Device and method of arthroscopic knee joint resurfacing

• US 20050137708A1
• Filed: 12/22/2004
• Published: 06/23/2005
• Est. Priority Date: 12/23/2003
• Status: Abandoned Application

• Current Assignee: Ron Clark
• Original Assignee: Ron Clark
• Inventors: Clark, Ron
• Application Number:
  US11/020,398
• Publication Number:
  US 20050137708A1
• Time in Patent Office: Days
• US Class Current: 623/20.150
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30604 modular
• 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 2002/30975 made of two halves
• CPC Class Codes: A61F 2002/3895 unicompartimental
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 using minimally invasive surgery
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0015 Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2310/00011 Metals or alloys

Abstract

A knee joint resurfacing implant is disclosed. The knee joint resurfacing implant may include femoral implant and tibial implant components. The femoral implant components may be attached to the femur using screws or other fixation devices. The femoral implant component may be configured to share loads between cortical and cancellous bone material. The tibial implant components are formed in modular portions which may be assembled within the knee joint and may be free-floating or fixed to the tibial surface. The implant components are of such a size and configuration that the components may be placed into the knee joint through an external skin incisions that measure 3 cm or less. Accordingly, the size of skin incisions required for implantation may be reduced when compared to incisions which are now commonly used.

Claims

9. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface for articulation with the tibial side of the joint and a proximal surface that has an apex for engagement with cancellous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur.

10. The implant of claim 9 wherein the profile of the distal, convex surface closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane.

11. The implant of claim 9 wherein fixation of the implant to the femur is provided by one or more screws that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface.

12. The implant of claim 9 wherein fixation is provided by one or more rigid fixation members, such as a screws, pegs, pins or stems, that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and that traverse the external articulating surface and have a terminal surface profile that uniformly matches the distal, convex articulating surface of the implant such that when fully seated the terminal surface of said fixation members is flush or congruent with the external articulating surface of the implant.

13. The implant of claim 9 wherein the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material.

14. The implant of claim 9 wherein fixation of the implant to the femur is augmented by bone cement or adhesive that is be placed between the implant and the femur.

15. The implant of claim 9 wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

16. The implant of claim 9 wherein the implant may be implanted using an arthroscopic visualization method.

17. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface with a profile that closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane for articulation with the tibial side of the joint and that has a proximal surface with an apex for engagement with cancellous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur.

18. The implant of claim 17 wherein fixation of the implant to the femur is provided by one or more screws that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface.

19. The implant of claim 17 wherein fixation is provided by one or more rigid fixation members, such as screws, pegs, pins or stems, that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and that traverse the external articulating surface and have a terminal surface profile that uniformly matches the distal, convex articulating surface of the implant such that when fully seated the terminal surface of said fixation members is flush or congruent with the external articulating surface of the implant.

20. The implant of claim 17 wherein the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material.

21. The implant of claim 17 wherein fixation of the implant to the femur is augmented by bone cement or adhesive that is be placed between the implant and the femur.

22. The implant of claim 17 wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

23. The implant of claim 17 wherein the implant may be implanted using an arthroscopic visualization method.

24. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface with a profile that closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane for articulation with the tibial side of the joint and that has a proximal surface with an apex for engagement with cancellous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur and where the fixation of the implant to the femur is provided by one or more screws that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material.

25. The implant of claim 24 wherein fixation of the implant to the femur is augmented by bone cement or adhesive that is be placed between the implant and the femur.

26. The implant of claim 24 wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

27. The implant of claim 24 wherein the implant may be implanted using an arthroscopic visualization method.

28. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface with a profile that closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane for articulation with the tibial side of the joint and that has a proximal surface with an apex for engagement with cancerous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur wherein fixation of the implant is provided by one or more rigid fixation members, such as screws, pegs, pins or stems, that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and that traverse the external articulating surface and have a terminal surface profile that uniformly matches the distal, convex articulating surface of the implant such that when fully seated the terminal surface of said fixation members is flush or congruent with the external articulating surface of the implant and the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material.

29. The implant of claim 28 wherein fixation of the implant to the femur is augmented by bone cement or adhesive placed between the implant and the femur.

30. The implant of claim 28 wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

31. The implant of claim 28 wherein the implant may be implanted using an arthroscopic visualization method.

32. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface with a profile that closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane for articulation with the tibial side of the joint and that has a proximal surface with an apex for engagement with cancellous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur and where the fixation of the implant to the femur is provided by one or more screws that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material and wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less and the implant may be implanted using an arthroscopic visualization method

33. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface with a profile that closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane for articulation with the tibial side of the joint and that has a proximal surface with an apex for engagement with cancellous bone of the distal end of a prepared femur and one or more supports for engagement with cortical bone of the distal end of a prepared femur wherein fixation of the implant is provided by one or more rigid fixation members, such as screws, pegs, pins or stems, that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and that traverse the external articulating surface and have a terminal surface profile that uniformly the distal convex articulating surface of the implant such that when fully seated the terminal surface of said fixation members is flush or congruent with the external articulating surface of the implant and the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material and wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less and the implant may be implanted using an arthroscopic visualization method.

34. An implant to resurface the tibial condyle of the knee joint comprising a tibial body that has a concave superior surface, a planar inferior surface, and divided into medial and lateral halves by a joint running longitudinally through the implant.

35. The implant of claim 34 wherein the medial and lateral halves of the tibial body may be passed separately into the joint space of a knee joint and be assembled into a single unit therein.

36. The implant of claim 34 wherein the medial and lateral halves are self-locking or include a separate locking device to maintain their attachment within the knee joint following assembly into a single unit.

37. The implant of claim 36 wherein the medial and lateral halves of the tibial body include complementary dovetail joints or other geometric interface junctions to permit assembly of the halves into a single unit.

38. The implant of claim 34 wherein the tibial component is free floating upon the tibial surface.

39. The implant of claim 35 wherein the tibial component is securely attached to the tibia.

40. The implant of claim 34 wherein the tibial component is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

41. The implant of claim 34 wherein the tibial implant component may be attached to the tibia by means placed through an oblique access channel formed through the tibia from the anterior tibial cortex to the central tibial condylar surface.

42. The implant of claim 41 wherein the tibial implant component is secured to the tibia by a cement, adhesive, or biologically active substance applied to the inferior tibial implant component surface through the oblique access channel.

43. The implant of claim of 41 wherein the tibial implant component is secured to the tibia by a strand or member that is attached to the inferior tibial implant component surface and which passes into the oblique access channel.

44. The implant of claim 41 wherein said strand or member extends through the length of the oblique access channel and exits through the opening of the oblique access channel on the anterior tibial cortex.

45. The implant of claim 44 wherein the strand or member is externally attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

46. The implant of claim 45 wherein the strand or member is under tension when said strand or member is attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

47. The implant of claim 41 wherein the strand or member is a suture, cable, chain, screw, rod, bolt, loop, hook, or grasping device.

48. An implant to resurface the tibial condyle of the knee joint comprising a tibial body that has a semicircular circumference, a concave superior surface, a planar inferior surface, and divided into medial and lateral halves by a joint running longitudinally through the implant.

49. The implant of claim 48 wherein the medial and lateral halves of the tibial body may be passed separately into the joint space of a knee joint and be assembled into a single unit therein.

50. The implant of claim 48 wherein the medial and lateral halves are self-locking or include a separate locking device to maintain their attachment following assembly into a single unit.

51. The implant of claim 50 wherein the medial and lateral halves of the tibial body include complementary dovetail joints or other geometric interface junctions to permit assembly of the halves into a single unit.

52. The implant of claim 48 wherein the tibial component is free floating upon the tibial surface.

53. The implant of claim 48 wherein the tibial component is securely attached to the tibia.

54. The implant of claim 48 wherein the tibial component is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

55. The implant of claim 48 wherein the tibial implant component may be attached to the tibia by means placed through an oblique access channel formed through the tibia from the anterior tibial cortex to the central tibial condylar surface.

56. The implant of claim 55 wherein the tibial implant component is secured to the tibia by a cement, adhesive, or biologically active substance applied to the inferior tibial implant component surface through the oblique access channel.

57. The implant of claim of 55 wherein the tibial implant component is secured to the tibia by a strand or member that is attached to the inferior tibial implant component surface and which passes into the oblique access channel.

58. The implant of claim 57 wherein said strand or member extends through the length of the oblique access channel and exits through the opening of the access channel on the anterior tibial cortex.

59. The implant of claim 58 wherein the strand or member is externally attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

60. The implant of claim 59 wherein the strand or member is under tension when said strand or member is attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

61. The implant of claim 55 wherein the strand or member is a suture, cable, chain, screw, rod, bolt, loop, hook, or grasping device.

62. An implant to resurface the tibial condyle of the knee joint comprising a tibial body that has a concave superior surface, a planar inferior surface, and divided into medial and lateral halves by a joint running longitudinally through the implant where the medial and lateral halves of the tibial body may be passed separately into the joint space of a knee joint and be assembled into a single unit therein.

63. The implant of claim 62 wherein the medial and lateral halves are self-locking or include a separate locking device to maintain their attachment following assembly into a single unit.

64. The implant of claim 63 wherein the medial and lateral halves of the tibial body include complementary dovetail joints or other geometric interface junctions to permit assembly of the halves into a single unit.

65. The implant of claim 62 wherein the tibial component is free floating upon the tibial surface.

66. The implant of claim 62 wherein the tibial component is securely attached to the tibia.

67. The implant of claim 62 wherein the tibial component is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

68. The implant of claim 62 wherein the tibial implant component may be attached to the tibia by means placed through an oblique access channel formed through the tibia from the anterior tibial cortex to the central tibial condylar surface.

69. The implant of claim 68 wherein the tibial implant component is secured to the tibia by a cement, adhesive, or biologically active substance applied to the inferior tibial implant component surface through the oblique access channel.

70. The implant of claim of 68 wherein the tibial implant component is secured to the tibia by a strand or member that is attached to the inferior tibial implant component surface and which passes into the oblique access channel.

71. The implant of claim 70 wherein said strand or member extends through the length of the oblique access channel and exits through the opening of the oblique access channel on the anterior tibial cortex.

72. The implant of claim 71 wherein the strand or member is externally attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

73. The implant of claim 72 wherein the strand or member is under tension when said strand or member is attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

74. The implant of claim 70 wherein the strand or member is a suture, cable, chain, screw, rod, bolt, loop, hook, or grasping device.

75. An implant to resurface the tibial condyle of the knee joint comprising a tibial body that has a semicircular circumference, a concave superior surface, a planar inferior surface, and divided into medial and lateral halves by a joint running longitudinally through the implant where the medial and lateral halves of the tibial body may be passed separately into the joint space of a knee joint and be assembled into a single unit therein.

1. An implant to resurface a femoral condyle of the knee joint comprising a femoral body that has a distal, convex surface for articulation with the tibial side of the joint and a proximal surface that has an apex for engagement with the distal end of a prepared femur.

2. The implant of claim 1 wherein the profile of the distal, convex surface closely approximates the radius of curvature of the articulating surface of a native femoral condyle in the sagital plane.

3. The implant of claim 1 wherein fixation of the implant to the femur is provided by one or more screws that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface.

4. The implant of claim 1 wherein fixation is provided by one or more rigid fixation members, such as a screws, pegs, pins or stems, that are inserted in one or more screw receiving holes that traverse the implant through the femoral body from the distal, convex surface to the proximal surface and that traverse the external articulating surface and have a terminal surface profile that uniformly matches the distal, convex articulating surface of the implant such that when fully seated the terminal surface of said fixation members is flush or congruent with the external articulating surface of the implant.

5. The implant of claim 1 wherein the implant is formed from a biologically compatible metal, polymer, biologic, allograft, or xenograft material.

6. The implant of claim 1 wherein fixation of the implant to the femur is augmented by bone cement or adhesive that is be placed between the implant and the femur.

7. The implant of claim 1 wherein the implant is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

8. The implant of claim 1 wherein the implant may be implanted using an arthroscopic visualization method.

76. The implant of claim 75 wherein the medial and lateral halves are self-locking or include a separate locking device to maintain their attachment following assembly into a single unit.

77. The implant of claim 76 wherein the medial and lateral halves of the tibial body include complementary dovetail joints or other geometric interface junctions to permit assembly of the halves into a single unit.

78. The implant of claim 75 wherein the tibial component is of such a size and configuration that it may be placed into the knee joint through an external skin incision that measures 3 cm or less.

79. The implant of claim 75 wherein the tibial implant component may be attached to the tibia by means placed through an oblique access channel formed through the tibia from the anterior tibial cortex to the central tibial condylar surface.

80. The implant of claim 79 wherein the tibial implant component is secured to the tibia by a cement, adhesive, or biologically active substance applied to the inferior tibial implant component surface through the oblique access channel.

81. The implant of claim of 79 wherein the tibial implant component is secured to the tibia by a strand or member that is attached to the inferior tibial implant component surface and which passes into the oblique access channel.

82. The implant of claim 81 wherein said strand or member extends through the length of the oblique access channel and exits through the opening of the oblique access channel on the anterior tibial cortex.

83. The implant of claim 82 wherein the strand or member is externally attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

84. The implant of claim 83 wherein the strand or member is under tension when said strand or member is attached to the anterior tibial cortex to secure the tibial implant component to the tibial surface.

85. The implant of claim 81 wherein the strand or member is a suture, cable, chain, screw, rod, bolt, loop, hook, or grasping device.

76-1. The implant of claim 75 wherein the tibial component is free floating upon the tibial surface.

77-2. The implant of claim 75 wherein the tibial component is securely attached to the tibia.

86. A knee replacement implant comprising:

a femoral implant component to resurface a femoral condyle of the knee joint that has a curved convex surface for articulation with the tibial side of the joint and the opposite surface composed of an apex for engagement with a prepared femur; and

a tibial implant component implant to resurface the tibial condyle of the knee joint that has a semicircular circumference, a concave superior surface, a planar inferior surface, and divided into medial and lateral halves by a joint running longitudinally through the implant.

87. The knee replacement implant of claim 86 wherein the opposite surface of the femoral implant component also includes one or more supports.

88. The knee replacement implant of claim 86 wherein the medial and lateral halves of the tibial implant component may be passed separately into the joint space of a knee joint and there be assembled into a single unit.

89. The knee replacement implant of claim 86 wherein the opposite surface of the femoral implant component also includes one or more supports and the medial and lateral halves of the tibial implant component may be passed separately into the joint space of a knee joint and there be assembled into a single unit.

90. The knee replacement implant of claim 89 wherein the size and configuration of the femoral implant component and of the medial and lateral halves of the tibial implant component are such that they may be placed into the knee joint through an external skin incision that measures 3 cm or less.

91. The knee replacement implant of claim 86 wherein the tibial implant component may be attached to the tibia by means placed through an oblique access channel formed through the tibia from the anterior tibial cortex to the central tibial condylar surface.

92. The implant of claim 91 wherein the tibial implant component is secured to the tibia by a cement, adhesive, or biologically active substance applied to the inferior tibial implant component surface through the oblique access channel.

93. The implant of claim of 91 wherein the tibial implant component is secured to the tibia by a strand or member that is attached to the inferior tibial implant component surface and which passes into the oblique access channel.

94. The knee replacement implant of claim 91 wherein the size and configuration of the femoral implant component and of the medial and lateral halves of the tibial implant component are such that they may be placed into the knee joint through an external skin incision that measures 3 cm or less.