DEVICE FOR THE MANUFACTURING OF HIP SPACERS

Description

AREA OF INVENTION

[0001] The present invention relates to the field of medical technology, in particular devices for the manufacture of medical implants, and the medical implants that can be manufactured therewith.

[0002] The invention relates in particular to a device for producing a spacer by hardening bone cement paste. The spacer is intended as a temporary placeholder for temporarily replacing a joint or part of a joint, which has an articulating surface of a joint head, in medical applications. The spacer is preferably suitable and intended for the temporary replacement of a hip joint or a shoulder joint, and particularly preferably for the temporary replacement of a hip joint. TECHNICAL BACKGROUND

[0003] Joint endoprostheses, such as hip and shoulder joint endoprostheses, are implanted extensively worldwide. Unfortunately, in a small percentage of cases, joint endoprostheses become colonized by microbial germs, particularly Gram-positive and Gram-negative bacteria, and to a very limited extent by yeasts and fungi. These microbial germs are mainly typical skin germs such as... Staphylococcus aureus and Staphylococcus epidermidis Microbial pathogens can enter the patient during surgical procedures. It is also possible for microbes to reach joint endoprostheses via hematogenous transmission. When joint endoprostheses become colonized with microbes, the surrounding bone and soft tissue also becomes infected and damaged by the microbes.

[0004] There are two predominant treatment methods for infected joint endoprostheses: one-stage septic revision and two-stage septic revision. In one-stage revision, the infected joint endoprosthesis is first removed in a single operation, followed by radical debridement, and then a revision joint endoprosthesis is implanted. In two-stage septic revision, the infected joint endoprosthesis is first removed in the first operation, followed by debridement, and then a spacer is implanted. A hip joint spacer consists of a stem, a collar, a neck, and a ball head and is modeled on the shape and size of hip joint endoprostheses. Similarly, a shoulder joint spacer is modeled on the shape and size of a shoulder joint endoprosthesis. The spacer is anchored to the respective bone with bone cement; for example, in the case of hip joint spacers, this is done on the proximal femur or in the femoral canal.The spacer typically remains in the patient for up to several weeks until the inflammation has subsided and the clinical inflammatory markers have decreased. Then, in a second surgery, the spacer is removed, and after further debridement, a revision joint prosthesis is implanted.

[0005] In two-stage septic revision surgeries of total hip and shoulder arthroplasty, spacers are essential as temporary placeholders during the interim phase. Plastic molds are known for the intraoperative fabrication of spacers using polymethyl methacrylate (PMMA) bone cement. Examples of such molds are described, for instance, in US6,361,731B1, US7,637,729B2, US7,789,646B2, US8,480,389B2, EP 3957280A1, and US8,801,983B2.

[0006] WO 2009 / 073781 A2 discloses a hip spacer mold forming a spacer with a spacer shaft connected to a spacer head, and includes a shaft section for forming a spacer shaft. The hip spacer mold also includes several interchangeable head modules configured to form spacer heads of several different predefined sizes. The head modules are configured to be positioned alongside the shaft section.

[0007] EP 2787928 B1 describes a mold for forming a prosthesis. The mold may include a stem section, a head section, and a retention assembly. The stem and head sections may be provided in a kit with different internal dimensions, allowing a user to select or adjust a mold cavity size based on the dimensions of a patient's specific implantation site. While a set of stem and head sections may have different internal dimensions, each stem section and each head section may have the same or similar external dimensions for retention using a common retention structure.

[0008] EP 2522310 A1 discloses a mold for manufacturing spacers for endoprostheses, which is essentially composed of two sub-molds. The first sub-mold has a receiving section on one open side into which an insertion section on the open side of the second sub-mold can be inserted. The two sub-molds are fixed to each other by means of connecting elements. DETAILED DESCRIPTION

[0009] The present invention is defined in claim 1 and provides a mold which can be used to produce joint spacers from bone cement paste.

[0010] Accordingly, the mold is preferably intended for the production of a hip joint spacer or a shoulder joint spacer. The invention also relates to a kit for producing such a spacer using such a device.

[0011] The invention relates in particular to a device in the form of a multi-part mold for the production of one-piece hip and shoulder spacers, wherein the mold comprises a head element and a stem element, and a metal core can be used to construct the spacer. Hip and shoulder spacers are intended as temporary placeholders (spacers) during the interim phase of two-stage revisions of infected total hip and shoulder endoprostheses. The device can be suitable for the production of hip and shoulder spacers using low-viscosity and high-viscosity polymethyl methacrylate bone cement paste.

[0012] For each of the embodiments described herein, whose elements "have" or "comprise" a particular feature (e.g., a material), a further embodiment is always considered in which the element in question consists solely of the feature, i.e., it does not include any other components. The word "comprise" or "comprise" is used synonymously with the word "have" or "have" herein.

[0013] If an element in an embodiment is designated in the singular, an embodiment containing several such elements is also considered. The use of a plural term for an element generally also includes an embodiment containing only a single corresponding element.

[0014] Unless otherwise stated or clearly excluded from the context, it is generally possible, and hereby expressly considered, that features of different embodiments may also be present in the other embodiments described herein. Likewise, it is generally considered that all features described herein in connection with a casting mold are also applicable to the kits, spacers, and processes described herein, and vice versa. For the sake of brevity, not all of these considered combinations are explicitly listed in every case. Technical solutions known to be equivalent to the features described herein are also generally considered to be within the scope of the invention.

[0015] In a first embodiment, one aspect of the invention relates to a mold for producing a spacer, for example a hip joint spacer, comprising a head element having an upper shell and a lower shell, and a stem element having an upper shell and a lower shell, wherein the mold has a locking element, and an upper shell and a lower shell of the head element and / or the stem element can be connected to each other by means of the locking element, wherein the mold further comprises a neck element which can be connected to the head element and the stem element; and wherein the neck element has a slot which is arranged parallel to the central axis of the neck element and is configured to allow the neck element to be bent apart or compressed together.

[0016] The head element can be designed and configured to mold part of a spacer that can engage in the socket of a hip joint.

[0017] The stem element can be designed and configured to mold part of a spacer that can be implanted into a femur or humerus.

[0018] The mold also features a neck element, which is positioned between the head element and the trunk element.

[0019] Preferably, the mold is designed to accommodate such neck elements of variable length, as described in more detail below. This can be achieved, among other things, by the modular mold designs described herein, in which head elements, stem elements, and neck elements of different sizes can be combined with one another.

[0020] The head elements, trunk elements and neck elements are each designed as separate, but connectable elements.

[0021] In addition to the locking element, the mold may include a form-fitting connecting element to join the upper and lower shells of the head element and / or the trunk element. Such a connecting element may consist, for example, of ribs and recesses arranged opposite each other on the upper and lower shells to allow them to interlock. These ribs and recesses may have orthogonal edges that interlock or rounded shapes, such as semi-cylindrical grooves or hemispheres. This connecting element may serve to align and / or secure the upper and lower shells together. The connecting element may support the function of the locking element by holding the upper and lower shells in a desired position relative to each other.

[0022] The locking element is a connecting element that can join several parts of the mold together using a positive-locking connection. The locking element can be in the form of a tab. The tab can have a tongue-shaped, flexible structure. The tab can have a smooth surface on the outside. Several identical or different tabs can be provided. The locking element can be arranged on an upper shell or on a lower shell of the head element. The locking element can be arranged on an upper shell or on a lower shell of the trunk element. The locking element can be arranged on the upper shell of the head element and configured to engage with a suitable structure located on the lower shell of the head element.For example, the locking element can be designed as a tab-shaped snap hook on an upper shell, arranged and configured to engage a projection on a lower shell. Alternatively or additionally, the mold can have a locking element designed as a tab-shaped snap hook on a lower shell, arranged and configured to engage a projection on an upper shell. Various combinations are possible here; for example, the upper shell of the head element can have several identical or several different locking elements, while the upper shell of the trunk element only has several identical locking elements.

[0023] The various locking elements can differ from each other, for example, in that despite having a fundamentally similar basic structure, such as a tab-shaped snap hook, they have an additional connecting element, such as a tongue and groove joint.

[0024] The head element and / or the trunk element can generally have several identical locking elements. Alternatively, several different locking elements can be provided on the head element and / or the trunk element.

[0025] In one embodiment, the locking element is arranged and configured to define a cavity for receiving excess bone cement paste when the mold is fully assembled. Although in preferred embodiments, the paste is primarily released through designated vent openings, leakage can also occur at the joint between the upper and lower shells, for example, due to user error. In the embodiment described here, this point of release is covered by the locking element, which can, for example, be designed as a tab. The escaping bone cement paste can then be collected in a cavity located between the locking element and the outer wall of the mold.

[0026] According to the invention, the mold has a neck element which can be connected to the head element and the stem element. The neck element can have a ring-shaped base.

[0027] In one embodiment, the neck element also has a bridge.

[0028] The bridge can be arranged parallel to the central axis of the neck element. The bridge can be positioned and configured to engage with a complementary structure located on the head element and / or the trunk element. This allows the neck element to be connected to the head element or the trunk element and held in a desired position relative to it.

[0029] According to the invention, the neck element has a slot. The slot can be configured as an interruption in the lateral surface of the neck element. The slot is arranged parallel to the central axis of the neck element. The slot is designed to allow the neck element to be bent apart or compressed. This makes it easier to remove the neck element from a spacer produced using the mold; that is, the slotted design of the neck element facilitates the disassembly of the mold for removing the spacer.

[0030] The neck element can further include a locking element to enable a secure connection with the head element and / or the stem element. Multiple such locking elements can also be provided on the neck element, for example, one locking element for connection with the head element and one locking element for connection with the stem element. In one embodiment, the neck element has two annular ribs, and both the neck element and the stem element each have locking elements that engage with these ribs. The locking elements can be configured as snap hooks, dowel pins, or other positive-locking connections.

[0031] The neck section is designed and configured to be assembled with a pre-assembled head section and a pre-assembled trunk section to form a fully assembled mold. A pre-assembled head section is one in which the upper shell is firmly connected to the lower shell, for example, by means of a snap-fit ​​element. A pre-assembled trunk section is one in which the upper shell is firmly connected to the lower shell, for example, by means of a snap-fit ​​element. In this way, the head section or trunk section can be filled with bone cement before being joined to the neck section to assemble the mold fully filled. If the head section and trunk section can be filled separately, i.e.,If the mold can be filled in a partially assembled state, it can be more easily filled completely with bone cement paste, especially when using high-viscosity bone cement paste. This prevents the formation of air bubbles within the mold during filling with bone cement paste, thus facilitating the production of a defect-free spacer.

[0032] In a further embodiment, the stem element comprises a lever element. The lever element can be arranged and configured to move the upper and lower shells of the stem element apart in order to release a locking element and / or connecting element arranged on the stem element. Advantageously, the lever element can be arranged at the distal end of the stem element, i.e., at the end of the stem element opposite the head element.

[0033] In one embodiment, the upper shell and / or lower shell of the head element is formed in multiple parts. For example, the lower shell of the head element can be composed of two symmetrical parts. The parts can be connected to each other via a positive-locking connection, such as a tongue and groove joint.

[0034] Alternatively or additionally, in one embodiment, the head element can include a fastening element designed to hold together the multi-part upper shell and / or lower shell of the head element. For example, the head element can include a tab which, as a fastening element, has two parallel webs that each engage in a complementary structure on the two parts of the upper shell or lower shell in order to hold them together.

[0035] Another aspect of the invention relates to a kit for manufacturing a spacer, for example a hip joint spacer, which includes a casting mold described herein and a metal core designed to be inserted into the stem element.

[0036] In one embodiment, the metal core has several wing elements to align the metal core centrally within the stem element. The wing elements are configured to define a distance between the metal core and the wall of the stem element.

[0037] In one embodiment, the kit comprises several head elements and / or stem elements, each in a different size. Alternatively or additionally, the kit may also include neck elements in different sizes. In some embodiments, the head elements, stem elements, and / or neck elements can be combined with one another as desired. This allows for the production of differently configured spacers, which can offer a better fit for different patients.

[0038] The kit may still include a metal core for insertion into the stem element.

[0039] The kit may also include starting materials for the production of a bone cement paste, for example PMMA bone cement paste.

[0040] The kit may also include an antibiotic intended for incorporation into the bone cement paste.

[0041] Another aspect of the invention relates to a kit comprising a mold with a head element, a neck element, and a stem element, wherein the kit includes multiple head elements, stem elements, and neck elements of varying sizes. The head elements, stem elements, and neck elements are preferably combinable with one another regardless of their size. The kit may further include a metal core for insertion into the stem element. The kit may also include starting materials for the production of a bone cement paste, for example, PMMA bone cement paste.

[0042] The kit may also include an antibiotic intended for incorporation into the bone cement paste.

[0043] The mold according to the invention can be filled with bone cement paste. "Bone cement paste" here refers to a malleable mass that can be hardened to form bone cement. Commercially available bone cements are often offered as a kit containing a liquid and a solid component. By mixing the liquid and solid components, the user can produce a bone cement paste that is easily deformable for a limited time. Shortly after mixing, the bone cement paste becomes non-sticky, meaning it no longer adheres to a glove upon light contact (as defined in ISO 5833:2002). In this state, the bone cement paste can preferably be filled into a mold cavity of the device according to the invention for the production of spacers, for example, using a stirring spatula or a suitable dispensing device. Commercially available bone cements are frequently based on polymethyl methacrylate (PMMA).The mold according to the invention can preferably be used with such PMMA bone cement. However, it is also possible in principle to use other types of bone cement.

[0044] In some embodiments, the mold is particularly suitable for filling with highly viscous bone cement paste. For this purpose, the multi-part design described herein is advantageous, wherein the mold comprises a head element and a trunk element, the head element and the trunk element of which can each be filled independently of one another with bone cement paste. Preferably, the head element and / or the trunk element are configured to be filled with bone cement paste in a state in which the upper and lower shells of the head element and / or the trunk element are already fused together, thereby forming a cavity.

[0045] The head element and the stem element can be connected via a neck element, forming a mold which allows the production of a spacer in a single casting process, so that the head part and the shaft of the spacer do not have to be produced separately and subsequently joined together.

[0046] The mold can be designed to produce a spacer without a sprue. This means that after the bone cement has hardened in the mold, the desired geometry of the spacer can be produced directly without having to mechanically remove any of the hardened bone cement. However, even without a sprue, it can be advantageous to deburr the produced spacer. Accordingly, minor burrs that may form during casting, for example, at the points where different parts of the mold, such as an upper and lower shell, are joined, are not considered "sprues" here. Similarly, small structures that may arise from the extrusion of bone cement paste at the vents are also not considered "sprues" here.To provide a mold that allows the production of a spacer without a sprue, the modular design of the mold described herein can be advantageous. The head element and the trunk element can be filled separately with bone cement paste and then joined together, optionally via an intermediate neck element.

[0047] The mold according to the invention can, in principle, be made of any suitable material.

[0048] Flexible, elastic materials can facilitate the removal of the molded spacers. The mold can be made of metal and / or polymer. Examples of suitable polymers include rubber, silicone rubber, synthetic rubber, ethylene propylene diene monomer (EPDM) rubber, polyethylene, polyetheretherketone, and polypropylene. Devices made of polypropylene allow for particularly easy removal of the hardened bone cement from the device. In some embodiments, the device is made of a transparent or at least translucent, i.e., optically transparent, material. Appropriate transparent or translucent polymers are suitable for this purpose. This allows the user of the device to check whether the mold is completely filled with bone cement.

[0049] Furthermore, the mold can be designed in such a way that it allows the production of spacers with different neck lengths without the user having to make adjustments to the mold or the molded spacer using a cutting tool. This can be achieved, for example, by making the head and stem elements described herein connectable to neck elements of different sizes.

[0050] Another aspect, which is not part of the invention, relates to a spacer that can be produced using a mold described herein. The spacer is preferably intended for use in the region of a hip, in particular a hip joint. Preferably, it is a hip joint spacer. Such a hip joint spacer can preferably be produced using a device described herein. In one example, the spacer is a shoulder joint spacer.

[0051] In one example, the spacer comprises or consists of bone cement. Preferably, the bone cement comprises PMMA. The bone cement may include an antibiotic. Examples of suitable antibiotics include gentamicin, clindamycin, and vancomycin. The spacer is preferably designed to temporarily replace a patient's natural joint, such as a hip joint, in connection with a surgical procedure.

[0052] The upper and lower shells of the head element and / or the main element can, in principle, be connected to each other by any suitable positive-locking connection, for example, a tongue-and-groove joint. Several identical or different types of connections can be provided for this purpose.

[0053] Another aspect, which is not part of the invention, relates to a method for manufacturing a spacer, preferably a hip joint spacer, comprising the following steps: (i) Providing a mold comprising a head element having an upper shell and a lower shell, a trunk element having an upper shell and a lower shell, and a locking element; (iia) optionally connecting the upper shell of the head element to the lower shell of the head element by means of the locking element; and / or (iib) optionally connecting the upper shell of the trunk element to the lower shell of the trunk element; (iii) introducing a bone cement paste into the head element and the trunk element; (iv) joining the head element and the trunk element to form a closed mold; (v) hardening the bone cement paste; (vi) opening the head element and / or the trunk element by releasing the locking element; and (vii) thereby obtaining a spacer, preferably a hip joint spacer, made of bone cement.

[0054] In a first step of the process (i) a mold is provided which includes a head element having an upper shell and a lower shell, a trunk element having an upper shell and a lower shell, and a locking element.

[0055] Several examples of such a casting mold are described elsewhere herein.

[0056] In a second step of the procedure (iia), the upper and lower shells of the head element are joined together if they are not already pre-assembled. For this purpose, connecting elements provided for this purpose can be used, as described in more detail elsewhere herein.

[0057] In a corresponding manner, the upper and lower shells of the main element are joined together in one step of the procedure (iib), if they are not already pre-assembled accordingly. For this purpose, connecting elements provided for this purpose can be used, as described in more detail elsewhere herein.

[0058] In a third step of the procedure (iii) bone cement paste is introduced into the head element and the stem element, for example with a suitable bone cement paste dispensing device, or by hand.

[0059] In a fourth step of the process (iv), the head element and the trunk element are assembled to form a closed mold. A neck element is used for this purpose, connecting the head element to the trunk element. For this, connecting elements such as those described in more detail elsewhere herein can be used.

[0060] In a fifth step (v) of the process, the bone cement mixture is cured. The bone cement mixture typically contains reactive components that, after mixing, combine with each other within a few minutes through a chemical reaction, forming a hard, non-deformable material. This material is called (cured) bone cement and forms the spacer.

[0061] In a sixth step (vi), the head element and / or the stem element, which contains the hardened bone cement, is opened by releasing the locking element. This separates the upper and lower shells of the head element or stem element, respectively, and releases the molded spacer.

[0062] The process may optionally include a further step in which a metal core is inserted into the parent element.

[0063] In some embodiments, the mold can be designed and configured to connect the same head element and the same trunk element with neck elements of different sizes, as described in more detail elsewhere herein.

[0064] The procedure described above can be performed entirely outside the human body, i.e. ex vivo

[0065] In one embodiment, the procedure is carried out in the sequence shown above (i) to (vii). EXAMPLES

[0066] The invention is further illustrated below by means of examples, which, however, are not to be understood as limiting. It will be apparent to those skilled in the art that other equivalent means can be used in a similar manner within the scope of the claims instead of the features described here. FIGURES

[0067] Figure 1This shows an exemplary embodiment of the invention. A casting mold 100 features a head element 110 on, which consists of an upper shell 120 and a lower shell 130 is formed. The upper shell 120 and the lower shell 130 are achieved using a locking element 101 held together. In the Figure 1 The example shown features six locking elements in the form of tabs on the upper shell. 120 attached, each designed as a snap hook. The casting mold 100 still has a stem element 150 the trunk element, which, like the head element, is formed from an upper shell and a lower shell. Similar to the head element, the trunk element also exhibits... 150 Latching elements 101 on, which are designed as tabs with snap hooks, and the upper shell and the lower shell of the trunk element 150 They fit together securely. At the distal part of the stem element.150 is still a lever element 151 arranged which allows disassembly of the main element by using the lever element 151 The upper and lower shells of the stem element are pushed apart. This allows for easier removal of the spacer produced using the mold. Between the head element 120 and the stem element 150 is a neck element 140 arranged, which is the head element 120 with the root element 150 connects. Figure 2 shows a cross-section through a casting mold according to the invention in the area of ​​the head element. The upper shell 120 features a locking element 101 on, which here is designed as a tab-shaped snap hook. The locking element holds the upper shell. 120 and lower shell 130 together using a positive locking connection. In addition to the locking element. 101 is the upper shell 120 with the lower shell130 via a connecting element 102 connected, which here is designed as a pair of interlocking bridges, each located on the upper shell 120 and lower shell 130 are arranged. Figure 3 shows a cross-section through a casting mold according to the invention in the area of ​​the main element. Similar to in Figure 2 As shown for the head element, the trunk element also has a locking element. 101 on, which is also designed as a tab-shaped snap hook. Several such locking elements can be provided on both sides of the main element, for example on the circumferential edge of the upper shell or the lower shell of the main element. In addition, similar to in Figure 2 shown for the head element, also connecting elements for the trunk element 102 available, which are independent of the locking element 101Connect the upper shell to the lower shell of the main element. In the example shown here, the connecting elements are... 102 interlocking webs on the upper shell and the lower shell of the trunk element. Figure 4 shows an exploded view of a casting mold according to the invention, and a joint spacer arranged therein. 400, which can be produced using the casting mold. On the upper shell 120 of the head element 110 is a snap hook as a locking element 101 arranged. In the example shown here, the lower shell 130 of the head element is 110 formed in two parts, with the two parts of the lower shell 130 using another locking element 171, which is designed as a snap hook, and additionally with the aid of another connecting element 172,which in this example is designed as a tongue and groove joint, can be connected to each other. Furthermore, a neck element is included. 140 provided which each form-fitting with the head element 110 and the stem element 150 is connected. The neck element 140 It has the form of a slotted ring and features two parallel ribs. 190 each parallel to the ring axis of the neck element 140 are arranged. In the example shown here, the ring element 140 Two pairs of such bridges are arranged opposite each other on the outside of the ring element. The two parts of the lower shell 130 of the head element 110 Each of these bridges has complementary structures. 191 on, which creates a positive-locking connection of the head element 110 with the ring element 140enable. In the example shown here, the pairs of bridges can 190 into the structures 191 They can be inserted, similar to how cable lugs are known, for example. Figure 5 shows an isometric view of a casting mold according to the invention. The head element 110 features several locking elements designed as tabs 101 on, which the upper shell 120 with the lower shell 130 The head element is connected using a snap hook. Additional connecting elements are also located on some of the tabs. 103 appropriate, which are integrated into complementary structures 104 intervene, which are located on the lower shell 130 are attached to the head element. The connecting elements 103 connect the upper shell 120 with the lower shell 130 of the head element. The connection of the connecting elements 103 with the complementary structures 104In this example, it is designed as a tongue and groove joint, which here prevents the lateral twisting of the upper shell. 120 opposite the lower shell 130 prevented. The head element still has openings. 500 These openings serve for venting when the mold is filled with bone cement paste. Such openings can also be found on the main element. 150 be provided for. The root element 150 features resting elements designed as tabs 101 on, which has a cavity 180 between these tabs and the wall of the main element 150 define this cavity 180 can, if necessary, be separated between the upper shell 160 and the lower shell 170 absorb the escaping bone cement dough without it getting onto the hand of the user of the casting mold. Figure 6ashows a spacer that can be produced using a mold described herein, after the head and stem elements have been removed. The neck element 140 is still attached to the spacer 400 remained. The neck element 140 has a slot 141 a feature which interrupts the wall of the neck element. This allows for deformation of the neck element 140. Furthermore, the neck element has 140 an attack 142 on, which runs laterally around and orthogonally to the ring axis of the neck element 140 is arranged. The attack 142 is arranged and set up to maintain a desired distance between the neck element during the assembly of the casting mold. 140 and head element 110 or between neck element 140 and stem element 150 to define. Figure 6b shows how by bending the neck element apart 140 this from the spacer 400 can be removed. Figure 7aThis shows a step in the assembly of a casting mold according to the invention. A neck element is being assembled. 140 into a head element 110 inserted, whereby the upper shell 120 and the lower shell 130 The head element is already connected. This involves connecting the bridges located on the neck element. 190 into complementary structures 191 inserted, which is attached to the head element 110 are arranged. Figure 7b Figure 1 shows a step in the assembly of a casting mold according to the invention. The neck element has a stop. 142 up. The neck element 140 is incorporated into the head element 110 inserted, whereby the stop 142 the depth of the insertion is limited. Figure 8a shows a further step in the assembly of a casting mold according to the invention. Into the main element 150, whose upper and lower shells are connected, bone cement paste is applied using a suitable discharge device. 300introduced until its interior is completely filled with bone cement paste. Figure 8b shows a further step in the assembly of a casting mold according to the invention. A metal core 200, which has several wing elements 210 exhibits, is inserted into the stem element already filled with bone cement dough. 150 introduced. The wing elements 210 are arranged and set up, a centered arrangement of the metal core 200 within the root element 150 to enable. Figure 9 The figure shows a further step in the assembly of a casting mold according to the invention. Bone cement paste is applied using an application device. 300 inserted into the head element, while the upper shell and the lower shell of the head element are already connected to each other, and the head element is connected to the neck element as described above. 140 is connected. Figure 10This shows a further step in the assembly of a casting mold according to the invention. After carrying out the steps described above, the mold, filled with bone cement paste and containing a metal core, is 210 provided stem element 150 into the neck element 140 inserted, which in turn is connected to the head element. The head element is also already filled with bone cement dough. LIST OF REFERENCE MARKS

[0068] 100 Mold 101 Locking element 102 Connecting element 103 Fastening element 104 Complementary structure to the fastening element 103 110 Head element 120 Upper shell of the head element 130 Lower shell of the head element 140 Neck element 141 Slot 142 Stop 150 Main element 151 Lever element 160 Upper shell of the main element 170 Lower shell of the main element 171 Further locking element 172 Further connecting element 180 Cavity 190 Web 191 Complementary structure to the web 190 200 Metal core 210 Wing element 300 Bone cement 400 Spacer 500 Opening

Claims

1. A casting mold for producing a joint spacer (100), comprising a head element (110) which comprises an upper shell (120) and a lower shell (130), and a stem element (150) which comprises an upper shell (160) and a lower shell (170), the casting mold comprising a latching element (101), and an upper shell (120, 160) and a lower shell (130, 170) of the head element (110) and / or of the stem element (150) being able to be connected to one another by means of the latching element (101); the casting mold further comprising a neck element (140) which can be connected to the head element (110) and to the stem element (150); characterized in that the neck element (140) comprises a slot (141) arranged parallel to the central axis of the neck element (140) and configured to enable the neck element (140) to be bent apart or pressed together.

2. The casting mold according to claim 1, further comprising a form-fitting connecting element (102), wherein an upper shell (120, 160) and a lower shell (130, 170) of the head element (110) and / or of the stem element (150) can be connected to one another by means of the form-fitting connecting element (102).

3. The casting mold according to either of the preceding claims, wherein the latching element (101) is designed as a tab.

4. The casting mold according to any of the preceding claims, wherein the head element (110) and / or the stem element (150) comprises a plurality of identical latching elements (101).

5. The casting mold according to any of the preceding claims, wherein the latching element comprises a cavity (180), wherein the cavity is suitable for receiving excess bone cement dough in a fully assembled state of the casting mold.

6. The casting mold according to any of the preceding claims, wherein the neck element further comprises a protrusion (190) arranged parallel to the central axis of the neck element, wherein the protrusion is arranged and configured to engage in a structure (191) which is complementary to the protrusion and which is arranged on the head element or the stem element.

7. The casting mold according to any of the preceding claims, wherein the neck element is designed and configured to be combined with a pre-assembled head element (110) and / or a pre-assembled stem element (150) to form a fully assembled state of the casting mold.

8. The casting mold according to any of the preceding claims, wherein the stem element (150) comprises a lever element (151) arranged and configured to move the upper shell (160) and the lower shell (170) of the stem element (150) apart in order to release a latching element (101) and / or connecting element (102) arranged on the stem element.

9. The casting mold according to any of the preceding claims, wherein the upper shell (160) and / or the lower shell (130) of the head element (110) is of multipart design.

10. The casting mold according to claim 9, wherein the latching element (101) is designed as a tab and is arranged on the head element (110), and wherein the tab (101) further comprises a fastening element (103) arranged to engage in a structure (104) of the head element (110) that is complementary to the fastening element (103) in order to hold the multipart upper shell (160) and / or lower shell (130) of the head element (110) together.

11. A kit for producing a hip joint spacer, comprising a casting mold according to any of the preceding claims and a metal core (200) configured to be introduced into the stem element (150).

12. The kit according to claim 11, wherein the metal core (200) comprises a plurality of wing elements (210) in order to centrally align the metal core within the stem element (150).

13. A kit for producing a spacer, comprising a casting mold according to any of claims 1 to 10, wherein the kit comprises a plurality of head elements (120), neck elements (140) and / or stem elements (150) in different sizes, which can preferably be combined with one another as desired.