Method and apparatus for antibiotic knee prothesis

• US 5,123,927 A
• Filed: 09/23/1991
• Issued: 06/23/1992
• Est. Priority Date: 12/05/1990
• Status: Expired due to Term

• Current Assignee: DePuy Orthopaedics Incorporated (Johnson & Johnson)
• Original Assignee: University of British Columbia
• Inventors: Paris, Nancy J., Breault, Martine J., Masri, Bassam A., Beauchamp, Chris P., Duncan, Clive P.
• Primary Examiner(s): Isabella, David J.
• Assistant Examiner(s): NOT, DEFINED
• Application Number:
  US07/764,167
• Time in Patent Office: 274 Days
• Field of Search: 623/20, 623/18, 623/16, 606/86, 606/92, 606/99, 264/222, 264/249, 264/261, 264/274, 264/336
• US Class Current: 623/20.21
• 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 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/3877 Patellae or trochleae
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30672 temporary
• CPC Class Codes: A61F 2002/30677 Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30957 using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2310/00353 Bone cement, e.g. polymethylmethacrylate or PMMA
• CPC Class Codes: B29L 2031/7532 Artificial members, protheses

Abstract

A method and equipment for producing an antibiotic loaded knee prothesis by custom molding a femoral prothesis in a removable mold from a settable material containing a selected antibiotic, applying the molded prothesis to the distal end of the femur, completing the set of the material to anchor the prothesis to the femur and removing the removable mold. Next a tibial prothesis is custom molded in a second removable mold from a settable material containing a selected antibiotic, the material set and the so formed tibial prothesis is removed from the second mold and is then connected to the proximal end of the tibia in a position to form an articulating joint with the previously molded and applied femoral prothesis.

Claims

1. A method of treatment of an infected knee joint requiring a knee joint prothesis between a femur and a tibia which comprises removing an implanted knee joint prothesis and infected tissue therearound, custom molding a femoral prothesis having a first bearing means disposed in a first removable mold, introducing a settable material into said mold, said settable material containing a selected antibiotic that may be elutriated from said femoral prothesis at a desired rate to combat an infection, at least partially setting said settable material, contacting and connecting said femoral prothesis to a distal end of said femur and removing said first mold, custom molding a tibial prothesis having a mating bearing means disposed in a second removable mold, said bearing means adapted to cooperate and form an articulated joint with said first bearing means introducing said settable material containing said selective antibiotic into said second mold, setting said material in said second mold to form said tibial prothesis, removing said tibial prothesis from said second mold, contacting and connecting said tibial prothesis to a proximal end of said tibia in a position for said first bearing means and said mating bearing means to form an articulated knee joint.

2. A method as defined in claim 1 wherein said settable material is bone cement.

3. A method as defined in claim 1 wherein said femoral prothesis is applied to said distal end of said femur before said settable material from which it is molded has set and the setting of said settable material is completed while said femoral prothesis is so applied so that said settable material bonds said femoral prothesis to said proximal end of said femur and then removing the first removable mold from said femoral prothesis.

4. A method as defined in claim 1 further comprising embedding a runner forming means into said femoral prothesis, during said molding of said femoral prothesis in a position for said runner means to form said first bearing means.

5. A method as defined in claim 1 further comprising embedding an insert of material with a low co-efficient of friction into said tibial prothesis during said molding of said tibial prothesis, said embedded insert forming said mating bearing means.

6. A method as defined in claim 2 wherein said femoral prothesis is applied to said distal end of said femur before said settable material from which it is molded has set and the setting of said settable material is completed while said femoral prothesis is so applied so that said settable material bonds said femoral prothesis to said proximal end of said femur and then removing the first removable mold from said femoral prothesis.

7. A method as defined in claim 3 further comprising embedding a runner forming means into said femoral prothesis, during said molding of said femoral prothesis in a position for said runner means to form said first bearing means.

8. A method as defined in claim 3 further comprising embedding an insert of material with a low co-efficient of friction into said tibial prothesis during said molding of said tibial prothesis, said embedded insert forming said mating bearing means.

9. A method as defined in claim 4 further comprising embedding an insert of material with a low co-efficient of friction into said tibial prothesis during said molding of said tibial prothesis, said embedded insert forming said mating bearing means.

10. A method as defined in claim 6 further comprising embedding an insert of material with a low co-efficient of friction into said tibial prothesis during said molding of said tibial prothesis, said embedded insert forming said mating bearing means.

11. A set of molds to produce mating femur and tibial prothesis to form a temporary knee joint that dispenses antibiotics to cure infection comprising a first mold having a first interior mold face shaped to form a knee joint forming end of a femur, said first mold including a first mold surface to form a first bearing means in the form of a convex runner on a femoral prothesis formed therein, said first mold surface forming said first bearing comprising a first removable insert means mounted in said mold, said first insert means having the required shape to form said first bearing means, means for temporarily positioning said first insert means in said first mold to permit said first insert means to separate from said first mold with said femoral prothesis on separation of said femur prosthesis from said first mold, a second mold, said second mold having a second interior molding face shaped to form a knee joint forming end of a tibia, said second molding face including a second mold surface to form a mating bearing means in a tibial prothesis formed therein, said mating bearing means being shaped to cooperate with said first bearing means to form an articulating knee joint.

12. A set of molds as defined in claim 11 wherein said second mold includes a means to position a second removable insert means in a position to form said mating bearing means, said second insert means being removable from said second mold to remain as a part of said tibial prothesis formed in said second mold.