Patellar prosthesis and method of making the same

Abstract: A composite metal/plastic patellar prosthesis for implantation in the human body to replace the articulating surface of the patella is provided. The prosthesis includes a polymeric articulating surface portion (15) and a metal backing (12) having an anterior surface adapted to be attached to the posterior surface of a resected patella and a dome or conically shaped posterior surface to which the polymeric articulating surface portion is heat and pressure molded. The metal backing portion has at least one aperture (16) extending therethrough which has a greater cross-sectional area on the anterior side than on the posterior side into which an anchoring peg integral with the anterior surface of the polymeric articulating surface portion is molded. The metal and plastic components of the composite are coextensive in size and shape.

Description: The present invention relates to an improved patellar prosthesis and method of making the same. A patellar prosthesis according to the features of the preamble of claim 1 is known from DE-U-89 07 010. Various prosthetic devices for replacement of the articulating surface of the patella or knee cap have been designed for implantation in cases where replacement of the natural articulating surface of the patella is indicated. Generally, the posterior surface of the patella is resected and replaced by an artificial articulating surface. Various patellar prostheses are known in the art and available commercially to surgeons. Examples of such are the designs shown in U.S. Patent No. 4,240,162 issued to Devas on December 23, 1980 in which a two-part snapped-together design is disclosed. Commercially available implants are shown, for example, in Publication No. 322-688T of Dow Corning Wright Corporation, 5677 Airline Road, Arlington, Tennessee, U.S.A., entitled "Whiteside Ortholoc II Patella Implants". Similar designs having a metal backing within a polymeric surface portion are shown, for example, in a publication by Howmedica, Inc., Orthopedics Division, 359 Veterans Boulevard, Rutherford, New Jersey, U.S.A., identified as No. H2050, dated 3/83, entitled "The PCA Revision Total Knee System" at page 4. Such prostheses have been known to fail by virtue of separation of the polymeric articulating surface from the metal backing. In light of these various designs, a need has existed for an improved patellar prosthesis having resistance to shear forces experienced during articulation of the patellar implant against an articulating surface of a femoral prosthesis. The present invention provides such increased resistance by a design in which shear forces imposed against the side of the patellar implant are, in part, converted to compression forces. The invention further provides a means and method of molding the polymeric articulating surface onto the metal backing in such fashion as to improve the mechanical locking, and thus resistance to wear, between the components of the prosthesis. Briefly summarized, the present invention provides a composite patellar prosthesis for implantation in the human body to replace the articulating surface of the patella which includes a polymeric articulating surface portion and a dome shaped metal backing which has an anterior surface adapted to be attached to the posterior surface of a resected patella, preferably by means of integral attachment pegs. The dome shaped or otherwise centrally elevated posterior surface is adapted to engage the polymeric articulating surface portion which is molded under heat and pressure to conform to it. The metal backing portion is provided with at least one, and preferably several, apertures extending therethrough which have a greater cross-sectional area on the anterior side than on the posterior side. These apertures are each adapted to fixedly receive an anchoring peg integral with the anterior surface of the polymeric articulating surface portion, the pegs being formed under heat and pressure to precisely fill the apertures. It is also preferred that the anterior surface of the polymeric articulating surface portion is coextensive in size and shape with the metal backing portion is molded to conform to the contour thereof. The articulating surface portion has a generally convex posterior articulating surface. The apertures through the metal backing are greater in area on the anterior side than on the posterior side so that the pegs firmly lock the two parts of the composite together. The anterior side may, for example, be counterbored or the apertures may be tapered or flared so as to be of greater size on the anterior side. The invention will be further explained with reference to the accompanying drawings wherein: Figure 1 is a perspective view of a patellar prosthesis of the present invention, and Figure 2 is a cross-sectional view of such a prosthesis. Referring more specifically to the drawings, patellar prosthesis 10 is formed from a rigid, preferably metallic backing portion 12, provided on its anterior surface with integrally formed securing pegs 13 which are provided to secure the prosthesis to the posterior side of a resected patella. In accordance with conventional practice, the anterior surface of metallic attachment portion 12 can be provided with a porous layer such as sintered metal microbeads 14 to allow for tissue ingrowth. Secured to the posterior side of metallic supporting layer 12 is a polymeric surface layer 15 preferably formed from a thermoplastic material such as ultra high molecular weight polyethylene. Other biologically acceptable moldable materials such as polypropylene or the like can be substituted in articulating surface 15. Polymeric articulating surface portion 15 is preferably formed so that it is the same size and shape as the metal backing element 12 and the anterior side of the articulating surface member is pressure molded so that it flows and conforms to the posterior surface of metal backing element 12. The polymeric surface portion is affixed to the metal backing portion by means of one or more integral pegs 16 which are molded by heat and pressure into an aperture 16 extending through metal backing member 12. The apertures are configured so that the anterior side is larger than the posterior side, for example, by means of a counter-bored portion 17 on the anterior side or by means of slightly tapered or anteriorly flared openings 18. The preferred embodiment, shown in the drawings, utilizes one central peg 16 along with four smaller pegs 18 all of which are heat and pressure molded into the apertures to provide a secure attachment of the backing member to the wear surface. Also as seen best in Figure 2, the central portion of the metal backing portion 12 is centrally thickened into a domed shape. This configuration has been found to be superior to prior art devices in which flat abutting surfaces were employed. Such flat surfaces may be subjected to shearing forces as the prosthesis wears, whereas the slightly dome shaped configuration of the present prosthesis causes a vector of those shearing forces to be converted into compression forces which have been discovered to be more resistant to failure at the junction between the parts of the composite prosthesis. The prosthesis of the present invention is formed by providing a plastic blank of the articulating surface which is provided with a central peg having a height slightly greater than the thickness of the metal backing member 12. When molded under heat and pressure the anterior surface of the plastic member is forced to assume the contour of the metal backing member and the central peg flows into the undercut portion 17 of aperture 16. Apertures 18, spaced around the central aperture, however, are of a smaller diameter and it has been found that the plastic material of the articulating surface 15 will flow into such apertures under heat and pressure, to fill the apertures as shown in Figure 2. This method of construction obviates the need for formation of additional pegs on the anterior surface of the articulating portion blank. If desired, however, additional pegs could be employed, particularly if it is desired to use somewhat larger diameter apertures than indicated in Figure 1. The prosthesis of the present invention is implanted in accordance with usual surgical procedures followed for implantation of patellar prostheses. Such procedures, therefore, will not be elaborated on in the present disclosure. While the foregoing specification gives a detailed description of specific embodiments of the invention for the purpose of illustration, it will be understood that many of the details given may be varied considerably by those skilled in the art without departing from the scope of the invention as defined by the claims.

Claims: A patellar prosthesis (10) for implantation in the human body to replace the articulating surface of the patella comprising: a polymeric articulating surface portion (15), and a metal backing portion (12) having an anterior surface adapted to be attached to the posterior surface of a resected patella and a posterior surface adapted to engage the polymeric articulating surface portion (15), said articulating surface portion (15) having a generally convex posterior articulating surface, characterized in that said metal backing portion (12) has at least one aperture extending therethrough which has a greater cross-sectional area on the anterior side than on the posterior side thereof, adapted to fixedly receive an anchoring peg (16;18) integral with the anterior surface of the polymeric articulating surface portion (15), that said anterior surface of said articulating surface portion (15) is coextensive in size and shape with said metal backing portion and is molded to conform to the contour thereof, and that said anchoring peg (16;18) is molded into said hole and fills substantially the entire volume thereof. A prosthesis according to claim 1 wherein said metal backing portion (12) also contains a plurality of small apertures each of which is of increasing diameter in the posterior to anterior direction. A prosthesis according to claim 1 wherein the metal backing portion (12) has a central portion that is thicker than the outer edges thereof and said central portion is elevated on the posterior side of said backing. A method of making a patellar prosthesis (10) for implantation in the human body to replace the articulating surface of the patella comprising: providing a polymeric articulating surface portion (15), and a metal backing portion (12) which has an anterior surface adapted to be attached to the posterior surface of a resected patella and a dome shaped posterior surface adapted to engage the polymeric articulating surface portion, said metal backing portion (12) having at least one aperture extending therethrough which has a greater cross-sectional area on the anterior side than on the posterior side thereof, adapted to fixedly receive an anchoring peg (16;18) integral with the anterior surface of the polymeric articulating surface portion (15), said anterior surface of said articulating surface portion being coextensive in size and shape with said metal backing portion (12) and being molded to conform to the contour thereof, said articulating surface portion (15) having a generally convex posterior articulating surface, molding polymeric surface portion onto the posterior side of said metal backing portion (12) under heat and pressure so that said anchoring peg is molded into said aperture and fills substantially the entire volume thereof. A method according to claim 4 wherein said metal backing portion (12) contains small diameter apertures therethrough which are of increasing diameter in the posterior to anterior direction and said apertures become filled with said polymeric material under application of such heat and pressure.

Inventors: COATES BRADLEY JAMES, WHITESIDE LEO ALLEN, COATES, BRADLEY JAMES, WHITESIDE, LEO ALLEN
Applicants: DOW CORNING WRIGHT CORP, DOW CORNING WRIGHT CORPORATION
Application year: 1990
Main classification: A61F2
IPC codes: A61F2