System and method for joint resurface repair

• US 6,679,917 B2
• Filed: 06/04/2002
• Issued: 01/20/2004
• Est. Priority Date: 05/01/2000
• Status: Expired due to Term

• Current Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Original Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Inventors: Ek, Steven W.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US10/162,533
• Publication Number:
  US 20030060887A1
• Time in Patent Office: 595 Days
• Field of Search: 623/20.14, 623/20.15, 623/20.18, 623/20.19, 623/20.21, 623/20.32, 623/20.31, 623/20.38, 606/71
• US Class Current: 623/20.14
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864
• CPC Class Codes: A61B 17/8615 at the central region of the screw head
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/8695 Washers surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 17/8827 with filtering, degassing, venting or pressure relief means
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 17/888 the driver bit acting on the central region of the screw head
• CPC Class Codes: A61B 17/8894 holding the implant into or through which the screw is to be inserted A61B17/7082, A61B17/7091 take precedence
• CPC Class Codes: A61B 2017/00238 : Type of minimally invasive operation A61B2017/00805 takes precedence
• CPC Class Codes: A61B 2017/00464 : for use with different instruments
• CPC Class Codes: A61B 2017/0404 : Buttons
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/044 : with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 : cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 : Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 : snug fit within the anchor
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/30756 : Cartilage endoprostheses A61F2/3603 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 2/30942 : 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 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4618 : of cartilage
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30065 : thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
• CPC Class Codes: A61F 2002/30069 : elastomeric
• CPC Class Codes: A61F 2002/30113 : circular
• CPC Class Codes: A61F 2002/30143 : hexagonal
• CPC Class Codes: A61F 2002/30225 : Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30324 : differing in thickness
• 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 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30451 : soldered or brazed or welded
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30831 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30858 : Threads interrupted by grooves or sidewalls, e.g. flat sidewalls
• CPC Class Codes: A61F 2002/30871 : Trapezoidal threads
• CPC Class Codes: A61F 2002/30873 : Threadings machined on non-cylindrical external surfaces
• 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 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30896 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30943 : using mathematical models
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30952 : using CAD-CAM techniques or NC-techniques
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4661 : for measuring thickness
• CPC Class Codes: A61F 2002/4663 : for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2210/0071 : thermoplastic
• 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 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2250/0036 : differing in thickness
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00059 : Chromium or Cr-based alloys
• CPC Class Codes: A61F 2310/00089 : Zirconium or Zr-based alloys
• CPC Class Codes: A61F 2310/00095 : Niobium or Nb-based alloys
• CPC Class Codes: A61F 2310/00203 : containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 : containing zirconia or zirconium oxide ZrO2
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

An implant for installation into a portion of an articular surface includes a protrusion configured to cover an un-excised portion of articular surface proximate to the implant. Another implant may form a cavity to allow the un-excised portion of articular surface to remodel over a perimeter edge of the implant. The implant may also include indentations such as grooves to promote articular cartilage remodeling over a portion of the load bearing surface of the implant. An elongated or non-round implant is also provided having two opposing concentric arcuate shaped sides, as well as a method to seat such an implant in an articular surface. A method for seating an implant without cutting articular cartilage is also provided.

Claims

1. An implant, comprising:

a bone-facing distal surface;

a proximal surface; and

a protrusion formed by an extension of said bone-facing distal surface and said proximal surface.

2. The implant of claim 1, wherein said distal surface is substantially round and said protrusion extends circumferentially from said distal surface.

3. The implant of claim 1, wherein said protrusion has a top surface, and wherein said top surface is a perimeter portion of said proximal surface.

4. The implant of claim 1, wherein said bone-facing distal surface is configured to mate with an implant site created by excising a portion of articular surface and said proximal surface has a contour based on an original surface contour of said excised portion of said articular surface.

5. The implant of claim 4, wherein said implant has an arced side surface configured to abut an edge of an excised portion of articular surface.

6. The implant of claim 2, wherein a distal side of said radial extension is arcuate shaped.

7. The implant of claim 4, wherein said protrusion further comprises protuberances configured to engage said un-excised portion of said articular surface proximate to said implant.

8. The implant of claim 4, wherein said implant further comprises at least one indentation formed in said proximal surface configured to promote remodeling of articular cartilage over said proximal surface of said implant once seated.

9. The implant of claim 8, wherein said at least one indentation is a groove.

10. The implant of claim 9, wherein said groove comprises thru holes providing a path from said proximal surface to said distal surface.

11. The implant of claim 1, wherein said implant is artificial comprising at least one material selected from the group consisting of:

ceramic, aluminum oxide, zirconium oxide, metal, metal alloy, Co—

Cr—

W—

Ni, Co—

Cr—

M, CoCr alloy, CoCr Molybdenum alloy, Cr—

Ni—

Mn alloy, powder metal alloy, 316L stainless steel, Ti 6A1-4V ELI, polymer, polyurethane, polyethylene, wear resistant polyethylene, cross-linked polyethylene, thermoplastic elastomer, biomaterial, polycaprolactone, diffusion hardened material, Ti-13-13, Zirconium, Niobium, porous coating system, hydrophilic coating, hydroxyapatite coating, and tri-calcium phosphate.

12. An implant for installation into a portion of an articular surface, said implant comprising:

a bone-facing distal surface configured to mate with an implant site created by excising a portion of said articular surface;

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface; and

a cavity configured to allow an un-excised portion of said articular surface proximate to said implant to remodel over a perimeter edge of said proximal surface.

13. The implant of claim 12, wherein said proximal surface has a first section substantially shaped to match said original surface contour of said excised portion and a second section depressed relative to said first section, said second section forming a floor of said cavity.

14. The implant of claim 12, wherein said implant further comprises at least one indentation formed in said proximal surface configured to promote remodeling of articular cartilage over a portion of said proximal surface of said implant once seated.

15. The implant of claim 14, wherein said at least one indentation is a groove.

16. The implant of claim 15, wherein said groove comprises thru holes providing a path from said proximal surface to said distal surface.

17. The implant of claim 12, wherein said implant is artificial comprising at least one material selected from the group consisting of:

ceramic, aluminum oxide, zirconium oxide, metal, metal alloy, Co—

Cr—

W—

Ni, Co—

Cr—

M, CoCr alloy, CoCr Molybdenum alloy, Cr—

Ni—

Mn alloy, powder metal alloy, 316L stainless steel, Ti 6A1-4V ELI, polymer, polyurethane, polyethylene, wear resistant polyethylene, cross-linked polyethylene, thermoplastic elastomer, biomaterial, polycaprolactone, diffusion hardened material, Ti-13-13, Zirconium, Niobium, porous coating system, hydrophilic coating, hydroxyapatite coating, and tri-calcium phosphate.

18. An implant for installation into a portion of an articular surface having an anterior portion, a posterior portion, a medial portion and a lateral portion, said implant comprising:

a bone-facing distal surface configured to mate with an implant site created by excising a portion of said articular surface; and

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface, and at least two side surfaces each having a concentric arcuate shape with a common center, wherein said implant has an elongate arcuate geometric shape.

19. The implant of claim 18, wherein said implant has a maximum arcuate length along said proximal surface from a first end of said implant seated proximate to said anterior portion of said articular surface to a second end of said implant seated proximate to said posterior portion of said articular surface, and a maximum arcuate width along said proximal surface from a third end of said implant seated proximate to said medial portion of said articular surface to a fourth end of said implant seated proximate to said lateral portion of said articular surface, wherein said arcuate length is greater than said arcuate width.

20. The implant of claim 18, wherein said distal surface is substantially planar to match said implant site having a substantially planar shape.

21. The implant of claim 18, further comprising a protrusion configured to cover an un-excised portion of said articular surface proximate to said implant.

22. The implant of claim 21, wherein said protrusion extends radially from said first and second ends.

23. The implant of claim 18, wherein said implant further comprises at least one indentation formed in said proximal surface configured to promote remodeling of articular cartilage over a portion of said proximal surface of said implant once seated.

24. The implant of claim 23, wherein said at least one indentation is a groove.

25. The implant of claim 24, wherein said groove comprises thru holes providing a path from said proximal surface to said distal surface.

26. The implant of claim 18, wherein said implant is artificial comprising at least one material selected from the group consisting of:

ceramic, aluminum oxide, zirconium oxide, metal, metal alloy, Co—

Cr—

W—

Ni, Co—

Cr—

M, CoCr alloy, CoCr Molybdenum alloy, Cr—

Ni—

Mn alloy, powder metal alloy, 316L stainless steel, Ti 6A1-4V ELI, polymer, polyurethane, polyethylene, wear resistant polyethylene, cross-linked polyethylene, thermoplastic elastomer, biomaterial, polycaprolactone, diffusion hardened material, Ti-13-13, Zirconium, Niobium, porous coating system, hydrophilic coating, hydroxyapatite coating, and tri-calcium phosphate.

27. A method for replacing a portion of an articular surface of bone, said method comprising:

establishing a working axis substantially normal to an articular surface of bone;

excising a portion of said articular surface adjacent to said axis, thereby creating an implant site, said implant site having a first and second opposing arcuate shaped sides; and

installing an implant to said implant site.

28. The method of claim 27, wherein said excising is performed by cutting at least a portion of said articular surface radially symmetrical about said axis.

29. The method of claim 28, wherein said cutting is performed by a cutting tool that rotates about said axis.

30. The method of claim 29, wherein said cutting tool has a circular blade portion, said circular blade portion having a diameter greater than a width of said implant site, wherein said articular surface has a medial side and a lateral side defining said width of said implant site.

31. The method of claim 27, wherein said working axis is established based on a first curve and second curve.

32. The method of claim 31, wherein said first curve is an anterior-posterior (AP) curve and said second curve is a medial-lateral (ML) curve.

33. The method of claim 27, further comprising the step of:

covering an un-excised portion of said articular surface proximate to said implant.

34. The method of claim 27, wherein said implant comprises:

a bone-facing distal surface configured to mate with said implant site;

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface; and

first and second opposed side surfaces, said first and second opposed side surfaces being arcuate and configured to mate with said first and second sides of said implant site.

35. The method of claim 34, wherein said implant further comprises a third and fourth opposed side surface.

36. The method of claim 34, wherein said implant further comprises a protrusion configured to cover an un-excised portion of said articular surface proximate to said implant.

37. The method of claim 36, wherein said protrusion extends radially from said first and second arcuate shaped side surfaces of said implant.

38. A method of replacing a portion of an articular surface of bone, said method comprising:

locating an existing defect in said articular surface;

establishing a working axis substantially normal to said articular surface and substantially centered with said existing defect;

excising a portion of said articular surface adjacent to said axis, thereby creating an implant site; and

installing an implant in said implant site, wherein at least a portion of said existing defect is exposed around a perimeter of said implant.

39. The method of claim 38, wherein said portion excised by said excising step has a surface area less than a surface area of said defect.

40. The method of claim 38, wherein said portion excised is bone.

41. The method of claim 38, wherein said excising step is performed by cutting at least a portion of said articular surface radially symmetrical about said axis.

42. The method of claim 41, wherein said cutting is performed by a cutting tool that rotates about said axis.

43. The method of claim 42, wherein said cutting tool has a circular blade portion, said circular blade portion having a diameter greater than a width of said implant site, wherein said articular surface has a medial side and a lateral side defining said width of said implant site.

44. The method of claim 38, wherein said implant comprises:

a bone-facing distal surface configured to mate with said implant site;

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface; and

a cavity configured to allow an un-excised portion of said articular surface proximate to said implant to remodel over a perimeter edge of said proximal surface.

45. The method of claim 44, wherein said proximal surface has a first section substantially shaped to match said original surface contour of said excised portion and a second section depressed relative to said first section, said second section forming a floor of said cavity.

46. An implant for installation into a portion of an articular surface, said implant comprising:

a bone-facing distal surface configured to mate with an implant site created by excising a portion of said articular surface;

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface; and

at least one arcuate shaped side surface configured to abut an edge of said excised portion of said articular surface, said arcuate shaped side surface having a radial extension configured to cover an un-excised portion of said articular surface proximate to said implant.

47. The implant of claim 46, wherein said implant is substantially round and said arcuate shaped side surface extends circumferentially along said implant.

48. The implant of claim 46, wherein said implant has a first side, said first side being said arcuate shaped side surface.

49. The implant of claim 48, wherein said implant has a second side opposing said first side, said second side also being an arcuate shaped side surface.

50. A method for replacing a portion of an articular surface of bone, said method comprising:

establishing a working axis substantially normal to an articular surface of bone, said articular surface having a medial side and lateral side defining a width of said articular surface;

excising a portion of said articular surface adjacent to said axis, thereby creating an implant site, wherein said excising is performed using a cutting tool that rotates about said axis, said cutting tool having a circular blade portion, said circular blade portion having a diameter greater than said width of said articular surface; and

installing an implant to said implant site.

51. An implant for installation into a portion of an articular surface, said implant comprising:

a bone-facing distal surface configured to mate with an implant site created by excising a portion of said articular surface; and

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface, wherein said proximal surface has at least one indentation formed in said proximal surface configured to promote remodeling of articular cartilage over a portion of said proximal surface of said implant once seated.

52. The implant of claim 51, wherein said at least one indentation is a groove.

53. The implant of claim 52, wherein said groove is a continuous groove from one perimeter point to another perimeter point across said proximal surface, and wherein said groove comprises at least one thru hole providing a path from said proximal surface to said distal surface.

54. The implant of claim 51, wherein said at least one indentation is formed in a perimeter edge of said proximal surface.

55. An implant for installation into a portion of an articular surface, said implant comprising:

a bone-facing distal surface configured to mate with an implant site created by excising a portion of said articular surface; and

a proximal surface having a contour based on an original surface contour of said excised portion of said articular surface, wherein said proximal surface is adapted to promote remodeling of articular cartilage over at least a portion of said proximal surface.

56. An implant according to claim 55 wherein said proximal surface comprises a cavity that is configured to allow articular cartilage to remodel over a perimeter edge of said proximal surface.

57. An implant according to claim 55 wherein said proximal surface comprises at least one indentation formed in said proximal surface to promote remodeling of articular cartilage over at least a portion of said proximal surface.

58. An implant according to claim 56 wherein said cavity has an arcuate shape.

59. An implant according to claim 56 wherein said cavity is depressed a predetermined distance relative to a load bearing surface of said proximal surface.

60. An implant according to claim 57 wherein said at least one indentation comprises a groove formed in said proximal surface.

61. An implant according to claim 60 wherein said at least one indentation comprises a continuous groove extending across said proximal surface.

62. An implant according to claim 55 wherein said proximal surface comprises through holes extending from said proximal surface.

63. An implant according to claim 60 further comprising a plurality of through holes extending from said groove.

64. An implant according to claim 63 wherein said through holes communicate to a bone surface associated with said implant site.

65. An implant according to claim 60 wherein said groove has a square shaped cross sectional geometry.

66. An implant according to claim 57 wherein said indentation is at least one space at a perimeter edge of said proximal surface.