This application claims the benefit of U.S. Provisional Application No. 61/816,213, filed Apr. 26, 2013. The disclosure of this prior application is incorporated by reference in its entirety.
The accompanying drawings are incorporated in and form a part of the specification, illustrate the embodiments of the invention, and together with the written description serve to explain the principles, characteristics, and features of the invention. In the drawings:
The following descriptions of the depicted embodiments are merely exemplary in nature and are in no way intended to limit the invention, its application, or uses.
A portion of a pelvis is illustrated in
The following disclosure provides systems, devices, and methods for aligning and implanting acetabular implants (e.g., a shell, liner, cup, cage, augment, etc.) using any suitable alignment tool, or in certain embodiments, preparing an acetabulum to receive an implant using a reamer or other suitable preparation tool. Instruments may include at least one position indicator with a PM surface feature or position indicator that contacts the pelvis within the acetabulum and provides a predetermined orientation of the implant (or in certain embodiments, the preparation device) relative to a patient's anatomy. The systems, devices, and methods may further include a translational feature which permits unilateral translation along a shaft of the alignment tool or preparation tool, and in certain embodiments, includes an orientation feature that positions an acetabular component (or preparation tool) to that of the guide in a particular orientation.
Portions of a prosthetic hip system 1 being directed toward an acetabulum of a pelvis are shown in
An embodiment of the acetabular component alignment guide 10 is illustrated in
The insertion guide 20 illustrated in
The acetabular component alignment guide 10 depicted has a first section embodied at least in the shaft 13 that is connectable to the acetabular component 17. The shaft 13 includes the distal threaded portion 14 by which the shaft 13 is connected to the acetabular component 17. In other embodiments, a shaft and an acetabular component may be connected by a snap fit connection, by an interference fit, by abutment, or by a connection of any effective type. In the illustrated embodiment, the first section is shown connected to a concave portion of the acetabular component 17. In other embodiments, a first section may be connected to an acetabular component by passing through or around the concave portion of the acetabular component and connecting to the convex portion of the acetabular component.
A second section of the acetabular component alignment guide 10 may be coupled to the first section and is configured to contact a top rim surface of the acetabular component. For example, as illustrated in
In the illustrated embodiment, the second section includes a portion of the insertion guide 20, but not the whole of the insertion guide 20. In particular, the second section includes at least the portion of the insertion guide 20 that contacts the top rim surface 18 of the acetabular component 17. In this embodiment, the portion of the insertion guide 20 that extends beyond the diameter of the acetabular component and is configured to match with a preplanned anatomical structure of a patient is an alignment structure. In the illustrated embodiment, the term diameter is applied to the acetabular component 17 as viewed from above, which is a round projection. The term diameter may also be used for shapes that are not precisely round by reference to the general outer extents of a shape, whether round, oval, rectangular, or having combinations of many sides or curvatures. The alignment structure depicted is coupled to the second section and is configured to orient the acetabular component alignment guide 10 relative to the patient's acetabulum. The alignment structure of the insertion guide 20 includes a position indicator surface 21 that has been preplanned to contact at least a part of the patient's ischium inside the acetabulum. The position indicator is also flush with the top of the patient's ischium in the illustrated embodiment, which provides an additional positional control. In some embodiments, in addition to the alignment structure being configured to match with a preplanned anatomical structure, an acetabular component or other instrument that is coupled directly or indirectly with the alignment structure may also be configured to contact a preplanned anatomical structure such that the alignment structure and the acetabular component or other instrument work in combination to achieve component alignment.
As illustrated by the progression of the device from
The illustrated position indicator surface 21 of the alignment structure of the insertion guide 20 is preplanned to contact at least a part of the patient's ischium inside the acetabulum. In various embodiments of the invention, a position indicator surface may be preplanned to contact or match any point or surface on an anatomical structure within a patient's acetabulum. Some embodiments, such as the embodiment illustrated in
The embodiment shown in
The insertion guide 120 illustrated in
The acetabular component alignment guide 110 depicted has a first section embodied at least in the shaft 13 that is connectable to the acetabular component 17. The shaft 13 includes the distal threaded portion 14 by which the shaft 13 is connected to the acetabular component 17. In other embodiments, a shaft and an acetabular component may be connected by a snap fit connection, by an interference fit, by abutment, or by a connection of any effective type. In the illustrated embodiment, the first section is shown connected to a concave portion of the acetabular component 17. In other embodiments, a first section may be connected to an acetabular component by passing through or around the concave portion of the acetabular component and connecting to the convex portion of the acetabular component.
A second section of the acetabular component alignment guide 110 may be coupled to the first section and is configured to contact a top rim surface 18 of the acetabular component. For example, as illustrated in
In the illustrated embodiment, the second section includes a portion of the insertion guide 120, but not the whole of the insertion guide 120. In particular, the second section includes at least the portion of the insertion guide 120 that contacts the top rim surface 18 of the acetabular component 17. In this embodiment, the portion of the insertion guide 120 that extends beyond the diameter of the acetabular component and is configured to match with a preplanned anatomical structure of a patient is an alignment structure. In the illustrated embodiment, the term diameter is applied to the acetabular component 17 as viewed from above, which is a round projection. The term diameter may also be used for shapes that are not precisely round by reference to the general outer extents of a shape, whether round, oval, rectangular, or having combinations of many sides or curvatures. The alignment structure depicted is coupled to the second section and is configured to orient the acetabular component alignment guide 110 relative to the patient's acetabulum. The alignment structure of the insertion guide 120 includes a position indicator surface 121 that has been preplanned to contact at least a part of the patient's pelvic inferior column region inside the acetabulum. The position indicator of some embodiments may extend throughout or near the acetabulum as far as may be practical to provide increased contact area so long as access to the implantation area of the device to be implanted is not impeded. In some embodiments, in addition to the alignment structure being configured to match with a preplanned anatomical structure, an acetabular component or other instrument that is coupled directly or indirectly with the alignment structure may also be configured to contact a preplanned anatomical structure such that the alignment structure and the acetabular component or other instrument work in combination to achieve component alignment.
Similar to the translation illustrated in
The embodiment shown in
The insertion guide 220 illustrated in
The acetabular component alignment guide 210 depicted has a first section embodied at least in the shaft 13 that is connectable to the acetabular component 17. The shaft 13 includes the distal threaded portion 14 by which the shaft 13 is connected to the acetabular component 17. In other embodiments, a shaft and an acetabular component may be connected by a snap fit connection, by an interference fit, by abutment, or by a connection of any effective type. In the illustrated embodiment, the first section is shown connected to a concave portion of the acetabular component 17. In other embodiments, a first section may be connected to an acetabular component by passing through or around the concave portion of the acetabular component and connecting to the convex portion of the acetabular component.
A second section of the acetabular component alignment guide 210 may be coupled to the first section and is configured to contact a top rim surface 18 of the acetabular component. For example, as illustrated in
In the illustrated embodiment, the second section includes a portion of the insertion guide 220 but not the whole of the insertion guide 220. In particular, the second section includes at least the portion of the insertion guide 220 that contacts the top rim surface 18 of the acetabular component 17. In this embodiment, the portion of the insertion guide 220 that extends beyond the diameter of the acetabular component and is configured to match with a preplanned anatomical structure of a patient is an alignment structure. In the illustrated embodiment, the term diameter is applied to the acetabular component 17 as viewed from above, which is a round projection. The term diameter also may be used for shapes that are not precisely round by reference to the general outer extents of a shape, whether round, oval, rectangular, or having combinations of many sides or curvatures. The alignment structure depicted is coupled to the second section and is configured to orient the acetabular component alignment guide 210 relative to the patient's acetabulum. The alignment structure of the insertion guide 220 includes a position indicator surface 221 that has been preplanned to contact at least a part of the patient's pubis inside the acetabulum. The position indicator of some embodiments may extend throughout or near the acetabulum as far as may be practical to provide increased contact area so long as access to the implantation area of the device to be implanted is not impeded. In some embodiments, in addition to the alignment structure being configured to match with a preplanned anatomical structure, an acetabular component or other instrument that is coupled directly or indirectly with the alignment structure may also be configured to contact a preplanned anatomical structure such that the alignment structure and the acetabular component or other instrument work in combination to achieve component alignment.
Similar to the translation illustrated in
Other embodiments of an acetabular component alignment guide may include a first section that is connectable to an acetabular component and an alignment structure that is coupled to the first section and extends beyond the diameter of the acetabular component and is configured to match at least a part of a patient's ischium inside the acetabulum to orient the acetabular component alignment guide relative to the patient's acetabulum. Certain embodiments do not necessarily have one or more sections that contact a top rim surface of the acetabular component. Other features of such embodiments may be essentially similar to the embodiments described in association with
In some embodiments, a fixation guide may be used in addition to an insertion guide. In the illustrated embodiments for example, once an insertion guide such as the insertion guides 20, 120, 220 (
In certain embodiments, an additional guide is provided for preparing the implantation site (e.g., the acetabulum). In such cases, the guide for preparation, for example reaming, is the first guide used of the series of guides, with the insertion guide being used second and the fixation guide being the third guide used. The fixation guide 50 is illustrated with a void 55 in its interior. This void may be filled with any device that would be useful to prepare or fix an instrument or implant. For example and without limitation, a drill guide, shaft, drill, cutting or reaming component, or any other device may be placed in or passed through the void and guidance structures placed in the void to assist with the preparation or fixation of an instrument or implant.
Another embodiment of the invention is a prosthetic hip system having a femoral stem configured to couple with a femur of a patient, a femoral head coupled to the femoral stem, an acetabular component configured to couple with the femoral head and configured to couple with an acetabulum of the patient, and an acetabular component alignment guide. The femoral stem and head and the acetabular component may be any type conventionally in use currently or developed and put in use at a later date for which alignment is necessary or desirable. Embodiments of the acetabular component alignment guide of the embodiments include a first section that is connectable to the acetabular component, and an alignment structure that is coupled to the first section and extends beyond the diameter of the acetabular component. The alignment structure may be configured to match at least a part of the patient's ischium inside the acetabulum to orient the acetabular component alignment guide relative to the patient's acetabulum. The acetabular component alignment guide of these embodiments may be of any type described or referenced herein.
Various embodiments of components described herein wholly or their parts individually may be made from any biocompatible material. For example and without limitation, biocompatible materials may include in whole or in part: non-reinforced polymers, reinforced polymers, metals, ceramics and combinations of these materials. Reinforcing of polymers may be accomplished with carbon, metal, or glass or any other effective material. Examples of biocompatible polymer materials include polyamide base resins, polyethylene, low density polyethylene, polymethylmethacrylate (PMMA), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), a polymeric hydroxyethylmethacrylate (PHEMA), and polyurethane, any of which may be reinforced. Example biocompatible metals include stainless steel and other steel alloys, cobalt chrome alloys, tantalum, titanium, titanium alloys, titanium-nickel alloys such as Nitinol and other superelastic or shape-memory metal alloys. Components described herein may be formed by conventional milling or casting processes, by any type of three-dimensional printing or deposition based processes, or by any effective process.
An embodiment of the invention is a method of providing instruments to align a prosthetic hip system. The embodiment may include receiving data about a patient's anatomy, using the received data to establish a three dimensional model of the patient's anatomy, and forming an acetabular component alignment guide. Patient anatomical data received may be from collected specifically for the purpose of forming a guide device or may be data gathered for another purpose. Patient anatomical data may be obtained with an imaging device. MRI scans or CT scans may be used to automatically obtain three-dimensional models of a patient's anatomy. Alternatively, two-dimensional imaging devices, such as a radiograph, may be used from more than one angle to approximate a three-dimensional model that may provide adequate size and shape characteristics.
The acetabular component guide may include at least one surface that interfaces with a surface within the patient's acetabulum such that when the at least one surface is positioned on the patient's anatomy, the acetabular component alignment guide is configured to direct an acetabular component toward a predetermined position in the patient's acetabulum. Acetabular component guides with surfaces that interface with surfaces within the patient's acetabulum are illustrated in
In some embodiments, the act of forming an acetabular component alignment guide includes forming an acetabular component alignment guide with at least one surface that interfaces with a surface on at least a part of a patient's ischium above the rim of the acetabular component when the acetabular component is seated in the patient's acetabulum. For example and without limitation, the acetabular component alignment guide 20 illustrated in
The act of forming an acetabular component alignment guide may include forming an acetabular component alignment guide configured to permit a portion of the acetabular component alignment guide coupled to the acetabular component to translate relative to the at least one surface of the acetabular component alignment guide to direct the acetabular component toward a predetermined position in the patient's acetabulum. Nonlimiting examples of such formed guides are illustrated in
The act of forming an acetabular component alignment guide may include providing a fixation guide with a least one surface that interfaces with the surface within the patient's acetabulum when the acetabular component is in the predetermined position in the patient's acetabulum. Some such fixation guides may also include one or more guide holes for the placement of fasteners such that the one or more guide holes provide a trajectory into one or more suitable locations in the patient's anatomy, as determined from the data received about the patient's anatomy. Examples of such fixation guides are described and referenced in association with
Terms such as distal, unilateral, contralateral, above, inside, and the like have been used relatively herein. However, such terms are not limited to specific coordinate orientations but are used to describe relative positions referencing particular embodiments. Such terms are not generally limiting to the scope of the claims made herein. Any embodiment or feature of any section, portion, or any other component shown or particularly described in relation to various embodiments of similar sections, portions, or components herein may be interchangeably applied to any other similar embodiment or feature shown or described herein.
As various modifications could be made to the exemplary embodiments, as described above with reference to the corresponding illustrations, without departing from the scope of the invention, it is intended that all matter contained in the foregoing description and shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the claims and their equivalents.
Number | Date | Country | |
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61816213 | Apr 2013 | US |