The present disclosure relates generally to orthopaedic prostheses, and particularly to constrained, hinged prosthesis for use in knee replacement surgery.
Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint. A typical knee prosthesis includes a tibial tray, a femoral component, and a polymer insert or bearing positioned between the tibial tray and the femoral component. Depending on the severity of the damage to the natural joint, orthopaedic prostheses of varying mobility may be used. For example, in cases involving significant bone loss or soft-tissue damage, a constrained orthopaedic prosthesis may be used. Constrained orthopaedic prostheses generally limit the mobility of the prosthetic joint to a single direction. One type of a constrained orthopaedic prosthesis is a hinged orthopaedic prosthesis.
According to one aspect, an orthopaedic prosthesis may include a tibial bearing, a hinge post, and a femoral component. The tibial bearing may include an upper bearing surface. The upper bearing surface may include an aperture defined therein. The hinge post may include a base and a stem extending downwardly from the base and received in the aperture of the tibial bearing. The hinge post may also include a medial axle extending medially from the base and a lateral axle extending laterally from the base. A first bushing received on the medial axle. Additionally, a second bushing received on the lateral axle.
The femoral component may be configured to be coupled to a surgically-prepared surface of the distal end of a femur. The femoral component may include an articulating surface including a pair of spaced apart condyles in contact with the upper bearing surface of the tibial tray. Additionally, the femoral component may include an internal chamber having an opening defined on the articulating surface. The medial axle, lateral axle, first bushing, and second bushing may be received in the internal chamber. The femoral component may be configured to rotate about an axis defined by the medial and lateral axles. In some embodiments, the base of the hinge post may include a flange, which may be received in a recess defined in the articulating surface defined around the aperture of the tibial bearing.
The orthopaedic prosthesis may also include a plug in some embodiments. The plug may be received in the internal chamber of the femoral component and positioned to secure the femoral component to the hinged post. The first and second bushings may include a planar side in contact with the plug. In some embodiments, the plug is configured to restrict the first and second bushings from rotating with respect to the medial and lateral axles. Additionally, in some embodiments, the plug includes an angled anterior surface having a tab defined thereon and the internal chamber of the femoral component is defined by an anterior wall having a recess defined therein. In such embodiments, the tab of the plug being received in the recess. Additionally, in some embodiments, the internal chamber of the femoral component is defined by a medial wall and a lateral wall. The medial wall may include a first slot and the lateral wall may include a second slot. In such embodiments, the plug may include a medial side having a first rail received in the first slot and a lateral side having a second rail received in the second slot.
Additionally, in some embodiments, the plug may include an articulating outer surface substantially flush with the articulating surface of the femoral component. Alternatively, the plug may be received in the internal chamber of the femoral component such that the outer surface of the plug is recessed with respect to the articulating surface of the femoral component. Additionally, in some embodiments, the orthopaedic prosthesis may include a bolt and the plug may include an aperture defined therein. The bolt may be received in the aperture to secure the plug to the femoral component. Additionally, a cap may be received in the aperture of the plug and over the bolt. The cap may be positioned to contact a portion of the hinge post during hyperextension.
In some embodiments, the femoral component may be embodied as a housing and a patella bearing. The housing may include the pair of spaced apart condyles. The patella bearing may be separate from the housing, but secured thereto. The housing of the femoral component may include an anterior plate. In such embodiments, a portion of the patella bearing may be in contact with the anterior plate. The patella bearing may be configured to secure the femoral component to the hinge post.
Accordingly to another embodiment, an orthopaedic prosthesis may include a hinge post and a femoral component. The hinge post may include a base and a stem extending downwardly from the base. Additionally, the hinge post may include a medial axle extending medially from the base and a lateral axle extending laterally from the base. A first bushing may be received on the medial axle and a second bushing may be received on the lateral axle
The femoral component may be configured to be coupled to a surgically-prepared surface of the distal end of a femur. The femoral component may have an internal chamber defined between a pair of condyles. The internal chamber may be defined by a medial wall having a first slot defined therein and a lateral wall having a second slot defined therein. The first bushing being may be received in the first slot and the second bushing may be received in the second slot.
The orthopaedic prosthesis may also include a plug received in the internal chamber of the femoral component and positioned to secure the femoral component to the hinged post. The first and second bushings include a planar side in contact with the plug. The plug may be configured to restrict the first and second bushings from rotating with respect to the medial and lateral axles. Additionally, the femoral component may include an articulating surface and the plug may include an articulating outer surface substantially flush with the articulating surface of the femoral component. In some embodiments, the plug may be received in the internal chamber of the femoral component such that an outer surface of the plug is recessed with respect to the articulating surface of the femoral component.
According to a further aspect, a hinged orthopaedic prosthesis may include a hinge post, a first bushing, a second bushing, an a femoral component coupled to the first bushing and the second bushing. The hinge post may include a base and a stem extending downwardly from the base. The hinge post may also include a first an second axle extending from the base. The first bushing may be received on the first axle and may include at least one flat side. The second bushing may be received on the second axle and may include at least one flat side. The femoral component may be configured to rotate about an axis defined by the first axle and the second axle.
The detailed description particularly refers to the following figures, in which:
While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
Referring now to
The tibial bearing 12 includes a platform 18 having an upper bearing surface 20 and a bottom surface 22. A stem 24 extends downwardly from the bottom surface 22 of the platform 18. The tibial bearing 12 is configured to be coupled to a tibial tray (not shown). When so coupled, the stem 24 of the tibial bearing 12 is received in an aperture of the tibial tray. In some embodiments, the tibial bearing 12 may be configured to rotate about an axis defined by the stem 24 relative to the tibial tray.
The upper bearing surface 20 of the tibia bearing 12 is configured to contact a pair of natural or prosthetic femoral condyles, such as the condyles 54, 56 of the femoral component 14 as discussed in more detail below. The upper bearing surface 20 includes a recess 26 defined therein. The recess 26 is shaped to receive a portion of a base 30 of the hinge post 16 as discussed below. The illustrative recess 26 has a substantially rectangular shape, but may have other shapes in other embodiments. An aperture 28 is defined in the recess 26 of the upper bearing surface 20. The aperture 28 is configured to receive a stem 32 of the hinge post 16.
The hinge post 16 includes a base 30 and a stem 32 extending downwardly therefrom. As discussed above, the stem 32 is configured to be received in the aperture 28 of the tibial bearing 12. The base 30 includes a flange 34 defined toward the bottom of the base 30. When the hinge post 16 is coupled to the tibial bearing 12, the flange 34 is received in the recess 26 of the bearing 12. As such, the flange 34 may have any shape corresponding to the shape of the recess 26. The base 30 of the hinge post 16 includes a mount 36. A pair of axles 38, 40 extend horizontally from the mount 36. In particular, a medial axle 40 extends from the mount 36 in the medial direction and a lateral axle 38 extends from the vertical mount 36 in the lateral direction. The axles 38, 40 extend from the mount 36 at a substantially orthogonal direction.
The orthopaedic prosthesis 10 also includes a pair of bushings 42, 44. The bushings 42, 44 are configured to be inserted onto the axles 38, 40. That is, each bushing 42, 44 includes an aperture 48 having a diameter slightly greater than the diameter of the respective axle 38, 40. As illustrated in
The femoral component 14 is configured to be coupled to a surgically-prepared surface of the distal end of a patient's femur (not shown). The femoral component 14 may be secured to the patient's femur via use of bone adhesive or other attachment means. The femoral component 14 includes an articulating surface 52 having a pair of spaced apart condyles 54, 56. In use, the condyles 54, 56 replace the natural condyles of the patient's femur and are configured to articulate on the upper bearing surface 20 of the tibial insert 12.
The femoral component 14 includes a housing 58 having an internal chamber 60 (see
The hinged orthopaedic prosthesis 10 may also include a plug 80. The plug 80 is insertable into the internal chamber 60 to secure the hinge post 10 and bushings 42, 44 to the femoral component 14. The plug 80 may have any shape configured to be received in the internal chamber 60 and secure the bushings 42, 44 therein. For example, as illustrated in
In use, the femoral component 14 is coupled to the hinge post 16, which is coupled to the tibial insert 12. To do so, the stem 32 of the hinge post 16 may be inserted into the aperture 28 of the tibial insert 12. The flange 34 of the base 30 of the hinge post 16 is received in the recess 26 before the hinge post 16 is fully seated on the tibial bearing 12. In some embodiments, the recess 26 is larger than the flange 34 to allow positioning of the hinge post 16 and increase the load transfer from the femoral condyles 54, 56 to the upper bearing surface 20 of the tibial bearing 12. The bushings 42, 44 may also be inserted onto the medial and lateral axles 38, 40 of the hinge post 16.
The femoral component 14 may be secured to the hinge post 16. To do so, the base 30, the axles 38, 40, and the bushings 42, 44 are inserted vertically into the internal chamber 60 of the femoral component 14. Once so inserted, the femoral component 14 is moved in the anterior direction until the bushings 42, 44 are received in the posterior slots 76 of the internal chamber 60 as illustrated in
After the axles 38, 40 and bushings 42, 44 have been inserted into the internal chamber 60 of the femoral component 60; the plug 80 may be coupled to the femoral component 14 to secure the hinge post 16 and the femoral component 14 together. To do so, the plug 80 is inserted into the internal chamber 60. Depending on the configuration of the plug 80, the plug 80 may be held in place via tabs, friction, securing devices, or the like. For example, in the embodiment illustrated in
Referring now to
Referring back to
Referring now to
As shown in
The outer surface or wall 148 of the plug 130 may be configured as an articulating surface in some embodiments. For example, as illustrated in
Referring now to
When the patella bearing 162 is removed from the housing 160, the internal chamber 60 is accessible. As such, the femoral component 14 may be coupled and secured to the hinge post 16 by initially removing the patella bearing 162. The femoral component 14 may then be positioned in an extended position. The mount 36 of the hinge post 16, axles 38, 40, and bushings 42, 44 may then be slid horizontally into the internal chamber 60 as illustrated in
The patella bearing 162 may be secured to the housing 160 via use of the bolt 168. That is, as illustrated in
The interface between the patella bearing 162 and the housing 160 of the femoral component 14 may vary in different embodiments. For example, as illustrated in
While the disclosure has been illustrated and described in detail in the drawings and foregoing description, such an illustration and description is to be considered as exemplary and not restrictive in character, it being understood that only illustrative embodiments have been shown and described and that all changes and modifications that come within the spirit of the disclosure are desired to be protected.
There are a plurality of advantages of the present disclosure arising from the various features of the devices and assemblies described herein. It will be noted that alternative embodiments of the devices and assemblies of the present disclosure may not include all of the features described yet still benefit from at least some of the advantages of such features. Those of ordinary skill in the art may readily devise their own implementations of the devices and assemblies that incorporate one or more of the features of the present invention and fall within the spirit and scope of the present disclosure as defined by the appended claims.
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