WO2005039439A2 - Cartilage-preserving long bone head prosthesis - Google Patents
Cartilage-preserving long bone head prosthesis Download PDFInfo
- Publication number
- WO2005039439A2 WO2005039439A2 PCT/IL2004/000980 IL2004000980W WO2005039439A2 WO 2005039439 A2 WO2005039439 A2 WO 2005039439A2 IL 2004000980 W IL2004000980 W IL 2004000980W WO 2005039439 A2 WO2005039439 A2 WO 2005039439A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- head
- bone
- long
- prosthetic
- bipolar
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
Definitions
- the present invention relates to a new type of prosthetic device, and a method that uses said device in the treatment of femoral and humeral neck fractures. More specifically, the prosthetic device of the invention is capable of being used to treat long bone neck fractures in procedures wherein the natural articular cartilage and subchondral bone of the long bone is preserved.
- Femoral neck fractures are usually entirely intracapsular, and (in common with all intracapsular fractures) the synovial fluid bathing the fracture may interfere with the healing process. Furthermore, all healing must be take place endo-osteally, in view of the fact that the femoral neck has essentially no periosteal layer. Finally, angiogenic-inhibiting factors in synovial fluid can also inhibit fracture repair. All of these factors, together with the aforementioned precarious blood supply to the femoral head, result in unpredictable healing and a subsequent fairly high incidence of nonunions.
- Fig. 1 Hemiartheoplasty - replacement of the femoral head with a (normally metal) prosthetic head attached to a monoblock or modular femoral stem.
- the most popular types of prosthesis used are the Thompson, Austin-Moore, bipolar and unipolar prostheses.
- a typical bipolar femoral prosthesis is shown in Fig. 1.
- surgeons recommend the second option, that is, the use of a primary prosthetic replacement for use in the treatment of elderly by ambulatory patients. While the use of prostheses may assist in the prevention of nonunion and avascular necrosis, their use is associated with a number of other complications.
- a further major problem associated with the use of existing prosthetic devices is the dysfunction that arises from the mismatch between the acetabulum and the prosthetic head. Further traumatic complications also arise from the fact that following implantation of the prosthesis, articulation takes place between the hard metal of the prosthetic head and the much softer acetabular surface.
- the head region of this endoprosthesis is characterized by being adapted for insertion into a shelllike cavity comprising the outer layers of the patient's femoral or humeral head, following removal of most of the cancellous bone.
- the cartilaginous articular surface of the long bone head, together with the underlying subchondral bone is preserved, thus retaining the natural articulating surfaces of the proximal long bone ball-and- socket joint.
- the present invention is thus primarily directed to a long- bone endoprosthesis comprising an essentially spherical head region that is connected to a narrowed stem section, wherein the head region is characterized in having a roughened outer surface.
- the roughened prosthetic head outer surface has an arithmetic average roughness (R ⁇ ) value in the range of 0.05 ⁇ m to 500 ⁇ m. More preferably, the R ⁇ value is between 40 ⁇ m and 200 ⁇ m. Most preferably, the R ⁇ value is 50 ⁇ m.
- R ⁇ is defined in accordance with the International Standards Organization document ISO 468 ("Surface Roughness Parameters - their values and general rules for specifying requirements") .
- the roughened prosthetic head outer surface is a surface comprising one or more surface features selected from the group consisting of indentations, ridges, slots, grooves, pores, dimples and protuberances. Theses features may be introduced into the surface of the prosthetic head by any standard procedure including mold-casting techniques, machine-cutting and (in the case of small-diameter surface protuberances) grit blasting techniques.
- the roughened prosthetic head outer surface is a surface fitted with one or more grooves or slots, as will be described in more detail hereinbelow.
- long- bone is used primarily to refer to the femur and humerus .
- the head and neck regions of the prosthesis are constructed as a one-piece unit, to be referred to hereinafter as the monoblock embodiment.
- the head and neck regions are constructed as two separate modular units.
- the separate head region is a bipolar prosthetic head.
- the present invention is directed to a long-bone endoprosthetic head comprising an essentially spherical portion, into the distal side of which is formed a recess such that a femoral stem endoprosthesis may be inserted therein and connected thereto, and wherein said endoprosthetic head is characterized by having a roughened outer surface, as defined and described hereinabove.
- the roughened prosthetic head outer surface has an arithmetic average roughness (R ⁇ ) value in the range of 0.05 ⁇ m to 500 ⁇ m. More preferably, the R ⁇ value is between 40 ⁇ m and 200 ⁇ m. Most preferably, the R ⁇ value is 50 ⁇ m.
- the roughened prosthetic head outer surface is a surface comprising one or more surface features selected from the group consisting of indentations, ridges, slots, grooves, pores, dimples and protuberances.
- the average depth or height of the aforementioned surface features is in the range of 0.05 ⁇ m to 5000 ⁇ m. More preferably, the average value is between 400 ⁇ m and 2000 ⁇ m. Most preferably, the average height or depth value is 1000 ⁇ m.
- the depth of said features is in the range of 1 ⁇ m to the maximum thickness of the material of the prosthetic head surface.
- the prosthetic head is actually perforated by the slots, grooves or pores, such that a channel is created from the external surface of the prosthetic head to the inner surface or cavity of said head.
- the aforementioned long-bone endoprosthetic head having a roughened outer surface is constructed as a bipolar prosthetic head, having an outer head (with the roughened outer surface) , an intermediate portion adjacent to the inner surface of said outer head, and an inner head that articulates with the inner surface of said intermediate portion.
- the present invention also encompasses an endoprosthetic system comprising a long-bone endoprosthetic head as disclosed and defined hereinabove, and a femoral stem endoprosthesis that may be connected thereto.
- the present invention is also directed to a method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing most or all of the cancellous bone from the head of said long-bone, thereby forming a long-bone head shell; b) preparing the long bone canal to accept a prosthetic stem; c) inserting, and optionally cementing said prosthetic stem into said long-bone canal; d) inserting and cementing a long-bone prosthetic head into said long-bone head shell; and e) reduction of the stem region into the recessed region of said prosthetic head.
- the present invention is also directed to a method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing the native long-bone head from its natural location in the body, by the use of a safe technique that does not cause injury to the cartilage or subchondral bone; b) preparing the head shell outside the body on the operative tray; c) preparing the long bone canal to accept a prosthetic stem section; d) inserting the prosthetic stem section with or without the use of cement; e) cementing the prosthetic head section to the shell formed in step (b) ; f) reduction of the prepared prosthetic head together with the attached head shell into the joint of the patient being treated, and connection of the distal portion of said prosthetic head to said prosthetic stem section.
- the present invention is further directed to a method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing the native long-bone head from its natural location in the body, by the use of a safe technique that does not cause injury to the cartilage or subchondral bone; b) preparing the head shell outside the body on the operative tray; c) preparing the long bone canal to accept the stem section of a monoblock prosthesis; d) inserting said monoblock prosthesis stem section into said long bone canal with or without the use of cement; e) cementing the head section of said monoblock prosthesis to the shell formed in step (b) ; f) reduction of the prepared monoblock prosthesis head together with the attached head shell into the joint of the patient being treated.
- the present invention is also directed to another method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing most or all of the cancellous bone from the head of said long-bone, thereby forming a long-bone head shell; b) preparing the long bone canal to accept a prosthetic stem; c) inserting, and optionally cementing said prosthetic stem into said long-bone canal; d) cementing the outer head of a bipolar prosthesis to the shell formed in step (a) ; e) placing prosthetic stem section trunion into the inner cavity of the inner prosthetic head; f) inserting the inner prosthetic head into the inner cavity of the outer prosthetic head; g) locking the bipolar head assembly by means of closing the locking ring.
- the present invention is further directed to a method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing the native long-bone head from its natural location in the body, by the use of a safe technique that does not cause injury to the cartilage or subchondral bone; b) preparing the head shell outside the body on the operative tray; c) preparing the long bone canal to accept a prosthetic stem section; d) inserting the prosthetic stem section with or without the use of cement; e) cementing the outer head of a bipolar prosthesis to the shell formed in step (b) ; f) placing prosthetic stem section trunion into the inner cavity of the inner prosthetic head; g) inserting the inner prosthetic head into the inner cavity of the outer prosthetic head; h) locking the bipolar head assembly by means of closing the locking ring; i) reduction of the prepared prosthetic head together with the attached head shell into the joint of the patient being treated.
- the present invention is further directed to another method for treating fractures of the neck region of a long-bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing the native long-bone head from its natural location in the body, by the use of a safe technique that does not cause injury to the cartilage or subchondral bone; b) preparing the head shell outside the body on the operative tray; c) preparing the long bone canal to accept the stem-inner section of a monoblock bipolar prosthesis; d) inserting the prosthetic stem section of the stem-inner head bipolar monoblock bipolar prosthesis, with or without the use of cement; e) cementing the bipolar prosthetic outer head section to the shell formed in step (b) ; f) reduction of the prepared bipolar prosthetic outer head together with the attached head shell into the joint of the patient being treated; g) inserting the bipolar inner head into the internal cavity of the bipolar outer head; h) locking the bipolar head assembly by means of closing the locking ring.
- the present invention is further directed to yet another method for treating fractures of the neck region of a long- bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing the native long-bone head from its natural location in the body, by the use of a safe technique that does not cause injury to the cartilage or subchondral bone; b) preparing the head shell outside the body on the operative tray; c) preparing the long bone canal to accept the stem-inner section of a monoblock bipolar prosthesis; d) inserting the prosthetic stem section of the stem-inner head bipolar monoblock bipolar prosthesis, with or without the use of cement; e) inserting the bipolar inner head into the internal cavity of the bipolar outer head; f) locking the bipolar head assembly by means of closing the locking ring; g) cementing the shell formed in step (b) onto the bipolar prosthetic outer head section; h) reduction of the prepared bipolar prosthetic outer head together with the attached bipolar prosthesis into the joint of the patient being
- the present invention is also directed to a yet further method for treating fractures of the neck region of a long- bone in a patient in need of such treatment, wherein said method comprises the steps of: a) removing most or all of the cancellous bone from the head of said long-bone, thereby forming a long-bone head shell; b) preparing the long bone canal to accept the stem-inner head section of a monoblock bipolar prosthesis; c) inserting, the prosthetic stem section of the stem-inner head bipolar monoblock bipolar prosthesis, with or without the use of cement; d) inserting the bipolar inner head into the internal cavity of the bipolar outer head; e) locking the bipolar head assembly by means of closing the locking ring; f) cementing the bipolar prosthetic outer head section to the shell formed in step (b) .
- the above methods of treatment are applicable to the treatment of fractures of both the femur and the humerus .
- Fig. 1 is a photograph of a prior art bipolar femoral endoprosthesis .
- Fig. 2 schematically depicts the prosthetic device of the present invention.
- Fig. 3 is a photographic representation of a prosthetic device of the present invention after insertion of the head of the device into the shell of a femoral head, following removal of most of the cancellous bone.
- Fig. 4 is a photograph demonstrating the head of a two-part prosthetic device according to the present invention following its insertion into a femoral head shell.
- Fig. 5 is a side view of one embodiment of a femoral endoprosthetic head according to the present invention, in which the roughened surface is provided by the presence of both circumferential and longitudinal slots.
- Fig. 6 is an inferior view of the embodiment of the endoprosthetic head depicted in fig. 5.
- Fig. 7 is a superior view of the embodiment of the endoprosthetic head depicted in figs. 5 and 6, showing the non-slotted region at the proximal pole of said head.
- Fig. 8 is an inferior view of a bipolar prosthetic head depicting the inner head portion residing within the internal cavity of the outer head portion.
- Fig. 9 is an inferior view of a bipolar prosthetic head depicting the inner head locked in place in the internal cavity of the outer head portion by means of a locking ring.
- the essential inventive feature of the endoprosthesis of the invention is the fact that the head region (or at least a portion thereof) has a roughened, non-polished outer surface, in order to permit optimal mechanical bonding of said head region to cement, and by which means to the inner surface of the femoral or humeral head shell-like cavity.
- This stands in marked contrast to prior art long-bone head and stem prostheses, whose head regions are characterized by having a polished surface, the purpose of which is to replace the natural cartilaginous articular surface of the natural femoral or humeral head.
- the retention of the natural articular surfaces of the ball-and-socket joints results in several clinical advantages, including prevention of acetabular erosion, obviation of the problem of ball/socket mismatch that is seen with prior art approaches, and pain reduction.
- Many of the above advantages arise from the fact that the retention of the anatomical articulating surfaces preserves the natural clearance between the long bone head and the socket within the joint. It should be noted that the viability and integrity of the long bone head articular cartilage is maintained by virtue of the fact that the nutritional requirements of this tissue are met by synovial fluid that bathes said tissue.
- FIG. 2 A typical femoral endoprosthesis in accordance with the present invention is schematically illustrated in Fig. 2.
- the prosthesis, shown generally as 20 consists essentially of two sections: the prosthetic head region 21 and the stem region 22.
- the proximal end 23 of the stem region is inserted into an elongated recess 24 in said head region.
- the femoral head shell 25 comprising the patient's articular cartilage and associated subchondral bone, is bonded to the prosthetic head region 21 by means of biocompatible cement 26.
- the surface roughness of the prosthetic head region 21 of the embodiment depicted in this figure is provided by a series of circumferentially arranged slots 27. As indicated in the figure, the biocompatible cement 26 is able to penetrate into said slots, thus increasing the strength of the bonding between the prosthetic head region 21 and the femoral head shell 25.
- Fig. 3 photographically depicts a prosthesis of the present invention, generally shown as 30 after assembly of the head 31 and stem 32 regions. Most of the surface area of head region 31 is obscured by the femoral head shell 33 that covers said region.
- Fig. 4 photographically depicts the head region of the prosthesis shown in Fig. 3 (generally shown here as 40) prior to insertion of the stem region.
- a small portion of the roughened outer surface 41 of the head region is shown extending below the inferior (distal) margin of the femoral head shell 42. It will be noted that said surface is perforated by a circular opening 43 into which the stem region of the prosthesis will be inserted.
- the prosthetic head having the roughened outer surface may be a bipolar prosthesis.
- bipolar prostheses for use in the management of long bone neck fractures comprise the following components:
- An outer head for articulation with the joint socket e.g. acetabular
- the outer head has a roughened outer surface, in order to permit attachment thereof to the prepared femoral head, as described herein.
- An intermediate layer or portion fixed within the inner cavity of the outer head Typically, the intermediate portion is constructed of a material that is softer than metal (such as polyethylene) . Alternatively, this portion may be constructed of the same material as the outer head, thereby forming a single unit therewith. (More details of the aterials used in the construction of bipolar prostheses according to the present invention are given hereinbelow. ) 3.
- FIG. 8 illustrates the articulation of the inner head 81 with the intermediate portion 83 within the inner cavity of the outer head 85.
- a locking ring whose function is to retain the inner head in movable contact with the intermediate portion within the inner cavity of the outer head.
- Fig. 9 illustrates (from an inferior aspect) the relative disposition of the inner head 91 and outer head 95, following closure of the locking ring 97.
- the prosthetic head having the roughened outer surface may be part of a bipolar monoblock prosthesis, wherein the inner head and femoral stem of said prosthesis are provided as a single integral unit.
- the inner head of the monoblock unit is retained in movable contact with the intermediate layer within the cavity of the outer head and locked in place with the above-described locking ring.
- the endoprostheses of the present invention may be constructed from cobalt-based alloys (e.g. cobalt-chrome), titanium, titanium-based alloys, stainless-steel, and combinations of the above-mentioned metals.
- the endoprostheses may also comprise components that are constructed from non-metallic materials such as biocompatible plastics and polymers, such as polyurethane and polyethylene, as well as other synthetic biocompatible materials that are softer than the aforementioned metals, and hard materials such as ceramics.
- non-metallic materials such as biocompatible plastics and polymers, such as polyurethane and polyethylene, as well as other synthetic biocompatible materials that are softer than the aforementioned metals, and hard materials such as ceramics.
- prosthetic heads may be constructed with a metal trunion in contact with a plastic body.
- Another example of the use of a combination of materials would be the case in which the central bulk of the prosthetic head is constructed of a metal or metal alloy, whereas the outer portion (having an external surface that is cemented to the femoral head shell and an inner surface that is bonded to said metal or alloy) may be constructed of a non-metallic, polymeric material.
- the outer head i.e. the portion bearing the roughened surface that is cemented to the femoral head shell
- the outer head may be constructed of a metal or metal alloy.
- the outer head may be constructed of a ceramic or polymeric material.
- the intermediate layer that lines the inside of said outer head is typically constructed of polyethylene.
- this layer may be constructed of the same material as the outer head, thereby forming a single unit therewith.
- the inner head like the outer head, may be constructed of either a metal or of a polymeric or ceramic material .
- prostheses having the desired physical properties such as hardness, resilience, elasticity etc.
- the external dimensions of the endoprosthesis of the present invention are essentially as the same as those of prior art femoral and humeral prostheses.
- the diameter of the spherical head is generally in the range of 22 to 40 mm.
- a preferred head diameter for the femoral head prosthesis is in the range of 28 to 32 mm. In practice, however, the head diameter may also be outside of these preferred ranges, in certain circumstances being as small as 12 mm or as large as 60 mm. It should be noted, however, that the prostheses of the present invention are not limited to those having head regions of spherical conformation.
- multi-sided head regions have three or more sides. More preferably, the number of sides present in such conformations is between four (e.g. square, rectangular and/or trapezoid) and eight (i.e. octagonal).
- multi-sided head geometries of any other type that are suitable for performing the present invention are also to be considered as falling within the scope thereof. Examples of such suitable geometries (in addition to those mentioned hereinabove) include, but are not limited to, regular pyramidal shapes as well as irregular polyhedrons, star-shaped, "hedgehog-shaped", and so on.
- other head geometries such as conical, frusto-conical and variations and combinations thereof may also be usefully employed, and form part of the scope of the present invention.
- the external shape and dimensions of the endoprostheses of the present invention may be similar to those of corresponding prior art devices, the presently-claimed devices are distinguished by having head regions that are unpolished, and which optionally are further roughened by the presence of one or more distinctive surface features, as described hereinabove, and exemplified hereinbelow.
- the roughened prosthetic head surface may be produced in several different ways, by the use of any standard procedure including mold-casting techniques, machine- cutting and (in the case of small-diameter surface protuberances) grit blasting techniques.
- the roughened prosthetic head outer surface is a surface fitted with one or more slots, as will be described in more detail in the illustrative example given hereinbelow.
- cements may be used to bond the head of the prosthesis into the head "shell" formed after removal of most or all of the cancellous bone from the long bone head.
- suitable cements and glues include Palacos cement, Simplex, CMW and Cementech.
- the endoprosthesis of the present invention may be used in the surgical treatment of long-bone neck fractures .
- the following procedure is one example of a surgical method that utilizes the instantly-disclosed prosthesis in the management of femoral neck fractures:
- Example A rough-surfaced, cartilage-sparing long bone prosthetic head according to the present invention is provided by the presence of slots or grooves cut into said surface.
- Figs. 5 to 7 illustrate a typical femoral head endoprosthesis of the present invention, in which the surface roughness is provided by the presence of said slots and grooves.
- the unpolished stainless steel prosthetic femoral head depicted therein (shown generally as 50) while generally spherical in shape, possesses a flattened, truncated base 51 which contains a circular opening 52 for receiving the proximal end of an appropriately-sized endoprosthetic femoral stem.
- the geometric center of femoral head 50 is situated approximately 11 mm above flattened base 51.
- the external diameter of the essentially-spherical head 50 shown in this example is 32 mm.
- the prosthetic femoral head depicted in this figure is characterized by the presence of two distinct types of surface feature. Firstly, there is a series of six, circumferentially-disposed grooves 53, the most inferior (distal) of which is situated 4.6 mm below a line defining the "equator" of the essentially spherical head (i.e. the horizontally disposed circumferential line of greatest length, when the prosthetic head is placed vertically such that the flattened base 51 is situated inferiorly) .
- the circumferential groove situated immediately adjacent and superior to the above-described groove is situated at a distance of 1 mm below said equatorial line.
- each circumferential groove 53 has a mean depth of 1 mm.
- the width of each groove at its outer end is 1.2 mm, while the width at the inner end thereof tapers to 0.8 mm.
- the second type of distinct surface feature of the prosthetic head depicted in this figure is a vertically- disposed slot 54 (of which two such grooves are depicted in fig. 5.) .
- said slots are situated along imaginary longitudinal lines, and are of such a length such that they intersect the three most superior (proximal) circumferential grooves 53 at an angle of 90°C.
- Said vertically-disposed slots are formed by the use of 5 mm diameter drill that is offered to the prosthetic head at an angle of 34 degrees in relation to the geometric center of the spherical head.
- each slot is located 9 mm from the superior (proximal) pole of the spherical head, while the lower end thereof is located 3.5 mm above the above-defined equatorial line.
- a total of four such vertically-disposed slots are present in the prosthetic head, as shown more clearly in Fig. 7, wherein said slots are indicated as 71. It will further be appreciated from this figure that said vertically-disposed slots are arranged equidistantly from each other.
- Fig. 6 schematically depicts the same prosthetic head (shown generally as 60) as presented in Figs. 5 and 7 in inferior view (i.e. with the distal surface uppermost).
- the truncated base 61 is shown to be perforated by circular opening 62, the purpose of which is to accept and retain the prosthetic stem section (not shown) .
- Said opening leads to an internal space that is essentially conical in shape, the external surface of said cone having a diameter of 14 mm and the internal base thereof having a diameter of 12 mm.
Abstract
Description
Claims
Priority Applications (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002544151A CA2544151A1 (en) | 2003-10-28 | 2004-10-27 | Cartilage-preserving long bone head prosthesis |
AU2004283563A AU2004283563A1 (en) | 2003-10-28 | 2004-10-27 | Cartilage-preserving long bone head prosthesis |
EP04791842A EP1682049A2 (en) | 2003-10-28 | 2004-10-27 | Cartilage-preserving long bone head prosthesis |
JP2006537551A JP2007509690A (en) | 2003-10-28 | 2004-10-27 | Long bone head prosthesis to protect cartilage |
US11/411,244 US20060259148A1 (en) | 2003-10-28 | 2006-04-26 | Cartilage-preserving long bone head prosthesis |
IL175262A IL175262A0 (en) | 2003-10-28 | 2006-04-27 | Cartilage-preserving long bone head prosthesis |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IL15863303A IL158633A0 (en) | 2003-10-28 | 2003-10-28 | Cartilage-preserving long bone head prosthesis |
IL158633 | 2003-10-28 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/411,244 Continuation-In-Part US20060259148A1 (en) | 2003-10-28 | 2006-04-26 | Cartilage-preserving long bone head prosthesis |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2005039439A2 true WO2005039439A2 (en) | 2005-05-06 |
WO2005039439A3 WO2005039439A3 (en) | 2006-05-11 |
Family
ID=34044239
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/IL2004/000980 WO2005039439A2 (en) | 2003-10-28 | 2004-10-27 | Cartilage-preserving long bone head prosthesis |
Country Status (7)
Country | Link |
---|---|
EP (1) | EP1682049A2 (en) |
JP (1) | JP2007509690A (en) |
CN (1) | CN1897894A (en) |
AU (1) | AU2004283563A1 (en) |
CA (1) | CA2544151A1 (en) |
IL (2) | IL158633A0 (en) |
WO (1) | WO2005039439A2 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2007069250A2 (en) | 2005-12-14 | 2007-06-21 | Presrv Ltd. | Faceted long bone head prosthesis |
US8277459B2 (en) | 2009-09-25 | 2012-10-02 | Tarsus Medical Inc. | Methods and devices for treating a structural bone and joint deformity |
US8652141B2 (en) | 2010-01-21 | 2014-02-18 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
US8696719B2 (en) | 2010-06-03 | 2014-04-15 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
US8870876B2 (en) | 2009-02-13 | 2014-10-28 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
ES2528294T3 (en) * | 2008-02-25 | 2015-02-06 | Smith & Nephew, Inc. | Method and system for mapping a femoral head for alignment of acetabular prostheses |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4687487A (en) * | 1978-07-21 | 1987-08-18 | Association Suisse Pour La Recherches Horlogere | Joint implant |
US5192323A (en) * | 1990-11-05 | 1993-03-09 | Zimmer, Inc. | Method of surface hardening orthopedic implant devices |
US6447550B1 (en) * | 1997-03-27 | 2002-09-10 | Smith & Nephew, Inc. | Method of surface oxidizing zirconium alloys and resulting product |
US6527808B1 (en) * | 2000-10-11 | 2003-03-04 | Zimmer Technology, Inc. | Constrained socket for use with a ball-and-socket joint |
-
2003
- 2003-10-28 IL IL15863303A patent/IL158633A0/en unknown
-
2004
- 2004-10-27 EP EP04791842A patent/EP1682049A2/en not_active Withdrawn
- 2004-10-27 CN CNA2004800389601A patent/CN1897894A/en active Pending
- 2004-10-27 AU AU2004283563A patent/AU2004283563A1/en not_active Abandoned
- 2004-10-27 JP JP2006537551A patent/JP2007509690A/en active Pending
- 2004-10-27 WO PCT/IL2004/000980 patent/WO2005039439A2/en active Application Filing
- 2004-10-27 CA CA002544151A patent/CA2544151A1/en not_active Abandoned
-
2006
- 2006-04-27 IL IL175262A patent/IL175262A0/en unknown
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4687487A (en) * | 1978-07-21 | 1987-08-18 | Association Suisse Pour La Recherches Horlogere | Joint implant |
US5192323A (en) * | 1990-11-05 | 1993-03-09 | Zimmer, Inc. | Method of surface hardening orthopedic implant devices |
US6447550B1 (en) * | 1997-03-27 | 2002-09-10 | Smith & Nephew, Inc. | Method of surface oxidizing zirconium alloys and resulting product |
US6527808B1 (en) * | 2000-10-11 | 2003-03-04 | Zimmer Technology, Inc. | Constrained socket for use with a ball-and-socket joint |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2007069250A2 (en) | 2005-12-14 | 2007-06-21 | Presrv Ltd. | Faceted long bone head prosthesis |
WO2007069250A3 (en) * | 2005-12-14 | 2007-11-01 | Presrv Ltd | Faceted long bone head prosthesis |
US8870876B2 (en) | 2009-02-13 | 2014-10-28 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
US8277459B2 (en) | 2009-09-25 | 2012-10-02 | Tarsus Medical Inc. | Methods and devices for treating a structural bone and joint deformity |
US8795286B2 (en) | 2009-09-25 | 2014-08-05 | Tarsus Medical Inc. | Methods and devices for treating a structural bone and joint deformity |
US8652141B2 (en) | 2010-01-21 | 2014-02-18 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
US8696719B2 (en) | 2010-06-03 | 2014-04-15 | Tarsus Medical Inc. | Methods and devices for treating hallux valgus |
Also Published As
Publication number | Publication date |
---|---|
IL175262A0 (en) | 2006-09-05 |
EP1682049A2 (en) | 2006-07-26 |
JP2007509690A (en) | 2007-04-19 |
WO2005039439A3 (en) | 2006-05-11 |
AU2004283563A1 (en) | 2005-05-06 |
IL158633A0 (en) | 2004-05-12 |
CA2544151A1 (en) | 2005-05-06 |
CN1897894A (en) | 2007-01-17 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20060259148A1 (en) | Cartilage-preserving long bone head prosthesis | |
US9763798B2 (en) | System and method for implanting a secondary glenoid prosthesis | |
US7621915B2 (en) | Acetabular reamer | |
US20210338437A1 (en) | Partial hip prosthesis | |
EP1138283B1 (en) | Femoral hip prosthesis | |
MORSCHER et al. | Cementless Press-Fit Cup Principles, Experimental Data, and Three-Year Follow-Up Study | |
Lee | The current concepts of total hip arthroplasty | |
US10507113B2 (en) | Reverse total hip replacement | |
WO2007014164A2 (en) | Site specific minimally invasive joint implants | |
WO2011081797A1 (en) | Humeral head resurfacing implant | |
JP4694117B2 (en) | Cemented prosthesis kit | |
EP1682049A2 (en) | Cartilage-preserving long bone head prosthesis | |
US20220183847A1 (en) | Resurfacing cup for acetabulum hemiarthroplasty of the hip joint | |
EP1588677B1 (en) | Acetabular prosthesis | |
US20210030547A1 (en) | Ceramic surface arthroplasty system | |
WO2007069250A2 (en) | Faceted long bone head prosthesis | |
Albright et al. | Cement-free, total hip replacement using a threaded titanium acetabulum | |
Kowaleski | Total hip replacement. | |
Malhotra et al. | 1 Evolution and Design Principles of Hip Arthroplasty | |
Munuera et al. | International Meeting on Total Hip Arthroplasty: Hospital La Paz-Madrid, April 6–8, 2000 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
WWE | Wipo information: entry into national phase |
Ref document number: 200480038960.1 Country of ref document: CN |
|
AK | Designated states |
Kind code of ref document: A2 Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW |
|
AL | Designated countries for regional patents |
Kind code of ref document: A2 Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LU MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
WWE | Wipo information: entry into national phase |
Ref document number: 2006537551 Country of ref document: JP Ref document number: 2004283563 Country of ref document: AU Ref document number: 11411244 Country of ref document: US |
|
WWE | Wipo information: entry into national phase |
Ref document number: 175262 Country of ref document: IL |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2544151 Country of ref document: CA |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2004791842 Country of ref document: EP |
|
ENP | Entry into the national phase |
Ref document number: 2004283563 Country of ref document: AU Date of ref document: 20041027 Kind code of ref document: A |
|
WWP | Wipo information: published in national office |
Ref document number: 2004283563 Country of ref document: AU |
|
WWE | Wipo information: entry into national phase |
Ref document number: 1418/KOLNP/2006 Country of ref document: IN |
|
WWP | Wipo information: published in national office |
Ref document number: 2004791842 Country of ref document: EP |
|
WWP | Wipo information: published in national office |
Ref document number: 11411244 Country of ref document: US |