distal view of the scapular anchor of figure 1;
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- figure 4 shows a second side view of the scapular anchor of figure 1;
- figure 5 shows a proximal view of the scapular anchor of figure 1 fixed to a scapula model with compro- mised anatomy;
- figure 6 shows a perspective view of the scapular anchor of figure 1 fixed to a scapula model with com- promised anatomy;
- figure 7 shows a proximal view in transparency of the scapular anchor of figure 1 fixed to a scapula model with compromised anatomy;
- figure 8 shows a first side view in transparency of the scapular anchor of figure 1 fixed to a scapula model with compromised anatomy;
- figure 9 shows a second side view in transparency of the scapular anchor of figure 1 fixed to a scapula model with compromised anatomy;
- figure 10 is a side view showing detached parts of an anatomical total artificial shoulder prosthesis comprising a scapular anchor according to the present invention;
- figure 11 is a side view showing detached parts of an inverse total artificial shoulder prosthesis com- prising a scapular anchor according to the present invention.
Detailed description
[0039] With reference to said figures, reference number 1 wholly and schematically indicates a preferred embodiment of an anchor element manufactured accord- ing to the present invention for stably and safely fixing a prosthesis for the shoulder joint to a scapula having com- promised bone anatomy.
[0040] In the following of the description we will refer to this anchor element 1 with the easier term of "scapular anchor".
[0041] Advantageously, the anchor 1 is a customizable component to be adapted to the compromised anatomy of the single patient.
[0042] The customization of the anchor can occur in the manufacturing step of the device or it can be directly carried out by the surgeon in the implantation step of the shoulder prothesis.
[0043] In the first case, the anchor morphology is adapted for each patient based on a faithful reconstruc- tion of the compromised scapular anatomy implemented by the modern computerized tomography techniques.
Said approach allows shaping the anchor so that in the implantation step it perfectly matches the articular bone surface which it will have to be fixed to.
[0044] On the contrary, in the second case the anchor has portions, which are standardized but at the same time modulable, allowing the surgeon to choose the an- chor configuration that best suits the patient’s anatomy in the implantation step.
[0045] The preferred embodiment described in the fol- lowing falls within the first customization case above de- scribed and in particular the anchor 1 is designed based on the model of a compromised scapular anatomy shown in figures 5-9. This does not exclude other customization ways of the anchor according to the compromised anat- omy of the single patient.
[0046] The anchor 1 shown in the appended figures comprises three portions for fixing to various bone sites of the scapula 50 with compromised anatomy: a glenoid support 2, a coracoid support projection 7 and an acro- mial support projection 8, arranged for fixing the anchor 1 to a glenoid cavity 51, to a coracoid process 52 and to an acromial process 53 of the scapula 50, respectively.
[0047] Other embodiments can provide a glenoid sup- port 2 with one or more coracoid support projections 7 and/or one or more acromial support projection 8.
[0048] The anchor 1 is made of a biocompatible metal material, for instance of titanium or an alloy thereof and has a macro-rough finish, for instance according to what is described in US 12/601,510 patent.
[0049] As it can be noticed from figures 1-4 showing the anchor 1 in itself, the glenoid support 2 comprises a pin element 3 that is hollow and extended along a longi- tudinal axis X-X with a longitudinal dimension greater than its diameter or than its radial size.
[0050] The outer surface of the pin element 3 has lon- gitudinal grooves to promote osteogenesis and bone in- tegration when inserted in a hole obtained by the surgeon in the glenoid cavity 51 of the scapula 50.
[0051] The pin 3 has a tapered distal end 3a, an op- posite flared proximal end 3c and is passed through by a fixing hole 3b. Within the hole 3b a glenoid component 100, 200 of a shoulder prosthesis is fixed.
[0052] A flange 4 is formed near the proximal end 3c.
The above flange 4 is defined by a distal surface 5 and by a proximal surface 6, which connect to each other at a proximal edge 20.
[0053] The proximal edge 20 is defined in turn by a first lateral edge 20a opposite a second lateral edge 20b, an upper edge 20c and a lower edge 20d. The terms "lower"
or "upper" are used here with reference to the prosthesis implanted on an upright patient, where the upper portion will face the head. Therefore, the preferential orientation of the anchor 1 corresponds to what is illustrated in figure 1.
[0054] The proximal surface 6 is a homogeneous and concave surface with a mirror pattern with respect to a symmetry axis Y-Y that is orthogonal to the axis X-X. On the bottom of the proximal surface 6 the flared proximal end 3c of the pin 3 and two stabilization through-holes 13 for the insertion of corresponding stabilization bone screws 12 to the glenoid cavity 51 open. The two stabi-
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lization holes 13 end up in the distal surface 5.
[0055] In the described preferred embodiment, the sta- bilization holes 13 are placed one above and one below the proximal end 3c of the pin 3.
[0056] Other arrangements and number of stabiliza- tion holes 13 can be provided in other embodiments ac- cording to the anatomic shape and quality of the glenoid bone tissue of the patient.
[0057] The distal surface 5, on the contrary, has a ten- dentially convex shape and a non-regular wavy pattern that reproduces the pathological morphology of the gle- noid cavity 51 of the scapula 50. In other words, the distal surface 5 of the glenoid support 2 is designed so as to be complementary shaped with respect to the surface of the glenoid cavity 51, which it will have to perfectly match at the time of implantation.
[0058] In particular, in the described embodiment, which is customized to match the anatomic model of fig- ures 5-9, the distal surface 5 of the glenoid support 2 wraps a first portion of the pin 3 from the closest side to the lateral edge 20a and has a tapered pattern starting from the pin 3 towards the lower edge 20c and the lateral edge 20a up to a lateral wall 20e connecting with the lateral edge 20a. At the opposite side of the pin with re- spect to the axis Y-Y, namely the closest one to the lateral edge 20b, the distal surface 5 wraps the proximal end 3c of the pin 3 and has a tapered pattern towards the lateral edge 20b up to a lateral wall 20f connecting with the lat- eral edge 20b. The lateral walls 20e, 20f are placed on planes parallel to the plane formed by the axes X-X and Y-Y.[0059] In alternative embodiments, the distal surface 5 may possibly or optionally not be customized to adapt to the single compromised scapular anatomy and have a standard shape, for instance plane or hemispherical, coupled in the implantation step with a seat suitably ob- tained at the glenoid cavity 51.
[0060] As it is clear from figures 2 and 4, the pin element 3 passes through the distal surface 5 protruding away therefrom. The pin element 3 can be made in one piece with the flange 4 or constrained to the latter by interfer- ence.
[0061] At the upper edge 20c the coracoid 7 and ac- romial 8 support projections depart.
[0062] The support projections 7, 8 have a substantial- ly tubular shape wherein a through-hole 11 extends from a proximal end 9 to a distal end 10. The proximal ends 9 of the support projections 7, 8 converge close to the axis Y-Y, but then the two support projections 7, 8 follow a divergent pattern away from the plane defined by the axes X-X and Y-Y and by the distal surface 5.
[0063] The through-holes 11 of the coracoid 7 and ac- romial 8 support projections allow the insertion of stabi- lization screws 12 for fixing to the coracoid 52 and acro- mial 53 processes, respectively.
[0064] In alternative embodiments the support projec- tions 7, 8 may take up different shapes, not be provided with a through-hole 11 and be fixed in other ways known
in the field, for instance by interference without using any fixing means.
[0065] In the described preferred embodiment, the coracoid 7 and acromial 8 support projections are made in one piece with the glenoid support 2. For instance, the projections can be made by EBM sintering or SLM man- ufacturing processes. Alternative embodiments can in- stead provide projections 7, 8 assembled with the glenoid support 2 in the implantation step of the anchor 1 so as to facilitate the surgery and possible future revisions.
[0066] Anyway, the support projections 7, 8 have a length and an orientation designed according to the com- promised scapular anatomy 50 so that, when the anchor 1 is implanted, the distal end 10 abuts against the corre- sponding surface of the bone process 52, 53, which the projection 7, 8 is fixed to by means of the stabilization screw 12.
[0067] As it is clear from figures 2 and 4, the distal end 10 of the coracoid support projection 7 and part of the distal surface 5 of the below glenoid support 2 have an irregular or trabecular structure 5a to promote osteogen- esis and bone integration and was chosen to increase the contact friction of the distal end 10 and of the glenoid support 2 with respect to the surface of the coracoid proc- ess 7 and of the glenoid cavity 51 which it is respectively coupled to. This does not exclude that other surfaces or all of the surfaces in contact with the bone can be man- ufactured with a trabecular structure.
[0068] Therefore, each projection 7 or 8 has a shape that can be customized for any patient in the implantation step, by adjusting for instance length and/or orientation thereof, adapting it to the specific anatomy of the coracoid 52 and acromial 53 processes of the patient prior to the manufacturing step.
[0069] Figures 5-9 show the preferred embodiment of the scapular anchor 1 fixed to a scapula model with com- promised anatomy, which it has been specifically de- signed for.
[0070] As it can be noticed from the above cited figures, the glenoid support 2 is implanted by making the distal surface 6, excluding the lateral walls 20e, 20f, match the glenoid cavity 51, which it perfectly coincides with. At the same time, the pin element 3 is inserted in a hole suitably formed in the glenoid cavity 51 and the stabilization screws 12 are inserted in the stabilization holes 8 and screwed to the bone below.
[0071] A further support is ensured by the two coracoid 7 and acromial 8 support projections that engage the distal end 10 against the respective coracoid 52 and ac- romial 53 process which they are fixed to by means of stabilization screws 12 inserted through the proximal end 9 into the through-hole 11.
[0072] Once the scapular anchor 1 has been fixed to the patient’s scapula 50, as just described, the glenoid component 100, 200 of the shoulder total prosthesis is fixed thereto, said glenoid component 100, 200 will ar- ticulate with a humeral component 101, 201 previously fixed at the top of the humerus by means of a humeral
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stem 102, 202.
[0073] Figures 10 and 11 is a side view showing de- tached parts of a total artificial shoulder prosthesis, an- atomic and inverse respectively, comprising a scapular anchor 1 according to the present invention.
[0074] From the above description it is clear that the anchor according to the present invention achieves the intended purposes and several advantages, the main of which are hereinbelow listed.
[0075] Essentially, the solution of the present invention provides a customized scapular anchor in the design or implantation step to adapt to the particular compromised scapular anatomy of the single patient, detected for in- stance by computerized tomography.
[0076] Advantageously, the scapular anchor provides a glenoid support that can be complementary shaped with respect to the glenoid cavity which it perfectly match- es once it has been implanted, thus promoting the implant stability.
[0077] Advantageously, the scapular anchor provides a coracoid support projection and/or an acromial support projection that offer a further support for the stabilization and fixing of the anchor to the scapula. Said projections can advantageously be customized in the design or im- plantation step to adapt to the particular anatomy of the coracoid and acromial processes of the patient.
[0078] Advantageously, the distal surface of the gle- noid support and/or the second distal end of the coracoid and/or acromial support projection can have an irregular or trabecular structure to promote osteogenesis and bone integration.
Claims
1. A scapular anchor (1) for fixing a glenoid component (100, 200) of a shoulder joint prosthesis to a patient’s scapula (50) with compromised anatomy, compris- ing a glenoid support (2) and at least one acromial support projection (8) arranged to be fixed to an ac- romial process (53) of said scapula (50), said glenoid support (2) being defined by a pin (3) for fixing said glenoid component (100, 200) to said scapular an- chor (1) and by a flange (4) integral with said pin (3), said flange (4) having a distal surface (5) adapted to be at least partially in contact with a glenoid cavity (51) of said scapula (50) and a proximal surface (6) opposite said distal surface (5); characterized in that said scapular anchor (1) comprises at least one customized portion (5, 7, 8) specifically shaped with respect to the bone morphology of the scapula (50) of a single patient with compromised anatomy; said at least one customized portion (5, 7, 8) comprises at least one coracoid support projection (7) arranged to abut at a coracoid process (52) of said scapula (50) and having a substantially tubular shape having a proximal end (9) adjacent to said glenoid support (2) and a distal end (10) adapted to abut to said cora-
coid process (52) of said scapula (50); a through- hole (11) extending between said proximal end (9) and said distal end (10) for inserting a stabilization bone screw (12) into said coracoid process (52) of said scapula (50); said coracoid support projection (7) and/or said acromial support projection (8) being made in one piece with said glenoid support (2).
2. The scapular anchor (1) according to claim 1, where- in said at least one customized portion (5, 7, 8) com- prises at least the distal surface (5) of said flange (4), said distal surface (5) being complementary shaped with respect to the glenoid cavity of said scapula.
3. The scapular anchor (1) according to claim 1, where- in said at least one customized portion (5, 7, 8) com- prises at least one acromial support projection (8) arranged to abut at an acromion process (53) of said scapula (50).
4. The scapular anchor (1) according to claim 3, where- in said at least one acromial support projection (8) has a substantially tubular shape having a proximal end (9) adjacent to said glenoid support (2) and a distal end (10) adapted to abut to said acromion proc- ess (53) of said scapula (50).
5. The scapular anchor (1) according to claim 4, where- in a through-hole (11) extends between said proxi- mal end (9) and said distal end (10) for inserting a stabilization bone screw (12) into said acromion process (53) of said scapula (50).
6. The scapular anchor (1) according to claim 5, where- in said coracoid support projection (7) and/or said acromial support projection (8) are structurally dis- tinct from the glenoid support (2), are selected from a plurality of projections with different dimensional and/or morphological features and are assembled to the glenoid support (2).
7. The scapular anchor (1) according to claim 5, where- in said distal end (5) of said glenoid support (2) and/or said distal end (10) of said coracoid support (7) and/or said distal end (10) of said acromial support projection (8) have a partially irregular or trabecular structure to promote osteogenesis and bone integra- tion.
8. The scapular anchor (1) according to claim 1, where- in said glenoid support (2) comprises at least one hole (13) for inserting stabilization bone screws (12) to stabilize said glenoid support (2) to said glenoid cavity (51).
9. A method for manufacturing a scapular anchor (1) for fixing a glenoid component (100, 200) of a shoul-
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der joint prosthesis to a patient’s scapula (50) with compromised anatomy, of the type comprising the steps of providing a glenoid support (2) and at least one acromial support projection (8) arranged to be fixed to an acromial process (53) of said scapula (50), said glenoid support (2) being defined by a pin (3) for fixing said glenoid component (100, 200) to said scapular anchor (1) and a flange (4) integral with said pin (3), said flange (4) having a distal sur- face (5) adapted to be at least partially in contact with a glenoid cavity (51) of said scapula (50) and a proximal surface (6) opposite said distal surface (5);
characterized in that it comprises a step of specif- ically providing at least one customized portion (5, 7, 8) of said scapular anchor (1) shaped to match the bone morphology of a scapula (50) of a single patient with compromised anatomy, in that said at least one customized portion (5, 7, 8) comprises at least one coracoid support projection (7) arranged to abut at a coracoid process (52) of said scapula (50), and in that the method comprises a step of forming said coracoid support projection (7) and/or said acromial support projection (8) in one piece with said glenoid support (2).
10. The method for manufacturing a scapular anchor (1) according to claim 9, wherein said method comprises a step of acquiring a bone morphology of a patient’s scapula, for example by computerized tomography, prior to the step of shaping said custom portion (5, 7, 8) of the scapular anchor (1).
11. A scapular anchor (1) for fixing a glenoid component (100, 200) of a shoulder joint prosthesis to a patient’s scapula (50) with compromised anatomy, compris- ing:
- a glenoid support (2) including a flange (4) and a pin (3) integral with the flange (4) for fixing said glenoid component (100, 200) to said scapular anchor (1);
- said flange (4) having a distal surface (5) struc- tured to be at least partially in contact with a glenoid cavity (51) of said scapula (50) and an opposite proximal surface (6);
- said scapular anchor (1) comprising at least one customized portion (5, 7, 8) specifically shaped to match the bone morphology of the scapula (50) of a single patient with compro- mised anatomy;
- said at least one customized portion (5, 7, 8) comprises at least one coracoid support projec- tion (7) having a substantially tubular shape in- tegrally formed with said glenoid support (2) and structured to abut at a coracoid process (52) of said scapula (50);
- a proximal end (9) of said at least one coracoid support projection (7) being adjacent to said gle-
noid support (2);
- a distal end (10) of said at least one coracoid support projection (7) being structured to abut to said coracoid process (52) of said scapula (50);
- a through-hole (11) extending between said proximal end (9) and said distal end (10) for in- serting a stabilization bone screw (12) into said coracoid process (52) of said scapula (50).
12. The scapular anchor (1) according to claim 11, wherein said at least one customized portion (5, 7, 8) comprises at least the distal surface (5) of said flange (4), said distal surface (5) being complemen- tary shaped with respect to the glenoid cavity (51) of said scapula (50).
13. The scapular anchor (1) according to claim 11, wherein said at least one customized portion (5, 7, 8) comprises at least one acromial support projection (8) arranged to abut at an acromion process (53) of said scapula (50).
14. The scapular anchor (1) according to claim 13, wherein said at least one acromial support projection (8) has a substantially tubular shape having a prox- imal end (9) adjacent to said glenoid support (2) and a distal end (10) adapted to abut to said acromion process (53) of said scapula (50).
15. The scapular anchor (1) according to claim 14, wherein a through-hole (11) extends between said proximal end (9) and said distal end (10) for inserting a stabilization bone screw (12) into said acromion process (53) of said scapula (50).
16. The scapular anchor (1) according to claim 15, wherein said acromial support projection (8) is made in one piece with said glenoid support (2).
17. The scapular anchor (1) according to claim 15, wherein said acromial support projection (8) is struc- turally distinct from the glenoid support (2), is select- ed from a plurality of projections with different dimen- sional and/or morphological features and are assem- bled to the glenoid support (2).
18. The scapular anchor (1) according to claim 15, wherein said distal end (5) of said glenoid support (2) and/or said distal end (10) of said coracoid sup- port (7) and/or said distal end (10) of said acromial support projection (8) have a partially irregular or trabecular structure to promote osteogenesis and bone integration.
19. The scapular anchor (1) according to claim 11, wherein said glenoid support (2) comprises at least one hole (13) for inserting stabilization bone screws
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(12) to stabilize said glenoid support (2) to said gle- noid cavity (51).
20. A method for manufacturing a scapular anchor (1) for fixing a glenoid component (100, 200) of a shoul- der joint prosthesis to a patient’s scapula (50) with compromised anatomy; the method including the steps of:
- providing a glenoid support (2) including a flange (4) and a pin (3) integral with the flange (4) for fixing said glenoid component (100, 200) to said scapular anchor (1);
- said flange (4) having a distal surface (5) struc- tured to be at least partially in contact with a glenoid cavity (51) of said scapula (50) and an opposite proximal surface (6);
- providing at least one customized portion (5, 7, 8) of said scapular anchor (1) specifically shaped to match the bone morphology of the scapula (50) of a single patient with compro- mised anatomy;
- said at least one customized portion (5, 7, 8) comprising at least one coracoid support projec- tion (7) having a substantially tubular shape in- tegrally formed with said glenoid support (2) and structured to abut at a coracoid process (52) of said scapula (50).
21. The method for manufacturing a scapular anchor (1) according to claim 20 wherein a proximal end (9) of said at least one coracoid support projection (7) be- ing formed adjacent to said glenoid support (2) while a distal end (10) of said at least one coracoid support projection (7) being structured to abut to said cora- coid process (52) of said scapula (50);
- a through-hole (11) extending between said proximal end (9) and said distal end (10) for re- ceiving a stabilization bone screw (12) into said coracoid process (52) of said scapula (50).
22. The method for manufacturing a scapular anchor (1) according to claim 21, wherein said method compris- es a step of acquiring a bone morphology of a pa- tient’s scapula, for example by computerized tom- ography, prior to the step of shaping said custom portion (5, 7, 8) of the scapular anchor (1).
Patentansprüche
1. Scapula-Anker (1) zum Befestigen einer Glenoid- komponente (100, 200) einer Schultergelenkprothe- se an einer Scapula (50) eines Patienten mit einge- schränkter Anatomie, aufweisend eine Glenoidstüt- ze (2) und mindestens einen Acromionstützvor- sprung (8), der dafür ausgelegt ist, um an einem
acrominalen Fortsatz (53) der Scapula (50) befestigt zu werden, , wobei die Glenoidstütze (2) durch einen Stift (3) zum Befestigen der Glenoidkomponente (100, 200) an dem Scapula-Anker (1) und durch ei- nen mit dem Stift (3) einstückig ausgebildeten Flansch (4) definiert ist, wobei der Flansch (4) eine distale Fläche (5), die angepasst ist, um mindestens teilweise mit der Gelenkpfanne (51) der Scapula (50) in Berührung zu stehen, und eine proximale Fläche (6) gegenüber der distalen Fläche (5) hat; dadurch gekennzeichnet, dass der Scapula-Anker (1) min- destens einen angepassten Abschnitt (5, 7, 8) auf- weist, der speziell in Bezug auf die Knochenmorpho- logie der Scapula (50) eines einzelnen Patienten mit eingeschränkter Anatomie geformt ist; der mindes- tens eine angepasste Abschnitt (5, 7, 8) mindestens einen Coracoidstützvorsprung (7) aufweist, der da- für ausgelegt ist, um an einem Coracoidfortsatz (52) der Scapula (50) anzuliegen, und eine im Wesentli- chen röhrenförmige Gestalt mit einem proximalen Ende (9), das an die Glenoidstütze (2) angrenzt, und einem distalen Ende (10) hat, das angepasst ist, um an dem Coracoidfortsatz (52) der Scapula (50) an- zuliegen; wobei sich zwischen dem proximalen Ende (9) und dem distalen Ende (10) ein Durchgangsloch (11) zum Einführen einer Stabilisierungsknochen- schraube (12) in den Coracoidfortsatz (52) der Sca- pula (50) erstreckt; wobei der Coracoidstützvor- sprung (7) und/oder der Acromionstützvorsprung (8) in einem Stück mit der Glenoidstütze (2) hergestellt sind/ist.
2. Scapula-Anker (1) nach Anspruch 1, wobei der min- destens eine angepasste Abschnitt (5, 7, 8) mindes- tens die distale Fläche (5) des Flansches (4) auf- weist, wobei die distale Fläche (5) in Bezug auf die Gelenkpfanne der Scapula komplementär geformt ist.
3. Scapula-Anker (1) nach Anspruch 1, wobei der min- destens eine angepasste Abschnitt (5, 7, 8) mindes- tens einen Acromionstützvorsprung (8) aufweist, der dafür ausgelegt ist, um an einem Acromionfortsatz (53) der Scapula (50) anzuliegen.
4. Scapula-Anker (1) nach Anspruch 3, wobei der min- destens eine Acromionstützvorsprung (8) eine im Wesentlichen röhrenförmige Gestalt mit einem pro- ximalen Ende (9), das an die Glenoidstütze (2) an- grenzt, und einem distalen Ende (10) hat, das ange- passt ist, um an den Acromionfortsatz (53) der Sca- pula (50) anzuliegen.
5. Scapula-Anker (1) nach Anspruch 4, wobei sich ein Durchgangsloch (11) zwischen dem proximalen En- de (9) und dem distalen Ende (10) zum Einführen einer Stabilisierungsknochenschraube (12) in den Acromionfortsatz (53) der Scapula (50) erstreckt.
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6. Scapula-Anker (1) nach Anspruch 5, wobei sich der Coracoidstützvorsprung (7) und/oder der Acromi- onstützvorsprung (8) strukturell von der Glenoidstüt- ze (2) unterscheiden, aus mehreren Vorsprüngen mit unterschiedlichen dimensionalen und/oder mor- phologischen Merkmalen ausgewählt sind und mit der Glenoidstütze (2) zusammengebaut sind.
7. Scapula-Anker (1) nach Anspruch 5, wobei das dis- tale Ende (5) der Glenoidstütze (2) und/oder das dis- tale Ende (10) der Coracoidstütze (7) und/oder das distale Ende (10) des Acromionstützvorsprungs (8) eine teilweise unregelmäßige oder trabekuläre Struktur haben, um Osteogenese und Knocheninte- gration zu fördern.
8. Scapula-Anker (1) nach Anspruch 1, wobei die Gle- noidstütze (2) mindestens ein Loch (13) zum Einfüh- ren von Stabilisierungsknochenschrauben (12) auf- weist, um die Glenoidstütze (2) an der Gelenkpfanne (51) zu stabilisieren.
9. Verfahren zur Herstellung eines Scapula-Ankers (1) zum Befestigen einer Glenoidkomponente (100, 200) einer Schultergelenkprothese an einer Scapula (50) eines Patienten mit eingeschränkter Anatomie, des Typs, der die Schritte des Vorsehens einer Gle- noidstütze (2) und mindestens eines Acromionstütz- vorsprungs (8) umfasst, der dafür ausgelegt ist, um an einem acrominalen Fortsatz (53) der Scapula (50) befestigt zu werden, wobei die Glenoidstütze (2) durch einen Stift (3) zum Befestigen der Glenoid- komponente (100, 200) an dem Scapula-Anker (1) und einen mit dem Stift (3) einstückig ausgebildeten Flansch (4) definiert ist, wobei der Flansch (4) eine distale Fläche (5), die angepasst ist, um mindestens teilweise mit der Gelenkpfanne (51) der Scapula (50) in Berührung zu stehen, und eine proximale Fläche (6) gegenüber der distalen Fläche (5) hat; dadurch gekennzeichnet, dass es einen Schritt umfasst, bei dem mindestens ein angepasster Abschnitt (5, 7, 8) des Scapula-Ankers (1) speziell vorgesehen wird, der geformt ist, um der Knochenmorphologie einer Scapula (50) eines einzelnen Patienten mit einer ein- geschränkten Anatomie zu entsprechen, dass der mindestens eine angepasste Abschnitt (5, 7, 8) min- destens einen Coracoidstützvorsprung (7) aufweist, der dafür ausgelegt ist, um an einem Coracoidfort- satz (52) der Scapula (50) anzuliegen, und dass das Verfahren einen Schritt zum Formen des Coracoid- stützvorsprungs (7) und/oder des Acromionstützvor- sprungs (8) in einem Stück mit der Glenoidstütze (2) umfasst.
10. Verfahren zur Herstellung eines Scapula-Ankers (1) nach Anspruch 9, wobei das Verfahren vor dem Schritt des Formens des angepassten Abschnitts (5, 7, 8) des Scapula-Ankers (1) einen Schritt des Er-
fassens einer Knochenmorphologie der Scapula ei- nes Patienten, beispielsweise durch Computerto- mographie, umfasst.
11. Scapula-Anker (1) zum Befestigen einer Glenoid- komponente (100, 200) einer Schultergelenkprothe- se an einer Scapula (50) eines Patienten mit einge- schränkter Anatomie, aufweisend:
- eine Glenoidstütze (2) mit einem Flansch (4) und einem mit dem Flansch (4) einstückig aus- gebildeten Stift (3) zum Befestigen der Gleno- idkomponente (100, 200) an dem Scapula-An- ker (1);
- wobei der Flansch (4) eine distale Fläche (5), die strukturiert ist, um mindestens teilweise mit der Gelenkpfanne (51) der Scapula (50) in Be- rührung zu stehen, und eine gegenüberliegende proximale Fläche (6) hat;
- wobei der Scapula-Anker (1) mindestens einen angepassten Abschnitt (5, 7, 8) aufweist, der speziell geformt ist, um der Knochenmorpholo- gie der Scapula (50) eines einzelnen Patienten mit eingeschränkter Anatomie zu entsprechen;
- wobei der mindestens eine angepasste Ab- schnitt (5, 7, 8) mindestens einen Coracoidstütz- vorsprung (7) mit einer im Wesentlichen röhren- förmigen Gestalt hat, der einstückig mit der Gle- noidstütze (2) ausgebildet und strukturiert ist, um an einem Coracoidfortsatz (52) der Scapula (50) anzuliegen;
- wobei ein proximales Ende (9) des mindestens einen Coracoidstützvorsprungs (7) an die Gle- noidstütze (2) angrenzt;
- wobei ein distales Ende (10) des mindestens einen Coracoidstützvorsprungs (7) strukturiert ist, um an den Coracoidfortsatz (52) der Scapula (50) anzuliegen;
- wobei sich zwischen dem proximalen Ende (9) und dem distalen Ende (10) ein Durchgangsloch (11) zum Einführen einer Stabilisierungskno- chenschraube (12) in den Coracoidfortsatz (52) der Scapula (50) erstreckt.
12. Scapula-Anker (1) nach Anspruch 11, wobei der min- destens eine angepasste Abschnitt (5, 7, 8) mindes- tens die distale Fläche (5) des Flansches (4) auf- weist, wobei die distale Fläche (5) in Bezug auf die Gelenkpfanne (51) der Scapula (50) komplementär geformt ist.
13. Scapula-Anker (1) nach Anspruch 11, wobei der min- destens eine angepasste Abschnitt (5, 7, 8) mindes- tens einen Acromionstützvorsprung (8) aufweist, der dafür ausgelegt ist, um an einem Acromionfortsatz (53) der Scapula (50) anzuliegen.
14. Scapula-Anker (1) nach Anspruch 13, wobei der min-
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destens eine Acromionstützvorsprung (8) eine im Wesentlichen röhrenförmige Gestalt mit einem pro- ximalen Ende (9), das an die Glenoidstütze (2) an- grenzt, und einem distalen Ende (10) hat, das ange- passt ist, um an den Acromionfortsatz (53) der Sca- pula (50) anzuliegen.
15. Scapula-Anker (1) nach Anspruch 14, wobei sich zwischen dem proximalen Ende (9) und dem distalen Ende (10) ein Durchgangsloch (11) zum Einführen einer Stabilisierungsknochenschraube (12) in den Acromionfortsatz (53) der Scapula (50) erstreckt.
16. Scapula-Anker (1) nach Anspruch 15, wobei der Acromionstützvorsprung (8) in einem Stück mit der Glenoidstütze (2) hergestellt ist.
17. Scapula-Anker (1) nach Anspruch 15, wobei sich der Acromionstützvorsprung (8) strukturell von der Gle- noidstütze (2) unterscheidet, aus mehreren Vor- sprüngen mit unterschiedlichen dimensionalen und/oder morphologischen Merkmalen ausgewählt ist und mit der Glenoidstütze (2) zusammengebaut ist.
18. Scapula-Anker (1) nach Anspruch 15, wobei das dis- tale Ende (5) der Glenoidstütze (2) und/oder das dis- tale Ende (10) der Coracoidstütze (7) und/oder das distale Ende (10) des Acromionstützvorsprungs (8) eine teilweise unregelmäßige oder trabekuläre Struktur haben/hat, um die Osteogenese und Kno- chenintegration zu fördern.
19. Scapula-Anker (1) nach Anspruch 11, wobei die Gle- noidstütze (2) mindestens ein Loch (13) zum Einfüh- ren von Stabilisierungsknochenschrauben (12) auf- weist, um die Glenoidstütze (2) an der Gelenkpfanne (51) zu stabilisieren.
20. Verfahren zur Herstellung eines Scapula-Ankers (1) zum Befestigen einer Glenoidkomponente (100, 200) einer Schultergelenkprothese an einer Scapula (50) eines Patienten mit eingeschränkter Anatomie;
wobei das Verfahren die folgenden Schritte umfasst:
- Vorsehen einer Glenoidstütze (2) mit einem Flansch (4) und einem mit dem Flansch (4) ein- stückig ausgebildeten Stift (3) zum Befestigen der Glenoidkomponente (100, 200) an dem Sca- pula-Anker (1);
- wobei der Flansch (4) eine distale Fläche (5), die strukturiert ist, um mindestens teilweise mit der Gelenkpfanne (51) der Scapula (50) in Be- rührung zu stehen, und eine gegenüberliegende proximale Fläche (6) hat;
- Vorsehen mindestens eines angepassten Ab- schnitts (5, 7, 8) des Scapula-Ankers (1), der speziell geformt ist, um der Knochenmorpholo-
gie der Scapula (50) eines einzelnen Patienten mit eingeschränkter Anatomie zu entsprechen;
- wobei der mindestens eine angepasste Ab- schnitt (5, 7, 8) mindestens einen Coracoidstütz- vorsprung (7) aufweist, der eine im Wesentli- chen röhrenförmige Gestalt hat, die einstückig mit der Glenoidstütze (2) ausgebildet und struk- turiert ist, um an einem Coracoidfortsatz (52) der Scapula (50) anzuliegen.
21. Verfahren zur Herstellung eines Scapula-Ankers (1) nach Anspruch 20, wobei ein proximales Ende (9) des mindestens einen Coracoidstützvorsprungs (7) an die Glenoidstütze (2) angrenzend ausgebildet wird, während ein distales Ende (10) des mindestens einen Coracoidstützvorsprungs (7) strukturiert wird, um an dem Coracoidfortsatz (52) der Scapula (50) anzuliegen;
- wobei sich ein Durchgangsloch (11) zwischen dem proximalen Ende (9) und dem distalen En- de (10) erstreckt zur Aufnahme einer Stabilisie- rungsknochenschraube (12) in den Coracoid- fortsatz (52) der Scapula (50).
22. Verfahren zur Herstellung eines Scapula-Ankers (1) nach Anspruch 21, wobei das Verfahren vor dem Schritt des Formens des angepassten Abschnitts (5, 7, 8) des Scapula-Ankers (1) einen Schritt des Er- fassens einer Knochenmorphologie der Scapula ei- nes Patienten, zum Beispiel durch Computertomo- graphie, umfasst.
Revendications
1. Ancrage scapulaire (1) pour fixer un composant glé- noïdien (100, 200) d’une prothèse d’articulation de l’épaule à l’omoplate (50) d’un patient dont l’anato- mie est endommagée, comprenant un support glé- noïdien (2) et au moins une saillie de support acro- mial (8) conçue pour être fixée à un processus d’acromion (53) de l’omoplate (50), le support glé- noïdien (2) étant défini par une broche (3) pour fixer le composant glénoïdien (100, 200) à l’ancrage sca- pulaire (1) et par une bride (4) solidaire de la broche (3), la bride (4) ayant une surface distale (5) adaptée pour être au moins partiellement en contact avec une cavité glénoïde (51) de l’omoplate (50) et une surface proximale (6) opposée à la surface distale (5) ; caractérisé en ce que l’ancrage scapulaire (1) comprend au moins une partie personnalisée (5, 7, 8) spécifiquement formée selon la morphologie os- seuse de l’omoplate (50) d’un patient particulier pré- sentant une anatomie endommagée ; ladite au moins une partie personnalisée (5, 7, 8) comprend au moins une saillie de support coracoïde (7) conçue pour s’adosser à un processus coracoïde (52) de
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l’omoplate (50) et a une forme sensiblement tubu- laire ayant une extrémité proximale (9) adjacente au support glénoïdien (2) et une extrémité distale (10) adaptée s’adosser au processus coracoïde (52) de l’omoplate (50) ; un trou traversant (11) s’étendant entre l’extrémité proximale (9) et l’extrémité distale (10) pour insérer une vis osseuse de stabilisation (12) dans le processus coracoïde (52) de l’omoplate (50) ; la saillie de support coracoïde (7) et/ou la saillie de support acromial (8) étant réalisées en une seule pièce avec le support glénoïdien (2).
2. Ancrage scapulaire (1) selon la revendication 1, dans lequel ladite au moins une partie personnalisée (5, 7, 8) comprend au moins la surface distale (5) de la bride (4), la surface distale (5) étant de forme com- plémentaire à la cavité glénoïde de l’omoplate.
3. Ancrage scapulaire (1) selon la revendication 1, dans lequel ladite au moins une partie personnalisée (5, 7, 8) comprend au moins une saillie de support acromial (8) conçue pour s’adosser à un processus d’acromion (53) de l’omoplate (50).
4. Ancrage scapulaire (1) selon la revendication 3, dans lequel ladite au moins une saillie de support acromial (8) a une forme sensiblement tubulaire ayant une extrémité proximale (9) adjacente au sup- port glénoïdien (2) et une extrémité distale (10) con- çue pour s’adosser au processus d’acromion (53) de l’omoplate (50).
5. Ancrage scapulaire (1) selon la revendication 4, dans lequel un trou traversant (11) s’étend entre l’ex- trémité proximale (9) et l’extrémité distale (10) pour insérer une vis osseuse de stabilisation (12) dans le processus d’acromion (53) de l’omoplate (50).
6. Ancrage scapulaire (1) selon la revendication 5, dans lequel la saillie de support coracoïde (7) et/ou la saillie de support acromial (8) sont structurelle- ment distinctes du support glénoïdien (2), elles sont sélectionnées parmi une pluralité de saillies ayant des caractéristiques dimensionnelles et/ou morpho- logiques différentes et sont assemblées au support glénoïdien (2).
7. Ancrage scapulaire (1) selon la revendication 5, dans lequel l’extrémité distale (5) du support glénoï- dien (2) et/ou l’extrémité distale (10) du support co- racoïde (7) et/ou l’extrémité distale (10) de la saillie de support acromial (8) ont une structure partielle- ment irrégulière ou trabéculaire pour favoriser l’os- téogenèse et l’intégration osseuse.
8. Ancrage scapulaire (1) selon la revendication 1, dans lequel le support glénoïdien (2) comprend au moins un trou (13) pour insérer des vis osseuses de
stabilisation (12) afin de stabiliser le support glénoï- dien (2) sur la cavité glénoïde (51).
9. Procédé de fabrication d’un ancrage scapulaire (1) pour fixer un composant glénoïdien (100, 200) d’une prothèse d’articulation de l’épaule à l’omoplate (50) d’un patient dont l’anatomie est endommagée, du type comprenant les étapes consistant à fournir un support glénoïdien (2) et au moins une saillie de sup- port acromial (8) conçue pour être fixée à un proces- sus d’acromion (53) de l’omoplate (50), le support glénoïdien (2) étant défini par une broche (3) pour fixer le composant glénoïdien (100, 200) à l’ancrage scapulaire (1) et par une bride (4) solidaire de la bro- che (3), la bride (4) ayant une surface distale (5) adaptée pour être au moins partiellement en contact avec une cavité glénoïde (51) de l’omoplate (50) et une surface proximale (6) opposée à la surface dis- tale (5) ; caractérisé en ce qu’il comprend une éta- pe consistant à fournir spécifiquement au moins une partie personnalisée (5, 7, 8) de l’ancrage scapulaire (1) formée pour correspondre à la morphologie os- seuse d’une omoplate (50) d’un patient particulier ayant une anatomie endommagée, en ce que ladite au moins une partie personnalisée (5, 7, 8) com- prend au moins une saillie de support coracoïde (7) conçue pour s’adosser à un processus coracoïde (52) de l’omoplate (50), et en ce que le procédé com- prend une étape consistant à former la saillie de sup- port coracoïde (7) et/ou la saillie de support acromial (8) en une seule pièce avec le support glénoïdien (2).
10. Procédé de fabrication d’un ancrage scapulaire (1) selon la revendication 9, dans lequel le procédé com- prend une étape consistant à acquérir une morpho- logie osseuse de l’omoplate d’un patient, par exem- ple par tomographie informatisée, avant l’étape con- sistant à façonner la partie personnalisée (5, 7, 8) de l’ancrage scapulaire (1).
11. Ancrage scapulaire (1) pour fixer un composant glé- noïdien (100, 200) d’une prothèse d’articulation de l’épaule à l’omoplate (50) d’un patient dont l’anato- mie est endommagée, comprenant :
- un support glénoïdien (2) comprenant une bri- de (4) et une broche (3) solidaire de la bride (4) pour fixer le composant glénoïdien (100, 200) à l’ancrage scapulaire (1) ;
- la bride (4) ayant une surface distale (5) struc- turée pour être au moins partiellement en con- tact avec une cavité glénoïde (51) de l’omoplate (50) et une surface proximale (6) opposée ; - l’ancrage scapulaire (1) comprenant au moins une partie personnalisée (5, 7, 8) spécifique- ment formée pour correspondre à la morpholo- gie osseuse de l’omoplate (50) d’un patient par- ticulier présentant une anatomie endommagée ;
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- ladite au moins une partie personnalisée (5, 7, 8) comprenant au moins une saillie de support coracoïde (7) ayant une forme sensiblement tu- bulaire formée d’un seul tenant avec le support glénoïdien (2) et structurée pour s’adosser à un processus coracoïde (52) de l’omoplate (50) ; - une extrémité proximale (9) de ladite au moins une saillie de support coracoïde (7) étant adja- cente au support glénoïdien (2) ;
- une extrémité distale (10) de ladite au moins une saillie de support coracoïde (7) étant struc- turée pour s’adosser au processus coracoïde (52) de l’omoplate (50) ;
- un trou traversant (11) s’étendant entre l’extré- mité proximale (9) et l’extrémité distale (10) pour insérer une vis osseuse de stabilisation (12) dans le processus coracoïde (52) de l’omoplate (50).
12. Ancrage scapulaire (1) selon la revendication 11, dans lequel ladite au moins une partie personnalisée (5, 7, 8) comprend au moins la surface distale (5) de la bride (4), la surface distale (5) étant de forme com- plémentaire à la cavité glénoïde (51) de l’omoplate (50).
13. Ancrage scapulaire (1) selon la revendication 11, dans lequel ladite au moins une partie personnalisée (5, 7, 8) comprend au moins une saillie de support acromial (8) conçue pour s’adosser à un processus d’acromion (53) de l’omoplate (50).
14. Ancrage scapulaire (1) selon la revendication 13, dans lequel ladite au moins une saillie de support acromial (8) a une forme sensiblement tubulaire ayant une extrémité proximale (9) adjacente au sup- port glénoïdien (2) et une extrémité distale (10) adap- tée pour s’adosser au processus d’acromion (53) de l’omoplate (50).
15. Ancrage scapulaire (1) selon la revendication 14, dans lequel un trou traversant (11) s’étend entre l’ex- trémité proximale (9) et l’extrémité distale (10) pour insérer une vis osseuse de stabilisation (12) dans le processus d’acromion (53) de l’omoplate (50).
16. Ancrage scapulaire (1) selon la revendication 15, dans lequel la saillie de support acromial (8) est réa- lisée en une seule pièce avec le support glénoïdien (2).
17. Ancrage scapulaire (1) selon la revendication 15, dans laquelle la saillie de support acromial (8) est structurellement distincte du support glénoïdien (2), elle est choisie parmi une pluralité de saillies ayant des caractéristiques dimensionnelles et/ou morpho- logiques différentes et elles sont assemblées au sup- port glénoïdien (2).
18. Ancrage scapulaire (1) selon la revendication 15, dans lequel l’extrémité distale (5) du support glénoï- dien (2) et/ou l’extrémité distale (10) du support co- racoïde (7) et/ou l’extrémité distale (10) de la saillie de support acromial (8) ont une structure partielle- ment irrégulière ou trabéculaire pour favoriser l’os- téogenèse et l’intégration osseuse.
19. Ancrage scapulaire (1) selon la revendication 11, dans lequel le support glénoïdien (2) comprend au moins un trou (13) pour insérer des vis osseuses de stabilisation (12) afin de stabiliser le support glénoï- dien (2) dans la cavité glénoïde (51).
20. Procédé de fabrication d’un ancrage scapulaire (1) pour fixer un composant glénoïdien (100, 200) d’une prothèse d’articulation de l’épaule à l’omoplate (50) d’un patient dont l’anatomie est endommagée ; le procédé comprenant les étapes consistant à :
- fournir un support glénoïdien (2) comprenant une bride (4) et une broche (3) solidaire de la bride (4) pour fixer le composant glénoïdien (100, 200) à l’ancrage scapulaire (1) ;
- la bride (4) ayant une surface distale (5) struc- turée pour être au moins partiellement en con- tact avec une cavité glénoïde (51) de l’omoplate (50) et une surface proximale (6) opposée ; - fournir au moins une partie personnalisée (5, 7, 8) de l’ancrage scapulaire (1) spécifiquement formée pour correspondre à la morphologie os- seuse de l’omoplate (50) d’un patient particulier dont l’anatomie est endommagée ;
- ladite au moins une partie personnalisée (5, 7, 8) comprenant au moins une saillie de support coracoïde (7) ayant une forme sensiblement tu- bulaire formée d’un seul tenant avec le support glénoïdien (2) et structurée pour s’adosser à un processus coracoïde (52) de l’omoplate (50).
21. Procédé de fabrication d’un ancrage scapulaire (1) selon la revendication 20, dans lequel une extrémité proximale (9) de ladite au moins une saillie de sup- port coracoïde (7) est formée adjacente au support glénoïdien (2) tandis qu’une extrémité distale (10) de ladite au moins une saillie de support coracoïde (7) est structurée pour s’adosser au processus co- racoïde (52) de l’omoplate (50) ;
- un trou traversant (11) s’étendant entre l’extré- mité proximale (9) et l’extrémité distale (10) pour recevoir une vis osseuse de stabilisation (12) dans le processus coracoïde (52) de l’omoplate (50).
22. procédé de fabrication d’un ancrage scapulaire (1) selon la revendication 21, dans lequel le procédé comprend une étape consistant à acquérir une mor-
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phologie osseuse de l’omoplate d’un patient, par exemple par tomographie informatisée, avant l’éta- pe consistant à façonner la partie personnalisée (5, 7, 8) de l’ancrage scapulaire (1)
REFERENCES CITED IN THE DESCRIPTION
This list of references cited by the applicant is for the reader’s convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.
Patent documents cited in the description
• US 200701799624 A [0015]
• US 8532806 B [0016] • US 12601510 B [0048]