U.S. patent number 3,840,904 [Application Number 05/355,875] was granted by the patent office on 1974-10-15 for acetabular cup prosthesis.
Invention is credited to Raymond G. Tronzo.
United States Patent |
3,840,904 |
Tronzo |
October 15, 1974 |
ACETABULAR CUP PROSTHESIS
Abstract
An acetabular cup prosthesis which has facilities for ready
removal. In one form it has grooves to guide a surgical saw on the
inside, preferably to cut the prosthesis in quadrants for removal,
and also having threaded sockets to insert a tool to remove the
quadrants. Additionally or alternatively, it has protrusions from
its rear not adapted to offer much resistance in case of removal.
In the preferred form two blades protrude from the rear and are
offset, so that they come to a point and also form a knife edge at
the side. Outrigger blades are provided extending perpendicular to
the diameter and terminating at a less height than the radius. In
the preferred form the rear of the prosthesis has a porous coating
and also the blades have a porous coating. In alternate forms,
spikes extend from the rear of the prosthesis offset and in
parallel relation, either from one side in a cluster or from one
side distributed over that side. In another form there is a screw
which extends from the rear end offset to the axis of symmetry. In
another form there are blades which lie along the rear, for example
parallel to one another and parallel to the diameter or at right
angles to the diameter.
Inventors: |
Tronzo; Raymond G.
(Philadelphia, PA) |
Family
ID: |
23399170 |
Appl.
No.: |
05/355,875 |
Filed: |
April 30, 1973 |
Current U.S.
Class: |
623/22.32 |
Current CPC
Class: |
A61F
2/30767 (20130101); A61F 2/34 (20130101); A61F
2230/0054 (20130101); A61F 2002/30845 (20130101); A61F
2002/30405 (20130101); A61F 2002/342 (20130101); A61F
2002/30176 (20130101); A61F 2220/0025 (20130101); A61F
2002/3425 (20130101); A61F 2002/30892 (20130101); A61F
2002/3429 (20130101); A61F 2002/30841 (20130101); A61B
17/86 (20130101); A61F 2002/3054 (20130101); A61F
2002/30797 (20130101); A61F 2002/4619 (20130101); A61F
2310/00011 (20130101); A61F 2002/3412 (20130101) |
Current International
Class: |
A61F
2/32 (20060101); A61F 2/30 (20060101); A61F
2/34 (20060101); A61B 17/68 (20060101); A61F
2/00 (20060101); A61B 17/86 (20060101); A61F
2/46 (20060101); A61f 001/24 () |
Field of
Search: |
;3/1
;128/92C,92CA,92BA,92BB,92BC,92D |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1,215,737 |
|
Dec 1970 |
|
GB |
|
742,618 |
|
Jan 1933 |
|
FR |
|
Other References
"Total Hip Arthroplasty, Using a Universal Joint Device-The Tronzo
Total Hip System," Advertisement by Richards Mfg. Co., The Journal
of Bone and Joint Surgery, Vol. 53-B, No. 2, May 1971. .
Vitallium Surgical Appliances (catalog), Austenal Co., New York,
N.Y. 1964, "McBride Acetabulum Cups/No. 6429 on page 30 relied
upon..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Jackson, Jackson & Chovanes
Claims
Having thus described my invention, what I claim as new and desire
to secure by Letters Patent is:
1. An acetabular cup prosthesis including a cup shaped insertion
and a guide groove across the inside of the insertion at
substantially diametrical distance for a surgical saw by which it
can be cut up for removal.
2. An acetabular cup prosthesis of claim 1, having guide grooves at
the inside surface which are of substantially diametrical length
and of cruxiform formation.
3. An acetabular cup prosthesis of claim 2, having in each quadrant
of the cup a threaded opening for receiving a threaded extraction
tool, the openings being near the center of the cup.
4. An acetabular cup prosthesis of claim 2, having converging
blades from the back of the cup diminishing in size away from the
cup and the blades having a common edge and making a V in
cross-section.
Description
DESCRIPTION OF THE INVENTION
In acetabular cup prostheses the object heretofore has been to have
the prosthesis remain as long as the person or animal in which it
is inserted is alive. In some prostheses this is counter
productive, because it is necessary to remove the prosthesis either
for the purpose of experiment or because of a desire to insert a
more suitable prosthesis.
One of the purposes of the present invention is to aid in cutting
the prosthesis to remove it from the body by inserting guide
grooves and possibly anchorages for a tool by which the prosthesis
may be removed.
Another aspect of the problem is that anchorage is from the rear
end of the prosthesis and may have a tendency to remain in the
acetabulum when the prosthesis is removed. Instead the anchorage
may be in the form of two blades sloping to a point and converging
toward one another, preferably with outrigger blades along the
sides of the cup at the back.
Also, the anchorage may preferably have pores on the back of the
acetabular cup prosthesis and on the blades into which bone can
grow, one or both can be coated.
Alternatively, the acetabular cup prosthesis may be supported by a
series of parallel spikes which are sloping with respect to the
axis of symmetry of the cup and are either grouped in a cluster at
one side at the back of the cup or distributed along one side of
the back of the cup. An alternate form may be an offset screw from
the back of the cup, with one or several screws being used.
Another alternate form may have blades along the back of the cup
extending either parallel to the diameter of the cup or at right
angles to the diameter of the cup.
As exemplary of these various forms, the following drawings are
presented.
FIG. 1 is a perspective of the preferred form of my acetabular cup
prosthesis.
FIG. 2 is an exploded perspective of FIG. 1 showing metallic parts
on the left and plastic on the right.
FIG. 3 is a rear view of the acetabular cup prosthesis of FIG. 1 in
place in an acetabulum.
FIG. 4 is a side view of the device of FIG. 1.
FIG. 5 is a front view of the device of FIG. 1.
FIG. 6 is a section along the line 6--6 of FIG. 5.
FIG. 7 is a section on the line 7--7 of FIG. 4.
FIG. 8 is a side elevation of an alternate form of the
invention.
FIG. 9 is a front elevation of the form of FIG. 8.
FIG. 10 is a side elevation of a somewhat different form of
acetabular cup prosthesis.
FIG. 11 is a front elevation of FIG. 10.
FIG. 12 is a side elevation of a somewhat different form of the
invention, partially broken away.
FIG. 13 is a front view of the form of FIG. 12.
FIG. 14 is a side elevation of a different form of the
invention.
FIG. 15 is a back view of the form of FIG. 14.
FIG. 16 is a side elevation of a further variation of the
invention.
FIG. 17 is a view of the form of FIG. 16 on the line 17--17.
The main purpose of this invention is to hold an acetabular cup
prosthesis by a means which will aid in removing it from the body
for evaluation or change, if removal is necessary or desirable.
Acetabular cup prostheses may be used on humans and also in
veterinary medicine, particularly for experimental purposes to test
the relative benefits of various prostheses.
For the purpose of removal, one improvement made by the present
invention is to insert guide grooves so that the prosthesis may be
readily and unerringly cut up for removal, and to add threaded
sockets to attach a removal tool to each piece.
Another desirable expedient is to attach converging blades
terminating in a point to the back of the acetabular cup prosthesis
and to have outriggers anchored to the back of the cup at right
angles to the diameter and terminating at a distance less than the
radius. The blades may be joined or separated.
Preferably these blades and the prosthesis itself have porous
coatings on the back which aid in anchorage by bone growth.
As an alternative, spikes are offset with respect to the axis of
symmetry to anchor the prosthesis, the spikes being distributed
around in a cluster together at one side, or all over one side as
preferred. As another form of anchorage, I may use an offset screw
secured to the back of the acetabular cup prosthesis. The spikes
and screws may or may not be coated in contrast to the main
cup.
Another embodiment, particularly when taken with a porous coating,
has blades on the outside of the cup which are either circular
around the cup parallel to the diameter or perpendicular to the
diameter or at any angle between these. The blades themselves may
or may not be coated in contrast to the main cup.
Considering the form of FIGS. 1 to 7, it consists of a preferably
metal cup 20 smooth on the inside, and preferably receiving a liner
22 of plastic such as high density polyethylene, which is smooth
and round on the inside and may have a gripping tendency on the
outside by way of slots 28 and/or holes 44. This liner is intended
to receive a ball from the femur, which may be the natural ball,
but will preferably be an artificial ball which replaces the
natural ball as well known in the art of prostheses. There is a rim
24 on the liner and at a suitable place around the circumference
the rim has an interlock 26 molded into it and adapted to fit into
an interlocking groove 28 on the outside of the cup. This interlock
26 is intended to keep the liner from rotating, but still making it
easily replaceable as desired.
It will be evident that in referring to the diameter of the cup,
reference is made to the diameter measured at the mouth of the cup
and being substantially the diameter of the ball which is fitted
into the cup. The cup is preferably about half a sphere.
On the outside of the cup and on the blades if any protruding from
it, a porous composition may be molded on with a view to aiding
bone growth to interlock with the cup. This porous interlock is
described more in detail below.
From the rear of the cup there protrude two blades 30 which are in
converging directions and meet on a line 32 and in an apex 34, so
that the cross section of the blades is V-shaped. It will be seen
that the faces of the blades are substantially triangular, except
that they meet the outer edge of the cup on a curved surface.
The orientation of the meeting blades 30 with respect to the axis
of symmetry of the cup is such that the blades are offset about
20.degree. toward the outside of the body for a human.
The cup is prevented from turning, particularly in the initial
stages of implant, by two blades 36 which are diametrically placed
at a point where they will not interfere with the blades 30 and
which extend at right angles to the diameter in a straight
direction and terminate preferably in a point 38 which aids
insertion. Short of the radius and preferably blending with the
cup, is a blade edge 40.
The blades 36 may to advantage not have the porous coating, since
their function is primarily though not entirely at the initial
phases of implant.
At the inner surface of the cup there are guide grooves 42 which
are arranged in quadrature, and which cooperate with threaded
sockets 44 for receiving a suitable pulling tool. The grooves 42
are intended to guide the surgical saw in cutting the acetabular
cup prosthesis for removal of one quadrant at a time. Of course, it
is evident that if trouble is anticipated in removing a quadrant,
then the portions indicated by the guide lines 42 may be
smaller.
The removal is contemplated in all forms of the invention, and it
will be evident that in discussing later alternate forms where the
removal may not be stressed, removal is still contemplated if
desired.
Alternatively, the blades 30 may be replaced by spikes 46 which are
extending in a direction at which they are inclined to the axis of
symmetry of the cup about 20.degree.. The spikes are preferably
free from interlocking projections and are diminishing
progressively from a maximum cross section adjoining the cup to a
minimum cross section at the point. They may be round, triangular,
or squared in cross section. The spikes may be arranged in a
cluster of three as shown in FIGS. 8 and 9, or they may be
distributed along one side as in FIGS. 10 and 11. In any case the
spikes are substantially parallel so that they will offer minimum
obstruction in extraction.
As an alternate method of affixation, a screw 48 is shown
protruding from the cup 20 at an angle of inclination with respect
to the axis of symmetry suitably about 20.degree.. A cluster of
screws could be used, also.
In FIGS. 14 and 15, I show a form which has blades 50 on the
outside of the cup, the blades extending in a circular direction
parallel to the diameter as shown in this figure, or at right
angles to the diameter as in FIGS. 16 and 17 or at any direction in
between. The blades 50 are parallel or substantially so in
themselves.
I find that porous material of the implant may to advantage be
provided with small pores to receive the bone growth immediately,
and also intermediate and large pores to receive the bone growth
later. The layer of porous material should be at least 100 microns
thick, preferably at least 1/16 inch thick and most desirably at
least 1/8 inch thick.
The pores cover a substantial part of the surface, at least 20 to
50 percent, preferably 30 to 40 percent and most desirably about 33
percent.
The pores in size are divided into small, intermediate and large
pores and at the surface from 20 to 40 percent of the pore area,
preferably from 30 to 36 percent and most desirably 33 percent must
be of each pore diameter (large, intermediate and small). For the
purpose of this invention small pores consist of pores having
diameters at the surface of 50 to 200 microns, preferably 75 to 125
microns and most desirably about 100 microns.
The intermediate pores range in diameter from 200 to 800 microns.
The large pores are larger than 800 microns and not larger than
3,500 microns.
The porous material may be put down by metallizing techniques as
described in Welding Handbook, 3rd Edition.
More information is given in my applications Ser. No. 228,052,
filed Feb. 22, 1972 for Bone Implant with Porous Exterior Surface,
since abandoned and Ser. No. 342,461, filed Mar. 19, 1973 for Bone
Implant with Porous Exterior Surface, and these applications are
incorporated herein by reference and are part hereof.
In view of my invention and disclosure, variations and
modifications to meet individual whim or particular need will
doubtless become evident to others skilled in the art, to obtain
all or part of the benefits of my invention without copying the
apparatus shown, and I therefore claim all such insofar as they
fall within the reasonable spirit and scope of my claims.
* * * * *