The present disclosure relates generally to orthopaedic prostheses and methods of using the same.
During the lifetime of a patient, it may be necessary to perform a orthopaedic procedure, such as a joint replacement procedure, on the patient as a result of, for example, disease or trauma. The orthopaedic procedure may involve the use of a prosthesis which is implanted into one or more of the patient's bones.
According to one aspect of the present disclosure, an implantable orthopaedic prosthesis includes a superparamagnetic material.
The prosthesis may include an elongated nail having a number of holes defined therein. The superparamagnetic material may be disposed in, around, or proximate to the holes.
The prosthesis may include a polyethylene implant.
The implantable orthopaedic prosthesis may include multiple components with one or more of such components having superparamagnetic material secured thereto.
The superparamagnetic material may be arranged in the form of a symbol, pattern, or any other type of indicia.
According to another aspect of the present disclosure, a method of determining the position of an orthopaedic prosthesis subsequent to implantation thereof includes the step of exposing the implanted orthopaedic prosthesis to a magnetic field to detect a superparamagnetic material secured to the prosthesis. In such a way, the relative position of one or more of the components of the prosthesis may be determined. Such a method may also be used to determine the position of the prosthesis relative to a bone. The method may also be used to determine the degree of wear of the prosthesis.
The above and other features of the present disclosure will become apparent from the following description and the attached drawings.
The detailed description particularly refers to the accompanying 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 disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives following within the spirit and scope of the invention as defined by the appended claims.
Referring now to
When a superparamagnetic material is exposed to a magnetic field, it produces distortion in the field that may be measurable by use of any of a number of techniques. For example, such distortion may be measurable with magnetic resonance imaging (MRI), or by the use of highly sensitive magnetic sensors such as Giant Magneto-Resistive (GMR), Magnetic Tunnel Junctions (MTJ), Spin Dependent Tunneling (SDT), Anisotropic Magneto-Resistive (AMR), Fluxgate Magnetometers (FGM), Superconducting Quantum Interference Devices (SQUIDs), or the like.
As will be described below in greater detail, superparamagnetic materials may be incorporated into the design of an implantable orthopaedic prosthesis to allow for the in vivo determination of a number of aspects of the prosthesis. For example, subsequent to implantation of the orthopaedic implant, superparamagnetic materials may be used to monitor wear of the implant, identify the implant, determine the position of the components of the implant relative to one another, determine the onset of subsidence or migration of the implant, visualize the implant (in the case of, for example, polyethylene implants), along with other uses.
Referring now in particular to
The femoral prosthesis 10 includes a stem 12 and a head 14. The prosthesis 10 is configured to be implanted into the femur 16 of a patient in order to replace certain natural features of the patient's femur as a result of, for example, disease or trauma. The prosthesis 10 is implanted into a surgically prepared (e.g., reamed and/or broached) medullary canal of the femur 16. The prosthesis is secured in place by the use of bone cement 18, although cement-less joints may be used.
The prosthesis 10 includes a superparamagnetic material arranged in a pattern 22. In the exemplary case of the prosthesis 10 shown in
It should be appreciated that the barcode may be used as a key into a database containing detailed identification information about the prosthesis 10 such as the manufacturer, product line, lot number, serial number, size, implanting surgeon, etcetera. In addition to, or in lieu of, being a key into a database, the barcode may be a portable database with such implant identification information being encoded in the barcode itself. This may be particularly useful when two-dimensional barcodes are used, although use of the barcode as a portable database (as opposed to a key) is not limited to two-dimensional barcodes. Due to the relatively small size of the individual particles of the superparamagnetic material (e.g., 0.2-1.5 microns), the pattern 22 (e.g., the barcode) may be configured with a relatively high data density.
The superparamagnetic pattern 22 of the prosthesis 10 may be visualized, in vivo. Specifically, subsequent to implantation of the prosthesis 10, the patient may be exposed to a magnetic field, such as an MRI, an X-ray, and/or a custom measurement system utilizing one or more of the aforementioned highly sensitive magnetic sensors, to visualize the barcode (or other type of human-readable or machine-readable indicia used as the pattern 22). In such a way, information, such as implant identification information, may be encoded with the prosthesis 1O.
The superparamagnetic pattern 22 may be placed (e.g., coated) on the surface of the implant. Alternatively, the pattern may be embedded in the implant such as in the case of a polyethylene implant.
It should be appreciated that, in addition to the exemplary barcodes described herein, the pattern 22 may take the form of any type of machine-readable indicia. In addition, the pattern 22 may be embodied as a human-readable indicia such as one or more alphanumeric characters.
Although use of a superparamagnetic material in the formation of human-readable or machine-readable indicia is described in regard to the stem 12 of the femoral prosthesis 10, it should be appreciated that any type of prosthesis may utilize such an indicia. For example, such concepts may be utilized in conjunction with the other components of a hip prosthesis (e.g., the head 14 or an acetabular cup and/or bearing), the components of a knee prosthesis (e.g., a femoral component, tibial tray, and/or tibial bearing), the components of a shoulder prosthesis (e.g., a humeral stem, head and/or glenoid bearing), long bone prosthesis (e.g., distractors or trauma nails), spinal implants, or any other type of prosthesis.
The prosthesis 10 also includes another pattern 24 of superparamagnetic material. In the exemplary embodiment of
A pattern 28 of superparamagnetic material may be secured to the patient's femur 16. As with the pattern 24 of the prosthesis 10, in the exemplary embodiment of
The superparamagnetic patterns 24, 28 may be used, in vivo, to determine the position of the prosthesis 10 relative to the femur 16. Specifically, subsequent to implantation of the prosthesis 10, the patient may be exposed to a magnetic field. By measuring the distortion the superparamagnetic material causes in the applied magnetic field at one or more of the points 26, the in vivo position of the point(s) 26 may be determined by, for example, triangulation. Likewise, by measuring the distortion the superparamagnetic material causes in the applied magnetic field at one or more of the points 30, the in vivo position of the point(s) 30 may be determined by, for example, triangulation. Once the in vivo position of the point(s) 26 and the point(s) 30 have been determined, the position of the prosthesis 10 relative to the femur 16 may be correlated.
It should be appreciated that the position of the prosthesis 10 relative to the femur 16 may be monitored over time subsequent to implantation of the prosthesis 10. In such a way, anomalies, such a implant subsidence or migration, may be detected. For example, the alignment of each of the point(s) 26 of the prosthesis 10 relative to a corresponding point(s) 30 of the femur 10 may be noted at the time of implantation of the prosthesis 10 (e.g., during or relatively soon after surgery). In the exemplary embodiment of
It should be appreciated that although the points 26 of the prosthesis 10 are shown in
In addition to triangulation, other methods for determining the location of the point(s) 26 of the prosthesis 10 and the point(s) 30 of the femur 16 in response to exposure to a magnetic field may also be used. For example, custom models, along with the associated measurement scheme and calculations, may be used to characterize the magnetic field as a permanent magnet to determine the location(s) of the point(s) 26 of the prosthesis 10 and the point(s) 30 of the femur 16. Such models may be analytical, finite elemental, or based on any other type of suitable mathematical method.
Moreover, the superparamagnetic patterns 24, 28 may be visualized in a similar manner to as described above in regard to the pattern 22 (e.g., by use of an MRI, an X-ray, and/or a custom measurement system utilizing one or more of the aforementioned highly sensitive magnetic sensors). The resultant film or digital rendering, (e.g., digital X-ray) may then be analyzed manually (e.g., visually) or by an automated device to determine the position of the point(s) 26 relative to the point(s) 30 with such data then being utilized to correlate the position of the prosthesis 10 relative to the femur 16.
As described above, although the use of a superparamagnetic material to monitor implant position/movement is described in detail in regard to the stem 12 of the femoral prosthesis 10, it should be appreciated that such concepts may be used to monitor implant position/movement of any type of prosthesis relative to a bone (or other anatomical structure). For example, such concepts may be used in regard to the other components of a hip prosthesis (e.g., the head 14 or an acetabular cup and/or bearing), the components of a knee prosthesis (e.g., a femoral component, tibial tray, and/or tibial bearing), the components of a shoulder prosthesis (e.g., a humeral stem, head and/or glenoid bearing), long bone prostheses (e.g., distractors or trauma nails), spinal implants, or any other type of prosthesis.
Patterns of superparamagnetic material may be used in other implant applications, as well. For example, as shown in
As shown in
A tibial bearing 48 of the knee prosthesis 40 has a pattern 50 of superparamagnetic material. As with the pattern 44 of the tibial tray 42, in the exemplary embodiment of
The superparamagnetic patterns 44, 50 may be used, in vivo, to detect motion (e.g., micromotion) of the tibial bearing 48 relative to the tibial tray 42. Specifically, subsequent to implantation of the knee prosthesis 40, the patient may be exposed to a magnetic field. By measuring the distortion the superparamagnetic material causes in the applied magnetic field at one or more of the points 46 and one or more of the points 52 (e.g., by triangulation of such points 46, 52) as a function of time, motion of the pattern 50 of the tibial bearing 48 relative to the pattern 44 of the tibial tray 42 may be detected. Such motion of the patterns 44, 50 may be correlated to motion of the components (e.g., the tibial bearing 48 and the tibial tray 42).
It should be appreciated that although the points 46 of the tibial tray 42 are shown in
In addition to triangulation, other methods for detecting the motion between of the point(s) 52 of the tibial bearing 48 and the point(s) 46 of the tibial tray 42 may also be used. For example, custom models, along with the associated measurement scheme and calculations, may be used to characterize the magnetic field as a permanent magnet to detect motion between of the point(s) 52 of the tibial bearing 48 and the point(s) 46 of the tibial tray 42. Such models may be analytical, finite elemental, or based on any other type of suitable mathematical method. Moreover, the location of the point(s) 52 of the tibial bearing 48 and the point(s) 46 of the tibial tray 42 may be visualized over time by use of, for example, an MRI, an X-ray, and/or a custom measurement system utilizing one or more of the aforementioned highly sensitive magnetic sensors. Such location over time data may be correlated to motion.
Although use of a superparamagnetic material to monitor motion between the components of an implant is described in detail in regard to a tibial bearing and a tibial tray, it should be appreciated that such concepts may be used to monitor motion of any of the components of any type of prosthesis. For example, such concepts may be used in regard to the other components of a knee prosthesis (e.g., motion of the tibial tray or bearing relative to the femoral component), the components of a hip prosthesis (e.g., a femoral implant, head, acetabular cup, and/or bearing), the components of a shoulder prosthesis (e.g., a humeral stem, head and/or glenoid bearing), the components of a long bone prosthesis (e.g., distractors), spinal implants, or any other type of prosthesis.
As shown in
A femoral component 58 of the knee prosthesis 40 has one or more patterns 60 of superparamagnetic material. Similar to the pattern 54 of the tibial tray 42, in the exemplary embodiment of
The superparamagnetic patterns 54, 60 may be used, in vivo, to determine the position of the femoral component 58 relative to the tibial tray 42. In such a way, post-operative wear of the tibial bearing 48 may be monitored (such bearings generally being constructed of a polymer). In particular, as the tibial bearing 48 wears, the distance between the femoral component 58 and the tibial tray 42 decreases since such a distance is indicative of the thickness of the tibial bearing 48. By monitoring the position of the superparamagnetic patterns 54, 60 relative to one another (and hence the position of the femoral component 58 and the tibial tray relative to one another), the thickness of the tibial bearing may be monitored. Subsequent to implantation of the knee prosthesis 40, the patient may be exposed to a magnetic field. By measuring the distortion the superparamagnetic material causes in the applied magnetic field at one or more of the points 56 and one or more of the points 62 (e.g., by triangulation of such points 56, 62) the location of the pattern 60 of the femoral component 58 relative to the pattern 54 of the tibial tray 42 may be determined. The location of the patterns 54, 60 may be correlated to a distance between the components (i.e., the femoral component 58 and the tibial tray 42) and hence the thickness of the tibial bearing 48.
It should be appreciated that although the points 56 of the tibial tray 42 are shown in
In addition to triangulation, other methods for determining the distance between of the point(s) 62 of the femoral component 58 and the point(s) 56 of the tibial tray 42 may also be used. For example, custom models, along with the associated measurement scheme and calculations, may be used to characterize the magnetic field as a permanent magnet to determine the distance between the point(s) 62 of the femoral component 58 and the point(s) 56 of the tibial tray 42. Such models may be analytical, finite elemental, or based on any other type of suitable mathematical method.
Although the use of a superparamagnetic material to monitor wear of a knee bearing (i.e., the tibial bearing 48) is herein described in detail, it should be appreciated that such concepts may be used to monitor wear of any of the components of any type of prosthesis. For example, such concepts may be used in regard to the other components of a knee prosthesis, the components of a hip prosthesis (e.g., an acetabular bearing), the components of a shoulder prosthesis (e.g., a glenoid bearing), any of the components of a long bone prosthesis, spinal implants, or any other type of prosthesis.
Superparamagnetic material may be used in other implant applications, as well. For example, as shown in
As shown in
For example, as shown in the exemplary embodiment of
As shown in
As shown in
The superparamagnetic material may be used, in vivo, to determine the position of the screw hole 74 of the nail 70. In such a way, a bone screw can be installed in the screw hole 74 without direct visualization of the hole. To do so, subsequent to implantation of the nail 70 into the intramedullary canal of one of the patient's long bones, the patient may be exposed to a magnetic field. By measuring the distortion the superparamagnetic material causes in the applied magnetic field at (e.g., by triangulation) the location of the coating 76 (in the case of
In addition to triangulation, other methods of determining the location of the coating 76, the gel-like substance 78, and/or the pattern(s) 80 may also be used. For example, custom models, along with the associated measurement scheme and calculations, may be used to characterize the magnetic field as a permanent magnet to determine the location of the coating 76, the gel-like substance 78, and/or the pattern(s) 80. Such models may be analytical, finite elemental, or based on any other type of suitable mathematical method.
Although the use of a superparamagnetic material to locate features of an implant is herein described in regard to the screw holes of an intramedullary nail, it should be appreciated that such concepts may be used to locate holes in other types of prosthesis or to locate features other than holes on the nail or other types of prosthesis. For example, such concepts may be used to locate features on the components of a knee prosthesis, a hip prosthesis, a shoulder prosthesis, other long bone prostheses (e.g., distractors), spinal implants, or any other type of prosthesis.
Referring now to
The superparamagnetic patterns 86 may be used, in vivo, to determine the degree of wear of the tibial bearing 84. For example, subsequent to implantation of the tibial bearing 84, the patient may be exposed to a magnetic field. By detecting the distortion the superparamagnetic material causes in the applied magnetic field at each of the points 88, the number of point(s) 88 remaining embedded in the bearing 84 may be determined. It should be appreciated that the number of points 88 embedded in the tibial bearing decreases as a result of wear of the bearing 84. As such, by determining presence (or by inference, lack thereof) of the points 88, the degree of wear of the tibial bearing 84 may be correlated.
It should be appreciated that although the points 88 of the patterns 86 of the tibial bearing 84 are shown in
It should also be appreciated that the superparamagnetic patterns 86 may be visualized in a similar manner to as described above in regard to the barcodes of
Although use of a superparamagnetic material to monitor wear of a knee bearing (i.e., the tibial bearing 48) is herein described in regard to
It should be appreciated from the above-description that superparamagnetic material may have numerous other uses in orthopaedic applications. For example, superparamagnetic materials which exhibit surface properties that allow the material to bind to bacteria are known. A coating having such a superparamagnetic material may be applied to an implantable prosthesis. A specific coating may be selected which allows for some degree of mobility of the superparamagnetic particles within the coating. If bacteria is present on the coated surface, the superparamagnetic particles with gather and bind to the bacteria. A detected increase in the concentration of superparamagnetic particles in a given area could be used as an indication of the presence of the bacteria. Such concentrations could be visualized using, for example, an MRI, an X-ray, and/or a custom measurement system utilizing one or more of the aforementioned highly sensitive magnetic sensors, or by monitoring distortion in an applied external magnetic field in any of the manners described above. In a similar concept, a superparamagnetic material and coating combination may be selected which allows the superparamagnetic material to bind to specific, predetermined molecular markers that are indicative of polyethylene wear.
Moreover, certain types of superparamagnetic materials, such as those having a high concentration of iron oxide, may be embedded in polymer implants such as polyethylene bearings. As a result of doing so, the polyethylene exhibits some degree of radiopaqueness. As such, the polyethylene bearing may be visualized on X-rays.
While the concepts of the present disclosure have 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 the 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 apparatus and methods described herein. It will be noted that alternative embodiments of the apparatus and methods 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 an apparatus and method that incorporate one or more of the features of the present disclosure and fall within the spirit and scope of the present disclosure.