WO1985003426A1 - Apparatus for affixing a prosthesis to bone - Google Patents
Apparatus for affixing a prosthesis to bone Download PDFInfo
- Publication number
- WO1985003426A1 WO1985003426A1 PCT/US1985/000212 US8500212W WO8503426A1 WO 1985003426 A1 WO1985003426 A1 WO 1985003426A1 US 8500212 W US8500212 W US 8500212W WO 8503426 A1 WO8503426 A1 WO 8503426A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- prosthesis
- bone
- component
- collar
- aperture
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30728—Collars; Bone edge protectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/367—Proximal or metaphyseal parts of shafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2/3676—Distal or diaphyseal parts of shafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/3011—Cross-sections or two-dimensional shapes
- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
- A61F2002/30364—Rotation about the common longitudinal axis
- A61F2002/30367—Rotation about the common longitudinal axis with additional means for preventing said rotation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
- A61F2002/30492—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking pin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
- A61F2002/30738—Sleeves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3662—Femoral shafts
- A61F2002/3678—Geometrical features
- A61F2002/369—Stepped shaft, i.e. having discrete diameter changes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0008—Rounded shapes, e.g. with rounded corners elliptical or oval
Definitions
- This invention relates to a method and apparatus for affixing a prosthesis to bone an , ⁇ in particular, to a method and apparatus for affixing a prosthesis to bone so as to produce stress transfers between the prosthesis and the bone which generally correspond to the stress transfers which occur in natural bone.
- the bony portion of human and animal bones consists of two types of tissue: hard or compact bone which is dense in texture, and soft or cancellous bone which consists of fibers and lamellae joined together to form a reticular network.
- the hard bone makes up the outer wall of the bone and provides most of the bone's overall strength. Cross-sections at all levels through a bone will include some hard bone.. The thickness of the hard bone will vary with the level of the cross-section, being smallest near the ends of the bone and greatest at the middle.
- Soft bone where present, forms the inner core of, the bone. This type of bone is primarily found near the ends of bone where the hard bone is thinnest. Current understanding is that, in these regions, the soft bone contributes to the overall strength of the bone by transferring at least some of the applied stresses from the thin portions of the hard bone to relatively large areas of the thicker portions of the hard bone located closer to the middle of the bone. In these regions of stress transfer, the fibers making up soft bone appear to have a regular, equipotential-like, arrangement wherein fibers intersect the hard bone at spaced intervals of approximately 1-2 mm. It is believed that this arrangement, at least in part, is responsible for the efficient transfer of applied stress from one part of hard bone to another.
- the invention in accordance with one of its aspects, provides apparatus for affixing a prosthesis to bone, wherein said bone has an outer wall of hard bone and may have an inner core of soft bone, comprising a body having an outer surface at least a portion of which is contoured to mate with a portion of the inner surface of the hard bone so that, in the region of said mating portions, a substantial fraction of the hard bone is in close proximity to or in contact with the outer surface of the body, said outer surface in said mating region being textured to increase the frictional engagement of the surface with the hard bone.
- the invention provides a method for affixing a prosthesis to bone, wherein said bone has an outer wall of hard bone and may have an inner core of soft bone, comprising the steps of:
- the textured surface of the prosthesis is formed from a plurality of spaced, outwardly extending shoulders, the distance between the shoulders being between approximately 0.5 and 5.0 mm so as to generally correspond to the observed spacing between the points of intersection of fibers of soft bone with hard bone. "
- the shoulders have sharp outer edges capable of cutting into the inner surface of the hard bone so that as the prosthesis is implanted, portions of the hard bone can be shaved away to produce an increased area of engagement between the prosthesis and the hard bone, while at the same time producing bone chips which will stimulate regenerative bone growth.
- the apparatus is constructed in the form of a hollow collar to which other components of the prosthesis are attached.
- parts of the outer surface of the prosthesis can be composed of porous metal into which bone can grow.
- porous metal is especially preferred with regard to the embodiments in the form of collars because the processes normally used to make metal porous generally weaken the metal and for the collar embodiment this weakening effect can be limited to the collar which typically is subjected to smaller stresses than other parts of the prosthesis.
- Figure 1 is a perspective , view of the femur portion of an artificial hip joint employing a collar constructed in accordance with the present invention.
- Figure 2 is a side view of the collar of Figure 1.
- Figure 3 is a top view of the collar of Figure 1.
- Figure 4 is a bottom view of the collar of Figure 1.
- Figure 5 is a front view of the collar of Figure 1.
- Figure 6 is a side view partially in section of a femur into which has been implanted the apparatus of Figure 1.
- Figure 6A is an exploded view of the indicated portion of Figure 6 showing the relationship between the outer surface of the collar and the hard and soft bone of the femur.
- Figure 7 is an exploded view of an artificial knee joint employing a tibia sleeve whose outer surface is constructed in accordance with the present invention.
- Figure 8 is a top view of the tibia sleeve of Figure 7.
- Figure 9 is a front view of the tibia sleeve of Figure 7.
- Figure 10 is a bottom view of the tibia sleeve of Figure 7.
- Figure 11 is a cross-sectional view of the tibia sleeve of Figure 7 along lines 11-11 in Figure 9.
- Figures 12 and 13 are exploded views of the outer surface of the tibia sleeve of Figure 7 showing, respectively, a porous coating and a texture designed to increase frictional engagement between the prosthesis and the bone in two directions.
- the present invention relates to a method and apparatus for affixing a prosthesis to bone so as to transfer stresses from the prosthesis to the bone in a manner which generally corresponds to the types of stress transfers which occur in natural bone.
- the prosthesis is provided with an outer surface at least a portion of which is both contoured to mate with a portion of the inner surface of the hard bone to which the prosthesis is being affixed, and provided with a texture which increases the frictional engagement between the outer surface and the hard bone.
- the texture with a plurality of spaced regions having high coefficients of friction and by adjusting the spacing between those regions to be on the order of a few millimeters, the anatomical details of the interaction of soft bone with hard bone, wherein fibers of soft bone intersect hard bone every few millimeters, are also approximated.
- Figures 1-6 and 7-13 illustrate the application of the invention to an artificial hip joint and an artificial knee joint, respectively. It is to be understood that the invention is equally applicable to other artificial joints, including, without limitation, artificial shoulder joints, artificial finger joints, artificial elbow joints, and the like. Along these same lines, in the discussion which appears below, certain features of the invention are described in detail with regard to only one of the two illustrated embodiments, e.g., the artificial hip joint. It is to be understood that these features can be used with both embodiments, as well as with the various other types of artificial joints listed above.
- the contoured and textured outer surface is shown associated with a separable component of the prosthesis, i.e., collar 18 in Figures 1-6 and tibia sleeve 38 in Figures 7-13. It is to be under ⁇ stood that this surface need not be carried by a separable component but can form part of the overall outer surface of a unitary prosthetic component, e.g., part of the outer surface of stem 12 in Figures 1-6.
- this figure shows a construction for femur portion 10 of an artificial hip joint.
- This portion includes a stem 12 to which is attached arm 14 and ball 16.
- Stem 12, arm 14 and ball 16 can be constructed in a variety of ways known to the art. Particularly preferred constructions for these components are described in U.S. Patents 3,820,167, 3,943,576, 3,996,625 and 4,077,070, the pertinent portions of which are included herein by reference.
- Femur portion 10 also includes collar 18 which is constructed in accordance with the present invention.
- Collar 18 includes body 20 having outer surface 22. It also includes walled aperture 24 for receiving stem 12. The walls of aperture 24 taper inwardly from the top to the bottom of collar 18 and mate with a complementary taper on the outside of stem 12. The slopes of these tapers are chosen so that the stem and the collar lock together as the stem is pushed into the collar.
- the stem is pro ⁇ vided with pins 28 which are received in recesses 26 formed in the collar. The pins and recesses prevent rotation of stem 12 within aperture 24.
- outer surface 22 of collar 18 is contoured to mate with inner surface 30 of the hard bone portion 32 of bone 34. That is, outer surface 22 is given a shape such that, when collar 18 is implanted in a suitably prepared bone, e.g., the upper part of the femur for a hip prosthesis, a substantial fraction of the hard bone's inner surface 30 is in close proximity to or in contact with the prosthesis' outer surface 22.
- outer surface 22 of collar 18 is also provided with a texture which increases the frictional engagement of the surface with the hard bone.
- the texture comprises a plurality of outwardly extending shoulders 36 oriented to increase the frictional engagement of surface 22 with the hard bone in the direction of the longitudinal axis of bone 34. Similar shoulders are used on tibia sleeve 38 of the artificial knee embodiment shown in Figures 7-11.
- the outer surface of the prosthesis is provided with a porous surface into which bone can grow.
- a porous surface can be obtained, among other ways, by coating the surface of the component with small balls 40 composed of the same metal as that used to form the component, e.g., a titanium alloy such as one containing 6% aluminum and 4% vanadium (see ASTM Spec. No. F136), and then heating the coated component to fuse the balls and the component together.
- An appro ⁇ priate size for the balls relative to the size of the prosthetic component is illustrated in Figure 12 wherein the distance represented by the longitudinal spacing (S) between shoulders 36 includes on the order of 2-10 balls. As discussed in detail below, this spacing is preferably on the order of between approximately 0.5 and 5.0 mm.
- porous coatings can be used in combination with a mating contour applied directly to a component which is subjected to high stresses, e.g., stem 12, this approach is believed to entail a risk of failure of the prosthesis with extended periods of use unless the component is substantially redesigned in view of the.weakened material. This is so because the heating process used to form the porous coating, as well as the surface characteristics produced by the coating, can significantly reduce the component's fatigue strength.
- this fatigue strength reduction can be compensated for by formulating or processing the alloy so that it has such a high initial strength that even significant strength reductions do not weaken the component to a point where it will not withstand the stresses associated with long periods of use.
- titanium-containing materials such as the titanium alloy described above
- the fatigue problem cannot be overcome by increasing the initial strength of the material.
- the reduction in strength caused by porous coating can be as high as 60% or more, e.g., from approximately 90,000 p.s.i. to about 30,000 p.s.i. for the titanium-aluminum-vanadium alloy described above.
- a titanium-containing prosthesis can be porous coated while still maintaining both its overall strength and its flexibility. Specifically, this result is achieved by separating the prosthesis into components, some of which are subjected to relatively high stress, e.g., stem 12, and others of which are subjected to relatively low stress, e.g., collar 18, and then porous coating only the relatively low stress components. In this way, the finished prosthesis can have all three characteristics considered desirable by the art, namely, porous coating, strength, and flexibility.
- Figure 13 shows an alternate surface texture designed to increase the frictional engagement of the prosthesis with the hard bone both in the direction of the longitudinal axis of the bone and in direction corresponding to rotation of the prosthesis about the longitudinal axis of the bone.
- cutouts 42 are formed in shoulders 36 so as to produce surface discontinuities 44 which help prevent rotation of the prosthesis about its longitudinal axis.
- the un-cutout portions of shoulders 36 continue to function as a texture which increases the coefficient of friction between the prosthesis and the bone in the direction of the longitudinal axis of the bone.
- the spacing between surface discontinuities 44 is on the order of a few millimeters to correspond generally to the spacing observed between the points of intersection of fibers of soft bone with hard bone.
- both tibia sleeve 38 and collar 18, as well as the inner surfaces of the hard bone portions of the tibia and femur with which these components mate, have non-circular cross-sections. These cross-sections in and of themselves tend to resist rotation so that in many cases texture enhancement in the direction corresponding to rotation of the prosthesis about the longitudinal axis of the bone may not be required.
- contoured outer surface 22 of the prosthesis is made up of a plurality of segments 46. Within each segment, the perimeter of the outer surface is constant in both size and shape. Between segments, however, the sizes and/or shapes of the perimeters change so as to produce the contour which mates with the inner surface of the hard bone and so as to provide the shoulders 36 which increase the frictional engagement of the contoured surface with the hard bone.
- outer surface 22 So that the overall contour of outer surface 22 will be a reasonable approximation of the shape of the inner surface 30 of hard bone 32, or, in other words, so that surfaces 22 and 30 will be in relatively close proximity over a substantial area, it is important to employ a sufficient number of segments 46 so that the outward extent of any shoulder 36 is no greater than approximately 1-2 mm. On the other hand, so that shoulders 36 are effective in increasing the coefficient of friction between the prosthesis and the hard bone, the outward extent of the shoulders should be at least approximately 0.25 mm. Since the outer edges 48 of shoulders 36 are the regions of outer surface 22 which have the highest coefficients of friction, in order to approximate the manner in which fibers of soft bone intersect with hard bone, the spacing between these edges should be on the order of a few millimeters.
- the spacing should be between approximately 1 and 2 millimeters, but in practice it has been found that to keep the depth of shoulders 36 between approximately 0.25 and 2 mm, it is necessary to use longitudinal spacings between edges 48 which vary between approximately 0.5 and 5.0 mm.
- Figures 7-13 illustrate the application of the invention to an artificial knee joint composed of femur component 50, intermediate bearing member 52 and tibia sleeve 38. A detailed discussion of the construction of this joint can be found in U.S. patent application Serial No. 578,437, to Douglas G. noisyles, which is being filed simultaneously herewith and is entitled "Semi-Constrained Artificial Joint.” The pertinent portions of that patent application are incorporated herein by reference.
- this sleeve has a body 20 whose outer surface 22 is contoured to mate with the inner surface of the hard bone at the upper end of the tibia.
- surface 22 is also textured by means of segments 46 which form spaced shoulders 36. As described in detail above, these shoulders represent regions of increased coefficient of friction between surface 22 and the inside surface of the hard bone.
- the combination of a contour which closely matches the shape of the inner surface of the hard bone over a substantial area and the presence of spaced regions having a relatively high coefficient of friction leads to stress transfers between the prosthesis and the hard bone which generally correspond to the stress transfers which occur in natural bone.
- Implantation of the prostheses of the present invention follows : standard procedures known in the art.
- the bone into which the prosthesis is to be inserted is resected as necessary and the core of the bone is reamed of soft bone and marrow.
- the contoured surface of the prosthesis and the hard bone will mate, it is desirable to leave some soft bone which can be captured and crushed between the surface and the hard bone as the surface is moved into position.
- This capturing and crushing process will pulverize some of the soft bone to the point of forming bone chips which can serve as nuclei for regenerative bone growth.
- the results of the process are illustrated in Figures 6 and 6A where the soft bone is identified by the number 54 and bone chips are identified by the number 56.
- edges 48 of shoulders 36 be sharp so that they can scrape away parts of the hard bone as the prosthesis is inserted into the bone, and thus automatically form and deposit the desired bone chips at the prosthesis/hard bone interface.
- the use of sharp edges at the ends of shoulders 36 also serves to shave away any high spots on inner surface 30 of hard bone 32 and thus produces an increased area of engagement between the prosthesis and the hard bone.
- contour of the outer surface of the prosthesis need not be formed from discrete segments of the shapes and sizes illustrated, but can be formed from segments having a variety of shapes and sizes or, alternatively, can be formed in a continuous manner without the use of segments with the surface texture being provided separately from contour formation.
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US57835184A | 1984-02-09 | 1984-02-09 | |
US578,351 | 1984-02-09 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1985003426A1 true WO1985003426A1 (en) | 1985-08-15 |
Family
ID=24312498
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1985/000212 WO1985003426A1 (en) | 1984-02-09 | 1985-02-08 | Apparatus for affixing a prosthesis to bone |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP0172883A1 (en) |
CA (1) | CA1262602C (en) |
WO (1) | WO1985003426A1 (en) |
Cited By (22)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0179626A2 (en) * | 1984-10-24 | 1986-04-30 | Finsbury (Instruments) Limited | Improvements relating to bone implants |
EP0238438A2 (en) * | 1986-03-15 | 1987-09-23 | Mecron Medizinische Produkte Gmbh | Bone implant |
US4714470A (en) * | 1986-02-19 | 1987-12-22 | Zimmer, Inc. | Grooved prosthetic implant |
WO1988001854A1 (en) * | 1986-09-15 | 1988-03-24 | Joint Medical Products Corporation | Sleeves for affixing artificial joints to bone |
EP0273871A1 (en) * | 1986-12-02 | 1988-07-06 | G. CREMASCOLI S.p.A. | A femoral neck hip prosthesis |
EP0285735A1 (en) * | 1987-04-08 | 1988-10-12 | Mecron Medizinische Produkte Gmbh | Method of producing a non-symmetrical stem of a hip joint prosthesis |
GB2178320B (en) * | 1985-07-29 | 1989-07-19 | Finsbury | Hip implant |
US4865603A (en) * | 1988-02-04 | 1989-09-12 | Joint Medical Products Corporation | Metallic prosthetic devices having micro-textured outer surfaces |
US5030238A (en) * | 1987-03-27 | 1991-07-09 | Gmt Gesellschaft Fur Medizinische Technik Mbh | Hip prosthesis |
US5041139A (en) * | 1989-04-25 | 1991-08-20 | Branemark Per Ingvar | Anchoring element for supporting a joint mechanism of an ankle, hip or other reconstructed joint |
US5116379A (en) * | 1988-09-15 | 1992-05-26 | Mclardy Smith Peter D | Prosthesis |
GB2259650A (en) * | 1991-09-23 | 1993-03-24 | Steven F Schutzer | Hip stem with proximal build-up blocks |
FR2691063A1 (en) * | 1992-05-15 | 1993-11-19 | Perot Francois | Indirect bone fastening assembly for hip or other joint prosthesis - has ball-and-socket joint components independent of bone configuration, with intermediate supports attached to or implanted in bone surfaces |
US5342366A (en) * | 1992-02-19 | 1994-08-30 | Biomet, Inc. | Surgical instruments for hip revision |
EP0631764A1 (en) * | 1993-06-22 | 1995-01-04 | ESKA Implants GmbH & Co. | Tibial part of a knee joint endoprosthesis |
US5725594A (en) * | 1994-07-14 | 1998-03-10 | Ortho Development Corporation | Proximal conical stem |
EP1043000A1 (en) * | 1999-04-09 | 2000-10-11 | Plus Endoprothetik Ag | Positioning element for a part of an endoprosthese and part of an endoprosthese with one or more of positioning elements |
EP0968691A3 (en) * | 1998-06-04 | 2001-10-17 | Benoist Girard Sas | Prosthesis provided with a mantle |
US6332896B1 (en) | 1994-07-14 | 2001-12-25 | Ortho Development Corporation | Orthopaedic implant with proximal collar |
EP1013241A3 (en) * | 1998-12-22 | 2002-03-06 | JOHNSON & JOHNSON PROFESSIONAL Inc. | Proximal femoral sleeve for a revision hip prosthesis |
EP2130516A1 (en) * | 2008-06-03 | 2009-12-09 | DePuy Products, Inc. | Porous titanium tibial sleeves |
US8241367B2 (en) | 2002-04-25 | 2012-08-14 | Zimmer, Inc. | Modular bone implant, tool, and method |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CA1304889C (en) * | 1988-05-12 | 1992-07-14 | Peter John Brooks | Femoral insert |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3808606A (en) * | 1972-02-22 | 1974-05-07 | R Tronzo | Bone implant with porous exterior surface |
US3848272A (en) * | 1972-01-13 | 1974-11-19 | United States Surgical Corp | Artificial hip joint |
US4352212A (en) * | 1979-03-05 | 1982-10-05 | Howmedica, Inc. | Joint prosthesis |
-
1985
- 1985-02-08 CA CA473947A patent/CA1262602C/en not_active Expired
- 1985-02-08 EP EP85901207A patent/EP0172883A1/en not_active Withdrawn
- 1985-02-08 WO PCT/US1985/000212 patent/WO1985003426A1/en not_active Application Discontinuation
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3848272A (en) * | 1972-01-13 | 1974-11-19 | United States Surgical Corp | Artificial hip joint |
US3808606A (en) * | 1972-02-22 | 1974-05-07 | R Tronzo | Bone implant with porous exterior surface |
US4352212A (en) * | 1979-03-05 | 1982-10-05 | Howmedica, Inc. | Joint prosthesis |
Cited By (28)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0179626A2 (en) * | 1984-10-24 | 1986-04-30 | Finsbury (Instruments) Limited | Improvements relating to bone implants |
EP0179626A3 (en) * | 1984-10-24 | 1988-04-20 | Finsbury (Instruments) Limited | Improvements relating to bone implants |
GB2178320B (en) * | 1985-07-29 | 1989-07-19 | Finsbury | Hip implant |
US4714470A (en) * | 1986-02-19 | 1987-12-22 | Zimmer, Inc. | Grooved prosthetic implant |
EP0238438A2 (en) * | 1986-03-15 | 1987-09-23 | Mecron Medizinische Produkte Gmbh | Bone implant |
EP0238438A3 (en) * | 1986-03-15 | 1988-03-30 | Mecron Medizinische Produkte Gmbh | Bone implant |
WO1988001854A1 (en) * | 1986-09-15 | 1988-03-24 | Joint Medical Products Corporation | Sleeves for affixing artificial joints to bone |
US4790852A (en) * | 1986-09-15 | 1988-12-13 | Joint Medical Products Corporation | Sleeves for affixing artificial joints to bone |
EP0273871A1 (en) * | 1986-12-02 | 1988-07-06 | G. CREMASCOLI S.p.A. | A femoral neck hip prosthesis |
US5030238A (en) * | 1987-03-27 | 1991-07-09 | Gmt Gesellschaft Fur Medizinische Technik Mbh | Hip prosthesis |
EP0285735A1 (en) * | 1987-04-08 | 1988-10-12 | Mecron Medizinische Produkte Gmbh | Method of producing a non-symmetrical stem of a hip joint prosthesis |
US4865603A (en) * | 1988-02-04 | 1989-09-12 | Joint Medical Products Corporation | Metallic prosthetic devices having micro-textured outer surfaces |
US5116379A (en) * | 1988-09-15 | 1992-05-26 | Mclardy Smith Peter D | Prosthesis |
US5041139A (en) * | 1989-04-25 | 1991-08-20 | Branemark Per Ingvar | Anchoring element for supporting a joint mechanism of an ankle, hip or other reconstructed joint |
GB2259650A (en) * | 1991-09-23 | 1993-03-24 | Steven F Schutzer | Hip stem with proximal build-up blocks |
US5342366A (en) * | 1992-02-19 | 1994-08-30 | Biomet, Inc. | Surgical instruments for hip revision |
FR2691063A1 (en) * | 1992-05-15 | 1993-11-19 | Perot Francois | Indirect bone fastening assembly for hip or other joint prosthesis - has ball-and-socket joint components independent of bone configuration, with intermediate supports attached to or implanted in bone surfaces |
EP0631764A1 (en) * | 1993-06-22 | 1995-01-04 | ESKA Implants GmbH & Co. | Tibial part of a knee joint endoprosthesis |
US6332896B1 (en) | 1994-07-14 | 2001-12-25 | Ortho Development Corporation | Orthopaedic implant with proximal collar |
US5725594A (en) * | 1994-07-14 | 1998-03-10 | Ortho Development Corporation | Proximal conical stem |
US6913624B2 (en) | 1994-07-14 | 2005-07-05 | Ortho Development Corporation | Orthopaedic implant with proximal collar |
EP0968691A3 (en) * | 1998-06-04 | 2001-10-17 | Benoist Girard Sas | Prosthesis provided with a mantle |
EP1013241A3 (en) * | 1998-12-22 | 2002-03-06 | JOHNSON & JOHNSON PROFESSIONAL Inc. | Proximal femoral sleeve for a revision hip prosthesis |
AU769625B2 (en) * | 1998-12-22 | 2004-01-29 | Depuy Orthopaedics, Inc. | Proximal femoral sleeve for a revision hip prosthesis |
EP1043000A1 (en) * | 1999-04-09 | 2000-10-11 | Plus Endoprothetik Ag | Positioning element for a part of an endoprosthese and part of an endoprosthese with one or more of positioning elements |
US8241367B2 (en) | 2002-04-25 | 2012-08-14 | Zimmer, Inc. | Modular bone implant, tool, and method |
EP2130516A1 (en) * | 2008-06-03 | 2009-12-09 | DePuy Products, Inc. | Porous titanium tibial sleeves |
EP2394607A1 (en) * | 2008-06-03 | 2011-12-14 | DePuy Products, Inc. | Porous titanium tibial sleeves |
Also Published As
Publication number | Publication date |
---|---|
CA1262602A (en) | 1989-11-07 |
CA1262602C (en) | 1989-11-07 |
EP0172883A1 (en) | 1986-03-05 |
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