WO2006091686A2 - Implant de surface articulaire - Google Patents

Implant de surface articulaire Download PDF

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Publication number
WO2006091686A2
WO2006091686A2 PCT/US2006/006323 US2006006323W WO2006091686A2 WO 2006091686 A2 WO2006091686 A2 WO 2006091686A2 US 2006006323 W US2006006323 W US 2006006323W WO 2006091686 A2 WO2006091686 A2 WO 2006091686A2
Authority
WO
WIPO (PCT)
Prior art keywords
implant
contour
articular surface
plane
load bearing
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.)
Ceased
Application number
PCT/US2006/006323
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English (en)
Other versions
WO2006091686A3 (fr
Inventor
Steven W. Ek
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Arthrosurface Inc
Original Assignee
Arthrosurface Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Arthrosurface Inc filed Critical Arthrosurface Inc
Priority to CA002598709A priority Critical patent/CA2598709A1/fr
Priority to EP06735827A priority patent/EP1850800A4/fr
Priority to AU2006216725A priority patent/AU2006216725A1/en
Priority to JP2007557134A priority patent/JP2008531127A/ja
Publication of WO2006091686A2 publication Critical patent/WO2006091686A2/fr
Publication of WO2006091686A3 publication Critical patent/WO2006091686A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • 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
    • A61F2/30721—Accessories
    • 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
    • A61F2/38—Joints for elbows or knees
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • 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
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3836—Special connection between upper and lower leg, e.g. constrained
    • 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
    • A61F2/40—Joints for shoulders
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • 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
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3085—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
    • A61F2002/30873—Threadings machined on non-cylindrical external surfaces
    • 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
    • A61F2/38—Joints for elbows or knees
    • A61F2/3804—Joints for elbows or knees for elbows
    • A61F2002/3822—Humeral components
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4207—Talar components
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4635—Special tools for implanting artificial joints using minimally invasive surgery
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Definitions

  • the present disclosure is directed at a system and method for accessing an articular joint surface.
  • the present disclosure is further directed at a method and system for replacing at least a portion of an articular surface.
  • BACKGROUND Articular cartilage found at the ends of articulating bone in the body, is typically composed of hyaline cartilage, which has many unique properties that allow it to function effectively as a smooth and lubricious load bearing surface.
  • Hyaline cartilage . . problems particularly in knee, hip joints, and should joints, are generally caused by disease such as occurs with rheumatoid arthritis or wear and tear (osteoarthritis), or secondary to an injury, either acute (sudden), or recurrent and chronic (ongoing).
  • Such cartilage disease or deterioration can compromise the articular surface causing pain and eventually, loss of joint movement.
  • various methods have been developed to treat and repair damaged or destroyed articular cartilage.
  • abrasion arthroplasty For smaller defects, traditional options for this type of problem include leaving the lesions or injury alone and living with it, or performing a procedure called abrasion arthroplasty or abrasion chondralplasty.
  • the principle behind this procedure is to attempt to stimulate natural healing.
  • the bone surface is drilled using a high speed rotary burr or shaving device and the surgeon removes, about lmm of bone from the . surface of the lesion. This creates an exposed subchondral bone bed that will bleed and will initiate a fibrocartilage healing response.
  • One problem with this procedure is that the exposed bone is not as smooth as it originally was following the drilling and burring which tends to leave a series of ridges and valleys, affecting the durability of the fibrocartilage response.
  • Microfracture incorporates some of the principles of drilling, abrasion and chondralplasty.
  • the calcified cartilage layer of the chondral defect is removed.
  • Several pathways or "microfractures" are created to the subchondral bleeding bone bed by impacting a metal pick or surgical awl at a minimum number of locations within the lesion.
  • a fibrocartilage healing response is initiated, forming a replacement surface. Results for this technique may be expected to be similar to abrasion chondralplasty.
  • cartilage transplant Another means used to treat damaged articular cartilage is a cartilage transplant. Essentially, this procedure involves moving cartilage from an outside source or other knee or from within the same knee into the defect. Typically, this is done by transferring a peg of cartilage with underlying bone and fixing it in place with a screw or pin or by a press fit. Although useful for smaller defects, large defects present a problem, as this procedure requires donor pegs proportionate to the recipient bed. Large diameter lesions may exceed the capacity to borrow from within the same knee joint and rule out borrowing from another source.
  • FIG. 1 is an exploded perspective view of an embodiment of an implant system including an implant consistent with the present disclosure and a fixation element that may be used in conjunction with the implant;
  • FIG. 2 is a perspective view of the embodiment of an implant system shown in FIG. 1 showing the implant assembled to the fixation element;
  • FIG. 3 is a perspective view of another embodiment of an implant system consistent with the present disclosure including an implant and a fixation element;
  • FIG. 4 illustrates the implant system shown in FIG. 3 from another perspective
  • FIG. 5 shows an ankle including a talus implant consistent with the present disclosure
  • FIG. 6 shows an ankle including a talus implant consistent with the present disclosure
  • FIG. 7 shows an ankle including a talus implant consistent with the present disclosure
  • FIG. 8 is a perspective view of another implant consistent with the present disclosure
  • FIG. 9 shows the implant of FIG. 8 from another perspective
  • FIG. 10 is a perspective view of yet another implant consistent with the ' present disclosure
  • FIG. 11 shows the implant of FIG. 10 from another perspective
  • FIG. 12 shows of a trochlear implant consistent with the present disclosure.
  • the present disclosure may provide an implant for replacing at least a portion of an articular surface. Furthermore, the present disclosure is also directed at a general design methodology for developing and producing a surface contour of an implant for replacing at least a portion of an articular surface.
  • An implant consistent with the present disclosure may be provided having a load-bearing surface that is adapted to interact with a cooperating articulating feature.
  • the cooperating articulating feature may include, for example, a cooperating articular surface, a cooperating surface of an implant replacing at least a portion of a cooperating articular surface, etc.
  • an implant may have a load bearing surface that may be based on an original geometry of an articular surface to be replaced by the implant.
  • an embodiment of an implant system 100 is schematically depicted in various views.
  • the implant system 100 may be employed to replace at least a portion of an articular surface, e.g., at least a portion of an articular surface of a joint.
  • the implant system 100 may generally include an articular surface implant 102 and a fixation element 104.
  • the fixation element 104 may be capable of coupling the implant 102 to bone and/or other tissue in the region of the portion of the articular surface to be replaced by the implant 102.
  • the fixation element 104 may be provided as a separate component from the implant 102.
  • the fixation element 104 may be capable of being coupled to the implant 102 and may be capable of being coupled to bone and/or tissue in the general region of the portion of the articular surface to be replaced by the implant system 100.
  • the articular surface implant 102 may generally include an implant body 10.6.
  • the implant body 106 may have a load bearing surface 108 and a bone contacting region 110.
  • the load bearing surface 108 may generally be configured to interact with a cooperating articulating feature, such as a cooperating articular surface, a cooperating articular surface implant, etc.
  • the implant body 106 may be at least partially received in an implant site provided by excising at least a portion of the articular surface and underlying bone.
  • the load bearing surface 108 may be disposed generally replacing at least a portion of the excised articular surface.
  • the bone contacting region 110 may engage and/or contact subchondral within and/or forming at least a portion of a bottom of the implant site.
  • the fixation element 104 maybe provided as a separate component from the implant 102. Providing the fixation element 104 as a separate component from the implant 102 may facilitate installation of the implant system 100.
  • the fixation element 104 may first be coupled to bone and/or other tissue in and/or around the implant site.
  • the implant 102 may then be positioned relative to the surrounding articular surface and the implant 102 maybe coupled to the fixation element 104. In such a manner, the implant 102 may be secured in position relative to the articular surface.
  • the fixation element 104 is depicted as a screw- type feature. Consistent with this illustrated embodiment, the fixation element 104 may be threadably engaged with bone and/or other tissue in and/or around the implant site. In addition to engaging bone and/or other tissue, a screw-type fixation element 104 may also facilitate depth positioning of the fixation element 104, and thereby depth positioning of the implant 102, relative to the articular surface. Suitable screw-type fixation elements are known in the art, for example, from U.S. Patent No. 6,520,964, issued on February 18, 2003. Consistent with various alternative embodiments, the fixation element may be configured having a barbed member or other similar features capable of engaging bone and/or other tissue in and/or around the implant site. In still other embodiments, the fixation element may include features that may be adhesively coupled to bone and/or other tissue in and/or around the implant site.
  • the implant 102 and the fixation element 104 may be provided as separate components.
  • the implant 102 may be coupled to the fixation element 104 to, at least in part, secure the implant 102 in position in the implant site.
  • the implant 102 and the fixation element 104 may, accordingly, include interacting features wherein the implant 102 and fixation element 104 are capable of being coupled to one another.
  • An embodiment of an implant 102 may be provided including a post 112 extending from the implant body 106.
  • the fixation element 104 may include an opening 114 capable of receiving at least a portion of the post 112. In one such embodiment, the post 112 and, the opening 114 may be provided having complimentary precision tapers.
  • the implant 102 and the fixation element 104 may be coupled to one another by inserting the post 112 into the opening 114 and pressing the features together, e.g., as by applying an impact force.
  • the precision taper of the post 112 and the opening 114 may achieve a secure frictional interaction between the implant 102 and the fixation element 104.
  • the implant and the fixation element may be assembled to one another prior to installation into an implant site.
  • the fixation element may be configured to engage and/or to be coupled to bone and/or tissue in and/or around the implant site during installation.
  • the fixation element may include a barbed post or similar feature.
  • the implant and the fixation element may be provided as a unitary structure.
  • the illustrated implant system 100 depicted in FIGS. 1 through 7 shows an implant 102 configured to replace a portion of the articular surface of the talus.
  • the illustrated implant system 100 shown in FIGS. 1 through 7 is configured to replace at least a portion of the lateral ridge of the trochlear surface of the talus, which articulates with the tibia. Damage to the lateral ridge of the trochlear surface of the talus may include fracture or shearing off of a portion of the ridge resulting from trauma.
  • the load bearing surface 108 may have a contour and/or geometry that may be capable of cooperating with an interacting articulating feature, including a cooperating articular surface, at least a portion of an implant replacing at least a portion of a cooperating articular surface, etc.
  • the load bearing surface 108 may have a contour and/or geometry that may be capable of cooperating with an interacting articular surface of a tibia.
  • the load bearing surface 108 of the implant 102 may include a geometry and/or contour that may be capable of cooperating with an interacting surface of an implant replacing at least a portion of an articular surface of a tibia.
  • an implant may include a load bearing surface having a contour and/or geometry that may be capable of cooperating with an interacting articulating surface.
  • the load bearing surface may have a contour and/or geometry that may generally approximate and/or be based on a contour and/or geometry of the portion of the articular surface being replaced by the implant, hi an embodiment, the portion of the articular surface being replaced may be mapped using various know techniques to quantitatively and/or qualitatively assess the contour and/or geometry of the portion of the articular surface that may be replaced by the implant.
  • An implant may be constructed and/or selected from a set of implants having various contours and/or geometries.
  • the load bearing surface of the implant may be based on the contour and/or geometry of the portion of the articular surface to be replaced by the implant.
  • an implant may be fabricated or selected from a set of standard size and/or shape implants to provide a general approximation of the articular surface being replaced. Selection and/or fabrication of an implant may rely on various degrees of quantitative reference to the articular surface being replaced, including no quantitative reference to the articular surface.
  • a contour and/or geometry of the load bearing surface 108 of an implant 102 may generally be defined by . a first curve string 116 and a second curve string 118.
  • a curve string may include a single curve and/or a plurality of curves joined together curves in a plane.
  • the first curve string 116 and the second curve string 118 generally defining the contour and/or geometry of the load bearing surface 108 may be disposed in intersecting planes.
  • the plane of the first curve string 116 and the plane of the second curve string 118 may generally be mutually perpendicular.
  • Various other angular relationships of the planes including the first curve string 116 and the second curve string 118 may also suitably be employed herein.
  • a design methodology capable of achieving a load bearing surface of an implant herein may include providing a curve string defining a contour and/or geometry of the load bearing surface and sweeping the curve string along another curve string, defining an intersecting contour and/or geometry of the load bearing surface.
  • curve strings defining the contour and/or geometry of the load bearing surface may be derived based on mapped curves and/or approximations of curves of a portion of an artic ⁇ lar surface to be replace, a portion of a cooperating articulating feature, etc.
  • measurements of the contour arid/or geometry of the portion of the articular surface to be replaced may be taken.
  • Measurement of the contour and/or geometry of the portion of the articular surface to be replaced by the implant may be achieved using direct contact contour mapping of the articular surface, e.g., measuring relative heights, of various regions of the articular surface, and/or using various imaging techniques, such as radiological imaging techniques. . .
  • the load bearing surface 108 may have a contour and/or geometry corresponding to the second curve string 118 lofted over the first curve string 116.
  • the contour and/or geometry of the load bearing surface 108 maybe achieved by sweeping the second curve string 118 along the first curve 116 while maintaining the second curve 118 normal to the first curve 116.
  • the first curve 116 may be provided in a first plane, e.g. a plane defined by the X and Z axis.
  • the second curve 118 may be provided in a perpendicular plane! The ang ⁇ lar pitch of the perpendicular plane relative to the first plane may vary along the.
  • first curve 116 to maintain the second curve 118 normal to the first curve 116 along the sweep of the first curve 116.
  • the second curve 118 may be swept along the first curve 116 with the first curve 116 and the second curve 118 in orthogonal planes.
  • first curve 116 may be provided in a first plane, e.g., a plane defined by the Y and Z axis and the second curve may be provided in an orthogonal plane, e.g., a plane defined by the X and Z axis.
  • an embodiment of an implant provided consistent with the preceding design methodology may be generally symmetrical in each of the planes including the first curve string and the second curve string.
  • the load bearing surface 108 may have a contour and/or geometry resulting from a faired transition between the first curve string 116 and the second curve string 118. That is, the contour and/or geometry of the load bearing surface 108 may be provided by a smooth transition between the first curve string 116 and the second curve string 118 at each quadrant between the first curve string 116 and the second curve string 118.
  • providing a faired transition between the first curve string and the second curve string may be achieved using various averaging techniques known for surface generation. Various such averaging techniques are commonly employed in commercial surfacing design and solid modeling computer assisted drafting software packages.
  • the implant 102 may include a relieved edge 120 around the perimeter of the load bearing surface 108.
  • the relieved edge 120 may include a rounded over, e.g., radiused, edge, a chamfer edge, etc.
  • the relieved edge 120 around the load bearing surface 108 may reduce the presence of a hard edge at a transition between the implant and surrounding articular surface.
  • a reduction and/or elimination of a hard edge at. the transition between the load bearing surface of the implant and the surrounding articular surface may reduce and/or eliminate scraping of an interacting articular surface during articulation of the joint.
  • the relieved edge 120 may accommodate manufacturing and/or installation tolerances.
  • the relieved edge 120 may permit smooth operation of the joint in a situation in which the implant 102 sits slightly proud above and/or slightly recessed below the surrounding articular surface.
  • ah implant site may be prepared using a rotating excision tool, e.g., an excision blade rotating about an axis.
  • the implant site may include a circular excision projected along the axis of rotation of the excision blade.
  • the cross-sectional geometry of the implant may generally correspond to the intersection of a projected circular excision with the articular surface of the talus.
  • excision site preparation tools and techniques are also be contemplated by the present disclosure, along with the attendant changes to the implant configuration.
  • the location of the fixation element and the orientation of the load bearing . surface to the fixation element may be selected to provide secure and stable anchoring of the implant relative to the articular surface.
  • the implant system may have a configuration wherein the fixation element may extend into the talus at an angle to, and/or spaced from, the lateral ridge. Such a configuration may provide secure anchoring of the implant and/or may reduce the occurrence of tear-out and/or crumbling of the talus resulting from weakening of the talus caused by extension of the fixation element along the lateral face adjacent the trochlear surface.
  • Various additional and/or alternative configurations may also be employed. .
  • the illustrated implant 200 is generally configured to replace at least a portion of an articular surface of a patella. Similar to the previously described embodiment, the implant 200 may generally include an implant body 202 having a load bearing surface 204. The load bearing surface 204 of the illustrated implant 200 may have a contour and/or geometry that may suitably replace at least a portion of an articular surface of a patella.
  • the implant 200 may also include a post 206 capable of coupling with a fixation element (not shown) for anchoring the implant 200 to an articular surface and/or underlying bone.
  • a fixation element not shown
  • a post may be employed for coupling the implant 200 to a fixation element.
  • an embodiment of an implant herein may be provided including an integral fixation element.
  • the feature for coupling to a fixation element may optionally be excluded.
  • the load bearing surface 204 of the implant 200 may be defined by a first curve string 208 and a second curve string 210.
  • the contour and/or geometry of the load bearing surface 204 may be provided as the first curve string 208 lofted over the second curve string 210, and/or vice- versa.
  • the lofted load bearing surface 204 may be achieved by sweeping the first curve string 208 along the second curve string 210.
  • the load bearing surface of the implant may be provided using averaging algorithms to provide a faired surface in between the first curve string and the second curve string.
  • an implant 300 may be capable of replacing at least a portion of a trochlear articular surface, for example a trochlear articular surface of a humerus, etc.
  • the implant 300 may generally include an implant body 302 having a load bearing surface 304.
  • the load bearing surface 304 may be defined by a first curve string 306 and a second curve string 308.
  • the load bearing surface 304 may be provided by sweeping the second curve string 308 along the first curve string 306 consistent with the previously described design methodology.
  • the load bearing surface may also be provided as a faired surface defined by a first and second intersecting curve string.
  • a model articular surface including an implant capable of replacing at least a portion of a trochlear surface is shown.
  • the implant depicted in FIG. 12 may be generally consistent with the embodiment described with reference to FIGS. 10 and 11.
  • the load bearing surface of the implant visible in the photograph of the model, may generally have a contour and/or geometry that may generally correspond to the portion of the articular surface being replaced by the implant.
  • the implant may provide smooth interaction with a cooperating articular surface, such as depicted.in FIG. 12.
  • an implant site may be created in an articular surface using a rotating excision tool.
  • a rotating excision tool may provide a circular cutting path that may be projected into the articular surface and/or the underlying subchondral bone.
  • the shape of the implant may, in such an embodiment, generally correspond to the intersection of the circular cutting path and the articular surface.
  • an implant may be provided for replacing a portion of an articular surface.
  • the implant may include a load bearing surface having a contour defined by a first curve string based on a contour of the articular surface in a first plane and by a second curve string based on a contour of the articular surface in a second plane.
  • the first and second planes may be planes which intersect one another.
  • the implant may further include a bone contacting surface.
  • the present disclosure may provide an implant system for replacing a portion of an articular surface.
  • the implant system may include an implant having a load bearing surface which is defined by a. first and a second curve string.
  • the first curve string may be based on a contour of the articular surface in a first plane and the second curve string may be based on a contour of the articular surface in a second plane.
  • the first and second planes may intersect one another.
  • the implant system may also include a fixation element capable of engaging bone and capable of ; being coupled to the implant.
  • the present disclosure may provide a method of forming an implant.
  • the method may include measuring a contour of an articular surface in a first plane and measuring a contour of the articular surface in a second plane, in which the first and second planes are intersecting planes.
  • the method may further include providing an implant body having a load bearing surface.
  • the load bearing surface of the implant body may have a contour defined by the contour of the articular surface in the first plane and the contour of the articular surface in the second plane.
  • an implant consistent with the present disclosure may be ' sized and shaped for replacing at least a portion of various other articular surfaces of the body. Accordingly, consistent with the present disclosure, an implant system may be provided to replace at least a portion of various articular surfaces in addition to a portion of an articular surface of a talus.
  • an implant herein may suitably be employed to replace a portion of an articular surface of a knee joint, a hip joint, a . shoulder joint, etc. Accordingly, the foregoing example should not be construed as limiting on the application of an implant consistent with the present disclosure.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un implant de remplacement d'une partie de surface articulaire avec une surface porteuse et une zone en contact avec l'os. Le contour de la surface porteuse est défini par une première ligne courbe tenant compte d'un contour de la surface remplacé dans un premier plan. La surface porteuse est définie en outre par le contour de la surface articulaire à remplacer dans un second plan. Les deux plans définissent entre eux une intersection.
PCT/US2006/006323 2005-02-22 2006-02-22 Implant de surface articulaire Ceased WO2006091686A2 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
CA002598709A CA2598709A1 (fr) 2005-02-22 2006-02-22 Implant de surface articulaire
EP06735827A EP1850800A4 (fr) 2005-02-22 2006-02-22 Implant de surface articulaire
AU2006216725A AU2006216725A1 (en) 2005-02-22 2006-02-22 Articular surface implant
JP2007557134A JP2008531127A (ja) 2005-02-22 2006-02-22 関節面インプラント

Applications Claiming Priority (2)

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US65498905P 2005-02-22 2005-02-22
US60/654,989 2005-02-22

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WO2006091686A2 true WO2006091686A2 (fr) 2006-08-31
WO2006091686A3 WO2006091686A3 (fr) 2006-11-23

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JP (1) JP2008531127A (fr)
AU (1) AU2006216725A1 (fr)
CA (1) CA2598709A1 (fr)
WO (1) WO2006091686A2 (fr)

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EP2116210A1 (fr) 2008-05-06 2009-11-11 Diamorph AB Nouvel implant du genou et utilisation associée
US7828853B2 (en) 2004-11-22 2010-11-09 Arthrosurface, Inc. Articular surface implant and delivery system
EP2389904A1 (fr) * 2010-05-24 2011-11-30 Episurf Medical AB Kit chirurgical pour réparation de cartilage comportant un implant et ensemble d'outils
EP2564792A1 (fr) 2011-09-02 2013-03-06 Episurf Medical AB Kit chirurgical modulaire pour la réparation de cartilages
US8644973B2 (en) 2010-05-24 2014-02-04 Episurf Ip-Management Ab Method of designing a surgical kit for cartilage repair in a joint
US8655468B2 (en) 2010-05-24 2014-02-18 Episurf Ip-Management Ab System of manufacturing a surgical kit for cartilage repair in a joint
US9662126B2 (en) 2009-04-17 2017-05-30 Arthrosurface Incorporated Glenoid resurfacing system and method
US9861492B2 (en) 2014-03-07 2018-01-09 Arthrosurface Incorporated Anchor for an implant assembly
US9931211B2 (en) 2003-02-24 2018-04-03 Arthrosurface Incorporated Trochlear resurfacing system and method
US10045788B2 (en) 2006-12-11 2018-08-14 Arthrosurface Incorporated Retrograde resection apparatus and method
US10076343B2 (en) 2002-12-03 2018-09-18 Arthrosurface Incorporated System for articular surface replacement
US10307172B2 (en) 2012-07-03 2019-06-04 Arthrosurface Incorporated System and method for joint resurfacing and repair
WO2019166793A1 (fr) * 2018-02-27 2019-09-06 Fitzbionics Limited Implant pour resurfaçage d'os
US10470886B2 (en) 2014-07-09 2019-11-12 Episurf Ip-Management Ab Method of a rig
US10470885B2 (en) 2010-05-24 2019-11-12 Episurf Ip-Management Ab Implant for cartilage repair
US10555815B2 (en) 2014-07-09 2020-02-11 Episurf Ip-Management Ab Surgical kit for cartilage repair comprising implant and a set of tools
US10603049B2 (en) 2011-09-02 2020-03-31 Episurf Ip-Management Ab Implant specific drill bit in surgical kit for cartilage repair
US10624752B2 (en) 2006-07-17 2020-04-21 Arthrosurface Incorporated Tibial resurfacing system and method
US10624748B2 (en) 2014-03-07 2020-04-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US10695096B2 (en) 2013-04-16 2020-06-30 Arthrosurface Incorporated Suture system and method
US10945743B2 (en) 2009-04-17 2021-03-16 Arthrosurface Incorporated Glenoid repair system and methods of use thereof
US11000387B2 (en) 2011-09-02 2021-05-11 Episurf Ip-Management Ab Implant for cartilage repair
US11160663B2 (en) 2017-08-04 2021-11-02 Arthrosurface Incorporated Multicomponent articular surface implant
US11478358B2 (en) 2019-03-12 2022-10-25 Arthrosurface Incorporated Humeral and glenoid articular surface implant systems and methods
US11529237B2 (en) 2018-04-27 2022-12-20 Episurf Ip-Management Ab Method of manufacturing an implant and an implant with two coatings
US11607319B2 (en) 2014-03-07 2023-03-21 Arthrosurface Incorporated System and method for repairing articular surfaces
WO2023107337A1 (fr) * 2021-12-10 2023-06-15 Arthrex, Inc. Implant huméral de coude unicompartimental canin
US11712276B2 (en) 2011-12-22 2023-08-01 Arthrosurface Incorporated System and method for bone fixation

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US10076343B2 (en) 2002-12-03 2018-09-18 Arthrosurface Incorporated System for articular surface replacement
US11337819B2 (en) 2003-02-24 2022-05-24 Arthrosurface Incorporated Trochlear resurfacing system and method
US9931211B2 (en) 2003-02-24 2018-04-03 Arthrosurface Incorporated Trochlear resurfacing system and method
US10624749B2 (en) 2003-02-24 2020-04-21 Arthrosurface Incorporated Trochlear resurfacing system and method
US7828853B2 (en) 2004-11-22 2010-11-09 Arthrosurface, Inc. Articular surface implant and delivery system
US11471289B2 (en) 2006-07-17 2022-10-18 Arthrosurface Incorporated Tibial resurfacing system and method
US10624752B2 (en) 2006-07-17 2020-04-21 Arthrosurface Incorporated Tibial resurfacing system and method
US10045788B2 (en) 2006-12-11 2018-08-14 Arthrosurface Incorporated Retrograde resection apparatus and method
US10959740B2 (en) 2006-12-11 2021-03-30 Arthrosurface Incorporated Retrograde resection apparatus and method
EP2116210A1 (fr) 2008-05-06 2009-11-11 Diamorph AB Nouvel implant du genou et utilisation associée
US11478259B2 (en) 2009-04-17 2022-10-25 Arthrosurface, Incorporated Glenoid resurfacing system and method
US10478200B2 (en) 2009-04-17 2019-11-19 Arthrosurface Incorporated Glenoid resurfacing system and method
US9662126B2 (en) 2009-04-17 2017-05-30 Arthrosurface Incorporated Glenoid resurfacing system and method
US10945743B2 (en) 2009-04-17 2021-03-16 Arthrosurface Incorporated Glenoid repair system and methods of use thereof
US8657822B2 (en) 2010-05-24 2014-02-25 Episurf Ip-Management Ab Surgical kit for cartilage repair comprising implant and a set of tools
WO2011147831A1 (fr) * 2010-05-24 2011-12-01 Episurf Medical Ab Trousse chirurgicale pour la réparation de cartilage, comprenant un implant et un ensemble d'outils
US10470885B2 (en) 2010-05-24 2019-11-12 Episurf Ip-Management Ab Implant for cartilage repair
US8655468B2 (en) 2010-05-24 2014-02-18 Episurf Ip-Management Ab System of manufacturing a surgical kit for cartilage repair in a joint
US8644973B2 (en) 2010-05-24 2014-02-04 Episurf Ip-Management Ab Method of designing a surgical kit for cartilage repair in a joint
EP2389904A1 (fr) * 2010-05-24 2011-11-30 Episurf Medical AB Kit chirurgical pour réparation de cartilage comportant un implant et ensemble d'outils
US9254196B2 (en) 2011-09-02 2016-02-09 Episurf Ip-Management Ab Implant specific drill bit
EP2564792A1 (fr) 2011-09-02 2013-03-06 Episurf Medical AB Kit chirurgical modulaire pour la réparation de cartilages
WO2013030372A1 (fr) 2011-09-02 2013-03-07 Episurf Medical Ab Nécessaire chirurgical modulaire pour la réparation du cartilage
WO2013030370A1 (fr) 2011-09-02 2013-03-07 Episurf Medical Ab Nécessaire chirurgical pour la réparation du cartilage
US11000387B2 (en) 2011-09-02 2021-05-11 Episurf Ip-Management Ab Implant for cartilage repair
US10966733B2 (en) 2011-09-02 2021-04-06 Episurf Ip-Management Ab Implant specific drill bit in surgical kit for cartilage repair
US9009012B2 (en) 2011-09-02 2015-04-14 Episure IP Management AB Modular surgical kit for cartilage repair
US10603049B2 (en) 2011-09-02 2020-03-31 Episurf Ip-Management Ab Implant specific drill bit in surgical kit for cartilage repair
US9826993B2 (en) 2011-09-02 2017-11-28 Episurf Ip-Management Ab Surgical kit for cartilage repair
US11712276B2 (en) 2011-12-22 2023-08-01 Arthrosurface Incorporated System and method for bone fixation
US11191552B2 (en) 2012-07-03 2021-12-07 Arthrosurface, Incorporated System and method for joint resurfacing and repair
US10307172B2 (en) 2012-07-03 2019-06-04 Arthrosurface Incorporated System and method for joint resurfacing and repair
US11648036B2 (en) 2013-04-16 2023-05-16 Arthrosurface Incorporated Suture system and method
US10695096B2 (en) 2013-04-16 2020-06-30 Arthrosurface Incorporated Suture system and method
US10575957B2 (en) 2014-03-07 2020-03-03 Arthrosurface Incoporated Anchor for an implant assembly
US11607319B2 (en) 2014-03-07 2023-03-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US9962265B2 (en) 2014-03-07 2018-05-08 Arthrosurface Incorporated System and method for repairing articular surfaces
US11083587B2 (en) 2014-03-07 2021-08-10 Arthrosurface Incorporated Implant and anchor assembly
US10624754B2 (en) 2014-03-07 2020-04-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US9931219B2 (en) 2014-03-07 2018-04-03 Arthrosurface Incorporated Implant and anchor assembly
US11766334B2 (en) 2014-03-07 2023-09-26 Arthrosurface Incorporated System and method for repairing articular surfaces
US10624748B2 (en) 2014-03-07 2020-04-21 Arthrosurface Incorporated System and method for repairing articular surfaces
US9861492B2 (en) 2014-03-07 2018-01-09 Arthrosurface Incorporated Anchor for an implant assembly
US10555815B2 (en) 2014-07-09 2020-02-11 Episurf Ip-Management Ab Surgical kit for cartilage repair comprising implant and a set of tools
US10470886B2 (en) 2014-07-09 2019-11-12 Episurf Ip-Management Ab Method of a rig
US11160663B2 (en) 2017-08-04 2021-11-02 Arthrosurface Incorporated Multicomponent articular surface implant
WO2019166793A1 (fr) * 2018-02-27 2019-09-06 Fitzbionics Limited Implant pour resurfaçage d'os
US11529237B2 (en) 2018-04-27 2022-12-20 Episurf Ip-Management Ab Method of manufacturing an implant and an implant with two coatings
US11478358B2 (en) 2019-03-12 2022-10-25 Arthrosurface Incorporated Humeral and glenoid articular surface implant systems and methods
WO2023107337A1 (fr) * 2021-12-10 2023-06-15 Arthrex, Inc. Implant huméral de coude unicompartimental canin

Also Published As

Publication number Publication date
JP2008531127A (ja) 2008-08-14
WO2006091686A3 (fr) 2006-11-23
EP1850800A2 (fr) 2007-11-07
EP1850800A4 (fr) 2010-01-06
CA2598709A1 (fr) 2006-08-31
AU2006216725A1 (en) 2006-08-31

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