The present invention relates generally to replacement assemblies for use in the acetabulofemoral (i.e. hip) joint. More particularly, the present invention teaches a self-contained and replaceable articulating hip utilized in a hip arthroplasty procedure, as well as an installation kit for assisting the preparation of the femur and ilium bones defining the hip joint, as well as the installation of the implant body into the upper conditioned femur end and the outer socket support to a reconditioned acetabulum defined in the ilium bone.
The prior art is documented with various types of hip replacement assemblies. These typically include either the removal and/or refashioning of the insertable head associated with the thigh or upper femur bone along with the receiving acetabulum socket defined in the pelvic area located ilium bone. Such replacement hip assemblies can also incorporate artificial or synthetic implant components, however their relative large size contributes to an attendant degree of installation effort and patient discomfort associated with its surgical implantation.
The present invention discloses a hip implant assembly including body exhibiting a substantially spherical shaped ball and an elongated stem. An annular defining rim separates the ball from the stem and abuts, in a maximum inserting condition, an exterior surface of a reconditioned femur upon inserting the stem within an interior passageway associated with the femur.
A three dimensional and interior volume defining support secures around the ball in a universally articulating permitting fashion. The support is affixed to a reconditioned acetabulum socket associated with an ilium bone by interconnecting posts and anchors established between the fixed support and the reconditioned surface of the acetabulum.
Additional features include the body and support being constructed of any type of plastic, metal or admixture thereof, and an inner remote end of the stem being cored or otherwise recess machined in order to promote the in-growth of marrow within the and around the stem. A plurality of entrapped lubricant defined passageways are located between the ball and an overlaying surface of the support. A venting port is incorporated into an interior socket configuration established between the support and ball in communication with the interior passageways to permit the removal, venting and/or replacement of the lubricant fluid.
The outer socket mounting support may also include a generally cup-shape defining a receiver for seating the ball and including a softer and inner/arcuate absorbing layer extending in embedded fashion between an inner facing surface and an outer facing surface seating against the acetabulum socket. The annular extending flange of the body may also constructed of a softer grade material than either the stem and ball to assist in shaping and form fitting about an exposed reconditioned surface of the upper femur.
A plurality of outwardly projecting posts integrally formed with an exposed surface of the support are dimensioned to seat within apertures defined in the reconditioned acetabulum socket. A plurality of anchors are installed within the apertures in an undercut engaging manner defined within the acetabulum socket, the posts extending from the support and seating within the apertures. The anchors can further be recess fitted within holes formed in the ilium bone and in an undercut engaging fashion.
Other features include an overlap configuration established between an end extending rim of the support and inner seating ball which is located posterior to the maximum width/diameter dimension of the ball. In this fashion, the ball is retained in seating fashion within the outer affixed and recess configuring support, while concurrently permitting a maximum possible degree of universal movement of said ball relative to said support without causing the rim edge to come into contact with the flange defining the boundary between the insertable stem and ball.
An outwardly displaceable anchor is further defined within the stem is actuated by a rotatable input to screw surface mounted in said annular flange. A series of interior and interconnected linkages are incorporated into the stem of the body and transfer a rotatable input applied to the annular flange located and surface exposed screw to outwardly displace the anchor into biasing contact with the interior of the femur, causing the flange to be drawn tight against the reconditioned surface of the femur. A subset variant also includes the one piece ball and supporting stem reconfigured as a pair of threadably engageable components, such that the ball includes an externally threaded shaft end which is threadably engaged with an inner threaded surface associated with a mating interior passageway of the stem and in proximity to the annular flange.
Yet additional features include a plurality of outwardly projecting posts with enlarged dimensioned ends mounted to the reconditioned acetabulum and resistively fitting within internal anchors configured within an increased dimensioned base of the support. In another variant, a first plurality of radial positioned posts with button projections is mounted to the reconditioned acetabulum, a matching plurality of recessed slots being configured upon the mounting surface of the support and including enlarged and perimeter defined inserting portions at an initial locating and inserting position. The outer socket support and ball are subsequently twist locked an incremental angular direction within the slots so that the button projections are caused to resistively seat within reduced dimensioned portions associated with each of the recess defined slots.
In another variant, a plurality of displaceable anchors are located in spaced fashion about an outermost periphery of the support and which are seated in linearly projecting fashion through perimeter spaced internal apertures defined in spaced apart fashion about the periphery of the support. Each the anchors include enlarged resistance engaging end which are linearly displaced into and in resistive engaging contact with previously defined undercut recesses formed about a corresponding perimeter of the acetabulum socket.
A yet further variant includes a plurality of circumferentially spaced and outwardly displaceable tabs disposed about a width periphery of the support and seated within associated recesses formed in the support. The tabs are outwardly displacing and downwardly rotating in successive motions and in order to overlay surrounding and spaced surface locations of the ilium bone in a precise and fit-adjustment fashion. A plurality of anchors are incorporated into the tabs and engage the bone. A like plurality of tab locking pins are mounted to the support at peripheral locations aligning with the tabs and which are downwardly displaced to fix the tabs at their extended and rotated positions concurrent with them being anchored in place to the ilium bone.
An associated installation kit for assisting the preparation of the femur and ilium bones defining the hip joint, as well as the installation of the implant body into the upper conditioned femur end and the outer socket support to a reconditioned acetabulum defined in the ilium bone, includes a saw for removing a damaged bulbous shaped head associated with the femur and in order to reveal a generally annular shaped receiving face which communicates an interior extending passageway. A hand held grinder exhibiting a hemispherical shaped and rotatably driven grinder bit reshapes the acetabulum socket to match a mounting surface associated with the outer socket support.
A drill fixture template is mounted to the ilium bone and overlays the reconditioned acetabulum, the template including a plurality of apertures arranged in a desired pattern array. A drill is insertable in succession into through each of the apertures defined in the template and in order to create an initial hole within the acetabulum. A subsequent undercut pattern is formed within a recessed side wall location of the hole, such as made possible by undercut engaging lateral blade portions associated with the drill.
A plurality of posts secure to either of said holes in the acetabulum or to the mounting surface of the outer socket support and in order to engaging the outer socket to the reconditioned acetabulum. In one embodiment, the posts project linearly from the outer socket support mounting surface and are resistively engaged within deformable anchors pre-fitted into the undercut machined holes in the ilium bone in communicating fashion with the acetabulum.
Additional features of the installation kit include the hemispherical shaped grinder bit of the hand held grinder further exhibiting a plurality of individual incising blade portions arranged in a longitudinal arrayed pattern. A three dimensional open interior created within a tool head of the grinder between a base and the hemispherical bit providing for collection of bone shavings and debris, these vacuum removed for storage within a waste chamber located in a rear handle.
The drill template further exhibits edge extending engagement tabs temporarily mounted to specified surface locations of the ilium bone. The drill further exhibits a fluted exterior configured and elongated bit, a secondary shaft extending linearly within a recess within the elongated bit and which is actuated via gear drive components built into a base of the bit to linearly elevate the shaft into engagement with a pair of progressively outward laterally and displaceable undercut machining bits seated within lateral passageways defined in the bit. Also provided are a plurality of recess anchors constructed of a durable and flexible/expandable plastic and which are sized so as to be installed within a previously formed drill hole with undercut profile.
Reference will now be made to the attached drawings, when read in combination with the following detailed description, wherein like reference numerals refer to like parts throughout throughout the several views, and in which:
The present invention teaches a self-contained and replaceable articulating hip utilized in a hip arthroplasty procedure. The ball, socket/receiver and associated stem components can be constructed of any type of plastic, metal or admixture according to any desired ration or percentage. As will be also described, the implant components can be provided with varying hardness/softness to maximize both comfort and wear, and it is further understood that the present assembly provides for a maximum degree of implant efficiency, universality in use and degree of comfort to the patient.
As supplemented by the lengthwise cutaway view of
A generally spherical or ball shaped head 14 is integrally formed with the stem 12 and, as shown, is separated by an interposed and annular surface exposed rim 16 which defines an installation limit of the stem 12 within the conditioned and passageway defined bone interior. The generally lengthwise cutaway illustration of the assembly further illustrates a plurality of entrapped lubricant defined passageways, at 18 and which are established at the interface between the inner ball 14 and a three dimensional shaped and interior volume defining outer support 20, which is in turn anchored within the acetabulum defined socket interior (see at 6 in
As further shown in
It is further understood that the annular extending flange 16 can be constructed of a softer grade plastic or other material as compared to either or both the stem 12 or ball 14, this assisting in more easily shaping and form fitting of the flange 16 about the exposed reconditioned surface of the upper femur 2. As shown in
Also shown at 23 are a plurality of forward projecting posts (with a larger selected post shown at 23′) and which are integrally formed with the exposed and seating outer surface of the support 20. As will be described in subsequent detail, the posts 23 are provided to facilitate anchoring of the outer fixed support 20 within the reconditioned acetabulum socket 6.
Further illustrated at 24 is a spaced dimension corresponding to an overlap configuration or dimension established between an end extending rim 26 of the affixed outer support 20 and the and any location of the inner seating ball 14 which is located posterior to the maximum width/diameter dimension of the ball, this in order to retain the ball in seating fashion within the outer affixed and recess configuring support 20, while at the same time permitting a maximum possible degree of universal movement of the ball 14 relative to the anchored support 20 without causing the rim edge 26 to come into contact with the annular exposed surface rim 16 defining the boundary between the insertable stem 12 and the exposed ball 14.
As further illustrated in both
The actuation linkage demonstrated is intended to show only one of a number of potentially varying mechanisms for outwardly displacing an anchor for providing an additional degree of fixed support to the stem, this in addition to either or both the use of adhesives and/or the notching or inner end coring of the stem in order to promote the natural growth of bone marrow. It is further understood that various combinations of some or all of these implant retaining features can be utilized in order to secure the implant assembly in place upon the reconditioned bone end and concurrent with
Referring now to
As is further illustrated, the hemispherical shaped grinder bit 46 exhibits a plurality of individual incising blade portions 48 which are arranged in a longitudinal arrayed pattern. Upon being placed over the acetabulum socket 6 of the ilium bone 8, this again being defined in the lateral base of the ilium and between the pubis and ischium branches, the grinder 42 is activated in order to progressively shave bone from the acetabulum 6, causing its socket profile to eventual match the exterior profile of the hemispherical bit 46. A three dimensional open interior is created within the tool head between the base 46 and attached hemispherical bit 48 and provides for collection of bone shavings and debris, these subsequently being vacuum removed from the grinding head for storage within such as a waste chamber located in a rear handle or other portion of the grinder 42 for subsequent emptying.
An objective of the hole pattern formed through the use of the template 50 and the drill such as shown at 56 is the eventual engagement of anchors or posts (as will be further described in reference to the related variants of
To this end,
Following completion of the initial drill hole within the ilium bone interior (and as dictated by the placement of apertures within the disk template 50), a secondary and interior shaft, at 62, is seated within a linear passageway defined in said bit 58 and is actuated to linearly/outwardly displace such as via gear drive components 64 built into a base housing 66 and which coact with a suitable mating teethed or other desirable pattern formed in a base of the inner displaceable shaft 62. A pair of laterally displaceable undercut defining bits 68 and 70 each exhibit an underside taper, see at 72 and 74 in
Given the precise and in situ nature of the bone machining process, it is further desirable to provide both the initial drill hole and secondary undercut hole using the same tool and in a quickly succeeding nature, with the undercut being located at any internal position of the initial drill hole in order to correspond to the configuration of any subsequently installed retaining post or anchor. That said, it is also envisioned and understood that the feature of the undercut formation can be provided by a separate drill bit with spring out portions such as described above or the like, and which may be inserted within a template defined aperture following completion of the primary drill hole by a more conventionally configured bit.
Referring now to
As is further shown in
Proceeding to
The larger/longer illustrated post illustrated at 23′ (as compared to additional smaller sized posts 23) extending from the forward seating face of the outer socket support 20 is shown configured with a unique shape (e.g. such as being longer or differently shaped) and an associated undercut hole and anchor can be likewise configured in mating fashion. By keying the post 23′ to a selected anchor 78, incorrect attachment of the socket is avoided. Additional variants also contemplate the socket exhibiting any number or configuration of posts and/or anchors.
Also not shown but understood to be provided is any arrangement of ligament or connective structure between the outer socket support 20 and the reformed acetabulum socket. Such can include the posts 23 and 23′ being reconfigured to resistively fit or otherwise engage within the undercut formed profile associated with each drill aperture. It is also understood and envisioned that any type of naturally forming and/or artificial ligament structure can be provided (not shown), such as replicating the traditional five types of ligaments of which four are extracapsular (iliofemoral, ischiofemoral and pubofemoral (2)) and one intracapsular (liagmentum teres). Also not shown but understood to be present both in the presently disclosed structure and succeeding description of the associated arthroplasty procedure are the features of reconstructed vein, nerve and muscle connections, these borrowing from both existing and novel techniques and procedures for creating an effective and durable artificial hip implant.
Referring now to
Referring now to
Finally, and referring to
Although not shown, it is understood that any of the preceded described forming processes can be employed in order to drill form receiving, including undercut, recesses such as spot located within the ilium bone in a simultaneous/concurrent fashion. A final installation step includes the provision of associated tab locking pins 140 designed into the architecture of the housing support 128 and at peripheral locations aligning with the tabs 130 in their fully extended position of
Having provided a detailed description of the working components of the hip installation assembly according to the several variants, a description will now be made of the associated procedure for placement, in situ with the patient, of the self-contained articulating total hip arthroplasty device which is self lubricating, and totally constrained, thereby preventing the occurrence of undesirable dislocations.
As is known, standard exposure for total hip arthroplasty via anterior, anterolateral, poster approaches include soft tissue dissections and corresponding arthrotomies. Acetabular (ilium socket) preparation through acetabular reamers (e.g. rotary drill of
The placement of the reconditioned acetabular shell (socket) is such that it is located at a customary articulating position of anteversion and horizontal inclination per the host (patient) anatomy. Fixation pegs for the acetabular anchoring devices are created through drilling into the acetubular bone stock (
The femoral (upper thigh bone) preparation created in a standard femoral neck osteotomy procedure includes adequately defining the entrance into the intramedullary canal of the femur (
The device is then inserted into the femoral canal (
The total articulating device, now entered into the femoral canal to a full seated position is then inserted with pegs/pins/screw fixation and the like into the acetabular component where it is engaged. As described in reference again to
Also previously described, the ball and socket articulating device can be constructed of a metal, plastic or any admixture or inter-percentage defined composite to provide any of a range of desired material properties. The femoral inserted and supporting stem can also be manufactured to exhibit either of a cemented or non-cemented macro or micro texture to allow bone fixation or growth (again exhibited by the interior configuration associated with the stem in
The acetabular component may also be constructed of a bone in-growth promoting macro or micro texture and which may also exhibit shock absorbing layers of polymers and/or plastics to prevent shock absorbing affect to the acetabulum and to prevent the incidence of stress transmission to the interfaces of the acetabulor or femoral implant. The phalange of the neck of the femoral prosthesis may also exhibit a softer material than either metals or ceramics to thereby allow shock absorbing affect with the interface of the femoral component.
The femoral stem itself may be made of metal or plastic and, as previously described, the integrally formed or separably attachable acetabular component may be combinations of metal, plastic and polymers. It is also envisioned that the articulation of the head relative to the receiving socket (again
Having described my invention, other and additional preferred embodiments will become apparent to those skilled in the art to which it pertains, and without deviating from the scope of the appended claims.
This Application is a divisional of application Ser. No. 12/649,456 filed on Dec. 30, 2009.
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Number | Date | Country | |
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Child | 13289132 | US |