Patent Application
20160302944
This patent application claims the benefit of priority, under 35 U.S.C. Section 119(e), to Austen Davenport et al. U.S. patent application Ser. No. 62/148,786, entitled “Hard Bearing Inserter Rings,” filed on Apr. 17, 2015 (Attorney Docket No. 5490-001149-US-PS1), each of which is hereby incorporated by reference herein in its entirety.
This document pertains generally, but not by way of limitation, to fitting a liner to an acetabular shell for hip replacement or revision surgery.
In a hip replacement or revision surgery, the acetabulum of the hip is reamed to provide a socket shaped mounting surface corresponding to the size and curvature of the femoral head of the natural or revised femur or femoral implant. After the prepared mounting surface is appropriately sized and shaped, an acetabular shell can be mounted to the mounting surface to provide a bearing surface for the femoral head. The acetabular shell can comprise a hemispherical shape to define a socket for receiving the femoral head. A liner can be inserted into the acetabular shell to fit the liner to an inner surface of the acetabular shell to cover mounting features or textures to provide a smooth bearing surface against which the femoral head can smoothly articulate.
The liner can often comprise a rigid or a resilient flexible material for withstanding the articulation of the femoral head, which requires the liner to be driven into the acetabular shell. If the liner is not properly aligned or centered with the acetabular shell prior to insertion, the liner can be improperly seated within the acetabular shell after insertion. A properly fitted liner is flush or nearly flush with the lip of the acetabular shell to avoid providing an edge or other protrusion that extends from the acetabular shell. The rigid or resilient flexible material of the liner requires the liner to be pried from the acetabular shell if improperly seated. The locking mechanism of the liner and the acetabular shell can make the liner difficult to pry from the acetabular shell. In addition, as the opening in the tissue to access the hip bone is usually minimally sized to reduce healing time, accessing the implanted acetabular shell and liner can be difficult causing discomfort or pain to the patient.
The inner surface of the acetabular shell can often have a curvature that corresponds to the outer surface of the acetabular shell. Acetabular shells commonly have a tapered region extending from the lip of the acetabular shell to the inner surface providing a thinner lip portion and corresponding to different bearing materials. While the tapered region provides an advantageous structure for the acetabular shell, the tapered region can make centering or aligning the liner more difficult and provide an angled surface that can cause the liner to shift or pivot as the liner is inserted into the acetabular shell.
The present inventors have recognized, among other things, that a problem to be solved can include the insertion of a liner into an acetabular shell at the proper alignment to avoid increasing the length of the surgical procedure or discomfort to the patient. In an example, the present subject matter can provide a solution to this problem, such as by attaching a fitting ring to an edge of a liner such that an alignment portion of the fitting ring extends radially outward from the liner. The alignment portion is shaped or configured to engage a lip portion of an acetabular shell as the liner is inserted into the acetabular shell. The engagement of the fitting ring to the lip portion of the acetabular shell centers the liner and corrects any pivoting of the liner relative to the acetabular shell. A driving force can be applied to the liner to drive the liner into the acetabular shell where the fitting ring guides the liner as the liner is inserted into the acetabular shell. Driving the liner into the acetabular shell can also cause the fitting ring to disengage from the liner.
A method for installing an acetabular implant can include reaming the acetabulum to prepare a curved mounting surface and fixing an outer surface of an acetabular shell to the mounting surface. The method can further include providing a liner and attaching a fitting ring to an edge portion of the liner such that an alignment feature of the fitting ring extends radially outward from the liner. The method can further include inserting the liner into an opening of the acetabular shell such that the liner is positioned adjacent to an inner surface of the acetabular shell. The insertion of the liner engages the alignment feature of the fitting ring to a lip portion of the acetabular shell defining the opening, where the fitting ring centers and corrects pivoting of the liner relative to the acetabular shell. The method can further include driving the liner into the acetabular shell such that the liner engages the inner surface of the acetabular shell and disengage the fitting ring from the liner.
This overview is intended to provide an overview of subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the present subject matter. The detailed description is included to provide further information about the present patent application.
In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
As depicted in
The acetabular shell 22 can comprise an outer surface 28 and an inner surface 30. The outer surface 28 can be textured, shaped, perforated or include mounting features for receiving fasteners, cement, and/or bone in-growth material to fix the acetabular shell 22 to the acetabulum of the hip. The acetabular shell 22 can comprise a generally hemispherical shape such that the inner surface 30 is curved to an apex 32 to define a socket space for receiving a femoral head of a femur or a femoral implant. The acetabular shell 22 can include a lip portion 34 (see
The liner 24 can comprise a bearing surface 38 and an edge portion 40 extending around the bearing surface 38. The liner 24 can comprise a generally hemispherical shape such that the bearing surface 38 is curved to define a socket space for receiving the femoral head. The liner 24 can be shaped to correspond to the curvature of the inner surface 30 of the acetabular shell 22. The liner 24 can comprise a rigid material, a resilient flexible material, or combinations thereof In an example, the liner 24 can comprise a polymer, a ceramic, a metal, a composite, or combinations thereof.
As depicted in
In operation, the engagement portion 42 of the fitting ring 26 can be attached to the edge portion 40. The fitting ring 26 can be flexed to engage the engagement portion 42 to the liner 24. As depicted in
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In the site preparation step 102, if necessary, a reamer is applied to the acetabulum of a hip at the mounting site to ream the bone. Increasingly sized reamers can be used to enlarge the mounting site and form an acetabular cavity. In an example, the bone can be reamed until bleeding subchondral bone is exposed. The acetabular orientation of the mounting site can be about 40 degrees inclination and about 20 degrees of anteversion, but depends on patient anatomy and the femoral implant and can be varied slightly.
In the acetabular shell mounting step 104, the outer surface 28 of the acetabular shell 22 can be fitted to the mounting surface of the acetabulum. As depicted in
In the fitting ring attachment step 106, the fitting ring 26 can be flexed to engage the engagement portion 42 to the liner 24 such that the alignment portion 44 of the liner 24 extends radially outward from the liner 24.
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Example 1 is an acetabular implant system, comprising: an acetabular shell including an inner surface and a lip portion defining an opening; a liner having an edge portion; and a fitting ring having an alignment portion and an engagement portion engageable to the edge portion of the liner such that the alignment portion extends radially outward from the liner; wherein the alignment portion is engageable to the lip portion of the acetabular shell to position the liner within the opening at a predetermined distance from the inner surface.
In Example 2, the subject matter of Example 1 optionally includes wherein the acetabular shell comprises a hemispherical shape and the inner surface is centered on an apex of the hemispherical shape.
In Example 3, the subject matter of Example 2 optionally includes wherein applying a driving force along an axis transverse to the apex releases the liner from the fitting ring and pushes the liner into engagement with the inner surface of the acetabular shell.
In Example 4, the subject matter of Example 3 optionally includes wherein the fitting ring comprises a flexible material such that applying the driving force to the liner flexes the engagement portion to release the liner.
In Example 5, the subject matter of Example 4 optionally includes wherein the engagement feature is an annular snap fit feature positioned on an interior surface of the fitting ring.
In Example 6, the subject matter of any one or more of Examples 1-5 optionally include wherein the liner comprises a rigid material.
In Example 7, the subject matter of Example 6 optionally includes wherein the rigid material comprises at least one of a ceramic, a metal, or a composite.
In Example 8, the subject matter of any one or more of Examples 1-7 optionally include wherein a diameter of the fitting ring corresponds to a diameter of the acetabular shell such that the alignment feature engages the lip portion of the acetabular shell when the liner is inserted into the opening.
In Example 9, the subject matter of any one or more of Examples 1-8 optionally include where the acetabular shell includes a taper portion between the inner surface and the lip portion; wherein the taper portion has a different curvature than the inner surface.
Example 10 is a method of implanting an acetabular implant, comprising: fixing an acetabular shell to a mounting surface on an acetabulum, the acetabular shell having an inner surface and a lip portion defining an opening; coupling an engagement portion of a fitting ring to an edge portion of a liner such that an alignment portion of the fitting ring extends radially outward from the liner; and inserting the liner into the opening such that the alignment portion engages the lip portion of the acetabular shell; wherein engaging the alignment portion to the lip portion of the acetabular shell maintains the liner at a predetermined distance from the inner surface.
In Example 11, the subject matter of Example 10 optionally includes applying a driving force to the liner toward the acetabular shell to disengage the liner from the fitting ring and push the liner into engagement with the inner surface of the acetabular shell.
In Example 12, the subject matter of Example 11 optionally includes wherein the acetabular shell comprises a hemispherical shape and the inner surface is centered on an apex of the hemispherical shape; wherein the driving force is applied along an axis transverse to the apex.
In Example 13, the subject matter of any one or more of Examples 11-12 optionally include wherein the fitting ring comprises a flexible material such that applying the driving force to the liner flexes the engagement portion to release the liner.
In Example 14, the subject matter of Example 13 optionally includes wherein the engagement feature is an annular snap fit feature positioned on an interior surface of the fitting ring.
In Example 15, the subject matter of any one or more of Examples 10-14 optionally include wherein the liner comprises a rigid material.
In Example 16, the subject matter of Example 15 optionally includes wherein the rigid material comprises at least one of a ceramic, a metal, or a composite.
Example 17 is a fitting ring for inserting a liner into an acetabular shell, comprising: a fitting ring body including: an alignment portion on an exterior surface, the alignment portion defining extending circumferentially around the fitting ring, and an engagement portion on an interior surface defining an opening for receiving the liner; wherein the alignment portion is engageable to a lip portion of the acetabular shell to position the liner within the opening at a predetermined distance from the inner surface.
In Example 18, the subject matter of Example 17 optionally includes wherein the fitting ring body comprises a flexible material such that applying the driving force to the liner flexes the engagement portion to release the liner.
In Example 19, the subject matter of Example 18 optionally includes wherein the engagement feature is an annular snap fit feature positioned on an interior surface of the fitting ring body.
In Example 20, the subject matter of any one or more of Examples 17-19 optionally include wherein the engagement portion defining extending circumferentially around the fitting ring.
Each of these non-limiting examples can stand on its own, or can be combined in any permutation or combination with any one or more of the other examples.
The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the present subject matter can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.
In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.
In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.
The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to comply with 37 C.F.R. §1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the present subject matter should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
| Number | Date | Country | |
|---|---|---|---|
| 62148786 | Apr 2015 | US |
