WO2012173605A1 - Système d'implant de hanche total épargnant le col du fémur - Google Patents

Système d'implant de hanche total épargnant le col du fémur Download PDF

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Publication number
WO2012173605A1
WO2012173605A1 PCT/US2011/040372 US2011040372W WO2012173605A1 WO 2012173605 A1 WO2012173605 A1 WO 2012173605A1 US 2011040372 W US2011040372 W US 2011040372W WO 2012173605 A1 WO2012173605 A1 WO 2012173605A1
Authority
WO
WIPO (PCT)
Prior art keywords
lateral
implant body
medial
column
femoral prosthesis
Prior art date
Application number
PCT/US2011/040372
Other languages
English (en)
Inventor
Declan Brazil
Timothy Mctighe
Bradley Walter
Original Assignee
Concept, Design And Development, Llc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Concept, Design And Development, Llc filed Critical Concept, Design And Development, Llc
Priority to AU2011371008A priority Critical patent/AU2011371008B2/en
Priority to PCT/US2011/040372 priority patent/WO2012173605A1/fr
Publication of WO2012173605A1 publication Critical patent/WO2012173605A1/fr

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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
    • A61F2/32—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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3601—Femoral heads ; Femoral endoprostheses for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices
    • 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
    • A61F2/3662—Femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30113—Rounded shapes, e.g. with rounded corners circular
    • A61F2002/30116—Rounded shapes, e.g. with rounded corners circular partial circles, i.e. circular segments
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30112—Rounded shapes, e.g. with rounded corners
    • A61F2002/30125—Rounded shapes, e.g. with rounded corners elliptical or oval
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30171—Concave polygonal shapes rosette- or star-shaped
    • 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A61F2002/30334—Cone of elliptical or oval basis
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30785—Plurality of holes parallel
    • 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
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30789—Plurality of holes perpendicular with respect to each other
    • 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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
    • A61F2002/30894—Plurality of protrusions inclined obliquely with respect to each other
    • 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
    • A61F2002/3625—Necks
    • 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
    • A61F2002/3652—Connections of necks to 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3662—Femoral shafts
    • A61F2002/3678—Geometrical features
    • A61F2002/368—Geometrical features with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft

Definitions

  • the present disclosure relates generally to an orthopedic implant for use in a total hip arthroplasty, i.e., a total hip replacement. More specifically, the disclosure relates to a femoral component of a total hip implant, and more particularly, but not necessarily entirely, to a femoral neck sparing implant that may be placed or located in a proximal femur.
  • This invention relates in general to prosthesis, parts thereof, or aids and accessories therefor. More particularly, the invention relates to a femoral prosthesis.
  • Total hip replacement has become the standard of care treatment to address a variety of degenerative and traumatic processes of the hip joint.
  • Previous devices have relied on entry into the femoral canal either in a straight entry or in a curvilinear fashion. Some have considered the proximal femoral metaphyseal bone incapable of sustaining load.
  • Fig. 1 is a partial sectional view in elevation of the proximal end of a femur and a femoral prosthesis.
  • Fig. 2A is a diagrammatic partial plan view of the femur and prosthesis shown in Fig. 1 , showing hoop stress at the femoral neck.
  • Figs. 2B-2C are diagrammatic partial plan views of other femurs and the prosthesis, showing hoop stress at the femoral necks.
  • Fig. 3 is an enlarged perspective view of a femoral prosthesis.
  • Fig. 4 is an end view of the femoral prosthesis shown in Fig. 3.
  • Fig. 5 is an enlarged perspective view of another femoral prosthesis.
  • Fig. 6 is an end view of the femoral prosthesis shown in Fig. 5.
  • Fig. 7 is an exploded sectional view of the prosthesis shown in Fig. 5.
  • Figs. 8A-8B are sectional views of prosthesis.
  • Fig. 9A shows a perspective view of a femoral prosthesis.
  • Fig 9B shows an anterior view of the femoral prosthesis of Fig. 9A.
  • Fig 9C shows lateral view of the femoral prosthesis of Fig. 9A.
  • Fig 10A shows a perspective view of a femoral prosthesis.
  • Fig 10B shows an anterior view of the femoral prosthesis of Fig. 10A.
  • Fig IOC shows lateral view of the femoral prosthesis of Fig. 10A.
  • Fig 11 A shows a perspective view of a femoral prosthesis.
  • Fig 1 IB shows an anterior view of the femoral prosthesis of Fig. 11A.
  • Fig. l lC shows lateral view of the femoral prosthesis of Fig. 11A.
  • Fig. 12 illustrates an embodiment of a hip prosthesis having a plurality of surface treatments.
  • Fig. 13 depicts a lateral cross-sectional view of one embodiment of an implant body for a hip prosthesis.
  • Fig. 14 depicts a lateral cross-sectional view of another embodiment of an implant body for a hip prosthesis.
  • Fig. 15 is a perspective view illustrating one embodiment of a femoral prosthesis.
  • Fig. 16 is a perspective view illustrating another embodiment of a femoral prosthesis.
  • Figs. 17A- 17F illustrate one embodiment of a system and method for installing a hip implant body into a femur.
  • proximal is a relative term and shall refer broadly to the concept of a more near portion.
  • the neck is the proximal-most portion of the prosthesis, relative to other portions of the prosthesis, because it is the nearest portion when said prosthesis is installed.
  • proximal is a relative term and shall refer broadly to the concept of a portion closer to the center of the body.
  • distal shall generally refer to the opposite of proximal, and thus to the concept of a further portion, a furthest portion, or a portion more distant from the center of the body, depending upon the context.
  • the phrase "in an at least partially proximal-to -distal direction” shall refer generally to a two-dimensional concept of direction in which the "proximal-to-distal” direction defines one direction or dimension.
  • the medial column extends in a proximal-to-distal direction.
  • any structure, apparatus or system for femoral prosthesis which performs functions the same as, or equivalent to, those disclosed herein are intended to fall within the scope of a means for a femoral prosthesis, including those structures, apparatus or systems for a femoral prosthesis which are presently known, or which may become available in the future. Anything which functions the same as, or equivalently to, a means for a femoral prosthesis falls within the scope of this element.
  • a femoral prosthesis 10 generally comprising an implant body 12 supporting a neck 14, which may be without modularity or optionally a modular neck.
  • the neck 14 may have a Morse taper, as is known in the art, to accommodate a substantially spherical joint ball, bearing or prosthetic head 16 at the proximal end of the neck 14.
  • the design may accommodate a wide variety of spherical ball sizes and/or materials (e.g., metal or ceramic).
  • the implant body 12 may be provided with a shoulder 18 at its proximal end.
  • This shoulder 18 may be conical or tapered at an angle. The angle may be in a range between about 2 degrees and about 10 degrees, or some other suitable angle that creates a Morse tapered or other machine taper retentive effect in the neck of the femur 26, as will become apparent in the description that follows.
  • the shoulder 18 may be structured and dimensioned for a tight press fit into the femoral neck 30, and thus increase hoop stress at the neck 30 (i.e., depicted by the radially directed arrows in Figs. 2A-2C).
  • the shoulder 18 may have a fixation surface, which may be rough and porous to promote impaction and/or press-fit of the shoulder 18 into the femoral neck 30 and subsequent fixation (e.g., ingrowth or ongrowth) of the cortical bone of the femoral neck 30 into shoulder 18.
  • the trunk 20 may have a generally sharply tapered portion extending from the shoulder 18 in the direction of the distal end of the trunk 20 to form a wedge 21 , as shown for example in Fig. 8 A, or a knife edge, as shown for example in Fig. 8B.
  • the trunk 20 may be provided with longitudinally extending webs or fins 22.
  • the fins 22 may function to provide a large surface area for initial multi-planar stability and an increased surface area for long term fixation (e.g., bony ingrowth or ongrowth), as will become apparent in the description that follows.
  • the illustrated implant body 12 has one or more superior (i.e., higher) fins and one or more inferior (i.e., lower) fins.
  • One or more central fins may also be provided.
  • the fins 22 may provide increased surface area contact or maximize surface area contact in the metaphyseal bone for fixation (e.g., bony ingrowth or ongrowth) and initial or preliminary cancellous bone press fit stability or fixation.
  • the implant body 12 e.g., the shoulder 18 and trunk 20
  • the wedge 21 of the trunk 21 may facilitate dilation and impaction of the cancellous bone. This may prevent the need for removal of substantial cancellous bone.
  • the shoulder 18 may be shaped and dimensioned to approximate the shape and dimension of the femoral neck to further maximize surface area contact.
  • the implant body 12 may have an overall elongated lateral cross-section, or a cross-section that otherwise fits the anatomy of the femoral neck to reduce rotation, and may have a substantially straight long axis so the implant body 12 does not curve into the diaphysis of the femur.
  • the superior and inferior fins 22 maybe curved to approximate the geometry of the superior and inferior part of the neck 18 (see Figs. 2A-2C). These curves may be substantially the same geometry as the corresponding curved portions of the femoral neck.
  • the implant body 12 and neck 14 maybe metal.
  • the metal used maybe titanium, chrome-cobalt or stainless steel based, or any metal commonly used in hip prosthesis construction.
  • the implant body 12 may be porous, and may have a porous coating, layer or surface 24.
  • a porous coating is titanium plasma spray, which promotes bony ingrowth or ongrowth into prosthetic implants.
  • the coating may further be in the form of sintered beads, plasma spray, a hydroxyapatite (HA), trabecular metal, porous titanium, or another suitable form, depending on the type of metal used for the prosthesis 10, as the prosthesis may be entirely formed from the same material (e.g., titanium, all chrome cobalt, or other suitable material).
  • the implant body 12 of the prosthesis 10 may be available in various sizes depending on anatomical requirements, and as mentioned above, the prosthetic head 16 may be a modular head, or a non- modular head.
  • Fixation of the prosthesis 10 to the femur can be achieved by inserting the implant body 12 into the open neck of a femur, along the anatomic or longitudinal axis of the femoral neck, as set forth for example in the description that follows. Because the implant body 12 is straight and oriented along the longitudinal axis of the femoral neck 30, rotational alignment can be allowed to shift based on anatomical variations.
  • femur 26 with an osteotomy or cut extending along a plane 28 perpendicular to the longitudinal axis of the femoral neck 30.
  • the implant body 12 may be fitted into the femoral neck 30 at an angle ⁇ to the longitudinal axis 36 of the femur 26 so that the long axis 38 of the implant body 12 corresponds approximately to the axis of a healthy femoral neck.
  • the implant body 12 may be inserted from the proximal direction into the femoral neck 30 so that the long axis 38 of the implant body 12 coincides with the axis made in the preoperative femur by an imaginary line connecting the center of the femoral neck 30 with the center of the femoral head, or at an angle ⁇ approximately corresponding to the normal anatomy of the patient (usually between 120 and 150 degrees), and preferably the cervico-diaphyseal angle (i.e., the angle between the long axis of the femoral neck and the longitudinal axis 36 of the femur 26), which varies per individual.
  • the implant body 12 may contact the inner cortical lateral wall 40 of the femoral neck 30 by tightly fitting the implant body 12 into the femoral neck 30. In another embodiment, the implant body 12 does not contact the inner cortical lateral wall 40.
  • the implant body 12 may have an overall length 102.
  • the implant body 12 may be sized such that the overall length 102 causes the distal end of the implant body 12 to extend between sixty (60) percent and eighty (80) percent of a distance 104 from a resection of the femoral neck 28 to the inner cortical lateral wall 40.
  • the tapered shoulder 18 at the proximal end of the implant body 12, when inserted in the neck 30 of the femur 26, may form a tight press fit within the neck 30 of the femur 26 to provide optimum contact and load transfer between the engagement surfaces of the shoulder 18 of the implant body 12 and the neck 30 of the femur 26.
  • the tight press fit configuration may increase the hoop stress at the neck 30 of the femur 26 (as represented by the arrows in Figs. 2A-2C), and thus increase the retentive effect of the shoulder 18 in the neck 30 of the femur 26.
  • the shape of the implant body 12 may differ from that of the femoral neck 30 (e.g., due to anatomic variations).
  • the implant body 12 may simply wedge into the "hoop" formed by the femoral neck 30 and thus increase hoop stress. It should be appreciated that the shape of the implant body 12 could be custom made to each patient, for example, using magnetic resonance imaging (MRI) or computer tomography (CT) templating, as mentioned below.
  • MRI magnetic resonance imaging
  • CT computer tomography
  • the surfaces of the implant body 12 disposed for engaging the interior of the femur 26 are broadly fixation surfaces.
  • the wedge 21 and the longitudinally extending fins 22 of the trunk 20 of the implant body 12 may penetrate the spongiosa 41 inside the femur 26 to secure the implant body 12 in the femur 26.
  • the overall elongated shape of the lateral cross-section of the implant body 12 may hold the implant body 12 securely against movement about the long axis 38 of the implant body 12 after implantation.
  • the wedge 21 and the fins 22 may provide increased surface contact for initial and late fixation. Fixation (e.g., bony ingrowth or ongrowth) may be encouraged on all surfaces of the implant body 12, including shoulder 18, the wedge 21 , and the fins 22. It should be appreciated that the shape and highly porous surface of the implant body 12, including the shoulder 18, the wedge 21, and the fins 22, may, in addition to resisting rotational movement, resist movement in all planes.
  • the distal end of the implant body 12 may be cut on an angle to the long axis 38 of the implant body 12, so that the distal end is substantially pointed. Moreover, the distal end of the implant body 12, when inserted in the femur 26, may be generally aligned with or parallel to the inner surface of the lateral wall 42 of the femur 26 or along the longitudinal axis 38 of the femur 26. The distal end of the implant body 12 remains within the femur 26, so as to not extend beyond the femur 26. It should be appreciated that the distal end of the implant body 12 may be curved.
  • a curved surface may be superimposed on the angled distal end of the implant body 12, or otherwise curved, such as curved transversely in relation to the long axis 38 of the implant body, to provide clearance between the distal end of the implant body 12 and the inner surface of the lateral wall 42 of the femur 26, as clearly shown in Fig. 1.
  • the prosthesis 10 may be installed and used without requiring any other fastener on the femur 26.
  • the prosthesis does not require screws or other fasteners to be placed in the femur 26, and it does not require any sort of support plate on the lateral wall of the femur 26.
  • one or more optional fasteners 43 may attach the implant body 12 to the lateral wall 42 of the femur 26, or just contact the inner surface of the lateral wall 42 (without penetration), which may add initial stability to the implant body 12.
  • the fasteners 43 may add stability to the construct by giving further stability to the implant body 12 of the prosthesis 10.
  • a fastener 43 may pass through a tubular channel 46 in the center of the implant body 12 of the prosthesis 10.
  • the head of the center fastener 43 may be located in the base of a female Morse taper 45 or other machine taper in the implant body 12, if a modular neck is used.
  • fasteners 43 may also pass through tubular channels 46 in the implant body 12 of the prosthesis 10, flanking the center of the implant body 12, adjacent the superior and inferior fins.
  • the flanking fasteners can be used to the exclusion of the center fasteners and vice versa. For example, if a non-modular neck is used, flanking fasteners may be used to the exclusion of the center fasteners.
  • fasteners 43 may or may not penetrate the lateral wall 42 of the femur 10 to breach the lateral wall 42.
  • the fasteners 43 may function to further reduce the likelihood of movement of the prosthesis 10 in all planes within the femoral neck 30.
  • the use of fasteners 43 may be dependent on the bone quality of the patient.
  • One or more anterior/posterior fasteners 44 such as screws (best shown in FIG. 3) may be provided. These fasteners 44 pass through one or more anterior/posterior cylindrical channels 106 in the implant body 12, and past though and/or threadably engage the anterior/posterior cortex of the femur 26. The fasteners 44 may allow for some load transfer to the anterior and posterior cortex of the femur 26 through the fasteners 44.
  • the one or more anterior/posterior channels 106 are circular in cross section. In certain embodiments, the one or more anterior/posterior channels 106 may be elongate in cross section. It should be appreciated that the prosthesis 10 can be used without cement.
  • the distal end of the neck 14 may have a male Morse taper 48 or other machine taper that may cooperate with a female Morse taper 45 or other machine taper in the implant body 12 and thus act as a joining portion in connecting the implant body 12 of the prosthesis 10 for the prosthetic head 16. Adjustments in the length of the neck 14 may be accommodated with the provision of necks of varying length.
  • the Morse tapers 46, 48 or other machine tapers may be provided to accommodate a modular neck 14. Such tapers would not be necessary if a non-modular neck is used.
  • the prosthetic head 16 may engage a male Morse taper 50 or other machine taper provided at the proximal end of the neck 14.
  • the prosthetic head 16 may have a female Morse taper 52 or other machine taper configured to receive the male Morse tapered or other machine tapered conical head 50 at the proximal end of the neck 14, as is well known in the art.
  • a modular neck 14 may have a Morse taper 48, 50 or other machine taper at each end, and a length of straight section connecting the Morse tapers 48, 50 or other machine tapers. The length of the straight section may vary so that necks of various sizes can be used for patients with differing requirements.
  • Prosthetic heads may be of various diameters depending on the type of hip arthroplasty (i.e., hip replacement) being performed (e.g., hemiarthoplasy versus total hip arthroplasty), and the type of acetabular component used.
  • hip arthroplasty i.e., hip replacement
  • hemiarthoplasy versus total hip arthroplasty
  • acetabular component used.
  • the prosthesis 10 loads the proximal end of the femur 26, and thus prevents bone resorption. Very little bone is resected in the implantation process. Hence, the femoral prosthesis 10 is bone sparing.
  • the prosthesis 10 may maintain its stability on initial implantation with the press fit in the femoral neck 30 via high hoop stress and a large metaphyseal bone surface contact area. This prosthesis may provide long term reliability while simplifying the technique of implantation through an anterior approach.
  • the prosthesis 10 permits ease of insertion via the anterior approach, following the anatomic neck angle. This allows less tissue dissection because there is less need to elevate the femur in order to gain access to the longitudinal axis of the femoral diaphysis.
  • the prosthesis 10 is ideal for MRI or CT templating in the hip. Using MRI or CT templating, a custom prosthesis as described above may be produced to specifically approximate or match an individual patient's anatomy, thus producing a custom- fit implant body.
  • Figs. 9A-9C illustrate an alternative embodiment of a femoral prosthesis 900.
  • Fig. 9A-9C illustrate an alternative embodiment of a femoral prosthesis 900.
  • FIG. 9 A shows a perspective view of the femoral prosthesis 900.
  • Fig. 9B shows an anterior view of the femoral prosthesis 900.
  • Fig. 9C shows lateral view of the femoral prosthesis 900.
  • the femoral prosthesis 900 includes a neck 902 and an implant body 904.
  • the implant body 904 includes a proximal end 906 and a distal end 908, a shoulder 910 and a trunk 912.
  • the shoulder 910 in some embodiments, located at or near the proximal end 906 of the implant body 904 and is similar to the shoulder 18 described in relation to Figs. 1-4.
  • the shoulder 910 may constitute an outer perimeter of the implant body 904.
  • the femoral prosthesis 900 is used in a hip replacement.
  • the trunk 912 in one embodiment, extends from the shoulder 910 toward the distal end 906 of the implant body 904.
  • the trunk 912 includes medial column 914, a lateral column 916, and a connecting body 918 that separates the medial column 914 and the lateral column 916.
  • the connecting body 918 may be connected to the medial column 914 on a medial side of the connecting body 918, and connected to the lateral column 916 on a lateral side of the connecting body 918.
  • the connecting body 918 is a wedge and has a cross section that is substantially wedge-shaped.
  • the connecting body may have a cross section similar to that illustrated in Fig. 8 A.
  • the connecting body 918 may have a cross section that has a knife edge shape, similar to that illustrated in Fig. 8B.
  • the implant body 904 has a long axis 920 running through the center of the neck 902 and the length of the implant body 904.
  • the implant body 904 in some embodiments, is substantially straight, and the long axis 920 is substantially straight and in the center of the implant body 904.
  • the implant body 904 may include a medial column axis 922.
  • the medial column axis 922 runs essentially through the center of the medial column 914.
  • the medial column axis 922 may run through successive center points of the medial column 914.
  • the medial column 914 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the medial column axis 922 runs through the center points.
  • the medial column axis 922 is substantially parallel to the long axis 920.
  • the implant body 904 may include a lateral column axis 924.
  • the lateral column axis 924 runs essentially through the center of the lateral column 916.
  • the lateral column axis 924 may run through successive center points of the lateral column 916.
  • the lateral column 916 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the lateral column axis 924 runs through the center points.
  • the lateral column axis 924 is substantially parallel to the long axis 920.
  • the medial column axis 922 and the lateral column axis 924 are substantially parallel.
  • the implant body 904 includes a flare 926 on a medial side of the shoulder 910 and a proximal portion of the medial column 914.
  • the flare 926 extends radially from the medial column axis 922, becoming larger as the flare 926 progresses along the implant body 904 in a distal to proximal direction.
  • the flare 926 acts to load the calcar region of the resected femur and helps prevent bone resorbtion.
  • the implant body 904 includes one or more terraces 928 on the connecting body 918.
  • the terraces 928 may be arranged such that each terrace 928 undercuts a more proximal level of the connecting body 918.
  • the connecting body 918 is roughly wedge-shaped, and the slope of the wedge is formed by successive terraces 928 on the anterior and posterior faces of the connecting body 918. The terraces 928 may provide increased boding and stress offloading of the implant body 904 to the femur.
  • the terraces 928 are angled relative to the long axis 920 of the implant body 904 at a terrace angle 930.
  • the terrace angle 930 is between 125 degrees and 160 degrees.
  • the terrace angle 930 is such that the terraces 928 run perpendicular to a long axis of the femur when the implant body 904 is installed in the femur.
  • the terrace angle 930 is such that the terraces 928 run perpendicular to the long axis 920 of the implant body 904.
  • the distal end 908 of the implant body 904 in some embodiments, is angled relative to the long axis 920 of the implant body 904.
  • the distal end 908 is angled such that it is roughly parallel with the inner cortical wall of the femur when the implant body 904 is installed. In some embodiments, the distal end 908 has a curved surface 932 superimposed on the distal end 908. In one embodiment, the curved surface 932 is a transverse curve.
  • the implant body 904 includes a medial cannula 934.
  • the medial cannula 934 may run the length of the implant body 904 such that it is accessible at both the proximal end 906 and the distal end 908 of the implant body 904.
  • the medial cannula 934 runs along the medial column axis 922.
  • the medial cannula 934 provides a pathway for a guide wire to guide the implant body 904 during installation.
  • the implant body 904 includes a lateral cannula 936.
  • the lateral cannula 936 may run the length of the implant body 904 such that it is accessible at both the proximal end 906 and the distal end 908 of the implant body 904.
  • the lateral cannula 936 runs along the lateral column axis 924. The lateral cannula 936 provides a pathway for a guide wire to guide the implant body 904 during installation.
  • the medial column 914 in one embodiment, has an inside surface 938.
  • the inside surface 938 may be formed by a taper of the connecting body 918 relative to the medial column 914.
  • the inside surface 938 is substantially fiat, or planar.
  • the inside surface 938 is convex over at least a portion of the inside surface 938.
  • the lateral column 916 may have a corresponding inside surface (not shown) which may also be substantially planar, convex, or another shape over at least a portion of the inside surface of the lateral column 916.
  • the medial column 914 and the lateral column 916 have a substantially constant lateral cross sectional area along the trunk 912. In some embodiments, the medial column 914 has a decreasing cross sectional area in the region where the flare 926 is located as cross sections move from the proximal end 906 toward the distal end 908 of the implant body 904.
  • Figs. 10 A- IOC illustrate another embodiment of a femoral prosthesis 1000.
  • Fig. 10A shows a perspective view of the femoral prosthesis 1000.
  • Fig. 10B shows an anterior view of the femoral prosthesis 1000.
  • Fig. IOC shows lateral view of the femoral prosthesis 1000.
  • the femoral prosthesis 1000 includes many structures and features similar to those of the femoral prosthesis 900 described above.
  • the femoral prosthesis 1000 is used in a hip replacement.
  • the femoral prosthesis 1000 includes an implant body 1002 with a proximal end 1004, a distal end 1006, a medial column 1008, and a lateral column 1010.
  • the medial column 1008, in one embodiment, tapers along at least a portion of the medial column 1008 from the proximal end 1004 to the distal end 1006.
  • the cross sectional area of the medial column 1008 decreases along at least a portion of the column as cross sections are viewed in a proximal to distal direction.
  • the lateral column 1010 tapers along at least a portion of the lateral column 1010 from the proximal end 1004 to the distal end 1006.
  • the cross sectional area of the lateral column 1010 decreases along at least a portion of the column as cross sections are viewed in a proximal to distal direction.
  • the implant body 1002 includes a long axis 1012 running through the center of the implant body 1002 along its length.
  • the implant body 1002 in some embodiments, is substantially straight, and the long axis 1012 is substantially straight and in the center of the implant body 1002.
  • the implant body 1002 may include a medial column axis 1014.
  • the medial column axis 1014 runs essentially through the center of the medial column 1008.
  • the medial column axis 1014 may run through successive center points of the medial column 1008.
  • the medial column 1008 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the medial column axis 1014 runs through the center points.
  • the medial column axis 1014 is substantially parallel to the long axis 1012.
  • the implant body 1002 may include a lateral column axis 1016.
  • the lateral column axis 1016 runs essentially through the center of the lateral column 1010.
  • the lateral column axis 1016 may run through successive center points of the lateral column 1010.
  • the lateral column 1010 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the lateral column axis 1016 runs through the center points.
  • the lateral column axis 1016 is substantially parallel to the long axis 1012.
  • the medial column axis 1014 and the lateral column axis 1016 are substantially parallel.
  • the implant body 1002, in some embodiments, includes a medial cannula 1018.
  • the medial cannula 1018 may run the length of the implant body 1002 such that it is accessible at both the proximal end 1004 and the distal end 1006 of the implant body 1002. In one embodiment, the medial cannula 1018 runs along the medial column axis 1014. The medial cannula 1018 provides a pathway for a guide wire to guide the implant body 1002 during installation.
  • the implant body 1002 includes a lateral cannula 1020.
  • the lateral cannula 1020 may run the length of the implant body 1002 such that it is accessible at both the proximal end 1004 and the distal end 1006 of the implant body 1002.
  • the lateral cannula 1020 runs along the lateral column axis 1016.
  • the lateral cannula 1020 provides a pathway for a guide wire to guide the implant body 1002 during installation.
  • Figs. 11 A-l 1C illustrate another embodiment of a femoral prosthesis 1100.
  • Fig. 11 A shows a perspective view of the femoral prosthesis 1100.
  • Fig. 1 IB shows an anterior view of the femoral prosthesis 1100.
  • Fig. 11 C shows lateral view of the femoral prosthesis 1100.
  • the femoral prosthesis 1100 includes many structures and features similar to those of the femoral prosthesis 900 described above.
  • the femoral prosthesis 1100 is used in a hip replacement.
  • the femoral prosthesis 1100 includes an implant body 1102 with a proximal end 1104, a distal end 1106, a medial column 1108, and a lateral column 1110.
  • the implant body 1102 includes a long axis 1112 running through the center of the implant body 1 102 along its length.
  • the implant body 1102 in some embodiments, is substantially straight, and the long axis 1112 is substantially straight and in the center of the implant body 1102.
  • the implant body 1102 may include a medial column axis 1114.
  • the medial column axis 1114 runs essentially through the center of the medial column 1108.
  • the medial column axis 1114 may run through successive center points of the medial column 1108.
  • the medial column 1108 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the medial column axis 1114 runs through the center points.
  • the medial column axis 1114 is substantially parallel to the long axis 1112.
  • the implant body 1102 may include a lateral column axis 1 116.
  • the lateral column axis 1116 runs essentially through the center of the lateral column 1110.
  • the lateral column axis 1116 may run through successive center points of the lateral column 1110.
  • the lateral column 1110 has a curved outer surface (best seen in Fig. 13) with a radius and a center point.
  • the lateral column axis 1116 runs through the center points.
  • the lateral column axis 1116 is substantially parallel to the long axis 1112.
  • the medial column axis 1114 and the lateral column axis 1116 are substantially parallel.
  • the implant body 1102 includes a medial cannula 1118.
  • the medial cannula 1118 may run the length of the implant body 1102 such that it is accessible at both the proximal end 1104 and the distal end 1106 of the implant body 1102.
  • the medial cannula 1118 runs along the medial column axis 1114.
  • the medial cannula 1118 provides a pathway for a guide wire to guide the implant body 1102 during installation.
  • the implant body 1102 includes a lateral cannula 1120.
  • the lateral cannula 1 120 may run the length of the implant body 1102 such that it is accessible at both the proximal end 1104 and the distal end 1106 of the implant body 1102.
  • the lateral cannula 1120 runs along the lateral column axis 1116.
  • the lateral cannula 1120 provides a pathway for a guide wire to guide the implant body 1102 during installation.
  • the inside surface 1122 may be formed by a taper of the connecting body relative to the medial column 1108.
  • the inside surface 1122 is substantially concave over at least a portion of the inside surface 1122.
  • the lateral column 1110 may have a corresponding inside surface (not shown) which may also be substantially concave over at least a portion of the inside surface of the lateral column 1110.
  • Fig. 12 illustrates an embodiment of a hip prosthesis 1200 having a plurality of surface treatments.
  • the hip prosthesis includes an implant body 1202 having a proximal region 1204, an intermediate region 1206, and a distal region 1208.
  • the proximal region 1204 has a first surface treatment 1210 that is relatively porous.
  • the relatively high porosity of the first surface treatment 1210 encourages bone ingrowth and acts to secure the proximal region 1204 of the implant body 1202 to the bone when the implant body 1202 is installed.
  • the intermediate region 1206, in one embodiment, has a second surface treatment 1212 that has an intermediate porosity.
  • the intermediate porosity of the second surface treatment 1212 encourages some bone ingrowth, but less than that of the first surface treatment 1210. Consequently, bone ingrowth over the intermediate region 1206 secures the implant body 1202 to a degree, but less so than the proximal region 1204.
  • the somewhat reduced fixation over the intermediate region 1206 may facilitate retrieval of the implant body 1202.
  • the distal region 1208 has a third surface treatment 1214 having a low porosity.
  • the low porosity of the third surface treatment 1214 resists bone ingrowth, resulting in relatively weaker fixation of the distal region 1208 to the femur.
  • the weaker fixation of the distal region 1208 may facilitate retrieval of the implant body 1202.
  • boundaries between the first surface treatment 1210, the second surface treatment 1212, and the third surface treatment 1214 are well defined.
  • the boundaries may be angled relative to a long axis of the implant body 1202, or they may be perpendicular to the long axis of the implant body 1202. In one embodiment, the boundaries are angled such that they proceed in a lateral and distal direction, as shown in Fig. 12. In an alternate embodiment, the boundaries are angled such that they proceed in a medial and distal direction.
  • Fig. 13 depicts a lateral cross-sectional view of one embodiment of an implant body for a hip prosthesis.
  • the lateral cross-sectional view is taken along a plane perpendicular to a long axis of the implant body.
  • the cross-sectional view shows a lateral column 1302, a medial column 1304, and a connecting body 1306.
  • the lateral column 1302 in one embodiment, includes a lateral outer surface 1308 that defines a portion of a perimeter of the implant body.
  • the cross section of the lateral outer surface 1308 is substantially at least a portion of a circle, or an arc.
  • the cross section of the lateral outer surface 1308 of the lateral column 1302 includes an arc having a constant radius 1310.
  • the lateral outer surface 1308 is a semicircle.
  • the medial column 130 in one embodiment, includes a medial outer surface 1312 that defines a portion of a perimeter of the implant body.
  • the cross section of the medial outer surface 1310 is substantially at least a portion of a circle, or an arc.
  • the cross section of the medial outer surface 1312 of the medial column 1304 includes an arc having a constant radius 1314.
  • the medial outer surface 1312 is a semicircle.
  • the cross- sectional area of the medial column 1304 is substantially equal to the cross-sectional area of the lateral column 1302.
  • the lateral column 1302 in some embodiments, includes a lateral cannula 1316 at the center point of the arc defining the lateral outer surface 1308.
  • the medial column 1304 includes a medial cannula 1318 at the center point of the arc defining the medial outer surface 1312.
  • the connecting body 1306 includes an anterior wall 1320 and a posterior wall 1322.
  • the cross section of the anterior wall 1320 and the posterior wall 1322 are parallel in one embodiment.
  • Fig. 14 depicts a lateral cross-sectional view of one embodiment of an implant body for a hip prosthesis.
  • the lateral cross-sectional view is taken along a plane perpendicular to a long axis of the implant body.
  • the cross-sectional view shows a lateral column 1402, a medial column 1404, and a connecting body 1406.
  • the lateral column 1402 in one embodiment, includes a lateral outer surface 1408 that defines a portion of a perimeter of the implant body.
  • the cross section of the lateral outer surface 1408 is substantially at least a portion of a circle, or an arc.
  • the cross section of the lateral outer surface 1408 of the lateral column 1402 includes an arc having a constant radius 1410.
  • the lateral outer surface 1408 is a semicircle.
  • the medial column 140 in one embodiment, includes a medial outer surface 1412 that defines a portion of a perimeter of the implant body.
  • the cross section of the medial outer surface 1410 is substantially at least a portion of a circle, or an arc.
  • the cross section of the medial outer surface 1412 of the medial column 1404 includes an arc having a constant radius 1414.
  • the medial outer surface 1412 is a semicircle.
  • the radius 1410 of the lateral outer surface 1408 and the radius 1414 of the medial outer surface 1412 are substantially different.
  • the radius 1414 of the medial outer surface 1412 may be larger than the radius 1410 of the lateral outer surface 1408.
  • the cross-sectional area of the medial column 1404 is thirty (30) percent larger than the cross-sectional area of the lateral column 1402.
  • the connecting body 1406 includes an anterior wall 1420 and a posterior wall 1422. The cross section of the anterior wall 1420 and the posterior wall 1422 are angled relative to one another in one embodiment.
  • the lateral column 1402 in some embodiments, includes a lateral cannula 1416 at the center point of the arc defining the lateral outer surface 1408.
  • the medial column 1404 includes a medial cannula 1418 at the center point of the arc defining the medial outer surface 1412.
  • Fig. 15 is a perspective view illustrating one embodiment of a femoral prosthesis 1500.
  • the femoral prosthesis includes an implant body 1502.
  • the femoral prosthesis 1500 is used in hip replacement.
  • the implant body 1502 in one embodiment, includes a proximal end 1504 with a collar 1506 disposed at or near the proximal end 1504.
  • the collar 1506 may be a portion of the implant body 1502 that extends radially as the proximal end 1504 of the implant body 1502 is approached along the implant body 1502.
  • the collar 1506 may serve to limit the extent to which the implant body 1502 may be inserted into the femur.
  • the implant body 1502 may include a collar 1506.
  • the implant body 1502 may be collarless.
  • Fig. 16 is a perspective view illustrating one embodiment of a femoral prosthesis 1600.
  • the femoral prosthesis includes an implant body 1602.
  • the femoral prosthesis 1600 is used in hip replacement.
  • the implant body 1602 in one embodiment, includes a proximal end 1604 with a stepped shoulder 1606 disposed at or near the proximal end 1604.
  • the stepped shoulder 1606 may be a portion of the implant body 1602 that includes one or more steps.
  • the stepped shoulder 1606 may serve to improve bone ingrowth and fixation of the implant body 1602 within the femur.
  • the implant body 1602 may include a stepped shoulder 1606.
  • the implant body 1602 may be have a smooth shoulder.
  • Figs. 17 A- 17F illustrate one embodiment of a system and method for installing a hip implant body 1702 into a femur 1700.
  • a neck sizing template 1706 may be positioned on a resected neck of the femur 1704.
  • the neck sizing template 1706 may be of a size selected to match the size of the femur 1704.
  • the femur 1704 may have a relatively large neck, and a correspondingly relatively large neck sizing template 1706 may be selected for positioning on the resected neck of the femur 1704.
  • the neck sizing template 1706 in one embodiment, has an outer perimeter 1708 similar to the outer perimeter of the implant body 1702.
  • the neck sizing template 1706 may have an outer perimeter 1708 that is roughly equal to that of the implant body 1702.
  • a neck sizing template 1708 similar in size to the implant body 1702 provides a tool for visualizing and testing the size of the implant body 1702 relative to the neck of the femur 1704.
  • the neck sizing template 1706 is undersized relative to the implant body 1702, having an outer perimeter 1708 less than the outer perimeter of the implant body 1702.
  • a neck sizing template 1708 having an outer perimeter 1708 smaller than that of the implant body 1702 may result in an undersized channel in the femur 1704, and a tighter fit for the implant body 1702.
  • the neck sizing template 1706 in one embodiment, includes a first aperture 1710 and a second aperture 1712.
  • the first and second apertures 1710, 1712 may correspond to and be alignable with a medial cannula 1714 and a lateral cannula 1716 of the implant body 1702.
  • the neck sizing template 1706 may be positioned such that one of the first aperture 1710 and the second aperture 1712 is positioned laterally from the center of the resected neck of the femur 1704 and so that the other of the first aperture 1710 and the second aperture 1712 is positioned medially from the center of the resected neck of the femur 1704.
  • a first guide wire 1718 is inserted through the first aperture 1710 and into the femur 1704.
  • the neck sizing template 1706 may guide and direct the first guide wire 1718 in a particular direction and orientation as it is inserted into the femur 1704.
  • the first guide wire 1718 may be inserted into the femur 1704 using any technique.
  • the first guide wire 1718 may be driven into the femur 1704 using a power drill .
  • the first guide wire 1718 may be impacted into the femur 1704.
  • the neck sizing template 1706 may be removed from the femur 1704 and the first guide wire 1718.
  • a cannulated tool 1720 may be positioned over the first guide wire 1718.
  • the cannulated tool 1720 may be used to form a first channel 1722 in the femur 1704 in preparation for installation of the implant body 1702.
  • the cannulated tool 1720 may follow the first guide wire 1718 and form the first channel 1722 around the first guide wire 1718.
  • the cannulated tool 1720 may be a cannulated reamer, and the cannulated reamer may ream a channel around the first guide wire 1718.
  • the neck sizing template 1708 may have a first surface 1724 and a second surface
  • the first and second apertures 1710, 1712 may each run perpendicular to and through the first surface 1724 and the second surface 1726.
  • the first surface 1724 is substantially planar or flat.
  • the fiat first surface 1724 is beneficial for stable placement of the neck sizing template 1708 on the resected neck of the femur 1704.
  • the second surface 1726 has a positioning plug 1728 to extend into the first channel 1722 formed around the first guide wire 1718.
  • the positioning plug 1728 may be placed over the first guide wire 1718 and stabilized within the first channel 1722.
  • the positioning plug 1728 may stabilize the neck sizing template 1708 to position one of the first aperture 1710 and the second aperture 1712 relative to the first guide wire 1718, with the other of the first aperture 1710 and the second aperture 1712 passing through the positioning plug 1728.
  • the first guide wire 1718 may be position through the positioning plug 1728 via one of the first aperture 1710 and the second aperture 1712.
  • a second guide wire 1730 maybe inserted through the one of the first aperture 1710 and the second aperture 1712 and into the femur 1704.
  • the neck sizing template 1706 may guide and direct the second guide wire 1730 in a particular direction and orientation as it is inserted into the femur 1704.
  • the neck sizing template 1706 may be positioned at least in part by one of the first guide wire 1718 and the positioning plug 1728.
  • the second guide wire 1730 may be substantially parallel to the first guide wire 1718.
  • the second guide wire 1730 maybe inserted into the femur 1704 using any technique.
  • the second guide wire 1730 may be driven into the femur 1704 using a power drill. In another example, the second guide wire 1730 may be impacted into the femur 1704.
  • the neck sizing template 1706 maybe removed from the femur 1704 and the second guide wire 1730.
  • a cannulated tool 1720 may be positioned over the second guide wire 1730.
  • the cannulated tool 1720 may be used to form a second channel 1732 in the femur 1704 in preparation for installation of the implant body 1702.
  • the cannulated tool 1720 may follow the second guide wire 1730 and form the second channel 1732 around the first guide wire 1718.
  • the cannulated tool 1720 may be a cannulated reamer, and the cannulated reamer may ream a channel around the second guide wire 1730.
  • the cannulated tool 1720 used to form the second channel 1732 has the same diameter of the cannulated tool 1720 used to form the first channel 1722.
  • the second channel 1732 is formed using a different cannulated tool than that used to form the first channel 1722.
  • the implant body 1702 may have substantially different sized medial and lateral columns, and the first and second channels may be formed to correspond to these sizes using different sized cannulated tools.
  • the implant body 1702 may have a flare 1734 along a proximal portion of the implant body 1702.
  • An additional cannulated tool 1736 maybe used to expand a channel 1722, 1732 to accommodate the flare 1734.
  • the flare 1734 may be at least partially conical, and the additional cannulated tool 1736 may be a cannulated conical reamer.
  • the implant body 1702 may be positioned with the first and second guide wires 1718, 1730 running through the medial and lateral cannulas 1714, 1716, one guide wire per cannula.
  • the implant body 1702 may progress along the guide wires 1718, 1730 and into the first and second channels 1722, 1732.
  • the implant body 1702 may be pressed into the femur 1704 using any technique for pressing an implant body 1702 into a femur 1704.
  • the implant body 1702 may be driven into the femur 1704 using a hammer.
  • the guide wires 1718, 1730 may guide the implant body 1702 into a desired position within the femur 1704.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une prothèse fémorale. La prothèse fémorale comprend un corps d'implant ayant une extrémité proximale et une extrémité distale et un épaulement à l'extrémité proximale, l'épaulement étant structuré et dimensionné pour un ajustement serré dans le col d'un fémur. Le corps d'implant comprend un tronc à l'extrémité distale, le tronc ayant un coin formé par une partie conique s'étendant dans la direction de l'extrémité distale du corps d'implant. Le corps d'implant comprend également une colonne médiale s'étendant à partir de l'épaulement vers l'extrémité distale et une colonne latérale s'étendant à partir de l'épaulement vers l'extrémité distale. Le coin, la colonne médiale et la colonne latérale sont destinées à assurer une stabilité multi-plan pour le corps d'implant et founir une aire de surface pour la fixation du corps d'implant.
PCT/US2011/040372 2011-06-14 2011-06-14 Système d'implant de hanche total épargnant le col du fémur WO2012173605A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2011371008A AU2011371008B2 (en) 2011-06-14 2011-06-14 Neck sparing total hip implant system
PCT/US2011/040372 WO2012173605A1 (fr) 2011-06-14 2011-06-14 Système d'implant de hanche total épargnant le col du fémur

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2011/040372 WO2012173605A1 (fr) 2011-06-14 2011-06-14 Système d'implant de hanche total épargnant le col du fémur

Publications (1)

Publication Number Publication Date
WO2012173605A1 true WO2012173605A1 (fr) 2012-12-20

Family

ID=47357367

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2011/040372 WO2012173605A1 (fr) 2011-06-14 2011-06-14 Système d'implant de hanche total épargnant le col du fémur

Country Status (2)

Country Link
AU (1) AU2011371008B2 (fr)
WO (1) WO2012173605A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9610084B2 (en) 2012-09-12 2017-04-04 Peter Michael Sutherland Walker Method and apparatus for hip replacements
WO2017054053A1 (fr) * 2015-09-30 2017-04-06 Kirwan David Phillip Prothèse de hanche

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US20050010232A1 (en) * 2002-04-11 2005-01-13 Crofford Theodre W. Method of implanting a femoral neck fixation prosthesis
US20090281583A1 (en) * 2007-02-06 2009-11-12 Zimmer, Inc. Femoral trochlea prostheses

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US5458645A (en) * 1992-04-03 1995-10-17 Bertin; Kim C. Method for resecting the knee using a resection guide and provisional prosthetic component
USRE39301E1 (en) * 1992-04-03 2006-09-19 Zimmer, Inc. Method for resecting the knee using a resection guide and provisional prosthetic component
US20050010232A1 (en) * 2002-04-11 2005-01-13 Crofford Theodre W. Method of implanting a femoral neck fixation prosthesis
US20090281583A1 (en) * 2007-02-06 2009-11-12 Zimmer, Inc. Femoral trochlea prostheses

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9610084B2 (en) 2012-09-12 2017-04-04 Peter Michael Sutherland Walker Method and apparatus for hip replacements
WO2017054053A1 (fr) * 2015-09-30 2017-04-06 Kirwan David Phillip Prothèse de hanche
EP3355833A4 (fr) * 2015-09-30 2019-08-07 David Phillip Kirwan Prothèse de hanche
US11045322B2 (en) 2015-09-30 2021-06-29 David Phillip KIRWAN Hip prosthesis
EP4169487A1 (fr) 2015-09-30 2023-04-26 David Phillip Kirwan Prothèse de hanche

Also Published As

Publication number Publication date
AU2011371008A1 (en) 2014-01-16
AU2011371008B2 (en) 2017-02-02

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