Skeletal reconstruction cages

• US 20010056302A1
• Filed: 03/22/2001
• Published: 12/27/2001
• Est. Priority Date: 03/22/2000
• Status: Active Grant

• Current Assignee: Synthes USA LLC (Johnson & Johnson)
• Original Assignee: Synthes USA LLC (Johnson & Johnson)
• Inventors: Paul, David C., Boyer, Michael L. II, Angelucci, Christopher M., Higgins, Thomas B.
• Granted Patent: US 6,660,038 B2
• Time in Patent Office: Days
• US Class Current: 623/17.15
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30724 Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30744 End caps, e.g. for closing an endoprosthetic cavity
• CPC Class Codes: A61F 2/3094 Designing or manufacturing processes
• CPC Class Codes: A61F 2/30942 for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/30965 Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/4644 Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material bone material A61F2/28; disintegrating or milling devices B02C
• CPC Class Codes: A61F 2002/2817 Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2825 Femur
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30011 differing in porosity
• CPC Class Codes: A61F 2002/30057 made from both cortical and cancellous adjacent parts
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30075 : swellable, e.g. when wetted
• CPC Class Codes: A61F 2002/30112 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30115 : circular-O-shaped
• CPC Class Codes: A61F 2002/30126 : oval-O-shaped
• CPC Class Codes: A61F 2002/30131 : horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30138 : Convex polygonal shapes
• CPC Class Codes: A61F 2002/30148 : lozenge- or diamond-shaped
• CPC Class Codes: A61F 2002/30151 : rhomboidal or parallelogram-shaped
• CPC Class Codes: A61F 2002/30153 : rectangular
• CPC Class Codes: A61F 2002/30154 : square
• CPC Class Codes: A61F 2002/30158 : trapezoidal
• CPC Class Codes: A61F 2002/30166 : H-shaped or I-shaped
• CPC Class Codes: A61F 2002/30168 : L-shaped
• CPC Class Codes: A61F 2002/30179 : X-shaped
• CPC Class Codes: A61F 2002/302 : toroidal, e.g. rings
• CPC Class Codes: A61F 2002/3021 : frustoconical
• CPC Class Codes: A61F 2002/30212 : Half-cones
• CPC Class Codes: A61F 2002/30224 : cylindrical
• CPC Class Codes: A61F 2002/30225 : Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/30228 : Cylinders of elliptical or oval basis
• CPC Class Codes: A61F 2002/3023 : wedge-shaped cylinders
• CPC Class Codes: A61F 2002/30232 : Half-cylinders
• CPC Class Codes: A61F 2002/30233 : Stepped cylinders, i.e. having discrete diameter changes
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30237 : partial tubes
• CPC Class Codes: A61F 2002/30261 : parallelepipedal
• CPC Class Codes: A61F 2002/3028 : polyhedral different from parallelepipedal and pyramidal
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30322 : differing in surface structures
• CPC Class Codes: A61F 2002/30324 : differing in thickness
• CPC Class Codes: A61F 2002/30327 : differing in diameter
• CPC Class Codes: A61F 2002/30329 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30332 : Conically- or frustoconically-shaped protrusion and recess
• CPC Class Codes: A61F 2002/30354 : Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
• CPC Class Codes: A61F 2002/30367 : with additional means for preventing said rotation
• CPC Class Codes: A61F 2002/30383 : made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30387 : Dovetail connection
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30411 : having two threaded end parts connected by a threaded central part with opposite threads at its opposite ends, i.e. for adjusting the distance between both end parts by rotating the central part
• CPC Class Codes: A61F 2002/30426 : Bayonet coupling
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30459 : stapled
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30477 : using sharp protrusions, e.g. spikes, for anchoring into connecting prosthetic part
• CPC Class Codes: A61F 2002/30481 : using a locking clip
• CPC Class Codes: A61F 2002/30484 : Mechanically expandable devices located on the first prosthetic part for locking into or onto the second prosthetic part
• CPC Class Codes: A61F 2002/30487 : Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
• CPC Class Codes: A61F 2002/30492 : using a locking pin
• CPC Class Codes: A61F 2002/30494 : Cooperating protrusions and recesses, e.g. radial serrations, located on abutting end surfaces of a longitudinal connection
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30515 : using a locking wedge or block
• CPC Class Codes: A61F 2002/30538 : for adjusting angular orientation
• CPC Class Codes: A61F 2002/3054 : about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30599 : stackable
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30617 : Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/3071 : Identification means; Administration of patients
• CPC Class Codes: A61F 2002/30733 : Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30782 : inclined obliquely
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3079 : Stepped or enlarged apertures, e.g. having discrete diameter changes
• CPC Class Codes: A61F 2002/3082 : Grooves
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30843 : Pyramidally-shaped
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30894 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/30909 : Nets
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/30971 : Laminates, i.e. layered products
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4638 : Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
• CPC Class Codes: A61F 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2210/0061 : swellable
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0066 : stapled
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0021 : square
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2230/0028 : Shapes in the form of latin or greek characters
• CPC Class Codes: A61F 2230/0043 : L-shaped
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0063 : Three-dimensional shapes
• CPC Class Codes: A61F 2230/0065 : toroidal, e.g. ring-shaped, doughnut-shaped
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0082 : parallelepipedal
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2250/0006 : for adjusting angular orientation
• CPC Class Codes: A61F 2250/0023 : differing in porosity
• CPC Class Codes: A61F 2250/0026 : differing in surface structures
• CPC Class Codes: A61F 2250/0036 : differing in thickness
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2250/0089 : coded with symbols, e.g. dots, numbers, letters, words
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00353 : Bone cement, e.g. polymethylmethacrylate or PMMA
• CPC Class Codes: B29C 33/26 : by pivotal movement
• CPC Class Codes: B29C 43/006 : Pressing and sintering powders, granules or fibres
• CPC Class Codes: B29L 2031/3041 : Trim panels

Abstract

The present invention relates to skeletal reconstruction cages and a method of providing variable fit for a skeletal reconstruction cage. The skeletal reconstruction cages include a central body having first and second ends, a first end cap coupled to one end of the central body, and a second end cap coupled to the other end of the central body. At least two of the central body, first end cap, and second end cap are formed from bone. Each of the central body, first end cap, and second end cap may be provided in different sizes so that cages with varying overall heights, and related angulations, may be created.

Claims

1. A skeletal reconstruction cage comprising:

a central body having first and second ends;

a first end cap; and

a second end cap,

wherein the first end cap is coupled to one end of the central body and the second end cap is coupled to the other end of the central body.

2. The skeletal reconstruction cage of

claim 1

, wherein the first end is disposed in a first body plane and the second end is disposed in a second body plane, the first and second planes converging with respect to each other.

3. The skeletal reconstruction cage of

claim 2

, wherein a first alignment plane extending perpendicular to the central axis is disposed at a first angle with respect to the first body plane, and a second alignment plane extending perpendicular to the central axis is disposed at a second angle with respect to the second body plane.

4. The skeletal reconstruction cage of

claim 3

, wherein the first and second angles are about the same.

5. The skeletal reconstruction cage of

claim 4

, wherein the first and second angles are between about 1°

and about 3°

.

6. The skeletal reconstruction cage of

claim 3

, wherein the end caps each include a top face disposed in a first cap plane and a bottom face disposed in a second cap plane, the first and second cap planes being disposed at a cap angle with respect to each other.

7. The skeletal reconstruction cage of

claim 6

, wherein the first angle, the second angle, and the cap angle are about the same.

8. The skeletal reconstruction cage of

claim 7

, wherein the first angle, the second angle, and the cap angle are between about 1°

and about 3°

.

9. The skeletal reconstruction cage of

claim 1

, wherein one of the central body and an end cap further comprises a protrusion and the other further comprises a recess, the protrusion configured and dimensioned for mating with the recess.

10. The skeletal reconstruction cage of

claim 9

, wherein the protrusion and recess are non-circular.

11. The skeletal reconstruction cage of

claim 10

, wherein the protrusion is symmetrical about a central protrusion axis, the protrusion being selectably positionable within the recess in two orientations.

12. The skeletal reconstruction cage of

claim 1

, wherein the central shaft is threadably associated with at least one end cap.

13. The skeletal reconstruction cage of

claim 1

, wherein each end cap further comprises a migration-resistant surface.

14. The skeletal reconstruction cage of

claim 1

, wherein the central body further comprises a hole extending from the first end to the second end, the hole disposed about a central axis.

15. The skeletal reconstruction cage of

claim 14

, further comprising a core configured and dimensioned to be received in the hole, the core being formed of bone.

16. The skeletal reconstruction cage of

claim 1

, further comprising a core, wherein the central body further comprises a hole extending from the first end toward the second end, the hole disposed about a central axis, wherein at least one of the central body, first end cap, second end cap, and core is formed from bone and the core is configured and dimensioned to be received in the hole.

17. The skeletal reconstruction cage of

claim 16

, wherein at least one of the central body, first end cap, second end cap, and core is formed of cancellous bone.

18. The skeletal reconstruction cage of

claim 16

, wherein at least one of the central body, first end cap, second end cap, and core is formed of cortical bone.

19. The skeletal reconstruction cage of

claim 16

, wherein at least one of the central body, first end cap, second end cap, and core is formed of autograft, allograft, or xenograft bone tissue.

20. The skeletal reconstruction cage of

claim 16

, wherein at least one of he central body, first end cap, second end cap, and core is formed of partially demineralized or demineralized bone tissue.

21. The skeletal reconstruction cage of

claim 1

, wherein at least two of the central body, first end cap, second end cap, and core are fastened together with at least one fastener.

22. The skeletal reconstruction cage of

claim 21

, wherein the at least one fastener is selected from a screw, key, pin, peg, rivet, cotter, nail, spike, bolt, stud, staple, boss, clamp, clip, dowel, stake, hook, anchor, tie, band, crimp, and wedge.

23. The skeletal reconstruction cage of

claim 1

, wherein at least two of the central body, first end cap, second end cap, and core are bonded together with a bonding agent.

24. The skeletal reconstruction cage of

claim 2

, wherein at least one of the central body, first end cap, second end cap, and core is at least partially dehydrated to fit against a surrounding mating surface.

25. The skeletal reconstruction cage of

claim 2

, wherein at least one of component selected from the central body, first end cap, second end cap, and core is at least partially dehydrated to mate with another component.

26. A method of providing variable fit for a skeletal reconstruction cage, the method comprising:

providing a first set of central bodies, each central body having a different maximum height from one another;

providing a second set of top end caps of variable sizes, each top end cap having a different maximum height from one another;

providing a third set of bottom end caps of variable sizes, each bottom end cap having a different maximum height from one another;

selecting the central body, top end cap, and bottom end cap that provide preferred skeletal reconstruction cage height when coupled together;

coupling the first and second end caps to the central body to form a first skeletal reconstruction cage, with the end caps disposed on opposing ends of the central body.

27. The method of

claim 26

, further comprising:

providing a fourth set of inserts of variable sizes, each insert having a different maximum height from one another;

selecting the insert that provides preferred height when disposed in a hole in the central body;

inserting the insert in the central body.

28. The method of

claim 27

, wherein at least one of the first central body, top end cap, bottom end cap, and insert are formed of bone.

29. A skeletal reconstruction cage comprising:

a central body having first and second free ends, each end comprising a receiving region;

a first end cap coupled to one free end of the central body and comprising a first protruding region; and

a second end cap coupled to the other free end of the central body and comprising a second protruding region,

wherein the first protruding region and the second protruding region are configured and dimensioned to be received in the receiving regions, and wherein each of the regions is symmetrical about at least one central plane extending generally perpendicular to the first and second free ends.

30. The skeletal reconstruction cage of

claim 29

, wherein at least one of the central body, first end cap, and second end cap is formed from bone.

31. An end cap for use with a skeletal reconstruction cage, comprising a cap body having a top face disposed in a first cap plane and a bottom face disposed in a second cap plane transverse to the first cap plane, wherein the first and second cap planes are disposed at a cap angle with respect to each other.

32. The end cap of

claim 31

, wherein the cap angle is between about 1°

and about 3°

.

33. The end cap of

claim 32

, wherein the cap body is formed of bone.