System and method for joint resurface repair

• US 8,147,559 B2
• Filed: 10/20/2009
• Issued: 04/03/2012
• 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: Tallarida, Steven J., Ek, Steven W.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/582,345
• Publication Number:
  US 20100070048A1
• Time in Patent Office: 896 Days
• Field of Search: 623/23.42, 623/20.14, 623/23.6, 623/20.18, 623/20.19, 623/20.2, 623/14.12, 623/20.16, 623/20.17, 623/20.33, 623/17.19, 606/80, 606/87, 606/102, 606/96, 606/99, 606/104
• US Class Current: 623/23.42
• CPC Class Codes: A61B 1/317 for bones or joints, e.g. osteoscopes, arthroscopes
• 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 17/1764 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 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• 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
• CPC Class Codes: Y10S 606/902 : Cortical plate specifically adapted for a particular bone
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated
• CPC Class Codes: Y10S 606/91 : Polymer

Abstract

A system for positioning an element relative to an articular surface. An embodiment of the system may include a first element having a positional reference relative to an articular surface. The system may further include a second element capable of indicating the positional reference of the first element relative to said articular surface. Of course, many alternatives, variations, and modifications are possible without departing from this embodiment.

Claims

1. An implant system, comprising:

a reamer comprising a shaft and at least one cutting surface extending radially outwardly from said shaft, wherein said reamer is configured to rotate around a longitudinal axis of said shaft to define an excision site having a generally circular cross-section; and

a post comprising a threaded portion configured to engage bone beneath a patient'"'"'s articular surface;

an implant configured to be received in said excision site, said implant having a generally circular outer perimeter corresponding to said generally circular excision site defined by said reamer, wherein said generally circular outer perimeter defines an outer bound of a continuous load bearing surface that substantially matches at least one curvature of said patient'"'"'s articular surface; and

a fixation element configured to couple said post to said implant, wherein said fixation element is further configured to permit said implant to rotate with respect to said post.

2. The implant system according to claim 1, wherein said fixation element is further configured to secure said implant to said post.

3. The implant system according to claim 2, wherein implant is configured to be rotated to a predetermined alignment with respect to said articular surface before said implant is secured to said post.

4. The implant system according to claim 1, wherein said fixation element comprises a first fixation element coupled to said post and a second fixation element coupled to said implant.

5. The implant system according to claim 4, wherein at least one of said first or said second fixation elements includes a tapered surface.

6. The implant system according to claim 4, wherein said first fixation element comprises a male member and said second fixation element comprises a female member.

7. The implant system according to claim 6, wherein said male member comprises a generally cylindrical extension having a taper.

8. The implant system according to claim 7, wherein said female member comprises a protrusion extending generally outwardly from a bone-facing distal surface, said protrusion including a tapered recess.

9. The implant system according to claim 4, wherein said first fixation element comprises a female member and said second fixation element comprises a male member.

10. The implant system according to claim 9, wherein said female member comprises a tapered recess disposed proximate a proximal-most end of said post.

11. The implant system according to claim 9, wherein said male member comprises a protrusion extending generally outwardly from a bone-facing distal surface, at least a portion of an outer surface of said protrusion having a taper.

12. The implant system according to claim 4, wherein said first and said second fixation elements each include a tapered surface configured to engage each other in a snap-fit arrangement.

13. The implant system according to claim 4, wherein said first and said second fixation elements each include a tapered surface configured to engage each other in a press-fit arrangement.

14. The implant system according to claim 4, wherein said first and said second fixation elements each include a tapered surface configured to engage each other in a threaded arrangement.

15. The implant system according to claim 1, wherein said post comprises a passageway disposed along a longitudinal axis of said post.

16. The implant system according to claim 1, wherein said post comprises a tapered distal end and aggressive distal threads configured to dilate open and radially compress said bone.

17. The implant system according to claim 16, wherein a diameter of a center region of said post is substantially uniform along a longitudinal axis of said post.

18. The implant system of claim 1, wherein at least a portion of said implant system defines a central passageway.

19. The implant system of claim 8, wherein at least a portion of said implant and said post defines said central passageway.

20. An implant system, comprising:

a reamer comprising a shaft and at least one cutting surface extending radially outwardly from said shaft, wherein said reamer is configured to rotate around a longitudinal axis of said shaft to define an excision site having a generally circular cross-section;

an implant configured to be received in said excision site, said implant having a generally circular cross-section perimeter corresponding to said generally circular excision site defined by said reamer, wherein said generally circular perimeter defines an outer bound of a continuous a load bearing surface that substantially matches at least one curvature of a patient'"'"'s articular surface, said implant further comprising a first fixation element coupled to a bottom surface; and

a post comprising a second fixation element configured to rotatably couple said post to said first fixation element of said implant, said post configured to extend outwardly from said implant and configured to engage bone beneath said patient'"'"'s articular surface;

wherein implant is configured to be rotated to a predetermined alignment with respect to said articular surface before said implant is secured to said post.

21. The implant system of claim 20, wherein at least a portion of said implant system defines a central passageway.

22. The implant system of claim 21, wherein at least a portion of said implant defines said central passageway.

23. The implant system of claim 21, wherein at least a portion of said post defines said central passageway.

24. The implant system of claim 21, wherein at least a portion of said implant and said post defines said central passageway.

25. The implant system of claim 21, wherein said central passageway is configured to receive a guide wire.

26. The implant system of claim 25, wherein said post further comprises aggressive distal threads.

27. The implant system according to claim 25, wherein said post comprises a tapered distal end having aggressive distal threads configured to dilate open and radially compress said bone.

28. The implant system of claim 21, wherein said implant system comprises a CoCr molybdenum alloy.

29. The implant system of claim 21, wherein said implant system comprises Ti 6Al-4V ELI.