This application claims priority to pending European Application No. 12159757 filed on 15 Mar. 2012.
1. Field of the Invention
The invention relates to trial components for joint implants and prosthesis, in particular to trial components for shoulder implants and prosthesis.
2. Description of Relevant Art
The shoulder joint is a ball-and-socket joint, which has an exceptional range of motion. Shoulder instability and other maladies of the shoulder joint, such as arthrosis or fracture, may require a replacement of the joint. Also, other joints other than a shoulder joint may require a replacement.
A shoulder joint prosthesis, which includes the replacement of the convex head of the humerus, is disclosed in U.S. Pat. No. 7,819,923. It reflects the orientation and the center of rotation of actual joints. In the case of a worn or damaged rotator cuff or too much bone loss, such a prosthesis would not recover the range of motion. In such a case, a reverse shoulder prosthesis may be preferable. An example of such a prosthesis is disclosed in the US patent application publication 2009/0210065 A1. In such a prosthesis the humeral component includes a stem and a cup attached to the stem. The glenoid component supports a convex head, which articulates with the cup of the humeral component.
In general, the geometry of the prosthesis has to be adjusted to the patient's needs. This may be done by inserting trial liners into the socket part of the joint. The European patent application EP 2 047 827 A1 discloses an expandable trial component which can be adjusted by rotation. It allows a precise adjustment in size, but the reproducibility is poor, as the height cannot precisely be reconstructed after the trial component has been removed from the joint.
The international patent application publication WO 2007/084939 discloses to provide a plurality of trial or provisional articulating liners, which lack spring fingers for fixing the liner to the stem, but otherwise are substantially identical to the implanted articulating liner. Due to the lacking spring fingers these trial liners often wobble, piston or pivot out of position during trail reduction of a joint. Therefore, the surgeon does not obtain a true representation of the new joint and can get a false message during this critical operative step.
The embodiments are based on the object of designing a trial component for joint implants and prosthesis, in particular for trial components for shoulder implants and prosthesis, which can easily be inserted and removed, but which are still securely held in position during trial.
The trial component of a prosthesis preferably has an outer surface including at least one recess for interfacing with at least one groove of a joint adapter. Most preferably the at least one recess is a circumferential recess at an outer surface of the trial component, which is adapted to fit into a circumferential groove of the inner surface of the joint adapter. The trial component has at least one approximately radially oriented slit, which allows compression of the trial component for easy insertion and removal of the trial component into the joint adapter. Before inserting the trial component into the joint adapter, the trial component may be compressed, so that the width of the at least one approximately radial slit is reduced, therefore reducing the width or the radius of the recess, so it can easily be inserted into the groove of the joint adapter. The trial component may also have a ramp shaped outer surface, which allows snapping of the trial component into the joint adapter. This may result in a clicking noise and/or vibration, giving the surgeon a feedback, that the trial component has securely been locked within the joint adapter. For removal of the trial component, it is compressed, so that the width of the at least one approximately radial slit is reduced and therefore the width or the radius of the recess is reduced which allows removal of the trial component from the joint adapter. Preferably, the trial component is a liner of the joint, which may have a recessed spherical cavity. Furthermore, the trial component may be a spacer, which may be inserted between the joint adapter and the liner. In a further embodiment, the trial components may be a set of liners and spacers.
A further embodiment relates to a joint prosthesis, preferably to the humeral component of a shoulder prosthesis, although the embodiment may be applied to any other kind of prosthesis. A stem module is provided for fixing the prosthesis into the bone. A joint adapter can be attached, preferably under different angles to the stem module. The joint adapter must not necessarily be a separate part. It may also be one part with the stem module. In an alternative embodiment, the joint adapter may be directly mounted, e.g. screwed into the bone. The joint adapter holds a liner preferably having a recessed spherical cavity, which is the cup of the joint. The joint adapter has an inner surface and at least one preferably circumferential groove. The liner has an outer surface including at least one preferably circular recess. This recess preferably is concentric to the major body diameter of the liner. Its purpose is to interface with the at least one groove of the joint adapter or a spacer. Furthermore, the liner is a trial component, which has an approximately radial slit, which allows compression of the liner for easy insertion into the joint adapter or spacer and removal therefrom. This allows inserting different trial liners with different sizes thus allowing to try out different sizes to find the best size for the patient. Furthermore, an optional spacer may be inserted between the liner and the joint adapter. Like the joint adapter, the spacer has an inner surface and at least one preferably circumferential groove for interfacing with the liner. Furthermore, it has an outer surface including at least one preferably circular recess. This recess preferably is concentric to the major body diameter of the liner. Its purpose is to interface with the at least one groove of the joint adapter. Furthermore, the spacer has an approximately radial slit, which allows compression of the spacer for easy insertion into the joint adapter and removal therefrom. This allows inserting different spaces with different sizes, thus allowing to try out different sizes to find the best size for the patient. When the best sizes of the spacer and the liner have been identified a final liner and an optional final spacer without a slit may be inserted, which can no more be removed.
Furthermore, the trial components can be used with both trial cups and definitive implants (cup and spacer) to allow a second trial reduction step.
According to a further embodiment the trial component and/or the liner and/or the spacer has a plurality of slits for increasing flexibility and decreasing compression force to allow for simplified insertion and removal.
According to another embodiment the trial component and/or the liner and/or the spacer has at least one hole, preferably two holes, for inserting a tool which allows compression of the trial component and/or the liner. Most preferably, the tool comprises a pair of pliers.
It is further preferred, if the trial component and/or the liner and/or the spacer has means for preventing rotation within the joint adapter. Such means may be protrusions and/or recesses interfacing with recesses and/or protrusions of the joint adapter.
A further object of the invention is to provide a kit of trial components having different heights. In an alternative embodiment, the trial components may also have their recessed spherical cavity at different radial offsets compared to the joint adapter, therefore providing different eccentricities and/or positions. Furthermore different spacers my may be provided to adapt for different heights.
Another object of the invention is a method for optimizing the joint distance, preferably of a shoulder joint. After inserting a stem module, holding a joint adapter into the bone, at least one trial component of a liner as disclosed above is inserted into the joint adapter and the joint distance is measured and/or tested. The trial component is then removed from the joint adapter by compression of the trial component and pulling the trial component out of the joint adapter. If required, further trial components may be tried out. After the correct liner size has been identified, a final liner, which can no more be removed, is inserted into the stem module.
In the following, the invention will be described by way of example, without limitation of the general inventive concept, on examples of embodiment and with reference to the drawings.
While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof are shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that the drawings and detailed description thereto are not intended to limit the invention to the particular form disclosed, but on the contrary, the intention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the present invention as defined by the appended claims.
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It will be appreciated to those skilled in the art having the benefit of this disclosure that this invention is believed to provide trial components for joint implants and prosthesis. Further modifications and alternative embodiments of various aspects of the invention will be apparent to those skilled in the art in view of this description. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the invention. It is to be understood that the forms of the invention shown and described herein are to be taken as the presently preferred embodiments. Elements and materials may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the invention may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of this description of the invention. Changes may be made in the elements described herein without departing from the spirit and scope of the invention as described in the following claims.
Number | Date | Country | Kind |
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12159757.9 | Mar 2012 | EP | regional |