Method and apparatus for arthroscopically replacing a bone joint

• US 5,263,987 A
• Filed: 05/28/1991
• Issued: 11/23/1993
• Est. Priority Date: 08/25/1989
• Status: Expired due to Fees

• Current Assignee: Mrugesh K. Shah
• Original Assignee: Mrugesh K. Shah
• Inventors: Shah, Mrugesh K.
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): KENEALY, DAVID
• Application Number:
  US07/705,766
• Time in Patent Office: 910 Days
• Field of Search: 606/86-89, 606/99, 623/18-23
• US Class Current: 623/18.11
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30 Joints
• CPC Class Codes: A61F 2/30721 Accessories
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30965 Reinforcing the prosthesis by embedding particles or fibres during moulding or dipping
• CPC Class Codes: A61F 2/32 for the hip
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/3603 implanted without ablation of the whole natural femoral head endoprosthetic cartilage A61F2/30756
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3877 Patellae or trochleae
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30892 parallel
• CPC Class Codes: Y10S 623/908 Bone

Abstract

A method and apparatus for arthroscopically replacing a joint between two bones utilizes a plurality of joint surface members which are attached to a prepared surface arthroscopically formed on the end of a bone, and the joint surface members are inserted through an arthroscopic portal adjacent to the joint to be repaired.

Claims

1. An apparatus for arthroscopically replacing a joint between two bones, each bone having at least one prepared surface formed thereon, at least one of the prepared surfaces of each bone being disposed opposite each other in a spaced relationship, comprising:

a plurality of joint surface members, each joint surface member including an upper bearing surface formed of a bio-compatible, low friction material, and a lower surface;

a second plurality of joint surface members, each joint surface member including an upper bearing surface formed of a bio-compatible, low friction material, and a lower surface;

the upper bearing surfaces of the first plurality of joint surface members adapted to be attached to one bone having a concave configuration, and the upper bearing surfaces of the second plurality of joint surface members adapted to be attached to the oppositely disposed bone having a convex configuration, whereby opposing upper bearing surfaces are matingly received within one another;

first means for attaching the first plurality of joint surface members to a prepared bone surface, he first attachment means being located at the lower surface of each joint surface member of the first plurality of joint surface members;

second means for attaching the second plurality of joint surface members to a prepared bone surface, the second attachment means located at the lower surface of each joint surface member of the second plurality of joint surface members;

each of the joint surface members of the first and second plurality of joint surface members having three external dimensions including height, width, and length, and at least two of the external dimensions of each joint surface member is equal to, or less than, one centimeter, whereby the joint surface members may be passed through an arthroscopic portal adjacent to the joint and the first plurality of joint surface members may be attached to one prepared bone surface and the second plurality of joint surface members may be attached to an oppositely disposed bone surface to form a replacement joint between the two bones.

2. The apparatus of claim 1, wherein the first and second attachment means are a staple member associated with the lower surface of the joint surface members.

3. The apparatus of claim 1 wherein, the first and second attachment means are bone cement.

4. The apparatus of claim 1, wherein the first and second attachment means include a porous coating into which the bone may grow.

5. The apparatus of claim 1, wherein at least one of the attachment means includes a plurality of scaffold members upon which are disposed the plurality of joint surface members, the scaffold members having an upper and a lower surface, the lower surface of each joint surface member being disposed upon an upper surface of one of the scaffold members, and the lower surface of each scaffold member is adapted to be attached a prepared bone surface.

6. The apparatus of claim 5, wherein each scaffold member has three external dimensions, including height, width and length, and at least two of the three external dimensions of each scaffold member is equal to, or less than, one centimeter.

7. The apparatus of claim 5, wherein the scaffold members include a positioning means which cooperates with a mating surface on each joint surface member.

8. The apparatus of claim 5, wherein the scaffold members are integral elongate members.

9. The apparatus of claim 5, wherein the scaffold members are elongate members formed of connected segments, and include means for connecting the segments of the scaffold members.

10. The apparatus of claim 5, wherein one of the bones is a femur having a plurality of planar thereon and the scaffold members which are adapted for attachment to the planar surfaces of the femur have a U-shaped configuration which conforms to the shape of the prepared surfaces on the femur.

11. The apparatus of claim 5, wherein the upper bearing surface of each joint surface member is formed as an integral part of the upper surface of each scaffold member.

12. The apparatus of claim 1, wherein the upper bearing surface is formed integral with each joint surface member of at least one of the plurality of joint surface members.

13. The apparatus of claim 1, wherein the upper bearing surface of each joint surface member of at least one of the plurality of joint surface members is a cap member fixedly secured to the joint surface member.

14. The apparatus of claim 1, wherein the cross-sectional configuration of some of the joint surface members of at least one of the plurality of joint surface members is circular.

15. The apparatus of claim 1, wherein the cross-sectional configuration of some of the joint surface members of at least one of the plurality of joint surface members is triangular.

16. The apparatus of claim 1, wherein the cross-sectional configuration of some of the joint surface members of at least one of the plurality of joint surface members is rectangular.

17. The apparatus of claim 1, wherein the cross-sectional configuration, of some of the joint surface members of at least one of the plurality of joint surface members is hexagonal.

18. The apparatus of claim 1, wherein the upper bearing surfaces of each joint surface member of at least one of the plurality of joint surface members is planar.

19. The apparatus of claim 1, wherein the joint surface members of at least one of the plurality of joint surface members are elongate members which have a generally semi-circular configuration, and are adapted to be attached to an arthroscopically prepared bone surface on the head of a femur and within an acetabulum.

28. The apparatus of claim 1, wherein the attachment means is a screw associated with the lower surface of the joint surface members.

29. The apparatus of claim 1, wherein the attachment means is a pin associated with the lower surface of the joint surface members.

30. The apparatus of claim 1, wherein the attachment means is a nail associated with the lower surface of the joint surface members.

31. The apparatus of claim 1, wherein the attachment means is a bio-compatible glue.

32. The apparatus of claim 5, wherein one of the bones is a femur having a plurality of planar bone surfaces thereon and the scaffold members which are adapted for attachment to the planar surfaces of the femur have a J-shaped configuration which conforms to the shape of the prepared surfaces on the femur.

33. The apparatus of claim 5, wherein one of the bones is a femur having a plurality of planar bone surfaces thereon and the scaffold members which are adapted for attachment to the planar surfaces of the femur have a C-shaped configuration which conforms to the shape of the prepared surfaces on the femur.

20. A method for arthroscopically replacing a joint between two bones, comprising the steps of:

forming a plurality of arthroscopic portals adjacent the joint;

inserting an arthroscope through one of the arthroscopic portals;

arthroscopically preparing at least one surface on each bone, with at least one of the prepared surfaces of each bone being disposed opposite each other in a spaced relationship;

inserting a plurality of joint surface members through at least some of the arthroscopic portals, each joint surface member including an upper bearing surface formed of a bio-compatible, low friction material, and a lower surface;

attaching the plurality of joint surface members to the prepared bone surfaces to cover a substantial portion of each prepared bone surface, whereby a replacement joint between the two bones is formed by the upper bearing surfaces of the joint surface members, which upper bearing surfaces abut oppositely disposed upper bearing surfaces as one bone moves with respect to the other bone.

21. The method of claim 20, including the step of:

inserting a plurality of scaffold members through some of the arthroscopic portals;

attaching the scaffold members to the prepared bone surfaces; and

attaching the joint surface members to the scaffold members.

22. The method of claim 21, wherein one of the bones is a femur, further including the step of:

arthroscopically forming a plurality of planar surfaces on the femur in a J-shaped configuration;

attaching a plurality of J, C, or U-shaped scaffold members to the femur planar surfaces; and

attaching a plurality of joint surface members to the scaffold members.

23. The method of claim 21, including the steps of utilizing the scaffold members as the joint surface members, and forming the upper bearing surface of the joint surface members as an integral part of an upper surface of each scaffold member.

24. The method of claim 20, including the steps of:

forming the upper bearing surfaces from a single block of bearing surface material having a shape approximating the shape of the prepared bone surface to be covered;

disposing the upper bearing surfaces upon the prepared bone surface in the same location and orientation the upper bearing surfaces originally had with respect to the block of bearing surface material, whereby the plurality of upper bearing surfaces form a substantially continuous bearing surface on the prepared bone surface.

25. The method of claim 24, including the step of utilizing a block of bearing surface material which has a planar lower surface and either a concave or convex upper surface.

26. The method of claim 23, including the steps of:

forming the scaffold members from a single block of bearing surface material having a shape approximating the shape of the prepared bone surface to be covered;

disposing the scaffold members upon the prepared bone surface in the same location and orientation the scaffold members originally had with respect to the block of bearing surface material, whereby the upper surfaces of the scaffold members form a substantially continuous bearing surface on the prepared bone surface.

27. The method of claim 20, including the steps of:

utilizing a plurality of elongate joint surface members which have a generally semi-circular configuration;

arthroscopically attaching a plurality of the joint surface members upon a prepared bone surface on a head of a femur and within an acetabulum to form a replacement hip joint.