Implantation and removal of orthopedic prostheses

• US 5,456,686 A
• Filed: 10/25/1993
• Issued: 10/10/1995
• Est. Priority Date: 01/31/1989
• Status: Expired due to Term

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Klapper, Robert C., Caillouette, James T.
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): KENEALY, DAVID
• Application Number:
  US08/143,521
• Time in Patent Office: 715 Days
• Field of Search: 606/53, 606/86, 606/99, 606/79, 606/127, 606/128, 606/168-171, 601/2, 604/22, 433/119, 433/165, 433/84, 623/22, 623/23
• US Class Current: 606/99
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/8847 for removing cement from a bone cavity using surgical bone chisels, drills, mills, rasps, reamers or scrapers A61B17/16; using laser A61B18/20; using ultrasonic surgical instruments A61N7/00
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4607 of hip femoral endoprostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30795 Blind bores, e.g. of circular cross-section
• CPC Class Codes: A61F 2002/3631 with an integral complete or partial peripheral collar or bearing shoulder at its base
• CPC Class Codes: A61F 2002/368 with lateral apertures, bores, holes or openings, e.g. for reducing the mass, for receiving fixation screws or for communicating with the inside of a hollow shaft
• CPC Class Codes: A61F 2002/4619 for extraction
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/465 using heating means
• CPC Class Codes: A61F 2002/4683 by applying ultrasonic vibrations
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: B06B 3/00 Methods or apparatus specially adapted for transmitting mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
• CPC Class Codes: F16B 21/02 Releasable fastening devices locking by rotation with snap-action F16B21/06; studs or coupling pins with resilient protrusions F16B21/08
• CPC Class Codes: F16L 37/2445 in which a male cylindrical element is introduced into a female cylindrical element, each element containing several threads axially spaced and circumferentially discontinuous which engage with each other as a result of the rotation of one of the elements

Abstract

Ultrasonic vibrations are employed for forming a cavity into which a prosthesis is implanted. This technique includes vibrating the prosthesis itself as it is inserted to enlarge the cavity and assure a tight fit.

Claims

1. A method for implanting an orthopedic prosthesis into a bone, comprising the steps of:

providing an orthopedic prosthesis comprising a stem portion to be implanted and a head portion coupled to said stem portion;

exposing a bone into which said orthopedic prosthesis is to be implanted, said bone having a cancellous bone component and a cortical bone component;

forming a medullary canal in said cancellous bone component, said canal having a shape which is generally complementary to the shape of at least said stem portion of said orthopedic prosthesis;

coupling said orthopedic prosthesis to a source of ultrasonic energy;

vibrating said source of ultrasonic energy at a frequency which generally corresponds to a resonant frequency of said prosthesis; and

advancing at least said stem portion of said orthopedic prosthesis into said formed medullary canal while ultrasonically vibrating at least said stem portion of said orthopedic prosthesis with sufficient energy to modify a portion of the surrounding bone.

2. A method as recited in claim 1, wherein said medullary canal is formed in a femur.

3. A method of implanting an orthopedic prosthesis having stem and head portions into a bone, comprising the steps of:

coupling an ultrasonic transducer to an orthopedic prosthesis;

forming a cavity in a bone;

vibrating said ultrasonic transducer at a frequency which generally corresponds to a resonant frequency of said prosthesis; and

implanting at least the stem portion of said orthopedic prosthesis into said formed cavity while ultrasonically vibrating at least a portion of said orthopedic prosthesis with sufficient energy to modify a portion of the surrounding bone.

4. The method of claim 3, wherein said implanting step involves vibrating the orthopedic prosthesis at a frequency sufficient to disrupt cancellous bone adjacent to the portion of the prosthesis being implanted.

5. The method of claim 4, wherein said prosthesis is vibrated at a frequency within a range from about 20 kHz to about 40 kHz.

6. The method of claim 4, wherein the ultrasonic frequency at which the orthopedic prosthesis is vibrated is insufficient for significantly disrupting cortical bone.

7. The method of claim 3, wherein said step of forming a cavity involves forming a cavity substantially in the same shape as at least the stem portion of the prosthesis to be implanted.

8. The method of claim 7, wherein said step of forming a cavity comprises the steps of providing a surgical tool and ultrasonically vibrating said surgical tool with sufficient energy to disrupt cancellous bone.

9. The method of claim 8, wherein said step of providing a surgical tool involves providing a surgical tool having a plurality of teeth.

10. The method of claim 3, wherein said cavity is formed in cancellous bone.

11. The method of claim 10, wherein said step of forming a cavity comprises removing cancellous bone to create a medullary canal in a femur.

12. The method of claim 3, wherein said cavity is formed in an acetabulum.

13. The method of claim 3 additionally comprising the step of providing an orthopedic prosthesis comprising a porous surface.

14. The method of claim 13, wherein said porous surface has a surface roughness sufficient to disrupt cancellous bone when vibrated at a frequency within a range from about 20 kHz to about 40 kHz.

15. The method of claim 13, wherein said porous surface has interstices sized to promote the ingrowth of cancellous bone.

16. The method of claim 15, wherein said interstices of said porous surface have sizes ranging from about 50 micrometers to about 400 micrometers.

17. A method of implanting an orthopedic prosthesis of a type having a porous surface for the ingrowth of cancellous bone, said method comprising the steps of:

forming a cavity in cancellous bone;

coupling said orthopedic prosthesis to a source of ultrasonic energy;

vibrating said source of ultrasonic energy at a frequency which generally corresponds to a resonant frequency of said prosthesis;

and

implanting at least a portion of said porous surface of said prosthesis into said formed cavity while vibrating said prosthesis with sufficient energy to disrupt a portion of the surrounding cancellous bone, said prosthesis being vibrated at an ultrasonic frequency which generally corresponds to a resonant frequency of said prosthesis.

18. The method of claim 17, wherein said cavity has a shape complimentary to at least the portion of the prosthesis to be implanted and has a cross-sectional dimension slightly smaller than that of the portion of the prosthesis to be implanted.