|Publication number||US20080021567 A1|
|Application number||US 11/616,369|
|Publication date||Jan 24, 2008|
|Filing date||Dec 27, 2006|
|Priority date||Jul 18, 2006|
|Also published as||US8202324, US8845749, US20100185296, US20110166666, US20120221114|
|Publication number||11616369, 616369, US 2008/0021567 A1, US 2008/021567 A1, US 20080021567 A1, US 20080021567A1, US 2008021567 A1, US 2008021567A1, US-A1-20080021567, US-A1-2008021567, US2008/0021567A1, US2008/021567A1, US20080021567 A1, US20080021567A1, US2008021567 A1, US2008021567A1|
|Inventors||Steven L. Meulink, Ryan D. Schlotterback, Barish Banerjee, Stephen J. Vankoski|
|Original Assignee||Zimmer Technology, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Referenced by (60), Classifications (30), Legal Events (2)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This application is a continuation-in-part of co-pending U.S. patent application Ser. No. 11/458,257, filed Jul. 18, 2006, entitled METHOD FOR SELECTING MODULAR IMPLANT COMPONENTS, assigned to the assignee of the present application, the disclosure of which is hereby expressly incorporated herein by reference.
1. Field of the Invention
The present invention relates to modular components for prosthetic joints. More particularly, the present invention relates to a case for modular neck components for prosthetic hip joints.
2. Description of the Related Art
Orthopaedic prosthetic implants are commonly used to replace some or all of a patient's hip joint in order to restore the use of the hip joint, or to increase the use of the hip joint, following deterioration due to aging or illness, or injury due to trauma. In a hip replacement, or hip arthroplasty procedure, a femoral component is used to replace a portion of the patient's femur, including the femoral neck and head. The femoral component is typically a hip stem, which includes a stem portion positioned within the prepared femoral canal of the patient's femur and secured via bone cement, or by a press-fit followed by bony ingrowth of the surrounding tissue into a porous coating of the stem portion. The hip stem also includes a neck portion adapted to receive a prosthetic femoral head. The femoral head may be received within a prosthetic acetabular component, such as an acetabular cup received within the prepared recess of the patient's acetabulum.
Orthopaedic implants for hip replacement may include modular hip joint components. For example, the hip stem and the neck portion with femoral head are formed as separate components. Prior to an operation, a surgeon chooses a hip stem and a neck portion based on patient anatomy, body image scans, and/or other patient-specific data. However, during surgery, the surgeon may discover that a different hip stem or a different neck portion is desired to provide more optimum results. Modular hip joint components allow the surgeon to choose a different hip stem or neck portion depending on the specific application and needs of the patient and surgeon. Typically, the surgeon will only change the neck portion because the hip stem is usually implanted first, and removal of the hip stem from the femoral intramedullary canal is generally undesirable. Thus, the neck portion is usually the component that is most often changed intraoperatively. The surgeon may be provided with a number of different neck portions to accommodate various patient anatomies.
In one known system, for example, the surgeon chooses from a plurality of options to replace an existing neck portion with an alternative neck portion to provide the best outcome for the patient. The surgeon's choices rely on the location of the center of rotation of the femoral head component of the implant. Referring to
The present disclosure provides a case for modular neck components for hip implants. The case may include indicators based on independent variables associated with physical characteristics of the implant, including leg length, offset, and anteversion. During surgery, the surgeon may be confronted with a need to change a preoperatively-chosen modular neck. For example, the surgeon may desire a change in at least one of the variables, e.g., leg length, offset, and/or anteversion. The case allows the surgeon to quickly and easily select a different modular neck based on an evaluation of one of the variables without requiring reevaluation of the other variables. A method described herein may include preoperative planning in which a template including a grid coordinate system is used, which advantageously provides an intuitive system for the surgeon both preoperatively and during surgery.
In one form thereof, the present disclosure provides a system for facilitating implant selection, the system including a plurality of implants including at least one subset in which at least one of a first, second, and third variable associated with a respective different physical characteristic of the implants is constant and the others of the first, second, and third variables vary within each subset; and at least one case including a plurality of receptacles, each receptacle configured to receive a corresponding one of the plurality of implants, the plurality of receptacles configured to facilitate selection of one of the plurality of implants based on a change in the at least one variable.
In another form thereof, the present disclosure provides a system for facilitating implant selection, the system including a plurality of implants including at least one subset in which at least one of a first, second, and third variable associated with a respective different physical characteristic of the implants is constant and the others of the first, second, and third variables vary within each subset; and receptacle means for receiving each of the plurality of implants and for facilitating selection of one of the plurality of implants based on a change in the at least one variable.
The above-mentioned and other features of the disclosure, and the manner of attaining them, will become more apparent and will be better understood by reference to the following description of embodiments of the disclosure taken in conjunction with the accompanying drawings, wherein:
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate embodiments of the disclosure and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
Referring now to
As shown in
In step 106, the surgeon selects the template 50 corresponding to the femoral stem component of the hip implant to be used in the surgical procedure. Template 50 may be chosen in a conventional manner such that the representation of stem 46 on template 50 substantially fills the intramedullary canal of femoral shaft 27 of the image, such that the actual femoral stem component of the hip implant will correctly fit the intramedullary canal of the actual femur.
In step 108 and as shown in
Still referring to step 110 and
In step 110, the surgeon may mark directly on the image where center 49 of head 42 of modular neck 44 (
Alternatively, template 50 may be a template on a computer screen in a computer assisted surgery (CAS) system. The surgeon may superimpose the computer generated template 50 in the CAS system on the image of the proximal femur to determine the optimal position of center 49 of head 42 of a modular neck 44 (
During surgery and as shown in step 114, a preoperatively-chosen femoral stem 46 of hip implant 40 (
In step 116, the surgeon may trial the provisionally implanted modular neck 44 (
Similarly, the surgeon may observe that a different anteversion component is necessary, but that the leg length and offset are satisfactory. The present method advantageously allows the surgeon to select a new modular neck based only on the change in anteversion without affecting the leg length and offset. Because the anteversion component is based on a grid coordinate system, similar to leg length and offset, described above, or, alternatively, on a polar coordinate system, the surgeon can easily and intuitively select a new modular neck component based on a change in anteversion without requiring an extensive lookup table or complicated mathematical conversion calculations to ensure that no other variables are being changed undesirably.
After the surgeon determines the desired change, the surgeon may employ system 60 (
Referring now to
A subset of system 60 may be provided and arranged in container or case 61. Alternatively, a plurality of subsets of system 60 may be provided and arranged in at least one container 61. System 60 is arranged such that all necks 44 within a given subset of necks correspond to a particular anteversion component. Each subset may have a different anteversion component, thereby permitting a surgeon to independently assess the desired anteversion component and have an identical subset of necks 44 for each anteversion component. For example, the anteversion component may be, for example, anteverted, straight, or retroverted. Thus, for example, referring to
Still referring to
Each subset 60 a, 60 b, 60 c may include two sets of pairs of identifying coordinates corresponding to leg length and offset. Each set corresponds to either a right hip or a left hip. Advantageously, as shown in
Intraoperatively, if the surgeon does not want any change in offset but needs a change in leg length, the surgeon will choose a new neck 44 having the following coordinates: (preoperatively-planned offset value, preoperatively-planned leg length value±change in leg length) from a particular subset according to the chosen anteversion component. Similarly, if the surgeon does not want any change in leg length but needs a change in offset, the surgeon will choose a neck 44 having the following coordinates: (preoperatively-planned offset value±change in offset, preoperatively-planned leg length value) from a particular subset according to the chosen anteversion component.
Advantageously, arranging the plurality of modular necks 44 in each subset 60 a, 60 b, 60 c of system 60 in a Cartesian coordinate grid allows the surgeon to easily and intuitively intraoperatively choose a modular neck 44 which corresponds to an independent change in leg length, offset, or anteversion. The surgeon may use a fluoroscopic or other image-guided system (not shown) to facilitate the assessment of the change in leg length, offset, and/or anteversion, as described above, or, alternatively, the surgeon may simply manually/visually determine the desired change in leg length, offset, and/or anteversion, and subsequently choose a neck 44 from a subset of system 60 corresponding to the desired change.
In one example, if the surgeon determines in step 116 that more or less leg length is desired but that the offset and anteversion are satisfactory, the surgeon may select a different modular neck 44 from a subset of system 60 which corresponds to the desired change. For example, if the surgeon needs no change in offset and 4 millimeters (mm) more of leg length, the surgeon chooses the neck with the following coordinates from a subset of system 60 corresponding to the satisfactory anteversion component: (preoperatively-planned offset value, preoperatively-planned leg length value plus 4). Subsequently, the surgeon implants neck 44 into the femoral stem component of the hip implant. The surgeon may similarly choose a different neck 44 depending on how much change in leg length was desired.
In another example, if the surgeon determines in step 116 that less leg length and more offset are desired but the anteversion is satisfactory, the surgeon may select a different modular neck 44 from a subset of system 60 which corresponds to the desired change. For example, if the surgeon needs 4 mm more of offset and 4 mm less of leg length, the surgeon chooses the neck with the following coordinates from a subset of system 60 corresponding to the satisfactory anteversion component: (preoperatively-planned offset value plus 4, preoperatively-planned leg length value minus 4). Subsequently, the surgeon implants neck 44 into the femoral stem component of the hip implant. The surgeon may similarly choose a different neck 44 depending on how much change in leg length and/or offset was desired.
In yet another example, if the surgeon determines in step 116 that leg length and offset are satisfactory but the anteversion needs changed, the surgeon may select a different modular neck 44 from a subset of system 60 which corresponds to the desired change. For example, if the surgeon needs to change from a retroverted neck to a straight neck, the surgeon will select neck 44 from subset 60 a of system 60 corresponding to a straight neck and having the desired leg length and offset.
In step 118, the different neck 44 chosen by the assessment of leg length, offset, and anteversion in step 116 is implanted into the stem component of the hip implant.
Referring now to
Still referring to
Container 61′ may also be divided into secondary region 78 and primary region 76 which are divided by boundary 80. Primary region 76 may include a color, pattern, or other identifying structure on container 61′ such as to identify a range of modular necks 44 which are most often used in a surgical procedure. Secondary region 78 identifies a range of modular necks 44 which are less often used in a surgical procedure. Each container 61′ for subsets 60 a, 60 b, and 60 c (
Container 61′ may also include a plurality of removable portions or trays 72. Each removable tray 72 may be positioned in a corresponding recess 74 in container 61′. Removable tray 72 may include one or more modular necks 44 which may be less often used in a surgical procedure. Removable trays 72 may be snap-fit into engagement with recess 74 when necessary. If the modular necks 44 in removable trays 72 are not necessary, container 61′ may be used without trays 72 positioned therein.
Although illustrated throughout as having intervals of 4 mm for both offset and leg length, system 60 could be arranged to have intervals of any dimension to accommodate the needs of a particular patient or the desires of a particular surgeon. For example, the interval could be 1, 2, 3, 4, or 5 mm, or any fraction thereof, for both offset and leg length.
The above-described concept has generally been described as a system having three variables, i.e., leg length, offset, and anteversion. The system has been described in which one of these three variables, i.e., the anteversion component, is constant for any given subset of implants having various offsets and leg lengths. For example, the surgeon may pre-operatively choose a desired anteversion component, which may not change intraoperatively, and then need only choose various modular necks 44 from the subset corresponding to the desired anteversion component of system 60 based only on offset and leg length. Alternatively, the system may be constructed such that leg length is the constant variable and the implants of each subset of system 60 are arranged to have identical leg lengths and varying offset and anteversion components. In another alternative embodiment, the system may be constructed such that offset is the constant variable and the implants of each subset of system 60 are arranged to have identical offsets and varying leg lengths and anteversion components.
Although described throughout with respect to a hip implant, the method could be utilized in any procedure which uses modular components, for example, but not limited to, shoulder implant procedures, knee implant procedures, etc.
While this disclosure has been described as having exemplary designs, the present disclosure can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the disclosure using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this disclosure pertains and which fall within the limits of the appended claims.
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|Cooperative Classification||A61F2/3609, A61F2002/30708, A61B19/0271, A61F2002/30963, A61F2002/30948, A61B5/4528, A61F2/38, A61F2/0095, A61F2/40, A61B5/107, A61F2002/30332, A61F2220/0033, A61F2/46, A61B2019/0278, A61F2002/30604, A61F2002/365, A61F2002/3652, A61F2002/30616, A61F2250/0084, A61F2002/3611, A61F2250/0089, A61B19/026, A61F2002/30714, A61F2002/4633, A61F2002/3625|
|European Classification||A61F2/36C, A61F2/00P, A61B19/02P|
|Jan 12, 2007||AS||Assignment|
Owner name: ZIMMER TECHNOLOGY, INC., INDIANA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MEULINK, STEVEN L.;SCHLOTTERBACK, RYAN D.;VANKOSKI, STEPHEN J.;AND OTHERS;REEL/FRAME:018753/0552;SIGNING DATES FROM 20070102 TO 20070112
|Jan 25, 2013||AS||Assignment|
Free format text: MERGER;ASSIGNOR:ZIMMER TECHNOLOGY, INC.;REEL/FRAME:029698/0017
Owner name: ZIMMER, INC., INDIANA
Effective date: 20121127