An ankle joint may become severely damaged and painful due to arthritis, prior ankle surgery, bone fracture, osteoarthritis, and/or one or more additional conditions. Options for treating the injured ankle have included anti-inflammatory and pain medications, braces, physical therapy, joint arthrodesis, and total ankle replacement.
Total ankle replacement generally comprises two components—a tibial implant and a talar implant. The implants comprise articulation surfaces sized and configured to mimic the range of motion of the ankle joint. For example, the talar implant may comprise an implant sized and configured to mimic the talar dome and the tibial implant may comprise an articulation surface sized and configured to mimic articulation of the tibia.
Installation of a total ankle replacement can include forming one or more holes or cuts in a bone. For example, a hole may be drilled through the talus and into the tibia to create a channel for inserting a tibial stem. In some installations, additional bone is removed from the talus to make space for a talar stem extending from the talar portion.
In one aspect, a system includes a first implant component and a second implant component. The first implant component is configured to be secured to a bone and includes a plate and a coupler extending upward from the plate and defining a coupler axis. The second implant component is configured to be coupled to the first implant component. The second implant component includes an articulation surface and defines a cavity configured to receive the coupler of the first implant component. The second implant component is couplable to the first implant component at a plurality of rotational orientations about the coupler axis.
In another aspect, an adaptor for orienting a second implant component to a first implant component includes a top surface, a bottom surface, and an outer surface extending between the top surface and the bottom surface. The adaptor has an indexing feature configured to engage the second implant component to rotationally orient the second implant component.
In another aspect, a method includes attaching a first implant component to a bone. The method further includes selecting a desired rotational orientation for a second implant component relative to the first implant component from a plurality of rotational orientations. The method further includes coupling the second implant component to the first implant component in the desired rotational orientation.
These and other features and advantages of the devices and methods described herein will be more fully disclosed in, or rendered obvious by, the following detailed description of the preferred embodiments, which is to be considered together with the accompanying drawings wherein like numbers refer to like parts and further wherein:
This description of preferred embodiments is intended to be read in connection with the accompanying drawings, which are to be considered part of the entire written description of this invention. The drawing figures are not necessarily to scale and certain features of the invention may be shown exaggerated in scale or in somewhat schematic form in the interest of clarity and conciseness. In the description, relative terms such as “horizontal,” “vertical,” “up,” “down,” “top,” and “bottom” as well as derivatives thereof (e.g., “horizontally,” “downwardly,” “upwardly,” etc.) should be construed to refer to the orientation as then described or as shown in the drawing figure under discussion. These relative terms are for convenience of description and normally are not intended to require a particular orientation. Terms including “inwardly” versus “outwardly,” “longitudinal” versus “lateral” and the like are to be interpreted relative to one another or relative to an axis of elongation, or an axis or center of rotation, as appropriate. Terms concerning attachments, coupling and the like, such as “connected” and “interconnected,” refer to a relationship wherein structures are secured or attached to one another either directly or indirectly through intervening structures, as well as both movable or rigid attachments or relationships, unless expressly described otherwise.
The present disclosure generally provides a bone implant for use with a joint replacement system. The embodiments described herein include features that allow the articulation surface of the implant to be oriented at a desired rotational orientation from a plurality of potential rotational orientations. Although described herein with reference to an ankle replacement system, the implants described herein can be used in the repair of any joint or bone. Further, a joint replacement system can include two components that allow for rotational alignment or repositioning as described herein. For example, in an ankle replacement system, both the talar implant and the tibial implant can include features that allow the articulation surfaces of the respective implant to be oriented in a desired orientation.
The joint surfaces 16, 20 may be made of various materials, such as, for example, polyethylene, ultra-high molecular weight polyethylene (UHMWPE), rubber, titanium, titanium alloys, chrome cobalt, surgical steel, and/or any other suitable metal, ceramic, sintered glass, artificial bone, and/or any combination thereof. In some embodiments, the joint surfaces 16, 20 may comprise a coated surface. For example, in some embodiments, the joint surfaces 16, 20 may be plasma sprayed with a closed pore or porous material, The joint surfaces 16, 20 may comprise different materials. For example, the tibial joint surface 20 may comprise a plastic or other non-metallic material and the talar joint surface 16 may comprise a metal surface. Those skilled in the art will recognize that any suitable combination of materials may be used.
As shown in
The talar platform 102 can further include one or more pegs 118 extending from the plate 106 configured to secure the plate 106 to the talus. The pegs 118 can be angled or straight and can include tapered tips to facilitate insertion into the talus. The talar platform 102 can also include a stem, such as the stem 22 shown in
The talar dome 104 is configured to be coupled to the talar platform 102. The talar dome 104 includes an articulation surface 120 configured to contact the articulation surface of the tibial implant (e.g., articulation surface 20) to provide smooth articulation of the ankle joint and to mimic the natural movement of the joint. As shown best in
The talar dome 104 further includes an indexing feature 124 configured to engage the indexing feature 114 of the talar platform 102. For example, the talar dome 104 can include one or more teeth 126 within the cavity 122, each tooth configured to engage one of the plurality of notches 116 formed in the coupler 108 of the talar platform 102.
Further, the resolution of the indexing features 114, 124 may allow the talar dome 104 to be oriented at positions that are spaced apart by a desired angle, for example, 1° or 2°, so that the talar dome 104 can be positioned as desired so that the talar dome 104 is positionable in a variety of positions to allow the talar dome 104 to be positioned as desired.
In another embodiment, shown in
The talar platform 202 can further include one or more pegs 218 extending from the plate 206 configured to secure the plate 206 to the talus. The pegs 218 can be angled or straight and can include tapered tips to facilitate insertion into the talus. The talar platform 202 can also include a stem, as shown in
The adaptor 230 is configured for orienting the talar dome 204 relative to the talar platform 202. The adaptor 230 includes a top surface 232, a bottom surface 234, and an outer surface 236 extending between the top surface 232 and the bottom surface 234. The adaptor 230 is configured to be received at least partially in the cavity 222 of the talar dome 204. The adaptor 230 defines a recess 238 configured to receive the coupler 208 of the talar platform 202. In various embodiments, the adaptor 230 is frustoconical. In various embodiments, the coupler 208 is tapered and the recess 238 in the adaptor 230 is tapered to receive the coupler 208. The engagement of the coupler 208 and the recess 238 may engage as with a Morse taper to lock the adaptor 230 in position with respect to the talar platform 202.
The adaptor 230 includes an indexing feature 240 configured to orient the talar dome 204 relative to the talar platform 202. The indexing feature 240 can include a plurality of notches 216 formed around all or a portion of the perimeter of the adaptor 230, similar to the indexing feature 114 of the talar platform 102 described above. The indexing feature 240 can include any number of notches 242 with each corresponding to a different rotational orientation of the talar dome 204 relative to the talar platform 202.
The talar dome 204 is configured to be coupled to the talar platform 202 via the adaptor 230. The talar dome 204 includes an articulation surface 220 configured to contact the articulation surface of the tibial implant (e.g., articulation surface 20) to provide smooth articulation of the ankle joint and to mimic the natural movement of the joint. The talar dome 204 defines a cavity 222 configured to receive the adaptor 230. The cavity 222 can be tapered to receive a tapered adaptor 230.
The talar dome 204 further includes an indexing feature 224 configured to engage the indexing feature 240 of the adaptor 230. For example, the talar dome 204 can include a tooth 226 within the cavity 222 configured to engage one of the plurality of notches 242 formed in the adaptor 230.
As described above with respect to the system 100, the system 200 can provide a range of rotational orientations. For example, in various embodiments, the talar dome 204 can be positioned such that the centerline of the talar dome 204 forms an angle of up to about 25° in each direction with respect to the centerline of the talar platform 202. Further, the resolution of the indexing features 224, 240 may allow the talar dome 204 to be oriented at positions that are spaced apart by a desired angle, for example, 1° or 2°.
It should be understood that the indexing features described herein can be provided in other arrangements. For example, the talar dome 104, 204 can have an indexing feature that includes a plurality of notches and the coupler 108 or adaptor 230 can include one or more teeth configured to engage the notches in the talar dome 104, 204 to orient the talar dome 104, 204 with respect to the talar platform 102, 202.
Further, other indexing features can be used in the embodiments described herein. For example, as shown in
In addition, as shown in
In another aspect, a method of implanting an implant (e.g., a talar implant) includes attaching a first implant component to a bone. The method further includes selecting a desired rotational orientation for a second implant component relative to the first implant component from a plurality of potential rotational orientations. The method further includes coupling the second implant component to the first implant component in the desired rotational orientation.
In various embodiments, the method further includes coupling an adaptor to the first implant component. In such embodiments, the adaptor can include an indexing feature for orienting the second implant component relative to the first implant component. In some embodiments, the indexing feature includes a plurality of notches arranged around a perimeter of the adaptor. In such embodiments, coupling the second implant component to the first implant component includes engaging a tooth of the second implant component with one of the plurality of notches.
In other embodiments, the first implant component includes an indexing feature comprising a plurality of notches arranged around a perimeter of the adaptor. In such embodiments, coupling the second implant component to the first implant component includes engaging a tooth of the second implant component with one of the plurality of notches.
Although the devices, systems, and methods have been described in terms of exemplary embodiments, they are not limited thereto. Rather, the appended claims should be construed broadly, to include other variants and embodiments of the devices, systems, and methods, which may be made by those skilled in the art without departing from the scope and range of equivalents of the devices, kits, systems, and methods.
This application claims priority to U.S. Provisional Patent Application No. 62/956,699, filed on Jan. 3, 2020, the entirety of which is incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US2020/054901 | 10/9/2020 | WO |
Number | Date | Country | |
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62956699 | Jan 2020 | US |