Abstract:
A hip joint apparatus is described. The apparatus has an acetabular cup designed for both seated engagement within a patient&#39;s acetabulum, and articulatory reception of a matingly shaped femoral component, wherein the dome of the acetabular cup has holes configured for accepting wires and variable angle locking screws to facilitate attachment of the acetabular cup to the acetabulum, and wherein the rim of the acetabular cup has holes configured for accepting wires to provide provisional stability to the acetabular cup. The apparatus also has an insertion handle with a graspable portion and a mating portion, the mating portion attached to the graspable portion and configured for engaging with the rim of the acetabular cup, thereby coupling the insertion handle to the acetabular cup.

Description:
CROSS-REFERENCE TO RELATED PATENT APPLICATIONS 
       [0001]    This application claims priority from Provisional U.S. application 62/214,099, filed Sep. 3, 2015, titled “REVISION ACETABULAR COMPONENT,” which is incorporated herein by reference in its entirety. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
       [0002]    Certain exemplary embodiments are described herein with reference to the following Figures, wherein: 
         [0003]      FIG. 1  is a front perspective view of an exemplary acetabular cup. 
         [0004]      FIG. 2  is a back perspective view of the exemplary acetabular cup, depicted with exemplary securing means for assisting with securing the acetabular cup to an acetabulum. 
         [0005]      FIG. 3A  is a perspective view of an exemplary insertion handle. 
         [0006]      FIG. 3B  is a perspective view of the exemplary insertion handle, coupled with the exemplary acetabular cup. 
     
    
     DETAILED DESCRIPTION 
       [0007]    The detailed description set forth below in connection with the appended drawings is intended as a description of various aspects of certain exemplary embodiments and is not intended to represent the only aspects of those embodiments. Each aspect described in this disclosure is provided merely as an example or illustration, and should not necessarily be construed as preferred or advantageous over other aspects. The detailed description includes specific details for providing an adequate understanding of the present disclosure. However, it will be apparent to those skilled in the art that the present disclosure may be practiced without these specific details. Acronyms and other descriptive terminology may be used merely for convenience and/or clarity and are not intended to limit the scope of the present disclosure. Any steps in a method should not be construed as needing to be carried out, or needing to be carried out in the order listed, unless stated otherwise. 
         [0008]    Embodiments of the present disclosure relate generally to acetabular components. The exemplary embodiment relates to an acetabular cup and an offset insertion handle, which enable a surgeon to more effectively secure the acetabular cup inside a patient&#39;s acetabulum. 
         [0009]    Hip surgery can be challenging when the patient has severe bone loss. In such cases, it can be a struggle for the surgeon to insert an acetabular cup and hold it in the appropriate position, while inserting screws to stabilize the cup for osseous integration. Accordingly, there exists a need to provide better ways to help the surgeon secure the acetabular cup in the acetabulum. To address this and/or other problems, the present disclosure includes, among other things, one or more exemplary systems, kits, methods, devices, assemblies, and/or components related to hip surgery. The exemplary embodiment uses K wire, variable angle locking screws, an offset insertion handle, and an acetabular cup design to aid in acetabular reconstruction. 
         [0010]    Referring to  FIG. 1 , a front perspective view of an exemplary acetabular cup  100  is shown. The acetabular cup  100  can have protrusions  110  located around its rim, wire holes  120  both on the rim and in the dome, and screw holes  130  in the dome. In the exemplary embodiment, the wire holes  120  are approximately  3 . 2  mm holes configured to accept K wire. In other embodiments, different types of wire and corresponding wire holes  120  may be used. The screw holes  130  are combination holes configured to accept different types of screws, such as cancellous screws and variable angle locking screws. The wire holes  120  can be used along with wire to provide provisional stabilization of the acetabular cup  100  in an appropriate position during surgery. The screw holes  130  can be used with a variety of different screws to secure the acetabular cup  100  to the acetabulum. The surgeon can choose which screws to place in which screw holes  130 . For example, a cancellous screw can be placed in one screw hole  130  and a variable angle locking screw can be placed in another screw hole  130 . In other embodiments, the number, arrangement, and size of the wire holes  120  and screw holes  130  can vary. 
         [0011]    In one embodiment, the acetabular cup  100  uses cementless fixation and has a porous coating surface to allow osseous integration. In the exemplary embodiment, the acetabular cup  100  has properties to enable it to magnetically engage with an insertion handle. 
         [0012]    Referring to  FIG. 2 , a back perspective view of the exemplary acetabular cup  100  is shown. In the exemplary embodiment, the acetabular cup  100  has a variable angle locking screw  220  threaded through one of the screw holes  130 . The variable angle locking screw  220  can be angled through the screw hole  130  over an exemplary trajectory  210  of about 15 degrees. This allows the surgeon to secure the acetabular cup  100  to the acetabulum in a way that allows for more screw-bone purchase, accounting for locations in the acetabulum where bone loss may be more severe. The acetabular cup  100  also has a wire  200  inserted through the wire hole  120 . The wire  200  can be used to provide provisional stability to the acetabular cup  100  while the surgeon inserts screws. 
         [0013]    Referring to  FIG. 3A , a perspective view of an exemplary insertion handle  300  is shown. The insertion handle  300  can have a graspable portion  310  and a mating portion  320 . The mating portion  320  can have recesses  330  configured for engaging with the acetabular cup  100 . In the exemplary embodiment, the mating portion  320  can align with at least a portion of the rim of the acetabular cup  100  (substantially covering at least a portion of the rim without substantially covering the generally part-spherical cavity of the lower side) and can be made of a magnetic material, thereby enabling a magnetic connection with the acetabular cup  100 . This helps to prevent any torque forces on the acetabular cup  100  when the insertion handle  300  is detached. The magnet can be of a strength so as to not hurt any provisional stability upon removal, but strong enough, together with protrusions  110  and recesses  330 , to hold and help position the acetabular cup  100  during surgery. The recesses  330  can correspond to the protrusions  110  of the acetabular cup  100 , such that when the mating portion  320  engages with the acetabular cup  100 , the protrusions  110  enter the recesses  330  and help secure the engagement. In the exemplary embodiment, the protrusions  110  and recesses  330  are spaced in such a way that they provide rotational stability to the acetabular cup  100  when the graspable portion  310  is being held and a screw is being threaded into a screw hole  130 . However, if recesses  330  were, for example, located too closely together or too close to the longitudinal axis of the graspable portion  310 , they might not provide adequate rotational stability. 
         [0014]    In some embodiments, the number and location of the protrusions  110  and recesses  330  can be varied to achieve the desired effect. In some embodiments, the recesses can be located on the acetabular cup  100  instead, with the protrusions  110  being located on the mating portion  320 . 
         [0015]    In other embodiments, other means of coupling the insertion handle  300  with the acetabular cup  100  can be used. For example, the mating portion  320  of insertion handle  300  can essentially be an acetabular cup  100  template. The template can be a smaller version of the acetabular cup  100 , with corresponding wire holes  120  and screw holes  130  to match those of acetabular cup  100 . The mating portion  320 , as a template of acetabular cup  100 , can fit into the articulation surface of acetabular cup  100  while still enabling the surgeon to see and access the wire holes  120  and screw holes  130 . This type of engagement of the insertion handle  300  can provide more surface area contact and therefore stability when inserting the acetabular cup  100  and screws into the acetabulum. 
         [0016]    In another embodiment, the mating portion  320  can be a snap or clip fit mechanism to snap or clip onto the rim of acetabular cup  100 . The acetabular cup  100  can have corresponding structure to enable a snap or clip fit of the mating portion  320  to its rim. In yet other embodiments, the mating portion  320  can be threaded and configured to screw into the rim of acetabular cup  100 . The acetabular cup  100  can have corresponding structure to enable the mating portion  320  to be screwed into its rim. In some embodiments, the mating portion  320  can screw or clip into the center of acetabular cup  100 , instead of or in addition to the rim. 
         [0017]    Referring to  FIG. 3B , a perspective view of the exemplary insertion handle  300 , coupled with the exemplary acetabular cup  100  is shown. The insertion handle  300  can be placed in various positions around the circumference of the acetabular cup  100 . In the exemplary embodiment, based on the number and location of protrusions  110  and recesses  330 , the insertion handle  300  can be engaged with the acetabular cup  100  on its right-hand, left-hand, top, or bottom sides. This allows the surgeon and/or their assistant to choose the best location for the insertion handle  300 , so as to hold the acetabular cup  100  securely in place and to provide an unobstructed view and access of the acetabular cup  100  to the surgeon. 
         [0018]    In the exemplary embodiment, the insertion handle  300  is an offset insertion handle, in that the graspable portion  310  ends up being located at the rim of the acetabular cup  100 , rather than at its center. Additionally, the mating portion  320  uses magnetic means to engage with the acetabular cup  100 , rather than threaded means. This reduces torque forces on the acetabular cup  100  when the insertion handle  300  is being detached, thereby improving pressfit stability of the acetabular cup  100  in the acetabulum. This can be important especially in cases of severe bone loss, where pressfit stability may be low. The use of the offset insertion handle  300 , combined with the mating portion&#39;s  320  and acetabular cup&#39;s  100  magnetic properties, and the combination screw holes  130  and wire holes  120 , can help with performing hip surgery, especially in cases with severe bone loss. 
         [0019]    An exemplary technique is for the surgeon to first impact the acetabular cup  100  in place. The surgeon can use the offset insertion handle  300  to have easy access to the screw holes  130  and wire holes  120 . The wire  200  can be used to provisionally hold the acetabular cup  100  if there is a poor press fit. The surgeon can then insert a cancellous screw to compress the acetabular cup  100  to the surrounding bone. This can then be followed by insertion of variable angle locking screws  220  and/or more cancellous or other screws, depending on the patient&#39;s bone quality and the intrinsic stability of the acetabular cup  100 . The addition of variable angle locking screws  220  provides more stable fixation than standard non-locking screws, especially in cases with severe bone loss, osteoporotic bone, or when the acetabular cup  100  is not fully seated. The variable angle locking screws  220  can be angulated over trajectory  210  in all directions to achieve adequate screw-bone purchase. This can be most useful in revision scenarios with large bony defects. Once the screws are inserted and the surgeon is satisfied with stability of the acetabular cup  100 , the wire  200  can be removed. A polyethylene liner can then be inserted into the articulation surface of the acetabular cup  100 , and impacted into place. The femoral head can then be reduced into the acetabular cup  100 . 
         [0020]    Other objects and features of the present disclosure will become apparent as the description proceeds, especially when taken in conjunction with the accompanying drawing sheets illustrating embodiments of the disclosure.