US RE40090 E1
An acetabular component for a hip replacement system comprises an acetabular shell, and a liner having a seal for insertion into the acetabular shell. In the preferred embodiment, the shell has a smooth tapered surface in its peripheral inner surface, and the liner has several annular ridges protruding from its outer surface. Upon insertion of the liner into the shell, the annular ridges of the liner come into sealing engagement with the smooth tapered surface of the shell. This sealing engagement substantially prevents a migration of debris along an interface of the liner with the shell. The liner is provided with several peripheral tabs for interference fit with several peripheral notches in the shell. An interlock comprising another liner ridge and a shell groove, provide a positive engagement to hold the liner in the shell as it bottoms therein. In an alternative embodiment, each notch is provided with protruding lips which project into the notch and firmly grasp one of the tabs of the liner upon insertion of the liner into the shell. In this manner, micromotion between the liner and the shell is substantially inhibited.
1. An acetabular component comprising:
an acetabular shell, said shell including at least one screw hole formed therein, said shell including a smooth inner sealing surface;
said acetabular shell also having at least one interlock circumferential groove and a plurality of peripheral notches formed therein;
a liner configured to seat within said acetabular shell, said liner including at least one circumferential peripheral annular seal, said at least one peripheral seal engaging said smooth inner sealing surface of said acetabular shell in a sealing engagement to restrict migration of debris toward said at least one screw hole;
said liner also including a separate raised locking ridge positioned to engage said interlock groove of said acetabular shell in a snap-lock arrangement; and
a plurality of generally rounded peripheral tabs on the peripheral edge of said liner, said tabs disposed to engage said plurality of notches on said acetibular shell so as to prevent rotational movement of said liner within said acetabular shell.
2. The acetabular component of
3. The acetabular component of
4. The acetabular component of
5. The acetabular component of
6. The acetabular component of
7. A prosthesis comprising:
a shell having at least one screw hole formed therein and a smooth inner sealing surface;
a liner configured to seat within said smooth inner surface of said shell, said liner including at least one circumferential peripheral annular seal flexibly and sealingly engaging said smooth inner sealing surface of said shell to restrict migration of debris toward said at least one screw hole;
said shell having a plurality of peripheral notches therein; and
said liner having a plurality of tabs extending outwardly from the liner with each tab being received in a respective one of said notches in said shell, each said notch having a pair of inwardly projecting lips to grasp its respective said tab.
8. The prosthesis of
9. A component for an orthopedic joint replacement system, said component comprising a metal shell adapted to be affixed to a bony structure within the human body by means of bone screws, said shell having one or more holes therein for reception of said bone screws and an inner surface, a liner of a suitable synthetic resin material adapted to fit closely within said inner surface of said shell, said liner constituting a bearing surface for another component of said joint replacement system, said liner having at least one flexible seal extending outwardly from said liner for sealing engagement with said inner surface of said shell around the entire liner so as to prevent the migration of joint fluid and debris from said joint to said screw holes, said seal being configured so as to flex upon insertion of said liner into said shell after said shell has been affixed to said bony structure by said bone screws, said liner further having a lock separate from said seal, said lock comprising a plurality of notches in an upper peripheral edge of said shell and a plurality of tabs, at least one notch for each said tab, said tabs extending outwardly from said liner and being adapted to be received in said notches upon installation of said liner into said shell, each said notch having a pair of inwardly sloping sidewalls cooperating with said tabs so as to substantially inhibit micro motion between said liner and said shell.
10. The prosthesis of
This application is a continuation of application Ser. No. 08/466,607 filed on Jun. 6, 1995 now abandoned.This is a reissue of U.S. Pat. No. 5,766,260, issued Jun. 16, 1998, which was based on application Ser. No. 08/847,887, filed Apr. 28, 1997, which is a continuation of application Ser. No. 08/466,607, filed Jun. 6, 1995, abandoned.
Prosthesis components for replacing anatomical joints are well known in the art, including total hip replacement systems. These systems include acetabular components and femoral components which interact with the acetabular components to replicate the articulation between the head of a femur and an acetabulum, or cotyloid cavity, of a pelvic girdle. The acetabular component typically comprises two parts, a metal acetabular shell and a polyethylene liner for insertion into the acetabular shell.
Acetabular shells typically have openings in the shell, including screw holes, which give rise to at least two problems. First, wear debris that is generated from the articular movement between a femoral head component and the liner can migrate between the liner and the acetabular shell, pass through the openings in the acetabular shell, and cause damage to the bone into which the acetabular shell is implanted. Second, debris can also be generated as a result of minor movement between the liner and the acetabular shell, commonly known as micromotion. This debris can also pass through the openings in the acetabular shell and cause damage to the bone.
Some efforts have been made to address this second problem, including providing an acetabular shell with a polished inner shell surface so as to minimize the amount of debris generated. Additionally, several manufacturers provide shells and liners with a variety of tongue and groove like configurations, such as generally rectangular tabs and indentations for mutual engagement. While these interlocking means serve to reduce the amount of debris generated by micromotion, they fail to solve the problem of migration of debris from the prosthetic articular surface between the acetabular shell and liner. Thus, despite these efforts, large numbers of polyethylene particles still have access to the acetabular bone.
Another approach, which attempts to address both of the debris problems mentioned above, particularly for acetabular shells having screw holes, is to utilize what are known as “man-hole covers,” or plugs, for insertion into unused screw holes to prevent the migration of debris therethrough. The main disadvantage of this approach is that the plugs fail to prevent the migration of debris through holes that have bone screws inserted therethrough. The debris will still migrate around the screws and through the holes, and ultimately damage the bone. Additionally, many acetabular components are now made without screw holes to prevent migration of polyethylene debris into bone behind the metal shell, but this can compromise fixation of the shell to bone in cases in which screws are necessary.
The inventor herein is aware of only one design that obviates both of the problems mentioned above, but the usefulness of this design has its own limitations. The acetabular shell is provided with a tapered inner surface for interfacing with a liner having a corresponding taper. Because the taper interface must fit tightly with each other to be effective, it is virtually impossible to seat the polyethylene liner onto the inner dome surface of the metal shell. Because the liner only contacts the acetabular shell about the peripheral edge of the shell to create an annulus of contact, part of the liner, which extends into the acetabular shell, is unsupported. Although such a configuration does provide a sealing effect between the liner and the acetabular shell, the design is unsuitable as liners formed from polyethylene deform over time which interferes with the desired smooth motion between the head and liner. Moreover, because all the load exerted on the liner is concentrated at the peripheral interface with the acetabular shell, the thickness of the shell must be relatively large, which, for acetabular components of smaller joints, requires a relatively and unacceptably thin liner. If the tapered portions of the shell and liner are made large enough to avoid distortion of the polyethylene shell, then this leaves no room for screws to be placed through the most effective portion of the shell's dome.
What is needed is an acetabular component that provides a seal for the interface of the acetabular shell with the liner, that can substantially inhibit micromotion between the acetabular shell and liner, and that provides adequate support for the liner across substantially all of liner so that the liner can be formed from polyethylene.
The acetabular component for a hip replacement system according to the present invention comprises an acetabular shell and liner, with an integrally formed seal and interlock. The seal is formed between the acetabular shell and the liner upon insertion and interlock of the liner into the acetabular shell. The seal is provided to substantially prevent a migration of poly debris along an interface of the outer surface of the liner with an inner surface of the acetabular shell. The interlock provides a positive engagement between the liner and shell to indicate a complete and proper seating of the liner and shell. The outer surface of the liner is of a shape complementary to the inner surface of the acetabular shell so that substantially all of the outer surface of the liner is supported by the acetabular shell upon insertion of the liner into the shell.
In the preferred embodiment, the seal is provided as an integral part of the liner, and comprises several annular ridges protruding from the outer surface of the liner and having a generally sloped triangular cross-sectional configuration. The acetabular shell is provided with a peripheral, smooth portion in its inner surface and positioned so that the seal, or annular ridges, of the liner is in sealing engagement with the smooth inner surface upon insertion and interlock of the liner into the acetabular shell. The smooth portions could alternatively be rough or roughened with ripples or ridges, non-tapered, non-cylindrical, non-recessed, or otherwise shaped, oriented, or configured as long as they provide a sealing surface for the annular ridges. The interlock is also provided as an integral part of the liner and comprises an interrupted ridge extending circumferentially between the tabs, described infra. The shell has a matching interrupted groove extending between the notches, described infra. The interlock is engaged as the interrupted ridge moves into the groove and the liner seats within the shell.
The sealing engagement of the seal ridges with the smooth portion prevents debris generated by the articulation of a femoral head component with the inner surface of the liner from migrating along the liner/shell interface. This ultimately prohibits the debris from passing through openings in the acetabular shell and damaging the bone into which the acetabular component is implanted. Typically, these openings in the acetabular shell include screw holes provided for attaching the acetabular shell to the bone with bone screws.
All of the annular ridges and liner are formed from polyethylene, and are therefore resilient. During insertion of the liner into the acetabular shell, he seal ridges will flex as they are forced against the inner surface of the acetabular shell, and remain at least partially flexed as they are seated into the seal recess. As the interlock engages, the seal ridges will, due to their resiliency, attempt to return to their original configuration, and will then be in sealing engagement with the seal recess. Since the ridges are resilient, they allow the polyethylene liner to seat fully in the dome of the metal shell to achieve full support of the polyethylene.
The liner is provided with several peripheral tabs for interlocking engagement with several notches provided about the periphery of the acetabular shell. The tabs are rounded to facilitate insertion into the notches and are located to permit bottoming of the insert into the shell before they themselves bottom. In a first embodiment, the notch sidewalls are rectangular cut and form an opening slightly smaller than each tab to thereby provide an interference fit to control relative rotation. In an alternative embodiment, each notch has two lips projecting into the notch opening for firmly grasping a corresponding tab of the liner upon insertion of the liner into the shell. In either embodiment, the tabs of the liner must be forced into the notches of the shell, and in this manner, micromotion between the liner and the shell is substantially inhibited.
While the principle advantages and features of the invention have been described above, a greater understanding of the invention may be attained by referring to the drawings and the description of the preferred embodiment which follow.
The prosthesis component of the present invention is an acetabular component for a hip replacement system.
The liner 42, as shown in
As a result of articular movement between the femoral head component and the inner surface 44 of the liner 42, polyethylene and metal debris is generated. Ordinarily, this debris can migrate along the interface of the liner 42 and the shell 32, then through any opening in the shell 32, and consequently disease the bone. The congruency between the liner 42 and the shell 32, by itself, is insufficient to prevent this debris migration. For this reason, the liner 42 is provided with a peripheral seal 46 for substantially preventing a migration of debris. The seal 46 is positioned so that it forms a barrier for debris traveling between the shell inner surface 38 and the liner outer surface 45, towards the shell holes 34.
As shown in
Although the sealing surface of the shell is depicted smooth and tapered, it could also be rippled or have small ridges and still allow the flexible sealing ridge to achieve a tight seal. It could also be cylindrical with parallel walls and still allow sealing. The acetabular shell 32 of the preferred embodiment includes a matching slightly smooth tapered surface 53 formed along its peripheral inner surface which, as shown in
In addition to the seal 46, the liner 42 “snap” fits and interlocks into shell 32 through an interlocking ridge and groove. As shown in
The shell screw holes 34 are utilized to secure the shell 32 to the acetabulum into which the shell 32 is implanted. Ordinarily, bone screws are inserted through one or more of screw holes 34 from inside the shell 32, and are then screwed into the bone contacting the outer surface 40 of the shell 32. Alternatively, modular pegs can be used instead of bone screws, or the shell 32 can be cemented or press fitted into an acetabulum, or some combination of these means for attaching. Although the shell 32 of the preferred embodiment is metallic, non-metallic materials could also be used in the construction of the shell.
While the shapes of the matching surfaces of the acetabular shell 32 and liner 42 have been described and shown as generally hemispherical, other shapes could be utilized in a particular application. As shown in the drawings, the surfaces are customarily machined to close tolerance to achieve an accurate conformance. It is desirable for the liner inner surface 44 to be generally hemispherical to accommodate rotational motion with a femoral component to simulate the articulation between a head of a femur and an acetabulum. Furthermore, while the acetabular component of the preferred embodiment utilizes only one seal 46 and one interlock, the acetabular shell can have more than one such seal, with each seal surface having one or more corresponding seal ridges 48 and 50 on the liner 42, without departing from the scope of the present invention. Alternatively, the seal 46 could be located more closely to the screw holes 34, and even surround them separately or protrude into them.
In the preferred embodiment, the liner 42 is provided with one or more peripheral tabs 60 for engagement with several peripheral notches 36 in the shell 32 upon insertion of the liner 42 into the shell 32. For convenience in manufacture, peripheral notches 36 may be generally rectangular. The tabs 60 are sized to be slightly wider than each of notches 36 in order to provide an interference fit therebetween and thereby rotationally locate the liner 42 within shell 32. The upper surface of tabs 60 is generally sloped or rounded on either side to facilitate insertion of liner 42 and tabs 60 into shell 32 and notches 36, respectively. As explained above, as the liner outer surface 45 “bottoms” in the shell's inner surface 38, interlock ridge 56 engages interlock groove 54 which ensures that tabs 60 are sufficiently inserted into notches 36 so as to achieve an interference fit and reduce micromotion. As shown in
To further prevent micromotion between the liner 42 and the shell 32, each notch 36 may be provided with protruding lips 78, 80 as shown in the alternative construction in FIG. 3. These lips 78, 80 project into the notches 36 and firmly grasp the tabs upon insertion of the liner 42 into the shell 32. In this manner, relative motion, or micromotion, between the liner 42 and the shell 32 is further substantially inhibited. Alternatively, the tabs 60 of the liner 42 could be lipped, and the notches 36 could have tapered sides, or the shell 32 could be provided with tabs 60 and the liner 42 provided with notches 36, with either the tabs 60 or the notches 36 being lipped, possibly in conjunction with tapered sides of the non-lipped member for ease of insertion.
While the liner 42 has been described as being formed from polyethylene, liners comprising other types of materials can also be used with the present invention where similar problems with debris generation or migration exist, or where sealing between the liner 42 and shell 32 is otherwise necessary.
To implant the acetabular components of the present invention, an appropriately sized component must be selected with consideration of anatomical and biomedical factors such as the patient's age, activity levels, weight, and bone and muscle conditions. Preparation of the acetabular cavity is necessary prior to insertion of the component. Thereafter, the acetabular shell can be inserted into the cavity and attached by any of the means described above. Where bone screws or modular pegs are to be utilized, the acetabular shell must be affixed prior to inserting the liner into the shell. Inserting the liner into the shell typically requires impacting the liner, which will cause the annular seal ridges to flex. The interlock ridge must also be forced past the outer lip of the shell and into the interlock groove which seats the liner in the shell, the seal, and the tabs into the notches. At that time, the annular seal ridges, due to their resiliency, will be in sealing engagement with the annular seal surface, thereby substantially preventing a migration of debris between the liner and shell. Meanwhile, the tabs of the liner have an interference fit into the notches, with the lips of each notch firmly grasping its respective tab (alternative embodiment), thereby substantially inhibiting micromotion between the liner and the shell.
While the prosthesis component of the present invention has been described as an acetabular component for a hip replacement system, this description is not intended to be limiting. The prosthesis component of the present invention can be utilized in other articulating anatomical joint systems, such as shoulder joint systems, and not limited to ball and socket joints, and is equally suited for other types of uses, including veterinarian applications.
There are various changes and modifications which may be made to the invention as would be apparent to those skilled in the art. However, these changes or modifications are included in the teaching of the disclosure, and it is intended that the invention be limited only by the scope of the claims appended hereto.