The present disclosure relates to a method and apparatus for pre-forming a high tibial osteotomy.
This section provides background information related to the present disclosure which is not necessarily prior art.
Various knee osteotomies are performed to adjust or change the orientation of the tibia to correct various abnormalities caused by birth defects, trauma, or disease. High tibial osteotomies include open-wedge and closed-wedge osteotomies. Various implants designed to fill osteotomies exist. Some are modeled after a patient's specific anatomy, which increases the cost of the implant and complexity of production. Therefore, a simplified and cost-effective osteotomy implant that can be adjusted to fit a patient's anatomy would be desirable.
This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
The present teachings provide for an osteotomy implant including a porous portion, a solid portion, and a hinge portion. The porous portion includes a first part and a second part that defines a clearance therebetween. A solid portion abuts the porous portion. A hinge portion of the solid portion is coupled to the first part and the second part. The hinge portion is configured to enable the implant to be changed from a first configuration to a second configuration.
The present teachings also provide for an osteotomy implant including a porous metallic portion, a solid metallic portion, and a metallic hinge portion. The porous metallic portion includes a first part spaced apart from a second part. The solid metallic portion is integral with the porous metallic portion. The metallic hinge portion of the solid metallic portion is one of aligned with or between the first part and the second part. The hinge portion is configured to enable the implant to be changed from a first configuration to a second configuration.
The present teachings also provide for an osteotomy implant including a generally “U” shaped loadbearing porous portion including a first part and a second part. The first part includes a first inner surface that opposes a second inner surface of the second part. A solid portion is coupled to both a first outer surface of the first part and a second outer surface of the second part. The first outer surface is opposite to the first inner surface and the second outer surface is opposite to the second inner surface. A flexible hinge portion is included with the solid portion. The implant is bendable at the flexible hinge portion to compress or expand the implant. The flexible hinge portion is configured to enable the implant to be changed from a first configuration to a second configuration.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
Example embodiments will now be described more fully with reference to the accompanying drawings.
With initial reference to
The osteotomy implant 10 generally includes a porous portion 20 and a solid portion 22. The porous portion 20 generally includes a first part 24 and a second part 26, which define a clearance or gap 28 therebetween. Both the first part 24 and the second part 26 include an inner surface 30 and an outer surface 32, which is opposite to the inner surface 30. The first part 24 and the second part 26 are arranged such that the inner surface 30 of the first part 24 faces and is opposite to the inner surface 30 of the second part 26. Each of the first part 24 and the second part 26 further include an upper or superior surface 34, which is opposite to an under or inferior surface 36. The solid portion 22 includes an inner surface 38, which is opposite to an outer surface 40. The solid portion 22 extends across the outer surface 32 of each of the first part 24 and the second part 26 of the porous portion 20, and thus extends across the gap 28. The solid portion 22 includes a hinge 42, such as a living hinge, opposite to the gap 28.
The implant 10 can be made of any suitable biocompatible material sufficient to bear loads on the tibia 14 at the osteotomy site 12. For example, the implant 10 can be made out of a suitable metallic, such as titanium including commercially pure (CP) titanium or Grade 5 titanium alloy (Ti6Al4V). An example of a suitable porous titanium construct that the implant can be made from is Regenerex® by Biomet of Warsaw, Ind. Any suitable cobalt chrome based alloy may also be used. Both the porous portion 20 and the solid portion 22 can be made of the same material. The porous portion 20 can be made from any suitable implantable plastic, such as PEEK (polyether ether ketone) or PEKK (polyether ketone ketone). For example, the porous portion 20 can include ProOsteon® by Biomet of Warsaw, Ind.
The implant 10 can be manufactured in any suitable manner. For example, the porous portion 20 and the solid portion 22 can be individually manufactured and then subsequently coupled or joined together using any suitable coupling process. Other manufacturing processes that are suitable include electron beam melting or any suitable additive manufacturing process, such as a suitable additive metal fabrication technique. Using laser sintering, for example, the entire implant 10 can be manufactured or printed together, such that the porous portion 20 and the solid portion 22 are integrally formed and the implant 10 is monolithic. The porous portion 20 can be formed in any suitable manner that will provide for pores into which bone growth may occur in order to further secure the implant 10 at the osteotomy site 12. The porous portion 20 is a generally “U” shaped, load-bearing portion able to withstand loads upon the tibia 14. Upon being inserted into the osteotomy site 12, the implant 10 will be retained within the osteotomy site 12 through friction between the tibia 14 and the porous portion 20. The solid portion 22 further increases the compression strength of the implant 10 and prevents tissue from growing into the porous portion 20 from outside of the osteotomy site 12. The porous portion 22 may include ribs 44, which are not porous to further increase the compression strength of the implant 10.
Implantation of the implant 10 at the osteotomy site 12 will now be described. The implant 10 selected for implantation can be chosen from a plurality of implants 10 having a similar overall configuration, but having different general sizes to facilitate customization. For example, a plurality of implants 10 having different superior-inferior heights and medial-lateral widths can be provided and selected based on dimensions of the osteotomy size 12. The width of the implant 10 is first compared to the width of the osteotomy site 12 in the anterior to the posterior direction. The width of the implant 10 is generally considered with respect to the distance between the first part 24 and the second part 26 of the porous portion 20. If the width of the implant 10 is wider than the width of the osteotomy site 12, then the implant 10 can be compressed in order to decrease the width. If the width of the implant 10 is narrower than the width of the osteotomy site 12, then the implant 10 can be expanded in order to increase its width.
The implant 10 can be compressed (closed) or expanded (opened) either manually or using a suitable tool. The material of the solid portion 22 is rigid enough to maintain structural integrity of the implant 10, but flexible enough to permit the implant 10 to be compressed in this manner. As the first part 24 and the second part 26 are moved together, the gap 28 therebetween will become smaller. As the first part 24 and the second part 26 are moved apart, the gap 28 therebetween will become larger. Specifically, implant 10 pivots generally at the hinge 42, which can be configured in any suitable manner to facilitate bending of the solid portion 22, such as with a thinned portion, a notched portion, or any weakened portion. The first part 24 and the second part 26 can be compressed or expanded to any suitable position, such as between a first configuration and a second configuration, thus providing the implant 10 with a near infinite number of medial-lateral widths. The rigidity of the solid portion 22 will maintain the implant 10 in the compressed or expanded position to provide the implant 10 with a desired medial-lateral width to fit the osteotomy site 12. As the first part 24 and the second part 26 are moved, the solid portion 22 bends at the hinge 42. The implant 10 is retained within the osteotomy site 12 due to friction between the portion of the tibia 14 at the osteotomy site 12 and the porous portion 20. The implant 10 will be further retained within the osteotomy site 12 by bone ingrowth into the porous portion 20. The implant 10 can also be retained within the osteotomy site 12 with any suitable retention device or feature, such as a suitable locking plate.
With additional reference to
Another osteotomy implant according to the present teachings is illustrated in
The porous portion 20 of the implant 60 is divided into a plurality of porous parts 20A through 20F. Each of the porous parts 20A-20F is surrounded by the solid portion 22. Between adjacent ones of the porous parts 20A-20F, the solid portion 22 includes the hinge 42, and thus a plurality of hinges 42A-42E are provided to link together the plurality of porous parts 20A-20F. Any suitable number of porous portions 20 can be included with the implant 60 depending on the size of the osteotomy site 12. To optimize fit between the implant 60 and the osteotomy site 12, the implant 60 can be flexed or compressed either inward or outward at any of the hinges 42A-42E, allowing the implant 60 to be flexed or compressed to nearly an infinite number of positions. The porous portions 20 define therebetween a plurality of clearances or gaps 28 that allow the implant 60 to be flexed inward and outward at the hinges 42. The width of the clearances or gaps 28 can be set to limit the amount of flex between the porous portions 20. The porous portions 20A-20F are exposed at the upper surfaces 34 and the under surfaces 36 thereof in order to permit bone growth therein, which further secures the implant 60 at the osteotomy site 12. The thickness of the hinge 42 can be adjusted to control the flexibility of the hinge 42.
Another osteotomy implant according to the present teachings is illustrated in
The ball and socket hinge 42F/42G facilitates movement of the first part 24 and the second part 26 of the porous portion 20 together or apart in order to decrease or increase the medial-lateral width of the implant to correspond to the implant site 12. When set at the desired medial-lateral width, the ball and socket hinge 42F/42G will retain the implant 70 at the set width in any suitable manner, such as by friction between the ball 42F and the socket 42G, or with any suitable locking device. Although the implant 70 is not illustrated with the first solid portion 22A extending entirely across the outer surface 32 of each of the first part 24 of the porous portion 20, the first solid portion 22A can be lengthened to extend entirely across the outer surface 32 of the first part 24. Similarly, the second solid portion 22B can be lengthened so as to extend across the entire outer surface 32 of the second part 26 of the porous portion 20. The ball 42F and the socket 42G can be provided in place of the hinge 42 of any one of the implants 10, 50, or 60, as well as the implants 80 and 90 described herein.
Yet another osteotomy implant according to the present teachings is illustrated in
The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
Number | Name | Date | Kind |
---|---|---|---|
4421112 | Mains et al. | Dec 1983 | A |
5053039 | Hofmann et al. | Oct 1991 | A |
5364402 | Mumme et al. | Nov 1994 | A |
5417694 | Marik et al. | May 1995 | A |
5613969 | Jenkins, Jr. | Mar 1997 | A |
5620448 | Puddu | Apr 1997 | A |
5722978 | Jenkins, Jr. | Mar 1998 | A |
5921988 | Legrand | Jul 1999 | A |
6086593 | Bonutti | Jul 2000 | A |
6514259 | Picard et al. | Feb 2003 | B2 |
6823871 | Schmieding | Nov 2004 | B2 |
7060074 | Rosa et al. | Jun 2006 | B2 |
7104997 | Lionberger et al. | Sep 2006 | B2 |
7121832 | Hsieh et al. | Oct 2006 | B2 |
7935119 | Ammann et al. | May 2011 | B2 |
7959637 | Fox et al. | Jun 2011 | B2 |
7967823 | Ammann et al. | Jun 2011 | B2 |
8062301 | Ammann et al. | Nov 2011 | B2 |
8083749 | Taber | Dec 2011 | B2 |
8133230 | Stevens et al. | Mar 2012 | B2 |
8137406 | Novak et al. | Mar 2012 | B2 |
8167951 | Ammann et al. | May 2012 | B2 |
8182489 | Horacek | May 2012 | B2 |
8192441 | Collazo | Jun 2012 | B2 |
8192495 | Simpson et al. | Jun 2012 | B2 |
8211112 | Novak et al. | Jul 2012 | B2 |
8241292 | Collazo | Aug 2012 | B2 |
8241293 | Stone et al. | Aug 2012 | B2 |
8265790 | Amiot et al. | Sep 2012 | B2 |
8303596 | Plaβky et al. | Nov 2012 | B2 |
8333772 | Fox et al. | Dec 2012 | B2 |
8355773 | Leitner et al. | Jan 2013 | B2 |
8632547 | Maxson et al. | Jan 2014 | B2 |
20030105526 | Bryant et al. | Jun 2003 | A1 |
20040153087 | Sanford et al. | Aug 2004 | A1 |
20050033432 | Gordon et al. | Feb 2005 | A1 |
20050075641 | Singhatat et al. | Apr 2005 | A1 |
20050228393 | Williams et al. | Oct 2005 | A1 |
20050234465 | McCombs et al. | Oct 2005 | A1 |
20050240195 | Axelson et al. | Oct 2005 | A1 |
20050273114 | Novak | Dec 2005 | A1 |
20060195111 | Couture | Aug 2006 | A1 |
20060200158 | Farling et al. | Sep 2006 | A1 |
20060241635 | Stumpo et al. | Oct 2006 | A1 |
20060241636 | Novak et al. | Oct 2006 | A1 |
20060293681 | Claypool et al. | Dec 2006 | A1 |
20070016209 | Ammann et al. | Jan 2007 | A1 |
20070118138 | Seo et al. | May 2007 | A1 |
20070244487 | Ammann et al. | Oct 2007 | A1 |
20070288029 | Justin et al. | Dec 2007 | A1 |
20070288030 | Metzger et al. | Dec 2007 | A1 |
20080015603 | Collazo | Jan 2008 | A1 |
20080015604 | Collazo | Jan 2008 | A1 |
20080015605 | Collazo | Jan 2008 | A1 |
20080039850 | Rowley et al. | Feb 2008 | A1 |
20080097451 | Chen et al. | Apr 2008 | A1 |
20080140081 | Heavener et al. | Jun 2008 | A1 |
20080140213 | Ammann et al. | Jun 2008 | A1 |
20080147073 | Ammann et al. | Jun 2008 | A1 |
20080161816 | Stevens et al. | Jul 2008 | A1 |
20080195109 | Hunter et al. | Aug 2008 | A1 |
20080287954 | Kunz et al. | Nov 2008 | A1 |
20080294170 | O'Brien | Nov 2008 | A1 |
20080306485 | Coon et al. | Dec 2008 | A1 |
20090076520 | Choi | Mar 2009 | A1 |
20090082774 | Oti et al. | Mar 2009 | A1 |
20090088759 | Aram et al. | Apr 2009 | A1 |
20090088760 | Aram et al. | Apr 2009 | A1 |
20090099567 | Zajac | Apr 2009 | A1 |
20090118769 | Sixto, Jr. et al. | May 2009 | A1 |
20090131942 | Aker et al. | May 2009 | A1 |
20090222015 | Park et al. | Sep 2009 | A1 |
20090248044 | Amiot et al. | Oct 2009 | A1 |
20090287217 | Ammann et al. | Nov 2009 | A1 |
20090318921 | White et al. | Dec 2009 | A1 |
20100010493 | Dower | Jan 2010 | A1 |
20100023015 | Park | Jan 2010 | A1 |
20100042105 | Park et al. | Feb 2010 | A1 |
20100049195 | Park et al. | Feb 2010 | A1 |
20100057088 | Shah | Mar 2010 | A1 |
20100121334 | Couture et al. | May 2010 | A1 |
20100145344 | Jordan et al. | Jun 2010 | A1 |
20100168752 | Edwards | Jul 2010 | A1 |
20100191244 | White et al. | Jul 2010 | A1 |
20100198224 | Metzger et al. | Aug 2010 | A1 |
20100212138 | Carroll et al. | Aug 2010 | A1 |
20100217338 | Carroll et al. | Aug 2010 | A1 |
20100318088 | Warne et al. | Dec 2010 | A1 |
20110015636 | Katrana et al. | Jan 2011 | A1 |
20110015639 | Metzger et al. | Jan 2011 | A1 |
20110022049 | Huebner et al. | Jan 2011 | A1 |
20110166578 | Stone et al. | Jul 2011 | A1 |
20110172672 | Dubeau et al. | Jul 2011 | A1 |
20110184419 | Meridew et al. | Jul 2011 | A1 |
20110218634 | Ringeisen | Sep 2011 | A1 |
20110251617 | Ammann et al. | Oct 2011 | A1 |
20110269100 | Furrer et al. | Nov 2011 | A1 |
20110275032 | Tardieu et al. | Nov 2011 | A1 |
20120109138 | Meridew et al. | May 2012 | A1 |
20120130382 | Iannotti et al. | May 2012 | A1 |
20120141034 | Iannotti et al. | Jun 2012 | A1 |
20120143197 | Lang et al. | Jun 2012 | A1 |
20120143267 | Iannotti et al. | Jun 2012 | A1 |
20120215225 | Philippon et al. | Aug 2012 | A1 |
20120221017 | Bonutti | Aug 2012 | A1 |
20120232596 | Ribeiro | Sep 2012 | A1 |
20120259335 | Scifert et al. | Oct 2012 | A1 |
20120271314 | Stemniski et al. | Oct 2012 | A1 |
20120276509 | Iannotti et al. | Nov 2012 | A1 |
20120283840 | Frederick et al. | Nov 2012 | A1 |
20120289965 | Gelaude et al. | Nov 2012 | A1 |
20120296339 | Iannotti et al. | Nov 2012 | A1 |
20120303004 | Uthgenannt et al. | Nov 2012 | A1 |
20120303033 | Weiner et al. | Nov 2012 | A1 |
20120310399 | Metzger | Dec 2012 | A1 |
20130006250 | Metzger et al. | Jan 2013 | A1 |
20130035766 | Meridew | Feb 2013 | A1 |
20130085500 | Meridew et al. | Apr 2013 | A1 |
20130110116 | Kehres et al. | May 2013 | A1 |
20130119579 | Iannotti et al. | May 2013 | A1 |
20130131681 | Katrana et al. | May 2013 | A1 |
Number | Date | Country |
---|---|---|
2741525 | May 1997 | FR |
2771282 | May 1999 | FR |
Entry |
---|
“Arthrex® iBalance® HTO System for Medial Hight Tibial Opening Wedge Osteotomy—Surgical Technique,” Medical brochure. (2013) 16 sheets. |
“iBalance® HTO System Innovative Solutions for Varus Knee Realignment,” Arthrex® medical brochure. (2013). 6 sheets. |
“iBalance® Medial Opening Wedge Tibial System,”Arthrex®. (2011). 63 sheets. |
“Pro Osteon® 200 R Bone Graft Substitute,” Biomet brochure. (2014) 1 sheet. |
“Pro Osteon® 500R Bone Graft Substitute,” Biomet brochure. (2014) 1 sheet. |
“Regenerex® Porous Titanium Construct,” Biomet brochure. (2008) 12 sheets. |
International Search Report and Written Opinion mailed Mar. 13, 2014 for PCT/US2013/074723 claiming benefit of U.S. Appl. No. 13/720,644, filed Dec. 19, 2012. |
Number | Date | Country | |
---|---|---|---|
20140172116 A1 | Jun 2014 | US |