This application relates to the field of prosthetic devices, and particularly joint prostheses comprising head and cup arrangements.
A common orthopedic joint prosthesis includes a ball and cup arrangement. For example, hip joints typically comprise a rounded femoral head and an acetabular cup. The rounded femoral head is provided on a stem that is configured to engage the intramedullary cavity of the femor and secure the head on the femor. The rounded femoral head includes a convex surface configured to engage a concave surface on the acetabular cup. The acetabular cup is configured for implantation on the acetabulum of the pelvis. When the rounded femoral head is received within the acetabular cup, a ball and socket joint is provided.
In order to reduce wear between the components of the joint prosthesis, the components are manufactured such that the clearance between the bearing surfaces is minimized. The term “clearance” is often used in reference to a “diametral clearance” of the joint prosthesis. The diametral clearance between bearing surfaces is generally considered to be the difference in the diameter defining the bearing surface of the ball and the diameter defining the bearing surface of the cup.
While minimal diametral clearance between the bearing surfaces is desired, at least two factors limit the reduction of clearances. First, manufacturing tolerances generally limit the extent to which clearances may be reduced. For example, for diametral clearances below the 15-30 micron range, it has been observed that imperfect formation of the femoral head and the acetabular cup contributes to local interferences and small deformations that result in wear.
Second, acetabular cup deformation during implantation into the acetabulum also limits the degree to which clearances may be reduced in a hip joint prosthesis. This deformation generally occurs near the equatorial lip of the acetabular cup. For substantially spherical cup and head arrangements, reduction in clearances near the pole of the head also means reduction in clearances near the equatorial lip. In other words, when the head and the cup of a hip prosthesis are substantially spherical, the small clearances near the pole of the head are also found in the region near the equatorial lip of the cup. Thus, when cup deformation occurs near the equatorial lip in a low clearance spherical deign, interference is likely to occur between the equatorial lip of the cup and the ball.
One way to reduce clearance complications resulting from acetabular cup deformation is to provide a conformal region having a small clearance near the center of the primary articulation area of the femoral head, and a peripheral region surrounding the conformal region, wherein the peripheral region has a significantly greater clearance than the conformal region, including a significantly greater clearance near the lip of the cup. With this arrangement, deformations near the equatorial lip of the acetabular cup are less likely to result in obstruction with the femoral head because of the increased clearance near the equatorial lip. Although several of these arrangements have been provided in the past, they have not provided optimal solutions. In particular, many of these arrangements include peripheral regions surrounding the conformal region where the clearances in these peripheral regions quickly diverge from the relatively small clearances in the conformal zone. However, when the clearance in the peripheral region is too great, significant wear may result.
Accordingly, what is needed is a joint prosthesis configured to avoid interference between the ball and cup even if the equatorial region of the cup is deformed during implantation. It would also be advantageous if the clearance between the ball and cup could remain relatively low even in a peripheral region surrounding the conformal region.
A joint prosthesis device comprises a head configured to fit within a cup. The cup includes a concave cup surface defined by at least one radius of curvature RC. The head includes a convex head surface defined by at least one radius of curvature RH. The convex head surface is configured to engage the concave cup surface. The convex head surface provides an articulation zone where the head surface engages the cup surface. In one embodiment, RC differs from RH in the articulation zone by a first amount that is no greater than forty microns. The convex head surface also provides a peripheral zone outside of the articulation zone. RC differs from RH in the peripheral zone by a second amount that is greater than the first amount but is no greater than fifty microns. The peripheral zone generally extends over an area subtended by an angle of at least 10°, the angle having a vertex at a center of the head.
In at least one embodiment, the peripheral zone includes a transition zone and an equatorial zone. The equatorial zone is provided in proximity of a region of the head opposing the lip of the acetabular cup and the transition zone lies between the equatorial zone and the articulation zone. In such embodiment, the clearance in the transition zone is generally greater than the clearance in the articulation zone. Furthermore, the clearance in the equatorial zone is generally greater than the clearance in the transition zone. In one embodiment, the clearance in the transition zone gradually increases moving from the perimeter of the articulation zone to the perimeter of the equatorial zone. In another embodiment, the clearance in the transition zone remains substantially constant in both the transition zone and the equatorial zone.
The above described features and advantages, as well as others, will become more readily apparent to those of ordinary skill in the art by reference to the following detailed description and accompanying drawings.
With reference to
The acetabular cup 12 is the part of the prosthetic hip joint 10 that forms the socket of a ball-and-socket structure. The acetabular cup 12 includes a convex outer surface 20 configured for engagement with a patient's acetabulum and a concave interior surface 22 configured to engage the femoral head 14. The cup 12 includes a lip 21 which defines a rim in a peripheral region where the convex outer surface 20 meets the concave interior surface 22. A vertex 33 is provided upon the concave interior surface 22 of the cup 12. The vertex 33 is generally the point on the cup 12 that is at the peak of the concave interior surface and equidistant from all points on the lip 21. The convex outer surface 20 of the acetabular cup 12 is provided as part of a shell comprised of a biocompatible material. In at least one embodiment, the shell is comprised of a relatively rigid material, such as a biocompatible metal or ceramic. For example, the shell may be comprised of titanium or cobalt chrome. The concave interior surface 22 of the cup 12 comprises a liner that provides a bearing surface for the acetabular cup. The liner may be comprised of a biocompatible material that offers a low coefficient of friction, such as polyethylene. Alternatively, the liner may be comprised of a metal or ceramic. While exemplary materials for the acetabular cup have been offered herein, one of skill in the art will recognize that numerous other biocompatible materials may be used as are known in the art.
The femoral component which includes the femoral stem 16 and the femoral head 14 replaces the natural head of the femur. The femoral head 14 includes a ball-shaped member that provides a convex outer surface 24 designed and dimensioned to be received by the concave interior surface 22 of the acetabular cup 12. The femoral head 14 is fixed to the femoral stem 16. The femoral head 14 and femoral stem are comprised of a relatively rigid biocompatible material such as a ceramic or metal. For example, the ball may be comprised of cobalt chrome or stainless steel. While exemplary materials for the femoral component have been offered herein, one of skill in the art will recognize that numerous other biocompatible materials may be used as are known in the art.
As shown in
With reference now to
The term “articulation zone” as used herein refers to a region of the head 14 which provides a main contact area for engagement between the head 14 and the cup 12 for nearly all joint movements once implanted in a patient. Accordingly, with reference to
In the embodiment of
The acetabular cup 12 is shown in the embodiment of
The region outside of the articulation zone A on the head 14 is generally referred to herein as the peripheral zone or peripheral region P. The peripheral zone P is shown in
In the embodiment of
In the embodiment of
The transition zone T is the region lying between the articulation zone A and the equatorial zone E. The transition zone T includes those portions of the convex outer surface 24 of the head 14 subtending the angle τ in
With continued reference to
Similar to the head 14, the acetabular cup 12 is also defined by a radius of curvature RC. The radius of curvature RC extends from the virtual center of the cup 12 to the concave inner surface 22 of the acetabular cup 12. In at least one embodiment, the radius of curvature RC is constant at all points on the concave inner surface 22 such that the concave inner surface 22 of the cup is spherical. In another embodiment, the radius of curvature RC is different at different points on the concave inner surface 22, and in different regions. For example, the radius of curvature RC of the cup may be smaller at those points opposing the articulation zone A than at those points opposing the peripheral zone P. Furthermore, the radius of curvature RC of the cup 12 may be smaller at those points opposing the transition zone T than at those points opposing the equatorial zone E.
The difference between RC and RH at a given point on the head 14 and the opposing point on the cup 12 (i.e., on a given ray extending from the center of the head to the concave surface 22 of the cup) defines half the diametral clearance at that location. The term “radial clearance” as used herein refers to half the diametral clearance. Accordingly, a “radial clearance” may be calculated as either RC-RH or RH-RC. When reference is made herein to a radial clearance in a given zone (i.e., the articulation zone, the transition zone or the equatorial zone), such radial clearance refers to the difference between RH and RC along a ray extending from the center 30 of the head 14 and passing through such zone, with the cup 12 in an equilibrium position with respect to the head 14. In at least one embodiment of the prosthetic device, the radial clearance in the articulation zone A is no more than forty microns and the radial clearance in the peripheral zone P is no greater than fifty microns. For example, in one embodiment the radial clearance in the articulation zone A is about thirty microns and the radial clearance in the equatorial zone E is about forty microns. In the transition zone T lying between the articulation zone and the equatorial zone, the radial clearance may gradually increase from thirty microns to forty microns moving from the perimeter of the articulation zone to the perimeter of the equatorial zone. Alternatively, the transition zone T may provide a generally uniform radial clearance, such as thirty-five microns, which lies between the thirty micron radial clearance in the articulation zone A and the forty micron radial clearance in the equatorial zone E. Although exemplary radial clearances have been provided with reference to
In the embodiment of
Although the present invention has been described with respect to certain preferred embodiments, it will be appreciated by those of skill in the art that other implementations and adaptations are possible. For example, although
Number | Name | Date | Kind |
---|---|---|---|
3510883 | Cathcart, III | May 1970 | A |
3521302 | Müller | Jul 1970 | A |
4031570 | Frey | Jun 1977 | A |
4784662 | Müller | Nov 1988 | A |
4840632 | Kampner | Jun 1989 | A |
4911723 | Menschik | Mar 1990 | A |
5383936 | Kubein-Meesenburg et al. | Jan 1995 | A |
5443519 | Averill et al. | Aug 1995 | A |
5549690 | Hollister et al. | Aug 1996 | A |
5549693 | Roux et al. | Aug 1996 | A |
5609643 | Colleran et al. | Mar 1997 | A |
5641323 | Caldarise | Jun 1997 | A |
5879405 | Ries et al. | Mar 1999 | A |
5879406 | Lilley | Mar 1999 | A |
5928285 | Bigliani et al. | Jul 1999 | A |
5972032 | Lopez et al. | Oct 1999 | A |
6013103 | Kaufman et al. | Jan 2000 | A |
6059830 | Lippincott, III et al. | May 2000 | A |
6126695 | Semlitsch | Oct 2000 | A |
6660040 | Chan et al. | Dec 2003 | B2 |
6706068 | Ferree | Mar 2004 | B2 |
20040225370 | Cruchet et al. | Nov 2004 | A1 |
20050087047 | Farrar | Apr 2005 | A1 |
20050256584 | Farrar | Nov 2005 | A1 |
20070073410 | Raugel | Mar 2007 | A1 |
20080114459 | Scott et al. | May 2008 | A1 |
20100063589 | Tepic | Mar 2010 | A1 |
Number | Date | Country |
---|---|---|
4428290 | Feb 1996 | DE |
19915814 | Oct 2000 | DE |
19915814 | Oct 2000 | DE |
0226762 | Jul 1987 | EP |
0302850 | Feb 1989 | EP |
0648478 | Apr 1995 | EP |
0681815 | Nov 1995 | EP |
0841041 | May 1998 | EP |
0748193 | Dec 2001 | EP |
0841041 | Sep 2002 | EP |
1340477 | Sep 2003 | EP |
1442725 | Aug 2004 | EP |
1337204 | Apr 2005 | EP |
1598033 | Nov 2005 | EP |
1465557 | Oct 2006 | EP |
1767171 | Mar 2007 | EP |
1 337 204 | Aug 2007 | EP |
1952786 | Aug 2008 | EP |
1767171 | Dec 2008 | EP |
2134170 | Dec 1972 | FR |
2366733 | Apr 1998 | GB |
2366733 | Mar 2002 | GB |
WO 9523566 | Sep 1995 | WO |
9716138 | May 1997 | WO |
WO 0243626 | Jun 2002 | WO |
03061532 | Jul 2003 | WO |
WO 2008015287 | Feb 2008 | WO |
Entry |
---|
Bergmann, G. et al., “Hip Contact Forces and Gait Patterns from Routine Activities”, Journal of Biomechanics, 34, 859-871, (13 pages). |
European Search Report of European Application No. EP 08 25 0408. |
European Search Report in corresponding EP application (i.e., EP 08 17 1397) completed May 11, 2009 (2 pages). |
Anderson, Andrew Edward, “Computational Modeling of Hip Joint Mechanics,” (Apr. 2007) (unpublished Ph.D. dissertation, The University of Utah), (available on the web at mrl.sci.utah.edu/mrl/papers/Dissertation—AEA.pdf) (34 pages). |
Cilingir et al, “Three-Dimensional Anatomic Finite Element Modeling of Hemi-Arthroplasty of Human Hip Joint,” Trends in Biomaterials and Artificial Organs, vol. 21(1), pp. 63-72, 2007, (10 pages). |
Hurwitz et al., “A new parametric approach for modeling hip forces during gait,” Journal of Biomechanics, 2003, pp. 113-119, vol. 36, Elsevier, USA (7 pages). |
McKellop, Ph.D. et al., “In Vivo Wear of 3 Types of Metal on Metal Hip Prostheses During 2 Decades of Use,” Clinical Orthopaedics and Related Research, No. 329S, pp. S128-S140, © 1996 Lippincott-Raven Publishers, (13 pages). |
Morlock et al., “Duration and frequency of every day activities in total hip patients,” Journal of Biomechanics, 2001, pp. 873-881, vol. 34, Elsevier, USA (9 pages). |
Reinbolt et al., “Determination of patient-specific multi-joint kinematic models through two-level optimization,” Journal of Biomechanics, 2005, pp. 621-626, vol. 38, Elsevier, USA (6 pages). |
Sbarbaro, Jr., “The Sbarbaro Total Hip,” published at least as early as Feb. 4, 2007 (1 page). |
McKee et al., “The McKee-Farrar Total Hip,” published at least as early as Feb. 4, 2007 (1 page). |
European Search Report in corresponding European patent application (i.e., EP08250408.5), dated Dec. 29, 2009 (4 pages). |
Number | Date | Country | |
---|---|---|---|
20080188944 A1 | Aug 2008 | US |