Orthopedic augments having recessed pockets

Abstract
Systems, devices and methods for providing orthopedic augments having recessed pockets that receive a fixation material. The orthopedic augments include an outer surface that interfaces with a patient's tissue or bone, an inner surface that interfaces with an implant and having a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim, wherein the recessed pocket extends along the inner surface in at least a lateral direction from the port.
Description
BACKGROUND

Joints often undergo degenerative changes due to a variety of reasons. When joint degeneration becomes advanced or irreversible, it may become necessary to replace the natural joint with a prosthetic joint. Artificial implants, including hip joints, shoulder joints, and knee joints are widely used in orthopedic surgery. Specifically, hip joint prostheses are common. The human hip joint acts mechanically as a ball and socket joint, wherein the ball-shaped head of the femur is positioned within the socket-shaped acetabulum of the pelvis. Various degenerative diseases and injuries may require replacement of all or a portion of a hip using synthetic materials, typically metals, ceramics, or plastics.


It may become necessary to conduct a second or subsequent surgery in order to replace a prosthetic joint with a (often larger) replacement joint. Such surgeries, known as “revision” surgeries, often occur due to further degeneration of bone or advancement of a degenerative disease, requiring removal of further bone and replacement of the removed, diseased bone with a larger or enhanced prosthetic joint, often referred to as a revision prosthesis. For example, bone is often lost around the rim of the acetabulum, and this may provide less rim coverage to securely place an acetabular cup.


In cases where the patient's bone around an implant is compromised, it may be necessary to utilize an augment to add additional support. For example, an acetabular augment may be placed to fill in a defect cavity around the acetabular shell to help support the loads transmitted to the shell. As part of the surgical technique, the surgeon may place both the shell and augment within the patient in order to ensure a proper fit before fastening the two components together to prevent motion between them. However, fastening the two components may be difficult, particularly when using bone cement, if the two components are congruent. Inadequate cementing between the components may cause them to separate after implantation, possibly causing particle generation and leading ultimately to revision.


In current augment designs no provision is typically given to assist with cement application. Therefore, surgeons apply the cement ad hoc (e.g., along the edges of the augment similar to a caulking bead) before fully assembling the components together or forgo the use of cement altogether. This leads to inconsistent and sometimes undesirable results with techniques that are not easily replicated.


SUMMARY

Disclosed herein are systems, devices, and methods for orthopedic augments having retaining pockets. In certain embodiments, the systems, devices, and methods include an orthopedic augment comprising an outer surface that interfaces with a patient's tissue or bone, and an inner surface that interfaces with an implant, the inner surface comprising a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim. The rim can mate with an implant. In certain embodiments, the recessed pocket extends along the inner surface in at least a direction laterally from the port. The port extends from the outer surface to the inner surface and thereby allows insertion of the fixation material into the recessed pocket.


In certain embodiments, the recessed pocket comprises a first compartment and a second compartment separated by a ridge. The ridge may be recessed relative to the rim. The fixation material rigidly affixes the augment to the implant. In certain embodiments, the fixation material is a cement or paste. In certain embodiments, the orthopedic augment further comprises a second port. The second port may be a fill gauge positioned inferiorly to the port, and the second port may have a geometry that is different than the geometry of the port. In certain embodiments, the port comprises a luer-lock fitting or a plug, and the port may be tapered. In certain embodiments, the orthopedic augment may further comprise an extension member configured to couple with an insertion device. The orthopedic augment may further comprise flanges, blades, hooks, or plates.


In certain embodiments, a surface of the augment is at least one of polished, matte, and porous. In certain embodiments, at least a portion of the outer surface comprises a polished finish. The outer surface may further comprise a matte finish or porous composition. In certain embodiments, the upper surface comprises a porous composition.


In certain embodiments, methods for implanting an orthopedic augment include placing an inner surface of the augment adjacent to an implant, wherein the inner surface comprises a recessed pocket and a port, and inserting a fixation material into the recessed pocket of the augment via the port, thereby affixing the augment to the implant. In certain embodiments, the inner surface of the augment further comprises a plurality of ports. The method may further include using at least one of the plurality of ports as a fill gauge, whereby the fixation material is injected into a first port until the fixation material is observed via a second port used as the fill gauge. The method may further include selecting a first port within which to inject the fixation material into the recessed pocket, and injecting the fixation material into the recessed pocket until the fixation element is observed passing a second port. In certain embodiments, the method includes determining a preferred orientation of the augment with respect to the implant and selecting, in response to the determining, one of the plurality of ports within which to inject the fixation material.


In certain embodiments, the recessed pocket comprises a first compartment and a second compartment. The port may be disposed proximate the first compartment. The method may further include injecting the fixation material into the first compartment via the port, wherein overfilling the first compartment causes the fixation material to flow into the second compartment. The fixation material may be a cement or paste and the implant may be an acetabular shell or cage.


In certain embodiments, a surface of the augment is at least one of polished, matte, and porous. In certain embodiments, at least a portion of the outer surface comprises a polished finish. The outer surface may further comprise a matte finish or porous composition. In certain embodiments, the upper surface comprises a porous composition.


In certain embodiments, a kit for use in orthopedic procedures is provided that includes a plurality of augments, each comprising a surface having a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim, wherein at least one of the plurality of augments has more than one port in the rim.


In certain embodiments, an orthopedic augment is provided that includes an outer surface that interfaces with a patient's tissue or bone, and an inner surface that interfaces with an implant, the inner surface comprising recessed means for receiving a fixation material, a rim around at least a portion of the recessed means, and access means in the rim, wherein the recessed means extend along the inner surface in at least a direction laterally from the access means.


Variations and modifications of these embodiments will occur to those of skill in the art after reviewing this disclosure. The foregoing features and aspects may be implemented, in any combination and sub combinations (including multiple dependent combinations and sub combinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.





BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects and advantages will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which:



FIG. 1A shows a perspective view of an illustrative augment having a recessed pocket;



FIG. 1B shows a front elevation view of the illustrative augment of FIG. 1A;



FIG. 1C shows a side elevation view of the illustrative augment of FIG. 1A adjacent to an implant;



FIG. 1D shows a top plan view of the illustrative augment of FIG. 1A adjacent to an implant;



FIG. 2 shows a perspective view of an acetabular shell and an illustrative augment having a plurality of ports;



FIGS. 3A-3F show partial cross-sectional views of illustrative ports, and FIG. 3F also shows an illustrative insertion device coupled thereto;



FIG. 4 shows a perspective view of an illustrative augment having a recessed pocket and a mounting member;



FIGS. 5A and 5B show perspective views of an illustrative augment having multiple recessed pockets;



FIG. 5C shows a cross-sectional view of the illustrative augment of FIG. 5A, taken along line C-C;



FIG. 5D shows a top plan view of the illustrative augment of FIGS. 5A and 5B adjacent to an implant; and



FIGS. 6A and 6B show perspective views of an illustrative augment having various surface finishes.





DETAILED DESCRIPTION

To provide an overall understanding of the systems, devices, and methods described herein, certain illustrative embodiments will be described. Although the embodiments and features described herein are specifically described for use in connection with acetabular systems, it will be understood that all the components, connection mechanisms, adjustable systems, manufacturing methods, coatings, and other features outlined below may be combined with one another in any suitable manner and may be adapted and applied to medical devices and implants to be used in other surgical procedures, including, but not limited to orthopedic knee replacement procedures, spine arthroplasty, cranio-maxillofacial surgical procedures, hip arthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, and other extremity procedures.


The augments described herein provide a surgeon with unitization options to accommodate a wide variety of bone anatomies and implant structures. The augments preferably maintain a close interface with both an implant and a patient's surrounding bone or tissue while allowing the surgeon to place the augments in a variety of positions, either before or after implantation of the implant, in order to suit different bone anatomies and implant structures. In addition, the augments incorporate recessed pockets into which a fixation material, such as cement, may be deposited. The recessed pockets allow pressurized deposition of the fixation material into locations that provide improved bonding across a greater surface area between the augment and the implant to which the augment is coupled.



FIG. 1A shows a perspective view of an augment 100 having a recessed pocket 130 within an inner surface 120 of the augment 100. The augment 100 has an outer surface 110 that interfaces with a patient's tissue or bone and an inner surface 120 that interfaces with an implant. The inner surface 120 has a recessed pocket 130 formed therein that, as shown in FIG. 1A, occupies a substantial area of the inner surface 120 and is configured to receive a fixation material such as a cement or paste. When injected into the recessed pocket 130, the cement or paste affixes the augment 100 to an implant. Any suitable cement or paste may be used, including but not limited to polymethyl-methacrylate (PMMA), any other suitable biocompatible cement or paste, or other fixation material, or any combination thereof. In certain embodiments, the fixation material (e.g., PMMA) may be mixed with one or more pharmacological agents including, but not limited to, antibiotics, anti-inflammatory drugs, and growth factors.


The inner surface 120 also includes a rim 140 that mates with an implant and extends around at least a portion of the recessed pocket 130. As shown in FIG. 1A, for example, the rim 140 encircles the perimeter of the recessed pocket 130 along the periphery of the inner surface 120. When the augment 100 is positioned against an implant, the rim 140 substantially prevents a fixation material disposed in the recessed pocket 130 from leaving the recessed pocket 130. For example, the rim 140 is configured to mate with an implant and may be shaped so that the rim 140 matches the geometry of the implant and abuts the implant, which prevents a fixation material from leaving the recessed pocket 130. As shown in FIGS. 1C and 1D, the rim 140 has a curvilinear or arced shape to complement the shape of an implant 190 such as an acetabular shell. In certain embodiments, the rim 140 may be optionally coated with a resorbable or non-resorbable material such as a polylactic plastic (PLA) or PGA plastic. In certain embodiments, a gasket or other sealing means may be optionally provided between the rim of the augment and the implant. The gasket may help to contain the fixation material with the recessed pocket.


In order to allow a surgeon to inject or otherwise insert a fixation material into the recessed pocket 130, the inner surface 120 includes a port 150 within the rim 140 that extends from the outer surface 110 to the recessed pocket 130 of the inner surface 120. As shown in FIG. 1A, for example, the port 150 is disposed in the top of the rim 140 and extends from the superior outer surface 110a to the recessed pocket 130, thereby allowing a surgeon to inject a fixation material into the recessed pocket 130 when the augment 100 is mated with an implant. This can be done before or after the implant and augment have been implanted into a patient. The port 150 is shown as a half-circle or half-oval cutout made into the top of the rim 140 and having an open end 150a. In certain embodiments, a port may be provided as a through-hole made into the rim 140. For example, port 152 is provided as a through-hole in the rim 140. Alternatively, or additionally, in certain embodiments a port 154 may be provided as a through-hole in the outer surface 110 that accesses the recessed pocked 130 but is not disposed in the rim 140.


The port 150 assists with the injection of a fixation material into desired areas of the augment regardless of where the augment is positioned relative to the implant or whether the augment is affixed to the implant before or after the two components are implanted. Unlike current augment designs, where if the surgeon desires to use cement, the surgeon must first cement the augment to the implant before implantation, the recessed pockets described herein (such as recessed pocket 130) allow surgeons to place the augment adjacent to the implant in the desired location before or after implantation and then fill the recessed pocket with the fixation material via the port, thereby affixing the augment to the implant. Thus, the features of the augment 100 provide improved securement options for surgeons to implant augments before or after the acetabular shell or other implant has been implanted.



FIG. 1B shows a front elevation view of the inner surface 120 of the augment 100 of FIG. 1A, including the recessed pocket 130, the rim 140 that substantially encircles the recessed pocket 130, and the port 150 disposed on an upper portion of the rim 140. As shown in FIG. 1B, the recessed pocket 130 has a shape that conforms to the shape of the augment 100 itself, although in certain embodiments the recessed pocket 130 may have any suitable shape including shapes that may not comport with the shape of the augment 100, yet still fit within the inner surface 120 of the augment 100. The rim 140 extends around at least a portion of the recessed pocket 130 and, as shown in FIG. 1B, extends around the entirety of the recessed pocket 130. The rim 140 provides the surface with which the augment 100 mates with an implant and also prevents a fixation material within the recessed pocket 130 from leaving the pocket 130 when the augment is adjacent the implant. For example, in certain embodiments the rim 140 makes a fluid-tight seal with the surface of the implant. In certain embodiments, contact that does not create a fluid-tight seal may still be sufficient to prevent the fixation material from leaving the recessed pocket 130. Disposed within the upper portion of the rim 140 is the port 150 that provides access to the recessed pocket 130.


As discussed above, the rim 140 provides that portion of the inner surface 120 that contacts an orthopedic implant. FIG. 1C shows a side elevation view of the augment 100 of FIG. 1A adjacent to an implant 190. The rim 140 of the augment 100 mates with the implant 190 and is shaped to complement the shape of the implant 190. The rim 140 makes a substantially flush contact with the implant 190, which substantially prevents a fixation material within the recessed pocket 130 from leaving the recessed pocket 130. As discussed above, the recessed pocket 130 can have any suitable shape. The recessed pocket 130 can also be provided with any suitable depth, where the depth 130a depicted in FIG. 1C is the absolute depth of the pocket, as the depth varies with proximity to the rim 140. The depth 130a of the recessed pocket 130 is proportional to the amount of fixation material that may be deposited within the recessed pocket 130 to affix the augment 100 to the implant 190. In certain embodiments, it may be desirable to provide a recessed pocket 130 having a relatively large depth 130a. For example, the depth of the recessed pocket (e.g., depth 130a) may be designed as deep as possible without sacrificing the material strength of the augment or fixation material. Suitable depths include, for example, about 1-10 millimeters, about 2-5 millimeters, or about 2-3 millimeters.


Because the rim 140 mates substantially flush with the implant 190, one or more ports 150 are provided to give a surgeon access to the recessed pocket 130 in order to inject or otherwise insert the fixation material into the recessed pocket 130. FIG. 1D shows a top plan view of the augment 100 of FIG. 1C and depicts the port 150 disposed in the upper portion of the rim 140 and extending from the recessed pocket 130 to the superior outer surface 110a. Although only one port 150 is shown, it will be understood that any suitable number of ports may be provided and, moreover, that the ports may be provided on any suitable portion of the outer surface 110 of the augment 100. For example, although the port 150 is shown on the superior outer surface 110a, alternatively or additionally, ports may be provided on the lateral outer surfaces 110b and the inferior outer surface 110c.


As shown in FIGS. 1A-1D, the recessed pocket 130 extends beyond the opening created by the port 150. In particular, the recessed pocket 130 extends along the inner surface 120 in at least a direction laterally from the port 150, as depicted by the direction of arrows 144 of FIG. 1D. The recessed pocket 130 therefore has a volume that does not depend upon the size of the port 150. As shown in FIGS. 1C and 1D, the recessed pocket 130 also has a depth 130a that extends beyond the opening created by the port 150.


As discussed above, in certain configurations the augment may include more than one port. FIG. 2 shows a perspective view of an implant adjacent to an augment having multiple ports. In particular, FIG. 2 shows an implant 202, in this case an acetabular shell, and an augment 200 mated thereto and having three ports 212, 214, 216. The ports 212, 214, 216 are located on the superior outer surface 210a and extend through the top rim 240 of the augment 200. The augment 200 includes a recessed pocket 230, accessible from any of the ports 212, 214, 216. Providing multiple ports gives the surgeon the option, for example, to use any or all of them to inject a fixation material into the recessed pocket 230. For example, in certain embodiments, the operating window within which the surgeon works may be restricted so that one or more ports are not be accessible. However, because three ports 212, 214, 216 are provided, at least one of the ports may be accessible and the surgeon may fill the recessed pocket 230 by injecting a fixation material into that port. It will be understood that any suitable number of ports may be provided. For an augment having two or more ports, a surgeon would have similar options to use alternate ports if one or more ports are inaccessible for certain orientations of the augment with respect to an implant.


The above description applies to acetabular augments. However, similar recessed pockets could be applied to knee augments or other orthopedic implants where component are fixed together with a fixation material such as bone cement. An additional advantage of providing multiple ports is that a surgeon can inject the fixation material into one of the ports and use an unused port as a fill gauge to visually judge the amount of fixation material that has been injected into the augment. For example, as the recessed pocket is filled with fixation material, the surgeon can observe the fixation material through the unused port by looking into that port. This is helpful because the recessed pocket extends beyond the opening of the port. Numerous ports also give a surgeon the option to place the augment in any desired orientation, where at least one port is accessible from any orientation.


Although the ports 212, 214, 216 are shown as each having substantially the same geometry, it will be understood that any suitable geometry may be provided. For example, certain port geometries may be preferred for different types of syringes or other insertion devices used by the surgeon to inject a fixation material into the recessed pocket of an augment. As shown in FIG. 3A, a port 250 can have a straight-edge cut 252 through, for example, the outer surface of an augment. FIG. 3B shows that a port 255 can be tapered 257, while FIG. 3C shows a port 260 having both a tapered portion 262 and a straight-edge portion 264 to create a funnel-shaped port 260. In certain embodiments, any of ports 250, 255, 260 may be configured to include an integral lip at the upper surface for interfacing with an insertion device. In certain embodiments, the ports may include an insertion device fitting in order to assist with injection of the fixation material into the recessed pocket. A luer-lock type fitting, shown in FIGS. 3D (female luer-lock 270) and 3E (male luer-lock 275), or tapered plug 282, shown in FIG. 3F, may be incorporated into the port and outer surface so that a standard insertion device may be used, rather than requiring the surgeon to modify the insertion device. The insertion device fitting (e.g., the luer-lock or plug) allows for greater pressure to be generated, assisting with adequate flow of the fixation material into the gap between the augment and the implant and enhancing the fixation between the two components. In certain embodiments, both a plug and a luer-lock fitting are used. For example, as shown in FIG. 3F, in lieu of attaching the insertion device 290 directly to the plug 282 disposed within the port 280, an extension tube 294 coupled to the insertion device 290 via a luer-lock 292 is used. The extension tube 294 prevents interference, for example, from soft tissues proximate the port 280. In certain embodiments, the extension member such as extension tube 294 can have alternative fittings (e.g., other than the luer-lock 292) for various syringe types or other insertion devices.


In addition to configurations of augments having multiple ports, in certain configurations, augments may include mounting members such as flanges, blades, hooks, plates, or any combination thereof, to assist with mounting the augment to the implant, the patient's tissue or bone, or both. Mounting members provide additional support and/or stability for the augment once positioned. Mounting members are often preferred due to bone degeneration, bone loss, or bone defects in the affected area (e.g., a hip joint). FIG. 4 shows a perspective view of an augment 300 having a mounting member 360. The mounting member 360 is a flange with one or a plurality of screw holes 362 configured to receive a fixation member such as a bone screw. In some embodiments, mounting members such as mounting member 360 may include conventional screw holes, locking holes, combi-holes, or slots. The sites may be threaded, unthreaded, or partially threaded, and may be fixed or polyaxial. In some embodiments, attachment sites may include variable low-profile holes that allow for locking at a variety of angles. The flange mounting member 360 is coupled to, and extends from, the outer surface 310 of the augment 300.


The inner surface 320 of the augment 300 has similar features as discussed above in connection with augment 100 of FIG. 1A, such as a recessed pocket 330 surrounded at least in part by a rim 340 and a port 350 therethrough that provides access to the recessed pocket 330. The port 350 is provided in the bottom 340a of the rim 340 and extends to the inferior outer surface 310c of the augment 300. It will be understood, however, that the port 350 (or additional ports, not depicted) could be provided on one or both lateral sides of the rim or on the top of the rim, similar to the location of the port 150 of FIG. 1A (e.g. along the top 340b of the rim, adjacent the mounting member 360 and the screw holes 362). Furthermore, in certain embodiments, one or more ports could be provided on a part of the outer surface 310 that provides access to the recessed pocket 330 without going through the rim 340 (e.g. through a back side of the pocket). As shown, the rim (e.g., rim 140 and 340) substantially encircles the perimeter of the recessed pocket and thereby provides a perimeter for the recessed pocket and a perimeter for the inner surface. In certain embodiments, however, the rim may not fully encircle the perimeter of the recessed pocket. For example, an augment may include multiple recessed pockets.



FIGS. 5A and 5B show perspective views of an augment having multiple recessed pockets. Multiple pockets give a surgeon various options during the procedure. For example, not every pocket need be filled with a fixation element. Furthermore, the pockets can be designed with different respective volumes depending, for example, on patient-specific or implant-specific applications. As shown in FIG. 5A, for example, the augment 400 includes an inner surface 420 having recessed pockets 430, 432, 434. The rim 440 of augment 400 is provided around at least a portion of each of the recessed pockets 430, 432, 434, although the rim 440 does not fully encircle the perimeter of any one recessed pocket 430, 432, 434. For example, the rim 440 provides an upper bound and a lower bound for the central recessed pocket 430, and provides a lateral bound for the lateral recessed pocket 432 and a lateral bound for the lateral recessed pocket 434. Disposed between the respective recessed pockets are ridges 442a and 442b. The ridges 442a and 442b do not extend as far as the rim 440, and therefore do not contact an implant when the augment 400 is placed adjacent to an implant (although in certain embodiments at least a portion of the ridges 442a and 442b could be configured to contact an implant). It will be understood that the ridges 442a and 442b may have any suitable respective height. The augment 400 includes two ports 450 and 452, where port 450 provides direct access to lateral recessed pocket 432 and port 452 provides direct access to lateral recessed pocket 434. Although there is no port shown that provides direct access to the central recessed pocket 430, overfilling either or both of the lateral recessed pockets 432, 434 via ports 450, 452 causes a fixation material to flow over the ridges 442a and 442b and thereby fill the central recessed pocket 430. Therefore, access can be provided to a plurality of recessed pockets that are separated by ridges, even in the event where only one recessed pocket has direct access to a port. In certain embodiments, the multiple recessed pockets could be provided without ridges between the pockets. For example, the augment could be provided with continuous and/or smooth portions between the pockets or have other ridges or protrusions along the inner surface 420 that grasp or otherwise provide a non-smooth structure with which the fixation material couples.



FIG. 5B is a perspective view of the superior outer surface 410a and provides another view of the ports 450, 452. As can be seen in FIG. 5B, for example, the port 452 is shaped similarly to the recessed pocket 434 and provides, by use of the ridges 442a and 442b, indirect access to the central recessed pocket 430 and the lateral recessed pocket 432, whereby overfilling the lateral recessed pocket 434 would cause the fixation material to flow to the other recessed pockets 430, 432. As can also be seen in FIG. 5B, the rim 440 provides the contact surface against which an implant is placed, whereas the ridges 442a and 442b are inset relative to the rim 440. The ridges 442a and 442b do not extend as far the rim 440 and do not contact the implant in order to allow the fixation material to overfill from pocket to pocket. For example, as shown in FIG. 5C, which is a cross-sectional view taken along line C-C of FIG. 5A, the central recessed pocket 430 of the augment 400 has the greatest depth relative to the rim 440, and the ridge 442b, located between the central recessed pocket 430 and the lateral recessed pocket 434, is inset relative to the rim 440 by a distance, d. The distance, d, between the rim 440 and the ridge 442b is the area through which the fixation material is overfilled and flows from pocket to pocket. The ridge 442b can be provided at any suitable distance, d, that is inset relative to the rim 440. FIG. 5D shows a top plan view of the augment 400 of FIGS. 5A and 5B. As shown, the ports 450 and 452 are provided on the superior outer surface 410a and each of the recessed pockets 430, 432, 432 has a respective depth from the edge of the rim 440, depicted by depths 430a, 432a, and 434a. Also shown are the ridges 442a and 442b that separate the respective pockets. FIG. 5D also shows that the rim 440 of the inner surface 410 abuts the implant 490, but the ridges 442a and 442b are inset and do not contact the implant 490.


As shown in FIGS. 5A-5D, the lateral recessed pockets 432, 434 extend beyond the opening created by the ports 450, 452. In particular, the lateral recessed pockets 432, 434 extend along the inner surface 420 in at least a direction laterally from the ports 450, 452, as depicted by the direction of arrows 444 of FIG. 5D. The central recessed pocket 430 does not have a port that provides direct access thereto. The recessed pockets 430, 432, 434 therefore have respective volumes that do not depend upon the size of the ports 450, 452. As shown in FIGS. 5C and 5D, the recessed pockets also have depths 430a, 432a, 434a that extend beyond the opening created by the ports 450, 452.



FIGS. 6A and 6B show perspective views of an augment 500 having various surface finishes. The augment 500 shown includes two recessed pockets 530 and 532 at least partially enclosed by a rim 540 and a mounting flange 560 extending from the augment 500. In certain embodiments, at least one of the recessed pockets is configured to accept a screw. For example, recessed pocket 532 may be configured to accept a screw. The recessed pockets 530 and 532 are separated at least in part by a ridge 542 and are accessible through ports 550 and 552, respectively. The ridge 542 has a height that does not extend as far as that of the rim 540, and therefore the ridge 542 does not contact an implant when the augment 500 is placed adjacent to the implant, such as implant 490. However, in certain embodiments, the ridge 542 can be extended to contact the implant 490. For example, the ridge 542 may have a height equal to or greater than that of rim 540. The ports 550 and 552 are shown as half circle or half oval cutouts made into the bottom 540b of the rim 540. It is understood, however, that one or more ports could be provided on any of the lateral sides 540a of the rim 540 or on the bottom 540b or top 540c of the rim 540, for example, as a through-hole or cut out made into the rim 540, or in any other suitable shape. Furthermore, in certain embodiments, one or more ports could be included on the outer surface 510 that provide access to the recessed pockets 530 and 532 without passing through the rim 540. The inner surface 530a of the recessed pocket 530 and surface 540d of the rim 540 are shown in FIG. 6A as having a porous composition, while the inner surface 532a of the recessed pocket 532 is shown as having a matte surface finish. The porous composition allows for better adhesion to fixation material such as cement or paste. The porous composition may interface with bone to promote ingrowth of the bone. In certain embodiments, the inner surfaces 530a and 532a in addition to the surface 540d of the rim 540 may include, at least in part, a variety of different surface treatments, compositions, or coatings. For example, the augment 500 shows a porous composition, a matte finish, and a polished finish on the back of the augment that extends to the mounting flange 560.


The mounting flange 560 extends outward from the augment 500 and includes six screw holes 562 configured to receive a fixation member such as a bone screw. In certain embodiments, any number of screw holes 562 may be included. As shown in FIGS. 6A and 6B, the mounting flange 560 has an upper surface 564 having a porous composition and a lower surface 510 having a polished finish. The porous upper surface 564 may receive a fixation material, and the polished lower surface 510 may be configured to interface with a patient's tissue, muscles, ligaments, or bone, or any combination thereof. The porous upper surface 564 is preferably configured to interface with bone and promote ingrowth of the bone. The polished lower surface 510 is preferably configured to interface with a patient's tissue, muscles, and/or ligaments to prevent interactions and attachments between the tissue, muscles, and/or ligaments and the polished lower surface 510. In certain embodiments, the upper surface 564 and lower surface 510 may include, at least in part, a variety of different surface treatments, compositions, or coatings. For example, the augment 500 shows a mounting flange 560 with a porous composition and a polished finish. Any other suitable combination of surface treatments may be used on various surfaces of the augment 500.


The augments described herein may be made of a number of materials, including Titanium, Cobalt-Chromium, Zirconium oxide, Stainless steel, monolithic ceramic or composite ceramic, such as Zirconia, Alumina, or other composites, or any other biocompatible materials or alloys that have the appropriate strength, resistance to wear, etc., or any combinations thereof. The augments may also be made fully porous or partially porous to allow for greater bone in-growth, for example, and the augments may be coated with hydroxyapatite or any other bone-promoting agents or combinations thereof. The augments may be manufactured according to any suitable technique or techniques, including, for example, using rapid manufacturing machines or standard manufacturing machines.


The foregoing is merely illustrative of the principles of the disclosure, and the systems, devices, and methods can be practiced by other than the described embodiments, which are presented for purposes of illustration and not of limitation. It is to be understood that the systems, devices, and methods disclosed herein, while shown for use in acetabular systems, may be applied to systems, devices, and methods to be used in other surgical procedures including, but not limited to, spine arthroplasty, cranio-maxillofacial surgical procedures, knee arthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, and extremities procedures.


Variations and modifications will occur to those of skill in the art after reviewing this disclosure. The disclosed features may be implemented, in any combination and sub combination (including multiple dependent combinations and sub combinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.


Examples of changes, substitutions, and alterations are ascertainable by one skilled in the art and could be made without departing from the scope of the information disclosed herein. All references cited herein are incorporated by reference in their entirety and made part of this application.

Claims
  • 1. An orthopedic augment that interfaces with an implant, the orthopedic augment comprising: an outer surface adapted to interface with a tissue or bone, the outer surface comprising superior, lateral, and inferior surfaces of the orthopedic augment;an inner surface configured to interface with a curved surface of an exterior surface of the implant, the inner surface comprising a medial surface of the orthopedic augment;a recessed pocket extending from the inner surface and having a volume, the recessed pocket comprising superior, lateral, and inferior surfaces, the recessed pocket configured to receive a fixation material to fill the volume when the inner surface is interfaced with the curved surface of the implant; anda port extending through the superior surface of the outer surface and the superior surface of the recessed pocket, the port to provide for receipt of the fixation material to fill the volume of the recessed pocket via the superior surface of the outer surface of the orthopedic augment when the inner surface is interfaced with the curved surface of the implant; andwherein the inner surface defines a rim extending about an opening to the recessed pocket on the medial surface of the orthopedic augment, and wherein the rim is shaped to engage the curved surface of the implant to further retain the fixation material within the recessed pocket such that the rim seals the inferior and lateral surfaces of the recessed pocket against the curved surface of the implant when the inner surface of the orthopedic augment is interfaced with the curved surface of the implant.
  • 2. The orthopedic augment of claim 1, wherein the port extends to and intersects the rim.
  • 3. The orthopedic augment of claim 2, wherein the port is in fluid communication with the opening to the recessed pocket.
  • 4. The orthopedic augment of claim 1, wherein the rim is shaped to matingly engage a complementary shaped portion of the exterior surface of the implant.
  • 5. The orthopedic augment of claim 1, wherein the rim has a shape that matches a geometry of a corresponding portion of the exterior surface of the implant.
  • 6. The orthopedic augment of claim 1, wherein the rim has a curvilinear shape and is configured to matingly engage a complementary shaped portion of the exterior surface of the implant.
  • 7. The orthopedic augment of claim 1, wherein the rim is arc shaped and is configured to mate with an arc shaped portion of the exterior surface of the implant.
  • 8. The orthopedic augment of claim 1, wherein the rim is curved and is configured to mate with a curved portion of the exterior surface of the implant.
  • 9. The orthopedic augment of claim 8, wherein the rim has a concave shape configured to mate with a convex shape of the exterior surface of the implant.
  • 10. The orthopedic augment of claim 1, wherein the rim makes flush contact with the exterior surface of the implant.
  • 11. The orthopedic augment of claim 1, wherein the implant comprises an acetabular cup or shell.
  • 12. The orthopedic augment of claim 1, wherein the port comprises a first port, and the orthopedic augment further comprises at least a second port extending through the outer surface and in communication with the recessed pocket.
  • 13. The orthopedic augment of claim 12, wherein the second port comprises a fill gauge positioned inferiorly to the first port.
  • 14. The orthopedic augment of claim 1, wherein the second port has a geometry that is different than a geometry of the first port.
  • 15. The orthopedic augment of claim 1, comprising the fixation material, wherein at least a portion of the fixation material within the recessed pocket adj acent the opening facilitates rigid affixation of the orthopedic augment to the implant.
  • 16. The orthopedic augment of claim 1, comprising the fixation material, wherein the fixation material comprises a cement or paste.
  • 17. The orthopedic augment of claim 1, wherein the rim surrounds the opening to the recessed pocket.
  • 18. A kit for use in orthopedic procedures that use one or more orthopedic implants, the kit comprising a plurality of orthopedic augments including the orthopedic augment of claim 1.
CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No. 14/363,776 filed Jun. 6, 2014 and issued as U.S. Pat. No. 9,814,582, which is a U.S. National Phase of International PCT Application No. PCT/US2012/068304 filed Dec. 6, 2012, which claims the benefit of U.S. Provisional Patent Application No. 61/568,023 filed Dec. 7, 2011, the contents of each application are hereby incorporated by reference herein in their entirety.

US Referenced Citations (149)
Number Name Date Kind
3874003 Moser et al. Apr 1975 A
3882550 Karpf et al. May 1975 A
3894297 Mittelmeier et al. Jul 1975 A
4141088 Treace et al. Feb 1979 A
4437193 Oh Mar 1984 A
4473068 Oh Sep 1984 A
4475549 Oh Oct 1984 A
4566138 Lewis et al. Jan 1986 A
4612160 Donlevy et al. Sep 1986 A
4623352 Oh Nov 1986 A
4632111 Roche Dec 1986 A
4666450 Kenna May 1987 A
4673409 Van Kampen Jun 1987 A
4676799 Legrand Jun 1987 A
4704127 Averill et al. Nov 1987 A
4718908 Wigginton et al. Jan 1988 A
4795469 Oh Jan 1989 A
4883490 Oh Nov 1989 A
4888024 Powlan Dec 1989 A
4904265 MacCollum et al. Feb 1990 A
4955919 Pappas et al. Sep 1990 A
4959072 Morscher et al. Sep 1990 A
4990149 Fallin Feb 1991 A
4995883 Demane et al. Feb 1991 A
4997447 Shelley Mar 1991 A
5047033 Fallin Sep 1991 A
5078746 Gamer Jan 1992 A
5080677 Shelley Jan 1992 A
5108452 Fallin Apr 1992 A
5133764 Pappas et al. Jul 1992 A
5171276 Caspari et al. Dec 1992 A
5176711 Grimes Jan 1993 A
5192329 Christie et al. Mar 1993 A
5193679 White Mar 1993 A
5211665 Ku May 1993 A
5217499 Shelley Jun 1993 A
5226917 Schryver Jul 1993 A
5310408 Schryver et al. May 1994 A
5314487 Schryver et al. May 1994 A
5324291 Ries et al. Jun 1994 A
5326367 Robioneck Jul 1994 A
5326368 Callazo Jul 1994 A
5350381 Melton Sep 1994 A
5358532 Evans et al. Oct 1994 A
5370703 Willert et al. Dec 1994 A
5387241 Hayes Feb 1995 A
5405005 White Apr 1995 A
5405392 Deckner Apr 1995 A
5456717 Zweymuller et al. Oct 1995 A
5507825 Frei Apr 1996 A
5507830 Demane et al. Apr 1996 A
5549702 Ries et al. Aug 1996 A
5571105 Gundolf Nov 1996 A
5593446 Kuoni Jan 1997 A
5641323 Caldarise Jun 1997 A
5676704 Ries et al. Oct 1997 A
5755720 Mikhail May 1998 A
5755793 Smith et al. May 1998 A
5782928 Ries et al. Jul 1998 A
5874123 Park Feb 1999 A
5879405 Ries et al. Mar 1999 A
5928288 Wilson Jul 1999 A
5931870 Cuckler et al. Aug 1999 A
5938698 Sandoz et al. Aug 1999 A
6059833 Doets May 2000 A
6136037 Hassig et al. Oct 2000 A
6162227 Eckhardt et al. Dec 2000 A
6270502 Stulberg Aug 2001 B1
6325829 Schmotzer Dec 2001 B1
6344060 Schmotzer et al. Feb 2002 B1
6383228 Schmotzer May 2002 B1
6436147 Zweymuller Aug 2002 B1
6451058 Tuke et al. Sep 2002 B2
6458161 Gibbs et al. Oct 2002 B1
RE38058 Fallin Apr 2003 E
6540788 Zweymuller Apr 2003 B1
6613094 Zweymuller Sep 2003 B2
6626913 McKinnon et al. Sep 2003 B1
6652289 Bae Nov 2003 B2
6666870 Dixon et al. Dec 2003 B2
6746452 Tuke et al. Jun 2004 B2
6808539 Zweymuller Oct 2004 B2
6916342 Frederick et al. Jul 2005 B2
6986792 McLean et al. Jan 2006 B2
7004973 Zweymuller Feb 2006 B2
7074241 McKinnon Jul 2006 B2
7160307 Harwood et al. Jan 2007 B2
7160332 Frederick et al. Jan 2007 B2
7175668 Zweymuller Feb 2007 B2
7179297 McLean Feb 2007 B2
7250054 Allen et al. Jul 2007 B2
7255701 Allen et al. Aug 2007 B2
7335231 McLean Feb 2008 B2
7374576 Ries et al. May 2008 B1
7455693 Zweymuller Nov 2008 B2
7494510 Zweymuller Feb 2009 B2
7497875 Zweymuller Mar 2009 B1
7534271 Ries et al. May 2009 B2
7575603 Bergin et al. Aug 2009 B2
7591821 Kelman Sep 2009 B2
7621915 Frederick et al. Nov 2009 B2
7682393 Trieu et al. Mar 2010 B2
7682398 Croxton et al. Mar 2010 B2
7749277 McLean Jul 2010 B2
7749278 Frederick et al. Jul 2010 B2
7780667 Watanabe et al. Aug 2010 B2
7794502 Michelson Sep 2010 B2
7828806 Graf et al. Nov 2010 B2
7863410 Smith et al. Jan 2011 B2
7879106 McMinn Feb 2011 B2
7892290 Bergin et al. Feb 2011 B2
7901411 Frederick et al. Mar 2011 B2
7985260 Keefer et al. Jul 2011 B2
7993408 Meridew et al. Aug 2011 B2
8123814 Meridew et al. Feb 2012 B2
8506643 Keefer et al. Aug 2013 B2
8551181 Meridew et al. Oct 2013 B2
8597365 Meridew Dec 2013 B2
8608744 Ries et al. Dec 2013 B2
8828089 Perez et al. Sep 2014 B1
9248023 Ries et al. Feb 2016 B2
9345576 Shea et al. May 2016 B2
20020177900 Serbousek et al. Nov 2002 A1
20030065397 Hanssen et al. Apr 2003 A1
20030125809 Iannotti et al. Jul 2003 A1
20050021148 Gibbs Jan 2005 A1
20060074430 Deffenbaugh et al. Apr 2006 A1
20070078477 Heneveld, Sr. et al. Apr 2007 A1
20070088443 Hanssen et al. Apr 2007 A1
20070173940 Hestad et al. Jul 2007 A1
20070179627 Gustilo et al. Aug 2007 A1
20070250175 Meridew et al. Oct 2007 A1
20080021568 Tulkis et al. Jan 2008 A1
20080051908 Angibaud et al. Feb 2008 A1
20080119939 Termanini May 2008 A1
20090112323 Hestad et al. Apr 2009 A1
20090143824 Austin et al. Jun 2009 A1
20090204225 Meridew et al. Aug 2009 A1
20090326670 Keefer et al. Dec 2009 A1
20100161064 Kellar et al. Jun 2010 A1
20110125158 Diwan et al. May 2011 A1
20110288650 Ries et al. Nov 2011 A1
20120016485 Sharp Jan 2012 A1
20120016487 Conway Jan 2012 A1
20120022663 Quinn et al. Jan 2012 A1
20120109137 Iannotti et al. May 2012 A1
20120215311 Parry Aug 2012 A1
20130338786 Haidukewych Dec 2013 A1
20140276870 Eash Sep 2014 A1
Foreign Referenced Citations (19)
Number Date Country
2159767 Mar 1994 CN
2217965 Jan 1996 CN
2684790 Mar 2005 CN
101172061 May 2008 CN
201668539 Dec 2010 CN
102048600 May 2011 CN
102300520 Dec 2011 CN
202011050057 Sep 2011 DE
2140835 Jan 2010 EP
2519248 Jul 1983 FR
2633509 Jan 1990 FR
2008532716 Aug 2008 JP
2009502336 Jan 2009 JP
2010012254 Jan 2010 JP
2011511699 Apr 2011 JP
20020083035 Oct 2002 WO
2006099751 Sep 2006 WO
2007014192 Feb 2007 WO
2011012892 Feb 2011 WO
Non-Patent Literature Citations (39)
Entry
Canadian Office Action; Canadian Intellectual Property Office; Canadian Patent Application No. 2,858,559; dated Aug. 31, 2018; 3 pages.
Australian Examination Report (2nd), Australian Patent Office, Australian Patent Application No. 2017279646, dated Jun. 18 2018, 2 pages.
Australian Examination Report, Australian Patent Office, Australian Patent Application No. 2017279646, dated May 16, 2018, 4 pages.
Canadian Office Action; Canadian Intellectual Property Office; Canadian Patent Application No. 2,858,553; dated Jul. 27 2018; 4 pages.
Australian Examination Report; Australian Patent Office; Australian Patent Application No. 2017213493; dated Aug. 9, 2018; 4 pages.
Chinese Search Report; State Intellectual Property Office, Peoples Republic of China; Chinese Patent Application No. 201710685364.1; dated Sep. 18, 2018; 6 pages.
Chinese Office Action (1st); State Intellectual Property Office, Peoples Republic of China; Chinese Patent Application No. 201710685364.1; dated Sep. 29, 2018; 13 pages.
European Office Action; European Patent Office; European Patent Application No. 12854571.2; dated Jul. 24, 2018; 4 pages.
PCT International Search Report dated Mar. 13, 2013; International Application No. PCT/US2012/068219; 12 pages.
PCT International Search Report dated Mar. 28, 2013; International Application No. PCT/US2012/068222; 14 pages.
International Search Report dated Mar. 25, 2013; International Application No. PCT/US2012/068304; 14 pages.
Timoteo French U.S. Pat. No. 2,519,248; English Machine Translation; Dec. 31, 1981.
Australian Examination Report; Australian Patent Office; Australian Patent Application No. 2012347730; dated Aug. 12, 2016; 3 pages.
Australian Examination Report No. 1; Australian Patent Office; Australian Patent Application No. 2012347700; dated Oct. 14, 2016; 4 pages.
Australian Examination Report No. 2; Australian Patent Office; Australian Patent Application No. 2012347700; dated Jul. 20, 2017; 3 pages.
Australian Examination Report No. 2; Australian Patent Office; Australian Patent Application No. 2012347730; dated Aug. 7, 2017; 4 pages.
Chinese Office Action; Chinese Patent Office; Chinese Patent Application No. 201280069283.4; dated Dec. 1, 2016; 13 pages.
Chinese Office Action; Chinese Patent Office; Chinese Patent Application No. 201280069276.4; dated Feb. 13, 2017; 14 pages.
Chinese Search Report; Chinese Patent Office; Chinese Patent Application No. 201280069276.4; dated May 4, 2016; 4 pages.
Chinese Office Action; Chinese Patent Office; Chinese Patent Application No. 201280069276.4; dated May 13, 2016; 12 pages.
Chinese Office Action; Chinese Patent Office; Chinese Patent Application No. 201280069283.4; dated Apr. 15, 2016; 17 pages.
European Examination Report; European Patent Office; European Patent Application No. 12855969.7; dated Jun. 28, 2016; 4 pages.
European Search Report; European Patent Office; European Patent Application No. 12854571.2; dated Jun. 26, 2015; 7 pages.
European Examination Report; European Patent Office; European Patent Application No. 12854571.2; dated Nov. 29, 2016; 4 pages.
Japanese Decision of Rejection; Japanese Patent Office; Japanese Patent Application No. 2014-546071; dated Jul. 21, 2017; 5 pages.
Japanese Notice of Reasons for Rejection; Japanese Patent Office; Japanese Patent Application No. 2014-546071; dated Sep. 26, 2016; 10 pages.
Japanese Notice of Reasons for Rejection; Japanese Patent Office; Japanese Patent Application No. 2014-546096; dated Oct. 3, 2016; 11 pages.
Chinese Office Action; Chinese Patent Office; Chinese Patent Application No. 201280069276.4; dated Oct. 24, 2017; 9 pages.
Japanese Notice of Reasons for Rejection; Japanese Patent Office; Japanese Patent Application No. 2017-194155; dated Jul. 9, 2018; 4 pages.
Examination Report No. 2 for Australian Patent Application No. 2017213493, dated Jun. 27, 2019.
Examination Report No. 3 for Australian Patent Application No. 2017213493, dated Aug. 1, 2019.
Second Office Action for Chinese Patent Application No. 201710685364.1, dated Jul. 29, 2019.
Examination Report for Indian Patent Application No. 4606/DELNP/2014, dated Feb. 28, 2020.
Examination Report for Indian Patent Application No. 4617/DELNP/2014, dated Mar. 18, 2020.
First Office Action for Chinese Patent Application No. 2018111291140, dated Dec. 30, 2019.
Australia Examination report No. 2 for standard patent applicaiton No. 2019213389, dated Dec. 23, 2020, 4 pages.
Third Office Action for Chinese Patent Application No. 201710685364.1, dated Apr. 22, 2020.
Examination report No. 1 for Australian Patent Application No. 2019213389, dated Jul. 2, 2020.
Chinese Office Action for CN Patent Application No. 201811129114.0, dated Dec. 1, 2020, 24 pages.
Related Publications (1)
Number Date Country
20180064541 A1 Mar 2018 US
Provisional Applications (1)
Number Date Country
61568023 Dec 2011 US
Continuations (1)
Number Date Country
Parent 14363776 US
Child 15812545 US