Various embodiments disclosed herein are directed to structure for attachment to body anatomy, and more particularly, towards approaches for providing mounting members for extra-articular implantable mechanical energy absorbing systems.
Joint replacement is one of the most common and successful operations in modern orthopaedic surgery. It consists of replacing painful, arthritic, worn or diseased parts of a joint with artificial surfaces shaped in such a way as to allow joint movement. Osteoarthritis is a common diagnosis leading to joint replacement. Such procedures are a last resort treatment as they are highly invasive and require substantial periods of recovery. Total joint replacement, also known as total joint arthroplasty, is a procedure in which all articular surfaces at a joint are replaced. This contrasts with hemiarthroplasty (half arthroplasty) in which only one bone's articular surface at a joint is replaced and unincompartmental arthroplasty in which the articular surfaces of only one of multiple compartments at a joint (such as the surfaces of the thigh and shin bones on just the inner side or just the outer side at the knee) are replaced. Arthroplasty as a general term, is an orthopaedic procedure which surgically alters the natural joint in some way. This includes procedures in which the arthritic or dysfunctional joint surface is replaced with something else, procedures which are undertaken to reshape or realigning the joint by osteotomy or some other procedure. As with joint replacement, these other arthroplasty procedures are also characterized by relatively long recovery times and their highly invasive procedures. A previously popular form of arthroplasty was interpositional arthroplasty in which the joint was surgically altered by insertion of some other tissue like skin, muscle or tendon within the articular space to keep inflammatory surfaces apart. Another previously done arthroplasty was excisional arthroplasty in which articular surfaces were removed leaving scar tissue to fill in the gap. Among other types of arthroplasty are resection(al) arthroplasty, resurfacing arthroplasty, mold arthroplasty, cup arthroplasty, silicone replacement arthroplasty, and osteotomy to affect joint alignment or restore or modify joint congruity. When it is successful, arthroplasty results in new joint surfaces which serve the same function in the joint as did the surfaces that were removed. Any chodrocytes (cells that control the creation and maintenance of articular joint surfaces), however, are either removed as part of the arthroplasty, or left to contend with the resulting joint anatomy. Because of this, none of these currently available therapies are chondro-protective.
A widely-applied type of osteotomy is one in which bones are surgically cut to improve alignment. A misalignment due to injury or disease in a joint relative to the direction of load can result in an imbalance of forces and pain in the affected joint. The goal of osteotomy is to surgically re-align the bones at a joint and thereby relieve pain by equalizing forces across the joint. This can also increase the lifespan of the joint. When addressing osteoarthritis in the knee joint, this procedure involves surgical re-alignment of the joint by cutting and reattaching part of one of the bones at the knee to change the joint alignment, and this procedure is often used in younger, more active or heavier patients. Most often, high tibial osteotomy (HTO) (the surgical re-alignment of the upper end of the shin bone (tibia) to address knee malalignment) is the osteotomy procedure done to address osteoarthritis and it often results in a decrease in pain and improved function. However, HTO does not address ligamentous instability—only mechanical alignment. HTO is associated with good early results, but results deteriorate over time.
Other approaches to treating osteoarthritis involve an analysis of loads which exist at a joint. Both cartilage and bone are living tissues that respond and adapt to the loads they experience. Within a nominal range of loading, bone and cartilage remain healthy and viable. If the load falls below the nominal range for extended periods of time, bone and cartilage can become softer and weaker (atrophy). If the load rises above the nominal level for extended periods of time, bone can become stiffer and stronger (hypertrophy). Finally, if the load rises too high, then abrupt failure of bone, cartilage and other tissues can result. Accordingly, it has been concluded that the treatment of osteoarthritis and other bone and cartilage conditions is severely hampered when a surgeon is not able to precisely control and prescribe the levels of joint load. Furthermore, bone healing research has shown that some mechanical stimulation can enhance the healing response and it is likely that the optimum regime for a cartilage/bone graft or construct will involve different levels of load over time, e.g. during a particular treatment schedule. Thus, there is a need for devices which facilitate the control of load on a joint undergoing treatment or therapy, to thereby enable use of the joint within a healthy loading zone.
Certain other approaches to treating osteoarthritis contemplate external devices such as braces or fixators which attempt to control the motion of the bones at a joint or apply cross-loads at a joint to shift load from one side of the joint to the other. A number of these approaches have had some success in alleviating pain but have ultimately been unsuccessful due to lack of patient compliance or the inability of the devices to facilitate and support the natural motion and function of the diseased joint. The loads acting at any given joint and the motions of the bones at that joint are unique to the body that the joint is a part of. For this reason, any proposed treatment based on those loads and motions must account for this variability to be universally successful. The mechanical approaches to treating osteoarthritis have not taken this into account and have consequently had limited success.
Prior approaches to treating osteoarthritis have also failed to account for all of the basic functions of the various structures of a joint in combination with its unique movement. In addition to addressing the loads and motions at a joint, an ultimately successful approach must also acknowledge the dampening and energy absorption functions of the anatomy, and be implantable via a minimally invasive technique. Prior devices designed to reduce the load transferred by the natural joint typically incorporate relatively rigid constructs that are incompressible. Mechanical energy (E) is the action of a force (F) through a distance (s) (i.e., E=Fxs). Device constructs which are relatively rigid do not allow substantial energy storage as the forces acting on them do not produce substantial deformations—do not act through substantial distances—within them. For these relatively rigid constructs, energy is transferred rather than stored or absorbed relative to a joint. By contrast, the natural joint is a construct comprised of elements of different compliance characteristics such as bone, cartilage, synovial fluid, muscles, tendons, ligaments, etc. as described above. These dynamic elements include relatively compliant ones (ligaments, tendons, fluid, cartilage) which allow for substantial energy absorption and storage, and relatively stiffer ones (bone) that allow for efficient energy transfer. The cartilage in a joint compresses under applied force and the resultant force displacement product represents the energy absorbed by cartilage. The fluid content of cartilage also acts to stiffen its response to load applied quickly and dampen its response to loads applied slowly. In this way, cartilage acts to absorb and store, as well as to dissipate energy.
With the foregoing applications in mind, it has been found to be necessary to develop effective structure for mounting to body anatomy. Such structure should conform to body anatomy and cooperate with body anatomy to achieve desired load reduction, energy absorption, energy storage, and energy transfer. The structure should also provide a base for attachment of complementary structure across articulating joints.
For these implant structures to function optimally, they must not cause a disturbance to apposing tissue in the body, nor should their function be affected by anatomical tissue and structures impinging on them. Moreover, there is a need to reliably and durably transfer loads across members defining a joint. Such transfer can only be accomplished where the base structure is securely affixed to anatomy. Therefore, what is needed is an approach which addresses both joint movement and varying loads as well as complements underlying anatomy and provides an effective base for connecting an implantable extra-articular assembly.
Briefly, and in general terms, the disclosure is directed to base components that are mountable to a bone and may be used for cooperation with an implantable extra-articular system. In one approach, the base components facilitate mounting an extra-articular implantable link or mechanical energy absorbing system.
According to one embodiment, the base components of the link or energy absorbing system are contoured to the bone surfaces of the femur and tibia and are secured with bone screws on the medial cortices of the femur and the tibia. The bases can also be attached to lateral sides of the bones of a knee joint or on either side of members defining other joints. The base components are also designed to preserve the articulating joint and capsular structures of the knee. Accordingly, various knee procedures, including uni-compartmental and total joint replacement, may be subsequently performed without requiring removal of the base components.
In one specific embodiment, the base component includes a body having an inner surface that is contoured to mate with a bone surface. The inner surface contacts the bone surface and may be porous, roughened or etched to promote osteointegration. The inner surface can be coated with an osteointegration composition. Optionally, or additionally, the base component is secured to a bone surface with a plurality of fastening members. The base component is also shaped to avoid and preserve structures of the knee. Moreover, the base component is configured to locate a mounting member on the bone in order to position a kinematic load absorber for optimal reduction of forces on a joint. The base component is a rigid structure that may be made from titanium, cobalt chrome, or polyetheretherketones (PEEK). In an alternate approach, the base can be formed at least partially from flexible material.
It is contemplated that the base component includes a low-profile body having an elongate, straight portion at a first end portion and a curved body portion at a second end portion. The second end portion is elevated as compared to the first end portion and occupies a plane displaced from the first end. An inner surface of the low-profile body has a raised portion extending along the elongate, straight portion of the body. The base component also includes a plurality of openings positioned along the elongate portion of the body. Additionally, the body can include two openings positioned side-by-side on the curved portion thereof.
According to another embodiment, the base component is a generally curved body having a first end, a second end, an outer surface, and an inner surface. The curved body is non-planar such that the second end of the body is elevated as compared to the first end of the body. In an application relating to treating a knee joint, the inner surface of the body includes a raised portion that is contoured to the medial surface of the femur above the medial epicondyle. The body also includes a plurality of openings, wherein two openings are positioned side-by-side near the second end. Additionally, the openings provide differing trajectories for receiving fastening members.
In one particular approach, the disclosed base has an osteointegration surface area greater than 39 mm2. More specifically, a femoral base component can embody a surface area of 971 mm2 and a tibial component can have a surface area of approximately 886 mm2. The bases can further be coated with a titanium plasma spray having a thickness of 0.033 inches plus or minus 0.005 inches. Alternatively, an hydroxyapatite plasma spray resulting in a 35 μm plus or minus 10 μm thickness is contemplated.
Moreover, it is contemplated that various sized bases be made available. In that regard, due to expected variability in anatomy, up to five or more femoral base sizes and two or more tibial base sizes can be available to a physician.
The bases can be configured so that relative motion between a base component and a mating bone is less than 150 microns. For certain applications, the durability of the base to bone connection as well as material should be such that the structure can withstand five million cycles of functional loading.
Other features and advantages will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, which illustrate by way of example, the features of the various embodiments.
Various embodiments are disclosed which are directed to base components for attachment to body anatomy. In a preferred approach, femoral and tibial base components are provided for attachment to extra-articular implantable link or mechanical energy absorbing systems.
In a specific embodiment, the femoral and tibial base components are contoured to the medial surfaces of the femur and tibia, respectively. The base components have a low-profile design and contoured surfaces thereby minimizing the profile of the base components when mounted to the bone surface and enabling atraumatic soft tissue motions over the bone components. The base component is secured to a bone surface with one or more fastening members. Optionally, or additionally, the inner surface of the base components may be modified to promote osteointegration of the base component into bone. Osteointegration is a process of bone growth onto and about an implanted device that results in integrating the implant to the bone, thereby facilitating the transfer of load and stress from the implant directly to the bone. After osteointegration, fasteners used to initially attach the base component to bone no longer are needed to carry the load and stress from the implant.
The base component can be configured to be an anchor for the extra-articular implantable link or mechanical energy absorbing system used to reduce forces on the knee or other joints (e.g., finger, toe, elbow). The base component can be also designed to distribute loads onto the bone from an extra-articular implantable link or mechanical energy absorbing system while avoiding articulating joint and capsular structures.
Various shapes of bases are contemplated and described. Moreover, it is contemplated that various sized and similar shaped bases be made available to a physician so that a proper fit to variably sized and shaped bones can be accomplished. In that regard, it is contemplated that up to five or more different femoral bases and two or more different tibial bases can be available to a physician.
The base components disclosed herein are structures that are different and distinct from bone plates. As defined by the American Academy of Orthopedic Surgeons, bone plates are internal splints that hold fractured ends of bone together. In contrast, the base components disclosed herein are designed to couple to and transfer loads from a link of an implanted extra-articular system to the bones of the joint. Furthermore, the loading conditions of a bone plate system are directly proportional to the physiological loads of the bone it is attached to, by contrast the loading conditions of a base is not directly proportional to the physiological loading conditions of the bone but is directly proportional to the loading conditions of the link to which it is coupled. In various embodiments, the base component is configured to transfer the load through a combination of the fastening members used to secure the base component to the bone and/or one or more osteointegration areas on the base component.
Further, previous approaches and studies on osteointegration surfaces have not considered cyclic loading. Thus, the approaches to the bases disclosed herein address needs in this area and in particular, provides an approach which achieves extra-cortical boney in-growth under cyclic loading. In certain disclosed applications, a shear strength of about 3 MPa or more can be expected.
Referring now to the drawings, wherein like reference numerals denote like or corresponding parts throughout the drawings and, more particularly to
Turning now to
It is contemplated that the inner surface of the base component 1 be contoured to directly contact the bone surface. The inner surface may be curved in an anterior to posterior direction as well as superior to inferior directions. According to one embodiment, the inner surface includes one or more compositions that induce osteointegration to the cortex of long bones in the body. The inner surface represents the base component 1 to bone surface area required to support expected shear forces resulting from 40 lbs. of load carrying. Alternatively, the inner surface 5 is roughened or etched to improve osteointegration.
The surface area of the osteointegration area is proportional to the forces being carried at a joint by the extra-articular mechanical energy absorbing system. For example, the surface area of the inner surface is at least 39 mm2 for a secure fixation to the femur and in order to carry 40 pounds in 4 mm of compression of a kinematic load absorber. A safety factor may be built into base component as larger surfaces may be used in other embodiments. For example, a femoral base component can include an osteointegration surface area of approximately 971 mm2. Alternatively, a tibial base component includes an osteointegration surface area of approximately 886 mm2.
In certain embodiments, the load transferred from the absorber to the base component can change over time. For example, when the base component is initially fixed to the bone, the fastening members carry all the load. Over time, as the base component osteointegrates with the underlying bone, both the fastening members and the osteointegrated surface carry the load from the implanted system. Once the base component is completely osteointegrated with the underlying bone, the osteointegration area carries most (if not all) the load. Due to the same, the energy absorbing system may be configured in an inactive state, only later activating the device once sufficient osteointegration has occurred.
Alternatively, the implant may be intended for temporary use and so removability of the components is important. In these instances boney in-growth is not desirable. To prevent boney in-growth no porous coating is applied and alternative surface geometry and/or material may be used that does not encourage bone growth, additionally the fasteners are designed to carry 100% of link loads for duration of implantation.
The base component also includes a plurality of openings 7 that are sized to receive fastening members used to permanently secure the base component to the bone. The openings 7 define through-holes that may receive fastening members such as compression screws and/or locking screws. As shown in
As shown in
Turning now to
As shown in
Additionally, two openings 22, 24 are provided on the curved portion 14 of the body. The openings 22, 24 are positioned such that fastening members inserted there through (as shown in
Additionally, the openings 20, 21, 22, 24 can be oriented to provide fastening member trajectories that maximize pull out forces thereby minimizing the possibility that the base component is separated from the bone. According to one embodiment, the trajectories of the openings are oriented such that the opening trajectories are normal or approximately normal to the shear loading forces on the base component 10. For example, the two openings 22, 24 on the curved portion 14 of the body have differing fastening member trajectories as the posterior opening 22 orients a fastening member at a downward trajectory (See
The openings 20, 21, 22, 24 can be countersunk to allow the fastening members to sit below the surface of the base body as shown in
In a preferred embodiment, two openings 20 on the elongated portion of the base component 10 are sized and threaded to accommodate 3.5 mm bicortical compression screws. The most inferior opening 21 on the elongated portion of the base component is sized to accommodate a 6.5 mm unicortical compression screw. The openings 22, 24 on the curved portion 14 of the body are sized and threaded to accommodate 4.5 mm locking screws.
While screws are used to fix the base component 10 to the bone, those skilled in the art will appreciate that any fastening members known or previously developed may be used to secure a base component to a bone. For example, in other embodiments, a fastening device similar to a moly bolt or a toggle bolt is used to secure the base component to a bone. Additionally,
Referring back to
As shown in
Additionally, as best seen in
Additionally, as shown in
With reference to
The base component 10 shown in
A presently preferred embodiment of base component 60 that is mountable to the medial surface of the tibia is depicted in
As shown in
Additionally, the openings 70, 72, 74 are oriented to provide differing trajectories for fastening members that maximize pull forces thereby minimizing the possibility that the base component 60 is separated from the bone. According to one embodiment, the opening trajectories are oriented such that the hole trajectories are normal or approximately normal to the shear loading forces on the base component 10. For example, as shown in
The openings 70, 72, 74 can be countersunk to allow the heads of fastening members to sit below the surface of the body as shown in
While screws are used to fix the femoral and tibial base components 10, 60 to the bone, those skilled in the art will appreciate that any fastening members known or developed in the art may be used to accomplish desired affixation. Although the base components 10, 60 depicted in
As shown in
With reference to
The tibial base component 60 shown in
The various embodiments of the base component may be made from a wide range of materials. According to one embodiment, the base components are made from metals and alloys such as, but not limited to, Titanium, stainless steel, Cobalt Chrome. Alternatively, the base components are made from thermo-plastic materials such as, but not limited to, polyetheretherketones (PEEK). Various embodiments of the base components are rigid structures.
Various other embodiments of bases are contemplated. Such bases can incorporate one or more of the previously described features or can embody structure separate to itself.
In particular, as shown in
Moreover, a base 136 can be configured to attach to cortical bone as shown in
In yet other approaches, the base component can include structure which relies on surrounding anatomy for additional support. For example, as shown in
Similarly, as depicted in
Turning now to
Finally, as shown in
The various embodiments described above are provided by way of illustration only and should not be construed to limit the claimed invention. Those skilled in the art will readily recognize various modifications and changes that may be made to the claimed invention without following the example embodiments and applications illustrated and described herein, and without departing from the true spirit and scope of the claimed invention, which is set forth in the following claims. In that regard, various features from certain of the disclosed embodiments can be incorporated into other of the disclosed embodiments to provide desired structure.
This application is a continuation-in-part of U.S. application Ser. No. 11/743,097, filed May 1, 2007, a continuation-in-part of U.S. application Ser. No. 11/743,605, filed May 2, 2007, a continuation-in-part of U.S. Application Ser. No. 11/775,139, filed Jul. 9, 2007, now U.S. Pat. No. 7,611,540, a continuation-in-part of U.S. Application Ser. No. 11/775,149, filed Jul. 9, 2007, now U.S. Pat. No. 7,655,041, and a continuation-in-part of U.S. application Ser. No. 11/775,145, filed Jul. 9, 2007, now U.S. Pat. No. 7,678,147, the entire disclosures of which are expressly incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
2632440 | Hauser | Mar 1953 | A |
2877033 | Koetke | Mar 1959 | A |
3242922 | Thomas | Mar 1966 | A |
3407409 | Prahl | Oct 1968 | A |
3648294 | Shahrestani | Mar 1972 | A |
3681786 | Lynch | Aug 1972 | A |
3779654 | Horne | Dec 1973 | A |
3875594 | Swanson | Apr 1975 | A |
3902482 | Taylor | Sep 1975 | A |
3988783 | Treace | Nov 1976 | A |
3990116 | Fixel et al. | Nov 1976 | A |
4187841 | Knutson | Feb 1980 | A |
4246660 | Wevers | Jan 1981 | A |
4308863 | Fischer | Jan 1982 | A |
4353361 | Foster | Oct 1982 | A |
4501266 | McDaniel | Feb 1985 | A |
4570625 | Harris | Feb 1986 | A |
4576158 | Boland | Mar 1986 | A |
4621627 | DeBastiani et al. | Nov 1986 | A |
4637382 | Walker | Jan 1987 | A |
4696293 | Ciullo | Sep 1987 | A |
4759765 | Van Kampen | Jul 1988 | A |
4769011 | Swaniger | Sep 1988 | A |
4776851 | Bruchman et al. | Oct 1988 | A |
4846842 | Connolly et al. | Jul 1989 | A |
4851005 | Hunt et al. | Jul 1989 | A |
4863475 | Andersen et al. | Sep 1989 | A |
4871367 | Christensen et al. | Oct 1989 | A |
4923471 | Morgan | May 1990 | A |
4942875 | Hlavacek et al. | Jul 1990 | A |
4959065 | Arnett et al. | Sep 1990 | A |
4988349 | Pennig | Jan 1991 | A |
5002574 | May et al. | Mar 1991 | A |
5011497 | Persson et al. | Apr 1991 | A |
5019077 | De Bastiani et al. | May 1991 | A |
5026372 | Sturtzkopf et al. | Jun 1991 | A |
5041112 | Mingozzi et al. | Aug 1991 | A |
5100403 | Hotchkiss et al. | Mar 1992 | A |
5103811 | Crupi | Apr 1992 | A |
5121742 | Engen | Jun 1992 | A |
5152280 | Danieli | Oct 1992 | A |
5234435 | Seagrave, Jr. | Aug 1993 | A |
5316546 | Lindh et al. | May 1994 | A |
5318567 | Vichard | Jun 1994 | A |
5352190 | Fischer | Oct 1994 | A |
5375823 | Navas | Dec 1994 | A |
5405347 | Lee et al. | Apr 1995 | A |
5415661 | Holmes | May 1995 | A |
5540688 | Navas | Jul 1996 | A |
5575819 | Amis | Nov 1996 | A |
5578038 | Slocum | Nov 1996 | A |
5601553 | Trebing et al. | Feb 1997 | A |
5624440 | Huebner | Apr 1997 | A |
5662648 | Faccioli et al. | Sep 1997 | A |
5662650 | Bailey et al. | Sep 1997 | A |
5681313 | Diez | Oct 1997 | A |
5695496 | Orsak et al. | Dec 1997 | A |
5716357 | Rogozinski | Feb 1998 | A |
5803924 | Oni et al. | Sep 1998 | A |
5873843 | Draper | Feb 1999 | A |
5928234 | Manspeizer | Jul 1999 | A |
5976125 | Graham | Nov 1999 | A |
5976136 | Bailey et al. | Nov 1999 | A |
5993449 | Schlapfer | Nov 1999 | A |
5993486 | Tomatsu | Nov 1999 | A |
6036691 | Richardson | Mar 2000 | A |
6113637 | Gill et al. | Sep 2000 | A |
6139550 | Michelson | Oct 2000 | A |
6162223 | Orsak et al. | Dec 2000 | A |
6176860 | Howard | Jan 2001 | B1 |
6197030 | Pham | Mar 2001 | B1 |
6264696 | Reigner et al. | Jul 2001 | B1 |
6277124 | Haag | Aug 2001 | B1 |
6315852 | Magrini et al. | Nov 2001 | B1 |
6355037 | Crosslin et al. | Mar 2002 | B1 |
6364881 | Apgar et al. | Apr 2002 | B1 |
6409729 | Martinelli et al. | Jun 2002 | B1 |
6482232 | Boucher et al. | Nov 2002 | B1 |
6494914 | Brown et al. | Dec 2002 | B2 |
6527733 | Ceriani et al. | Mar 2003 | B1 |
6540708 | Manspeizer | Apr 2003 | B1 |
6572653 | Simonson | Jun 2003 | B1 |
6599322 | Amrich et al. | Jul 2003 | B1 |
6620332 | Amrich | Sep 2003 | B2 |
6623486 | Weaver et al. | Sep 2003 | B1 |
6663631 | Kuntz | Dec 2003 | B2 |
6679921 | Grubbs | Jan 2004 | B2 |
6692497 | Tormala et al. | Feb 2004 | B1 |
6692498 | Niiranen et al. | Feb 2004 | B1 |
6752831 | Sybert et al. | Jun 2004 | B2 |
6884242 | LeHuec et al. | Apr 2005 | B2 |
6966910 | Ritland | Nov 2005 | B2 |
6972020 | Grayson et al. | Dec 2005 | B1 |
6997940 | Bonutti | Feb 2006 | B2 |
7018418 | Amrich et al. | Mar 2006 | B2 |
7029475 | Pajabi | Apr 2006 | B2 |
7128744 | Weaver et al. | Oct 2006 | B2 |
7141073 | May et al. | Nov 2006 | B2 |
7188626 | Foley et al. | Mar 2007 | B2 |
7201728 | Sterling | Apr 2007 | B2 |
7235077 | Wang et al. | Jun 2007 | B1 |
7235102 | Ferree et al. | Jun 2007 | B2 |
7238203 | Bagga et al. | Jul 2007 | B2 |
7241298 | Nemec et al. | Jul 2007 | B2 |
7247157 | Prager et al. | Jul 2007 | B2 |
7252670 | Morrison et al. | Aug 2007 | B2 |
7261739 | Ralph et al. | Aug 2007 | B2 |
7273481 | Lombardo et al. | Sep 2007 | B2 |
7276070 | Muckter | Oct 2007 | B2 |
7282065 | Kirschman | Oct 2007 | B2 |
7285134 | Berry et al. | Oct 2007 | B2 |
7288094 | Lindemann et al. | Oct 2007 | B2 |
7288095 | Baynham et al. | Oct 2007 | B2 |
7291150 | Graf | Nov 2007 | B2 |
7306605 | Ross | Dec 2007 | B2 |
7322983 | Harris | Jan 2008 | B2 |
7322984 | Doubler et al. | Jan 2008 | B2 |
7341589 | Weaver et al. | Mar 2008 | B2 |
7361196 | Fallin et al. | Apr 2008 | B2 |
20010020143 | Stark et al. | Sep 2001 | A1 |
20020095154 | Atkinson et al. | Jul 2002 | A1 |
20020151978 | Zacouto et al. | Oct 2002 | A1 |
20030216809 | Ferguson | Nov 2003 | A1 |
20040102776 | Huebner | May 2004 | A1 |
20040260302 | Manspeizer | Dec 2004 | A1 |
20040267179 | Leman | Dec 2004 | A1 |
20050049708 | Atkinson et al. | Mar 2005 | A1 |
20050085815 | Harms et al. | Apr 2005 | A1 |
20050119744 | Buskirk et al. | Jun 2005 | A1 |
20050154390 | Biedermann et al. | Jul 2005 | A1 |
20050192674 | Ferree | Sep 2005 | A1 |
20050251260 | Gerber et al. | Nov 2005 | A1 |
20050261680 | Draper | Nov 2005 | A1 |
20060064169 | Ferree | Mar 2006 | A1 |
20060085001 | Michelson | Apr 2006 | A1 |
20060167559 | Johnstone et al. | Jul 2006 | A1 |
20060178744 | de Villiers et al. | Aug 2006 | A1 |
20060247637 | Colleran et al. | Nov 2006 | A1 |
20070043356 | Timm et al. | Feb 2007 | A1 |
20070053963 | Hotchkiss et al. | Mar 2007 | A1 |
20070106299 | Manspeizer | May 2007 | A1 |
20070161993 | Lowery et al. | Jul 2007 | A1 |
20070168033 | Kim et al. | Jul 2007 | A1 |
20070168036 | Ainsworth et al. | Jul 2007 | A1 |
20070198088 | Biedermann et al. | Aug 2007 | A1 |
20070198091 | Boyer et al. | Aug 2007 | A1 |
20070244483 | Winslow et al. | Oct 2007 | A9 |
20070244488 | Metzger et al. | Oct 2007 | A1 |
20070288014 | Shadduck et al. | Dec 2007 | A1 |
20080015591 | Castaneda et al. | Jan 2008 | A1 |
20080015592 | Long et al. | Jan 2008 | A1 |
20080015593 | Pfefferle et al. | Jan 2008 | A1 |
20080027558 | Palmer et al. | Jan 2008 | A1 |
20080071373 | Molz et al. | Mar 2008 | A1 |
20080071375 | Carver et al. | Mar 2008 | A1 |
20080097441 | Hayes et al. | Apr 2008 | A1 |
20080132954 | Sekhon et al. | Jun 2008 | A1 |
20080154378 | Pelo | Jun 2008 | A1 |
20080275560 | Clifford et al. | Nov 2008 | A1 |
Number | Date | Country |
---|---|---|
1205602 | Jun 1986 | CA |
19855254 | Jun 2000 | DE |
0383419 | Aug 1990 | EP |
0953317 | Apr 1999 | EP |
1770302 | Apr 2007 | EP |
1429675 | Oct 2007 | EP |
1682020 | Oct 2007 | EP |
1847228 | Oct 2007 | EP |
1847229 | Oct 2007 | EP |
1005290 | Feb 2008 | EP |
1468655 | May 2008 | EP |
1507953 | Apr 1978 | GB |
2223406 | Apr 1990 | GB |
2250919 | Jun 1992 | GB |
2250919 | Oct 1993 | GB |
59-131348 | Jul 1984 | JP |
7-100159 | Apr 1995 | JP |
2532346 | Apr 1995 | JP |
2000-503865 | Apr 2000 | JP |
2001-145647 | Apr 2000 | JP |
2003-102744 | May 2001 | JP |
2006-280951 | Oct 2006 | JP |
2007-167318 | Jul 2007 | JP |
2007-167319 | Jul 2007 | JP |
2007-170969 | Jul 2007 | JP |
2085148 | Jul 1997 | RU |
2217105 | Nov 2003 | RU |
2241400 | Sep 2004 | RU |
578063 | Nov 1977 | SU |
578957 | Nov 1977 | SU |
624613 | Aug 1978 | SU |
640740 | Jan 1979 | SU |
704605 | Dec 1979 | SU |
719612 | Mar 1980 | SU |
741872 | Jul 1980 | SU |
1186204 | Oct 1985 | SU |
1251889 | Aug 1986 | SU |
1316666 | Jun 1987 | SU |
1588404 | Aug 1990 | SU |
1699441 | Dec 1991 | SU |
1769868 | Oct 1992 | SU |
WO9107137 | May 1991 | WO |
WO 9406364 | Mar 1994 | WO |
WO 9619944 | Jul 1996 | WO |
WO 2004019831 | Mar 2004 | WO |
WO 2004024037 | Mar 2004 | WO |
WO 2007056645 | May 2005 | WO |
WO2006045091 | Apr 2006 | WO |
WO2006049993 | May 2006 | WO |
WO 2006110578 | Oct 2006 | WO |
WO 2007090009 | Aug 2007 | WO |
WO 2007090015 | Aug 2007 | WO |
WO 2007090017 | Aug 2007 | WO |
WO 2007106962 | Sep 2007 | WO |
WO 2007109417 | Sep 2007 | WO |
WO 2007109436 | Sep 2007 | WO |
WO 2007114769 | Oct 2007 | WO |
WO 2007117571 | Oct 2007 | WO |
WO 2008006098 | Jan 2008 | WO |
Entry |
---|
Aldegheri, Roberto, M.D. et al.; “Articulated Distraction of the Hip-Conservative Surgery for Arthritis in Young Patients”, Clinical Orthopaedics and Related Research, No. 301, pp. 94-101. |
Benzel, Edward; “Qualitative Attributes of Spinal Implants”; in: Biomechanics of Spine Stabilization, 1995. |
Buckwalter, Joseph A.; “Joint distraction for osteoarthritis”; The Lancet, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, vol. 347, Feb. 3, 1996, pp. 279-280. |
Coathup, M.J. et al.; “Osseo-mechanical induction of extra-cortical plates with reference to their surface properties and gemoetric designs”, Elsevier, Biomaterials 20 (1999) 793-800. |
Deie, Masataka, M.D. et al.; “A New Articulated Distraction Arthroplasty Device for Treatment of the Osteoarthritic Knee Joint: A Preliminary Report”; Arthroscopy: The Journal of Arthroscopic and Related Surgery; vol. 23, No. 8 (Aug. 2007): pp. 833-838. |
Dienst, M. et al.; “Dynamic external fixation for distal radius fractures”; Clinical Orthopaedics and Related Research, 1997, vol. 338, pp. 160-171. |
Gunther, Klaus-Peter, M.D.; “Surgical approaches for osteoarthritis”; Best Practice & Research Clinical Rheumatology, vol. 15, No. 4, pp. 627-643, 2001. |
Hall, J. et al.; “Use of a hinged external fixator for elbow instability after severe distal humeral fracture”; Journal of Orthopaedic Trauma, 2000, vol. 14, No. 6, pp. 442-448. |
Klein, D. et al.; “Percutaneous treatment of carpal, metacarpal, and phalangeal injuries”; Clinical Orthopaedics and Related Research, 200, vol. 375, pp. 116-125. |
Krakauer, J. et al.; “Hinged device for fractures involving the proximal interphalangeal joint”; Clinical Orthopaedics and Related Research, 1996, vol. 327, pp. 29-37. |
Lafeber et al., Unloading Joints to Treat Osteoarthritis, Including Joint Distraction, Current Opinion in Rheumatology 2006, 18;519-525. |
Madey, S. et al.; Hinged external fixation of the elbow: optimal axis alignment to minimize motion resistance; Journal of Orthopaedic Trauma, 2000, vol. 14, No. 1, pp. 41-47. |
Neel, Michael D., M.D.; “Repiphysis—Limb Salvage System for the Skeletally Immature”; Wright Medical Technology, Repiphysis Limb Salvage System, 2001, pp. 1-8. |
Neel, Michael D, M.D. et al.; “Early Multicenter Experience With a Noninvasive Expandable Prosthesis”; Clinical Orthopaedics and Related Research, 2003, No. 415, pp. 72-81. |
Nockels, Russ P.; “Dynamic Stabilization in the Surgical Management of Painful Lumbar Spinal Disorders”; Spine, 2005, vol. 30, No. 16S, pp. S68-S72. |
Perry, Clayton R. et al.; “Patellar Fixation Protected with a Load-Sharing Cable: A Mechanical and Clinical Study”; Journal of Orthopaedic Trauma, 1988, vol. 2, No. 3, pp. 234-240. |
Orthofix; “Xcaliber Articulated Ankle”; advertising brochure, May 2004. |
Orthofix; “Gentle Limb Deformity Correction”; website pages, http://www.eight-plate.com/, 2008. |
Pilliar et al., Bone Ingrowth and Stress Shielding with a Porous Surface Coated Fracture Fixation Plate, Journal of Biomedical Materials Research, vol. 13, 799-810 (1979). |
Pollo, Fabian E. et al.; “Reduction of Medial Compartment Loads With Valgus Bracing of the Osteoarthritic Knee”; American Journal Sports Medicine, vol. 30, No. 3, 2002; pp. 414-421. |
Repicci, John A., M.D. et al. “Minimally invasive unicondylar knee arthroplasty for the treatment of unicompartmental osteoarthritis: an outpatient arthritic bypass procedure”; Orthopedic Clinics of North America, 35 (2004), pp. 201-216. |
Sommerkamp, G. et al.; “Dynamic external fixation of unstable reactures of the distal part of the radius”; The Journal of Bone and Joint Surgery; 1994, vol. 76-A, No. 8, pp. 1149-1161. |
Tencer, Allan F. et al. “Fixation of the Patella (Chap. 9.3)”; in: Biomechanics in Orthopedic Trauma Bone Fracture and Fixation, 1994. |
Thakur, A.J.; “Tension Band Wiring”; in; The Elements of Fracture Fixation, 1997. |
Uchikura, C. et al.; “Comparative study of nonbridging and bridging external fixators fro unstable distal raduis fractures”; Journal of Orthopaedic Science, 2004, vol. 9, pp. 560-565. |
Weisstein. Jason S., M.D. et al.; “Oncologic Approaches to Pediatric Limb Preservation”; Journal of the American Academy of Orthopaedic Surgeons; vol. 13, No. 8, Dec. 2005. |
Wilke, Hans-Joachim et al.; “Biomechanical Evaluation of a New Total Posterior-Element Replacement System”; Spine, 2006, vol. 31, No. 24, pp. 2790-2796. |
Wilkins, Ross M., M.D. et al.; “The Phenix Expandable Prosthesis”; Clinical Orthopaedics and Related Research, No. 382, pp. 51-58. |
Yamamoto, Ei et al.; “Effects of Stress Shielding on the Transverse Mechanical Properties of Rabbit Patellar Tendons”; Journal of Biomechanical Engineering, 2000, vol. 122, pp. 608-614. |
Lapinskaya, V.S., et al., “An Endoapparatus for Restoration of the Hip Joint”, Writers Collective, 2008, UDK 615.472.03:616.728.2-089.28. |
Nagai, et al., “B109 Mobility Evaluation of Hip-Joint Nonweight-Bearing Device”, The Japan Society of Mechanical Engineers No. 02-26. |
Tomita, Naohide, “Development of Treatment Devices for Cartilage Regeneration”, BME vol. 16, No. 2. |
Lentsner, A.A., et al., “Device for Functional Relief of Hip Joint in Cotyloid Cavity Fracture Cases”, Ortop Travmatol Protez. Apr. 1990(4) 44-6. |
Lapinskaya, Valentina Spiridonovna, “Treatment of Diseases and Injuries of Hip Joint Using a Method of Distraction”, Kuibyshev Medical Institute, 1990. |
Larionov d. Yu, et al., “Medical Devices”, Scientific and Technical Bimonthly Journal, May-Jun. 2008. |
PCT search report dated Jan. 20, 2010 from PCT application No. PCT/US2009/002714 as issued by the European Patent Office as searching authority. |
Office Action from U.S. Appl. No. 12/113,164 dated Dec. 26, 2014. |
Office Action from U.S. Appl. No. 12/702,599 dated Mar. 24, 2015. |
Office Action from U.S. Appl. No. 13/309,984 dated Jun. 26, 2015. |
Office Action from U.S. Appl. No. 13/800,676 dated Jul. 8, 2015. |
Office Action from U.S. Appl. No. 12/112,659 dated Sep. 1, 2015. |
Office Action from U.S. Appl. No. 14/075,090 dated Mar. 14, 2016. |
Office Action from U.S. Appl. No. 11/743,605 issued Jun. 13, 2016. |
Office Action from U.S. Appl. No. 14/075,090, issued Dec. 2, 2016. |
Number | Date | Country | |
---|---|---|---|
20080275562 A1 | Nov 2008 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 11743097 | May 2007 | US |
Child | 12112415 | US | |
Parent | 11743605 | May 2007 | US |
Child | 11743097 | US | |
Parent | 11775139 | Jul 2007 | US |
Child | 11743605 | US | |
Parent | 11775149 | Jul 2007 | US |
Child | 11775139 | US | |
Parent | 11775145 | Jul 2007 | US |
Child | 11775149 | US |