US20070050041A1 - Orthopaedic implant stem component, joint component, and associated kit - Google Patents
Orthopaedic implant stem component, joint component, and associated kit Download PDFInfo
- Publication number
- US20070050041A1 US20070050041A1 US11/216,396 US21639605A US2007050041A1 US 20070050041 A1 US20070050041 A1 US 20070050041A1 US 21639605 A US21639605 A US 21639605A US 2007050041 A1 US2007050041 A1 US 2007050041A1
- Authority
- US
- United States
- Prior art keywords
- component
- stem
- joint
- canal
- neck
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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- A—HUMAN NECESSITIES
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- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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- A—HUMAN NECESSITIES
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- A61F2/02—Prostheses implantable into the body
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
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- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/30—Joints
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Transplantation (AREA)
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Abstract
A stem component having a body portion and a connection portion is provided. A portion of the stem component may be fitted to a cavity in a canal of a long bone. The stem component includes a canal portion and a sleeve portion that has an internal periphery that forms an internal cavity. A portion of the external periphery of the sleeve portion may be fitted to the cavity of the long bone. A portion of the external periphery of the connection portion may be fitted into the internal cavity of the sleeve portion, so that the external periphery of the connection portion of the joint component is spaced inwardly from the external periphery of the sleeve portion of the stem component when the joint component is fixedly connected to the stem component so that the joint component may be removed without disturbing the fixation to the long bone.
Description
- Cross-reference is made to the following applications: DEP5419USNP titled “ORTHOPAEDIC IMPLANT, STEM AND ASSOCIATED METHOD” and DEP5563USNP titled “ORTHOPAEDIC IMPLANT KIT, ORTHOPAEDIC SURGERY KIT AND ASSOCIATED METHOD” filed concurrently herewith which are incorporated herein by reference.
- The present invention relates generally to the field of orthopaedics, and more particularly, to an implant for use in arthroplasty.
- Patients who suffer from the pain and immobility caused by osteoarthritis and rheumatoid arthritis have an option of joint replacement surgery. Joint replacement surgery is quite common and enables many individuals to function properly when it would not be otherwise possible to do so. Artificial joints are usually comprised of metal, ceramic and/or plastic components that are fixed to existing bone.
- Such joint replacement surgery is otherwise known as joint arthroplasty. Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged joint is replaced with a prosthetic joint. In a typical total joint arthroplasty, the ends or distal portions of the bones adjacent to the joint are resected or a portion of the distal part of the bone is removed and the artificial joint is secured thereto.
- There are known to exist many designs and methods for manufacturing implantable articles, such as bone prostheses. Such bone prostheses include components of artificial joints such as elbows, hips, knees and shoulders.
- Currently in total hip arthroplasty, a major critical concern is the instability of the joint. Instability is associated with dislocation. Dislocation is particularly a problem in total hip arthroplasty.
- Factors related to dislocation include surgical technique, implant design, implant positioning and patient related factors. In total hip arthroplasty, implant systems address this concern by offering a series of products with a range of lateral offsets, neck offsets, head offsets and leg lengths. The combination of these four factors affects the laxity of the soft tissue. By optimizing the biomechanics, the surgeon can provide a patient a stable hip much more resistant to dislocation. In order to accommodate the range of patient arthropometrics, a wide range of hip implant geometries are currently manufactured by DePuy Orthopaedics, Inc., the assignee of the current application, and by other companies. In particular, the S-ROM® total hip systems offered by DePuy Orthopaedics, Inc. include three offsets, three neck lengths, four head lengths and one leg length adjustment. The combination of all these biomechanic options is rather complex.
- Anteversion of a total hip system is closely linked to the stability of the joint. Improper version can lead to dislocation and patient dissatisfaction. Version control is important in all hip stems. However, it is a more challenging issue with the advent of stems with additional modularity.
- The prior art has provided for some addressing of the anteversion problem. For example, the current S-ROM® stems have laser markings on the medial stem and the proximal sleeve. This marking enables the surgeon to measure relative alignment between these components. Since the sleeve has infinite anteversion, it is not necessarily oriented relative to a bony landmark that can be used to define anteversion. In fact, the current sleeves are sometimes oriented with the spout pointing directly laterally into the remaining available bone.
- Prior art stems may be aligned relative to a patient's bony landmarks. These stems are monolithic. They cannot locate the neck independently of the distal stem. Therefore, anteversion is limited. Most bowed, monolithic stems are sold in fixed anteversion; for example, at an anteversion of 15 degrees. These monolithic stems have limited flexibility for rotational alignment since the distal stem must follow the bow of the patient's femur and this may not provide an operable biomechanical result.
- In a common step in the surgical procedure known as total hip arthroplasty, a trial or substitute stem is first implanted into the patient. The trial is utilized to verify the selected size and shape of the implant in situ on the patient and the patient is subjected to what is known as a trial reduction. This trial reduction represents moving the joint, including the trial implant through selected typical motions for that joint. Current hip instruments provide a series of trials of different sizes to help the surgeon assess the fit and position of the implant. Trials, which are also known as provisionals, allow the surgeon to perform a trial reduction to assess the suitability of the implant and implant's stability prior to final implant selection.
- Most hip stems implanted currently are of a one-piece or mono-block design. Mono-block hip stem designs allow for no adjustments. Thus, they require that the hip stem be removed and replaced to adjust head height or offset. Also, mono-block stems are not designed to be used in minimally invasive surgery and are not optimal for use with minimally invasive surgery procedures.
- Surgical variables such as leg length discrepancy may result in surgical error that may need to be corrected or optimized. Further, due to implant subsidence during the use of an implant, the head-height at a revision surgery may need to be corrected. Further, revision surgery may be required to correct the instability of the hip joint. Stability may be restored by moving the head proximally and or increasing the offset of the implant to tighten the soft tissues. These corrections may be made at revision surgery to address these dislocations, however with current mono-block stems the stem must be removed from the femur to accomplish these changes in the implant configuration. Such removal of the stem from the femur may make the revision surgery quite difficult in that the stem tends to engrow with the tissues of the bone. Also, removal of the stem may lead to significant loss of bone, which can compromise the fixation of the stem upon re-implantation.
- Further revision surgery may be required to correct weak abductor function by increasing the offset of the stem. The changing in a revision surgery to an increased offset stem may require that the stem be removed from the medullary canal of the femur and replaced with a stem with a different offset.
- Further mono-block stems are not easily used in minimally invasive hip procedures where the incision through the skin and soft tissue is minimized. The surgeon may have difficulty to work in the joint space after the stem is in place. The neck of the mono-block stem may be in the way during the performance of the surgery.
- In order to reduce inventory costs and complexity, many trialing systems are modular. For example, in the Excel Instrument System, a product of DePuy Orthopaedics, Inc., there is a series of broaches and neck trials that can be mixed and matched to represent the full range of implants. There is a single fixed relationship between a broach and a neck trial, because these trials represent a system of monolithic stem implants.
- Likewise, in the current S-ROM® instrument systems provided by DePuy Orthopaedics, Inc., there are neck, proximal body, distal stem, head and sleeve trials. By combining all these components, the implant is represented. Since the S-ROM® stem is modular and includes a stem and a sleeve, the angular relationship or relative anteversion between the neck and the sleeve is independent and represented by teeth mating between the neck and the proximal body trial. The proximal body trial has fixed transverse bolts that are keyed to the sleeve in the trialing for straight, primary stems. The long stem trials do not have the transverse bolts and are thus not rotationally stable during trial reduction and therefore are not always used by the surgeon.
- Prosthetic joint implants are currently surging in use and technology. In performing most prosthetic joint implants, what is known as a ‘trial’ or ‘provisional’ is used before a final prosthesis is used. The trial or provisional is used to select the proper joint prosthesis and/or to orient or align one or more of the components of the final joint prosthesis. The trial or trial components are temporarily implanted to achieve proper sizing, placement and/or orientation of the final joint prosthesis, as well as achieve anatomical orientation of the prosthesis and/or components of the joint prosthesis.
- Hip arthroplasty provisionals or trials have a neck that is used to attach a femoral head provisional or trial thereto. The orientation of the neck relative to the shaft of the broach or trial is described in terms of anteversion, neck length, neck angle, and/or neck offset. Because each patient's original femoral neck anatomy is different, the ability to replicate the original femoral neck anatomy of each patient during hip arthroplasty requires multiple neck trials having various orientations. The use of multiple neck segments is not advantageous since it requires more time, increased instrument cost and increased space in the instrument sterilization case.
- Thus, trialing systems utilized by many hip implants or prostheses generally consist of a broach and a neck segment. In order to intraoperatively change the offset of the trial (i.e. neck segment and broach), the neck trial must be removed and another neck trial must be put in its place. Thus, multiple neck trials that are exchangeable with one another relative to the broach are necessary in order to replicate the original hip anatomy.
- Other hip systems utilize only one neck segment with the offset incorporated into the location of the trunnion of the broach. This design, however, does not mimic the exact geometry of the actual implant. While it is desired to be able to try several neck offsets relative to the broach in order to achieve a proper head positioning for the final implant, the prior art is deficient.
- In U.S. Pat. No. 5,645,607 issued to Hickey, a hip trial or prosthesis having an adjustable neck portion is disclosed in which the problem of multiple neck trials is addressed. The adjustable neck of Hickey allows the trialing of various neck offsets in order to achieve a correspondence between the spatial orientation of a patient's original anatomy and a final implanted hip ball prosthesis.
- However, Hickey requires a vertical height change of the neck segment in order to move between the various offsets. Where vertical height is restricted during surgery, especially in current, less invasive arthroplasty procedures, vertical height adjustment is undesirable.
- There are a variety of modular stem designs in the prior art. Most of these designs focus on the ability to use varying stem diameters and length with various size proximal bodies to provide optimal fill on both the diaphysis and the metaphysis simultaneously (to optimize fixation of the device). In many of these designs the neck cannot be removed or replaced to adjust head-height or offset without disturbing the fixation of at least the modular proximal body portion of the stem. Prior art modular stems include the modular stem as disclosed in U.S. Pat. No. 5,370,706 to Bolesky, et al. and assigned to the applicant of the instant application. The Bolesky patent, U.S. Pat. No. 5,370,706 is hereby incorporated in its entirety by reference.
- Another modular stem available in the prior art is the S-ROM® stem sold by DePuy Orthopaedics, Inc., Warsaw, Ind. and described in U.S. Pat. Nos. 4,624,673, 4,790,852, and 4,846,839. The U.S. Pat. Nos. 4,624,673, 4,790,852, and 4,846,839 are incorporated herein by reference in their entireties.
- The prior art further includes a modular stem marketed by Wright Medical, Inc. of Arlington, Tenn. The Pro-Femur Stem provides a modular neck with a taper on both ends, one to engage the stem proximal body and one to engage the head.
- The present invention is adapted to solve at least some of the aforementioned problems with the prior art.
- An aspect of the present invention is in the form of a hip stem that utilizes a modular neck portion. The hip stem includes two main parts. These parts are a hip stem body and a modular neck portion. The modular neck provides the surgeon the ability to adjust the proximal-distal head height and the head offset. These adjustments may be either independent or in combination with each other. The adjustment can be made after the stem is seated and fixed into place, eliminating the need to disturb the fixation of the stem. The adjustment can take place as fine tuning at the end of the initial orthopaedic surgery or upon a revision surgery when it is determined that the cause for the revision (such as instability or leg length discrepancy) may be addressed by adjustment.
- The design of an aspect of the present invention allows the stem body to be implanted separately from the modular neck portion. This feature may be advantageous in minimally invasive surgery where smaller components may be easier to place through smaller incisions and where waiting until near the end of the operation to implant the neck portion provides more room for the surgeon to work and better access to the joint space.
- According to yet another aspect of the present invention, the hip stem design includes two main parts, a hip stem body and a modular neck portion. The modular neck portion fits within a recess in the top of the stem body. This modular design allows the modular neck portion to be placed or removed without disturbing the fixation of the stem body in the bone. A variety of methods can be used to obtain mechanical attachment of the modular stem portion to the body.
- For example, in one embodiment of the present invention, dowel pins are pressed into one side of the interface with a tight slip fit on the other side to align and aid in carrying bending moments across the interface. This design ensures that the screw (which is used to apply the compressive locking forces across the interface) is subjected only to axial tension loads. By eliminating bending moments in the screw, fatigue failure of the thread fastener can be better avoided.
- According to another aspect of the present invention, a means for holding the screw captive in the modular stem portion may be desirable to aid in assembling the modular stem portion to the stem body. Such capture of the screw would minimize the number of parts to be handled and eliminate the need to handle or assemble many small pieces.
- In yet another embodiment of the present invention, the dowel pins are replaced with tapers, which may be either rectangular or cylindrical. The tapers serve to align the parts and carry any bending moments so that the screw is subjected to only axial tension loads.
- In yet another aspect, the present invention provides a hip stem for use in performing hip arthroplasty. The hip stem is to be fitted to a cavity in the canal of a femur. The hip stem includes a stem component including a distal stem portion and a proximal body portion. The hip stem also includes a neck component fixedly connectable to the stem component. The neck component includes a proximal neck portion and a distal body portion. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone.
- In another aspect, the present invention provides a hip prosthesis for use in performing hip arthroplasty. The hip stem is fitted to a cavity in the canal of a femur. The hip prosthesis includes an acetabular cup, a head, a neck component and a stem component. The stem component includes a distal stem portion and a proximal body portion. The neck component is fixedly connectable to the stem component. The neck component includes a proximal neck portion and a distal body portion. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone.
- In another aspect, the present invention provides a kit for performing revision surgery. The kit includes a stem component having a distal stem portion and a proximal body portion. The kit also includes a first neck component fixedly connectable to the stem component. The first neck component includes a proximal neck portion and a distal body portion. The first neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. The kit also includes a second neck component fixedly connectable to the stem component. The second neck component includes a proximal neck portion and a distal body portion. The second neck component is adapted for removal from the femur without disturbing the fixation of bone surrounding the stem component.
- In another aspect, the present invention provides an orthopaedic implant for use in performing joint arthroplasty. A portion of the orthopaedic implant is to be fitted to a cavity in the canal of a long bone. The orthopaedic implant includes a stem component having a stem portion and a body portion. The orthopaedic implant also includes a joint component fixedly connectable to the stem component. The joint component has an articulation portion and a connection portion. The joint component is adapted for removal from the long bone without disturbing the fixation of bone surrounding the stem.
- In another aspect, the present invention provides a stem component for use with a joint component having an articulation portion and a connection portion in performing joint arthroplasty. At least a portion of the stem component is to be fitted to a cavity in the canal of a long bone. The stem component includes a stem portion and a body portion. The body portion is adapted to permit removal of the connection portion of the joint component from the long bone without disturbing the fixation of bone surrounding the joint component.
- In another aspect, the present invention provides a joint component for use with a stem component having a body portion and a stem portion in performing joint arthroplasty. At least a portion of the stem component is to be fitted to a cavity in the canal of a long bone. The joint component includes a connection portion and an articulation portion. The connection portion is adapted to permit the removal of the joint component from the long bone without disturbing the fixation of bone surrounding the joint component.
- In another aspect, the present invention provides an orthopaedic implant trial for use in performing joint arthroplasty and to assist in performing a trial reduction in performing joint arthroplasty. A portion of the orthopaedic implant trial is fitted to a cavity in the canal of a long bone. The orthopaedic implant trial includes a stem component having a stem portion and a body portion. The orthopaedic implant trial also includes a joint component fixedly connectable to the stem component. The joint component has an articulation portion and a connection portion. A portion of the body portion of the stem component extends over a portion of the connection portion of the joint component.
- In another aspect, the present invention provides a kit for use in performing joint arthroplasty. The kit includes an orthopaedic implant trial for use in performing joint arthroplasty. The trial is to be fitted to a cavity in the canal of a long bone and to assist in performing a trial reduction in performing joint arthroplasty. The orthopaedic implant trial includes a stem component having a stem portion and a body portion. The orthopaedic implant trial also includes a joint component fixedly connectable to the stem component. The joint component has an articulation portion and a connection portion. The joint component is adapted for removal from the long bone without disturbing the fixation of the stem component to the bone. The kit includes an orthopaedic implant for use in performing joint arthroplasty. A portion of the orthopaedic implant is fitted to a cavity in the canal of a long bone. The orthopaedic implant includes a stem component having a stem portion and a body portion. The orthopaedic implant also includes a joint component fixedly connectable to the stem component. The joint component includes an articulation portion and a connection portion. The joint component is adapted for removal from the long bone without disturbing the fixation of bone surrounding the joint component.
- In another aspect, the present invention provides a method for treating orthopaedic joint disease of a patient. The method includes the step of implanting an orthopaedic implant into a cavity in the canal of a long bone. The orthopaedic implant includes a stem component and a first joint component fixedly connectable to the stem component. The joint component is adapted for removal from the long bone without disturbing the fixation of the stem component to the bone. The method also includes the steps of monitoring the condition of the patient and determining that the patient needs a revision prosthesis. The method also includes the steps of providing a second joint component compatible with the stem component and removing the first joint component from the stem component of the orthopaedic implant in vivo in the patient without disturbing the fixation of bone surrounding the orthopaedic implant. The method also includes the step of implanting the second joint component into the stem component in vivo in the patient.
- In another aspect, the present invention provides a method for providing revision joint arthroplasty on a patient having an orthopaedic implant. The orthopaedic implant includes a stem component and a first joint component fixedly connectable to the stem component. The joint component is adapted for removal from the long bone without disturbing the fixation of the stem component to the bone. The method includes the steps of monitoring the condition of the patient and determining that the patient needs a revision prosthesis. The method also includes the steps of providing a second joint component compatible with the stem component and removing the first joint component from the stem component of the orthopaedic implant in vivo in the patient without disturbing the fixation of bone surrounding the orthopaedic implant. The method also includes the step of implanting the second joint component into the stem component in vivo in the patient.
- In another aspect of the present invention an orthopaedic implant for use in performing joint arthroplasty is provided. A portion of the implant is fitted to a cavity in the canal of a long bone. The cavity extends from a resected plane of the long bone. The implant includes a joint component having a stem element with an external periphery. The stem element defines a distal end for insertion into the cavity. The external periphery of the stem element has a resection ring that aligns with the resected plane of the long bone and a body element fixedly connectable to the stem element. The body element has a external periphery. A distal portion of the body element extends from the resection ring toward the distal end of the stem element. The periphery of the body element is spaced from the external periphery of the stem element so that the body element may be removed without disturbing the fixation.
- According to yet another aspect of the present invention an orthopaedic implant stem for use in performing joint arthroplasty is provided. A portion of the orthopaedic implant stem is to be fitted to a cavity in the canal of a long bone. The orthopaedic implant stem includes a distal element defining an external periphery of the distal element. The distal element defines a distal end of the element for insertion into the cavity and an opposed connection end. The distal element defines a recess therein extending from the opposed connection end of the distal element. The orthopaedic implant stem component also includes a proximal element fixedly connectable to the distal element. A distal portion of the proximal element extends generally from the connection end of the distal element toward the distal end of the distal element when the proximal element is fixedly connected to the stem. The distal portion of the proximal element is spaced inwardly from the external periphery of the distal element when the proximal element is fixedly connected to the stem component so that the proximal element may be removed from the long bone without disturbing the fixation of the distal element to the long bone.
- According to another aspect of the present invention a method for treating orthopaedic joint disease of a patient is provided. The method includes the steps of resecting a long bone along a resection plane and preparing a cavity in the canal of the long bone. The method includes the step of implanting an orthopaedic implant into a cavity in the canal of a long bone. The orthopaedic implant includes a joint component having a stem element and a first body element fixedly connectable to the stem element. The orthopaedic implant is secured in the canal of the long bone with the body element being spaced from the long bone. The method further includes the steps of monitoring the condition of the patient, determining that the patient needs a revision prosthesis, providing a second body element compatible with the stem element, and removing the first body element from the stem element of the orthopaedic implant in vivo in the patient without disturbing the fixation of bone surrounding the stem element of the orthopaedic implant and without damaging bone surrounding the first body element. The method also includes the step of implanting the second body element into the stem element in vivo in the patient.
- According to yet another aspect of the present invention an orthopaedic implant for use in performing joint arthroplasty is provided. A portion of the orthopaedic implant is capable of being fitted to a cavity in the canal of a long bone. The cavity extends from a resected plane of the long bone. The orthopaedic implant includes a joint component. The joint component includes a stem element defining an external periphery of the stem element. The stem element has a first end for insertion into the cavity. The external periphery of the stem element has a stem resection ring. The stem resection ring may be aligned with the resected plane of the long bone. The joint component also includes a body element, which is capable of being fixedly fitted to the stem element. The body element includes an external periphery. The external periphery of the body element has a body resection ring. The body resection ring may be aligned with the resected plane of the long bone. A canal portion of the body element extends generally from the resection ring of the external periphery of the body element toward the first end of the stem element when the body element is fixedly connected to the stem element. The external periphery of the canal portion of the body element is spaced inwardly from the external periphery of the stem element when the body element is fixedly connected to the stem so that the body element may be removed from the long bone without disturbing the fixation of the stem element to the long bone.
- According to a further aspect of the present invention an orthopaedic implant stem for use in performing joint arthroplasty is provided. A portion of the orthopaedic implant stem may be fitted to a cavity in the canal of a long bone. The orthopaedic implant stem includes a canal element having an external periphery. The canal element has a first end for insertion into the cavity and an opposed connection end. The canal element has a recess extending from the opposed connection end of the canal element. The recess has a internal periphery. The canal element also has an external periphery spaced outwardly from the internal periphery of the recess. The orthopaedic implant stem further includes a body element that may be fixedly connected to the canal element. A first portion of the body element may be inserted into the recess of the canal element when the first element is fixedly connected to the canal element. The first portion of the body element is spaced inwardly from the external periphery of the canal element when the body element is fixedly connected to the canal element so that the body element may be removed from the long bone without disturbing the fixation of the canal element to the long bone.
- According to a another aspect of the present invention a method for treating orthopaedic joint disease of a patient is provided. The method includes the steps of resecting a long bone along a resection plane and preparing a cavity in the canal of the long bone. The method also includes the step of implanting an orthopaedic implant into a cavity in the canal of the long bone. The orthopaedic implant includes a joint component having a canal element and a first body element. The first body element may be fixedly connected to the canal element. The orthopaedic implant is secured in the canal of the long bone with the first body element being spaced from the long bone. The method further includes the steps of monitoring the condition of the patient and determining that the patient needs a revision prosthesis. The method also includes the steps of providing a second body element connectable to the canal element and removing the first body element from the canal element of the orthopaedic implant in vivo without disturbing the fixation of bone surrounding the canal element of the orthopaedic implant and without damaging bone surrounding the first body element. The method further includes the step of implanting the second body element into the canal element in vivo.
- The technical advantages of the present invention include the ability to independently adjust the head-height and the head offset without disturbing the fixation of the stem in the bone. For example, according to one aspect of the present invention a hip stem is provided including a stem component including a distal stem portion and a proximal body portion and a neck component. The neck component is fixably connected to the stem component. The neck component includes a proximal neck portion and a distal body portion. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. Thus, the present invention provides for the ability to independently adjust the head-height and the head offset without disturbing the fixation in the stem of the stem in the bone by merely changing the neck component by removing the neck component from the stem component while the stem component is in position in the bone.
- The technical advantages of the present invention further include the ability to enhance minimally invasive hip procedures by having smaller incisions for the stem and neck. For example, according to another aspect of the present invention, a hip stem is provided including a stem component having a distal stem component and a proximal body portion and a neck component. The neck component is fixably connectable to the stem component. The neck component includes a proximal neck portion and a distal body portion. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. The stem component may thus be first inserted into the incision, put in position and then the neck component may be secured to the stem component. Thus the present invention provides for the enhancing of minimally invasive hip procedures by having smaller incisions for the stem and body. By allowing the neck portion to be inserted separately from the stem body, the implants may be inserted through a smaller incision with reduced soft tissue stretching and allowing the surgeon more space to work within the joint space until later in the procedure when the neck portion is inserted. In other words, the stem may be positioned in the incision and through the soft tissue put in place in the canal of the long bone and, in fact, cemented into position and permitted to be fixably secured into the proper position. At that time, the neck portion may then be inserted through the incision and the procedure continued.
- The technical advantages of the present invention include the ability to permit common hip prostheses to be used for right and left hand versions of the hip prosthesis. For example, according to yet another aspect of the invention, a hip stem is provided with a stem component and a neck component. At least one of the stem component and the neck component are adapted to permit the stem component and neck component to have a first assembly relationship as well as a second assembly relationship which is different than the first assembly relationship. Thus the present invention provides for a hip stem assembly that permits both right and left hand versions with a common set of hip stem components.
- The technical advantages of the present invention further include the ability to correct surgical error or optimize the surgical variables such as leg length discrepancy. For example, according to yet another aspect of the present invention, a hip stem is provided including a hip stem component and a neck component. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. Thus, the present invention provides for the replacement of the neck from the stem with the replacement neck having a different neck length than the replaced neck while replacing the neck with the stem in place. Thus the present invention provides for the correction of surgical error or optimization of a surgical variable such as leg length discrepancy.
- The technical advantages of the present invention also include the ability to correct head height at revision surgery due to implant subsidence. For example, according to yet another aspect of the present invention, a hip stem is provided including a stem component and a neck component. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. Thus, the present invention provides for a replacement of the neck component with a replacement neck component with a different head-height than the initial neck component while having the stem component remain in place on the bone. Thus, the present invention provides for a correction of head height at revision surgery to adjust for implant subsidence.
- The technical advantages of the present invention include the ability to correct instability of the hip joint. Stability may be restored by moving the head proximally and/or increasing the offset to tighten the soft tissue. The corrections can also be made at revision surgery to address dislocations. For example, according to yet another aspect of the present invention, a hip stem is provided including a stem component as well as a plurality of neck components. One of the pluralities of neck components may have a first offset dimension and the second component have a greater offset dimension. Thus, the present invention provides for replacing the first neck component with a second neck component with greater offset while having the stem remain in place on the bone. Thus, the present invention provides for the correction of instability by moving the head proximally or increasing the offset to tighten the soft tissues.
- The technical advantages also include the ability to correct weak abductor function by increasing the offset of the hip stem, which increases the efficiency of the abductor muscles by increasing the moment arm of the abductor muscle action For example, according to yet another aspect of the present invention, a hip stem is provided including a stem component and a first neck component having a first offset and a second neck component having a greater offset than the first neck component. The neck component is adapted for removal from the femur without disturbing the fixation of the stem component to the bone. Thus, the present invention provides for replacing a first neck component with a second neck component of greater offset while the stem is in place in the bone. Thus, the present invention provides for correction of weak abductor function by increasing the offset of the hip stem.
- Other technical advantages of the present invention will be readily apparent to one skilled in the art from the following figures, descriptions and claims.
- For a more complete understanding of the present invention and the advantages thereof, reference is now made to the following description taken in connection with the accompanying drawings, in which:
-
FIG. 1 is a plan view of a modular hip stem in accordance with an embodiment of the present invention utilizing a tapered lock and screw; -
FIG. 1A is a partial plan view of an alternate embodiment of the present invention in the form of a modular hip stem with a tapered stem connection and a modular neck; -
FIG. 1B is a cross-sectional view ofFIG. 1 along theline 1B-1B in the direction of the arrows; -
FIG. 2 is a top view of the modular hip stem ofFIG. 1 ; -
FIG. 3 is a plan view of a modular hip stem in accordance with another embodiment of the present invention utilizing dowel pins and a screw; -
FIG. 3A is a partial plan view of an alternate embodiment of the present invention in the form of a modular hip stem with a pinned stem connection and a modular neck; -
FIG. 4 is a top view of the modular hip stem ofFIG. 3 ; -
FIG. 5 is a plan view of a kit for performing hip orthopaedic surgery in accordance with yet another embodiment of the present invention; -
FIG. 6 is a plan view of a second stem component of a modular hip stem for use with the kit ofFIG. 5 ; -
FIG. 7 is a plan view of a neck component of a modular hip stem for use with the kit ofFIG. 5 including a through opening for utilizing a screw and having different offsets than the neck components ofFIG. 5 ; -
FIG. 8 is a plan view of a modular hip stem in accordance with another embodiment of the present invention utilizing dowel pins to provide for different version with the same stem; -
FIG. 9 is a plan view of a modular hip stem in accordance with yet another embodiment of the present invention utilizing a rectangular tapered lock and a screw; -
FIG. 9A is a cross-sectional view ofFIG. 9 along theline 9A-9A in the direction of the arrows; -
FIG. 10 is a top view of the modular hip stem ofFIG. 9 ; -
FIG. 11 is an end view of the modular hip stem ofFIG. 9 ; -
FIG. 12 is a plan view of a modular hip stem in accordance with a further embodiment of the present invention utilizing a tapered lock; -
FIG. 13 is a plan view of a hip implant in accordance to another embodiment of the present invention including a modular hip stem similar to that ofFIG. 3 ; -
FIG. 14 is a top view of a modular hip stem with left handed proximal component with a neck extending posteriorly and a distal component; -
FIG. 15 is a top view of a modular hip stem with a right handed proximal component with a neck extending posteriorly, utilizing the distal component of the hip stem ofFIG. 14 ; -
FIG. 16 is a plan view of the modular hip stem ofFIGS. 14 and 15 ; -
FIG. 17 is a plan view of a modular stem in accordance with a further embodiment of the present invention in the form of a tibial tray assembly implanted in the tibia; -
FIG. 18 is a plan view of a further embodiment of the modular stem of the present invention in the form of a modular shoulder prosthesis implanted in the humerus and glenoid cavity; -
FIG. 19 is a plan view of a kit for performing joint arthoplasty including the modular stem of the present invention; -
FIG. 20 is a process flow diagram of a method of performing joint arthroplasty surgery in accordance with yet another embodiment of the present invention; -
FIG. 21 is a process flow diagram for a method of performing joint arthroplasty surgery according to a further embodiment of the present invention; -
FIG. 22 is a process flow diagram of a method of performing joint arthroplasty surgery in accordance with yet another embodiment of the present invention; -
FIG. 23 is a process flow diagram for a method of performing joint arthroplasty surgery according to a further embodiment of the present invention; -
FIG. 24 is a plan view of another kit for performing joint arthroplasty including the modular stem of the present invention; -
FIG. 25 is a plan view of a modular hip stem in accordance with a further embodiment of the present invention utilizing a location ring; -
FIG. 26 is a plan view of a body component of a modular hip stem in accordance with a further embodiment of the present invention utilizing a location ring; and -
FIG. 27 is a plan view of yet another kit for performing joint arthroplasty including the modular stem of the present invention. - Embodiments of the present invention and the advantages thereof are best understood by referring to the following descriptions and drawings, wherein like numerals are used for like and corresponding parts of the drawings.
- According to the present invention and referring now to
FIG. 1 , an embodiment of the present invention is shown aship stem 10.Hip stem 10 is utilized for performing hip arthroplasty. The hip stem 10 is designed to be fitted into acavity 2 in thecanal 4 of along bone 6, for example, the femur. The hip stem 10 includes astem component 12 including adistal stem portion 14 and aproximal body portion 16. The hip stem 10 further includes aneck component 18 which, is as shown inFIG. 1 , is fixedly connectable to thestem component 12. Theneck component 18 includes aproximal neck portion 20 and adistal body portion 22. Theneck component 18 is adapted for removal from thefemur 6 without disruption ofbone 8 around thestem component 12. - To provide for the removal of the neck component without disturbing the fixation of the
stem component 12 to thebone 8, thehip stem 10 of the present invention may be adapted to provide all the support for the hip stem and fixation of thehip stem 10 to thefemur 6 with thestem component 12. Thus, as shown inFIG. 1 , thestem component 12 is configured, preferably, to provide as much support as possible for thehip stem 10 to thefemur 6. For example, and as shown inFIG. 1 , aportion 24 of theproximal body portion 16 of thestem component 12 extends over a portion of thedistal body portion 22 of theneck component 18. - While the
portion 24 of the proximal body portion of thestem component 12 may be positioned anywhere around thefemur 6 to provide additional support for thestem component 12, it should be appreciated, and referring toFIG. 1 , theportion 24 may extend substantially around the periphery of thefemur 6. - For example, and as shown in
FIG. 1 , thestem component 12 may include asleeve portion 26 extending proximally from theproximal body portion 16 of thestem component 12. Thesleeve portion 26 may extend laterally, medially, anteriorly, or posteriorly or a combination thereof. For example, and as shown inFIG. 1 , thesleeve portion 26 extends substantially aroundperiphery 28 of thedistal body portion 22 of theneck component 18. - As shown in
FIG. 1 , thedistal body portion 22 of theneck component 18 may receive thestem component 12. To accommodate theneck component 18, theproximal body portion 16 of thestem component 12 may define apocket 32 in theproximal body portion 16 for receiving theneck component 18. - As shown in
FIG. 1 , thehip stem 10 may be configured to assist in the removal of theneck component 18 from thefemur 6 without disturbing the fixation of the stem component to thebone 8, theneck component 18 may be spaced from the femur. By spacing theneck component 18 from the femur, theneck component 18 may be removed without disturbing the fixation of thestem component 12 to the bone. - As shown in
FIG. 1 , thedistal body portion 22 of theneck component 18 is removably secured to theproximal body portion 16 of thestem component 12. Thedistal body portion 22 and theproximal body portion 16 may be removably secured to each other in any reasonable manner. - For example, and as shown in
FIG. 1 , theproximal body portion 16 of thestem component 12 includes aperiphery 34 of theproximal body portion 16. Aportion 36 of theperiphery 34 is generally planer. Similarly, thedistal body portion 22 of theneck component 18 defines aperiphery 38 of the distal body portion. Aportion 40 of theperiphery 38 is generally planer. Theneck planer portion 40 and thebody planer portion 36 are in contact with each other. The contact of theneck planer portion 40 and thebody planer portion 36 provide for a stable support of theneck component 18 onto thestem component 12. - For simplicity and as shown in
FIG. 1 , thestem component 12 defines alongitudinal axis 42 of thestem component 12. For simplicity and to provide for strength and rigidity, theneck planer portion 40 and thebody planer portion 36 are generally normal or perpendicular to thelongitudinal axis 42. - As shown in
FIG. 1 , thehip stem 10 may include a connector in the form of, for example a fastener, for example ascrew 44 to connect theneck component 18 to thestem component 12. As shown inFIG. 1 , theconnector 44 may be in the form of, for example, a screw. -
Neck component 18 may be connected to thestem component 12 in many different ways within the various embodiments of the present invention. For example and as shown inFIG. 1 , thedistal body portion 22 of theneck component 18 may include aprotrusion 46 extending downwardly from theneck planer portion 40.Protrusion 46 may have any suitable shape, and may as shown inFIG. 1 have a generally circular cross-section and be tapered defining an included angle α.Stem component 12 may, in order to receive theprotrusion 46 of theneck component 18, define anaperture 48 formed in theproximal body portion 16 of thestem component 12.Aperture 48 may have a contour matching that of theprotrusion 46 for receiving the protrusion therein. It should be appreciated that the angle α may be sufficiently small to provide for a soft self-locking feature between theprotrusion 46 and theaperture 48. - For a self-locking taper the angle α should be defined by the formula;
- Referring now to
FIG. 1 -B, theprotrusion 46 and theaperture 48 are shown in cross-section. As shown inFIG. 1 -B, theprotrusion 46 has a circular cross-section defined by protrusion diameter PD. - As shown in
FIG. 1 , theconnector 44 may be in the form of a screw. Thescrew 44 may be any suitable screw and may, as shown inFIG. 1 , have a flat head and be in the form of a socket-headed cap screw.Connector 44 may be received by theneck component 18 by aconnector opening 50 formed in theneck component 18 and positioned aboutlongitudinal axis 42. Theconnector 44 may be received into thestem component 12 throughstem component aperture 52. Thestem component aperture 52 may includeinternal threads 54 that mate withexternal threads 56 formed on the connector orscrew 44. - The hip stem 10 including the
stem component 12, theneck component 18 as well as thescrew 44 may be made of any suitable durable material. For example, thestem component 12, theneck component 18 and theconnector 44 may be made of, for example, a metal, a plastic or a composite. The materials from which the components of thehip stem 10 are manufactured preferably are materials that are compatible with the human body. For example, if thestem component 12,neck component 18, or the connector or screw 44 are made of a metal, the components may be made of, for example, a cobalt chromium alloy, a stainless steel alloy, or a titanium alloy. - The
stem component 12 may have any suitable shape capable of insertion into thecanal 4 of thefemur 6. For example, thestem component 12 may include astem periphery 58 having a shape similar to that of the broach or rasp used to form thecavity 2 in thecanal 4 of the long bone orfemur 6. Theproximal body portion 16 of thestem component 12 may, as shown inFIG. 1 , have a larger cross-section than that of thedistal stem portion 14 to conform with the corresponding shape of thenatural femur 6. - The
neck component 18 of thehip stem 10 may have any suitable shape capable of mating with thestem component 12 and capable of providing support for the ball orhead 60 which may be placed onexternal taper 62 formed onneck 64 of theneck component 18. It should be appreciated that thehip stem 10 may be integral with theneck component 18. - As shown in
FIG. 1 , hip stem or orthopaedic implant stem 10 is used for performing joint arthroplasty. A portion of the orthopaedic implant stem 10 may be fitted tocavity 2 in thecanal 4 oflong bone 6. The orthopaedic implant stem 10 includes a stem component orcanal element 12 havingexternal stem periphery 58. Thecanal element 12 has afirst end 15 for insertion into the cavity and anopposed connection end 17. Thecanal element 12 has pocket orrecess 32 extending from opposed connection end 17 of thecanal element 12. Therecess 32 has aninternal periphery 23. Thecanal element 12 also hasexternal periphery 58 spaced outwardly from theinternal periphery 23 of therecess 32. The orthopaedic implant stem 10 further includes neck component orbody element 18 that may be fixedly connected to thecanal element 12. Distal body portion or firstdistal body portion 22 of theneck component 18 may be inserted into therecess 32 of thecanal element 12 when theneck component 18 is fixedly connected to thecanal element 12.External periphery 78 of thefirst portion 22 of theneck component 18 is spaced inwardly from theexternal periphery 58 of thecanal element 12 when theneck component 18 is fixedly connected to thecanal element 12 so that theneck component 18 may be removed from thelong bone 6 without disturbing the fixation of thecanal element 12 to thelong bone 6. - As shown in
FIG. 1 , thedistal body portion 22 of theneck component 18 may have any suitable shape and typically has a shape compatible for placement within the recess orpocket 32 formed in theproximal body portion 16 of thestem component 12. For example, thedistal body portion 22 may, as shown inFIG. 2 , have a generally rectangular shape defined by neck body width NBW and neck body length NBL. - Referring now to
FIG. 1A , another embodiment of the present invention is shown as hip stem 10A. The hip stem 10A is similar to thehip stem 10 ofFIG. 1 , except that theneck component 18A is of a modular construction or is made from more than one piece. For example, as shown inFIG. 1A , theneck component 18A includes adistal body component 22A and aproximal neck component 20A. Theproximal neck component 20A may be secured to thedistal body component 22A in any suitable fashion. - As shown in
FIG. 1A , theproximal neck component 20A includes anexternal taper 21A that mates with acavity 23A formed in thedistal body component 22A. It should be appreciated that the components forming theneck component 18A may be threadably attached, press-fit attached or have a bayonet lock or any type of connector. The hip stem 10A further includes astem component 12A which is similar to thestem component 12 and includes adistal stem portion 14A and aproximal body portion 16A. - Hip stem 10 of the present invention, as shown in
FIG. 1 andFIG. 2 , may be utilized for both cemented and cementless hip arthroplasty. For example, thehip stem 10 may be used with a femur having a cavity prepared for cement with the cement being positioned between thefemur 6 and thehip stem 10. Thecavity 2 of thefemur 6 may alternatively be prepared such that thestem periphery 58 may directly connect with the periphery of thecavity 2. It should be appreciated that whether thehip stem 10 uses cemented or cementless construction, theneck component 18 may be removed from thestem component 12 without disruption of the bone implant ingrowth. - According to the present invention and referring now to
FIGS. 3 and 4 , yet another embodiment of the present invention is shown aship stem 110.Hip stem 110 is similar to thehip stem 10 ofFIGS. 1 and 2 and may, in fact, be made of similar materials with generally similar shapes. Thehip stem 110, however, is different from thehip stem 10 ofFIGS. 1 and 2 . - For example and as shown in
FIGS. 3 and 4 , thehip stem 110 includes astem component 112 somewhat similar to thehip stem component 12 ofFIGS. 1 and 2 . The hip stem 110 further includes aneck component 118 somewhat similar to theneck component 18 ofFIGS. 1 and 2 . The hip stem 110 further includes aconnector 144 which is different thanconnector 44 of thehip stem 10 ofFIGS. 1 and 2 . - For example, as shown in
FIGS. 3 and 4 , theconnector 144 includes ascrew 164 similar to thescrew 44 of thehip stem 10 ofFIGS. 1 and 2 . In addition to thescrew 64, theconnector 144 further includes a pin, for example,first pin 166. Thehip stem 110, it should be appreciated, may be manufactured with asolitary pin 166 but may, as shown inFIGS. 3 and 4 , further include asecond pin 168. Thepins screw 164 serve to form theconnector 144. Theconnector 144 is used to connect theneck component 118 to thestem component 112. - The
first pin 166 and thesecond pin 168 may, for simplicity as shown inFIGS. 3 and 4 , be substantially the same. For example, thepins first pin 166 and thesecond pin 168 may be defined by a pin diameter PD and a pin length PIL. Thefirst pin 166 and thesecond pin 168 may be made of any suitable durable material and may, for example, be made of a metal. If made of a metal, thefirst pin 166 and thesecond pin 168 may, for example, be made of a material compatible with a human body. For example, a cobalt chromium alloy, a stainless steel alloy, or a titanium alloy. - The
stem component 112 may, as is shown inFIGS. 3 and 4 , have adistal stem portion 114 and aproximal body portion 116.Internal threads 156 may be formed onproximal body portion 116 to mate withexternal threads 148 formed on thescrew 164. Theproximal body portion 116 of thestem component 112 may define a first pin stem opening 170 for receiving thefirst pin 166 as well as a second pin stem opening 172 for receiving thesecond pin 168. Thepins openings proximal body portion 116 may further include asleeve portion 126 which forms apocket 132 for receiving theneck component 118. Theneck component 118 may include ascrew opening 150 for receiving thescrew 164. Theneck component 118 may further define a first pin neck opening 174 for receiving a portion of thefirst pin 166 as well as a second pin neck opening 176 for receiving thesecond pin 168. - It should be appreciated that to minimize the number of loose parts the
first pin 166 and thesecond pin 168 may be fixably secured to one of theneck component 118 or thestem component 112. It should be appreciated that thefirst pin 166 and thesecond pin 168 would then be slidably secured to the other of thestem component 112 and theneck component 118. - The
neck component 118 includes adistal body portion 122 as well as aproximal neck portion 120. Theproximal neck portion 120 may define anexternal taper 162 which matingly receives a ball orhead 160. - Referring now to
FIG. 3A , yet another embodiment of the present invention is shown as hip stem 110A. The hip stem 110A is similar to thehip stem 110 ofFIGS. 3 and 4 , except that theneck component 118A is different than theneck component 118 of thehip stem 110 ofFIGS. 3 and 4 in that theneck component 118A is modular or made of more than one component. For example, as shown inFIG. 3A , theneck component 118A includes adistal body component 122A which is connectable to aproximal neck component 120A. It should be appreciated that thedistal body component 122A and theproximal neck component 120A may be connected to each other in any suitable fashion, for example they may be threadably connected, have a bayonet connection, have a press-fit connection or, as is shown inFIG. 3A , have a tapered connection. For example, thedistal body component 122A may include atapered cavity 123A for receiving atapered protrusion 121A extending from theproximal neck component 120A. Hip stem 110A further includes astem component 112A which together with theneck assembly 118A forms thehip stem 110A. - Referring now to
FIGS. 5, 6 and 7, yet another embodiment of the present invention is shown asKit 200. TheKit 200 is for use in performing a primary or a revision arthroplasty. TheKit 200 includes afirst stem component 212, afirst neck component 218, and asecond neck component 318. - The
first stem component 212 includes adistal stem portion 214 and aproximal body portion 216. Thefirst stem component 212 may have any suitable shape and may have a shape somewhat similar to thestem component 12 ofFIG. 1 . As shown inFIG. 5 , thefirst stem component 212 may include apocket 232 formed bysleeve 226 of thestem 212. Thepocket 232 is adapted for receiving thefirst neck component 218 or, alternatively, thesecond neck component 318. - As shown in
FIG. 5 , to secure theneck components first stem component 212, thestem component 212 may include an aperture 252 extending inwardly fromplaner face 236 of thepocket 232. Internal threads 254 may be formed in aperture 252. The internal threads 254 may cooperate withexternal threads 256 formed onscrew 244. - The
first neck component 218 may be similar to theneck component 18 of thehip stem 10 ofFIGS. 1 and 2 . Thefirst neck component 218, however, does not include a protrusion such as theprotrusion 46 of theneck component 18 ofFIGS. 1 and 2 .First neck component 218 includes adistal body portion 222 and aproximal neck portion 220 extending from thedistal body portion 222. - The
distal body portion 222 defines aplaner face 240 for cooperation with theplaner face 236 of thefirst stem component 212. Thedistal body portion 222 further defines aperiphery 278 which mates withsleeve 226 of thefirst stem component 212. Thedistal body portion 222 further defines anopening 250 for receiving thescrew 244. Theproximal neck portion 220 defines aneck 264 from which extends anexternal taper 262. A head 260, as shown in phantom, may be fitted onto theexternal taper 262. - The
first neck component 218 defines a height H1, a neck length NL1 and a neck angle α NA1. The combination of neck height, length, and angle assist in positioning the head 260 with respect to thestem 212. Unique patient anatomies require that the head 260 be put in the proper position. By utilizing thekit 200 of the present invention, various neck components can be utilized to provide for variations in the position of the head. - For example, and as shown in
FIG. 5 , thekit 200 further includes asecond neck component 318. Thesecond neck component 318 includes different dimensions than thefirst neck component 218 so that the head may be positioned in a different location than that obtained if thefirst neck component 218 is used. - For example, and as shown in
FIG. 5 , thesecond neck component 318 includes adistal body portion 322 and aproximal neck portion 320.Distal body portion 322 includes aplaner face 340 for cooperation with theplaner face 236 of thestem 212. Thedistal body portion 322 further defines aperiphery 378 for mating withsleeve 226 of thestem 214. Thedistal body portion 322 defines anopening 350 receiving thescrew 244. - The
proximal neck portion 320 defines aneck 364 which is connected to thedistal body portion 322. Anexternal taper 362 extends from theneck 364. As shown inFIG. 5 , the periphery 366 of thedistal body portion 322 and theplaner face 340, as well as theopening 350 of thesecond neck component 318 have configurations compatible with theplaner face 340, theopening 350, and the periphery 266 of thedistal body portion 322 of thefirst neck component 218 in order that thefirst neck component 218 and thesecond neck component 318 may be selectively used with thefirst stem component 212. - As shown in
FIG. 5 , thesecond neck component 318 may include a height H2 which is different than the height H1 of thefirst neck component 218. Similarly, theproximal neck portion 320 of thesecond neck component 318 may define a neck length NL2 which is different than neck length NL1 of theproximal neck portion 220 of thefirst neck component 218. Further, the proximal neck portion of thesecond neck component 318 may define a neck angle α NA2 which is different than the neck angle α NA1 of theproximal neck portion 220 of thefirst neck component 218. It should be appreciated that different neck components may be accomplished where only one of the neck height, neck length, and neck angle are different from each other. - Referring again to
FIG. 5 and according to the present invention akit 201 for use in performing revision surgery on thecavity 2 in thecanal 4 of thelong bone 6 is shown. Thecavity 2 extends from a resectedplane 11 of thelong bone 6. Thekit 20 includes first stem component orcanal component 212 having anexternal periphery 221. A portion of thecanal component 212 may be fitted to thecavity 2 in thecanal 4 of thelong bone 6. Thecanal component 212 includes distal stem portion orcanal portion 214 having afirst end 215 for insertion into the cavity and an opposedsecond end 217. Thecanal component 212 further includes asleeve portion 226 extending from thesecond end 217 of thecanal portion 212. Thesleeve portion 226 has an internal periphery 219 defining pocket orinternal cavity 232. Thesleeve portion 226 also has anexternal periphery 227. Thekit 201 also includes first neck component or firstjoint component 218 removably connectable to thecanal component 212. The firstjoint component 218 has a proximal neck portion orbody portion 220 and a distal body portion orconnection portion 222. Theconnection portion 222 of the firstjoint component 218 has anexternal periphery 278. A portion of theexternal periphery 278 of theconnection portion 222 of the firstjoint component 218 may be fitted into theinternal cavity 232 of thesleeve portion 226 of thecanal component 212. - The
kit 201 also includes a second neck component or a secondjoint component 318 that is removably connectable to thecanal component 212. The secondjoint component 318 has a proximal neck portion orbody portion 320 and distal body portion orconnection portion 322. Theconnection portion 322 of the secondjoint component 318 has anexternal periphery 378. A portion of theexternal periphery 378 of theconnection portion 322 of the secondjoint component 318 is fitted into theinternal cavity 232 of thesleeve portion 226 of thecanal component 212 so that theexternal periphery 378 of theconnection portion 322 of the firstjoint component 218 is spaced inwardly from theexternal periphery 227 of thesleeve portion 226 of thecanal component 212 when the firstjoint component 218 is fixedly connected to thecanal component 212 so that the firstjoint component 218 may be removed from thelong bone 6 and replaced with the secondjoint component 318 without disturbing the fixation of thecanal component 212 to thelong bone 6. - The
kit 201 may, as shown inFIG. 5 , be configured such that thecanal component 212, the firstjoint component 218, and/or the secondjoint component 318 define resection rings 231, 233 and 333, respectively, on a surface of the component. The resection rings 231, 233 and 333 may be used to align the component axially with theresection plane 11. - The
first resection ring 231 as shown inFIG. 5 may be visually distinguishable from the exterior periphery orsurface 227 of thecanal component 212 adjacent to thering 231. It should be appreciated that any or all of the resection rings 231, 233 and 333 may be invisible. - The
kit 201, may as shown inFIG. 5 , be configured such that a portion of thecanal component 212 is extendable over a portion of at least one of the firstjoint component 218 or the secondjoint component 318. - The
kit 201 may, as shown inFIG. 5 , be configured such that the firstjoint component 218 and the secondjoint component 318 have at least one dimension that is different from each other. - The
kit 201 may, as shown inFIG. 5 , be configured such that aportion 236 of theexternal periphery 227 of thecanal component 212 is generally planar. Further aportion 240 of theexternal periphery 278 of theconnection portion 222 of the firstjoint component 218 may, as shown, be generally planar. Theportion 236 of theexternal periphery 227 of thecanal component 212 and theportion 240 of theexternal periphery 278 of theconnection portion 222 of the firstjoint component 218 may, as shown, contact each other. - The
kit 201 may, as shown inFIG. 5 , also include aconnector 244 to connect thejoint component 218 to thecanal component 212. For example, theconnector 244 may be in the form of a screw or as shown inFIG. 13 as a pin. - The
kit 201 may alternately (seeFIG. 1 ) be constructed such that the firstjoint component 218 may include a protrusion. To cooperate with the protrusion, thecanal component 212 may define an aperture for receiving the protrusion. The protrusion and the aperture may have any suitable shape and may, for example, be cylindrical or tapered. - It should be appreciated that the
canal component 212 may alternately include a protrusion (not shown). The firstjoint component 218 may then include an aperture for receiving the protrusion. - The
kit 201 may (seeFIG. 16 ) further include a prosthetic component adapted for implantation to a second bone. The prosthetic component may cooperate with the firstjoint component 218. Further at least a portion of thebody portion 220 of the firstjoint component 218 may include an articulation surface for articulation with the prosthetic component. - The
kit 201 may also include a prosthetic component for fixed implantation to a second bone and for cooperation with the first joint component. Thekit 201 may also include a bearing component positionable between the first joint component and the prosthetic component. The bearing component may articulate with the first joint component and/or the prosthetic component. - As shown in
FIG. 5 , the firstjoint component 218 may be in the form of, for example, a hip neck. Thecanal component 212 may correspondingly be in the form of a hip stem. Further the kit may include hip head 260 for attachment to thehip neck 218 and an acetabular cup (seeFIG. 16 ) for articulating cooperation with the hip head 260. - Referring again to
FIG. 5 , thecanal component 212 may define alongitudinal axis 235 and the internal periphery 219 and theexternal periphery 227 of the sleeve portion of the canal component may also define a wall thickness WT2 therebetween. The wall thickness WT2 may, as shown, be generally uniform in a plane normal to thelongitudinal axis 235 of thecanal component 212. Theexternal periphery 278 of theconnection portion 222 of the firstjoint component 218 may be adapted to closely conform to the internal periphery 219 of thesleeve portion 226 of thecanal component 212. - The
canal component 212 may (seeFIG. 18 ) be in the form of a humeral stem and the firstjoint component 218 may be in the form of a humeral neck. Thekit 201 may also include a humeral head for connection with the humeral neck. - Referring now to
FIG. 5 the kit may also includeconnector 244 to connect at the firstjoint component 218 or the secondjoint component 318 to thecanal component 212. The connector may be in the form of a screw or a pin (SeeFIG. 16 ). - As shown in
FIG. 6 , thekit 200 may further include asecond stem component 312. Thesecond stem component 312 may be different than thefirst stem component 212 and may include adistal stem portion 314 that is longer, has a different angle, is narrower, or is larger or smaller in diameter than thedistal stem portion 214 of thefirst stem component 212. - As shown in
FIG. 6 , thesecond component 312 may define apocket 332 which has generally the same size and shape as thepocket 232 of thefirst stem component 212 such that either thefirst neck component 218 orsecond neck component 318 may be compatible with thesecond stem component 312 as well as with thefirst stem component 212. For example, thepocket 332 may be defined by thesleeve 326 extending fromplaner surface 336. Thesecond stem component 312 may include aproximal body portion 316 that defines anaperture 352 defininginternal threads 356 which mate withexternal threads 256 of thescrew 244. - Referring now to
FIG. 7 , theKit 200 may further include athird neck component 418. Thethird neck component 418 includes adistal body portion 422 and aproximal body portion 420. Thedistal body portion 422 of thethird neck component 418 may defineplaner surface 440 andperiphery 478. Thesurface 440 andperiphery 478 which as shown inFIG. 7 are selected such that thethird neck component 418 may be compatible and fit in thepocket 232 of thefirst stem 212. - The
distal body portion 422 defines anopening 450 for receiving thescrew 244. Theproximal neck portion 420 defines aneck 464 extending from thedistal body portion 422 and anexternal taper 462 that extends from theneck 464 and that is adapted for cooperation with a ball or head, forexample head 460. It should be appreciated that theexternal taper 462, ofthird neck component 418 theexternal taper 362 of thesecond neck component 318, as well as theexternal taper 262 of thefirst neck component 218 may have similar sizes and shapes, such that the same head or similar heads may be accommodated by all of the associated tapers of the associated neck components. - As shown in
FIG. 7 thethird neck component 418 defines a neck length NL3, a neck angle α NA3, and a neck height H3. It should be appreciated that at least one of the neck height H3, the neck length NL3 or the neck angle α NA3 may be different than the corresponding dimension for thefirst neck component 218 or thesecond neck component 318. - Referring now to
FIG. 8 , yet another embodiment of the present invention is shown aship stem 510. Thehip stem 510 is different than thehip stem 110 ofFIGS. 1 and 2 in that thehip stem 510 provides for two assembly positions. For example, as shown inFIG. 8 , hip stem 510 may include ananterior assembly position 580 as is shown in solid and aposterior assembly position 582 as is shown in phantom. - It should be appreciated that as is shown in
FIG. 8 , thehip stem 510 may be a right hip stem. It should be appreciated that for a left hip stem, the anterior assembly position and the posterior assembly position would be reversed. - According to the present invention, and as shown in
FIG. 8 , thehip stem 510 includes astem component 512 as well as aneck component 518. Thestem component 512 may be similar to thestem component 12 ofFIGS. 1 and 2 , except that thestem component 512 includes a plurality of mounting positions for mounting theneck component 518 onto thestem component 512 in a plurality of positions. For example, as shown inFIG. 8 , thestem component 518 includes a first stem opening 570 for cooperating withfirst pin 566. - The
stem component 512 further includes a second pin stemanterior opening 571 for receiving thesecond pin 568. When thesecond pin 568 is positioned in the second pin stemanterior opening 571, theneck component 518 is positioned with respect to thestem component 512 such that thehip stem 510 is in theposterior assembly position 582 as shown in phantom. - The
stem component 512 further includes a second pin stemposterior opening 572. The second pin stemposterior opening 572 is adapted for likewise receiving thesecond pin 568. When thesecond pin 568 is positioned in the second pin stemposterior opening 572, theneck component 518 is aligned with thestem component 512 such that thehip stem 510 is assembled into theanterior assembly position 580 is shown in solid. -
Proximal body portion 516 of thestem component 512 includes asleeve portion 526 for cooperation with bone and or cement. - The
neck component 518 includes adistal body portion 522 defining aperiphery 578 thereof. Theperiphery 578 of thedistal body portion 522 is fitted within cavity orpocket 532 formed in thestem component 512 by thesleeve portion 526. Thedistal body portion 522 of theneck component 518 includes a first pin neck opening 574 as well as a secondpin neck opening 576. The firstpin neck opening 574 cooperates with thefirst pin 566 while the secondpin neck opening 576 cooperates with thesecond pin 568. - A
neck 564 extends from thedistal body portion 522 of theneck component 518. Anexterior taper 562 extends from theneck 564 and serves to receivehead 560. Theneck 564 andexterior taper 562 form theproximal neck portion 520 of theneck component 518. As can be seen by simply rotating thecomponent 518 after removing thesecond pin 568 from thestem component 512, theneck component 518 may be rotated aboutfirst pin 566 in the direction ofarrows 584 to eitheranterior assembly position 580 orposterior assembly position 582. - Referring now to
FIGS. 9 and 10 , yet another embodiment of the present invention is shown aship stem 610. The hip stem 610 ofFIGS. 9, 10 and 11 is different than thehip stem 10 ofFIGS. 1 and 2 in that thehip stem 610 includes anexternal protrusion 646, which is different than theexternal protrusion 46 of thehip stem 10 in that theexternal protrusion 646 is rectangular rather than circular in cross-section. For example, and as shown inFIG. 9 , thehip stem 610 includes astem component 612 as well as aneck component 618. - The
stem component 612 includes adistal stem portion 614 for cooperation with thecavity 2 formed in thecanal 4 of thefemur 6. The stem component further includes aproximal body portion 616 which defines apocket 632 for receiving theneck component 618. Anopening 652 formed in thepocket 632 includesinternal threads 656 for cooperation withexternal threads 648 formed on thescrew 644. Theproximal body portion 616 ofstem component 612 includes anaperture 648 formed therein for receiving theexternal protrusions 646 extending fromneck component 618. - Referring now to
FIG. 9 -A, theexternal protrusion 646 and theaperture 648 are shown in cross-section. Theaperture 648 and theexternal protrusion 646 are defined by a protrusion width PW and a protrusion length PL which defines a generally rectangular cross-section of theexternal protrusion 646, and correspondingly theaperture 648. - Referring again to
FIG. 9 , theexternal protrusion 646 further defines a protrusion height PH extending alonglongitudinal axis 642 of thehip stem 610. - Referring to
FIGS. 10 and 11 , theneck component 618 includes adistal body portion 622 and aproximal neck portion 620 extending from thedistal body portion 622.Stem component 612 includes asleeve portion 624 which defines apocket 632 for receivingperiphery 678 of thedistal body portion 622 of theneck component 618. Theneck component 618 includes thedistal body portion 622 and theproximal neck portion 620. Theproximal neck portion 620 includes aneck 664 and anexternal taper 662 extending from theneck 664. Ahead 660 may mate withexternal taper 662. - The
external protrusion 646 may, as shown inFIGS. 10 and 11 , be tapered and define first included angle αSQ1 and second included angle αSQ2 - Referring now to
FIG. 12 , another embodiment of the present invention is shown aship stem 710. Thehip stem 710 is different than thehip stem 10 ofFIGS. 1 and 2 in that thehip stem 710 relies solely on a self-locking tapered connection to combine the components of thehip stem 710. - For example, and as shown in
FIG. 12 , thehip stem 710 includes astem component 712 as well as aneck component 718. Thestem component 712 includes a distal stem portion 714 and aproximal body portion 716. Theproximal body portion 716 defines aplaner surface 736 from which acavity 748 extends. - The
neck component 718 includes adistal body portion 722 and aproximal neck portion 720 extending from thedistal body portion 722. Thedistal body portion 722 includes aprotrusion 746 extending fromplaner surface 740 of thedistal body portion 722. - The
protrusion 746 is tapered and defines an included angle β of, for example, two to twenty degrees (2°-20°) for a self locking taper, the angle β is defined by equation:
tan β/2<μ
Where: -
- μ=coefficient of friction
- β=included angle
- The
protrusion 746 cooperates with thecavity 748 to lock theneck component 718 to thestem component 712. - The
distal body portion 722 fits withinpockets 732 formed by thesleeve portion 726 of theproximal body portion 716 of thestem component 712. - The
proximal neck portion 720 includesneck 764 from whichexternal taper 762 extends. Thehead 760 is fitted ontoexternal taper 762. - According to the present invention and referring now to
FIG. 13 , yet another embodiment of the present invention is shown asprosthesis 800. Theprosthesis 800 as shown inFIG. 13 is in the form of a hip prosthesis. Theprosthesis 800 includes a hip stem 810. The hip stem 810 is similar to thehip stem 110 ofFIGS. 3 and 4 . The hip stem 810 includes astem component 812 as well as aneck component 818. - The
stem component 812 may be similar to thestem component 112 ofFIGS. 3 and 4 . Thestem component 812 includes adistal stem portion 814 adapted to fit withincavity 2 of thecanal 4 offemur 6. The stem component further includes aproximal body portion 816 extending from thedistal stem portion 814 of thestem component 812. Theproximal body portion 816 includes anaperture 852 extending inwardly frominner face 836 of theproximal body portion 816 of thestem component 812.Internal threads 854 are formed in theaperture 852. Theinternal threads 854 cooperate withexternal threads 848 formed onscrew 851. - The
neck component 818 is, as is shown inFIG. 13 , connected to thestem component 814 by any suitable connector, for example, byconnector 844. Theconnector 844, as is shown inFIG. 13 includes thescrew 851, as well as, afirst pin 866. Theconnector 844 may further include asecond pin 868 spaced from and parallel to thefirst pin 866. - The
neck component 818 includes adistal body portion 822 and aproximal neck portion 820 extending from thedistal body portion 822. Thedistal body portion 822 includes anaperture 850 for receiving thescrew 851. Thedistal body portion 822 further includes a first pin neck opening 874 for cooperating with thefirst pin 866 and a second pin neck opening 876 for cooperating with thesecond pin 868. Thedistal body portion 822 further defines aplanar face 840 for cooperation with aplanar face 836 of thestem component 812. - The
proximal body portion 816 of thestem component 812 includes a first pin stem opening 870 for cooperation with thefirst pin 866 and a second pin stem opening 872 for cooperation with thesecond pin 868. Theproximal body portion 816 of thestem component 812 includes asleeve portion 826 defining apocket 832 for receivingperiphery 878 of thedistal body portion 822 of theneck component 818. - The
proximal neck portion 820 of theneck component 818 includes aneck 864 as well asexternal taper 862 extending from theneck 864. - In addition to the hip stem 810, the
prosthesis 800 further includes ahead 860 which matingly fits onexternal taper 862 of theneck component 818. Theprosthesis 800 further includes anacetabular cup 886 for cooperation withacetabulum 9 of the patient. Theacetabular cup 886 may include a feature in the form of, for example, a porouscoated surface 888 for promoting boney in-growth between theacetabulum 9 and theacetabular cup 886. Theprosthesis 800 may include abearing 890 positioned between theacetabular cup 886 and thehead 860. It should be appreciated that theacetabular cup 886 may directly cooperate with thehead 860. - It should be appreciated that the hip stem 810,
head 860,acetabular cup 886, and bearing 890 may be made of any suitable durable material. The hip stem 810 including thedistal stem portion 814, theneck component 818, as well aspins screw 864, may all be made of a suitable durable material. The materials for the components of theprosthesis 800 may, for example, be made of a plastic, a metal, or a composite. The material for which the prosthesis is made preferably is compatible with the human anatomy. Theprosthesis 800, if made of a metal may for example be made of a cobalt chromium alloy, a stainless steel alloy, or a titanium alloy. - The bearing 890 of the
prosthesis 800 may for example, be made of a metal, a ceramic, or a plastic. Thehead 860 may be made of a metal, or a ceramic. - According to the present invention and referring now to
FIGS. 14-16 , yet another embodiment of the present invention is shown asprosthesis 800A. Theprosthesis 800A is shown inFIG. 14 in the form of a hip prosthesis. Theprosthesis 800A includes ahip stem 810A. The hip stem 810A is similar to the hip stem 810 ofFIG. 13 except the hip stem 810A provides for posterior version for hip stems for both the right leg and the left leg of the patient. The hip stem 810A includes astem component 812A as well as aright neck component 818A as shown inFIG. 14 and aleft neck component 819A as shown inFIG. 15 . - As shown in
FIG. 16 , thestem component 812A may be similar to thestem component 812 ofFIG. 13 . Thestem component 812A includes a distal stem portion 814A adapted to fit withincavity 2 of thecanal 4 offemur 6. Thestem component 812A further includes aproximal body portion 816A extending from the distal stem portion 814A of thestem component 812A. Theproximal body portion 816A includes an aperture 852A extending inwardly frominner face 836A of theproximal body portion 816A of thestem component 812A.Internal threads 854A are formed in the aperture 852A. Theinternal threads 854A cooperate with external threads 848A formed onscrew 851A. - The
right neck component 818A and theleft neck component 819A are thus alternatively connected to the stem component 182A. Thecomponents stem component 812A by any suitable connector. - The
right neck component 818A is shown connected to thestem component 812A inFIG. 16 . It should be appreciated that theleft neck component 819A is likewise, similarly connected to thestem component 812A. - The
right neck component 818A is, as is shown inFIG. 16 , connected to the stem component 814A by, for example,connector 844A. Theconnector 844A, as is shown inFIG. 16 includes thescrew 851A, as well as, afirst pin 866A. Theconnector 844A may further include asecond pin 868A spaced from and parallel to thefirst pin 866A. - The
right neck component 818A includes adistal body portion 822A and aproximal neck portion 820A extending from thedistal body portion 822A. Thedistal body portion 822A includes anaperture 850A for receiving thescrew 851A. Thedistal body portion 822A further includes a firstpin neck opening 874A for cooperating with thefirst pin 866A and a secondpin neck opening 876A for cooperating with thesecond pin 868A. Thedistal body portion 822A further defines aplanar face 840A for cooperation with aninner face 836A of thestem component 812A. - The
proximal body portion 816A of thestem component 812A includes a first pin stem opening 870A for cooperation with thefirst pin 866A and a second pin stem opening 872A for cooperation with thesecond pin 868A. Theproximal body portion 816A of thestem component 812A includes asleeve portion 826A defining apocket 832A for receivingperiphery 878A of thedistal body portion 822A of theright neck component 818A. - As shown in
FIG. 14 , theproximal neck portion 820A of theright neck component 818A includes aright neck 864A as well as a rightexternal taper 862A extending from theright neck 864A. Theright neck 864A extends posteriorly from thedistal body portion 822A of theright neck component 818A at an angle θθ of, for example, 10 to 40 degrees. The posterior extension is intended to mimic the geometry of the natural right femur. - As shown in
FIG. 15 , theproximal neck portion 821A of theleft neck component 819A includes aleft neck 865A as well as a leftexternal taper 863A extending from theleft neck 865A. Theleft neck 865A extends posteriorly from the distal body portion 823A of theleft neck component 819A at an angle θθθ of, for example, 10 to 40 degrees. While as shown inFIG. 15 theneck 865A extends downwardly, it should be appreciated that shape when placed in a left femur will extend posteriorly. The posterior extension is intended to mimic the geometry of the natural left femur. - It should be appreciated that both the
right neck component 818A ofFIG. 14 and theleft neck component 819A ofFIG. 15 may be used with theidentical stem component 812A. This may be accomplished by providing the leftexternal taper 863A of theleft neck component 819A with identical dimensions to that of the rightexternal taper 862A of theright neck component 818A. Thus both the rightexternal taper 862A and the leftexternal taper 863A may mate with the internal taper of thestem component 812A. - Referring again to
FIG. 16 , in addition to hip stem 810A, theprosthesis 800 further includes ahead 860A, which matingly fits onexternal taper neck components prosthesis 800A further includes anacetabular cup 886A for cooperation withacetabulum 9 of the patient. Theacetabular cup 886A may include a feature in the form of, for example, a porouscoated surface 888 for promoting boney in-growth between theacetabulum 9 and theacetabular cup 886A. Theprosthesis 800A may include a bearing 890A positioned between theacetabular cup 886A and thehead 860A. It should be appreciated that theacetabular cup 886A may directly cooperate with thehead 860A. - It should be appreciated that the hip stem 810A,
head 860A,acetabular cup 886A, and bearing 890A may be made of any suitable durable material. The hip stem 810A including the distal stem portion 814A, theneck components pins screw 864A, may all be made of a suitable durable material. The materials for the components of theprosthesis 800A may, for example, be made of a plastic, a metal, or a composite. The material for which the prosthesis is made preferably is compatible with the human anatomy. Theprosthesis 800A, if made of a metal may, for example, be made of a cobalt chromium alloy, a stainless steel alloy, or a titanium alloy. - The bearing 890A of the
prosthesis 800A may for example, be made of a metal, a ceramic, or a plastic. Thehead 860A may be made of a metal, or a ceramic. - According to the present invention and referring to
FIG. 17 another embodiment of the present invention is shown asprosthesis 900. Theprosthesis 900 as shown inFIG. 17 is for use in the knee joint. Theorthopedic prosthesis 900 as shown inFIG. 16 includes atibial component 910, abearing 990 and afemoral component 992. - The
tibial component 910 for theprosthesis 900 is for use withtibia 5. Thetibial component 910 includes ajoint component 918 and astem component 912. Thestem component 912 fits within theintramedullary canal 7 of thetibia 5. Thestem component 912 includes adistal stem portion 914 as well as aproximal body portion 916.Proximal body portion 916 of thestem component 912 defines apocket 932 formed fromsleeve portion 926 of theproximal body portion 916. Aconnector 944 is used to connect thestem component 912 to thejoint component 918. - The
joint component 918 includes anarticulation portion 920 and adistal body portion 922 extending from thearticulation portion 920. Thedistal body portion 922 of thejoint component 918 defines aprotrusion 946 which cooperates with thepocket 932 formed by thesleeve 926 of thestem component 912. - The
connector 944 connects thejoint component 918 to thestem component 912. Theconnector 944 may have any suitable shape and may, as shown inFIG. 17 , include ascrew 964 as well as afirst pin 966 and asecond pin 968. Thepins joint component 918 and with thestem component 912. Thescrew 964 includesexternal threads 948 which cooperate withinternal threads 954 formed on theproximal body portion 916 of thestem component 912. As shown inFIG. 17 , thearticulation portion 920 of thejoint component 918 extends transversely or perpendicular tolongitudinal axis 942 of thestem component 912 substantially past thestem component 912. - The
sleeve 926 may extend, as shown inFIG. 17 , up against the taper of thepocket 932. Thesleeve 926 may, as shown inFIG. 17 , extend out transversely from thelongitudinal axis 942 and define aplaner surface 936 of thestem component 912. Similarly, thejoint component 918 may include aplaner portion 940 extending transversely from thelongitudinal axis 942. Theplaner portions stem component 912. - As shown in
FIG. 17 , theorthopedic prosthesis 900 further includes afemoral component 992 connected tocavity 2 formed incanal 4 of thefemur 6. Thefemoral component 992 cooperates with thejoint component 918 of thestem 912. Thefemoral component 992 may cooperate directly with thetibial component 910. Theorthopedic prosthesis 900 may further include abearing 990 supported by the articulatingportion 920 of thejoint component 918. Thebearing 990 may, for example, be made of a pliable material, for example, a plastic. - The
femoral component 992 and thestem component 912 may be made of any suitable material, for example, a plastic, a composite, or a metal and if made of a metal, for example, cobalt chromium alloy, stainless steel alloy, or titanium alloy. - Referring now to
FIG. 18 , yet another embodiment of the present invention is shown asshoulder prosthesis 1000. Theshoulder prosthesis 1000 includes astem 1010 and a glenoid 1094. Thestem 1010 includes astem component 1012 for cooperation withhumerus 9. - The
stem component 1012 includes adistal stem portion 1014 and aproximal body portion 1016. Theproximal body portion 1016 includes asleeve 1026 defining apocket 1032 therein. Within the pocket 1032 astem planer face 1036 is formed. Extending distally from thestem planer face 1036 is a taperedaperture 1048. Extending distally from the taperedaperture 1048 is acylindrical aperture 1052 havinginternal threads 1056 formed thereon. - The
stem 1010 further includes aneck component 1018 having adistal body portion 1022 and aproximal neck portion 1020. Thedistal body portion 1022 defines anaperture 1050 therein. - The
distal body portion 1022 defines a distalbody planer face 1040 as well as aperiphery 1078. Theperiphery 1078 and theneck planer face 1040 cooperate withpocket 1032 to position theneck component 1018 with thestem component 1012. Theneck component 1018 further includes aprotrusion 1046 extending from theplaner face 1040. Theprotrusion 1046 matingly fits with theaperture 1048 to provide a taper-lock of theneck component 1018 to thestem component 1012. - While the
neck component 1018 may be securely fastened to thestem component 1012 by means of the protrusion in taper lock, it should be appreciated that theshoulder prosthesis 1000 may further include a connector in the form of ascrew 1044. Thescrew 1044 fits within theaperture 1050 of theneck component 1018 and includesexternal threads 1049 that cooperate with theinternal threads 1056 formed on thestem component 1012. - The
proximal neck portion 1020 includes anexternal taper 1062. Theexternal taper 1062 is adapted to receivehead 1060. Thehead 1060 cooperates with glenoid 1094 secured toglenoid facia 3 by pigs 1086.Stem 1010,head 1060, and glenoid 1094 may be made of any suitable durable material. Thestem 1010 including thestem component 1012 and theneck component 1018 as well as thescrew 1044 may be made, for example, of a plastic, a metal, or a composite. If made of a metal, theneck component 1018,stem component 1012, andscrew 1044 may be made of, for example, a cobalt chromium alloy, a stainless steel alloy, or a titanium alloy. The glenoid 1094 may be made of a metal or be made of, for example, a more pliable material, for example, a plastic. - Referring now to
FIG. 19 , yet another embodiment of the present invention is shown askit 1100. Thekit 1100 includes thetrial hip stem 1110 and theimplant hip stem 1210. Thetrial hip stem 1110 and theimplant hip stem 1210 preferably have similar, if not almost identical, shapes and dimensions. Thetrial 1110 is implanted into the body and used to perform a trial reduction or to verify the dimensions and selection of the hip stem components. The trial is removed after a trial reduction and the corresponding implant is permanently secured into the bone of the patient. The use of the trial verifies the selection of the implant and if the trial selection is believed to be sub-optimum, an alternate trial is used in the patient and if that alternate trial is found to be optimum, its corresponding implant is then implanted into the patient. -
Trial 1110 includes atrial stem component 1112 and atrial neck component 1118. Thetrial stem component 1112 includes adistal stem portion 1114 and aproximal body portion 1116. Theproximal body portion 1116 includes asleeve portion 1126 defining apocket 1132 and asurface 1136. Extending distally from thesurface 1136 is acavity 1148. - The
trial 1110 further includes thetrial neck component 1118. Thetrial neck component 1118 includes adistal body portion 1122 and aproximal neck portion 1120. Thedistal body portion 1122 includes aperiphery 1178 for fitting against asleeve portion 1126 of thestem component 1112. Thedistal body portion 1122 further includes asurface 1140 for mating with thesurface 1136 of thestem component 1112. Thedistal body portion 1122 also includes aprotrusion 1146 which mates withcavity 1148 of thestem component 1112. Theprotrusion 1146 defines included angle ββ. - The angle ββ is selected to provide for a self-locking taper between
protrusion 1146 and thecavity 1148. The angle ββ may be, for example, from two to twenty degrees (2°-20°). - The angle ββ is preferably selected by the formula:
Tan ββ/2<μ
where: -
- μ=coefficient of friction
- ββ=included angle
- The
proximal neck portion 1120 includes anexternal taper 1162 to whichhead 1160 is matingly fitted. - The
implant hip stem 1210 has a size and shape the same astrial 1110. For example, theimplant 1210 includes astem component 1212 having adistal stem 1212portion 1214 and aproximal body portion 1216. Theproximal body portion 1216 includes asleeve portion 1226 definingpocket 1232. Thepocket 1232 includes asurface 1236 as well as acavity 1248 extending below thesurface 1236. - The
implant hip stem 1210 also includes aneck component 1218 including adistal body portion 1222 and aproximal neck portion 1220. Thedistal body portion 1222 defines aperiphery 1278 thereof, as well as asurface 1240 of thedistal body portion 1222. Aprotrusion 1246 extends downwardly from thesurface 1240 and defines an included angle ββ. Theproximal neck portion 1220 includes anexternal taper 1262 to whichhead 1260 is matingly fitted. - The
trial stem component 1112 may be first implanted into the patient and thetrial neck component 1118 may be secured to thetrial stem component 1112. Alternatively, theimplant stem component 1212 may be permanently secured to the patient and thetrial neck component 1118 may be fitted to theimplant stem component 1212. - The
trial neck component 1118 may be secured to theimplant stem component 1212 and a trial reduction made. If the trial reduction is satisfactory, theimplant neck component 1218, which is identical to thetrial neck component 1118, may be implanted into the patient. If, however, thetrial neck component 1118 is found in a trial reduction to not be optimum, an alternate trial neck component may be utilized in a trial reduction attempted with the new trial neck component. If that second trial neck component is found to be satisfactory, a corresponding implant neck component is then implanted. - According to the present invention and referring again to
FIG. 19 , akit 1101 for use in performing joint arthroplasty is shown. Thekit 1101 includes the orthopaedic stem trial ortrial hip stem 1110 for use in performing joint arthroplasty. Thetrial 1110 may be fitted to acavity 2 in thecanal 4 of along bone 6 and assists in performing a trial reduction in performing joint arthroplasty. Theorthopaedic stem trial 1110 includes canal component ortrial stem component 1112 having an external periphery 1113. A portion of thecanal component 1112 may be fitted to thecavity 2 in thecanal 4 of thelong bone 6. Thecanal component 1112 includes distal stem portion orcanal portion 1114 that has afirst end 1115 for insertion into thecavity 2 and an opposedsecond end 1117. Thecanal component 1112 further includes asleeve portion 1126 extending from thesecond end 1117 of thecanal portion 1114. Thesleeve portion 1126 has aninternal periphery 1119 that defines pocket orinternal cavity 1132. Thesleeve portion 1126 also has anexternal periphery 1121. - The
orthopaedic stem trial 1112 also includes trial neck component orjoint component 1118 removably connectable to thecanal component 1112. Thejoint component 1118 has neck portion orbody portion 1120 and distal body portion orconnection portion 1122. Theconnection portion 1122 of thejoint component 1118 defines anexternal periphery 1178. A portion of theexternal periphery 1121 of thesleeve portion 1126 may be fitted to thecavity 2 of thelong bone 6. At least a portion of theexternal periphery 1178 of theconnection portion 1122 of thejoint component 1118 may be fitted into theinternal cavity 1132 of thesleeve portion 1126 so that theexternal periphery 1178 of theconnection portion 1122 of thejoint component 1118 is spaced inwardly from theexternal periphery 1121 of thesleeve portion 1126 of thestem component 1112 when thejoint component 1118 is fixedly connected to thestem component 1112 so that thejoint component 1118 may be removed from thelong bone 6. - The
kit 1101 includes orthopaedic hip stem ororthopaedic stem implant 1210 for use in performing joint arthroplasty. Theimplant 1210 may be fitted tocavity 2 incanal 4 oflong bone 6 to perform a joint arthroplasty. Theorthopaedic stem implant 1210 includes implant stem component orcanal component 1212 having anexternal periphery 1221. At least a portion of thecanal component 1212 may be fitted to thecavity 2 in thecanal 4 of thelong bone 6. Thecanal component 1212 includes distal stem portion orcanal portion 1214 having afirst end 1215 for insertion into thecavity 2 and an opposedsecond end 1217. Thecanal component 1212 further includessleeve portion 1226 extending from thesecond end 1217 of thecanal portion 1214. Thesleeve portion 1226 has aninternal periphery 1219 that defines pocket orinternal cavity 1232. Thesleeve portion 1226 also has anexternal periphery 1221. Theorthopaedic stem implant 1210 also includes implant neck component orjoint component 1218 that may be removably connected to thecanal component 1212. Thejoint component 1218 has distal body portion orconnection portion 1222 and neck portion orbody portion 1220. Theconnection portion 1222 of thejoint component 1218 definesexternal periphery 1278. A portion ofexternal periphery 1221 of thesleeve portion 1226 may be fitted to thecavity 2 of thelong bone 6. A portion of theexternal periphery 1278 of theconnection portion 1222 of thejoint component 1218 may be fitted into theinternal cavity 1232 of thesleeve portion 1226. Theexternal periphery 1278 of theconnection portion 1222 of thejoint component 1218 is spaced thereby inwardly from theexternal periphery 1221 of thesleeve portion 1226 of thestem component 1212. This is accomplished when thejoint component 1218 is fixedly connected to the stem component 121. Thejoint component 1218 may thereby be removed from the long bone without disturbing the fixation of thestem component 1212 to thelong bone 6. - Referring now to
FIG. 20 , yet another embodiment of the present invention is shown asmethod 1300 for treating orthopedic joint disease of the patient. Themethod 1300 includes afirst step 1310 of implanting an orthopedic implant into a cavity in the canal of the long bone. The orthopedic implant includes a stem component and a first joint component fixedly connectable to the joint component. The joint component is adapted for removal from the long bone without disturbing the fixation of the stem component to the bone. Themethod 1300 includes asecond step 1312 of monitoring the condition of the patient and athird step 1314 of determining that the patient needs a revision prosthesis. Themethod 1300 also includes afourth step 1316 of providing a second joint component compatible with the stem component. Themethod 1300 further includes afifth step 1318 of removing the first joint component from the stem component of the orthopedic implant in vivo without disturbing the fixation of the stem component to the bone the orthopedic implant. Themethod 1300 further includes asixth step 1320 of implanting the second joint component into the stem component in vivo in the patient. - According to the present invention and referring now to
FIG. 21 , yet another embodiment of the present invention is shown assurgical method 1400. Themethod 1400 represents a method for providing revision joint arthroplasty on a patient having an orthopedic implant. The orthopedic implant includes a stem component and a first joint component fixedly connectable to the stem component. The joint component is adapted for removal from the long bone without disturbing the fixation of the stem component to the bone. Themethod 1400 includes afirst step 1410 of monitoring the condition of the patient and asecond step 1412 of determining whether the patient needs a revision prosthesis. Themethod 1400 includes athird step 1414 of providing a second joint component compatible with the stem component. Themethod 1400 further includes afourth step 1416 of removing the first joint component from the stem component of the orthopedic implant in vivo in the patient without disturbing the fixation of the stem component to the bone. Themethod 1400 further includes afifth step 1418 of implanting the second joint component in vivo in the patient. - Referring now to
FIG. 22 , another aspect of the present invention is shown asmethod 1500 for treating orthopaedic joint disease of a patient. Themethod 1500 includes afirst step 1510 of resecting a long bone along a resection plane and asecond step 1512 preparing a cavity in the canal of the long bone. The method also includes athird step 1514 of implanting an orthopaedic implant into a cavity in the canal of the long bone. The orthopaedic implant includes a joint component having a canal element and a first body element. The first body element may be fixedly connected to the canal element. The orthopaedic implant is secured in the canal of the long bone with the first body element being spaced from the long bone. The method further includes afourth step 1516 of monitoring the condition of the patient and afifth step 1518 of determining that the patient needs a revision prosthesis. The method also includes asixth step 1520 of providing a second body element connectable to the canal element and aseventh step 1522 of removing the first body element from the canal element of the orthopaedic implant in vivo in the patient without disturbing the fixation of bone surrounding the canal element of the orthopaedic implant and without damaging bone surrounding the first body element. The method further includes aneighth step 1524 of implanting the second body element into the canal element in vivo in the patient. - Referring now to
FIG. 23 a method 1600 for providing joint arthroplasty on a joint of a patient with an orthopaedic implant is shown. Themethod 1600 includes afirst step 1610 of resecting a long bone along a resection plane and asecond step 1612 of preparing a cavity in the canal of the long bone. The method also includes athird step 1614 of implanting an orthopaedic implant canal component into a cavity in the canal of a long bone. The orthopaedic implant canal component may have a stem element and a first body element fixedly connectable to the stem element. The orthopaedic implant canal component is secured in the canal of the long bone. The method further includes afourth step 1616 of connecting an orthopaedic trial body component to the implant canal component, the orthopaedic trial body component being spaced from the long bone and afifth step 1618 of performing a trial reduction of the joint of the patient. The method also includes asixth step 1620 of determining if the orthopaedic trial body component provides satisfactory results for the patient and aseventh step 1622 of implanting an orthopaedic implant body component corresponding to the orthopaedic trial body component onto the orthopaedic implant canal component if the orthopaedic trial body component provides satisfactory results for the patient. - The
third step 1614 of implanting the canal component step may further include permanently securing the canal component to the long bone. - The
third step 1614 of implanting the canal component step may further include positioning the canal component such that the canal component intersects the resection plane. - Referring now to
FIG. 24 the present invention may be in the form of akit 1700 for use in performing joint arthroplasty. Thekit 1700 includes a canal component implant 1712I having an external periphery 1713I. A portion of the canal component implant 1712I may be fitted to acavity 2 in acanal 4 of along bone 6. The canal component implant 1712I includes a canal portion 1714I. The canal portion 1714I has afirst end 1715I for insertion into thecavity 2 and an opposed second end 1717I. - The canal component implant 1712I further including a sleeve portion 1726I extending from the second end 1717I of the canal portion 1714I. The sleeve portion 1726I has an internal periphery 1719I defining an internal cavity 1732I. The sleeve portion 1726I also has an external periphery 1721I. The
kit 1700 also includes a first joint component implant removeably connectable to the canal component implant. The firstjoint component implant 1718I has a body portion 1720I and a connection portion 1722I. The connection portion 1722I of the firstjoint component implant 1718I has an external periphery 1778I. A portion of the external periphery 1778I of the connection portion 1722I of the firstjoint component implant 1718I may be fitted into the internal cavity 1732I of the sleeve portion 1726I of the canal component implant 1712I, so that the external periphery 1778I of the connection portion 1722I of the firstjoint component implant 1718I is spaced inwardly from the external periphery 1721I of the sleeve portion 1726I of the canal component implant 1712I when the firstjoint component implant 1718I is fixedly connected to the canal component implant 1712I so that the firstjoint component implant 1718I may be removed from thelong bone 6 without disturbing the fixation of the canal component implant 1712I to thelong bone 6. - The
kit 1700 also includes a firstjoint component trial 1718T generally corresponding in size and shape with the firstjoint component implant 1718I. The firstjoint component trial 1718T may be removeably connected to the canal component implant 1712I. The firstjoint component trial 1718T having a body portion 1720T and a connection portion 1722T. The connection portion 1722T of the firstjoint component trial 1718T has an external periphery 1778T. A portion of the external periphery 1778T of the connection portion 1722T of the firstjoint component trial 1718T may be fitted into the internal cavity 1732I of the sleeve portion 1726I of the canal component implant 1712I. The external periphery 1778T of the connection portion 1722T of the firstjoint component trial 1718T is thereby spaced inwardly from the external periphery 1721T of the sleeve portion 1726T of the canal component implant 1712I. This occurs when the firstjoint component trial 1718T is fixedly connected to the canal component implant 1712I. The firstjoint component trial 1718T may thus be removed from thelong bone 6 without disturbing the fixation of the canal component implant 1712I to thelong bone 6. - The kit further includes a second joint component implant 1818I removeably connectable to the canal component implant 1712I. The second joint component implant 1818I has a body portion 1820I and a connection portion 1822I. The connection portion 1822I of the second joint component implant 1818I has an external periphery 1878I. A portion of the external periphery 1878I of the connection portion 1822I of the second joint component implant 1818I may be fitted into the internal cavity 1732I of the sleeve portion 1726I of the canal component implant 1712I so that the external periphery 1878I of the connection portion 1822I of the second joint component implant 1818I is spaced inwardly from the external periphery 1721I of the sleeve portion 1726I of the canal component implant 1712I when the second joint component implant 1818I is fixedly connected to the canal component implant 1712I so that the second joint component implant 1818I may be removed from the
long bone 6 without disturbing the fixation of the canal component implant 1712I to thelong bone 6. - The
kit 1700 also includes a secondjoint component trial 1818T generally corresponding in size and shape with the second joint component implant 1818I. The secondjoint component trial 1818T may be removeably connectable to the canal component implant 1712I. The secondjoint component trial 1818T having a body portion 1820T and a connection portion 1822T. The connection portion 1822T of the secondjoint component trial 1818T has an external periphery 1878T. A portion of the external periphery 1878T of the connection portion 1822T of the secondjoint component trial 1818T may be fitted into the internal cavity 1732I of the sleeve portion 1726I of the canal component implant 1712I so that the external periphery 1878T of the connection portion 1822T of the secondjoint component trial 1818T is spaced inwardly from the external periphery 1721I of the sleeve portion 1726I of the canal component implant 1712I when the secondjoint component trial 1818T is fixedly connected to the canal component implant 1712I so that the secondjoint component trial 1818T may be removed from thelong bone 6 without disturbing the fixation of the canal component implant 1712I to thelong bone 6. - The
kit 1700 permits the canal component implant 1712I to be permanently implanted. Thekit 1700 also permits the firstjoint component trial 1718T to be assembled to the canal component implant 1712I and used to perform a trial reduction. Thekit 1700 further permits the firstjoint component trial 1718T to be replaced with the secondjoint component trial 1818T if the trial reduction has unsatisfactory results. - Referring now to
FIG. 25 , anorthopaedic implant 2011 is used to perform joint arthroplasty. A portion of theorthopaedic implant 2011 is capable of being fitted tocavity 2 in thecanal 4 oflong bone 6. Thecavity 2 extends from a resectedplane 11 of thelong bone 6. Theorthopaedic implant 2011 includesjoint component 2010. Thejoint component 2010 includesstem element 2012 definingexternal periphery 2058 of thestem element 2012. Thestem element 2012 has afirst end 2015 for insertion into thecavity 2. Theexternal periphery 2058 of thestem element 2012 has astem resection ring 2041. Thestem resection ring 2041 may be aligned with the resectedplane 11 of thelong bone 6. - The
joint component 2010 also includes afirst body element 2018 capable of being fixedly fitted to thestem element 2012. Thefirst body element 2018 includes anexternal periphery 2078. Theexternal periphery 2078 of thefirst body element 2018 has abody component ring 2043. Thebody component ring 2043 may be aligned with the resectedplane 11 of thelong bone 6. Acanal portion 2045 of thefirst body element 2018 extends generally from thecomponent ring 2043 of theexternal periphery 2078 of thefirst body element 2018 toward thefirst end 2015 of thestem element 2012 when thefirst body element 2018 is fixedly connected to thestem element 2012. - The
external periphery 2047 of thecanal portion 2045 of thefirst body element 2018 is spaced inwardly fromexternal periphery 2058 of thestem element 2012 when thefirst body element 2018 is fixedly connected to thestem element 2012 so that thefirst body element 2018 may be removed from thelong bone 6 without disturbing the fixation of thestem element 2012 to thelong bone 6. - As shown in
FIG. 25 theorthopaedic implant 2011 may be configured such that the first mentionedbody element 2018 may be removably fixedly connected to thestem element 2012 and may include asecond body element 2018S that may be removably fixedly connected to thestem element 2012. Thefirst body element 2018 and thesecond body element 2018S may thus be interchangeably connected to thestem element 2012 while thestem element 2012 is implanted in thecavity 2 of thelong bone 6. - The
orthopaedic implant 2011 may have a portion of thestem element 2012 that extends over a portion of thefirst body element 2018. - The
stem element 2012 of the orthopaedic implant, as shown inFIG. 25 , may include asleeve portion 2016. Thesleeve portion 2016 may receive at least a portion of thecanal portion 2045 of thefirst body element 2018. - The
first body element 2018 of theorthopaedic implant 2011, as shown inFIG. 25 , may be removably securable to thestem element 2012. - As shown in
FIG. 25 , aportion 2036 of theexternal periphery 2058 of thestem element 2012 may be generally planar. Also aportion 2040 of the external periphery of thebody element 2018 may be generally planar. Theportion 2036 of theexternal periphery 2058 of thestem element 2012 and theportion 2040 of theexternal periphery 2078 of thebody element 2018 may be in contact with each other. - A
connector 2044 may be used to connect thebody element 2018 to thestem element 2012. Theconnector 2044 may be in the form of a screw or a pin (seeFIG. 16 ). - The
body element 2018 may include aprotrusion 2044 extending from a surface of the connection element 2022. Thestem element 2012 may include an aperture 2048 for receiving theprotrusion 2046. It should be appreciated that the body may include an aperture (not shown) and the stem element may include a protrusion (not shown). The protrusion may be tapered. - The
implant 2011 may further include secondjoint component 2010S for cooperation with a firstjoint component 2010. A portion of the external periphery of thebody element 2018 may include anarticulation surface 2017 for articulation with the secondjoint component 2010S. - The second
joint component 2010S may be adapted for fixed implantation onto asecond bone 17. Abearing component 2055 may be positioned between the firstjoint component 2010 and the secondjoint component 2010S. Thebearing component 2055 articulates at the firstjoint component 2010 and is fixedly attached to the secondjoint component 2010S. Alternately thebearing component 2055 may articulate with the secondjoint component 2010S and be fixedly attached to the firstjoint component 2010. - As shown in
FIG. 25 , theorthopaedic implant 2011 may be in the form of a hip implant. Thejoint component 2010 is in the form of a hip stem. Theorthopaedic implant 2011 may also include the secondjoint component 2010S in the form of an acetabular cup for articulating cooperation with the hip stem. - As shown in
FIG. 25 , thebody element 2018 may include atapered protrusion 2059. Theorthopaedic implant 2011 may also include a generallyspherical head 2060. Thehead 2060 may, as shown, be removably fixedly secured to the taperedprotrusion 2059. - As shown in
FIG. 1 , the joint component defines alongitudinal axis 2039. Thestem element 2012 may have asleeve portion 2026. Thesleeve portion 2026 may define a wall thickness WT3 of thesleeve portion 2026. The wall thickness WT3 may generally be uniform about theouter periphery 2058 of thestem element 2012 in a plane normal to thelongitudinal axis 2039 of thejoint component 2010 and may be defined by wall thickness WT3. Theexternal periphery 2078 of thebody element 2018 may, as shown, closely conform to thesleeve portion 2026 of thestem element 2012. - It should be appreciated that the
orthopaedic implant 2011 may be in the form of a knee prosthesis, a hip prosthesis or a shoulder prosthesis. - Referring again to
FIG. 25 , it should be appreciated that thestem element 2012 may be interchangeably connectable to the firstjoint element 2018 and with the secondjoint element 2018S. The firstjoint element 2018 and the secondjoint element 2018S may as shown include a different dimension, or several different dimensions from each other. Thus, it should be appreciated that the stem element can receive joint elements of varying heights, offsets and degrees of version. - Continuing to refer to
FIG. 25 , thestem resection ring 2041 may be in the form of a recess. Therecess 2041 may be a score mark or a machined or formed groove. It should be appreciated that the ring may likewise be a raised area or protrusion (not shown). It should be further appreciated that thering 2041 may be acid etched or marked with ink or paint. It should be appreciated that thering 2041 may be continuous or discontinuous around thestem 2012. - It should be appreciated that
body element 2018 may likewise includebody component ring 2043. Thebody component ring 2043 may have the same configuration as that of thestem resection ring 2041 and may be recessed or protruding. - It should be appreciated that the
stem resection ring 2041 and/or thebody component ring 2043 may, as shown inFIG. 25 , be visually distinguishable from theexternal periphery 2058 of thestem element 2012 and/or theexternal periphery 2078 of thebody element 2018. - It should likewise be appreciated that the
stem resection ring 2041 and/or thebody component ring 2043 may be visually indistinguishable from theexternal periphery 2058 of thestem element 2012 and/or theexternal periphery 2078 of thebody element 2018. Thestem resection ring 2041 and/or thebody component ring 2043 may thus be invisible. - According to the present invention and referring to
FIG. 26 , a firstjoint component 2118 for use with astem component 2112 having acanal portion 2114 and asleeve portion 2116 for use as part of aprothesis 2101 in performing joint arthroplasty is shown. Thesleeve portion 2116 of thestem component 2112 has aninternal periphery 2134 and anexternal periphery 2158. A portion of theexternal periphery 2158 of thesleeve portion 2116 of thestem component 2112 may be fitted to acavity 2 in thecanal 4 of along bone 6. Thecavity 2 extends from a resectedplane 11 of thelong bone 6. - The first
joint component 2118 includes abody portion 2122 and aconnection portion 2120. Theconnection portion 2120 extends from thebody portion 2122 and has anexternal periphery 2128. Theexternal periphery 2128 of theconnection portion 2120 may be positioned within theinternal periphery 2134 of thesleeve portion 2116 of thestem component 2112. - The
external periphery 2128 of theconnection portion 2120 may include aconnection resection ring 2139. Theconnection resection ring 2139 may be used for alignment with the resectedplane 11 of thelong bone 6. Theexternal periphery 2128 of theconnection portion 2120 is spaced inwardly from theexternal periphery 2158 of thesleeve portion 2116 of thestem component 2112 when the firstjoint component 2118 is fixedly connected to thestem component 2112 so that thejoint component 2018 may be removed from thelong bone 6 without disturbing the fixation of thestem component 2112 to thelong bone 6. - As shown in
FIG. 26 , theconnection portion 2120 of the firstjoint component 2118 may be adapted to be removably fixedly connected to thestem component 2112. Further theprosthesis 2101 may include a secondjoint component 2160 removably fixedly connectable to the stem component. The firstjoint component 2118 and the secondjoint component 2160 may, as shown, be interchangeably connected to thestem component 2112 while thestem component 2112 is implanted in thecavity 2 of thelong bone 6. - As shown in
FIG. 26 , theconnection portion 2120 of the firstjoint component 2118 may be adapted to fit within theinternal periphery 2134 of thestem component 2112. - As shown in
FIG. 26 , aportion 2136 of theexternal periphery 2158 of thestem component 2112 may be generally planar. Further aportion 2140 of theexternal periphery 2128 of the firstjoint component 2118 may be generally planar. Theportion 2136 of theexternal periphery 2158 of thestem component 2112 and theportion 2140 of theexternal periphery 2128 of the firstjoint component 2118 may, as shown, be adapted for contact with each other. - The first
joint component 2118, as shown inFIG. 26 , may include afeature 2148 for cooperation with aconnector 2144 to connect the firstjoint component 2118 to thestem component 2112. Thefeature 2148 may be in the form of anaperture 2148 for passing theconnector 2144 through the firstjoint component 2118. For example, theaperture 2148 may be a cylindrical aperture. - The first
joint component 2118 as shown inFIG. 26 may include aprotrusion 2146. Alternatively, the joint component may include an aperture (not shown). Theprotrusion 2146 may, as shown, be tapered. - It should be appreciated that first
joint component 2118 may be in the form of ahip stem neck 2118. - The first
joint component 2118 and the secondjoint component 2160 may, as shown inFIG. 26 , be interchangeably connectable to thestem component 2112. Thereby thestem component 2112 can receive joint components of varying heights, offsets and degrees of version. - According to the present invention and as shown in
FIG. 27 , astem component 2212 for use with ajoint component 2218 having abody portion 2220 and aconnection portion 2222 in performing joint arthroplasty is provided. Theconnection portion 2222 of thejoint component 2218 has anexternal periphery 2278. At least a portion of thestem component 2212 may be fitted tocavity 2 incanal 4 of along bone 6. Thestem component 2212 includes a canal portion 2214 having afirst end 2215 for insertion into the cavity and an opposedsecond end 2217. - The
stem component 2212 also includes asleeve portion 2226 extending from thesecond end 2217 of the canal portion 2214. Thesleeve portion 2226 has an internal periphery 2219 that forms aninternal cavity 2232. Thesleeve portion 2226 has anexternal periphery 2221. The canal portion 2214 and/or thesleeve portion 2226 may be in removable fixed engagement with thejoint component 2218. At least a portion of theexternal periphery 2221 of thesleeve portion 2226 may be fitted to thecavity 2 of thelong bone 6. At least a portion of theexternal periphery 2278 of theconnection portion 2222 of thejoint component 2218 may be fitted into theinternal cavity 2232 of thesleeve portion 2226, so that theexternal periphery 2278 of theconnection portion 2222 of thejoint component 2218 is spaced inwardly from theexternal periphery 2221 of thesleeve portion 2226 of thestem component 2212 when thejoint component 2218 is fixedly connected to thestem component 2212 so that thejoint component 2218 may be removed from thelong bone 6 without disturbing the fixation of thestem component 2212 to thelong bone 6. - As shown in
FIG. 27 , thestem component 2212 may be configured with a portion 2236 of theexternal periphery 2221 of thestem component 2212 being generally planar. Further aportion 2240 of theexternal periphery 2278 of thejoint component 2218 may as shown be generally planar. The portion 2236 of theexternal periphery 2221 of thestem component 2212 and theportion 2240 of theexternal periphery 2278 of thejoint component 2218 as shown inFIG. 27 it should be appreciated are adapted for contact with each other. - The
stem component 2212 may as shown inFIG. 27 include afeature 2252 for cooperation with aconnector 2244 to connect thestem component 2212 to thejoint component 2218. As shown inFIG. 27 , thefeature 2252 may be in the form of a threaded cavity or in the form of a cylindrical cavity which have been formed in thestem component 2212. - Further and as shown in
FIG. 27 , thestem component 2212 may include aconnection feature 2248 for connection with thejoint component 2218. Theconnection feature 2248 may, as shown, be in the form of acavity 2248 formed in thestem component 2212. Alternatively, the connection feature (not shown) may be in the form of a cavity. Theconnection feature 2248 may be tapered. - The
stem component 2212 may be in the form of ahip stem 2212. Alternatively thestem component 2212 may be in the form of a tibial implant or a shoulder stemFIGS. 17 and 18 respectively. It should be appreciated that thestem component 2212 may be any component for cooperation with along bone 6. - The
sleeve portion 2226 of thestem component 2212 may define a wall thickness WT thereof. The wall thickness WT may, as shown, be generally uniform about theexternal periphery 2221 of thesleeve portion 2226 in a plane normal tolongitudinal axis 2223 of thejoint component 2218. Theexternal periphery 2278 of theconnection portion 2222 of thejoint component 2218 may, as shown, be adapted to closely conform to thesleeve portion 2226 of thestem component 2212. - It should be appreciated that the
stem component 2212 may be interchangeably connected to a variety ofjoint components 2218 with similar or identical connectors, so that thestem component 2212 can receive joint components of varying heights, offsets and degrees of version. - Although the present invention and its advantages have been described in detail, it should be understood that various changes, substitutions, and alterations can be made therein without departing from the spirit and scope of the present invention as defined by the appended claims.
Claims (22)
1. A stem component for use with a joint component having a body portion and a connection portion in performing joint arthroplasty, the connection portion of the joint component defining an external periphery thereof, at least a portion of the stem component to be fitted to a cavity in a canal of a long bone, said stem component comprising:
a canal portion, said canal portion defining a first end thereof for insertion into the cavity and an opposed second end; and
a sleeve portion extending from the second end of said canal portion, said sleeve portion having an internal periphery thereof defining an internal cavity thereof, said sleeve portion also having an external periphery thereof, at least one of said canal portion and said sleeve portion adapted for removable fixed engagement with the joint component, at least a portion of the external periphery of said sleeve portion adapted to be fitted to the cavity of the long bone, at least a portion of the external periphery of the connection portion of the joint component to be fitted into the internal cavity of said sleeve portion, so that the external periphery of the connection portion of the joint component is spaced inwardly from the external periphery of said sleeve portion of the stem component when the joint component is fixedly connected to the stem component so that the joint component may be removed from the long bone without disturbing the fixation of the stem component to the long bone.
2. The stem component of claim 1:
wherein a portion of the external periphery of said stem component is generally planar; and
wherein a portion of the external periphery of the joint component is generally planar, the portion of the external periphery of said stem component and the portion of the external periphery of the joint component being adapted for contact with each other.
3. The stem component of claim 1 , further comprising a feature for cooperation with a connector to connect said stem component to the joint component.
4. The stem component of claim 3 , wherein said feature comprises a threaded cavity formed in said stem component.
5. The stem component of claim 3 , wherein said feature comprises a cylindrical cavity formed in said stem component.
6. The stem component of claim 1:
wherein said stem component comprises a connection feature for connection with the joint component; and
wherein said connection feature comprises one of a protrusion or a cavity formed in said stem component.
7. The stem component of claim 6 , wherein said connection feature is tapered.
8. The stem component of claim 1 , wherein said stem component comprises a hip stem.
9. The stem component of claim 1:
wherein the joint component defines a longitudinal axis thereof; and
wherein said sleeve portion defines a wall thickness thereof, the wall thickness being generally uniform about the outer periphery of said sleeve portion in a plane normal to the longitudinal axis of the joint component, the external periphery of the body portion of the joint component adapted to closely conform to the sleeve portion of said stem component.
10. The stem component of claim 1 , wherein said stem component is interchangeably connectable to the joint component, so that said stem component can receive joint components of varying heights, offsets and degrees of version.
11. A joint component for use with a stem component having a canal portion and a sleeve portion in performing joint arthroplasty, the sleeve portion of the stem component defining an internal periphery thereof and an external periphery thereof, at least a portion of the external periphery of the sleeve portion of the stem component to be fitted to a cavity in the canal of a long bone, the cavity extending from a resected plane of the long bone, said joint component comprising:
a body portion; and
a connection portion extending from said body portion, said connection portion of said joint component defining an external periphery thereof, the external periphery of said connection portion adapted to be positioned within the internal periphery of the sleeve portion of the stem component, the external periphery of said connection portion defining a connection resection ring thereof, the connection resection ring adapted for alignment with the resected plane of the long bone, the external periphery of said connection portion be spaced inwardly from the external periphery of the sleeve portion of the stem component when said joint component is fixedly connected to the stem component so that said joint component may be removed from the long bone without disturbing the fixation of the stem component to the long bone.
12. The joint component of claim 11:
wherein said connection portion of said joint component is adapted to be removably fixedly connectable to the stem component; and
further comprising a second joint component removably fixedly connectable to the stem component, whereby the first mentioned joint component and the second joint component are interchangeably connected to the stem component while the stem component is implanted in the cavity of the long bone.
13. The joint component of claim 11 , wherein said connection portion of said joint component is adapted to fit within the internal periphery of the stem component.
14. The joint component of claim 11:
wherein a portion of the external periphery of the stem component is generally planar; and
wherein a portion of the external periphery of said joint component is generally planar, the portion of the external periphery of the stem component and the portion of the external periphery of said joint component being adapted for contact with each other.
15. The joint component of claim 11 , further comprising a feature for cooperation with a connector to connect said joint component to the stem component.
16. The joint component of claim 15 , wherein said feature comprises an aperture for passage of the connector therethrough.
17. The joint component of claim 16 , wherein said aperture comprises a cylindrical aperture.
18. The joint component of claim 11 , wherein said joint component comprises one of a protrusion or an aperture.
19. The joint component of claim 18 , wherein the protrusion is tapered.
20. The joint component of claim 11 , wherein said joint component comprises a hip stem neck.
21. The joint component of claim 11 , wherein said joint component is interchangeably connectable to the stem component, so that the stem component can receive joint components of varying heights, offsets and degrees of version.
22. A kit for use in performing joint arthroplasty, said kit comprising:
an orthopaedic stem trial for use in performing joint arthroplasty, said trial to be fitted to a cavity in the canal of a long bone and to assist in performing a trial reduction in performing joint arthroplasty, said orthopaedic stem trial including a canal component defining a external periphery thereof, at least a portion of said canal component to be fitted to the cavity in the canal of the long bone, the canal component including a canal portion, the canal portion defining a first end thereof for insertion into the cavity and an opposed second end, the canal component further including a sleeve portion extending from the second end of said canal portion, the sleeve portion having an internal periphery thereof defining an internal cavity thereof, the sleeve portion also having an external periphery thereof, said orthopaedic stem trial also including a joint component removably connectable to the canal component, the joint component having a body portion and a connection portion, the connection portion of the joint component defining an external periphery thereof, at least a portion of the external periphery of the sleeve portion adapted to be fitted to the cavity of the long bone, at least a portion of the external periphery of the connection portion of the joint component to be fitted into the internal cavity of the sleeve portion, so that the external periphery of the connection portion of the joint component is spaced inwardly from the external periphery of the sleeve portion of the stem component when the joint component is fixedly connected to the stem component so that the joint component may be removed from the long bone without disturbing the fixation of the stem component to the long bone; and
an orthopaedic stem implant for use in performing joint arthroplasty, said implant to be fitted to a cavity in the canal of a long bone to perform a joint arthroplasty, said orthopaedic stem implant including a canal component defining a external periphery thereof, at least a portion of the canal component to be fitted to the cavity in the canal of the long bone, the canal component including a canal portion, the canal portion defining a first end thereof for insertion into the cavity and an opposed second end, the canal component further including a sleeve portion extending from the second end of the canal portion, the sleeve portion having an internal periphery thereof defining an internal cavity thereof, the sleeve portion also having an external periphery thereof, said orthopaedic stem implant also including a joint component removably connectable to the canal component, the joint component having a body portion and a connection portion, the connection portion of the joint component defining an external periphery thereof, at least a portion of the external periphery of the sleeve portion adapted to be fitted to the cavity of the long bone, at least a portion of the external periphery of the connection portion of the joint component to be fitted into the internal cavity of the sleeve portion, so that the external periphery of the connection portion of the joint component is spaced inwardly from the external periphery of said sleeve portion of the stem component when the joint component is fixedly connected to the stem component so that the joint component may be removed from the long bone without disturbing the fixation of the stem component to the long bone.
Priority Applications (15)
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US11/215,929 US8048167B2 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant kit, orthopaedic surgery kit and associated method |
US11/216,588 US20070050039A1 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant, stem and associated method |
US11/216,396 US20070050041A1 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant stem component, joint component, and associated kit |
DE602006003958T DE602006003958D1 (en) | 2005-08-30 | 2006-08-21 | Kit for use in orthopedic surgery |
EP06254379A EP1759664B1 (en) | 2005-08-30 | 2006-08-21 | Orthopaedic surgery kit |
EP06254387A EP1762200A2 (en) | 2005-08-30 | 2006-08-21 | Orthopaedic implant stem component |
AT06254379T ATE415912T1 (en) | 2005-08-30 | 2006-08-21 | KIT FOR USE IN ORTHOPEDIC SURGERY |
EP06254386A EP1762199A3 (en) | 2005-08-30 | 2006-08-21 | Orthopaedic implant component |
AU2006203780A AU2006203780A1 (en) | 2005-08-30 | 2006-08-28 | Orthopaedic implant stem component, joint component and associated kit |
AU2006203744A AU2006203744A1 (en) | 2005-08-30 | 2006-08-28 | Orthopaedic implant, stem and associated method |
AU2006203745A AU2006203745B2 (en) | 2005-08-30 | 2006-08-28 | Orthopaedic implant kit, orthopaedic surgery kit and associated method |
JP2006231984A JP5456228B2 (en) | 2005-08-30 | 2006-08-29 | Orthopedic implant kit, orthopedic kit, and related methods |
JP2006231972A JP2007061618A (en) | 2005-08-30 | 2006-08-29 | Orthopedic implant and stem and related method |
JP2006231978A JP2007061619A (en) | 2005-08-30 | 2006-08-29 | Orthopedic implant stem component, joint component and related kit |
US13/246,397 US20120016488A1 (en) | 2005-08-30 | 2011-09-27 | Orthopaedic implant kit, orthopaedic surgery kit and associated method |
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US11/216,588 US20070050039A1 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant, stem and associated method |
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US11/216,396 Abandoned US20070050041A1 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant stem component, joint component, and associated kit |
US13/246,397 Abandoned US20120016488A1 (en) | 2005-08-30 | 2011-09-27 | Orthopaedic implant kit, orthopaedic surgery kit and associated method |
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US11/216,588 Abandoned US20070050039A1 (en) | 2005-08-30 | 2005-08-30 | Orthopaedic implant, stem and associated method |
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US13/246,397 Abandoned US20120016488A1 (en) | 2005-08-30 | 2011-09-27 | Orthopaedic implant kit, orthopaedic surgery kit and associated method |
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JP (3) | JP2007061619A (en) |
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US8795381B2 (en) | 2006-12-07 | 2014-08-05 | Ihip Surgical, Llc | Methods and systems for hip replacement |
US8974540B2 (en) | 2006-12-07 | 2015-03-10 | Ihip Surgical, Llc | Method and apparatus for attachment in a modular hip replacement or fracture fixation device |
US9237949B2 (en) | 2006-12-07 | 2016-01-19 | Ihip Surgical, Llc | Method and apparatus for hip replacement |
CN113491603A (en) * | 2020-03-20 | 2021-10-12 | 贺利氏医疗有限公司 | Apparatus and method for making spacers with variable head |
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AU2006203780A1 (en) | 2007-03-15 |
US20070050039A1 (en) | 2007-03-01 |
EP1759664B1 (en) | 2008-12-03 |
EP1762200A2 (en) | 2007-03-14 |
ATE415912T1 (en) | 2008-12-15 |
US8048167B2 (en) | 2011-11-01 |
US20120016488A1 (en) | 2012-01-19 |
JP2007061618A (en) | 2007-03-15 |
EP1762199A2 (en) | 2007-03-14 |
EP1759664A1 (en) | 2007-03-07 |
US20070050042A1 (en) | 2007-03-01 |
JP2007061620A (en) | 2007-03-15 |
AU2006203744A1 (en) | 2007-03-15 |
JP5456228B2 (en) | 2014-03-26 |
AU2006203745B2 (en) | 2012-05-03 |
EP1762199A3 (en) | 2010-12-01 |
JP2007061619A (en) | 2007-03-15 |
AU2006203745A1 (en) | 2007-03-15 |
DE602006003958D1 (en) | 2009-01-15 |
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