The present invention is directed to bone fixation and, in particular, is directed to a method and apparatus for buttressing a prosthetic acetabular component for a deficient acetabulum.
Every year, thousands of individuals undergo total hip replacement (THR) as a result of degeneration or otherwise excessive damage to the acetabulum. This damage causes irregular and/or painful articulation between the femoral head and the acetabulum during normal movement of the leg and hip. It therefore becomes necessary to replace the damaged articulation site with a prosthetic implant that can adequately manage the normal forces encountered at the site while maintaining a sufficient range of motion between the femur and pelvic girdle.
A THR procedure typically involves resecting a portion or all of the acetabulum so that a prosthetic component mimicking the acetabulum can be installed in its place. The cup is contoured and constructed such that its functionality closely resembles that of the native acetabulum. The femoral head may also be partially or fully resected to accommodate a prosthetic stem and head that will articulate with the prosthetic cup.
The efficacy of current acetabular cups lies in the ability to retain a secure connection between the cup and the pelvic girdle. By maintaining a strong connection, the ability of the surrounding bone to heal is improved, as is the reliability of the replaced articulation site. However, due to constant and variable articulation between the femoral head and the acetabular cup, the cup may loosen over time. This movement may contribute to a weakened articulation site or may make the femoral head susceptible to slippage out of the cup, resulting in severe pain and discomfort. Another contributing factor to the performance decline of an acetabular cup can be the complex anatomical geometry of the pelvic girdle. This geometry may make it difficult to ensure a lasting, rigid connection between the cup and the bone. Current cups use bone cement, friction, and/or fasteners/screws to directly secure the cup to the pelvic girdle. For the above reasons, these fastening constructions can fail to ensure proper fixation of the cup within the acetabulum.
Accordingly, there is a need for an apparatus and method for ensuring that prosthetic acetabular cups are securely fitted to the pelvic girdle to ensure proper healing and reliable articulation with the femoral head.
In accordance with the present invention, a buttress plate for retaining an acetabular cup implanted in an acetabulum is provided. The buttress plate includes a base having a first end and a second end. The first end extends along a plane and includes at least one passage for receiving a fastener to secure the base to the acetabulum. The second end includes a lip extending transverse to the plane for securing the acetabular cup within the acetabulum.
In accordance with another embodiment of the present invention, a method is provided for retaining an acetabular cup implanted in an acetabulum. The acetabular cup is placed within the acetabulum, wherein the cup is pre-contoured to the acetabulum. A buttress plate is fastened to a lateral surface of the acetabulum, the plate including a base having a first end and a second end, the first end extending along a plane and including at least one passage for receiving a fastener to secure the base to the acetabulum, the second end including a lip extending transverse to the plane for securing the acetabular cup within the acetabulum.
In accordance with another embodiment of the present invention, a buttress plate for retaining an acetabular cup implanted in an acetabulum is provided. A buttress plate includes an arcuate base having a first end and a second end. The first end extends along a plane and includes at least one tab extending outward from the first end. Each of the at least one tabs includes at least one passage for receiving a fastener to secure the base to the acetabulum. The second end includes an arcuate lip extending transverse to the plane for securing the acetabular cup within the acetabulum. The base further includes means for engaging bone and means for promoting bone growth
The foregoing and other features and advantages of the present invention will become apparent to those skilled in the art to which the present invention relates upon reading the following description with reference to the accompanying drawings, in which:
The present invention is directed to bone fixation and, in particular, is directed to a method and apparatus for buttressing a prosthetic cup for an acetabulum within the pelvis of a patient. An embodiment of a buttress plate 10 in accordance with the present invention is illustrated in
The buttress plate 10 has an arcuate construction extending generally about an axis 16 and may, for example, be pre-contoured to the shape of the pelvis 34 of the patient. In particular, the buttress plate 10 may be pre-contoured to the posterior column of the acetabulum. The plate 10 includes a base 40 having a top surface 42, a bottom surface 44, a first end 46, and a second end 48 (
The first end 46 of the base 40 includes at least one tab 50 which projects radially outward from the first end. Although three tabs 50 are illustrated in
The first end 46 of the base 40 and the tabs 50 extend generally along a plane 60 extending substantially parallel to the top surface 42 and the bottom surface 44 of the base. The second end 48 of the base 40 includes a lip 62 which extends at an angle relative to the plane 60. In particular, the lip 62 extends downward and away from the top surface 42 of the base 40. Although
The bottom surface 44 of the base 40 may include means for engaging bone (not shown). The means may include ribs, projections, or barbs, or may otherwise be textured or adapted to increase the ability of the bottom surface 44 of the base 40 to engage bone. Furthermore, the plate 10 may be mechanically, chemically, and/or biologically treated to promote bone growth once the plate has been installed within the patient.
The plate 10 is constructed of any biocompatible material capable of providing a secure fixation site at the pelvic girdle 30. The plate 10 can be made of metal, polymers, or combinations thereof. The plate 10 should be strong enough to maintain engagement with the pelvis 30 while the femoral head is articulating within the acetabular cup 20.
As shown in
In operation, the cup 20 is placed within the acetabulum 32 such that a rim 70 of the cup is recessed from a lateral surface 36 of the pelvis 30 which helps define the acetabulum 32. As shown in
A fastener or screw 80 is inserted into each passage 52 on the tabs 50 of the base 40. The fastener 80 includes a biocompatible screw or other structure suitable for penetration into bone. Each fastener 80 is screwed into the lateral surface 36 of the pelvis 34 until the head of the fastener applies a compressive force to the top surface 42 of the base 40 of the plate 10 to thereby pin the plate against the lateral surface (
Alternatively, the lip 62 on the base 40 of the plate 10 may be configured such that when the plate is placed across the pelvis 34, the lip overlies and engages a top surface 72 of the rim 70 of the acetabular cup 20 (
In accordance with another aspect of the present invention, the lip 62 of the base 40 of the plate 10 and the rim 70 of the cup 20 may be configured with additional structure to mate with one another. The mating connection between the plate 10 and the cup 20 provides a more rigid engagement between the cup 20 and the acetabulum 32. In particular, the rim 70 of the cup 20 may include one or more projections 90 which engage one or more projection 92 on the lip 62 of the plate 10 (
From the above description of the invention, those skilled in the art will perceive improvements, changes and modifications. Such improvements, changes and modifications within the skill of the art are intended to be covered by the appended claims.
This application claims priority from U.S. Provisional Patent Application Ser. No. 61/036,487, filed on Mar. 14, 2008, the subject matter of which is incorporated herein by reference.
Number | Date | Country | |
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61036487 | Mar 2008 | US |