The present invention relates to surgical implants and is particularly suitable for implants used in articulating joints and/or in the presence of muscular deficiency.
Knee arthrodesis, indicated in the presence of inadequate muscular control or soft tissue stability, allows for patients to successfully ambulate. This surgery results in a rigidly extended lower limb that cannot be flexed or reduced in length. The extended position requires greater muscular strength and endurance to control, even when not mobile, which can lead to secondary joint pain and muscular fatigue. The permanence of this rigid extension can also prevent patient participation in many normal daily living activities such as bathing, tying shoes, or sitting in close quarter spaces such as a cars, airplanes and theaters.
Total knee replacement (TKR) is a surgical procedure to relieve pain, correct deformity, and restore knee function using artificial materials to restore the load bearing and movement functions of the knee. If primary treatment fails, a revision procedure is required. As the number of knee replacement procedures increases, so does the incidence of revision surgeries. With each surgery more native anatomy is lost and the risk of secondary damage to musculature, nerves and bone increases. Multiple surgical interventions can compound these risks and negative complications, and can lead to terminal knee dysfunction.
Other joints that may be suitable for implants can have similar or other issues.
Embodiments of the present invention provide lockable implants that allow for flexion when desired by the patient, and that lock into a fixed or semi-rigid configuration for structurally stable alternative configurations.
The lockable implants can be selectively locked and/or unlocked by a user.
The lockable implants can have mechanical or electromechanical locks to lock and unlock the implant, and thus the associated lower anatomical member, into a specific orientation.
The lockable implants can include a magnetically operated lock that cooperates with an externally applied magnetic field to lock and unlock the implant.
The lockable implants can be self-locking, responsive to applying a force at or above a defined force or load.
The lockable implants can include buttons, latches or flexible surfaces on the implant that are accessible by the user (through palpation or the like) either manually or with a tool, that can be used to activate the locking or unlocking ability of the implant.
Embodiments of the invention are directed to implants that include: (a) a first member configured to attach to a first bone; (b) a second member in cooperating alignment with the first member configured to reside in a second adjacent bone; and (c) a lock mechanism in communication with the first and/or second members configured to (i) lock the first member to the second member for a stabilized configuration and (ii) unlock the first and second members to allow them to pivot relative to each other for flexion or bending.
The lock mechanism can be selectively actuated by a user to lock and unlock the implant.
The implant may include a hinge assembly having an axle configured to hingedly attach the first member to the second member. The hinge assembly can include a yoke with an axle channel that holds the axle and at least one spaced apart second channel. The lock mechanism can include at least one locking member that selectively slides in defined forward and reverse directions in the at least one second channel to respectively lock and unlock the first and second members.
The implant can include a hinge assembly having an axle configured to hingedly attach the first member to the second member. The hinge assembly can include a yoke that resides between the first and second members and has a laterally extending yoke axle channel and at least one spaced apart laterally extending second channel that is spaced apart from the axle channel. The second member can include outer laterally extending locking channels that reside on opposing ends of and can align with the at least one second laterally extending second channel. The lock mechanism can include at least one locking member that can slide, side-to-side, through the second member locking channels to enter and exit a defined interior space of the at least one second channel of the yoke to lock and unlock the implant.
The second member can include spaced apart laterally extending axle channels that reside on opposing ends of and can align with the laterally extending axle channel so that the axle resides in the second member axle channels and the yoke axle channel.
The first member can have a bearing surface defined by a polymer insert that holds the yoke and allows the second member to rotate in a flexion axis relative to the first member.
The lock mechanism can include a magnet that slides to lock and/or unlock in response to application of an external magnetic field.
The lock mechanism can be configured to be manually selectively actuated upon a contact force associated with a user physically pressing on an actuation member in communication with the lock mechanism that resides under skin of the patient with the implant.
The implant can include a hinge assembly that attaches the first and second members. The hinge assembly can include a yoke with a channel that receives first and second laterally spaced apart first and second magnets. The first or second member can include spaced apart open interior spaces that align with opposing sides of the yoke, one that receives a first magnet and one that receives the second magnet. The first and second magnets can slide out of the yoke channel into the respective first or second member interior spaces to unlock the lock mechanism and the magnets can slide into the yoke interior space to lock the implant.
The lock mechanism can be self-engaging in response to application of a load introduced by the patient when the first and second members are in a substantially aligned orientation.
The implant can be a total joint replacement implant.
The implant can be a total knee replacement implant.
The implant can be a total joint replacement implant of an elbow.
Other embodiments are directed to methods of operating an implant in a patient. The methods include: (a) selectively unlocking a lock of an implant having first and second members using an implantable lock onboard the implant; and (b) selectively locking the lock to lock the first member and the second member together in a fixed configuration for structural stability using the onboard lock.
The lock can include at least one magnet that slides and the selectively locking and unlocking can be carried out by passing an external magnetic field over the at least one magnet.
The selectively locking can be manually carried out by physically pressing on an actuation member in communication with the lock that resides under skin of the patient with the implant.
Other embodiments are directed to lockable implants. The implants include a first member configured to attach to a first bone; a second member in cooperating alignment with the first member configured to reside in a second adjacent bone; and a lock mechanism in communication with the first and second members configured to (i) lock the first member to the second member for a stabilized configuration and (ii) unlock the first and second members to allow them to pivot relative to each other for flexion or bending.
The lock mechanism can be selectively actuated by a user to lock and unlock the implant.
The lock mechanism can include at least one magnet that slides to lock and/or unlock in response to application of an external magnetic field.
The lock mechanism can be configured to be manually selectively actuated upon a contact force associated with a user physically pressing on an actuation member in communication with the lock mechanism that resides under skin of the patient with the implant.
The implant first and second members can have a cooperating ball and socket configuration and the lock mechanism can include at least one locking member that can slide through a locking channel to enter and exit a defined interior space of the first and/or second member to lock and unlock the implant.
The implant first and second members can be attached with a hinge having an axle in an axle channel.
The implant can be a total hip replacement implant.
The lock mechanism can be self-engaging in response to application of a load introduced by the patient when the first and second members are in a substantially aligned and/or defined orientation.
The implant can be a total knee replacement implant.
The implant can be a total joint replacement implant.
The implant can be a total joint replacement implant of a wrist.
The implant can be a total joint replacement implant of a hip.
The implant can be a total joint replacement implant of a shoulder.
The implant can be a total joint replacement implant of an elbow.
The implant can be a total joint replacement implant of an ankle.
The selectively locking can be manually carried out by physically pressing on an actuation member in communication with the lock that resides under skin of the patient with the implant.
It is noted that aspects of the invention described with respect to one embodiment, may be incorporated in a different embodiment although not specifically described relative thereto. That is, all embodiments and/or features of any embodiment can be combined in any way and/or combination. Applicant reserves the right to change any originally filed claim or file any new claim accordingly, including the right to be able to amend any originally filed claim to depend from and/or incorporate any feature of any other claim although not originally claimed in that manner. These and other objects and/or aspects of the present invention are explained in detail in the specification set forth below.
Other systems and/or methods according to embodiments of the invention will be or become apparent to one with skill in the art upon review of the following drawings and detailed description. It is intended that all such additional systems, methods, and/or devices be included within this description, be within the scope of the present invention, and be protected by the accompanying claims.
Other features of the present invention will be more readily understood from the following detailed description of exemplary embodiments thereof when read in conjunction with the accompanying drawings.
The present invention now is described more fully hereinafter with reference to the accompanying drawings, in which embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art.
Like numbers refer to like elements throughout. In the figures, the thickness of certain lines, layers, components, elements or features may be exaggerated for clarity. Broken lines illustrate optional features or operations unless specified otherwise. One or more features shown and discussed with respect to one embodiment may be included in another embodiment even if not explicitly described or shown with another embodiment.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. As used herein, phrases such as “between X and Y” and “between about X and Y” should be interpreted to include X and Y. As used herein, phrases such as “between about X and Y” mean “between about X and about Y.” As used herein, phrases such as “from about X to Y” mean “from about X to about Y.”
Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the specification and relevant art and should not be interpreted in an idealized or overly formal sense unless expressly so defined herein. Well-known functions or constructions may not be described in detail for brevity and/or clarity.
It will be understood that when an element is referred to as being “on”, “attached” to, “connected” to, “coupled” with, “contacting”, etc., another element, it can be directly on, attached to, connected to, coupled with or contacting the other element or intervening elements may also be present. In contrast, when an element is referred to as being, for example, “directly on”, “directly attached” to, “directly connected” to, “directly coupled” with or “directly contacting” another element, there are no intervening elements present. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “adjacent” another feature may have portions that overlap or underlie the adjacent feature.
Spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms “upwardly”, “downwardly”, “vertical”, “horizontal” and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.
It will be understood that, although the terms first, second, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer or section from another region, layer or section. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the present invention. The sequence of operations (or steps) is not limited to the order presented in the claims or figures unless specifically indicated otherwise.
The term “about” means that the recited number or value can vary by +/−20%.
The term “sterile” means that the noted device or material meets or exceeds defined medical guidelines of cleanliness and is substantially (if not totally) without contaminants so as to be suitable for medical uses.
Turning now to the figures,
Although the implant 10 is shown primarily herein as including a hinge to allow pivoting movement between two attached cooperating members 20, 30, other attachment configurations for other movement of a particular joint can be used, such as a ball and socket type configuration (
As shown, the implant 10 includes a first member 20, e.g., lower (tibial) member a second member 30, e.g., upper (femoral) member 30 with a lock or locking mechanism 40 (also called a latch). The lower member 20 can be attached to the tibia (“T”) and the upper member 30 can be attached to the femur (“F”) via respective stems 25, 35. The lower and upper members 20, 30 can be connected via a hinge yoke 22. The locking mechanism 40 can be incorporated into the hinge that is attached to the rotating platform area using the hinge yoke 22.
The hinge yoke 22 can include a laterally extending channel or aperture 1222 that is aligned with channel 1301 in the upper member 30 to hold an axle 50, typically inside an axle bearing 51, so as to allow the upper member 30 to pivot with respect to the lower member 20 via the axle 50. The hinge yoke 22 can include a second channel or laterally extending aperture 1221 that holds a moveable locking member 52, shown as a pin or bolt, that can selectively slide to engage or disengage a channel 1302 in the upper member 30 to (i) lock into a full stabilization walking configuration (e.g., full extension) to allow an arthrodesis gait without requiring normal muscular strength and/or control and (ii) unlock to allow the members 20, 30 to pivot relative to each other for flexion or bending when not ambulating.
In some embodiments, the hinge yoke 22 can include first and second spaced apart, laterally extending apertures or channels 1221, 1222 (
In the embodiment shown, at least one slidable locking member 52 includes two locking members, one on each side of the implant 10. The locking members 52 can slide inward and outward substantially in concert, or be separately deployable.
The hinge yoke locking member(s) channel 1221 can be configured as a single channel with a constant diameter or with different diameters. Where more than one locking member 52 is used, the different locking members 52 can have different sizes (e.g., diameters) and/or configurations or may have the same configurations and sizes. In the embodiment shown, the hinge yoke 22 includes a forward channel 1221 with a reduced diameter or inner extending lip 57 at a medial section thereof 57 (
In some embodiments, the implant 10 can include a polymer insert 21 forming part of the hinge/rotating platform 121 as in conventional implants 10. The locking mechanism 40 can be incorporated into conventional or novel hinge/rotating platform systems.
In some embodiments, the insert 21 and/or hinge yoke 22 can be provided in multiple configurations that can be selected by a doctor for a particular patient so that the doctor can choose one that locks the patient's leg 5-10 degrees short of “full extension” for a stable walking configuration.
The implants 10 can be modular, interfacing with other implantable components of a knee replacement system, allowing for adjustment of limb length and fixation angle. The implants 10 can be suitable for patients who could undergo revision, but are at risk of complications that could compromise its success. The implants 10 can be used for patients with poorly performing revision implants, but who do not desire permanent fusion (or amputation). The implants 10 can be used for patients that otherwise would require fusion or amputation. The implants 10 can be used with patients having existing fusions who can “take-down” to the lockable knee implant to provide them with increased mobility or quality of life. The implants 10 may also be used as a primary implant for a first TKR surgery irrespective of whether a patient may have the compromised tissue or bone structure as a precaution.
The implants 10 can have a hinge/rotating platform 121 and provide industry standard stability. The locking configurations can be configured to fit modular revision TKRs. The interfacing configurations of modular revision TKR implants can allow mix and match of components to custom fit to individual patients. The implant 10 can restore the knee joint function using a rotating hinge-like function with two axis of articulation, including articulating members 21, 30, which rotate about axle 50, and articulating members 20 and 21, 22 which rotate about the stem 23 (
The device 10 can be locked via mechanical or electromechanical locking mechanism 40 that engages the hinge comprising the hinge yoke 22. The lock or locking mechanism 40 is typically unpowered, but may be passively powered (e.g., inductively powered) without requiring an on board power source. The lock can be selectively activated and/or deactivated by a user. The locking mechanism 40 can be manually or electronically activated and/or deactivated. The locking mechanism 40 can be manually actuated.
A user can activate and/or deactivate the locking mechanism from one state to the other. The device 10 can maintain its current status until the user intervenes.
The locking mechanism 40 may be self-activating in response to a large load, such as a load-bearing weight, being applied to the members 20, 30, when the members 20, 30 are aligned in a substantially straight or other stable (walking) orientation (such that the pivot shaft of the two components 20, 30, e.g., femoral and tibial components, are substantially in-line so that the limb is substantially straight). This activation can be while a patient is prone on a bed or sofa by pushing against a foot board, for example, but is typically in response to standing upright. The activation can be induced by a jolt, small jump or other movement to cause the mechanical lock to move to the lock orientation.
When members 22 and 30 are aligned as shown in
In some particular embodiments, an interruption 57 in the interior channel 1221 that divides internal spaces 53 can take the form of a reduced diameter, and can keep locking members 52 from physically contacting either other, or from traveling beyond a pre-determined distance.
When the device 10 is rotated about axle 50, interference geometry 60 of the hinge yoke 22 blocks access of channel 1221 and can serve to keep locking members 52 from leaving interior space 54.
In some embodiments, as shown for example in
With the use of an internal magnetic material 55, attractive or repulsive axial (side-to-side relative to the implant body) force can be applied to the bolts 52 with a user interface device 155 which can apply an external magnetic field (physical or electrical magnet via a user probe, control or other user interface input device), causing the locking member(s) 52 to translate laterally with respect to the implant body 10.
In some embodiments, the polar axis of magnetic material 55 can be in-line with the axis of the lock, and external magnets in the same polar axis can be passed over either side of the device 10, pulling the bolts medially and into an unlocked configuration as shown in
In some particular embodiments, the magnetic material 55 can be a rare earth magnet, which is typically much stronger than ferrous magnets. There are two conventional types of rare earth magnets, neodymium magnets (e.g., neodymium-iron-boron) and samarium-cobalt magnets.
In some embodiments, the polar magnetic axis of magnetic material 55 within locking members 52 can be aligned in such a way that the natural state of the implant is to remain locked until user intervention.
Magnetic material can be extremely brittle and can also be vulnerable to corrosion (such as from the digestive acids in the body). The magnetic material can be sealed within the locking member 52 and cap 56. The magnetic material 55 can be alternatively or additionally plated or coated with a biocompatible material such as polyethylene to protect them from breaking, chipping and/or for corrosion resistance. Particular examples of rare earth magnets include Nd2Fe14B, SmCo5 and Sm(Co,Fe,Cu,Zr).
The magnetic material 55 can include a material that moves or changes viscosity in response to exposure to a magnetic field such as a magnetorheological fluid (also known as an MR fluid, available from Lord Corporation, Erie, Pa.) or a ferrofluid. The fluids change viscosity when subjected to a magnetic field.
The lock 40 can also or alternatively be a mechanical lock 58, as seen in
In some embodiments, the hinge yoke 22 can include a set of stacked dome or belleview washers, springs or other biasing members that can bias the movement in one direction (to the unlocked or locked position).
The locking mechanism 40 can be self-activating in response to application of load bearing weights as noted above.
The locking mechanism 40 can be a mechanical assembly that includes a set of stacked dome or belleview washers, springs or other biasing members that compress when a defined load is applied and allow a locking member to translate in a defined direction, e.g., sideways or up or down to engage a mechanical lock retention feature associated with the hinge yoke 22.
As shown in
In some embodiments of the device 10, the locking mechanism 40 is configured so that locking can occur in response to when the device is moved into full extension, as shown in
In other embodiments, the locking mechanism can be activated using an inductively powered circuit/switch based on an externally applied inductive power source.
While the foregoing written description of the invention enables one of ordinary skill to make and use what is considered presently to be the best mode thereof, those of ordinary skill will understand and appreciate the existence of variations, combinations, and equivalents of the specific embodiment, method, and examples herein. The invention should therefore not be limited by the above described embodiment, method, and examples, but by all embodiments and methods within the scope and spirit of the invention as claimed.
This application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/672,352, filed Jul. 17, 2012, the contents of which are hereby incorporated by reference as if recited in full herein.
Number | Date | Country | |
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61672352 | Jul 2012 | US |