U.S. patent number 3,889,299 [Application Number 05/431,553] was granted by the patent office on 1975-06-17 for prosthetic hip joint devices.
This patent grant is currently assigned to National Research Development Corporation. Invention is credited to Geoffrey Vaughan Osborne, Roger Gilbert Rowland.
United States Patent |
3,889,299 |
Osborne , et al. |
June 17, 1975 |
Prosthetic hip joint devices
Abstract
The femoral component of a prosthetic total hip joint
replacement device which normally also includes an acetabular
socket component is modified for initial use as a partial hip joint
replacement by the securement in demountable manner of a larger
ball-shaped head around the ball-shaped head of the original
femoral component. Thus, the modified component is used with the
natural acetabular socket, and future provision of a total hip
joint replacement in the same patient then only requires demounting
of the larger head assembly and provision of a prosthetic
acetabular socket.
Inventors: |
Osborne; Geoffrey Vaughan
(Southport, EN), Rowland; Roger Gilbert (Southport,
EN) |
Assignee: |
National Research Development
Corporation (London, EN)
|
Family
ID: |
9728053 |
Appl.
No.: |
05/431,553 |
Filed: |
January 7, 1974 |
Foreign Application Priority Data
|
|
|
|
|
Jan 12, 1973 [GB] |
|
|
1790/73 |
|
Current U.S.
Class: |
623/22.17 |
Current CPC
Class: |
A61F
2/3609 (20130101); A61F 2/4637 (20130101); A61F
2220/0041 (20130101); A61F 2220/0025 (20130101); A61F
2002/4641 (20130101); A61F 2002/3611 (20130101); A61F
2002/3079 (20130101); A61F 2002/30975 (20130101); A61F
2002/3625 (20130101); A61F 2002/30507 (20130101); A61F
2002/30433 (20130101); A61F 2002/365 (20130101); A61F
2002/30774 (20130101); A61F 2002/30487 (20130101); A61F
2002/30383 (20130101) |
Current International
Class: |
A61F
2/46 (20060101); A61F 2/36 (20060101); A61F
2/00 (20060101); A61F 2/30 (20060101); A61f
001/24 () |
Field of
Search: |
;3/1
;128/92C,92CA,92R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Other References
"Moore Self-Locking Hip Prostheses" and Protective Caps for
Vitallium Hip Prostheses, Vitallium Surgical Appliances (catalog),
Anstenal Co., Div. of Howe Sound Co., New York, N.Y., page 18,
1964..
|
Primary Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Cushman, Darby & Cushman
Claims
We claim:
1. A prosthetic hip joint device comprising:
a femoral head replacement component of integral metal construction
including a relatively small ball-shaped head for use in
articulating engagement with a prosthetic acetabular socket
component, and a larger ball-shaped head assembly secured around
said smaller head to modify said femoral component for initial use
in articulating engagement with the natural acetabular socket, said
larger ball-shaped head assembly being adapted for release from
said smaller head, and said larger ball-shaped head assembly being
of multiple-layer construction including an inner layer of plastic
material adjacent said smaller head and an outer layer of metal
remote from said smaller head.
2. A device according to claim 1 wherein said femoral component and
said assembly are sealably secured together against ingress of body
fluid and like matter therebetween.
3. A device according to claim 1 wherein said larger ball-shaped
head assembly is secured with said femoral head replacement
component in mutually non-rotatable manner.
4. A device according to claim 1 wherein said femoral component
comprises an elongated tapered intramedullary stem terminating, at
its wider end, and by way of a necked portion, in said smaller
head; said assembly inner layer extends over said smaller head and
said necked portion; and said assembly outer layer extends over
only said smaller head and is seated in said inner layer to provide
a substantially continuous exterior surface for said assembly.
5. A device according to claim 1 wherein said assembly
comprises:
a cap formed by said inner and outer layers to engage over said
smaller head, and
a pair of similar semi-annular shells formed by further parts of
said inner layer, which shells mutually connect around said necked
portion and secure said cap.
6. A device according to claim 1 wherein said smaller and larger
heads have mutually-concentric respective spherical exterior
shapings.
7. A prosthetic hip joint device comprising:
a femoral head replacement component having a relatively small
spherically-shaped head for use in articulating engagement with a
prosthetic acetabular socket component; and a larger
spherically-shaped head assembly secured around said smaller head
in mutually non-rotatable, liquid-tight, demountable manner to
modify said femoral component for initial use in articulating
engagement with the natural acetabular socket.
8. A device according to claim 7 wherein the spherical shapings of
said smaller and larger heads are concentric.
9. A prosthetic hip joint device comprising:
a femoral head replacement component having a relatively small
spherically-shaped head for use in articulating engagement with a
prosthetic acetabular socket component; and a larger
spherically-shaped head assembly secured concentrically around said
smaller head in demountable manner to modify said femoral component
for initial use in articulating engagement with the natural
acetabular socket.
10. The use of a prosthetic hip joint device comprising a femoral
head replacement component having a relatively small ball-shaped
head with a larger ball-shaped head demountably secured
therearound, which use comprises:
initially securing said femoral component in the femur to employ
said larger head in articulating engagement with the natural
acetabulum; and subsequently securing a prosthetic acetabular
component in the acetabulum, and removing said larger head assembly
to employ said smaller head in articulating engagement with said
acetabular component.
Description
This invention concerns prosthetic hip joint devices and more
particularly such devices for femoral head replacement.
The latter devices are used basically in two situations which are
commonly referred to as partial and total hip joint replacement,
respectively. Partial replacement in this context involves
replacement of the natural femoral head, normally by way of a
prosthetic femoral device having a tapered intramedullary stem
which terminates, by way of a necked portion, at its wider end with
a ball-shaped head offset from the longitudinal axis of the stem.
Total replacement in the same context normally involves use of a
femoral component similar to that just described which co-operates
with a prosthetic acetabular component in the form of a concave
socket member to receive the ball-shaped head of the femoral
component in mutual articulating bearing relationship. While the
femoral components used in both the partial and total replacement
situations are basically similar, it is relevant to note that the
head is normally larger in the first situation compared to the
second since the one head co-operates with the natural acetabulum,
while the other head co-operates with a prosthetic socket which is
normally of smaller dimensions than the natural acetabulum.
The invention is concerned with a difficulty which becomes more
pronounced with increasing use of partial replacements. Thus,
fractures of the femoral neck and other conditions in which the
function of the femoral head, but not the acetabulum, is affected
have been conventionally treated by the use of pins, plates and
similar fixation devices, but are now often treated by use of
partial replacement. This last use arises from the fact that
advantage accrues in a quicker return to full mobility for the
patient. Also, this treatment is preferable for patients, such as
the aged, who are more liable than the average to suffer a
recurrence of the original, or a similar, condition requiring
treatment. However, by the same token, this increase in use is
accompanied by an increase in situations where a partial
replacement will be followed, in the course of time, by a
requirement for a total replacement due to deterioration of the
natural acetabulum. The more particular difficulty is that the
transition from a partial to total replacement involves removal,
from the femoral shaft, of the prosthesis for partial replacement
and substitution, in such shaft, of a component of a new prosthesis
for the total replacement.
An object of the present invention is to obviate this last
difficulty and, to this end, provides a prosthetic hip joint device
comprising a femoral component of a form such as described above
having a smaller head, and a larger head assembly adapted for
securement around said smaller head in demountable manner.
It will be appreciated that the device of the present invention is
intended to be employed for partial hip joint replacement, when the
larger head assembly of the device will be employed to co-operate
with the natural acetabulum, while allowing subsequent demounting
of the larger head assembly to expose the smaller head for
co-operation with a prosthetic acetabular socket component in the
event that a total hip joint replacement becomes appropriate. The
self-evident advantage of this situation is that the later
requirement for total hip joint replacement only involves exposure
of the joint, removal of the larger head assembly, and the
implantation of the necessary prosthetic acetabular component.
The femoral component of the proposed device is preferably of
integral metal construction, in which case the larger head assembly
should seal the smaller head against intrusion of body fluid or
other matter which may give rise to corrosion of the smaller head.
This sealing conveniently involves use of a plastics material to
define the inner surface of the larger head assembly, but such
assembly also preferably has an outer surface, for articulation
with the acetabulum, which is made of metal.
In any event, a clearer understanding of the invention can be
gained by consideration of the single FIGURE of the accompanying
drawing which is given by way of example and illustrates in a side
elevation one form of a device according to the invention. For
reasons of clarity, one longitudinal half of the drawing shows the
relevant device in fully assembled form, while the other half shows
the components of the device in partly-sectioned form and exploded
manner.
The illustrated device comprises a femoral component denoted
generally at 1 and comprising an intramedullary stem 2, a necked
portion 3, and a ball-shaped head 4. When seen in an orthogonal
side elevation to that of the drawing, the stem is tapered towards
its free end, and cranked or curved part-way along its other end
portion to offset the head 4 relative to the longitudinal axis of
the major `straight` length of the stem 2. The component 1 is in
fact of `Charnley` type, for example, as employed for total hip
joint replacement, and is of integral metal construction.
The remaining parts of the illustrated device comprise a larger
head assembly denoted generally at 5 and which comprises a cap part
6 and two similar neck parts 7. The cap part 6 is in the form of a
hollow part-spherical member of which the inner surface is of
complementary form to the outer surface of the head 4. Accordingly,
the outer surface of the cap part 6 will be spherically concentric
with the outer surface of the head 4.
The cap part 6 is of double-layer construction having a thicker
inner layer 6a of plastics material and an outer layer 6b of metal.
Also, the inner layer extends to a greater extent at its rim than
does the outer layer, and this further extended part of the inner
layer is formed with an annular groove 6c extending
circumferentially around its outer surface adjacent its rim.
The neck parts 7 are formed as diametrally opposed halves of an
annular continuation of the head part 6, which continuation has an
inner surface complementary with the grooved portion of the cap
part 6 and also the neck 3, and an outer surface which continues
smoothly from that of the cap 6 in convergent manner towards the
end of the neck 3 adjacent stem 2.
The remaining feature of the necked parts 7 is the provision of two
bores 8 in each part, corresponding ones of these bores being
aligned in orthogonal relation with the mutually engaged faces of
the parts 7 on opposite sides of the neck 3 when the device is
completely assembled. In one of the necked parts 7 the outer ends
of these bores 8 are counterbored at 9. The bores 8 receive screws
10 to secure the device in its fully assembled form, the heads of
the screws being disposed in the counter bores 9 so as not to
protrude.
From this description and the drawing it will be appreciated that
the cap part 6 can be engaged over the head 4, conveniently in a
snap-fit manner, and held captive by screw connection of the neck
parts 7, while the neck parts 7 serve to seal the head 4 within the
cap part 6. In this assembled form, the device serves as a femoral
head component for use in a partial hip joint replacement, while
demounting of the larger head assembly 5 exposes the femoral head
component 1 for use in a total hip joint replacement.
This demounting can be facilitated by further counter boring the
inner ends of the bores 8 which receive the threaded ends of the
screw 10, the further counter bores serving to receive washers 11
which co-operate with the screws 10 to withdraw the associated neck
part 7 from the full assembly when the screws are themselves
withdrawn.
While the invention has been more particularly described with
reference to the illustrated embodiment, the scope of the invention
is not intended to be limited thereby. Indeed, the illustrated
embodiment is presently regarded as a development prototype which
may be subject to modification during further development of the
invention. For example, in the illustrated embodiment the rim of
the outer layer 6b of the larger head assembly 5 is defined by a
plane orthogonal to the longitudinal axis of the stem as viewed in
the drawing, but in practice it may be preferred to incline this
plane in a similar sense to that in which the stem/neck region of
the component 1 is cranked or curved. This takes account of the
fact that the normal position of maximum load on the head assembly
does not lie on the axis of symmetry thereof, but is offset from
this axis in the sense just indicated and it is desirable to
provide a maximized circumferential extent for the articulating
surface of layer 6b in any direction from this position of maximum
load. Also it may be preferred to arrange for securement of the
head assembly 5 around the head 4 in such a way as to inhibit
mutual rotational movement therebetween. This can be effected by
the provision of complementary flats in the groove 6c and the neck
parts 7, for example. It may also be preferred to employ bore and
screw arrangements or some other fixation device for the neck parts
7 whereby the outer surfaces of these parts are subject to a lesser
interruption in smoothness and continuity.
* * * * *