Source: https://patents.google.com/patent/US10265177B2/en
Timestamp: 2019-12-16 04:14:31
Document Index: 650932750

Matched Legal Cases: ['Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 61', 'Application No. 2011264852', 'Application No. 2016202986', 'Application No. 2016231485', 'Application No. 2018200989', 'Application No. 201180039337', 'Application No. 11793105', 'Application No. 11793107', 'Application No. 11793109', 'Application No. 10', 'Application No. 10', 'Application No. 10', 'Application No. 10']

US10265177B2 - Method of implanting an acetabular shell and an augment - Google Patents
Method of implanting an acetabular shell and an augment Download PDF
US10265177B2
US10265177B2 US15/472,844 US201715472844A US10265177B2 US 10265177 B2 US10265177 B2 US 10265177B2 US 201715472844 A US201715472844 A US 201715472844A US 10265177 B2 US10265177 B2 US 10265177B2
US15/472,844
US20170196694A1 (en
2015-03-05 Priority to US14/639,508 priority patent/US9949836B2/en
2017-03-29 Priority to US15/472,844 priority patent/US10265177B2/en
2017-03-29 Application filed by Smith and Nephew Inc filed Critical Smith and Nephew Inc
2017-07-13 Publication of US20170196694A1 publication Critical patent/US20170196694A1/en
2019-04-23 Publication of US10265177B2 publication Critical patent/US10265177B2/en
230000000399 orthopedic Effects 0 abstract claims description 15
210000000588 Acetabulum Anatomy 0 claims description 44
Systems, devices, and methods are provided for orthopedic implants. The implants may include a base member, such as an acetabular shell or an augment, that is configured to couple with an augment, flange cup, mounting member, or any other suitable orthopedic attachment. An implant may include a base member that has at least two projections with a gap between the projections. The gap between the projections allows the implant to fee implanted around another implanted component, such as around a bone screw of an acetabular shell. The implant may include a fixation element, such as a screw or a cement trough, on one or more projections to couple the implant to an implanted acetabular shell. The implant may also include timing marks to facilitate alignment with corresponding marks on another implanted component.
This application is a continuation of U.S. patent application Ser. No. 14/639,508 filed Mar. 5, 2015, which is a continuation of U.S. patent application Ser. No. 14/616,525 filed Feb. 6, 2015 and now issued as U.S. Pat. No. 9,468,530, which is a divisional of U.S. patent application Ser. No. 13/156,248 filed Jun. 8, 2011 and now issued as U.S. Pat. No. 8,979,926, which claims the benefit of U.S. Provisional Patent Application No. 61/352,705 filed Jun. 8, 2010, U.S. Provisional Application No. 61/352,722 filed Jun. 8, 2010, U.S. Provisional Application No. 61/422,903 filed Dec. 14, 2010, and U.S. Provisional Application No. 61/466,817 filed Mar. 23, 2011, the contents of each application hereby incorporated by reference in their entireties.
Joints often undergo degenerative changes due to a variety of reasons. When joint degeneration becomes advanced or irreversible, it may become necessary to replace the natural joint with a prosthetic joint. Artificial implants, including hip joints, should joints, and knee joints are widely used in orthopedic surgery. Specifically, hip joint prostheses are common. The human hip joint acts mechanically as a ball and socket joint, wherein the ball-shaped head of the femur is positioned within the socket-shaped acetabulum of the pelvis. Various degenerative diseases and injuries may require replacement of all or a portion of a hip using synthetic materials, typically metals, ceramics, or plastics.
Various types of these mounting members (which term is intended to include but not be limited to flanges, blades, plates and/or hooks) may be provided in conjunction with a prosthesis system in order to help the surgeon achieve optimal fixation, non-limiting examples of which include iliac flanges (providing securement and fixation in and against the ilium region of the pelvis), ischial blades (providing securement and fixation in and against the ischium), and obturator hooks (providing securement and interior fixation by engaging the obturator foramen). Although there have been attempts to provide such mounting attachments with modularity, the solutions to date have generally fallen short of providing true modularity. Instead, they typically provide a few discrete positions at which the mounting members may be positioned, without providing the surgeon a fuller range of decision options.
Disclosed herein are systems, devices, and methods for providing modular orthopedic implants. The implants may include a base member, such as an acetabular shell or an augment, that is configured to couple with an augment, flange cup, mounting member, any other suitable orthopedic attachment, or any combinations thereof. Mounting members include, for example, flanges, blades, hooks, and plates. In some embodiments, the orthopedic attachments may be adjustably positionable about the base member or other attachments thereby providing modularity for assembling and implanting the device. Various securing and/or locking mechanisms may be used between the components of the implants. In certain embodiments, the orthopedic attachments are removably coupled to the base member or other components. In certain embodiments, the orthopedic attachments are integrally provided on the base member or other components, yet may still be adjustably positionable thereabout. In some embodiments, expandable augments, base members, or other bone filling devices are provided. In some embodiments, surface features are provided that create friction and allow for surrounding bone ingrowth at the interface of the implants and a patient's bone.
The foregoing and other objects and advantages will be apparent upon consideration of the following detailed description, taken in conjuction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which:
To provide an overall understanding of the systems, devices, and methods described herein, certain illustrative embodiments will be described. Although the embodiments and features described herein are specifically described for use in connection with acetabular systems, it will be understood that all the components, connection mechanisms, adjustable systems, fixation methods, manufacturing methods, coatings, and other features outline below may be combined with one another in any suitable manner and may be adapted and applied to medical devices and implants to be used in other surgical procedures, including, but not limited to: spine arthroplasty, cranio-maxillofacial surgical procedures, knee arthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, and other extremity procedures.
Various implants and other devices described herein in their various embodiments may be used in conjunction with any appropriate reinforcement material, non-limiting examples of which include bone cement, appropriate polymers, resorbable polyurethane, and/or any materials provided by PolyNovo Biomaterials Limited, or any suitable combinations thereof. Further non-limiting limiting examples of potential materials that may be used are described in the following references: U.S. Patent Application Publication No. 2006/0051394, entitled “Biodegradable Polyurethane and Polyurethane Ureas,” U.S. Patent Application Publication No. 2005/0197422, entitled “Biocompatible Polymer Compositions for Dual or Multi Staged Curing,” U.S. Patent Application Publication No. 2005/0238683, entitled “Biodegradable Polyurethane/Urea Compositions,” U.S. Patent Application Publication No. 2007/0225387, entitled “Polymer Compositions for Dual or Multi Staged Curing,” U.S. Patent Application Publication No. 2009/0324675, entitled “Biocompatible Polymer Compositions,” U.S. Patent Application Publication No. 2009/0175921, entitled “Chain Extenders,” and U.S. Patent Application Publication No. 2009/0099600, entitled “High Modulus Polyurethane and Polyurethane/Urea Compositions.” Each of the prior references is incorporated by reference herein in its entirety.
Optional fixation elements include screw holes 930 and cement troughs 960. The fixation elements fix the augment 910 in place when implanted. Each fixation element may connect the augment 910 to a patient's bone, an acetabular shell, or both. The augment 910 may also include a connection element 940 on base member 970, for example, at the center top of the augment 910. In certain embodiments, connection element 940 is a threaded opening that may be attached to the end of a driver handle (e.g., driver handle 1060 of FIG. 7) for assisting with the implantation of the augment 910. However, the connection element 940 may be a tapered connection, a quick-connect, or any other type of fitting. The augment 910 may further include timing marks 950 to allow the augment 910 to be properly placed within the hip bone. Installation of the augment 910 is described in further detail below. As shown in at least FIG. 1, the cement troughs 960 can extend between an opening 962 at a terminal top surface 965 of the augment 910 to a closed end 964 and include an open side 966 along an axial length of the cement troughs 960.
In some embodiments, the augment 910 is held in place solely by a friction fit. In some embodiments, fixation devices like bone screws or cement may be used to secure augment 910 in place, for example, via crew holes 930 or cement troughs 960, respectively. Any kind of bone screw or cement familiar to one or ordinary skill in the art may be used.
Examples of changes, substitutions, and alterations are ascertainable by one skilled in the art and could be made without departing from the scope of the information disclosed herein. All references cited herein are incorporated by reference in their entirely and made part of this application.
securing the acetabular shell to the patient's acetabulum;
preparing a space in the patient's acetabulum;
inserting an augment into the prepared space, the augment comprising at least two projections defining a gap therebetween, with at least one of the projections defining a cement trough, the cement trough having an opening defined in a terminal top surface of the augment and an open side that extends an axial length of the cement trough from the opening; and
after inserting the augment into the prepared space, pouring cement through the opening in the top terminal surface of the augment and thereby into the open side of the cement trough.
2. The method of claim 1, further comprising fixing the augment using an augment screw.
3. The method of claim 1, further comprising attaching the augment to a driver handle to facilitate the inserting.
4. The method of claim 1, wherein the preparing the space in the patient's acetabulum is by use of a broach.
5. The method of claim 4, wherein the preparing the space in the patient's acetabulum comprises rasping or reaming the patient's acetabulum using the broach.
6. The method of claim 4, further comprising limiting an amount of bone removed from the patient's acetabulum by using a depth stop on the broach.
7. The method of claim 4, wherein a cross-sectional profile of the broach is approximately the same as a cross-sectional profile of the augment.
8. The method of claim 1, wherein the augment further comprises flanges, or plates attached thereto.
9. The method of claim 1, further comprising while inserting the augment, matching timing markings on the augment to timing marks of the acetabular shell.
10. The method of claim 9, further comprising aligning the augment relative to the acetabular shell using the timing markings of each of the augment and the acetabular shell to facilitate positioning of a fastener in the gap between the projections during the inserting of the augment into the prepared space, the fastener securing the acetabular shell to the patient's acetabulum.
11. The method of claim 1, wherein the space is prepared at a location adjacent to the acetabular shell that has been secured to the patient's acetabulum.
12. The method of claim 1, wherein the securing the augment comprises securing, using the poured cement, the augment to the acetabular shell that has been secured to the patient's acetabulum.
13. The method of claim 1, wherein the securing the augment comprises securing, using the poured cement, the augment to at least one of the patient's acetabulum and the acetabular shell that has been secured to the patient's acetabulum.
14. The method of claim 1, wherein securing the augment by pouring cement comprises directly pouring cement through the opening and into the cement trough.
15. The method of claim 1, wherein the cement trough extends between the opening and a closed end of the cement trough.
16. A method of implanting an orthopedic device in a patient's acetabulum, the method comprising:
inserting an augment into the prepared space, the augment comprising at least two projections defining a gap therebetween, with at least one of the projections defining a cement trough; and
after inserting the augment into the prepared space, securing the augment by pouring cement into the cement trough;
wherein the securing comprises fastening the acetabular shell to the patient's acetabulum by a fastener; and
wherein the inserting comprises positioning the augment around the fastener such that the fastener is positioned in the gap between the at least two projections.
17. The method of claim 16, further comprising while inserting the augment into the prepared space, aligning the augment relative to the acetabular shell to facilitate positioning of the fastener in the gap between the projections.
18. A method of implanting an orthopedic device in a patient's acetabulum, the method comprising:
wherein the securing comprises inserting a fastener through an opening in the acetabular shell and engaging the fastener to the patient's acetabulum; and
19. The method of claim 18, wherein the fastener comprises a bone screw.
20. A method of implanting an orthopedic device in a patient's acetabulum, the method comprising:
securing the acetabular shell to the patient's acetabulum by a fastener;
inserting an augment into the prepared space, the augment comprising at least two projections defining a gap therebetween, one or more of the at least two projections defining a cement trough, wherein the augment is inserted into the prepared space by positioning the augment around the fastener such that the fastener is positioned in the gap; and
21. The method of claim 20, further comprising while inserting the augment into the prepared space, aligning the augment relative to the acetabular shell to facilitate positioning of the fastener in the gap between the projections.
22. The method of claim 20, wherein the securing comprises inserting the fastener through an opening in the acetabular shell and engaging the fastener to the patient's acetabulum.
23. The method of claim 20, wherein a cross-sectional profile of the broach is approximately the same as a cross-sectional profile of the augment.
24. The method of claim 20, further comprising while inserting the augment, matching timing markings on the augment to timing marks of the acetabular shell.
25. The method of claim 24, further comprising aligning the augment relative to the acetabular shell using the timing markings of each of the augment and the acetabular shell to facilitate positioning of the fastener in the gap between the projections during the inserting of the augment into the prepared space.
US15/472,844 2010-06-08 2017-03-29 Method of implanting an acetabular shell and an augment Active US10265177B2 (en)
US20170196694A1 US20170196694A1 (en) 2017-07-13
US10265177B2 true US10265177B2 (en) 2019-04-23
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