U.S. patent number 3,694,820 [Application Number 05/059,083] was granted by the patent office on 1972-10-03 for prosthetic shoulder joint.
This patent grant is currently assigned to National Research Development Corporation. Invention is credited to David Goddard, John Tracey Scales.
United States Patent |
3,694,820 |
Scales , et al. |
October 3, 1972 |
PROSTHETIC SHOULDER JOINT
Abstract
A prosthetic scapular device is provided having a generally
cup-shaped member, normally of a hemispherical form at least
internally, and intracancellous fixation means extending from
approximately one half only of the outer surface of the cup. The
fixation means, normally in the form of mutually divergent spikes,
include long members extending from points adjacent the central
radial plane of the relevant cup half and diverge in the same sense
from such plane, together with short members on opposite sides of
such plane. Preferably, the long members increase in length and
divergence from said plane as they approach the cup rim.
Inventors: |
Scales; John Tracey (Stanmore,
EN), Goddard; David (Kings Langley, EN) |
Assignee: |
National Research Development
Corporation (London, EN)
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Family
ID: |
10423286 |
Appl.
No.: |
05/059,083 |
Filed: |
July 29, 1970 |
Foreign Application Priority Data
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Aug 25, 1969 [GB] |
|
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42,197/69 |
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Current U.S.
Class: |
623/19.12 |
Current CPC
Class: |
A61F
2/40 (20130101); A61F 2002/30894 (20130101); A61F
2/4059 (20130101); A61F 2/4081 (20130101); A61F
2002/30878 (20130101); A61F 2310/00029 (20130101); A61F
2002/30574 (20130101) |
Current International
Class: |
A61F
2/30 (20060101); A61F 2/40 (20060101); A61F
2/00 (20060101); A61f 001/24 () |
Field of
Search: |
;3/1
;128/92R,92C,92CA |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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1,552,585 |
|
Nov 1968 |
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FR |
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1,448,955 |
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Jul 1966 |
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FR |
|
976,768 |
|
Apr 1964 |
|
DT |
|
1,047,640 |
|
Jul 1953 |
|
FR |
|
Other References
Neer Shoulder Prostheses, Vitallium Surgical Appliance (Catalog),
Austenal Medical Div., Howmet Corp., New York, N.Y., 1964, page 55
relied upon..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
We claim:
1. A prosthetic device for use as a human shoulder joint
replacement, which device is designed to be used together with a
self-hardening or self-curing gap-filling agent within cavities cut
in the bone of the scapular glenoid and humerus, comprising:
a scapular glenoid first bearing member having a part-spherically
shaped first bearing surface;
intracancellous first fixation means connected or integrally formed
with said first member;
said first fixation means projecting from said first member along a
succession of points adjacent a symmetrically disposed radial plane
of said first surface, said succession of points extending between
a central portion and one edge portion of said first member as
intersected by said plane, said first fixation means projecting
further from said member at said one edge portion than from said
central portion, and said first fixation means diverging from said
plane to one side thereof with increasing projection from said
first member;
a humeral second bearing member having a part-spherically shaped
second bearing surface complementary to and rotatably received by
said first bearing surface;
and intra-medullary second fixation means connected or integrally
formed with said second member;
said second fixation means including an elongate tapered projecting
from said second member to terminate in a tapered stem.
2. A device according to claim 1 wherein said fixation means
project from said first bearing member by distances in the range of
about 1/2 inch to 1 inch, the divergence of said first fixation
means increases in the range of about 9.degree. to 13.degree.
relative to said plane with progression along said succession of
points towards said edge portion, and said second fixation means
projects from said second bearing member while turning through an
angle of about 45.degree. relative to the longitudinal axis of said
tapered stem.
3. A prosthetic device for use as a scapular glenoid replacement,
which device is designed to be used together with a self-hardening
or self-curing gap-filling agent within cavities cut in the bone of
the scapular, which device comprises:
a cup to act as a scapular glenoid replacement and having a
part-spherically shaped inner surface, a generally convex outer
surface, and a rim joining said inner and outer surfaces;
intracancellous fixation means connected or integrally formed with
said cup and for bonding in said gap-filling agent;
said fixation means projecting from said outer surface along a
succession of points adjacent a plane which is radially and
symmetrically disposed relative to said inner surface;
said succession of points extending between a central portion of
said outer surface and an edge portion of said outer surface where
said plane makes one intersection with said rim;
said fixation means projecting further from said outer surface at
said edge portion than from said central portion;
and said fixation means diverging from said plane to one side
thereof with increasing projection from said outer surface.
4. A device according to claim 3 wherein the divergence of said
fixation means from said plane increases with progression along
said succession of points toward said edge portion, said divergence
being in the range of about 9.degree. to 13.degree. relative to
said plane.
5. A device according to claim 3 wherein said fixation means
comprise a plurality of spike-like members, the geometrical
projections of which in said plane are mutually divergent.
6. A device according to claim 3 wherein said fixation means
project from said cup by distances in the range of about 1/2 inch
to 1 inch, and further comprising relatively shorter fixation means
projecting from said cup outer surface adjacent the first-mentioned
fixation means and on both sides thereof relative to said
succession of points.
7. A device according to claim 4 in combination with prosthetic
humeral device comprising a head part having a spherically shaped
bearing surface complementary to and received in said cup inner
surface, and a fixation member projecting from said head part
through a neck portion and terminating in a tapered stem, the
longitudinal axis of said stem being disposed at about 45.degree.
inclination relative to that of said neck portion adjoining said
head part.
Description
This invention concerns prosthetic shoulder joint devices and it is
intended to permit complete replacement of shoulder joints affected
by disease or injury.
It appears, at least from the currently available range of
prosthetic devices, that no successful attempt has been made
previously to permit complete shoulder joint replacement. The
available devices include humeral head prostheses, but no
associated glenoid prosthesis. Moreover, implantation of the
existing humeral head devices usually involves removal of the
rotator cuff muscles, and the resultant implant is liable to
dislocate.
The present invention seeks to alleviate this situation by
effectively providing a prosthetic glenoid cavity for co-operation
with a prosthetic humeral head.
According to the invention there is provided a prosthetic scapular
glenoid device comprising a generally cup-shaped member having
intracancellous fixation means rigidly connected to or integral
with, and extending from, approximately one half only of the outer
surface of said member.
The glenoid cup, as said member may be termed, will normally be
substantially hemispherical, at least over its inner surface.
In a preferred form the fixation means comprise a plurality of
mutally divergent spike-like elements, including both long and
short spikes. The longer spikes stem from a succession of points
adjacent the central radial plane of the relevant half of the cup,
and they diverge in the same sense slightly away from such plane.
As will be seen hereinafter from an illustrated embodiment the
longer spike of greatest length and divergence from the central
radial plane is that closest to the rim of the cup.
The associated shorter spikes are located on both sides of the
succession of larger spikes and within the relevant half cup
surface.
As an indication of the more particular shaping and dimensioning of
a device as just described, the cup has an internal diameter of
about 3/4 inch and external diameter of about 1 inch, the longer
spikes range from about 1/2 to 1 inch in length with respective
divergence of about 9.degree. and 13.degree. from the central
radial plane, and the shorter spikes are about 1/8 inch in
length.
While it is presently preferred to employ spike-like elements as
fixation means, this is not essential. For example, the role of
some or all of the longer spikes may be served by an appropriately
shaped web and the role of some or all of the shorter spikes may be
served by ribs.
An associated prosthetic humeral head device for use with a cup as
just described may be of any suitable form given that it comprises
a ball-like head part which can, when the device is implanted, be
presented to the cup to form an appropriate ball-and-socket joint.
This point will become clearer after consideration of the
illustrated embodiment hereinafter and the desired relative
attitudes of the joint parts.
However, a preferred form of the latter device comprises a rod-like
intramedullary fixation part integrally formed with a ball-like
humeral head part at one end, the longitudinal axis of the head
part being turned from that of the fixation part by about
45.degree. .
For a fuller understanding of the present invention, the same will
now be described by way of example with reference to the
accompanying drawings, in which:
FIG. 1 shows one embodiment of a glenoid device according to the
invention in plan view,
FIGS. 2 and 3 are side views of the embodiment of FIG. 1 as seen in
the directions indicated at A and B,
FIGS. 4, 5 and 6 are sectional views respectively taken at C -- C,
D -- D, and E -- E in FIG. 1,
FIGS. 7 and 8 are sectional views respectively taken at F -- F, and
G -- G in FIG. 2,
FIG. 9 is a sectional view taken at H -- H in FIG. 3,
FIG. 10 is a plan view of the cup of FIG. 1 showing the co-ordinate
positions of the fixation means,
FIG. 11 is a diametral section of the cup of FIG. 1,
FIGS. 12 and 13 respectively show an associated embodiment of a
humeral head device according to the invention in plan and side
views,
FIGS. 14 and 15 are sectional views respectively taken at I -- I,
and J -- J in FIG. 13, and
FIGS. 16 and 17 diagrammatically illustrate the manner of
implantation of the illustrated devices.
The illustrated glenoid device comprises a substantially
hemispherical cup 1 and a plurality of mutually divergent,
spike-like fixation means 2 to 6 of the preferred form described
above. It will be seen that the spikes 2 to 6 extend from
substantially one half of the exterior of the cup as separated by
the diametral plane in the direction A of FIG. 1, the longer spikes
2, 3 and 4 extend from a succession of points adjacent the central
radial plane in the direction B of FIG. 1 and diverge from the
latter plane in the same sense, and the shorter spikes 5 and 6 are
located on opposite sides of the succession of longer spikes. The
two spikes 2 and 3 of the longer spikes are of similar length and
similar lateral inclination to the central radial plane, while
spike 4 nearest the rim of the cup is of greater length and lateral
inclination than spikes 2 and 3.
More particular details of the illustrated glenoid device are given
by the following table of dimensions, each dimension being denoted
by a reference numeral and letter of which the former denotes the
relevant figure of the drawing and the latter the dimension in that
figure, and the dimension value being given in inches unless
otherwise denoted as an angle.
1a 13.degree. 6a 22.5.degree. 8b 9/16 10c 0.060 10h 0.4333 3a
13.degree. 7a 13.degree. 9a 25.degree. 10d 0.110 11a 0.750 4a
13.degree. 7b 13.degree. 9b 0.125 10e 0.150 11b 0.960 5a 25.degree.
7c 9/16 10a 0.245 10f 0.030 11c 0.067 5b 7.degree. 8a 9.degree. 10b
0.215 10g 0.235 11d 0.547
The associated humeral device illustrated by FIGS. 12 to 15 is
detailed in similar manner by the following table:
12a 11/32 13d 13/32 13j 1/4 13p 23/16 14c 11/32 12b 9/32 13e 5/8
13k 7/16 13q 39/8 14d 37/32 12c 21/16 13f 3/4 13l 5/2 13r 1/16 15a
1/8 13a 0.750 13g 67.5.degree. 13m 1 14a 37/64 15b 3/16 13b 7/32
13h 21/16 13n 5/16 14a 33/32 15c 1/16 13c 1/16 13i 45.degree. 13o
37/16
Regarding materials: the illustrated devices can be conveniently
made of cobalt-chromium alloy as is often the case with such
devices. However this is not essential since the glenoid device may
equally well be made of titanium housing a high-density polythene
insert as a bearing liner. The liner is conveniently of
hemispherical cup form, retained by a spring circlip seated in an
annular groove in the main cup adjacent to its rim. More generally,
the associated devices may be made of any suitable materials, be
they metal, plastics, ceramic, composite or combination
thereof.
Lastly, it is appropriate to indicate the manner of implantation,
and this is effected by reference to FIGS. 16 and 17.
The glenoid is excavated and cancellous bone removed to permit
cementing or grouting of the device in position, as shown, with
acrylic resin or other suitable material. When correctly positioned
the cup should lie at an angle of about 60.degree. to the
horizontal plane as viewed anteriorly, and should lie at an angle
10.degree. to 13.degree. to the plane of the glenoid cavity as
viewed from above.
The humeral device is similarly cemented or grouted into a
preformed hole made in the humeral marrow cavity so that the
ball-like head part engages the glenoidal device cup as shown.
* * * * *