U.S. patent number 3,896,503 [Application Number 05/440,274] was granted by the patent office on 1975-07-29 for endosphosthetic ankle joint devices.
This patent grant is currently assigned to National Research Development Corporation. Invention is credited to Michael Alexander Reykers Freeman, Geoffrey Edward Kempson, Michael Anthony Tuke.
United States Patent |
3,896,503 |
Freeman , et al. |
July 29, 1975 |
Endosphosthetic ankle joint devices
Abstract
An endoprosthetic ankle joint comprises a tibial component and
talar component defining respective concave and convex surfaces of
substantially complementary, open-ended, generally cylindrical form
for mutual articulatory bearing engagement. These surfaces are
preferably more precisely cylindrical, but may have curvature in
the axial direction for added stability. Fixation is effected with
gap-filling cement between the bones and low relief configurations
provided on the components remotely from their bearing
surfaces.
Inventors: |
Freeman; Michael Alexander
Reykers (London, EN), Kempson; Geoffrey Edward
(Flackwell Heath, EN), Tuke; Michael Anthony (Sutton,
EN) |
Assignee: |
National Research Development
Corporation (London, EN)
|
Family
ID: |
9815783 |
Appl.
No.: |
05/440,274 |
Filed: |
February 6, 1974 |
Foreign Application Priority Data
Current U.S.
Class: |
623/21.18 |
Current CPC
Class: |
A61F
2/4202 (20130101); A61F 2220/0033 (20130101); A61F
2002/30154 (20130101); A61F 2002/30153 (20130101); A61F
2002/30883 (20130101); A61F 2230/0021 (20130101); A61F
2002/30795 (20130101); A61F 2230/0019 (20130101); A61F
2002/30331 (20130101) |
Current International
Class: |
A61F
2/42 (20060101); A61F 2/00 (20060101); A61F
2/30 (20060101); A61f 001/24 () |
Field of
Search: |
;3/1,30-35,1.9,1.91
;128/92C,92CA,92R |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Cushman, Darby & Cushman
Claims
We claim:
1. An endoprosthetic ankle joint device comprising:
a tibial component in the general form of a first rectangular block
having one side grooved to define a concave surface of
substantially part-circular cylindrical shape, said concave surface
opening at its longitudinal ends into two opposed sides of said
first block serially adjacent said one side, and the side of said
first block opposite said one side being provided with a low relief
configuration; and
a talar component in the general form of a second rectangular block
having three serially-adjacent sides cut away to define a convex
surface of substantially part-circular cylindrical shape
complementary to and in mutual articulatory bearing engagement with
said concave surface, and the side of said second block opposite
said convex surface being provided with a low relief
configuration.
2. A device according to claim 1 wherein said first block is
substantially square in plan view relative to said concave surface,
and said second block is rectangular in plan view relative to said
convex surface, said second block plan view having similar width to
and greater length than said first block, with the circular curve
of said convex surface cylindrical shape extending in the length
direction of said second block.
3. A device according to claim 2 wherein said first and second
blocks are respectively of plastics material and metal.
4. A device according to claim 1 wherein each of said low relief
configurations comprises a plurality of recesses and a stud
projecting from the sides including said low relief
configurations.
5. The use of an endoprosthetic bone joint device including:
a first component in the form of an open-ended trough defining a
concave inner surface of substantially part-cylindrical shape with
a circular arcuate cross-sectional profile, and defining an outer
surface having a rear surface portion which is located remotely
from said concave surface and is provided with a low relief
configuration; and a second component of roller form defining a
convex outer surface portion of substantially part-cylindrical
shape with a circular arcuate cross-sectional profile, which convex
surface is generally complementary to said concave surface for
engagement therein in mutual articulatory relation, and defining a
rear surface portion which is located remotely from said convex
surface and provided with a relieved configuration;
said use comprising:
replacing the articular function of the tibial-talar ankle joint by
exposing said joint, resecting the tibia between the tibial medial
malleolus and the fibular lateral malleolus, connecting said first
component to the resected part of the tibia by way of the
respective rear surface portion and with the longitudinal direction
of said concave surface extending from one to the other of said
malleoli, resecting the talus, connecting said second component to
the resected talus by way of the respective rear surface portion
and with the longitudinal direction of said convex surface
extending parallel to that of said concave surface, and closing
said joint to engage said components in said articulatory relation.
Description
This invention concerns prosthetic devices and, more particularly,
articulatory endoprosthetic bone joint devices.
While such devices have been proposed for a number of different
bone joints, none appears to have been proposed for the ankle
joint. Indeed, when the natural articular function of the ankle
joint is beyond repair, the currently normal treatment is that of
fusion of the joint.
An object of the present invention is to improve this last
situation by the provision of an endoprosthetic ankle joint which
provides articulation similar to that of the natural joint.
In a more general aspect the relevant device comprises: a tibial
component and a talar component; said tibial component defining a
concave surface of revolution of open-ended generally cylindrical
form; said talar component defining a convex surface of revolution
substantially complementary to said concave surface for mutual
articulatory bearing engagement therewith; and said components
being adapted, remotely from said surfaces, for respective
securement to the tibia and talus.
In a presently preferred form of the proposed device, the bearing
surfaces are cylindrical and the securement adaption involves the
provision of low-relief formations on each component. Use of this
preferred form of device involves suitable excavation of the tibia
and talus to receive the tibial component in the tibia with the
longitudinal axis of the component extending between the tibial
medial malleolus and the fibular lateral malleolus, and to receive
the talar component in a similarly orientated contiguous position
in the talus. These dispositions of the components and the
associated bones form a mortise-like structure similar to that of
the natural joint and also having a similar articular function. The
components are secured in these dispositions with the use of
acrylic or equivalent gap-filling cement and the low-relief
formations assist in this by providing a key for the cement.
In order to provide a fuller understanding of the invention, the
same will now be described, by way of example, with reference to
the accompanying drawings, in which:
FIGS. 1, 2 and 3 illustrate the tibial component of the initially
developed embodiment of the invention in respective underneath plan
views and mutually orthogonal side elevations,
FIGS. 4, 5 and 6 similarly illustrate the associated talar
component of this initial embodiment,
FIGS. 7, 8 and 9 illustrate the tibial component of a further
developed embodiment of the invention in respective underneath plan
views and mutually orthogonal side elevations, and
FIGS. 10, 11 and 12 similarly illustrate the associated talar
component of this further embodiment.
The tibial component of FIGS. 1 to 3 is denoted generally at 10 and
comprises a main body in the form of a square platform 11 having
one major surface 12 concavely dished to provide a part-circular
cylindrical bearing surface with its longitudinal axial direction
parallel to one opposed pair of sides of the platform and with
circular arcuate cross-sectional profile. The other major surface
13 of the platform 11 has a subsidiary platform 14 which is also of
square form, with a side length of about half that of platform 11
and projecting centrally therefrom, and has undercut sides.
The associated talar component of FIGS. 4 to 6 is denoted generally
at 20 and is, in most respects, essentially the same as the tibial
component in comprising a main body platform 21 with one major
surface 22 serving as a part-circular-cylindrical bearing surface,
and the other major surface 23 having an undercut subsidiary
platform 24 extending integrally therefrom. However, a principal
difference from the tibial component is that the bearing surface is
convexly formed to be complementary with that of the tibial
component.
Another difference between the two components lies in the fact that
it was preferred to make the tibial component of metal, suitably an
appropriate quality stainless steel, and the talar component of
plastics material, such as high density polyethylene. Such a choice
of materials was considered advantageous in affording the low
friction characteristics of a metal/plastics material combination,
while allocating the use of metal, with its lower susceptibility to
wear, to the concavely dished tibial component so that this
component need not require undue penetration into the bone simply
for the purpose of providing a satisfactory component
thickness.
Securement of the components of FIGS. 1 to 6 is effected in the
manner described hereinbefore, it being understood that the
undercut subsidiary platforms 13 and 24 provide the relevant low
relief structures for this purpose.
It remains to note in respect of the components, that the bearing
surfaces 12 and 22 should, of course, be of like curvature, and
they should preferably be of such circumferential extent as to
provide an angular range of mutual articulation of the same order
as that in the natural joint, namely, 50.degree.-70.degree.. In a
prototype of this initial embodiment each of the main bodies 11 and
21 is substantially 1 inch square, and the radii of curvature of
the surfaces 12 and 22 are substantially thirteen-sixteenths
inch.
Turning to the further developed embodiment of FIGS. 7 to 12, the
tibial component is denoted generally at 30 and comprises a main,
square platform body 31, with one major surface defining a
part-circular-cylindrical concave bearing surface 32 extending
parallel to one opposed pair of sides of the body 31, and with the
other major surface 33 provided with a relatively low relief
configuration. This component will be seen to be similar to that of
FIGS. 1 to 3 except for the relief configuration. In this case the
configuration comprises a stud 34 projecting from the surface 33
adjacent to and midway along one periphery thereof parallel to the
axial direction of the surface 32. In addition, this configuration
comprises the provision of four bores 35 extending partway into the
body 31 in respective corner regions of the surface 33.
The associated talar component is denoted generally at 40 and
comprises a main, rectangular platform body 41, with one major
surface defining a part-circular-cylindrical convex bearing surface
42 extending parallel to the shorter opposed pair of sides of the
body 41, and with the other major surface 43 provided with a
relatively low relief configuration. The radius of curvature of the
surface 42 is equal to that of surface 32 so that these surfaces
are complementary for mutual articulatory bearing engagement about
a common axis of revolution for the relevant surfaces. This
arrangement is similar to that of the initial embodiment, but a
difference arises in that the bodies 31 and 41 are respectively
square and rectangular, surface 42 of the latter having greater
extent in the direction of revolution, but similar axial extent,
compared to surface 32 of the former. The greater extent in
question allows mutual articulation between the components to occur
over a requisite angular range while maintaining the whole of the
surface 32 engaged with surface 42. This is advantageous in that
the area of bearing engagement is substantially constant throughout
articulation to spread the bearing load and reduce wear. At the
same time, it is now preferred that the talar component be made of
metal, and the tibial component be made of plastics material,
whereby there are no exposed "edges" of metal involved in the
mutual articulatory engagement, and this is desirable to further
reduce possible wear and also the risk of pain in the event that a
metal edge should bear movably and directly against the bone.
The low relief configuration of the talar component 40 comprises a
stud 44 projecting from the surface 43 adjacent and midway along
one of the axial peripheries, and two bores 44 extending partway
into the body 41 from respective locations as shown in FIG. 10.
In practice, the surgical procedure preferably involves the use of
a template and drill to provide bores into the prepared bone sites,
the locations of which bores coincide with the positions the studs
34, 44 and bores 35, 45 are to assume. Cement is then applied to
the sites and the studs 34, 44 entered into their corresponding
bone bores to locate the components whereby cement enters the then
aligned component and remaining bone bores. This procedure
effectively provides opposed cement stems extending into the
components and bones.
While the invention has been described with reference to the
illustrated embodiments, it is not intended to be limited thereby
and can take other forms within the ambit of the appendant claims.
For example, the bearing surfaces need not necessarily be
cylindrical, but may have complementary curvature in their axial
directions to provide enhanced lateral stability in the prosthesis.
Also, other forms of low relief structures can be employed.
A further possibility for modification arises from the discussion
of possible risk of pain above. This risk is thought to arise with
direct engagement between a bone and a relatively movable
component, particularly if the component is metal and if the bone
has deteriorated as can be the case with one malleolus in an ankle
joint requiring a prosthesis. It may be appropriate therefore to
provide at least one malleolar component to serve as a buffer
between the talar component and one or both of the malleoli. Thus,
there may be two separate malleolar components for separate
fixation to respective malleoli, or just one such component.
Alternatively, such components may be provided as integral
extensions of a plastics material tibial component to be cut off or
not as appropriate to the situation at hand.
* * * * *