1. Field of the Invention
The present invention relates to a provisional prosthetic component for a medical device and the surgical methods for utilizing the same.
2. Description of the Related Art
Prostheses are commonly utilized to repair and/or replace damaged bone and tissue in the human body. For example, a hip prosthesis may be implanted to replace damaged or destroyed bone in the femur and/or acetabulum and recreate the natural, anatomical articulation of the hip joint. To implant a prosthesis, orthopedic surgery is performed which requires the creation of an incision in the skin of the patient and may necessitate the retraction of large portions of surrounding tissue to provide the surgeon with sufficient access to the surgical site. However, some orthopedic surgeries are performed utilizing minimally invasive techniques. When these techniques are utilized, a minimally invasive surgery is performed which may require only a small incision and very limited retraction of surrounding tissue. This may shorten a patient's recovery time and expedite healing.
To facilitate minimally invasive surgery, modular prostheses may be utilized. Modular prostheses have several individual, distinct components which are connected together to form the final, implanted prosthesis. Since the individual components of a modular system are smaller then the prostheses of a non-modular system, less retraction of tissue is needed at the surgical site to provide sufficient working space to the surgeon. Additionally, a modular prosthesis may include different interchangeable components, e.g., several stems having different lengths which are included in a modular femoral prosthesis system. This provides the surgeon greater flexibility to assemble a prosthesis that more closely approximates the patient's anatomy.
In addition to the final, implanted components of a modular prosthesis system, a modular prosthesis system may also include trial or provisional components which replicate the size and shape of the final, implanted components of the modular prosthesis system. The use of provisional components provides the surgeon with the ability to test the ultimate configuration of the prosthesis prior to the implantation of the final components. By trialing, i.e., testing, the surgeon is able to ensure that the fit, alignment, and range of motion provided by the final prosthesis will closely match the patient's natural anatomy.
Additionally, some modular prosthesis systems provide for the implantation of a final component prior to the use of mating provisional components for trialing. In these systems, the provisional components should be designed to accommodate the forces encountered during trial reduction and range of motion testing without compromising the functionality of the mating junction of the final component.
The present invention relates to provisional prosthetic components for a medical device and the surgical methods for utilizing the same. In one embodiment, the provisional prosthetic component includes a first portion and a core. The first portion is capable of mating with another modular prosthetic component. The first portion of the provisional prosthetic component may have a scratch hardness which is less than the scratch hardness of the modular prosthetic component. This allows for the first portion to be placed in mating engagement with the prosthetic component without scratching or damaging the junction of the modular prosthetic component. Additionally, the core of the provisional prosthetic component may have a scratch hardness greater than the scratch hardness of the first portion of the provisional prosthetic component and/or a stiffness sufficient to minimize deflection of the provisional prosthetic component during trial reduction and range of motion testing.
Advantageously, the design of the present provisional component allows for the use of a non-provisional modular prosthetic component during trialing of the provisional components. This results from the present provisional prosthetic component providing a connection with the non-provisional modular prosthetic component which will not scratch or damage the junction of the non-provisional modular prosthetic component. Additionally, the present provisional component includes a core which is stiff enough to limit deflection of the present provisional component during trialing to provide an accurate representation of the relative position of the final, non-provisional prosthetic component.
In one form thereof, the present invention provides a provisional prosthetic component, including a body sized to replicate the orientation of at least one component of a modular prosthetic component, the body including a core formed of a core material; and a first portion overlying the core, the first portion having a provisional prosthetic junction surface sized and shaped to mate with a final modular prosthetic junction surface of a component of the modular prosthetic component, the provisional prosthetic junction surface formed from a provisional prosthetic material, the final modular prosthetic junction surface formed from a final modular prosthetic material, the provisional prosthetic material having a lower scratch hardness than the final modular prosthetic material, whereby interaction of the provisional prosthetic material with the final modular prosthetic material will more likely cause scratching of the provisional prosthetic material than the final modular prosthetic material, the core material having a stiffness greater than the provisional prosthetic material from which the provisional prosthetic junction surface is formed.
In another form thereof, the present invention provides a provisional prosthetic component system, including a body sized to replicate the orientation of at least one component of a modular prosthetic component, the body including a core formed of a core material; and a first portion overlying the core, the first portion having a provisional prosthetic junction surface sized and shaped to mate with a final modular prosthetic junction surface of a component of the modular prosthetic component, the provisional prosthetic junction formed from a plastic, the final modular prosthetic junction surface formed from a final modular prosthetic material having a higher scratch hardness than the plastic from which the provisional prosthetic junction surface is formed, whereby interaction of the plastic with the final modular prosthetic material will more likely cause scratching of the plastic than the final modular prosthetic material.
In another form thereof, the present invention provides a method for trialing a prosthetic device including the steps of implanting a component of a modular prosthesis within a joint of a patient's body; attaching a provisional component to the component of the modular prosthesis, the provisional component having a body sized to replicate the orientation of at least one component of the modular prosthetic component, the body including a core formed of a core material; and a first portion overlying the core, the first portion having a provisional prosthetic junction surface sized and shaped to mate with a final modular prosthetic junction surface of the component of a modular prosthesis, the provisional prosthetic junction formed from a provisional material, the final modular prosthetic junction surface formed from a final modular prosthetic material, the provisional prosthetic material having a lower scratch hardness than the final modular prosthetic material, whereby interaction of the provisional prosthetic material with the final modular prosthetic material will more likely cause scratching of the provisional prosthetic material than the final modular prosthetic material, the core material having a stiffness greater than the provisional prosthetic material from which the provisional prosthetic junction surface is formed; reducing the joint, including the provisional component; evaluating the performance of the provisional component; and replacing the provisional component with a corresponding component of the modular prosthesis.
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following descriptions of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate exemplary embodiments of the invention and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
As discussed above, provisional components replicate the orientation of the individual components, i.e., stem 12, neck 14, and head 16, of a modular prosthesis component but are designed solely for trialing, i.e., testing, purposes. Referring to
As discussed above, the implantation of the present modular femoral prosthesis system begins by properly preparing the patient's femur for receipt of a femoral prosthesis. Once prepared, non-provisional stem 12, shown in
To ensure that the components provide the proper fit, the patient's leg is subjected to range of motion testing. If, after testing, the surgeon determines that the provisional components are acceptable, then provisional neck 30 and the provisional head (not shown) are removed and replaced by non-provisional neck 14 and non-provisional head 16. Alternatively, if the testing indicates that another non-provisional neck 14 and/or non-provisional head 16 would be more advantageous, provisional neck 30 and/or provisional head (not shown) are removed and replaced with provisional components corresponding in orientation to the newly selected non-provisional neck 14 and/or non-provisional head 16 and the process is repeated. As noted above, the provisional components of the present invention replicate the orientation of the non-provisional components. However, such replication does not require that the provisional components have the same size and shape as the non-provisional components.
In one exemplary embodiment, a plurality of different cores 34 are provided to allow for the exchange of one of the plurality of cores 34 for another of the plurality of cores 34. This would, after the insertion of first portion 32 into non-provisional stem 12, as discussed in detail above, allow the surgeon to exchange cores 34 for additional trialing without needing to remove first portion 32 from non-provisional stem 12.
As set forth above, provisional neck 30 includes first portion 32 and core 34. First portion 32 may be constructed from a material having a scratch hardness that is less than the scratch hardness of non-provisional stem 12. Scratch hardness refers to the resistance of a material to penetration, i.e., scratching, by other materials. Thus, a material having a high scratch hardness can penetrate, i.e., scratch, a material having a lower scratch hardness. Similarly, a material having a lower scratch hardness is less likely to penetrate, i.e., scratch, a material having a higher scratch hardness. By having a lower scratch hardness, first portion 32 is prevented from scratching or damaging the walls defining female tapered cavity 18 of non-provisional stem 12 when inserted therein. For example, when stem 12 is constructed of titanium or a titanium alloy, first portion 32 may be constructed of a suitable plastic having a lower scratch hardness than titanium or titanium alloy, such as carbon fiber polyetheretherketone, polyethelyene, polytetrafluoroethylene, or polyphenylsulfone, such as Radel® A and Radel® B. Radel® is a registered trademark of Amoco Polymers, Inc. of Alpharetta, Ga. In one exemplary embodiment, first portion 32 has a scratch hardness substantially less then the scratch hardness of core 34, for example, when first portion 32 is made of polyethylene and core 34 is made of a cobalt chromium alloy.
Because first portion 32 may be made from a suitable plastic, injection molding and other known forming methods may be used to manufacture first portion 32. Additionally, because numerous sizes and designs of provisional component 30 may be needed for a single modular prosthesis system, the ability to quickly differentiate between the various provisional components is advantageous. Therefore, prior to molding or otherwise forming first portion 32, a coloring may be added to the plastic to color code the varying provisional components. Thus, first portion 32 of the smallest size provisional neck 30 may be a made to have a first color, the next larger sized first portion 32 may be made to have a second color, and so on. This type of standardized color coding system provides the surgeon with a quick and easy way to identify the appropriate provisional component for trialing.
In contrast to the materials used for constructing first portion 32, core 34 may be formed from a material having a scratch hardness greater than the scratch hardness of the material forming first portion 32. This material should be capable of withstanding the loads encountered in the joint during trial reduction and range of motion testing while accurately replicating the positions of the final prosthetic components. Thus, when first portion 32 and core 34 are connected, core 34 may provide greater rigidity or stiffness to provisional neck 30, which limits deflection of provisional neck 30 and helps ensure accurate orientation of the components during trialing. Core 34 may be manufactured from metal, for example, including titanium alloys, cobalt chromium alloys, or surgical grade stainless steel. If core 34 is constructed of metal, traditional forming and machining techniques may be utilized.
As shown in
As shown in
Referring to
Referring to
Alternatively, in another exemplary embodiment, projection 55 of core 112, shown in
While this invention has been described as having a preferred design, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.