Method and apparatus for acetabular reconstruction

• US 8,551,181 B2
• Filed: 02/27/2012
• Issued: 10/08/2013
• Est. Priority Date: 02/23/2001
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Meridew, Jason D., Gibbs, Phillip M.
• Primary Examiner(s): Willse, David H
• Assistant Examiner(s): BLANCO, JAVIER G
• Application Number:
  US13/405,683
• Publication Number:
  US 20120150311A1
• Time in Patent Office: 589 Days
• Field of Search: None
• US Class Current: 623/22.28
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61F 2/30724 Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30734 Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30156 triangular
• CPC Class Codes: A61F 2002/30327 differing in diameter
• CPC Class Codes: A61F 2002/30383 made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30495 using a locking ring
• CPC Class Codes: A61F 2002/30535 Special structural features of bone or joint prostheses not otherwise provided for
• CPC Class Codes: A61F 2002/30553 for adjusting a position by translation along an axis
• CPC Class Codes: A61F 2002/30578 having apertures, e.g. for receiving fixation screws
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/30774 internally-threaded
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3082 : Grooves
• CPC Class Codes: A61F 2002/3401 : with radial apertures, e.g. radial bores for receiving fixation screws
• CPC Class Codes: A61F 2002/3403 : Polar aperture
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0023 : triangular
• CPC Class Codes: A61F 2250/0008 : for adjusting a position by translation along an axis or two perpendicular axes
• CPC Class Codes: A61F 2250/0039 : differing in diameter
• CPC Class Codes: A61F 2250/0058 : Additional features; Implant or prostheses properties not otherwise provided for
• CPC Class Codes: A61F 2250/0064 : Sets comprising a plurality of prosthetic parts of different sizes
• 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

Abstract

A trial system for a prosthesis is described. The prosthesis can include an acetabular prosthesis generally for implantation in an acetabulum and the surrounding pelvis. The acetabular prosthesis includes an acetabular cup having a substantially concave inner surface and a substantially convex outer surface. One trial shell or a collection of trial shells are provided to trial a range of motion of the hip joint before implanting a shell prosthesis into the acetabular prosthesis.

Claims

1. A method of providing an acetabular prosthesis system to replace at least a portion of an acetabulum of an anatomy, comprising:

positioning a trial cup relative to a first portion of the anatomy;

positioning a trial cement mantle member in a selected first position relative to the positioned trial cup to replicate a cement mantle portion between an implanted cup and an implanted liner;

positioning a trial liner relative to the trial cement mantle member, wherein the trial cement mantle member is between the trial liner and the positioned trial cup;

holding the trial liner in a first position relative to the trial cement mantle member;

passing a trial liner fixation member through a passage extending through the trial liner;

wherein the trial liner fixation member includes a shank and a head portion, wherein the shank portion extends through the passage and the head portion bears against the trial liner to hold the trial liner in the first position;

removing the positioned trial cement mantle member and the positioned trial cup;

implanting the implantable cup relative to the first portion of the anatomy; and

removing the trial liner and implanting an implantable liner;

wherein implanting an implantable liner includes cementing the trial liner to the implantable cup.

2. The method of claim 1, wherein implanting the implantable cup includes positioning an acetabular prosthesis in a prepared acetabulum of the anatomy;

and

moving a second portion of the anatomy includes moving a femur relative to the cup positioned in the anatomy.

3. The method of claim 1, further comprising;

engaging a trial cement mantle member cooperation system including a detent on the trial cup and a projection on the trial cement mantle member;

wherein positioning the trial cement mantle member includes engaging the detent of the cup and the projection of the trial cement mantle member.

4. The method of claim 3, further comprising;

selectively fixing the trial cement mantle member relative to the cup in a manner so that moving the second portion of the anatomy does not substantially move the trial cement mantle member relative to the cup.

5. The method of claim 1, further comprising;

moving the trial liner to a second position different than the first position;

holding the trial liner in the second position;

moving a second portion of the anatomy relative to the trial liner held in the first position; and

moving the second portion of the anatomy relative to the held trial liner in the second position.

6. The method of claim 5, further comprising;

comparing the movement of the second portion of the anatomy relative to the held liner in the first position and relative to the held liner in the second position; and

determining an optimized movement of the second portion from the comparison.

7. The method of claim 6, further comprising:

positioning an implantable liner in the optimized position; and

cementing the implantable liner to the cup in the optimized position.

8. The method of claim 1, further comprising:

positioning a protrusio cage relative to the first portion of the anatomy;

wherein positioning the cup includes positioning the cup within the protrusio cage.

9. The method of claim 1, wherein holding the trial liner includes selectively immovably fixing the trial liner in a single position relative to the trial cement mantle member.

10. The method of claim 1, wherein the passage is an elongated slot.

11. The method of claim 1, further comprising:

moving a second portion of the anatomy relative to the held trial liner.

12. The method of claim 11, wherein moving the second portion of the anatomy includes:

moving a femur of the anatomy; and

determining if impingement of the femur occurs on the held trial liner.

13. The method of claim 12, further comprising:

if impingement is determined, moving the trial liner to a second position relative to the trial liner different than the first position; and

moving the femur relative to the trial liner when in the second position.

14. The method of claim 1, wherein holding the trial liner in a first position relative to the trial cement mantle member, further includes positioning a projection of the trial cement mantle member in a detent of the trial cup.

15. A method of providing an acetabular prosthesis system to replace at least a portion of an acetabulum of an anatomy, comprising:

providing a trial cup to be positioned relative to a first portion of the anatomy;

providing a trial cement mantle member to be positioned within the trial cup to replicate a cement mantle portion between an implanted cup and an implanted liner;

providing a trial liner to be positioned within the trial cement mantle member, wherein the trial cement mantle member is to be positioned between the trial liner and the positioned trial cup;

providing a trial liner fixation member to hold the trial liner in a first trial liner position relative to the trial cement mantle member;

providing the implantable cup to be implanted relative to the anatomy based on the position of the provided trial cup relative to the first portion of the anatomy; and

providing an implantable liner to be cemented to the implantable cup at least once the provided implantable cup is implanted;

wherein when the trial liner and the trial cement mantle member are positioned relative to the trial cup a second portion of the anatomy is operable to be moved relative to the positioned trial liner and wherein the positioned trial cement mantle member and the positioned trial cup are operable to be removed.

16. The method of claim 15, wherein the provided implantable cup is determined to be implanted relative to the anatomy in substantially the same position as the position of the trial cup relative to the first portion of the anatomy.

17. The method of claim 16, further comprising:

providing projections on the trial cement mantle member to extend from an exterior of the trial cement mantle member; and

providing detents in the trial cup to receive the provided projections from the trial cement mantle member to hold the trial cement mantle member relative to the trial cup in a first trial cement mantle member position.

18. The method of claim 16, wherein providing the implantable cup includes providing the implantable cup to be substantially porous throughout.