This application is based upon and claims priority to European Application Serial No. EP07100948, entitled “An implant and a method for partial replacement of joint surfaces”, filed on Jan. 22, 2007, the entire disclosure of which is expressly incorporated by reference herein.
1. Field of the Invention
The present invention relates to orthopedic components and methods of implanting the same.
2. Background of the Related Art
Degenerative and traumatic damage to the articular cartilage of skeletal joints can result in pain and restricted motion. During the early stages of articular cartilage degeneration in the hip joint, the articular cartilage at the edge of the acetabulum may degrade and begin to undergo delamination. As indicated above, in its early stages, this damage is present at the edges of the acetabulum where the articulation strain on the cartilage is comparatively low. Thus, the damage in these areas may not result from loading stress, but, instead, may arise due to the neck of the femur striking the edge of the acetabulum during joint articulation. While such contact is undesirable, in specific bone morphologies, this contact results in constantly reoccurring contusions of the articular cartilage at specific points on the acetabulum, causing cartilage damage and, potentially, delamination.
The present invention provides an orthopedic implant for the partial replacement of joint surfaces. In one exemplary embodiment, the orthopedic implant includes an articulation portion having a concave articular surface and a base body. The orthopedic implant may be sized to replace a portion of the patient's natural acetabulum. In this manner, the orthopedic implant allows for the repair and/or replacement of a portion of the articular cartilage of the acetabulum. In one exemplary embodiment, a plurality of differently sized orthopedic implants may be connected together to replace a portion of the acetabulum.
In one exemplary embodiment, the articular surface of the orthopedic component has a substantially spheroidal shape that approximates the interior of a portion or section of a sphere. Stated another way, the articular surface has a concave substantially spherical surface. The articulation portion defining the articular surface is generally made from cartilage-compatible substances on which the natural cartilage can articulate without undergoing a substantial rate of wear. In exemplary embodiments, the articulation portion may be formed from hydrogels, polyethylenes (PE), polyurethanes (PU), polycarbonate urethanes (PCU), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), poly ethylene-co-vinyl alcohol (EVAL), polyvinyl alcohol (PVA), or materials of pyrolytic carbon. The cartilage-compatible materials may include a fiber-reinforcement and/or have a woven or non-woven structure or scaffold. A scaffold-like design may be advantageous to allow additional invasion of chondrocytes and its precursor cells in order to form new cartilage on top of the cartilage compatible materials In one exemplary embodiment, the articulation portion is formed from a cartilage-compatible material that is arranged on the base body. In one exemplary embodiment, the base body is at least partially formed from a highly porous biomaterial. In an embodiment, the implant can be flexible to allow geometrical adaptation of the implant to the defect morphology.
In one exemplary embodiment, the base body of the orthopedic implant provides support to the articulation portion and is sized to allow the base body to be received within the acetabulum in a pelvic bone. In this manner, the base body provides for the securement of the orthopedic implant in the acetabulum. In one exemplary embodiment, the base body includes a plurality of anchorage members extending therefrom that may facilitate attachment to the acetabulum by providing for securement in the areas of greatest bone stock of the pelvis.
Advantageously, the present invention allows for the replacement of the damaged cartilage of the acetabulum without otherwise influencing the remaining joint surface. Thus, the natural cartilage is maintained at the regions of the acetabulum exposed to the greatest strain during normal joint articulation, such as the cartilage at the polar region of the acetabulum, and at a region spaced at least 30°, 40°, or 45° therefrom, for example. Additionally, the present invention allows for the natural femoral head to articulate against the repaired acetabulum. Thus, the need to undergo total hip arthroplasty is eliminated.
In one form thereof, the present invention provides, an acetabular implant for the treatment of a defect in a bearing surface of an acetabulum, the acetabular implant including: a base body; and an elongate articulation portion defining a longitudinal axis and a substantially spherical articular surface defined by a portion of a sphere that substantially mimics the shape of the acetabulum, the substantially spherical articular surface extending along the longitudinal axis of the elongate articulation portion over a first angle and extending perpendicular to the longitudinal axis of the elongate articulation portion over a second angle, wherein the first angle is less than 180 degrees and the second angle is less than 90 degrees.
In another form thereof, the present invention provides an acetabular implant for the treatment of a defect in a bearing surface of an acetabulum, the acetabular implant including a first member having a base body and a substantially circular articulation portion having a substantially spherical articular surface, the substantially spherical articular surface defined by a portion of a sphere that substantially mimics the shape of the acetabulum, the substantially spherical articular surface extending across the articulation portion over a first angle extending from a pole of the substantially spherical articular surface to a line on the substantially spherical articular surface, the line parallel to an equator of the substantially spherical articular surface, the first angle measured in a plane perpendicular to the equator of the substantially spherical articular surface, wherein the first angle is less than 60 degrees.
In yet another form thereof, the present invention provides an acetabular implant for the treatment of a defect in a bearing surface of an acetabulum, the acetabular implant including a ring having a polar edge, an equatorial edge, and a substantially spherical articular surface extending between the polar edge and the equatorial edge, the substantially spherical articular surface defined by a portion of a sphere that substantially mimics the shape of the acetabulum, the substantially spherical articular surface extending from the polar edge to the equatorial edge over a first angle, the first angle contained in a plane perpendicular to the equatorial edge, wherein the first angle is less than 80 degrees.
In yet another form thereof, the present invention provides a method of repairing a defect in a bearing surface of an acetabulum, the acetabulum having a pole and an equator, the method including the steps of: providing an acetabular implant; removing the defect in the bearing surface of the acetabulum; shaping the acetabulum to receive the acetabular implant; and implanting the acetabular implant at a position spaced from the pole of the acetabulum by a first angular distance measured along a portion of a sphere that substantially mimics the shape of the acetabulum, the first distance defined by an implantation angle extending from the pole of the acetabulum toward the equator of the acetabulum, the implantation angle measuring at least 30 degrees, wherein the acetabular implant is at least 30 degrees from the pole of the acetabulum.
In yet another form thereof, the present invention provides a method of repairing a defect in a bearing surface of an acetabulum, the method including the steps of: providing an acetabular implant, the acetabular implant including: a base body and an articulation portion having a substantially spherical articular surface, the substantially spherical articular surface defined by a portion of a sphere that substantially mimics the shape of the acetabulum, the substantially spherical articular surface extending across the articulation portion over a first angle, wherein the first angle is less than 180 degrees; removing the defect in the bearing surface of the acetabulum; shaping the acetabulum to receive the acetabular implant; and implanting the acetabular implant in the acetabular, whereby the substantially spherical articular surface of the acetabular implant is aligned with the bearing surface of the acetabulum to provide a substantially seamless transition therebetween.
a is an illustration of an orthopedic component according to yet another exemplary embodiment;
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Similarly, the angle of the substantially spherical surface defined by articular surface 31 extending in the direction perpendicular to the longitudinal axis of implant 3 covers less than 90°. Stated another way, angle β defined between lines extending from opposing extremes of articular surface 31 perpendicular to the longitudinal axis of implant 3 to centerpoint CP of spherical articular surface 31 is less than 90°. Thus, articular surface 31 extends in a direction perpendicular to the longitudinal axis of implant 3 for a distance less than one-quarter of the distance around a sphere having a radius matching the radius of curvature of articular surface 31. In one exemplary embodiment, angle β is less than 45°. For example, angle β may be as small as 10°, 15°, 20°, or 25° or as large as 30°, 35°, 40°, or 45°. Referring to
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A highly porous biomaterial may have a porosity as low as 55, 65, or 75 percent or as high as 80, 85, or 90 percent. An example of such a material is produced using Trabecular Metal™ technology generally available from Zimmer, Inc., of Warsaw, Ind. Trabecular Metal™ is a trademark of Zimmer Technology, Inc. Such a material may be formed from a reticulated vitreous carbon foam substrate which is infiltrated and coated with a biocompatible metal, such as tantalum, etc., by a chemical vapor deposition (“CVD”) process in the manner disclosed in detail in U.S. Pat. No. 5,282,861, the entire disclosure of which is expressly incorporated herein by reference. In addition to tantalum, other metals such as niobium, or alloys of tantalum and niobium with one another or with other metals may also be used.
Generally, the porous tantalum structure includes a large plurality of ligaments defining open spaces therebetween, with each ligament generally including a carbon core covered by a thin film of metal such as tantalum, for example. The open spaces between the ligaments form a matrix of continuous channels having no dead ends, such that growth of cancellous bone through the porous tantalum structure is uninhibited. The porous tantalum may include up to 75%-85% or more void space therein. Thus, porous tantalum is a lightweight, strong porous structure which is substantially uniform and consistent in composition, and closely resembles the structure of natural cancellous bone, thereby providing a matrix into which cancellous bone may grow to anchor implant 3′ in the surrounding bone of the pelvis.
In this embodiment, articulation portion 30 may be molded onto base body 38. For example, implant 3′ may be formed according to the teachings of co-pending U.S. patent application Ser. No. 11/095,217, entitled HYDROGEL IMPLANT, filed on Mar. 31, 2005, the entire disclosure of which is expressly incorporated by reference herein. By utilizing a highly porous biomaterial, e.g., a material formed using Trabecular Metal™ technology, a metal having a porous coating, or a metal having a knurled surface, to form base body 38, the attachment of articulation portion 30 allows for some of the biocompatible polymer forming articulation portion 30 to be received within the pores of base body 38. This interaction creates a rigid, mechanical bond between articulation portion 30 and base body 38 to fixedly attach the two layers together, which allows for the transfer of the forces between articulation portion 30 and base body 38 that are encountered during the loading of the joint.
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In the embodiment shown in
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In order to facilitate the implantation of implant 3, 3′, an incision may be made in the area of the patient's acetabulum. The damaged portions of articular cartilage are then removed and the acetabulum prepared for the receipt of implant 3, 3′. Specifically, in order to prepare the acetabulum, instrument 100, shown in
Guide member 103 is then positioned against machining mask 106. Machining mask 106 has the basic shape of a spherical cap and fits into the acetabulum. Machining mask 106 is inserted in the acetabulum such that opening 107 comes to lie above the defect in the cartilage of the acetabulum. With guide member 103 positioned against machining mask 106, shaft 101 and working head 105 extend through guide member 103 and opening 107 in machining mask 106. Opening 107 in machining mask 106 is dimensioned such that actuation of shaft 101 and guide member 102 about guide surface 104 is restricted by shaft 101 contacting the outer periphery of opening 107. Thus, working head 105 is only allowed to move in a shape that substantially replicates the shape of implant 3, 3′. Thus, a surface corresponding to implant 3, 3′ is machined into the acetabulum. Specifically, the acetabulum is machined to provide a congruence between the articular cartilage of the acetabulum and articular surface 31 of implant 3, 3′. This congruence provides a substantially seamless transition between articular surface 31 and the articular cartilage of the acetabulum. To provide this seamless transition, working head 105 protrudes a distance from the spherically convex outer surface of machining mask 106 that is equal to the distance between the spherically concave bearing surface of implant 3, 3′ and the spherically convex bone contacting surface of implant 3, 3′.
Once a surface of the acetabulum is properly machined, bores may be drilled in the acetabulum to receive anchoring members 37, 37′, 62. In one exemplary embodiment, the bores are sized to provide a press-fit of anchoring members 37, 37′ therein. In this embodiment, implant 3, 3′ may be secure to the acetabulum without the use of bone cement. In another exemplary embodiment, the bores may be formed in the acetabulum for the receipt of both anchoring members 37, 37′ and bone cement. In this embodiment, the securement of implant 3, 3′ to the bone is further enhanced by the use of the bone cement.
Advantageously, by using implants 3, 3′, the articular cartilage at the polar region of the acetabulum may be retained. For example, referring to
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Extending around the outer surface 57 of ring 5 is bead 52. Bead 52 is configured to engage a groove that is machined into the acetabulum during implantation of ring 5. Specifically, by press-fitting ring 5 into the acetabulum, bead 52 may form a snap-fit connection with the groove in the acetabulum. The interaction of bead 52 with the corresponding groove formed in the acetabulum prevents ring 5 from separating from the acetabulum and facilitates the retention of ring 5 in position.
As indicated above, ring 5 has a substantially concave, spherical articulation surface 51. The angle of articulation surface 51 between edge 53 and edge 54 of ring 5 covers less than 80°. Stated another way, an angle defined between lines extending from opposing edges 53, 54 of articular surface 51 to a centerpoint of a sphere having a radius matching the radius of curvature of articular surface 51 and positioned in a plane containing the center point of the sphere and a pole of the sphere is less than 80°. In one exemplary embodiment, the angle is less than 60°. For example, the angle may be as small as 30°, 35°, 40°, or 45° or as large as 50°, 60°, 70°, or 80°.
In one exemplary embodiment, the opening half-angle of the cap which is “cut-off” from the implant at the polar side and therefore defines the polar opening in which the natural cartilage is maintained is at least 10°. In exemplary embodiments, the half-angle may be as small as 30°, 35°, 40°, or 45° or as large as 50°, 55°, 60°, or 65°.
While this invention has been described as having preferred designs, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.
Number | Date | Country | Kind |
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EP07100948 | Jan 2007 | EP | regional |