This invention relates to prosthetic acetabular cups and to methods of making them.
The invention is intended to improve the long term attachment to bone of an implant that incorporates the benefits of composite materials for structural and bearing functions.
Prosthetic metallic acetabular cup implants and assemblies are usually much stiffer than the surrounding bone and this stiffness of the acetabular cup causes changes of density in the bony structure surrounding the cup. U.S. Pat. No. 5,609,646 relates to an elastic acetabular cup which has now demonstrated in vivo its efficacy.
The applicants have developed a composite material made of polyetheretherketone (PEEK) resin and 20 to 40% of short carbon fibers, preferably with 30% short carbon fibers. This material has demonstrated good wear resistance properties and a prosthetic bearing component comprising these materials is described in U.S. Pat. No. 6,638,311.
Hydroxyapatite (HAP) coating activates bone cells attachment but HAP resorbs and bone cells come directly in contact with the material of the implant (which is usually made of a titanium alloy or of the composite material described in U.S. Pat. No. 6,638,311). Some material is more prone to encourage bone cell adherence and development. Beneath the hydroxyapatite layer, the surface roughness, porosity and purity do have an effect on the bone cells development. Pure titanium with a roughness in a range of 4 to 7 μm Ra, 30 to 40 μm Rz, and 35 to 65 μm Rt is known for encouraging bone cells adherence and growth so creating a microlock between newly formed bone and the implant.
Open pores at the surface of the implant are rooms for bone trabeculae formation and deep interdigitation. This mechanical interlocking is able to provide long term attachment after complete dissolution of the hydroxyapatite coating. Composite/plastic materials are not X-ray lucent.
According to the present invention a prosthetic acetabular cup includes a bearing surface layer made from a composite material including PEEK resin and at least 20 to 40% short carbon fibers, and a backing layer or layers to provide a barrier and/or porosity and/or roughness. The backing layer or layers can be coated with a bioactive material if required.
Depending on the coating properties one or more of the following three aspects of the invention is fulfilled:
The backing layer can be made from metal, for example titanium, titanium alloy, cobalt chrome alloy, tantalum or niobium, or from, for example, pure PEEK to produce a barrier between the composite material and the bone cells.
These and other aspects of the invention are provided by a prosthetic acetabular cup which has a bearing surface layer made from a composite material such as, for example, PEEK resin having at least 20%-40% short carbon fibers and a backing layer or layers providing a barrier and/or porosity and/or roughness. Preferably the backing layer is made from metal and is coated with a bioactive material. The backing layer could also be made from PEEK resin to produce a barrier between the composite material or the surface layer and the bone cells in which it will be used. The acetabular cup outer layer may be made of a bioactive material such as hydroxyapatite with or without bone morphogenic proteins.
The method of forming the prosthetic bearing surface has as a first step injection molding and bearing layer of PEEK resin having 20%-40% carbon fiber to form an inner bearing surface. Then metal particles are sputtered on to the outer nonbearing surface of the molded bearing to form a porous backing layer and then hydroxyapatite is sputtered on to the metal backing layer to form an outer surface of the prosthetic bearing element. PEEK may be plasma sprayed on the outer surface of the bearing layer prior to applying the metal layer. The metal particle size may be varied to form an interconnected porosity which increases towards the outer surface as the layer is built up. The particle size may increase from smaller to larger to form the increasing interconnected porosity. A mixture of metal particles and hydroxyapatite particles may be sputtered on to the backing layer to form the interconnected porosity. In a most preferred embodiment the bearing layer has about 30% short carbon fibers. Also preferably there is a metal layer between the PEEK bearing and the porous metal layer for blocking tissue ingrowth beyond the porous metal layer. The bearing layer may be preformed and the backing layer or layers may be applied by sputtering and/or chemical or plasma deposition. The metal utilized for the backing layer or layers is preferably selected from the group consisting of titanium, titanium alloy, tantalum, niobium or cobalt chrome alloy.
The benefit of the construction is that bioactive material encourages the bone cells apposition and development; rough surface and/or porous surface provides structure for mechanical fixation after dissolution of the bioactive layer; composite material provides elasticity for natural load distribution to the bone, and also provides highly wear resistant bearing surface; and the benefits of the metallic material, when provided, is to provide an opaque marker for X-rays and a proven biological interface for good bone ongrowth/ingrowth. The bioactive material can be hydroxyapatite (HAP) and/or bone morphogenic proteins (BMP).
The invention also includes a method of making an acetabular cup which includes a bearing surface layer made from a composite material including PEEK resin and at least 20 to 40% short carbon fibers, a backing layer or layers to provide a barrier and/or porosity and/or roughness and which is coated with a bioactive material by either forming the inner bearing surface layer and subsequently applying the backing layer to it, or forming the backing layer and applying the inner bear surface layer to it.
When preforming the bearing surface layer the backing layer can be applied to it by sputtering, plasma spraying and/or vapor deposition. If the backing layer is preformed the inner bearing surface layer can be provided by molding. The backing layer can be arranged to have a porosity which varies from its inner to its outer sides to form an outer porous surface. The bioactive material can be applied by sputtering, plasma spraying or chemical deposition such as chemical vapor deposition. Any well known deposition method can be used.
The invention can be performed in many ways and some embodiments will not be described by way of example and with reference to the accompanying drawing in which:
As shown in
Commercially pure titanium particles are then sputtered with a plasma torch under vacuum or under gas such as argon to form a backing layer 2. The outer side of the cup can be roughened prior to this metal coating. Hydroxyapatite (HAP) is then sputtered with a plasma torch onto the outer surface of the backing layer, as indicated by reference numeral 3.
The ensuing structure provides a prosthetic acetabular cup which has an inner bearing layer made from the composite material which has a natural elasticity for natural load distribution to the bone and provides a high wear-resistant bearing surface. The backing layer 2 creates a barrier between the composite material and the bone cells and/or provides an appropriately roughness for bone cell attachment and/or provides open porosity for bone cell ingrowth and the bioactive material 3 encourages the bone cells apposition and development. The use of a metallic material for the backing layer 2 provides an opaque marker for X-rays.
In the description and method shown in
A benefit of this construction and method is that it provides a predetermined type of porosity (size, extent), some fixation fixtures can be deposited, as indicated by reference numeral 16, and a porosity, density or a combination can be provided can be provided, for example fins or spikes. If barbs are included they can provide additional multidirectional torsional stability.
The metal perform may be made as a graded metal structure by, for example, laser sintering using titanium and having an overall thickness of 2-3 mm. The perform comprises an inner surface layer 22 which is porous to retain the plastic composite bearing surface 21, a dense layer 23 which acts as a barrier layer to stop ingress of the plastic/composite into the metallic structure and an outer layer 24 which is of controlled interconnected porosity and is intended for bone ingrowth. This has a nominal porosity of 400 μm which is able to sustain the bone ingrowth referred to above.
The preformed metal insert is made as shown at the upper part of
In the construction shown in
In the construction and method shown in
In the embodiment and method shown in
In all the above examples the composite material is preferably PEEK reinforced with 30% carbon fibers produced to actual shape by injecting molding. The part can also be formed by a combination of molding/extrusion and machining to final shape.
Any material such as tantalum or niobium could be used as an alternative to titanium. The hydroxyapatite bioactive layer can be enhanced or replaced by a coating with bone morphogenic proteins in any of the examples, or even omitted.
As described above the hydroxyapatite layer can be applied by plasma torch sputtering for non-porous surfaces. Onto porous surfaces, deposition process or any process that will ensure full covering of the open porous surface and allow thickness control can be applied. Such processes can be deposition or laser ablation.
Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.
Number | Date | Country | Kind |
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0422666.8 | Oct 2004 | GB | national |