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WO1997030661A1 - Elements cuneiformes provisoires d'orthese a adaptations magnetiques - Google Patents

Elements cuneiformes provisoires d'orthese a adaptations magnetiques Download PDF

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Publication number
WO1997030661A1
WO1997030661A1 PCT/US1997/002805 US9702805W WO9730661A1 WO 1997030661 A1 WO1997030661 A1 WO 1997030661A1 US 9702805 W US9702805 W US 9702805W WO 9730661 A1 WO9730661 A1 WO 9730661A1
Authority
WO
WIPO (PCT)
Prior art keywords
trial
joint replacement
wedges
orthopaedic joint
surgical orthopaedic
Prior art date
Application number
PCT/US1997/002805
Other languages
English (en)
Inventor
Thomas A. Carls
Jennifer J. Lackey
Dave Kelman
Todd Martens
Original Assignee
Smith & Nephew Inc.
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 Smith & Nephew Inc. filed Critical Smith & Nephew Inc.
Priority to AU23166/97A priority Critical patent/AU2316697A/en
Priority to EP97915841A priority patent/EP0888098A4/fr
Priority to CA 2247195 priority patent/CA2247195A1/fr
Priority to JP52633997A priority patent/JP2001503283A/ja
Publication of WO1997030661A1 publication Critical patent/WO1997030661A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1664—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip
    • A61B17/1668—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the upper femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1659—Surgical rasps, files, planes, or scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1675—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the knee
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1735—Guides or aligning means for drills, mills, pins or wires for rasps or chisels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
    • 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
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4684—Trial or dummy prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • 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
    • A61F2/367—Proximal or metaphyseal parts of 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
    • A61F2/38—Joints for elbows or knees
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30079—Properties of materials and coating materials magnetic
    • 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
    • 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
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
    • 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
    • A61F2/30721—Accessories
    • A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • A61F2002/30736—Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/009—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Definitions

  • U.S. Patent 5,425,763 discloses a magnet arrangement for fastening prostheses, in particular epitheses, such as for example artificial ears and the like.
  • a magnet arrangement for the fastening of prostheses in which a magnet can be inserted into a prosthesis and a magnet to be implanted or to be fastened on an implant are provided.
  • a guide by which the two magnets are guided one on the other in such a manner that they are displaceable telescopically relative to one another in the holding direction of the prosthesis is also provided, to achieve a more reliable mounting during a displacement movement of the prosthesis.
  • An artificial joint with magnetic attraction or repulsion is the subject of U.S. Patent 4,024,588.
  • the 588 patent discloses an artificial joint for implantation into the living body. It comprises a head portion adapted to be anchored in one bone of the body and a socket portion adapted to be anchored in another bone.
  • One of the head and socket portions includes a permanent magnet and the other portion ei her a magnetizable element or another permanent magnet.
  • the two interacting magnetic elements may be polarized for either attraction or 5 repulsion.
  • the head and socket portions are shaped to permit translatory movement relative to each other in addition to rotary movements of the head portion about at least one axis of rotation.
  • the present invention provides a magnetic orthopaedic trial apparatus that enables trial wedges to be easily attached to trial components (e.g., femoral components, tibial components, hip replacement components), cutting blocks or 0 other instruments that are used during total knee or total hip replacement surgery.
  • trial components e.g., femoral components, tibial components, hip replacement components
  • cutting blocks or 0 other instruments that are used during total knee or total hip replacement surgery.
  • the present invention provides a surgical orthopaedic joint replacement trial instrument that includes a trial body having a stem portion that fits a patients intramedullary canal.
  • a plurality of trial wedges removably attach to the trial body enabling a surgeon to vary the size and shape of the trial body such as during 5 the fitting of a trial to a patients femur or tibia tissue.
  • At least some of the trial wedges have opposed surfaces that are generally parallel to one another.
  • a magnetic member holds a selected of the trial wedges and the trial body together.
  • the magnetic member is a magnet that is o embedded within each trial wedge.
  • at least some of the trial wedges have opposed surfaces that define an acute angle.
  • the trial body preferably has at least one flat surface that receives a correspondingly flat surface of a trial wedge.
  • the trial body can have two spaced apart surfaces that enable a surgeon to attach two trial wedges simultaneously to the respective spaced apart surfaces of the trial body.
  • Each of the spaced apart surfaces is preferably flat. At least some of the wedges are shaped to stack one upon the other. In this fashion, the surgeon can place a first wedge on one of the flat surfaces of the trial body. The surgeon can then place another trial wedge on a second flat surface of the trial body. Alternatively, the surgeon can place an additional trial wedge on top of one of the previously placed trial wedges so that at least two of the trial wedges are stacked one upon the other at one of the flat surfaces of the trial body.
  • the trial body and at least some of the wedges are embossed with correspondingly shaped embossed surfaces to prevent rotation once a wedge is attached to a trial body.
  • the trial body and at least some of the wedges have corresponding interlocking portions such as, for example, a cylindrically-shaped socket on the trial body and a correspondingly shaped cylindrical projection on the trial wedge.
  • the interlocking portions can include interlocking socket and projecting portions that are correspondingly shaped.
  • a collection of trial wedges are provided having differing thicknesses and differing shapes.
  • the trial body can have an articulating surface portion for articulating with a corresponding articulating surface of another orthopaedic prosthetic component.
  • the surgical orthopaedic joint replacement trial is in the fo ⁇ n of a tibial trial having a stem, a tibial tray, and trial wedges that are fixed to distal surfaces of the tray portion of the trial body.
  • the trial instrument is in the form of a femoral trial component having trial wedges that affix to distal non-articulating surfaces of the trial body and to the posterior condylar non-articulating surface portions of the trial body.
  • trial wedges can be sized and shaped to provided surfaces that simultaneously abut both the distal non-articulating surface and the condylar non-articulating surface of the trial body-
  • a broach that is in the shape of a trial hip prosthesis that is sized and shaped to fit the patients proximal femur during hip joint replacement surgery.
  • the trial hip replacement prosthesis is in the form of a broach having a proximal end that removably accepts a trial neck member wherein a plurality of the removable trial members provide different neck geometry, enabling the surgeon to vary the configuration of a trial that fits the patients proximal femur during hip joint replacement surgery.
  • FIGURE 1 is a partial side view of the first embodiment of the apparatus of the present invention showing a trial femoral component
  • FIGURE 2 is a partial side view of the first embodiment of the apparatus of the present invention showing a trial femoral component with a trial wedge attached;
  • FIGURE 3 is a partial side view of the first embodiment of the apparatus of the present invention showing a trial femoral component with a pair of stacked trial wedges attached; -6-
  • FIGURE 4 is a partial side view of the first embodiment of the apparatus of the present invention showing a trial femoral component with a pair of stacked trial wedges attached;
  • FIGURE 5 is a perspective exploded view of the first embodiment of the apparatus of the present invention.
  • FIGURE 6 is a fragmentary perspective view of the first embodiment of the apparatus of the present invention showing the stacking tray portion thereof;
  • FIGURE 7 is a perspective view of the first embodiment of the apparatus of the present invention
  • FIGURE 8 is a fragmentary top view of the first embodiment of the apparatus of the present invention illustrating a trial wedge that can be attached to the femoral trial body of Figures 1-4;
  • FIGURE 9 is a fragmentary elevational view taken along lines 9-9 of Figure 8;
  • FIGURE 10 is a sectional view taken along lines 10-10 of Figure 8;
  • FIGURE 11 is a fragmentary top view of the first embodiment of the apparatus of the present invention illustrating a trial wedge that can be attached to the trial body of Figures 1-4;
  • FIGURE 12 is a side elevational view taken along lines 12-12 of Figure 11;
  • FIGURE 13 is an end, elevational view taken along lines 13-13 of Figure
  • FIGURE 14 is a fragmentary top view of the first embodiment of the apparatus of the present invention illustrating a trial wedge that can be attached to the femoral trial body of Figures 1-4;
  • FIGURE 15 is an end, elevational view taken along lines 15-15 of Figure
  • FIGURE 19 is a fragmentary perspective view of the second embodiment of the apparatus of the present invention showing the tibial tray;
  • FIGURE 20 is a fragmentary view of the second embodiment of the apparatus of the present invention illustrating the distal surface of the tibial trial body;
  • FIGURE 22 is an end view taken along lines 22-22 of Figure 20;
  • FIGURE 23 is a fragmentary top view of the second embodiment of the apparatus of the present invention illustrating one of the trial wedge portions thereof;
  • FIGURE 24 is an end view taken along lines 24-24 of Figure 23;
  • FIGURE 25 is a side view taken along lines 25-25 of Figure 23;
  • FIGURE 25 A is a side view of a trial wedge portion of the second embodiment of the apparatus of the present invention.
  • FIGURE 26 is a sectional view taken along lines 26-26 of Figure 23;
  • FIGURE 27 is a fragmentary top view of the second embodiment of the apparatus of the present invention illustrating one of the trial wedge portions thereof;
  • FIGURE 28 is an end view taken along lines 28-28 of Figure 27;
  • FIGURE 28A is an end view of a trial wedge portion of the second embodiment of the apparatus of the present invention.
  • FIGURE 29 is a side taken along lines 29-29 of Figure 27;
  • FIGURE 30 is a plane, fragmentary top view of the second embodiment of the apparatus of the present invention illustrating one of the trial wedge portions thereof;
  • FIGURE 31 is an end view taken along lines 31-31 of Figure 30;
  • FIGURE 32 is an elevational view of the second embodiment of the apparatus of the present invention.
  • FIGURE 33 is an elevational view of the second embodiment of the apparatus of the present invention.
  • FIGURE 34 is a perspective view of the second embodiment of the apparatus of the present invention illustrating its use with a tibial wedge cutting block;
  • FIGURE 35 is a partial perspective view of the second embodiment of the apparatus of the present invention illustrating the tibial wedge cutting block portion thereof and its handle;
  • FIGURE 36 is a side elevational view of the second embodiment of the apparatus of the present invention shown attached to a tibial wedge cutting guide and its handle;
  • FIGURE 37 is a side view of a third embodiment of the apparatus of the present invention.
  • FIGURE 38 is an exploded side view of the third embodiment of the apparatus of the present invention.
  • FIGURE 39 is a side view of the third embodiment of the apparatus of the present invention with the removable neck portion removed;
  • FIGURE 42 is a sectional view taken along lines 42-42 of Figure 37;
  • FIGURE 43 is a perspective view of a fourth embodiment of the apparatus of the present invention.
  • FIGURE 44 is a side view of the fourth embodiment of the apparatus of the present invention. DETAILED DESCRIPTION OF THE INVEN ⁇ ON
  • Figures 1-4 show generally the preferred embodiment of the apparatus of the present invention designated by the numeral 10A in Figures 2-4, 5, and 7.
  • Femoral trial prosthesis 10A includes a trial body 11 that is generally of a size and shape that corresponds to the shape of a final femoral prosthesis. A surgeon can use one or more such trials to obtain a correct fit Using the apparatus of the present invention and the method of the present invention, wedges can be added to the trial body 11 in order to compensate for bone loss and/or bone defect.
  • Trial body 11 includes a distal articulating surface 12, an anterior articulating surface 13, and a posterior articulating surface 14 in the form of a pair of space-apart condylar portions.
  • a plurality of five non-articulating surfaces are also provided on trial body 11 including flat non-articulating surfaces 15, 16, 17, 18, and 19. These five surfaces 15-19 correspond in size, shape, and positioning to surgical cuts that are made by a surgeon on a patients distal femur.
  • Trial body 11 has sockets HA, 1 IB that are receptive of projecting portions of trial wedges 20, 30.
  • two trial wedges 20 illustrate that further thickness can be provided to trial body 11 by stacking the two wedges 20 as shown.
  • two differing wedges 20 and 30 are shown stacked upon the non-articulating surfaces 16, 17, 18, 19.
  • the wedge 20 receives trial wedge 30, stacked thereon as shown in Figure 4.
  • FIG. 5-7 an additional stacking member is shown in the form of stacking tray 100.
  • the tray 100 has a stem portion 101 with a threaded end 102. This enables modular stem extensions to be threadably attached to the stacking tray 100 at threaded end 102.
  • the tray 100 has a distal surface 104 that carries a pair of spaced apart cylindrically-shaped projections 105, 106. These projections 105, 106 register in correspondingly-shaped sockets 11 A, 1 IB of femoral trial 11.
  • a magnetic member 29 is embedded within each trial wedge 115, 115 A, 116 as shown in Figures 14-16.
  • the overall shape and configuration of each of the trial wedges 115, 115A, and 116 are substantially the same, the difference being in the increased thickness of the wedge 115A compared to the wedge 115 and the increased length of the wedge 115 when compared to the wedge 116.
  • FIGS 18-19 show a second embodiment of the apparatus of the present invention designated generally by the numeral 10B in Figure 18.
  • the embodiment of Figures 18 and 19 shows a tibial trial.
  • the tibial trial includes a trial body tray 41 having a flat distal surface 42 that includes spaced apart flat surface areas 43, 44 to which magnetic trial wedges can be attached.
  • a flat proximal surface 45 is provided that can receive a polymeric liner 52 (see Figures 32, 33).
  • Stem 46 extends from distal surface 42 at angles thereto.
  • the stem 46 can have a threaded portion 47 for attaching a modular stem extension thereto when the surgeon is attempting to obtain a proper fit with the patients proximal tibia during knee joint replacement surgery.
  • the recess 60 is defined by intersecting shoulders 62 and 63.
  • the cutout 61 is defined by intersecting shoulders 64 and 65.
  • Each wedge 56, 56A has a peripheral curved surface 66 and a flat surface 67. Cutout 68 accommodates slot 55 as shown in Figures 18 and 20.
  • the trial wedges 56 and 56A have flat surfaces 57, 58 that are opposed and generally parallel. This differs from the trial wedges 5 69, 69A of Figures 27-29 and 28A and the trial wedge 84 of Figures 30-31 that have opposed surfaces forming an acute angle.
  • trial wedges of differing configuration are shown attached to the trial body 41.
  • trial wedges 69 and 69A are shown 5 attached to the distal surface 42 of trial body 41.
  • trial wedges 56 and 56A are shown attached to the distal surface 42 of trial body 41.
  • Removable neck member 135 also has a rectangular section 143 that corresponds in size and shape to the rectangular slot 139 at proximal end 131 of broach member 130.
  • the rectangular section 143 of removable neck section 135 fits into and closely conforms to slot 139 of broach member 130.
  • the projecting portion 138 of broach member 130 conforms to and occupies cylindrically-shaped socket 137 of removable neck section 135. This connection is illustrated by the arrows 144 in Figure 38.
  • the rectangular slot 139 has a flat surface portion 142 that forms a magnetic connection with magnet 140 that is embedded in socket 141 of removable neck section 135.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Dentistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un appareil provisoire de chirurgie orthopédique destiné à la chirurgie substitutive, par exemple du genou, de la hanche et de l'épaule. Cet appareil comporte un corps provisoire (11) de forme et de calibre choisis pouvant recevoir des cales d'épaisseur ou des éléments cunéiformes (20) de différents calibres et formes, ce qui permet au chirurgien de réaliser une orthèse provisoire pendant l'intervention, laquelle orthèse s'adapte exactement à l'anatomie du patient. Des adaptateurs magnétiques (29) permettent de maintenir un élément cunéiforme choisi sur une orthèse provisoire sélectionnée. Des protubérances (27, 11B) et des évidements (11A, 28) empêchent que les éléments cunéiformes (20) ne tournent par rapport à l'orthèse provisoire sélectionnée (11).
PCT/US1997/002805 1996-02-21 1997-02-21 Elements cuneiformes provisoires d'orthese a adaptations magnetiques WO1997030661A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
AU23166/97A AU2316697A (en) 1996-02-21 1997-02-21 Trial wedges with magnetic attachments
EP97915841A EP0888098A4 (fr) 1996-02-21 1997-02-21 Elements cuneiformes provisoires d'orthese a adaptations magnetiques
CA 2247195 CA2247195A1 (fr) 1996-02-21 1997-02-21 Elements cuneiformes provisoires d'orthese a adaptations magnetiques
JP52633997A JP2001503283A (ja) 1996-02-21 1997-02-21 磁性取付具を備えた試用楔部

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US1203096P 1996-02-21 1996-02-21
US60/013,030 1996-02-21

Publications (1)

Publication Number Publication Date
WO1997030661A1 true WO1997030661A1 (fr) 1997-08-28

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Country Status (4)

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EP (1) EP0888098A4 (fr)
JP (1) JP2001503283A (fr)
AU (1) AU2316697A (fr)
WO (1) WO1997030661A1 (fr)

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DE29906909U1 (de) 1999-03-02 1999-09-30 Plus Endoprothetik Ag, Rotkreuz Femurschlitten
WO2001028467A1 (fr) * 1999-10-20 2001-04-26 Smith & Nephew, Inc. Systeme d'essai tibial
WO2001032106A1 (fr) * 1999-10-30 2001-05-10 Eberhard-Karls-Universität Tübingen Endoprothese
US6974481B1 (en) 1999-10-20 2005-12-13 Smith & Nephew, Inc. Tibial trial system
US20080215157A1 (en) * 2007-03-01 2008-09-04 Zimmer Technology, Inc. Modular femoral provisional
WO2009089581A1 (fr) * 2008-01-18 2009-07-23 Atlax Pty Ltd Dispositif d'augmentation à utiliser dans un système de remplacement de genou et procédé pour une opération de remplacement de genou
CN101972178A (zh) * 2010-11-25 2011-02-16 高若云 一种磁悬浮人工膝关节
US7892288B2 (en) 2001-08-27 2011-02-22 Zimmer Technology, Inc. Femoral augments for use with knee joint prosthesis
US8187283B2 (en) 2008-09-30 2012-05-29 Depuy Products, Inc. Reusable orthopaedic instrument having drain holes
USD684693S1 (en) 2002-08-22 2013-06-18 Zimmer, Inc. Prosthetic implant support structure
US8506645B2 (en) 2001-08-27 2013-08-13 Zimmer, Inc. Tibial augments for use with knee joint prostheses
US8535385B2 (en) 2001-08-27 2013-09-17 Zimmer, Inc. Prosthetic implant support structure
US20140081408A1 (en) * 2012-09-20 2014-03-20 Jay R. Lieberman Femoral knee prosthesis system with augments and multiple lengths of sleeves sharing a common geometry
US8900317B2 (en) 2011-05-20 2014-12-02 Zimmer, Inc. Stabilizing prosthesis support structure
US9320603B2 (en) 2012-09-20 2016-04-26 Depuy (Ireland) Surgical instrument system with multiple lengths of broaches sharing a common geometry
WO2016071938A1 (fr) * 2014-11-06 2016-05-12 Cappelletti Ava Dispositif modulaire espaceur ajustable amélioré pour l'articulation du genou
US20170172764A1 (en) * 2015-04-03 2017-06-22 Biomet Manufacturing, Llc Glenoid trial and implant assembly for reverse total shoulder arthroplasty and method of use
US20170333208A1 (en) * 2016-05-18 2017-11-23 Depuy Ireland Unlimited Company System including femoral augment trials and method of performing an orthopaedic joint replacement procedure
US10470898B2 (en) 2016-05-18 2019-11-12 Depuy Ireland Unlimited Company Orthopaedic instrument system for surgically-preparing a patient's tibia
US10537439B2 (en) 2016-05-18 2020-01-21 Depuy Ireland Unlimited Company Orthopaedic instrument system for surgically-preparing a patient's femur
US10537446B2 (en) 2017-09-20 2020-01-21 Depuy Ireland Unlimited Company Method and instruments for assembling an orthopaedic prosthesis
US10537341B2 (en) 2017-09-20 2020-01-21 Depuy Ireland Unlimited Company Orthopaedic system and method for assembling prosthetic components
US10543001B2 (en) 2017-09-20 2020-01-28 Depuy Ireland Unlimited Company Method and instruments for assembling a femoral orthopaedic prosthesis
US11083585B2 (en) 2019-05-09 2021-08-10 Howmedica Osteonics Corp. Spring retained femoral augment
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US11266509B2 (en) * 2017-11-30 2022-03-08 Corentec Co., Ltd. Anatomically shaped knee joint augment
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US10285817B2 (en) 1999-03-02 2019-05-14 Smith & Nephew Orthopaedics Ag Femoral slideway and method
US7306609B2 (en) 1999-03-02 2007-12-11 Plus Orthopedics Ag Femoral slideway
US9265507B2 (en) 1999-03-02 2016-02-23 Smith & Nephew Orthopaedics Ag Femoral slideway
DE29906909U1 (de) 1999-03-02 1999-09-30 Plus Endoprothetik Ag, Rotkreuz Femurschlitten
WO2001028467A1 (fr) * 1999-10-20 2001-04-26 Smith & Nephew, Inc. Systeme d'essai tibial
US6974481B1 (en) 1999-10-20 2005-12-13 Smith & Nephew, Inc. Tibial trial system
WO2001032106A1 (fr) * 1999-10-30 2001-05-10 Eberhard-Karls-Universität Tübingen Endoprothese
US8506645B2 (en) 2001-08-27 2013-08-13 Zimmer, Inc. Tibial augments for use with knee joint prostheses
US10201426B2 (en) 2001-08-27 2019-02-12 Zimmer, Inc. Prosthetic implant support structure
US7892288B2 (en) 2001-08-27 2011-02-22 Zimmer Technology, Inc. Femoral augments for use with knee joint prosthesis
US10806587B2 (en) 2001-08-27 2020-10-20 Zimmer, Inc. Prosthetic implant support structure
US9713532B2 (en) 2001-08-27 2017-07-25 Zimmer, Inc. Method for augmenting femoral components of knee joint prosthesis
US9539096B2 (en) 2001-08-27 2017-01-10 Zimmer, Inc. Methods for supporting a prosthetic implant in a patient
US8535385B2 (en) 2001-08-27 2013-09-17 Zimmer, Inc. Prosthetic implant support structure
US10653526B2 (en) 2001-08-27 2020-05-19 Zimmer, Inc. Prosthetic implant support structure
US8728168B2 (en) 2001-08-27 2014-05-20 Zimmer, Inc. Prosthetic implant support structure
US10893947B2 (en) 2001-08-27 2021-01-19 Zimmer, Inc. Femoral augments for use with knee joint prosthesis
US9044326B2 (en) 2001-08-27 2015-06-02 Zimmer, Inc. Femoral augments for use with knee joint prosthesis
US10098743B2 (en) 2001-08-27 2018-10-16 Zimmer, Inc. Prosthetic implant support structure
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US9265614B2 (en) 2001-08-27 2016-02-23 Zimmer, Inc. Method of implanting the tibial augment
US10085841B2 (en) 2001-08-27 2018-10-02 Zimmer, Inc. Femoral implant systems
US9907664B2 (en) 2001-08-27 2018-03-06 Zimmer, Inc. Methods for augmenting a tibial component of a knee joint prosthesis
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USD684693S1 (en) 2002-08-22 2013-06-18 Zimmer, Inc. Prosthetic implant support structure
US10076418B2 (en) 2007-03-01 2018-09-18 Zimmer, Inc. Modular femoral provisional
US20080215157A1 (en) * 2007-03-01 2008-09-04 Zimmer Technology, Inc. Modular femoral provisional
US9168155B2 (en) * 2007-03-01 2015-10-27 Zimmer, Inc. Modular femoral provisional
WO2009089581A1 (fr) * 2008-01-18 2009-07-23 Atlax Pty Ltd Dispositif d'augmentation à utiliser dans un système de remplacement de genou et procédé pour une opération de remplacement de genou
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US9517138B2 (en) 2011-05-20 2016-12-13 Zimmer, Inc. Stabilizing prosthesis support structure
US8900317B2 (en) 2011-05-20 2014-12-02 Zimmer, Inc. Stabilizing prosthesis support structure
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Also Published As

Publication number Publication date
JP2001503283A (ja) 2001-03-13
EP0888098A1 (fr) 1999-01-07
AU2316697A (en) 1997-09-10
EP0888098A4 (fr) 2000-03-01

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