U.S. patent application number 13/246397 was filed with the patent office on 2012-01-19 for orthopaedic implant kit, orthopaedic surgery kit and associated method.
Invention is credited to TERRY L. DIETZ, JOHN S. WAGLEY.
Application Number | 20120016488 13/246397 |
Document ID | / |
Family ID | 42938190 |
Filed Date | 2012-01-19 |
United States Patent
Application |
20120016488 |
Kind Code |
A1 |
DIETZ; TERRY L. ; et
al. |
January 19, 2012 |
ORTHOPAEDIC IMPLANT KIT, ORTHOPAEDIC SURGERY KIT AND ASSOCIATED
METHOD
Abstract
A kit for use in performing revision surgery on a cavity in a
canal of extending from a resected plane a long bone is provided.
The kit includes a canal component fitted to the cavity. The canal
component includes a canal portion having first and second ends.
The canal component further includes a sleeve portion having an
external periphery and an internal periphery defining an internal
cavity. The kit also includes a first joint component having a body
portion and a connection portion. The connection portion is fitted
into the sleeve portion. A connection portion of a second joint
component also may be fitted into the sleeve portion so that the
external periphery of the connection portion of the first joint
component is spaced inwardly from the external periphery of the
sleeve portion of the canal component when the first joint
component is fixedly connected to the canal.
Inventors: |
DIETZ; TERRY L.; (COLUMBIA
CITY, IN) ; WAGLEY; JOHN S.; (WARSAW, IN) |
Family ID: |
42938190 |
Appl. No.: |
13/246397 |
Filed: |
September 27, 2011 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11215929 |
Aug 30, 2005 |
8048167 |
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13246397 |
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Current U.S.
Class: |
623/23.42 |
Current CPC
Class: |
A61F 2/4081 20130101;
A61F 2002/3069 20130101; A61F 2002/30708 20130101; A61F 2002/30878
20130101; A61F 2002/3652 20130101; A61F 2310/00011 20130101; A61F
2/3859 20130101; A61F 2/4014 20130101; A61F 2250/0064 20130101;
A61F 2002/30367 20130101; A61F 2/3676 20130101; A61F 2002/30405
20130101; A61F 2002/30604 20130101; A61F 2002/30616 20130101; A61F
2002/4077 20130101; A61F 2230/0004 20130101; A61F 2250/0084
20130101; A61F 2002/30331 20130101; A61F 2220/0041 20130101; A61F
2220/0025 20130101; A61F 2002/4029 20130101; A61F 2002/30797
20130101; A61F 2/3662 20130101; A61F 2/32 20130101; A61F 2/36
20130101; A61F 2002/30332 20130101; A61F 2/4059 20130101; A61F
2002/3611 20130101; A61F 2002/30359 20130101; A61F 2002/365
20130101; A61F 2310/00179 20130101; A61F 2002/3079 20130101; A61F
2220/0033 20130101; A61F 2002/4062 20130101; A61F 2002/4037
20130101; A61F 2002/4641 20130101; A61F 2002/4631 20130101; A61F
2/30767 20130101; A61F 2002/30153 20130101; A61F 2002/30894
20130101; A61F 2002/4044 20130101; A61F 2002/30538 20130101; A61F
2310/00017 20130101; A61F 2002/30339 20130101; A61F 2/3609
20130101; A61F 2/4684 20130101; A61F 2/389 20130101; A61F
2002/30426 20130101; A61F 2002/3446 20130101; A61F 2002/4018
20130101; A61F 2310/00023 20130101; A61F 2/367 20130101; A61F
2002/30606 20130101; A61F 2002/30614 20130101; A61F 2230/0019
20130101; A61F 2/38 20130101; A61F 2310/00029 20130101; A61F
2002/30112 20130101; A61F 2250/0006 20130101; A61F 2002/30492
20130101; A61F 2002/3625 20130101; A61F 2/40 20130101; A61F 2/34
20130101; A61F 2002/30433 20130101; A61F 2002/3054 20130101 |
Class at
Publication: |
623/23.42 |
International
Class: |
A61F 2/30 20060101
A61F002/30 |
Claims
1. A method for providing joint arthroplasty on a joint of a
patient with an orthopaedic implant, the method comprising the
steps: resecting a long bone along a resection plane; preparing a
cavity in the canal of the long bone; implanting an orthopaedic
implant canal component into a cavity in the canal of a long bone,
the orthopaedic implant canal component having a stem element and a
first body element fixedly connectable to said stem element, the
orthopaedic implant canal component being secured in the canal of
the long bone; connecting an orthopaedic trial body component to
the implant canal component, the orthopaedic trial body component
being spaced from the long bone; performing a trial reduction of
the joint of the patient; determining if the orthopaedic trial body
component provides satisfactory results for the patient; and
implanting an orthopaedic implant body component corresponding to
the orthopaedic trial body component onto the orthopaedic implant
canal component if the orthopaedic trial body component provides
satisfactory results for the patient.
2. The method of claim 1, wherein the implanting the canal
component step includes permanently securing the canal component to
the long bone.
3. The method of claim 1, wherein the implanting the canal
component step includes positioning the canal component such that
the canal component intersects the resection plane.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application is a divisional of U.S. Utility
patent application Ser. No. 11/215,929 entitled "Orthopaedic
Implant Kit, Orthopaedic Surgery Kit & Associated Method" which
was filed Aug. 30, 2005 by Terry Dietz, the entirety of which is
expressly incorporated herein by reference. Cross reference is made
to the following applications: Utility patent application Ser. No.
11/216,588 entitled "ORTHOPAEDIC IMPLANT, STEM AND ASSOCIATED
METHOD" and Utility patent application Ser. No. 11/216,396 entitled
"ORTHOPAEDIC IMPLANT STEM COMPONENT, JOINT COMPONENT, AND
ASSOCIATED KIT", both of which have been abandoned and each are
incorporated herein by reference.
TECHNICAL FIELD OF THE INVENTION
[0002] The present invention relates generally to the field of
orthopaedics, and more particularly, to an implant for use in
arthroplasty.
BACKGROUND OF THE INVENTION
[0003] Patients who suffer from the pain and immobility caused by
osteoarthritis and rheumatoid arthritis have an option of joint
replacement surgery. Joint replacement surgery is quite common and
enables many individuals to function properly when it would not be
otherwise possible to do so. Artificial joints are usually
comprised of metal, ceramic and/or plastic components that are
fixed to existing bone.
[0004] Such joint replacement surgery is otherwise known as joint
arthroplasty. Joint arthroplasty is a well-known surgical procedure
by which a diseased and/or damaged joint is replaced with a
prosthetic joint. In a typical total joint arthroplasty, the ends
or distal portions of the bones adjacent to the joint are resected
or a portion of the distal part of the bone is removed and the
artificial joint is secured thereto.
[0005] There are known to exist many designs and methods for
manufacturing implantable articles, such as bone prostheses. Such
bone prostheses include components of artificial joints such as
elbows, hips, knees and shoulders.
[0006] Currently in total hip arthroplasty, a major critical
concern is the instability of the joint. Instability is associated
with dislocation. Dislocation is particularly a problem in total
hip arthroplasty.
[0007] Factors related to dislocation include surgical technique,
implant design, implant positioning and patient related factors. In
total hip arthroplasty, implant systems address this concern by
offering a series of products with a range of lateral offsets, neck
offsets, head offsets and leg lengths. The combination of these
four factors affects the laxity of the soft tissue. By optimizing
the biomechanics, the surgeon can provide a patient a stable hip
much more resistant to dislocation. In order to accommodate the
range of patient arthropometrics, a wide range of hip implant
geometries are currently manufactured by DePuy Orthopaedics, Inc.,
the assignee of the current application, and by other companies. In
particular, the S-ROM.RTM. total hip systems offered by DePuy
Orthopaedics, Inc. include three offsets, three neck lengths, four
head lengths and one leg length adjustment. The combination of all
these biomechanic options is rather complex.
[0008] Anteversion of a total hip system is closely linked to the
stability of the joint. Improper version can lead to dislocation
and patient dissatisfaction. Version control is important in all
hip stems. However, it is a more challenging issue with the advent
of stems with additional modularity.
[0009] The prior art has provided for some addressing of the
anteversion problem. For example, the current S-ROM.RTM. stems have
laser markings on the medial stem and the proximal sleeve. This
marking enables the surgeon to measure relative alignment between
these components. Since the sleeve has infinite anteversion, it is
not necessarily oriented relative to a bony landmark that can be
used to define anteversion. In fact, the current sleeves are
sometimes oriented with the spout pointing directly laterally into
the remaining available bone.
[0010] Prior art stems may be aligned relative to a patient's bony
landmarks. These stems are monolithic. They cannot locate the neck
independently of the distal stem. Therefore, anteversion is
limited. Most bowed, monolithic stems are sold in fixed
anteversion; for example, at an anteversion of 15 degrees. These
monolithic stems have limited flexibility for rotational alignment
since the distal stem must follow the bow of the patient's femur
and this may not provide an operable biomechanical result.
[0011] In a common step in the surgical procedure known as total
hip arthroplasty, a trial or substitute stem is first implanted
into the patient. The trial is utilized to verify the selected size
and shape of the implant in situ on the patient and the patient is
subjected to what is known as a trial reduction. This trial
reduction represents moving the joint, including the trial implant
through selected typical motions for that joint. Current hip
instruments provide a series of trials of different sizes to help
the surgeon assess the fit and position of the implant. Trials,
which are also known as provisionals, allow the surgeon to perform
a trial reduction to assess the suitability of the implant and
implant's stability prior to final implant selection.
[0012] Most hip stems implanted currently are of a one-piece or
mono-block design. Mono-block hip stem designs allow for no
adjustments. Thus, they require that the hip stem be removed and
replaced to adjust head height or offset. Also, mono-block stems
are not designed to be used in minimally invasive surgery and are
not optimal for use with minimally invasive surgery procedures.
[0013] Surgical variables such as leg length discrepancy may result
in surgical error that may need to be corrected or optimized.
Further, due to implant subsidence during the use of an implant,
the head-height at a revision surgery may need to be corrected.
Further, revision surgery may be required to correct the
instability of the hip joint. Stability may be restored by moving
the head proximally and or increasing the offset of the implant to
tighten the soft tissues. These corrections may be made at revision
surgery to address these dislocations, however with current
mono-block stems the stem must be removed from the femur to
accomplish these changes in the implant configuration. Such removal
of the stem from the femur may make the revision surgery quite
difficult in that the stem tends to engrow with the tissues of the
bone. Also, removal of the stem may lead to significant loss of
bone, which can compromise the fixation of the stem upon
re-implantation.
[0014] Further revision surgery may be required to correct weak
abductor function by increasing the offset of the stem. The
changing in a revision surgery to an increased offset stem may
require that the stem be removed from the medullary canal of the
femur and replaced with a stem with a different offset.
[0015] Further mono-block stems are not easily used in minimally
invasive hip procedures where the incision through the skin and
soft tissue is minimized. The surgeon may have difficulty to work
in the joint space after the stem is in place. The neck of the
mono-block stem may be in the way during the performance of the
surgery.
[0016] In order to reduce inventory costs and complexity, many
trialing systems are modular. For example, in the Excel Instrument
System, a product of DePuy Orthopaedics, Inc., there is a series of
broaches and neck trials that can be mixed and matched to represent
the full range of implants. There is a single fixed relationship
between a broach and a neck trial, because these trials represent a
system of monolithic stem implants.
[0017] Likewise, in the current S-ROM.RTM. instrument systems
provided by DePuy Orthopaedics, Inc., there are neck, proximal
body, distal stem, head and sleeve trials. By combining all these
components, the implant is represented. Since the S-ROM.RTM. stem
is modular and includes a stem and a sleeve, the angular
relationship or relative anteversion between the neck and the
sleeve is independent and represented by teeth mating between the
neck and the proximal body trial. The proximal body trial has fixed
transverse bolts that are keyed to the sleeve in the trialing for
straight, primary stems. The long stem trials do not have the
transverse bolts and are thus not rotationally stable during trial
reduction and therefore are not always used by the surgeon.
[0018] Prosthetic joint implants are currently surging in use and
technology. In performing most prosthetic joint implants, what is
known as a `trial` or `provisional` is used before a final
prosthesis is used. The trial or provisional is used to select the
proper joint prosthesis and/or to orient or align one or more of
the components of the final joint prosthesis. The trial or trial
components are temporarily implanted to achieve proper sizing,
placement and/or orientation of the final joint prosthesis, as well
as achieve anatomical orientation of the prosthesis and/or
components of the joint prosthesis.
[0019] Hip arthroplasty provisionals or trials have a neck that is
used to attach a femoral head provisional or trial thereto. The
orientation of the neck relative to the shaft of the broach or
trial is described in terms of anteversion, neck length, neck
angle, and/or neck offset. Because each patient's original femoral
neck anatomy is different, the ability to replicate the original
femoral neck anatomy of each patient during hip arthroplasty
requires multiple neck trials having various orientations. The use
of multiple neck segments is not advantageous since it requires
more time, increased instrument cost and increased space in the
instrument sterilization case.
[0020] Thus, trialing systems utilized by many hip implants or
prostheses generally consist of a broach and a neck segment. In
order to intraoperatively change the offset of the trial (i.e. neck
segment and broach), the neck trial must be removed and another
neck trial must be put in its place. Thus, multiple neck trials
that are exchangeable with one another relative to the broach are
necessary in order to replicate the original hip anatomy.
[0021] Other hip systems utilize only one neck segment with the
offset incorporated into the location of the trunnion of the
broach. This design, however, does not mimic the exact geometry of
the actual implant. While it is desired to be able to try several
neck offsets relative to the broach in order to achieve a proper
head positioning for the final implant, the prior art is
deficient.
[0022] In U.S. Pat. No. 5,645,607 issued to Hickey, a hip trial or
prosthesis having an adjustable neck portion is disclosed in which
the problem of multiple neck trials is addressed. The adjustable
neck of Hickey allows the trialing of various neck offsets in order
to achieve a correspondence between the spatial orientation of a
patient's original anatomy and a final implanted hip ball
prosthesis.
[0023] However, Hickey requires a vertical height change of the
neck segment in order to move between the various offsets. Where
vertical height is restricted during surgery, especially in
current, less invasive arthroplasty procedures, vertical height
adjustment is undesirable.
[0024] There are a variety of modular stem designs in the prior
art. Most of these designs focus on the ability to use varying stem
diameters and length with various size proximal bodies to provide
optimal fill on both the diaphysis and the metaphysis
simultaneously (to optimize fixation of the device). In many of
these designs the neck cannot be removed or replaced to adjust
head-height or offset without disturbing the fixation of at least
the modular proximal body portion of the stem. Prior art modular
stems include the modular stem as disclosed in U.S. Pat. No.
5,370,706 to Bolesky, et al. and assigned to the applicant of the
instant application. The Bolesky patent, U.S. Pat. No. 5,370,706 is
hereby incorporated in its entirety by reference.
[0025] Another modular stem available in the prior art is the
S-ROM.RTM. stem sold by DePuy Orthopaedics, Inc., Warsaw, Ind. and
described in U.S. Pat. Nos. 4,624,673, 4,790,852, and 4,846,839.
The U.S. Pat. Nos. 4,624,673, 4,790,852, and 4,846,839 are
incorporated herein by reference in their entireties.
[0026] The prior art further includes a modular stem marketed by
Wright Medical, Inc. of Arlington, Tenn. The Pro-Femur Stem
provides a modular neck with a taper on both ends, one to engage
the stem proximal body and one to engage the head.
[0027] The present invention is adapted to solve at least some of
the aforementioned problems with the prior art.
SUMMARY OF THE INVENTION
[0028] An aspect of the present invention is in the form of a hip
stem that utilizes a modular neck portion.
[0029] The hip stem includes two main parts. These parts are a hip
stem body and a modular neck portion. The modular neck provides the
surgeon the ability to adjust the proximal-distal head height and
the head offset. These adjustments may be either independent or in
combination with each other. The adjustment can be made after the
stem is seated and fixed into place, eliminating the need to
disturb the fixation of the stem. The adjustment can take place as
fine tuning at the end of the initial orthopaedic surgery or upon a
revision surgery when it is determined that the cause for the
revision (such as instability or leg length discrepancy) may be
addressed by adjustment.
[0030] The design of an aspect of the present invention allows the
stem body to be implanted separately from the modular neck portion.
This feature may be advantageous in minimally invasive surgery
where smaller components may be easier to place through smaller
incisions and where waiting until near the end of the operation to
implant the neck portion provides more room for the surgeon to work
and better access to the joint space.
[0031] According to yet another aspect of the present invention,
the hip stem design includes two main parts, a hip stem body and a
modular neck portion. The modular neck portion fits within a recess
in the top of the stem body. This modular design allows the modular
neck portion to be placed or removed without disturbing the
fixation of the stem body in the bone. A variety of methods can be
used to obtain mechanical attachment of the modular stem portion to
the body.
[0032] For example, in one embodiment of the present invention,
dowel pins are pressed into one side of the interface with a tight
slip fit on the other side to align and aid in carrying bending
moments across the interface. This design ensures that the screw
(which is used to apply the compressive locking forces across the
interface) is subjected only to axial tension loads. By eliminating
bending moments in the screw, fatigue failure of the thread
fastener can be better avoided.
[0033] According to another aspect of the present invention, a
means for holding the screw captive in the modular stem portion may
be desirable to aid in assembling the modular stem portion to the
stem body. Such capture of the screw would minimize the number of
parts to be handled and eliminate the need to handle or assemble
many small pieces.
[0034] In yet another embodiment of the present invention, the
dowel pins are replaced with tapers, which may be either
rectangular or cylindrical. The tapers serve to align the parts and
carry any bending moments so that the screw is subjected to only
axial tension loads.
[0035] In yet another aspect, the present invention provides a hip
stem for use in performing hip arthroplasty. The hip stem is to be
fitted to a cavity in the canal of a femur. The hip stem includes a
stem component including a distal stem portion and a proximal body
portion. The hip stem also includes a neck component fixedly
connectable to the stem component. The neck component includes a
proximal neck portion and a distal body portion. The neck component
is adapted for removal from the femur without disturbing the
fixation of the stem component to the bone.
[0036] In another aspect, the present invention provides a hip
prosthesis for use in performing hip arthroplasty. The hip stem is
fitted to a cavity in the canal of a femur. The hip prosthesis
includes an acetabular cup, a head, a neck component and a stem
component. The stem component includes a distal stem portion and a
proximal body portion. The neck component is fixedly connectable to
the stem component. The neck component includes a proximal neck
portion and a distal body portion. The neck component is adapted
for removal from the femur without disturbing the fixation of the
stem component to the bone.
[0037] In another aspect, the present invention provides a kit for
performing revision surgery. The kit includes a stem component
having a distal stem portion and a proximal body portion. The kit
also includes a first neck component fixedly connectable to the
stem component. The first neck component includes a proximal neck
portion and a distal body portion. The first neck component is
adapted for removal from the femur without disturbing the fixation
of the stem component to the bone. The kit also includes a second
neck component fixedly connectable to the stem component. The
second neck component includes a proximal neck portion and a distal
body portion. The second neck component is adapted for removal from
the femur without disturbing the fixation of bone surrounding the
stem component.
[0038] In another aspect, the present invention provides an
orthopaedic implant for use in performing joint arthroplasty. A
portion of the orthopaedic implant is to be fitted to a cavity in
the canal of a long bone. The orthopaedic implant includes a stem
component having a stem portion and a body portion. The orthopaedic
implant also includes a joint component fixedly connectable to the
stem component. The joint component has an articulation portion and
a connection portion. The joint component is adapted for removal
from the long bone without disturbing the fixation of bone
surrounding the stem.
[0039] In another aspect, the present invention provides a stem
component for use with a joint component having an articulation
portion and a connection portion in performing joint arthroplasty.
At least a portion of the stem component is to be fitted to a
cavity in the canal of a long bone. The stem component includes a
stem portion and a body portion. The body portion is adapted to
permit removal of the connection portion of the joint component
from the long bone without disturbing the fixation of bone
surrounding the joint component.
[0040] In another aspect, the present invention provides a joint
component for use with a stem component having a body portion and a
stem portion in performing joint arthroplasty. At least a portion
of the stem component is to be fitted to a cavity in the canal of a
long bone. The joint component includes a connection portion and an
articulation portion. The connection portion is adapted to permit
the removal of the joint component from the long bone without
disturbing the fixation of bone surrounding the joint
component.
[0041] In another aspect, the present invention provides an
orthopaedic implant trial for use in performing joint arthroplasty
and to assist in performing a trial reduction in performing joint
arthroplasty. A portion of the orthopaedic implant trial is fitted
to a cavity in the canal of a long bone. The orthopaedic implant
trial includes a stem component having a stem portion and a body
portion. The orthopaedic implant trial also includes a joint
component fixedly connectable to the stem component. The joint
component has an articulation portion and a connection portion. A
portion of the body portion of the stem component extends over a
portion of the connection portion of the joint component.
[0042] In another aspect, the present invention provides a kit for
use in performing joint arthroplasty. The kit includes an
orthopaedic implant trial for use in performing joint arthroplasty.
The trial is to be fitted to a cavity in the canal of a long bone
and to assist in performing a trial reduction in performing joint
arthroplasty. The orthopaedic implant trial includes a stem
component having a stem portion and a body portion. The orthopaedic
implant trial also includes a joint component fixedly connectable
to the stem component. The joint component has an articulation
portion and a connection portion. The joint component is adapted
for removal from the long bone without disturbing the fixation of
the stem component to the bone. The kit includes an orthopaedic
implant for use in performing joint arthroplasty. A portion of the
orthopaedic implant is fitted to a cavity in the canal of a long
bone. The orthopaedic implant includes a stem component having a
stem portion and a body portion. The orthopaedic implant also
includes a joint component fixedly connectable to the stem
component. The joint component includes an articulation portion and
a connection portion. The joint component is adapted for removal
from the long bone without disturbing the fixation of bone
surrounding the joint component.
[0043] In another aspect, the present invention provides a method
for treating orthopaedic joint disease of a patient. The method
includes the step of implanting an orthopaedic implant into a
cavity in the canal of a long bone. The orthopaedic implant
includes a stem component and a first joint component fixedly
connectable to the stem component. The joint component is adapted
for removal from the long bone without disturbing the fixation of
the stem component to the bone. The method also includes the steps
of monitoring the condition of the patient and determining that the
patient needs a revision prosthesis. The method also includes the
steps of providing a second joint component compatible with the
stem component and removing the first joint component from the stem
component of the orthopaedic implant in vivo in the patient without
disturbing the fixation of bone surrounding the orthopaedic
implant. The method also includes the step of implanting the second
joint component into the stem component in vivo in the patient.
[0044] In another aspect, the present invention provides a method
for providing revision joint arthroplasty on a patient having an
orthopaedic implant. The orthopaedic implant includes a stem
component and a first joint component fixedly connectable to the
stem component. The joint component is adapted for removal from the
long bone without disturbing the fixation of the stem component to
the bone. The method includes the steps of monitoring the condition
of the patient and determining that the patient needs a revision
prosthesis. The method also includes the steps of providing a
second joint component compatible with the stem component and
removing the first joint component from the stem component of the
orthopaedic implant in vivo in the patient without disturbing the
fixation of bone surrounding the orthopaedic implant. The method
also includes the step of implanting the second joint component
into the stem component in vivo in the patient.
[0045] In another aspect of the present invention an orthopaedic
implant for use in performing joint arthroplasty is provided. A
portion of the implant is fitted to a cavity in the canal of a long
bone. The cavity extends from a resected plane of the long bone.
The implant includes a joint component having a stem element with
an external periphery. The stem element defines a distal end for
insertion into the cavity. The external periphery of the stem
element has a resection ring that aligns with the resected plane of
the long bone and a body element fixedly connectable to the stem
element. The body element has a external periphery. A distal
portion of the body element extends from the resection ring toward
the distal end of the stem element. The periphery of the body
element is spaced from the external periphery of the stem element
so that the body element may be removed without disturbing the
fixation.
[0046] According to yet another aspect of the present invention an
orthopaedic implant stem for use in performing joint arthroplasty
is provided. A portion of the orthopaedic implant stem is to be
fitted to a cavity in the canal of a long bone. The orthopaedic
implant stem includes a distal element defining an external
periphery of the distal element. The distal element defines a
distal end of the element for insertion into the cavity and an
opposed connection end. The distal element defines a recess therein
extending from the opposed connection end of the distal element.
The orthopaedic implant stem component also includes a proximal
element fixedly connectable to the distal element. A distal portion
of the proximal element extends generally from the connection end
of the distal element toward the distal end of the distal element
when the proximal element is fixedly connected to the stem. The
distal portion of the proximal element is spaced inwardly from the
external periphery of the distal element when the proximal element
is fixedly connected to the stem component so that the proximal
element may be removed from the long bone without disturbing the
fixation of the distal element to the long bone.
[0047] According to another aspect of the present invention a
method for treating orthopaedic joint disease of a patient is
provided. The method includes the steps of resecting a long bone
along a resection plane and preparing a cavity in the canal of the
long bone. The method includes the step of implanting an
orthopaedic implant into a cavity in the canal of a long bone. The
orthopaedic implant includes a joint component having a stem
element and a first body element fixedly connectable to the stem
element. The orthopaedic implant is secured in the canal of the
long bone with the body element being spaced from the long bone.
The method further includes the steps of monitoring the condition
of the patient, determining that the patient needs a revision
prosthesis, providing a second body element compatible with the
stem element, and removing the first body element from the stem
element of the orthopaedic implant in vivo in the patient without
disturbing the fixation of bone surrounding the stem element of the
orthopaedic implant and without damaging bone surrounding the first
body element. The method also includes the step of implanting the
second body element into the stem element in vivo in the
patient.
[0048] According to yet another aspect of the present invention an
orthopaedic implant for use in performing joint arthroplasty is
provided. A portion of the orthopaedic implant is capable of being
fitted to a cavity in the canal of a long bone. The cavity extends
from a resected plane of the long bone. The orthopaedic implant
includes a joint component. The joint component includes a stem
element defining an external periphery of the stem element. The
stem element has a first end for insertion into the cavity. The
external periphery of the stem element has a stem resection ring.
The stem resection ring may be aligned with the resected plane of
the long bone. The joint component also includes a body element,
which is capable of being fixedly fitted to the stem element. The
body element includes an external periphery. The external periphery
of the body element has a body resection ring. The body resection
ring may be aligned with the resected plane of the long bone. A
canal portion of the body element extends generally from the
resection ring of the external periphery of the body element toward
the first end of the stem element when the body element is fixedly
connected to the stem element. The external periphery of the canal
portion of the body element is spaced inwardly from the external
periphery of the stem element when the body element is fixedly
connected to the stem so that the body element may be removed from
the long bone without disturbing the fixation of the stem element
to the long bone.
[0049] According to a further aspect of the present invention an
orthopaedic implant stem for use in performing joint arthroplasty
is provided. A portion of the orthopaedic implant stem may be
fitted to a cavity in the canal of a long bone. The orthopaedic
implant stem includes a canal element having an external periphery.
The canal element has a first end for insertion into the cavity and
an opposed connection end. The canal element has a recess extending
from the opposed connection end of the canal element. The recess
has a internal periphery. The canal element also has an external
periphery spaced outwardly from the internal periphery of the
recess. The orthopaedic implant stem further includes a body
element that may be fixedly connected to the canal element. A first
portion of the body element may be inserted into the recess of the
canal element when the first element is fixedly connected to the
canal element. The first portion of the body element is spaced
inwardly from the external periphery of the canal element when the
body element is fixedly connected to the canal element so that the
body element may be removed from the long bone without disturbing
the fixation of the canal element to the long bone.
[0050] According to a another aspect of the present invention a
method for treating orthopaedic joint disease of a patient is
provided. The method includes the steps of resecting a long bone
along a resection plane and preparing a cavity in the canal of the
long bone. The method also includes the step of implanting an
orthopaedic implant into a cavity in the canal of the long bone.
The orthopaedic implant includes a joint component having a canal
element and a first body element. The first body element may be
fixedly connected to the canal element. The orthopaedic implant is
secured in the canal of the long bone with the first body element
being spaced from the long bone. The method further includes the
steps of monitoring the condition of the patient and determining
that the patient needs a revision prosthesis. The method also
includes the steps of providing a second body element connectable
to the canal element and removing the first body element from the
canal element of the orthopaedic implant in vivo without disturbing
the fixation of bone surrounding the canal element of the
orthopaedic implant and without damaging bone surrounding the first
body element. The method further includes the step of implanting
the second body element into the canal element in vivo.
[0051] The technical advantages of the present invention include
the ability to independently adjust the head-height and the head
offset without disturbing the fixation of the stem in the bone. For
example, according to one aspect of the present invention a hip
stem is provided including a stem component including a distal stem
portion and a proximal body portion and a neck component. The neck
component is fixably connected to the stem component. The neck
component includes a proximal neck portion and a distal body
portion. The neck component is adapted for removal from the femur
without disturbing the fixation of the stem component to the bone.
Thus, the present invention provides for the ability to
independently adjust the head-height and the head offset without
disturbing the fixation in the stem of the stem in the bone by
merely changing the neck component by removing the neck component
from the stem component while the stem component is in position in
the bone.
[0052] The technical advantages of the present invention further
include the ability to enhance minimally invasive hip procedures by
having smaller incisions for the stem and neck. For example,
according to another aspect of the present invention, a hip stem is
provided including a stem component having a distal stem component
and a proximal body portion and a neck component. The neck
component is fixably connectable to the stem component. The neck
component includes a proximal neck portion and a distal body
portion. The neck component is adapted for removal from the femur
without disturbing the fixation of the stem component to the bone.
The stem component may thus be first inserted into the incision,
put in position and then the neck component may be secured to the
stem component. Thus the present invention provides for the
enhancing of minimally invasive hip procedures by having smaller
incisions for the stem and body. By allowing the neck portion to be
inserted separately from the stem body, the implants may be
inserted through a smaller incision with reduced soft tissue
stretching and allowing the surgeon more space to work within the
joint space until later in the procedure when the neck portion is
inserted. In other words, the stem may be positioned in the
incision and through the soft tissue put in place in the canal of
the long bone and, in fact, cemented into position and permitted to
be fixably secured into the proper position. At that time, the neck
portion may then be inserted through the incision and the procedure
continued.
[0053] The technical advantages of the present invention include
the ability to permit common hip prostheses to be used for right
and left hand versions of the hip prosthesis. For example,
according to yet another aspect of the invention, a hip stem is
provided with a stem component and a neck component. At least one
of the stem component and the neck component are adapted to permit
the stem component and neck component to have a first assembly
relationship as well as a second assembly relationship which is
different than the first assembly relationship. Thus the present
invention provides for a hip stem assembly that permits both right
and left hand versions with a common set of hip stem
components.
[0054] The technical advantages of the present invention further
include the ability to correct surgical error or optimize the
surgical variables such as leg length discrepancy. For example,
according to yet another aspect of the present invention, a hip
stem is provided including a hip stem component and a neck
component. The neck component is adapted for removal from the femur
without disturbing the fixation of the stem component to the bone.
Thus, the present invention provides for the replacement of the
neck from the stem with the replacement neck having a different
neck length than the replaced neck while replacing the neck with
the stem in place. Thus the present invention provides for the
correction of surgical error or optimization of a surgical variable
such as leg length discrepancy.
[0055] The technical advantages of the present invention also
include the ability to correct head height at revision surgery due
to implant subsidence. For example, according to yet another aspect
of the present invention, a hip stem is provided including a stem
component and a neck component. The neck component is adapted for
removal from the femur without disturbing the fixation of the stem
component to the bone. Thus, the present invention provides for a
replacement of the neck component with a replacement neck component
with a different head-height than the initial neck component while
having the stem component remain in place on the bone. Thus, the
present invention provides for a correction of head height at
revision surgery to adjust for implant subsidence.
[0056] The technical advantages of the present invention include
the ability to correct instability of the hip joint. Stability may
be restored by moving the head proximally and/or increasing the
offset to tighten the soft tissue. The corrections can also be made
at revision surgery to address dislocations. For example, according
to yet another aspect of the present invention, a hip stem is
provided including a stem component as well as a plurality of neck
components. One of the pluralities of neck components may have a
first offset dimension and the second component have a greater
offset dimension. Thus, the present invention provides for
replacing the first neck component with a second neck component
with greater offset while having the stem remain in place on the
bone. Thus, the present invention provides for the correction of
instability by moving the head proximally or increasing the offset
to tighten the soft tissues.
[0057] The technical advantages also include the ability to correct
weak abductor function by increasing the offset of the hip stem,
which increases the efficiency of the abductor muscles by
increasing the moment arm of the abductor muscle action For
example, according to yet another aspect of the present invention,
a hip stem is provided including a stem component and a first neck
component having a first offset and a second neck component having
a greater offset than the first neck component. The neck component
is adapted for removal from the femur without disturbing the
fixation of the stem component to the bone. Thus, the present
invention provides for replacing a first neck component with a
second neck component of greater offset while the stem is in place
in the bone. Thus, the present invention provides for correction of
weak abductor function by increasing the offset of the hip
stem.
[0058] Other technical advantages of the present invention will be
readily apparent to one skilled in the art from the following
figures, descriptions and claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0059] For a more complete understanding of the present invention
and the advantages thereof, reference is now made to the following
description taken in connection with the accompanying drawings, in
which:
[0060] FIG. 1 is a plan view of a modular hip stem in accordance
with an embodiment of the present invention utilizing a tapered
lock and screw;
[0061] FIG. 1A is a partial plan view of an alternate embodiment of
the present invention in the form of a modular hip stem with a
tapered stem connection and a modular neck;
[0062] FIG. 1B is a cross-sectional view of FIG. 1 along the line
1B-1B in the direction of the arrows;
[0063] FIG. 2 is a top view of the modular hip stem of FIG. 1;
[0064] FIG. 3 is a plan view of a modular hip stem in accordance
with another embodiment of the present invention utilizing dowel
pins and a screw;
[0065] FIG. 3A is a partial plan view of an alternate embodiment of
the present invention in the form of a modular hip stem with a
pinned stem connection and a modular neck;
[0066] FIG. 4 is a top view of the modular hip stem of FIG. 3;
[0067] FIG. 5 is a plan view of a kit for performing hip
orthopaedic surgery in accordance with yet another embodiment of
the present invention;
[0068] FIG. 6 is a plan view of a second stem component of a
modular hip stem for use with the kit of FIG. 5;
[0069] FIG. 7 is a plan view of a neck component of a modular hip
stem for use with the kit of FIG. 5 including a through opening for
utilizing a screw and having different offsets than the neck
components of FIG. 5;
[0070] FIG. 8 is a plan view of a modular hip stem in accordance
with another embodiment of the present invention utilizing dowel
pins to provide for different version with the same stem;
[0071] FIG. 9 is a plan view of a modular hip stem in accordance
with yet another embodiment of the present invention utilizing a
rectangular tapered lock and a screw;
[0072] FIG. 9A is a cross-sectional view of FIG. 9 along the line
9A-9A in the direction of the arrows;
[0073] FIG. 10 is a top view of the modular hip stem of FIG. 9;
[0074] FIG. 11 is an end view of the modular hip stem of FIG.
9;
[0075] FIG. 12 is a plan view of a modular hip stem in accordance
with a further embodiment of the present invention utilizing a
tapered lock;
[0076] FIG. 13 is a plan view of a hip implant in accordance to
another embodiment of the present invention including a modular hip
stem similar to that of FIG. 3;
[0077] FIG. 14 is a top view of a modular hip stem with left handed
proximal component with a neck extending posteriorly and a distal
component;
[0078] FIG. 15 is a top view of a modular hip stem with a right
handed proximal component with a neck extending posteriorly,
utilizing the distal component of the hip stem of FIG. 14;
[0079] FIG. 16 is a plan view of the modular hip stem of FIGS. 14
and 15;
[0080] FIG. 17 is a plan view of a modular stem in accordance with
a further embodiment of the present invention in the form of a
tibial tray assembly implanted in the tibia;
[0081] FIG. 18 is a plan view of a further embodiment of the
modular stem of the present invention in the form of a modular
shoulder prosthesis implanted in the humerus and glenoid
cavity;
[0082] FIG. 19 is a plan view of a kit for performing joint
arthoplasty including the modular stem of the present
invention;
[0083] FIG. 20 is a process flow diagram of a method of performing
joint arthroplasty surgery in accordance with yet another
embodiment of the present invention;
[0084] FIG. 21 is a process flow diagram for a method of performing
joint arthroplasty surgery according to a further embodiment of the
present invention;
[0085] FIG. 22 is a process flow diagram of a method of performing
joint arthroplasty surgery in accordance with yet another
embodiment of the present invention;
[0086] FIG. 23 is a process flow diagram for a method of performing
joint arthroplasty surgery according to a further embodiment of the
present invention;
[0087] FIG. 24 is a plan view of another kit for performing joint
arthroplasty including the modular stem of the present
invention;
[0088] FIG. 25 is a plan view of a modular hip stem in accordance
with a further embodiment of the present invention utilizing a
location ring;
[0089] FIG. 26 is a plan view of a body component of a modular hip
stem in accordance with a further embodiment of the present
invention utilizing a location ring; and
[0090] FIG. 27 is a plan view of yet another kit for performing
joint arthroplasty including the modular stem of the present
invention.
DETAILED DESCRIPTION OF THE INVENTION
[0091] Embodiments of the present invention and the advantages
thereof are best understood by referring to the following
descriptions and drawings, wherein like numerals are used for like
and corresponding parts of the drawings.
[0092] According to the present invention and referring now to FIG.
1, an embodiment of the present invention is shown as hip stem 10.
Hip stem 10 is utilized for performing hip arthroplasty. The hip
stem 10 is designed to be fitted into a cavity 2 in the canal 4 of
a long bone 6, for example, the femur. The hip stem 10 includes a
stem component 12 including a distal stem portion 14 and a proximal
body portion 16. The hip stem further includes a neck component 18
which, is as shown in FIG. 1, is fixedly connectable to the stem
component 12. The neck component 18 includes a proximal neck
portion 20 and a distal body portion 22. The neck component 18 is
adapted for removal from the femur 6 without disruption of bone 8
around the stem component 12.
[0093] To provide for the removal of the neck component without
disturbing the fixation of the stem component 12 to the bone 8, the
hip stem 10 of the present invention may be adapted to provide all
the support for the hip stem and fixation of the hip stem 10 to the
femur 6 with the stem component 12. Thus, as shown in FIG. 1, the
stem component 12 is configured, preferably, to provide as much
support as possible for the hip stem 10 to the femur 6. For
example, and as shown in FIG. 1, a portion 24 of the proximal body
portion 16 of the stem component 12 extends over a portion of the
distal body portion 22 of the neck component 18.
[0094] While the portion 24 of the proximal body portion of the
stem component 12 may be positioned anywhere around the femur 6 to
provide additional support for the stem component 12, it should be
appreciated, and referring to FIG. 1, the portion 24 may extend
substantially around the periphery of the femur 6.
[0095] For example, and as shown in FIG. 1, the stem component 12
may include a sleeve portion 26 extending proximally from the
proximal body portion 16 of the stem component 12. The sleeve
portion 26 may extend laterally, medially, anteriorly, or
posteriorly or a combination thereof. For example, and as shown in
FIG. 1, the sleeve portion 26 extends substantially around
periphery 28 of the distal body portion 22 of the neck component
18.
[0096] As shown in FIG. 1, the distal body portion of the neck
component 18 may receive the stem component 12. To accommodate the
neck component 18, the proximal body portion 16 of the stem
component 12 may define a pocket 32 in the proximal body portion 16
for receiving the neck component 18.
[0097] As shown in FIG. 1, the hip stem 10 may be configured to
assist in the removal of the neck component 18 from the femur 6
without disturbing the fixation of the stem component to the bone
8, the neck component 18 may be spaced from the femur. By spacing
the neck component 18 from the femur, the neck component 18 may be
removed without disturbing the fixation of the stem component 12 to
the bone.
[0098] As shown in FIG. 1, the distal body portion 22 of the neck
component 18 is removably secured to the proximal body portion 16
of the stem component 12. The distal body portion 22 and the
proximal body portion 16 may be removably secured to each other in
any reasonable manner.
[0099] For example, and as shown in FIG. 1, the proximal body
portion 16 of the stem component 12 includes a periphery 34 of the
proximal body portion 16. A portion 36 of the periphery 34 is
generally planer. Similarly, the distal body portion 22 of the neck
component 18 defines a periphery 38 of the distal body portion. A
portion 40 of the periphery 38 is generally planer. The neck planer
portion 40 and the body planer portion 36 are in contact with each
other. The contact of the neck planer portion 40 and the body
planer portion 36 provide for a stable support of the neck
component 18 onto the stem component 12.
[0100] For simplicity and as shown in FIG. 1, the stem component 12
defines a longitudinal axis 42 of the stem component 12. For
simplicity and to provide for strength and rigidity, the neck
planer portion 40 and the body planer portion 36 are generally
normal or perpendicular to the longitudinal axis 42.
[0101] As shown in FIG. 1, the hip stem 10 may include a connector
in the form of, for example a fastener, for example a screw 44 to
connect the neck component 18 to the stem component 12. As shown in
FIG. 1, the connector 44 may be in the form of, for example, a
screw.
[0102] Neck component 18 may be connected to the stem component 12
in many different ways within the various embodiments of the
present invention. For example and as shown in FIG. 1, the distal
body portion 22 of the neck component 18 may include a protrusion
46 extending downwardly from the neck planer portion 40. Protrusion
46 may have any suitable shape, and may as shown in FIG. 1 have a
generally circular cross-section and be tapered defining an
included angle .alpha.. Stem component 12 may, in order to receive
the protrusion 46 of the neck component 18, define an aperture 48
formed in the proximal body portion 16 of the stem component 12.
Aperture 48 may have a contour matching that of the protrusion 46
for receiving the protrusion therein. It should be appreciated that
the angle .alpha. may be sufficiently small to provide for a soft
self-locking feature between the protrusion 46 and the aperture
48.
[0103] For a self-locking taper the angle .alpha. should be defined
by the formula;
Tan ( .alpha. / 2 ) < .mu. 2 ##EQU00001##
[0104] where .beta.=coefficient of friction [0105] .alpha.=included
angle
[0106] Referring now to FIG. 1-B, the protrusion 46 and the
aperture 48 are shown in cross-section. As shown in FIG. 1-B, the
protrusion 46 has a circular cross-section defined by protrusion
diameter PD.
[0107] As shown in FIG. 1, the connector 44 may be in the form of a
screw. The screw 44 may be any suitable screw and may, as shown in
FIG. 1, have a flat head and be in the form of a socket-headed cap
screw. Connector may be received by the neck component 18 by a
connector opening 50 formed in the neck component 18 and positioned
about longitudinal axis 42. The connector 44 may be received into
the stem component 12 through stem component aperture 52. The stem
component aperture 52 may include internal threads 54 that mate
with external threads 56 formed on the connector or screw 44.
[0108] The hip stem 10 including the stem component 12, the neck
component 18 as well as the screw 44 may be made of any suitable
durable material. For example, the stem component 12, the neck
component 18 and the connector 44 may be made of, for example, a
metal, a plastic or a composite. The materials from which the
components of the hip stem 10 are manufactured preferably are
materials that are compatible with the human body. For example, if
the stem component 12, neck component 18, or the connector or screw
44 are made of a metal, the components may be made of, for example,
a cobalt chromium alloy, a stainless steel alloy, or a titanium
alloy.
[0109] The stem component 12 may have any suitable shape capable of
insertion into the canal 4 of the femur 6. For example, the stem
component 12 may include a stem periphery 58 having a shape similar
to that of the broach or rasp used to form the cavity 2 in the
canal 4 of the long bone or femur 6. The proximal body portion 16
of the stem component 12 may, as shown in FIG. 1, have a larger
cross-section than that of the distal stem portion 14 to conform
with the corresponding shape of the natural femur 6.
[0110] The neck component 18 of the hip stem 10 may have any
suitable shape capable of mating with the stem component 12 and
capable of providing support for the ball or head 60 which may be
placed on external taper 62 formed on neck 64 of the neck component
18. It should be appreciated that the hip stem 10 may be integral
with the neck component 18.
[0111] As shown in FIG. 1, hip stem or orthopaedic implant stem 10
is used for performing joint arthroplasty. A portion of the
orthopaedic implant stem 10 may be fitted to cavity 2 in the canal
4 of long bone 6. The orthopaedic implant stem 10 includes a stem
component or canal element 12 having external stem periphery 58.
The canal element 12 has a first end 15 for insertion into the
cavity and an opposed connection end 17. The canal element 12 has
pocket or recess 32 extending from opposed connection end 17 of the
canal element 12. The recess 32 has an internal periphery 23. The
canal element 12 also has external periphery 58 spaced outwardly
from the internal periphery 23 of the recess 32. The orthopaedic
implant stem 10 further includes neck component or body element 18
that may be fixedly connected to the canal element 12. Distal body
portion or first distal body portion 22 of the neck component 18
may be inserted into the recess 32 of the canal element 12 when the
neck component 18 is fixedly connected to the canal element 12.
External periphery 78 of the first portion 22 of the neck component
18 is spaced inwardly from the external periphery 58 of the canal
element 12 when the neck component 18 is fixedly connected to the
canal element 12 so that the neck component 18 may be removed from
the long bone 6 without disturbing the fixation of the canal
element 12 to the long bone 6.
[0112] As shown in FIG. 1, the distal body portion 22 of the neck
component 18 may have any suitable shape and typically has a shape
compatible for placement within the recess or pocket 32 formed in
the proximal body portion 16 of the stem component 12. For example,
the distal body portion 22 may, as shown in FIG. 2, have a
generally rectangular shape defined by neck body width NBW and neck
body length NBL.
[0113] Referring now to FIG. 1A, another embodiment of the present
invention is shown as hip stem 10A. The hip stem 10A is similar to
the hip stem 10 of FIG. 1, except that the neck component 18A is of
a modular construction or is made from more than one piece. For
example, as shown in FIG. 1A, the neck component 18A includes a
distal body component 22A and a proximal neck component 20A. The
proximal neck component 20A may be secured to the distal body
component 22A in any suitable fashion.
[0114] As shown in FIG. 1A, the proximal neck component 20A
includes an external taper 21A that mates with a cavity 23A formed
in the distal body component 22A. It should be appreciated that the
components forming the neck component 18A may be threadably
attached, press-fit attached or have a bayonet lock or any type of
connector. The hip stem 10A further includes a stem component 12A
which is similar to the stem component 12 and includes a distal
stem portion 14A and a proximal body portion 16A.
[0115] Hip stem 10 of the present invention, as shown in FIG. 1 and
FIG. 2, may be utilized for both cemented and cementless hip
arthroplasty. For example, the hip stem 10 may be used with a femur
having a cavity prepared for cement with the cement being
positioned between the femur 6 and the hip stem 10. The cavity 2 of
the femur 6 may alternatively be prepared such that the stem
periphery 58 may directly connect with the periphery of the cavity
2. It should be appreciated that whether the hip stem 10 uses
cemented or cementless construction, the neck component 18 may be
removed from the stem component 12 without disruption of the bone
implant ingrowth.
[0116] According to the present invention and referring now to
FIGS. 3 and 4, yet another embodiment of the present invention is
shown as hip stem 110. Hip stem 110 is similar to the hip stem 10
of FIGS. 1 and 2 and may, in fact, be made of similar materials
with generally similar shapes. The hip stem 110, however, is
different from the hip stem 10 of FIGS. 1 and 2.
[0117] For example and as shown in FIGS. 3 and 4, the hip stem 110
includes a stem component 112 somewhat similar to the hip stem
component 12 of FIGS. 1 and 2. The hip stem 110 further includes a
neck component 118 somewhat similar to the neck component 18 of
FIGS. 1 and 2. The hip stem 110 further includes a connector 144
which is different than connector 44 of the hip stem 10 of FIGS. 1
and 2.
[0118] For example, as shown in FIGS. 3 and 4, the connector 144
includes a screw 164 similar to the screw 44 of the hip stem 10 of
FIGS. 1 and 2. In addition to the screw 64, the connector 144
further includes a pin, for example, first pin 166. The hip stem
110, it should be appreciated, may be manufactured with a solitary
pin 166 but may, as shown in FIGS. 3 and 4, further include a
second pin 168. The pins 166 and 168 as well as the screw 164 serve
to form the connector 144. The connector 144 is used to connect the
neck component 118 to the stem component 112.
[0119] The first pin 166 and the second pin 168 may, for simplicity
as shown in FIGS. 3 and 4, be substantially the same. For example,
the pins 166 and 168 may be cylindrical. For example, the first pin
166 and the second pin 168 may be defined by a pin diameter PD and
a pin length PIL. The first pin 166 and the second pin 168 may be
made of any suitable durable material and may, for example, be made
of a metal. If made of a metal, the first pin 166 and the second
pin 168 may, for example, be made of a material compatible with a
human body. For example, a cobalt chromium alloy, a stainless steel
alloy, or a titanium alloy.
[0120] The stem component 112 may, as is shown in FIGS. 3 and 4,
have a distal stem portion 114 and a proximal body portion 116.
Internal threads 156 may be formed on proximal body portion 116 to
mate with external threads 148 formed on the screw 164. The
proximal body portion 116 of the stem component 112 may define a
first pin stem opening 170 for receiving the first pin 166 as well
as a second pin stem opening 172 for receiving the second pin 168.
The pins 166 and 168 may be matingly fitted to the openings 172 and
170. The proximal body portion 116 may further include a sleeve
portion 126 which forms a pocket 132 for receiving the neck
component 118. The neck component 118 may include a screw opening
150 for receiving the screw 164. The neck component 118 may further
define a first pin neck opening 174 for receiving a portion of the
first pin 166 as well as a second pin neck opening 176 for
receiving the second pin 168.
[0121] It should be appreciated that to minimize the number of
loose parts the first pin 166 and the second pin 168 may be fixably
secured to one of the neck component 118 or the stem component 112.
It should be appreciated that the first pin 166 and the second pin
168 would then be slidably secured to the other of the stem
component 112 and the neck component 118.
[0122] The neck component 118 includes a distal body portion 122 as
well as a proximal neck portion 120. The proximal neck portion 120
may define an external taper 162 which matingly receives a ball or
head 160.
[0123] Referring now to FIG. 3A, yet another embodiment of the
present invention is shown as hip stem 110A. The hip stem 110A is
similar to the hip stem 110 of FIGS. 3 and 4, except that the neck
component 118A is different than the neck component 118 of the hip
stem 110 of FIGS. 3 and 4 in that the neck component 118A is
modular or made of more than one component. For example, as shown
in FIG. 3A, the neck component 118A includes a distal body
component 122A which is connectable to a proximal neck component
120A. It should be appreciated that the distal body component 122A
and the proximal neck component 120A may be connected to each other
in any suitable fashion, for example they may be threadably
connected, have a bayonet connection, have a press-fit connection
or, as is shown in FIG. 3A, have a tapered connection. For example,
the distal body component 122A may include a tapered cavity 123A
for receiving a tapered protrusion 121A extending from the proximal
neck component 120A. Hip stem 110A further includes a stem
component 112A which together with the neck assembly 118A forms the
hip stem 110A.
[0124] Referring now to FIGS. 5, 6 and 7, yet another embodiment of
the present invention is shown as Kit 200. The Kit 200 is for use
in performing a primary or a revision arthroplasty. The Kit 200
includes a first stem component 212, a first neck component 218,
and a second neck component 318.
[0125] The first stem component 212 includes a distal stem portion
214 and a proximal body portion 216. The first stem component 212
may have any suitable shape and may have a shape somewhat similar
to the stem component of FIG. 1. As shown in FIG. 5, the first stem
component 212 may include a pocket 232 formed by sleeve 226 of the
stem 212. The pocket 232 is adapted for receiving the first neck
component 218 or, alternatively, the second neck component 318.
[0126] As shown in FIG. 5, to secure the neck components 218 and
318 to the first stem component 212, the stem component 212 may
include an aperture 252 extending inwardly from planer face 236 of
the pocket 232. Internal threads 254 may be formed in aperture 252.
The internal threads 254 may cooperate with external threads 256
formed on screw 244.
[0127] The first neck component 218 may be similar to the neck
component 18 of the hip stem 10 of FIGS. 1 and 2. The first neck
component 218, however, does not include a protrusion such as the
protrusion 46 of the neck component 18 of FIGS. 1 and 2. First neck
component 218 includes a distal body portion 222 and a proximal
neck portion 220 extending from the distal body portion 222.
[0128] The distal body portion 222 defines a planer face 240 for
cooperation with the planer face 236 of the first stem component
212. The distal body portion 222 further defines a periphery 278
which mates with sleeve 226 of the first stem component 212. The
distal body portion 222 further defines an opening 250 for
receiving the screw 244. The proximal neck portion 220 defines a
neck 264 from which extends an external taper 262. A head 260, as
shown in phantom, may be fitted onto the external taper 262.
[0129] The first neck component 218 defines a height H1, a neck
length NL1 and a neck angle .alpha. NA1. The combination of neck
height, length, and angle assist in positioning the head 260 with
respect to the stem 212. Unique patient anatomies require that the
head 260 be put in the proper position. By utilizing the kit 200 of
the present invention, various neck components can be utilized to
provide for variations in the position of the head.
[0130] For example, and as shown in FIG. 5, the kit 200 further
includes a second neck component 318. The second neck component 318
includes different dimensions than the first neck component 218 so
that the head may be positioned in a different location than that
obtained if the first neck component 218 is used.
[0131] For example, and as shown in FIG. 5, the second neck
component 318 includes a distal body portion 322 and a proximal
neck portion 320. Distal body portion 322 includes a planer face
340 for cooperation with the planer face 236 of the stem 212. The
distal body portion 322 further defines a periphery 378 for mating
with sleeve 226 of the stem 214. The distal body portion 322
defines an opening 350 receiving the screw 244.
[0132] The proximal neck portion 320 defines a neck 364 which is
connected to the distal body portion 322. An external taper 362
extends from the neck 364. As shown in FIG. 5, the periphery 366 of
the distal body portion 322 and the planer face 340, as well as the
opening 350 of the second neck component 318 have configurations
compatible with the planer face 340, the opening 350, and the
periphery 266 of the distal body portion 322 of the first neck
component 218 in order that the first neck component 218 and the
second neck component 318 may be selectively used with the first
stem component 212.
[0133] As shown in FIG. 5, the second neck component 318 may
include a height H2 which is different than the height H1 of the
first neck component 218. Similarly, the proximal neck portion 320
of the second neck component 318 may define a neck length NL2 which
is different than neck length NL1 of the proximal neck portion 220
of the first neck component 218. Further, the proximal neck portion
of the second neck component 318 may define a neck angle .alpha.
NA2 which is different than the neck angle .alpha. NA1 of the
proximal neck portion 220 of the first neck component 218. It
should be appreciated that different neck components may be
accomplished where only one of the neck height, neck length, and
neck angle are different from each other.
[0134] Referring again to FIG. 5 and according to the present
invention a kit 201 for use in performing revision surgery on the
cavity 2 in the canal 4 of the long bone 6 is shown. The cavity 2
extends from a resected plane 11 of the long bone 6. The kit 20
includes first stem component or canal component 212 having an
external periphery 221. A portion of the canal component 212 may be
fitted to the cavity 2 in the canal 4 of the long bone 6. The canal
component 212 includes distal stem portion or canal portion 214
having a first end 215 for insertion into the cavity and an opposed
second end 217. The canal component 212 further includes a sleeve
portion 226 extending from the second end 217 of the canal portion
212. The sleeve portion 226 has an internal periphery 219 defining
pocket or internal cavity 232. The sleeve portion 226 also has an
external periphery 227. The kit 201 also includes first neck
component or first joint component 218 removably connectable to the
canal component 212. The first joint component 218 has a proximal
neck portion or body portion 220 and a distal body portion or
connection portion 222. The connection portion 222 of the first
joint component 218 has an external periphery 278. A portion of the
external periphery 278 of the connection portion 222 of the first
joint component 218 may be fitted into the internal cavity 232 of
the sleeve portion 226 of the canal component 212.
[0135] The kit 201 also includes a second neck component or a
second joint component 318 that is removably connectable to the
canal component 212. The second joint component 318 has a proximal
neck portion or body portion 320 and distal body portion or
connection portion 322. The connection portion 322 of the second
joint component 318 has an external periphery 378. A portion of the
external periphery 378 of the connection portion 322 of the second
joint component 318 is fitted into the internal cavity 232 of the
sleeve portion 226 of the canal component 212 so that the external
periphery 378 of the connection portion 322 of the first joint
component 218 is spaced inwardly from the external periphery 227 of
the sleeve portion 226 of the canal component 212 when the first
joint component 218 is fixedly connected to the canal component 212
so that the first joint component 218 may be removed from the long
bone 6 and replaced with the second joint component 318 without
disturbing the fixation of the canal component 212 to the long bone
6.
[0136] The kit 201 may, as shown in FIG. 5, be configured such that
the canal component 212, the first joint component 218, and/or the
second joint component 318 define resection rings 231, 233 and 333,
respectively, on a surface of the component. The resection rings
231, 233 and 333 may be used to align the component axially with
the resection plane 11.
[0137] The first resection ring 231 as shown in FIG. 5 may be
visually distinguishable from the exterior periphery or surface 227
of the canal component 212 adjacent to the ring 231. It should be
appreciated that any or all of the resection rings 231, 233 and 333
may be invisible.
[0138] The kit 201, may as shown in FIG. 5, be configured such that
a portion of the canal component 212 is extendable over a portion
of at least one of the first joint component 218 or the second
joint component 318.
[0139] The kit 201 may, as shown in FIG. 5, be configured such that
the first joint component 218 and the second joint component 318
have at least one dimension that is different from each other.
[0140] The kit 201 may, as shown in FIG. 5, be configured such that
a portion 236 of the external periphery 227 of the canal component
212 is generally planar. Further a portion 240 of the external
periphery 278 of the connection portion 222 of the first joint
component 218 may, as shown, be generally planar. The portion 236
of the external periphery 227 of the canal component 212 and the
portion 240 of the external periphery 278 of the connection portion
222 of the first joint component 218 may, as shown, contact each
other.
[0141] The kit 201 may, as shown in FIG. 5, also include a
connector 244 to connect the joint component 218 to the canal
component 212. For example, the connector 244 may be in the form of
a screw or as shown in FIG. 13 as a pin.
[0142] The kit 201 may alternately (see FIG. 1) be constructed such
that the first joint component 218 may include a protrusion. To
cooperate with the protrusion, the canal component 212 may define
an aperture for receiving the protrusion. The protrusion and the
aperture may have any suitable shape and may, for example, be
cylindrical or tapered.
[0143] It should be appreciated that the canal component 212 may
alternately include a protrusion (not shown). The first joint
component 218 may then include an aperture for receiving the
protrusion.
[0144] The kit 201 may (see FIG. 16) further include a prosthetic
component adapted for implantation to a second bone. The prosthetic
component may cooperate with the first joint component 218. Further
at least a portion of the body portion 220 of the first joint
component 218 may include an articulation surface for articulation
with the prosthetic component.
[0145] The kit 201 may also include a prosthetic component for
fixed implantation to a second bone and for cooperation with the
first joint component. The kit 201 may also include a bearing
component positionable between the first joint component and the
prosthetic component. The bearing component may articulate with the
first joint component and/or the prosthetic component.
[0146] As shown in FIG. 5, the first joint component 218 may be in
the form of, for example, a hip neck. The canal component 212 may
correspondingly be in the form of a hip stem. Further the kit may
include hip head 260 for attachment to the hip neck 218 and an
acetabular cup (see FIG. 16) for articulating cooperation with the
hip head 260.
[0147] Referring again to FIG. 5, the canal component 212 may
define a longitudinal axis 235 and the internal periphery 219 and
the external periphery 227 of the sleeve portion of the canal
component may also define a wall thickness WT2 therebetween. The
wall thickness WT2 may, as shown, be generally uniform in a plane
normal to the longitudinal axis 235 of the canal component 212. The
external periphery 278 of the connection portion 222 of the first
joint component 218 may be adapted to closely conform to the
internal periphery 219 of the sleeve portion 226 of the canal
component 212.
[0148] The canal component 212 may (see FIG. 18) be in the form of
a humeral stem and the first joint component 218 may be in the form
of a humeral neck. The kit 201 may also include a humeral head for
connection with the humeral neck.
[0149] Referring now to FIG. 5 the kit may also include connector
244 to connect at the first joint component 218 or the second joint
component 318 to the canal component 212. The connector may be in
the form of a screw or a pin (See FIG. 16).
[0150] As shown in FIG. 6, the kit 200 may further include a second
stem component 312. The second stem component 312 may be different
than the first stem component 212 and may include a distal stem
portion 314 that is longer, has a different angle, is narrower, or
is larger or smaller in diameter than the distal stem portion 214
of the first stem component 212.
[0151] As shown in FIG. 6, the second component 312 may define a
pocket 332 which has generally the same size and shape as the
pocket 232 of the first stem component 212 such that either the
first neck component 218 or second neck component 318 may be
compatible with the second stem component 312 as well as with the
first stem component 212. For example, the pocket 332 may be
defined by the sleeve 326 extending from planer surface 336. The
second stem component 312 may include a proximal body portion 316
that defines an aperture 352 defining internal threads 356 which
mate with external threads 256 of the screw 244.
[0152] Referring now to FIG. 7, the Kit 200 may further include a
third neck component 418. The third neck component 418 includes a
distal body portion 422 and a proximal body portion 420. The distal
body portion 422 of the third neck component 418 may define planer
surface 440 and periphery 478. The surface 440 and periphery 478
which as shown in FIG. 7 are selected such that the third neck
component 418 may be compatible and fit in the pocket 232 of the
first stem 212.
[0153] The distal body portion 422 defines an opening 450 for
receiving the screw 244. The proximal neck portion 420 defines a
neck 464 extending from the distal body portion 422 and an external
taper 462 that extends from the neck 464 and that is adapted for
cooperation with a ball or head, for example head 460. It should be
appreciated that the external taper 462, of third neck component
418 the external taper 362 of the second neck component 318, as
well as the external taper 262 of the first neck component 218 may
have similar sizes and shapes, such that the same head or similar
heads may be accommodated by all of the associated tapers of the
associated neck components.
[0154] As shown in FIG. 7 the third neck component 418 defines a
neck length NL3, a neck angle .alpha. NA3, and a neck height H3. It
should be appreciated that at least one of the neck height H3, the
neck length NL3 or the neck angle .alpha. NA3 may be different than
the corresponding dimension for the first neck component 218 or the
second neck component 318.
[0155] Referring now to FIG. 8, yet another embodiment of the
present invention is shown as hip stem 510. The hip stem 510 is
different than the hip stem 110 of FIGS. 1 and 2 in that the hip
stem 510 provides for two assembly positions. For example, as shown
in FIG. 8, hip stem 510 may include an anterior assembly position
580 as is shown in solid and a posterior assembly position 582 as
is shown in phantom.
[0156] It should be appreciated that as is shown in FIG. 8, the hip
stem 510 may be a right hip stem. It should be appreciated that for
a left hip stem, the anterior assembly position and the posterior
assembly position would be reversed.
[0157] According to the present invention, and as shown in FIG. 8,
the hip stem 510 includes a stem component 512 as well as a neck
component 518. The stem component 512 may be similar to the stem
component 12 of FIGS. 1 and 2, except that the stem component 512
includes a plurality of mounting positions for mounting the neck
component 518 onto the stem component 512 in a plurality of
positions. For example, as shown in FIG. 8, the stem component 518
includes a first stem opening 570 for cooperating with first pin
566.
[0158] The stem component 512 further includes a second pin stem
anterior opening 571 for receiving the second pin 568. When the
second pin 568 is positioned in the second pin stem anterior
opening 571, the neck component 518 is positioned with respect to
the stem component 512 such that the hip stem 510 is in the
posterior assembly position 582 as shown in phantom.
[0159] The stem component 512 further includes a second pin stem
posterior opening 572. The second pin stem posterior opening 572 is
adapted for likewise receiving the second pin 568. When the second
pin 568 is positioned in the second pin stem posterior opening 572,
the neck component 518 is aligned with the stem component 512 such
that the hip stem 510 is assembled into the anterior assembly
position 580 is shown in solid.
[0160] Proximal body portion 516 of the stem component 512 includes
a sleeve portion 526 for cooperation with bone and or cement.
[0161] The neck component 518 includes a distal body portion 522
defining a periphery 578 thereof. The periphery 578 of the distal
body portion 522 is fitted within cavity or pocket 532 formed in
the stem component 512 by the sleeve portion 526. The distal body
portion 522 of the neck component 518 includes a first pin neck
opening 574 as well as a second pin neck opening 576. The first pin
neck opening 574 cooperates with the first pin 566 while the second
pin neck opening 576 cooperates with the second pin 568.
[0162] A neck 564 extends from the distal body portion 522 of the
neck component 518. An exterior taper 562 extends from the neck 564
and serves to receive head 560. The neck 564 and exterior taper 562
form the proximal neck portion 520 of the neck component 518. As
can be seen by simply rotating the component 518 after removing the
second pin 568 from the stem component 512, the neck component 518
may be rotated about first pin 566 in the direction of arrows 584
to either anterior assembly position 580 or posterior assembly
position 582.
[0163] Referring now to FIGS. 9 and 10, yet another embodiment of
the present invention is shown as hip stem 610. The hip stem 610 of
FIGS. 9, 10 and 11 is different than the hip stem 10 of FIGS. 1 and
2 in that the hip stem 610 includes an external protrusion 646,
which is different than the external protrusion 46 of the hip stem
in that the external protrusion 646 is rectangular rather than
circular in cross-section. For example, and as shown in FIG. 9, the
hip stem 610 includes a stem component 612 as well as a neck
component 618.
[0164] The stem component 612 includes a distal stem portion 614
for cooperation with the cavity 2 formed in the canal 4 of the
femur 6. The stem component further includes a proximal body
portion 616 which defines a pocket 632 for receiving the neck
component 618. An opening 652 formed in the pocket 632 includes
internal threads 656 for cooperation with external threads 648
formed on the screw 644. The proximal body portion 616 of stem
component 612 includes an aperture 648 formed therein for receiving
the external protrusions 646 extending from neck component 618.
[0165] Referring now to FIG. 9-A, the external protrusion 646 and
the aperture 648 are shown in cross-section. The aperture 648 and
the external protrusion 646 are defined by a protrusion width PW
and a protrusion length PL which defines a generally rectangular
cross-section of the external protrusion 646, and correspondingly
the aperture 648.
[0166] Referring again to FIG. 9, the external protrusion 646
further defines a protrusion height PH extending along longitudinal
axis 642 of the hip stem 610.
[0167] Referring to FIGS. 10 and 11, the neck component 618
includes a distal body portion 622 and a proximal neck portion 620
extending from the distal body portion 622. Stem component 612
includes a sleeve portion 624 which defines a pocket 632 for
receiving periphery 678 of the distal body portion 622 of the neck
component 618. The neck component 618 includes the distal body
portion 622 and the proximal neck portion 620. The proximal neck
portion 620 includes a neck 664 and an external taper 662 extending
from the neck 664. A head 660 may mate with external taper 662.
[0168] The external protrusion 646 may, as shown in FIGS. 10 and
11, be tapered and define first included angle .alpha. SQ1 and
second included angle .alpha.SQ2
[0169] Referring now to FIG. 12, another embodiment of the present
invention is shown as hip stem 710. The hip stem 710 is different
than the hip stem 10 of FIGS. 1 and 2 in that the hip stem 710
relies solely on a self-locking tapered connection to combine the
components of the hip stem 710.
[0170] For example, and as shown in FIG. 12, the hip stem 710
includes a stem component 712 as well as a neck component 718. The
stem component 712 includes a distal stem portion 714 and a
proximal body portion 716. The proximal body portion 716 defines a
planer surface 736 from which a cavity 748 extends.
[0171] The neck component 718 includes a distal body portion 722
and a proximal neck portion 720 extending from the distal body
portion 722. The distal body portion 722 includes a protrusion 746
extending from planer surface 740 of the distal body portion
722.
[0172] The protrusion 746 is tapered and defines an included angle
.beta. of, for example, two to twenty degrees
(2.degree.-20.degree.) for a self locking taper, the angle .beta.
is defined by equation:
tan .beta./2<.mu.
Where: .mu.=coefficient of friction
[0173] .beta.=included angle
[0174] The protrusion 746 cooperates with the cavity 748 to lock
the neck component 718 to the stem component 712.
[0175] The distal body portion 722 fits within pockets 732 formed
by the sleeve portion 726 of the proximal body portion 716 of the
stem component 712.
[0176] The proximal neck portion 720 includes neck 764 from which
external taper 762 extends. The head 760 is fitted onto external
taper 762.
[0177] According to the present invention and referring now to FIG.
13, yet another embodiment of the present invention is shown as
prosthesis 800. The prosthesis 800 as shown in FIG. 13 is in the
form of a hip prosthesis. The prosthesis 800 includes a hip stem
810. The hip stem 810 is similar to the hip stem 110 of FIGS. 3 and
4. The hip stem 810 includes a stem component 812 as well as a neck
component 818.
[0178] The stem component 812 may be similar to the stem component
112 of FIGS. 3 and 4. The stem component 812 includes a distal stem
portion 814 adapted to fit within cavity 2 of the canal 4 of femur
6. The stem component further includes a proximal body portion 816
extending from the distal stem portion 814 of the stem component
812. The proximal body portion 816 includes an aperture 852
extending inwardly from inner face 836 of the proximal body portion
816 of the stem component 812. Internal threads 854 are formed in
the aperture 852. The internal threads 854 cooperate with external
threads 848 formed on screw 851.
[0179] The neck component 818 is, as is shown in FIG. 13, connected
to the stem component 814 by any suitable connector, for example,
by connector 844. The connector 844, as is shown in FIG. 13
includes the screw 851, as well as, a first pin 866. The connector
844 may further include a second pin 868 spaced from and parallel
to the first pin 866.
[0180] The neck component 818 includes a distal body portion 822
and a proximal neck portion 820 extending from the distal body
portion 822. The distal body portion 822 includes an aperture 850
for receiving the screw 851. The distal body portion 822 further
includes a first pin neck opening 874 for cooperating with the
first pin 866 and a second pin neck opening 876 for cooperating
with the second pin 868. The distal body portion 822 further
defines a planar face 840 for cooperation with a planar face 836 of
the stem component 812.
[0181] The proximal body portion 816 of the stem component 812
includes a first pin stem opening 870 for cooperation with the
first pin 866 and a second pin stem opening 872 for cooperation
with the second pin 868. The proximal body portion 816 of the stem
component 812 includes a sleeve portion 826 defining a pocket 832
for receiving periphery 878 of the distal body portion 822 of the
neck component 818.
[0182] The proximal neck portion 820 of the neck component 818
includes a neck 864 as well as external taper 862 extending from
the neck 864.
[0183] In addition to the hip stem 810, the prosthesis 800 further
includes a head 860 which matingly fits on external taper 862 of
the neck component 818. The prosthesis 800 further includes an
acetabular cup 886 for cooperation with acetabulum 9 of the
patient. The acetabular cup 886 may include a feature in the form
of, for example, a porous coated surface 888 for promoting boney
in-growth between the acetabulum 9 and the acetabular cup 886. The
prosthesis 800 may include a bearing 890 positioned between the
acetabular cup 886 and the head 860. It should be appreciated that
the acetabular cup 886 may directly cooperate with the head
860.
[0184] It should be appreciated that the hip stem 810, head 860,
acetabular cup 886, and bearing 890 may be made of any suitable
durable material. The hip stem 810 including the distal stem
portion 814, the neck component 818, as well as pins 866 and 868
and the screw 864, may all be made of a suitable durable material.
The materials for the components of the prosthesis 800 may, for
example, be made of a plastic, a metal, or a composite. The
material for which the prosthesis is made preferably is compatible
with the human anatomy. The prosthesis 800, if made of a metal may
for example be made of a cobalt chromium alloy, a stainless steel
alloy, or a titanium alloy.
[0185] The bearing 890 of the prosthesis 800 may for example, be
made of a metal, a ceramic, or a plastic. The head 860 may be made
of a metal, or a ceramic.
[0186] According to the present invention and referring now to
FIGS. 14-16, yet another embodiment of the present invention is
shown as prosthesis 800A. The prosthesis 800A is shown in FIG. 14
in the form of a hip prosthesis. The prosthesis 800A includes a hip
stem 810A. The hip stem 810A is similar to the hip stem 810 of FIG.
13 except the hip stem 810A provides for posterior version for hip
stems for both the right leg and the left leg of the patient. The
hip stem 810A includes a stem component 812A as well as a right
neck component 818A as shown in FIG. 14 and a left neck component
819A as shown in FIG. 15.
[0187] As shown in FIG. 16, the stem component 812A may be similar
to the stem component 812 of FIG. 13. The stem component 812A
includes a distal stem portion 814A adapted to fit within cavity 2
of the canal 4 of femur 6. The stem component 812A further includes
a proximal body portion 816A extending from the distal stem portion
814A of the stem component 812A. The proximal body portion 816A
includes an aperture 852A extending inwardly from inner face 836A
of the proximal body portion 816A of the stem component 812A.
Internal threads 854A are formed in the aperture 852A. The internal
threads 854A cooperate with external threads 848A formed on screw
851A.
[0188] The right neck component 818A and the left neck component
819A are thus alternatively connected to the stem component 182A.
The components 818A and 819A may be connected to the stem component
812A by any suitable connector.
[0189] The right neck component 818A is shown connected to the stem
component 812A in FIG. 16. It should be appreciated that the left
neck component 819A is likewise, similarly connected to the stem
component 812A.
[0190] The right neck component 818A is, as is shown in FIG. 16,
connected to the stem component 814A by, for example, connector
844A. The connector 844A, as is shown in FIG. 16 includes the screw
851A, as well as, a first pin 866A. The connector 844A may further
include a second pin 868A spaced from and parallel to the first pin
866A.
[0191] The right neck component 818A includes a distal body portion
822A and a proximal neck portion 820A extending from the distal
body portion 822A. The distal body portion 822A includes an
aperture 850A for receiving the screw 851A. The distal body portion
822A further includes a first pin neck opening 874A for cooperating
with the first pin 866A and a second pin neck opening 876A for
cooperating with the second pin 868A. The distal body portion 822A
further defines a planar face 840A for cooperation with an inner
face 836A of the stem component 812A.
[0192] The proximal body portion 816A of the stem component 812A
includes a first pin stem opening 870A for cooperation with the
first pin 866A and a second pin stem opening 872A for cooperation
with the second pin 868A. The proximal body portion 816A of the
stem component 812A includes a sleeve portion 826A defining a
pocket 832A for receiving periphery 878A of the distal body portion
822A of the right neck component 818A.
[0193] As shown in FIG. 14, the proximal neck portion 820A of the
right neck component 818A includes a right neck 864A as well as a
right external taper 862A extending from the right neck 864A. The
right neck 864A extends posteriorly from the distal body portion
822A of the right neck component 818A at an angle .theta..theta.
of, for example, 10 to 40 degrees. The posterior extension is
intended to mimic the geometry of the natural right femur.
[0194] As shown in FIG. 15, the proximal neck portion 821A of the
left neck component 819A includes a left neck 865A as well as a
left external taper 863A extending from the left neck 865A. The
left neck 865A extends posteriorly from the distal body portion
823A of the left neck component 819A at an angle
.theta..theta..theta. of, for example, 10 to 40 degrees. While as
shown in FIG. 15 the neck 865A extends downwardly, it should be
appreciated that shape when placed in a left femur will extend
posteriorly. The posterior extension is intended to mimic the
geometry of the natural left femur.
[0195] It should be appreciated that both the right neck component
818A of FIG. 14 and the left neck component 819A of FIG. 15 may be
used with the identical stem component 812A. This may be
accomplished by providing the left external taper 863A of the left
neck component 819A with identical dimensions to that of the right
external taper 862A of the right neck component 818A. Thus both the
right external taper 862A and the left external taper 863A may mate
with the internal taper of the stem component 812A.
[0196] Referring again to FIG. 16, in addition to hip stem 810A,
the prosthesis 800 further includes a head 860A, which matingly
fits on external taper 862A or 863A of either of the neck
components 818A and 819A respectively. The prosthesis 800A further
includes an acetabular cup 886A for cooperation with acetabulum 9
of the patient. The acetabular cup 886A may include a feature in
the form of, for example, a porous coated surface 888 for promoting
boney in-growth between the acetabulum 9 and the acetabular cup
886A. The prosthesis 800A may include a bearing 890A positioned
between the acetabular cup 886A and the head 860A. It should be
appreciated that the acetabular cup 886A may directly cooperate
with the head 860A.
[0197] It should be appreciated that the hip stem 810A, head 860A,
acetabular cup 886A, and bearing 890A may be made of any suitable
durable material. The hip stem 810A including the distal stem
portion 814A, the neck components 818A and 819A, as well as the
pins 866A and 868A and the screw 864A, may all be made of a
suitable durable material. The materials for the components of the
prosthesis 800A may, for example, be made of a plastic, a metal, or
a composite. The material for which the prosthesis is made
preferably is compatible with the human anatomy. The prosthesis
800A, if made of a metal may, for example, be made of a cobalt
chromium alloy, a stainless steel alloy, or a titanium alloy.
[0198] The bearing 890A of the prosthesis 800A may for example, be
made of a metal, a ceramic, or a plastic. The head 860A may be made
of a metal, or a ceramic.
[0199] According to the present invention and referring to FIG. 17
another embodiment of the present invention is shown as prosthesis
900. The prosthesis 900 as shown in FIG. 17 is for use in the knee
joint. The orthopedic prosthesis 900 as shown in FIG. 16 includes a
tibial component 910, a bearing 990 and a femoral component
992.
[0200] The tibial component 910 for the prosthesis 900 is for use
with tibia 5. The tibial component 910 includes a joint component
918 and a stem component 912. The stem component 912 fits within
the intramedullary canal 7 of the tibia 5. The stem component 912
includes a distal stem portion 914 as well as a proximal body
portion 916. Proximal body portion 916 of the stem component 912
defines a pocket 932 formed from sleeve portion 926 of the proximal
body portion 916. A connector 944 is used to connect the stem
component 912 to the joint component 918.
[0201] The joint component 918 includes an articulation portion 920
and a distal body portion 922 extending from the articulation
portion 920. The distal body portion 922 of the joint component 918
defines a protrusion 946 which cooperates with the pocket 932
formed by the sleeve 926 of the stem component 912.
[0202] The connector 944 connects the joint component 918 to the
stem component 912. The connector 944 may have any suitable shape
and may, as shown in FIG. 17, include a screw 964 as well as a
first pin 966 and a second pin 968. The pins 966 and 968 engage
with the joint component 918 and with the stem component 912. The
screw 964 includes external threads 948 which cooperate with
internal threads 954 formed on the proximal body portion 916 of the
stem component 912. As shown in FIG. 17, the articulation portion
920 of the joint component 918 extends transversely or
perpendicular to longitudinal axis 942 of the stem component 912
substantially past the stem component 912.
[0203] The sleeve 926 may extend, as shown in FIG. 17, up against
the taper of the pocket 932. The sleeve 926 may, as shown in FIG.
17, extend out transversely from the longitudinal axis 942 and
define a planer surface 936 of the stem component 912. Similarly,
the joint component 918 may include a planer portion 940 extending
transversely from the longitudinal axis 942. The planer portions
936 and 940 may cooperate with each other to support and form the
stem component 912.
[0204] As shown in FIG. 17, the orthopedic prosthesis 900 further
includes a femoral component 992 connected to cavity 2 formed in
canal 4 of the femur 6. The femoral component 992 cooperates with
the joint component 918 of the stem 912. The femoral component 992
may cooperate directly with the tibial component 910. The
orthopedic prosthesis 900 may further include a bearing 990
supported by the articulating portion 920 of the joint component
918. The bearing 990 may, for example, be made of a pliable
material, for example, a plastic.
[0205] The femoral component 992 and the stem component 912 may be
made of any suitable material, for example, a plastic, a composite,
or a metal and if made of a metal, for example, cobalt chromium
alloy, stainless steel alloy, or titanium alloy.
[0206] Referring now to FIG. 18, yet another embodiment of the
present invention is shown as shoulder prosthesis 1000. The
shoulder prosthesis 1000 includes a stem 1010 and a glenoid 1094.
The stem 1010 includes a stem component 1012 for cooperation with
humerus 9.
[0207] The stem component 1012 includes a distal stem portion 1014
and a proximal body portion 1016. The proximal body portion 1016
includes a sleeve 1026 defining a pocket 1032 therein. Within the
pocket 1032 a stem planer face 1036 is formed. Extending distally
from the stem planer face 1036 is a tapered aperture 1048.
Extending distally from the tapered aperture 1048 is a cylindrical
aperture 1052 having internal threads 1056 formed thereon.
[0208] The stem 1010 further includes a neck component 1018 having
a distal body portion 1022 and a proximal neck portion 1020. The
distal body portion 1022 defines an aperture 1050 therein.
[0209] The distal body portion 1022 defines a distal body planer
face 1040 as well as a periphery 1078. The periphery 1078 and the
neck planer face 1040 cooperate with pocket 1032 to position the
neck component 1018 with the stem component 1012. The neck
component 1018 further includes a protrusion 1046 extending from
the planer face 1040. The protrusion 1046 matingly fits with the
aperture 1048 to provide a taper-lock of the neck component 1018 to
the stem component 1012.
[0210] While the neck component 1018 may be securely fastened to
the stem component 1012 by means of the protrusion in taper lock,
it should be appreciated that the shoulder prosthesis 1000 may
further include a connector in the form of a screw 1044. The screw
1044 fits within the aperture 1050 of the neck component 1018 and
includes external threads 1049 that cooperate with the internal
threads 1056 formed on the stem component 1012.
[0211] The proximal neck portion 1020 includes an external taper
1062. The external taper 1062 is adapted to receive head 1060. The
head 1060 cooperates with glenoid 1094 secured to glenoid facia 3
by pigs 1086. Stem 1010, head 1060, and glenoid 1094 may be made of
any suitable durable material. The stem 1010 including the stem
component 1012 and the neck component 1018 as well as the screw
1044 may be made, for example, of a plastic, a metal, or a
composite. If made of a metal, the neck component 1018, stem
component 1012, and screw 1044 may be made of, for example, a
cobalt chromium alloy, a stainless steel alloy, or a titanium
alloy. The glenoid 1094 may be made of a metal or be made of, for
example, a more pliable material, for example, a plastic.
[0212] Referring now to FIG. 19, yet another embodiment of the
present invention is shown as kit 1100. The kit 1100 includes the
trial hip stem 1110 and the implant hip stem 1210. The trial hip
stem 1110 and the implant hip stem 1210 preferably have similar, if
not almost identical, shapes and dimensions. The trial 1110 is
implanted into the body and used to perform a trial reduction or to
verify the dimensions and selection of the hip stem components. The
trial is removed after a trial reduction and the corresponding
implant is permanently secured into the bone of the patient. The
use of the trial verifies the selection of the implant and if the
trial selection is believed to be sub-optimum, an alternate trial
is used in the patient and if that alternate trial is found to be
optimum, its corresponding implant is then implanted into the
patient.
[0213] Trial 1110 includes a trial stem component 1112 and a trial
neck component 1118. The trial stem component 1112 includes a
distal stem portion 1114 and a proximal body portion 1116. The
proximal body portion 1116 includes a sleeve portion 1126 defining
a pocket 1132 and a surface 1136. Extending distally from the
surface 1136 is a cavity 1148.
[0214] The trial 1110 further includes the trial neck component
1118. The trial neck component 1118 includes a distal body portion
1122 and a proximal neck portion 1120. The distal body portion 1122
includes a periphery 1178 for fitting against a sleeve portion 1126
of the stem component 1112. The distal body portion 1122 further
includes a surface 1140 for mating with the surface 1136 of the
stem component 1112. The distal body portion 1122 also includes a
protrusion 1146 which mates with cavity 1148 of the stem component
1112. The protrusion 1146 defines included angle .beta..beta..
[0215] The angle .beta..beta. is selected to provide for a
self-locking taper between protrusion 1146 and the cavity 1148. The
angle .beta..beta. may be, for example, from two to twenty degrees
(2.degree.-20.degree.).
[0216] The angle .beta..beta. is preferably selected by the
formula:
Tan .beta..beta./2<.mu.
where: .mu.=coefficient of friction
[0217] .beta..beta.=included angle
[0218] The proximal neck portion 1120 includes an external taper
1162 to which head 1160 is matingly fitted.
[0219] The implant hip stem 1210 has a size and shape the same as
trial 1110. For example, the implant 1210 includes a stem component
1212 having a distal stem 1212 portion 1214 and a proximal body
portion 1216. The proximal body portion 1216 includes a sleeve
portion 1226 defining pocket 1232. The pocket 1232 includes a
surface 1236 as well as a cavity 1248 extending below the surface
1236.
[0220] The implant hip stem 1210 also includes a neck component
1218 including a distal body portion 1222 and a proximal neck
portion 1220. The distal body portion 1222 defines a periphery 1278
thereof, as well as a surface 1240 of the distal body portion 1222.
A protrusion 1246 extends downwardly from the surface 1240 and
defines an included angle .beta..beta.. The proximal neck portion
1220 includes an external taper 1262 to which head 1260 is matingly
fitted.
[0221] The trial stem component 1112 may be first implanted into
the patient and the trial neck component 1118 may be secured to the
trial stem component 1112. Alternatively, the implant stem
component 1212 may be permanently secured to the patient and the
trial neck component 1118 may be fitted to the implant stem
component 1212.
[0222] The trial neck component 1118 may be secured to the implant
stem component 1212 and a trial reduction made. If the trial
reduction is satisfactory, the implant neck component 1218, which
is identical to the trial neck component 1118, may be implanted
into the patient. If, however, the trial neck component 1118 is
found in a trial reduction to not be optimum, an alternate trial
neck component may be utilized in a trial reduction attempted with
the new trial neck component. If that second trial neck component
is found to be satisfactory, a corresponding implant neck component
is then implanted.
[0223] According to the present invention and referring again to
FIG. 19, a kit 1101 for use in performing joint arthroplasty is
shown. The kit 1101 includes the orthopaedic stem trial or trial
hip stem 1110 for use in performing joint arthroplasty. The trial
1110 may be fitted to a cavity 2 in the canal 4 of a long bone 6
and assists in performing a trial reduction in performing joint
arthroplasty. The orthopaedic stem trial 1110 includes canal
component or trial stem component 1112 having an external periphery
1113. A portion of the canal component 1112 may be fitted to the
cavity 2 in the canal 4 of the long bone 6. The canal component
1112 includes distal stem portion or canal portion 1114 that has a
first end 1115 for insertion into the cavity 2 and an opposed
second end 1117. The canal component 1112 further includes a sleeve
portion 1126 extending from the second end 1117 of the canal
portion 1114. The sleeve portion 1126 has an internal periphery
1119 that defines pocket or internal cavity 1132. The sleeve
portion 1126 also has an external periphery 1121.
[0224] The orthopaedic stem trial 1112 also includes trial neck
component or joint component 1118 removably connectable to the
canal component 1112. The joint component 1118 has neck portion or
body portion 1120 and distal body portion or connection portion
1122. The connection portion 1122 of the joint component 1118
defines an external periphery 1178. A portion of the external
periphery 1121 of the sleeve portion 1126 may be fitted to the
cavity 2 of the long bone 6. At least a portion of the external
periphery 1178 of the connection portion 1122 of the joint
component 1118 may be fitted into the internal cavity 1132 of the
sleeve portion 1126 so that the external periphery 1178 of the
connection portion 1122 of the joint component 1118 is spaced
inwardly from the external periphery 1121 of the sleeve portion
1126 of the stem component 1112 when the joint component 1118 is
fixedly connected to the stem component 1112 so that the joint
component 1118 may be removed from the long bone 6.
[0225] The kit 1101 includes orthopaedic hip stem or orthopaedic
stem implant 1210 for use in performing joint arthroplasty. The
implant 1210 may be fitted to cavity 2 in canal 4 of long bone 6 to
perform a joint arthroplasty. The orthopaedic stem implant 1210
includes implant stem component or canal component 1212 having an
external periphery 1221. At least a portion of the canal component
1212 may be fitted to the cavity 2 in the canal 4 of the long bone
6. The canal component 1212 includes distal stem portion or canal
portion 1214 having a first end 1215 for insertion into the cavity
2 and an opposed second end 1217. The canal component 1212 further
includes sleeve portion 1226 extending from the second end 1217 of
the canal portion 1214. The sleeve portion 1226 has an internal
periphery 1219 that defines pocket or internal cavity 1232. The
sleeve portion 1226 also has an external periphery 1221. The
orthopaedic stem implant 1210 also includes implant neck component
or joint component 1218 that may be removably connected to the
canal component 1212. The joint component 1218 has distal body
portion or connection portion 1222 and neck portion or body portion
1220. The connection portion 1222 of the joint component 1218
defines external periphery 1278. A portion of external periphery
1221 of the sleeve portion 1226 may be fitted to the cavity 2 of
the long bone 6. A portion of the external periphery 1278 of the
connection portion 1222 of the joint component 1218 may be fitted
into the internal cavity 1232 of the sleeve portion 1226. The
external periphery 1278 of the connection portion 1222 of the joint
component 1218 is spaced thereby inwardly from the external
periphery 1221 of the sleeve portion 1226 of the stem component
1212. This is accomplished when the joint component 1218 is fixedly
connected to the stem component 121. The joint component 1218 may
thereby be removed from the long bone without disturbing the
fixation of the stem component 1212 to the long bone 6.
[0226] Referring now to FIG. 20, yet another embodiment of the
present invention is shown as method 1300 for treating orthopedic
joint disease of the patient. The method 1300 includes a first step
1310 of implanting an orthopedic implant into a cavity in the canal
of the long bone. The orthopedic implant includes a stem component
and a first joint component fixedly connectable to the joint
component. The joint component is adapted for removal from the long
bone without disturbing the fixation of the stem component to the
bone. The method 1300 includes a second step 1312 of monitoring the
condition of the patient and a third step 1314 of determining that
the patient needs a revision prosthesis. The method 1300 also
includes a fourth step 1316 of providing a second joint component
compatible with the stem component. The method 1300 further
includes a fifth step 1318 of removing the first joint component
from the stem component of the orthopedic implant in vivo without
disturbing the fixation of the stem component to the bone the
orthopedic implant. The method 1300 further includes a sixth step
1320 of implanting the second joint component into the stem
component in vivo in the patient.
[0227] According to the present invention and referring now to FIG.
21, yet another embodiment of the present invention is shown as
surgical method 1400. The method 1400 represents a method for
providing revision joint arthroplasty on a patient having an
orthopedic implant. The orthopedic implant includes a stem
component and a first joint component fixedly connectable to the
stem component. The joint component is adapted for removal from the
long bone without disturbing the fixation of the stem component to
the bone. The method 1400 includes a first step 1410 of monitoring
the condition of the patient and a second step 1412 of determining
whether the patient needs a revision prosthesis. The method 1400
includes a third step 1414 of providing a second joint component
compatible with the stem component. The method 1400 further
includes a fourth step 1416 of removing the first joint component
from the stem component of the orthopedic implant in vivo in the
patient without disturbing the fixation of the stem component to
the bone. The method 1400 further includes a fifth step 1418 of
implanting the second joint component in vivo in the patient.
[0228] Referring now to FIG. 22, another aspect of the present
invention is shown as method 1500 for treating orthopaedic joint
disease of a patient. The method 1500 includes a first step 1510 of
resecting a long bone along a resection plane and a second step
1512 preparing a cavity in the canal of the long bone. The method
also includes a third step 1514 of implanting an orthopaedic
implant into a cavity in the canal of the long bone. The
orthopaedic implant includes a joint component having a canal
element and a first body element. The first body element may be
fixedly connected to the canal element. The orthopaedic implant is
secured in the canal of the long bone with the first body element
being spaced from the long bone. The method further includes a
fourth step 1516 of monitoring the condition of the patient and a
fifth step 1518 of determining that the patient needs a revision
prosthesis. The method also includes a sixth step 1520 of providing
a second body element connectable to the canal element and a
seventh step 1522 of removing the first body element from the canal
element of the orthopaedic implant in vivo in the patient without
disturbing the fixation of bone surrounding the canal element of
the orthopaedic implant and without damaging bone surrounding the
first body element. The method further includes an eighth step 1524
of implanting the second body element into the canal element in
vivo in the patient.
[0229] Referring now to FIG. 23 a method 1600 for providing joint
arthroplasty on a joint of a patient with an orthopaedic implant is
shown. The method 1600 includes a first step 1610 of resecting a
long bone along a resection plane and a second step 1612 of
preparing a cavity in the canal of the long bone. The method also
includes a third step 1614 of implanting an orthopaedic implant
canal component into a cavity in the canal of a long bone. The
orthopaedic implant canal component may have a stem element and a
first body element fixedly connectable to the stem element. The
orthopaedic implant canal component is secured in the canal of the
long bone. The method further includes a fourth step 1616 of
connecting an orthopaedic trial body component to the implant canal
component, the orthopaedic trial body component being spaced from
the long bone and a fifth step 1618 of performing a trial reduction
of the joint of the patient. The method also includes a sixth step
1620 of determining if the orthopaedic trial body component
provides satisfactory results for the patient and a seventh step
1622 of implanting an orthopaedic implant body component
corresponding to the orthopaedic trial body component onto the
orthopaedic implant canal component if the orthopaedic trial body
component provides satisfactory results for the patient.
[0230] The third step 1614 of implanting the canal component step
may further include permanently securing the canal component to the
long bone.
[0231] The third step 1614 of implanting the canal component step
may further include positioning the canal component such that the
canal component intersects the resection plane.
[0232] Referring now to FIG. 24 the present invention may be in the
form of a kit 1700 for use in performing joint arthroplasty. The
kit 1700 includes a canal component implant 1712I having an
external periphery 1713I. A portion of the canal component implant
1712I may be fitted to a cavity 2 in a canal 4 of a long bone 6.
The canal component implant 1712I includes a canal portion 1714I.
The canal portion 1714I has a first end 1715I for insertion into
the cavity 2 and an opposed second end 1717I.
[0233] The canal component implant 1712I further including a sleeve
portion 1726I extending from the second end 1717I of the canal
portion 1714I. The sleeve portion 1726I has an internal periphery
1719I defining an internal cavity 1732I. The sleeve portion 1726I
also has an external periphery 1721I. The kit 1700 also includes a
first joint component implant removeably connectable to the canal
component implant. The first joint component implant 1718I has a
body portion 1720I and a connection portion 1722I. The connection
portion 1722I of the first joint component implant 1718I has an
external periphery 1778I. A portion of the external periphery 1778I
of the connection portion 1722I of the first joint component
implant 1718I may be fitted into the internal cavity 1732I of the
sleeve portion 17261 of the canal component implant 1712I, so that
the external periphery 1778I of the connection portion 1722I of the
first joint component implant 1718I is spaced inwardly from the
external periphery 1721I of the sleeve portion 1726I of the canal
component implant 1712I when the first joint component implant
1718I is fixedly connected to the canal component implant 1712I so
that the first joint component implant 1718I may be removed from
the long bone 6 without disturbing the fixation of the canal
component implant 1712I to the long bone 6.
[0234] The kit 1700 also includes a first joint component trial
1718T generally corresponding in size and shape with the first
joint component implant 1718I. The first joint component trial
1718T may be removeably connected to the canal component implant
1712I. The first joint component trial 1718T having a body portion
1720T and a connection portion 1722T. The connection portion 1722T
of the first joint component trial 1718T has an external periphery
1778T. A portion of the external periphery 1778T of the connection
portion 1722T of the first joint component trial 1718T may be
fitted into the internal cavity 1732I of the sleeve portion 1726I
of the canal component implant 1712I. The external periphery 1778T
of the connection portion 1722T of the first joint component trial
1718T is thereby spaced inwardly from the external periphery 1721T
of the sleeve portion 1726T of the canal component implant 1712I.
This occurs when the first joint component trial 1718T is fixedly
connected to the canal component implant 1712I. The first joint
component trial 1718T may thus be removed from the long bone 6
without disturbing the fixation of the canal component implant
1712I to the long bone 6.
[0235] The kit further includes a second joint component implant
1818I removeably connectable to the canal component implant 1712I.
The second joint component implant 1818I has a body portion 1820I
and a connection portion 1822I. The connection portion 1822I of the
second joint component implant 1818I has an external periphery
1878I. A portion of the external periphery 1878I of the connection
portion 1822I of the second joint component implant 1818I may be
fitted into the internal cavity 1732I of the sleeve portion 1726I
of the canal component implant 1712I so that the external periphery
1878I of the connection portion 1822I of the second joint component
implant 1818I is spaced inwardly from the external periphery 1721I
of the sleeve portion 1726I of the canal component implant 1712I
when the second joint component implant 1818I is fixedly connected
to the canal component implant 1712I so that the second joint
component implant 1818I may be removed from the long bone 6 without
disturbing the fixation of the canal component implant 1712I to the
long bone 6.
[0236] The kit 1700 also includes a second joint component trial
1818T generally corresponding in size and shape with the second
joint component implant 1818I. The second joint component trial
1818T may be removeably connectable to the canal component implant
1712I. The second joint component trial 1818T having a body portion
1820T and a connection portion 1822T. The connection portion 1822T
of the second joint component trial 1818T has an external periphery
1878T. A portion of the external periphery 1878T of the connection
portion 1822T of the second joint component trial 1818T may be
fitted into the internal cavity 1732I of the sleeve portion 1726I
of the canal component implant 1712I so that the external periphery
1878T of the connection portion 1822T of the second joint component
trial 1818T is spaced inwardly from the external periphery 1721I of
the sleeve portion 1726I of the canal component implant 1712I when
the second joint component trial 1818T is fixedly connected to the
canal component implant 1712I so that the second joint component
trial 1818T may be removed from the long bone 6 without disturbing
the fixation of the canal component implant 1712I to the long bone
6.
[0237] The kit 1700 permits the canal component implant 1712I to be
permanently implanted. The kit 1700 also permits the first joint
component trial 1718T to be assembled to the canal component
implant 1712I and used to perform a trial reduction. The kit 1700
further permits the first joint component trial 1718T to be
replaced with the second joint component trial 1818T if the trial
reduction has unsatisfactory results.
[0238] Referring now to FIG. 25, an orthopaedic implant 2011 is
used to perform joint arthroplasty. A portion of the orthopaedic
implant 2011 is capable of being fitted to cavity 2 in the canal 4
of long bone 6. The cavity 2 extends from a resected plane 11 of
the long bone 6. The orthopaedic implant 2011 includes joint
component 2010. The joint component 2010 includes stem element 2012
defining external periphery 2058 of the stem element 2012. The stem
element 2012 has a first end 2015 for insertion into the cavity 2.
The external periphery 2058 of the stem element 2012 has a stem
resection ring 2041. The stem resection ring 2041 may be aligned
with the resected plane 11 of the long bone 6.
[0239] The joint component 2010 also includes a first body element
2018 capable of being fixedly fitted to the stem element 2012. The
first body element 2018 includes an external periphery 2078. The
external periphery 2078 of the first body element 2018 has a body
component ring 2043. The body component ring 2043 may be aligned
with the resected plane 11 of the long bone 6. A canal portion 2045
of the first body element 2018 extends generally from the component
ring 2043 of the external periphery 2078 of the first body element
2018 toward the first end 2015 of the stem element 2012 when the
first body element 2018 is fixedly connected to the stem element
2012.
[0240] The external periphery 2047 of the canal portion 2045 of the
first body element 2018 is spaced inwardly from external periphery
2058 of the stem element 2012 when the first body element 2018 is
fixedly connected to the stem element 2012 so that the first body
element 2018 may be removed from the long bone 6 without disturbing
the fixation of the stem element 2012 to the long bone 6.
[0241] As shown in FIG. 25 the orthopaedic implant 2011 may be
configured such that the first mentioned body element 2018 may be
removably fixedly connected to the stem element 2012 and may
include a second body element 2018S that may be removably fixedly
connected to the stem element 2012. The first body element 2018 and
the second body element 2018S may thus be interchangeably connected
to the stem element 2012 while the stem element 2012 is implanted
in the cavity 2 of the long bone 6.
[0242] The orthopaedic implant 2011 may have a portion of the stem
element 2012 that extends over a portion of the first body element
2018.
[0243] The stem element 2012 of the orthopaedic implant, as shown
in FIG. 25, may include a sleeve portion 2016. The sleeve portion
2016 may receive at least a portion of the canal portion 2045 of
the first body element 2018.
[0244] The first body element 2018 of the orthopaedic implant 2011,
as shown in FIG. 25, may be removably securable to the stem element
2012.
[0245] As shown in FIG. 25, a portion 2036 of the external
periphery 2058 of the stem element 2012 may be generally planar.
Also a portion 2040 of the external periphery of the body element
2018 may be generally planar. The portion 2036 of the external
periphery 2058 of the stem element 2012 and the portion 2040 of the
external periphery 2078 of the body element 2018 may be in contact
with each other.
[0246] A connector 2044 may be used to connect the body element
2018 to the stem element 2012. The connector 2044 may be in the
form of a screw or a pin (see FIG. 16).
[0247] The body element 2018 may include a protrusion 2044
extending from a surface of the connection element 2022. The stem
element 2012 may include an aperture 2048 for receiving the
protrusion 2046. It should be appreciated that the body may include
an aperture (not shown) and the stem element may include a
protrusion (not shown). The protrusion may be tapered.
[0248] The implant 2011 may further include second joint component
2010S for cooperation with a first joint component 2010. A portion
of the external periphery of the body element 2018 may include an
articulation surface 2017 for articulation with the second joint
component 2010S.
[0249] The second joint component 2010S may be adapted for fixed
implantation onto a second bone 17. A bearing component 2055 may be
positioned between the first joint component 2010 and the second
joint component 2010S. The bearing component 2055 articulates at
the first joint component 2010 and is fixedly attached to the
second joint component 2010S. Alternately the bearing component
2055 may articulate with the second joint component 2010S and be
fixedly attached to the first joint component 2010.
[0250] As shown in FIG. 25, the orthopaedic implant 2011 may be in
the form of a hip implant. The joint component 2010 is in the form
of a hip stem. The orthopaedic implant 2011 may also include the
second joint component 2010S in the form of an acetabular cup for
articulating cooperation with the hip stem.
[0251] As shown in FIG. 25, the body element 2018 may include a
tapered protrusion 2059. The orthopaedic implant 2011 may also
include a generally spherical head 2060. The head 2060 may, as
shown, be removably fixedly secured to the tapered protrusion
2059.
[0252] As shown in FIG. 1, the joint component defines a
longitudinal axis 2039. The stem element 2012 may have a sleeve
portion 2026. The sleeve portion 2026 may define a wall thickness
WT3 of the sleeve portion 2026. The wall thickness WT3 may
generally be uniform about the outer periphery 2058 of the stem
element 2012 in a plane normal to the longitudinal axis 2039 of the
joint component 2010 and may be defined by wall thickness WT3. The
external periphery 2078 of the body element 2018 may, as shown,
closely conform to the sleeve portion 2026 of the stem element
2012.
[0253] It should be appreciated that the orthopaedic implant 2011
may be in the form of a knee prosthesis, a hip prosthesis or a
shoulder prosthesis.
[0254] Referring again to FIG. 25, it should be appreciated that
the stem element 2012 may be interchangeably connectable to the
first joint element 2018 and with the second joint element 2018S.
The first joint element 2018 and the second joint element 2018S may
as shown include a different dimension, or several different
dimensions from each other. Thus, it should be appreciated that the
stem element can receive joint elements of varying heights, offsets
and degrees of version.
[0255] Continuing to refer to FIG. 25, the stem resection ring 2041
may be in the form of a recess. The recess 2041 may be a score mark
or a machined or formed groove. It should be appreciated that the
ring may likewise be a raised area or protrusion (not shown). It
should be further appreciated that the ring 2041 may be acid etched
or marked with ink or paint. It should be appreciated that the ring
2041 may be continuous or discontinuous around the stem 2012.
[0256] It should be appreciated that body element 2018 may likewise
include body component ring 2043. The body component ring 2043 may
have the same configuration as that of the stem resection ring 2041
and may be recessed or protruding.
[0257] It should be appreciated that the stem resection ring 2041
and/or the body component ring 2043 may, as shown in FIG. 25, be
visually distinguishable from the external periphery 2058 of the
stem element 2012 and/or the external periphery 2078 of the body
element 2018.
[0258] It should likewise be appreciated that the stem resection
ring 2041 and/or the body component ring 2043 may be visually
indistinguishable from the external periphery 2058 of the stem
element 2012 and/or the external periphery 2078 of the body element
2018. The stem resection ring 2041 and/or the body component ring
2043 may thus be invisible.
[0259] According to the present invention and referring to FIG. 26,
a first joint component 2118 for use with a stem component 2112
having a canal portion 2114 and a sleeve portion 2116 for use as
part of a prothesis 2101 in performing joint arthroplasty is shown.
The sleeve portion 2116 of the stem component 2112 has an internal
periphery 2134 and an external periphery 2158. A portion of the
external periphery 2158 of the sleeve portion 2116 of the stem
component 2112 may be fitted to a cavity 2 in the canal 4 of a long
bone 6. The cavity 2 extends from a resected plane 11 of the long
bone 6.
[0260] The first joint component 2118 includes a body portion 2122
and a connection portion 2120. The connection portion 2120 extends
from the body portion 2122 and has an external periphery 2128. The
external periphery 2128 of the connection portion 2120 may be
positioned within the internal periphery 2134 of the sleeve portion
2116 of the stem component 2112.
[0261] The external periphery 2128 of the connection portion 2120
may include a connection resection ring 2139. The connection
resection ring 2139 may be used for alignment with the resected
plane 11 of the long bone 6. The external periphery 2128 of the
connection portion 2120 is spaced inwardly from the external
periphery 2158 of the sleeve portion 2116 of the stem component
2112 when the first joint component 2118 is fixedly connected to
the stem component 2112 so that the joint component 2018 may be
removed from the long bone 6 without disturbing the fixation of the
stem component 2112 to the long bone 6.
[0262] As shown in FIG. 26, the connection portion 2120 of the
first joint component 2118 may be adapted to be removably fixedly
connected to the stem component 2112. Further the prosthesis 2101
may include a second joint component 2160 removably fixedly
connectable to the stem component. The first joint component 2118
and the second joint component 2160 may, as shown, be
interchangeably connected to the stem component 2112 while the stem
component 2112 is implanted in the cavity 2 of the long bone 6.
[0263] As shown in FIG. 26, the connection portion 2120 of the
first joint component 2118 may be adapted to fit within the
internal periphery 2134 of the stem component 2112.
[0264] As shown in FIG. 26, a portion 2136 of the external
periphery 2158 of the stem component 2112 may be generally planar.
Further a portion 2140 of the external periphery 2128 of the first
joint component 2118 may be generally planar. The portion 2136 of
the external periphery 2158 of the stem component 2112 and the
portion 2140 of the external periphery 2128 of the first joint
component 2118 may, as shown, be adapted for contact with each
other.
[0265] The first joint component 2118, as shown in FIG. 26, may
include a feature 2148 for cooperation with a connector 2144 to
connect the first joint component 2118 to the stem component 2112.
The feature 2148 may be in the form of an aperture 2148 for passing
the connector 2144 through the first joint component 2118. For
example, the aperture 2148 may be a cylindrical aperture.
[0266] The first joint component 2118 as shown in FIG. 26 may
include a protrusion 2146. Alternatively, the joint component may
include an aperture (not shown). The protrusion 2146 may, as shown,
be tapered.
[0267] It should be appreciated that first joint component 2118 may
be in the form of a hip stem neck 2118.
[0268] The first joint component 2118 and the second joint
component 2160 may, as shown in FIG. 26, be interchangeably
connectable to the stem component 2112. Thereby the stem component
2112 can receive joint components of varying heights, offsets and
degrees of version.
[0269] According to the present invention and as shown in FIG. 27,
a stem component 2212 for use with a joint component 2218 having a
body portion 2220 and a connection portion 2222 in performing joint
arthroplasty is provided. The connection portion 2222 of the joint
component 2218 has an external periphery 2278. At least a portion
of the stem component 2212 may be fitted to cavity 2 in canal 4 of
a long bone 6. The stem component 2212 includes a canal portion
2214 having a first end 2215 for insertion into the cavity and an
opposed second end 2217.
[0270] The stem component 2212 also includes a sleeve portion 2226
extending from the second end 2217 of the canal portion 2214. The
sleeve portion 2226 has an internal periphery 2219 that forms an
internal cavity 2232. The sleeve portion 2226 has an external
periphery 2221. The canal portion 2214 and/or the sleeve portion
2226 may be in removable fixed engagement with the joint component
2218. At least a portion of the external periphery 2221 of the
sleeve portion 2226 may be fitted to the cavity 2 of the long bone
6. At least a portion of the external periphery 2278 of the
connection portion 2222 of the joint component 2218 may be fitted
into the internal cavity 2232 of the sleeve portion 2226, so that
the external periphery 2278 of the connection portion 2222 of the
joint component 2218 is spaced inwardly from the external periphery
2221 of the sleeve portion 2226 of the stem component 2212 when the
joint component 2218 is fixedly connected to the stem component
2212 so that the joint component 2218 may be removed from the long
bone 6 without disturbing the fixation of the stem component 2212
to the long bone 6.
[0271] As shown in FIG. 27, the stem component 2212 may be
configured with a portion 2236 of the external periphery 2221 of
the stem component 2212 being generally planar. Further a portion
2240 of the external periphery 2278 of the joint component 2218 may
as shown be generally planar. The portion 2236 of the external
periphery 2221 of the stem component 2212 and the portion 2240 of
the external periphery 2278 of the joint component 2218 as shown in
FIG. 27 it should be appreciated are adapted for contact with each
other.
[0272] The stem component 2212 may as shown in FIG. 27 include a
feature 2252 for cooperation with a connector 2244 to connect the
stem component 2212 to the joint component 2218. As shown in FIG.
27, the feature 2252 may be in the form of a threaded cavity or in
the form of a cylindrical cavity which have been formed in the stem
component 2212.
[0273] Further and as shown in FIG. 27, the stem component 2212 may
include a connection feature 2248 for connection with the joint
component 2218. The connection feature 2248 may, as shown, be in
the form of a cavity 2248 formed in the stem component 2212.
Alternatively, the connection feature (not shown) may be in the
form of a cavity. The connection feature 2248 may be tapered.
[0274] The stem component 2212 may be in the form of a hip stem
2212. Alternatively the stem component 2212 may be in the form of a
tibial implant or a shoulder stem FIGS. 17 and 18 respectively. It
should be appreciated that the stem component 2212 may be any
component for cooperation with a long bone 6.
[0275] The sleeve portion 2226 of the stem component 2212 may
define a wall thickness WT thereof. The wall thickness WT may, as
shown, be generally uniform about the external periphery 2221 of
the sleeve portion 2226 in a plane normal to longitudinal axis 2223
of the joint component 2218. The external periphery 2278 of the
connection portion 2222 of the joint component 2218 may, as shown,
be adapted to closely conform to the sleeve portion 2226 of the
stem component 2212.
[0276] It should be appreciated that the stem component 2212 may be
interchangeably connected to a variety of joint components 2218
with similar or identical connectors, so that the stem component
2212 can receive joint components of varying heights, offsets and
degrees of version.
[0277] Although the present invention and its advantages have been
described in detail, it should be understood that various changes,
substitutions, and alterations can be made therein without
departing from the spirit and scope of the present invention as
defined by the appended claims.
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