Tibial prosthesis systems, kits, and methods

• US 9,149,206 B2
• Filed: 03/15/2013
• Issued: 10/06/2015
• Est. Priority Date: 03/30/2012
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Claypool, Jody, Paprosky, Wayne, Lewallen, David, Stump, Steven, White, Stephen E.
• Primary Examiner(s): Shay, Randy
• Application Number:
  US13/836,665
• Publication Number:
  US 20130261757A1
• Time in Patent Office: 935 Days
• Field of Search: 623/14.12, 623 2014- 2036, 623/23.39
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/0268 for the knee
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 5/1036 Measuring load distribution, e.g. podologic studies
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/4661 for measuring thickness
• CPC Class Codes: A61F 2002/4666 for measuring force, pressure or mechanical tension

Abstract

Tibial prosthesis systems for implantation or use in a knee joint are disclosed. A tibial prosthesis system can include a bearing component, a base component, a shim component, and optionally a spacer component. The shim or spacer component can be inserted between an inferior surface of the bearing component and a superior surface of the base component. The insertion of the shim or spacer component can provide spacing adjustment between the bearing and base components. The shim component can include one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge. The differing edge height of the shim component can provide a surgeon with knee joint kinematic insight regarding an angled bone cut before the cut is made, and can allow for sizing of an appropriately permanent prosthesis system using a reduced number of provisional components.

Claims

1. A tibial prosthesis system, comprising:

a bearing component having a superior articulating surface and an inferior surface, the inferior surface having a base component engagement feature;

a base component having a superior surface and an inferior surface, the superior surface having a bearing component engagement feature configured to mate with the base component engagement feature such that the bearing component and the base component are removably engageable with each other,

whereby mating of the base component engagement feature and the bearing component engagement feature restrains at least one of anterior/posterior movement or medial/lateral movement between the bearing component and the base component; and

a shim component configured to be slidable between the inferior surface of the bearing component and the superior surface of the base component, when the bearing component and the base component are engaged with each other, to removably engage the shim component with at least one of the bearing component and the base component, the shim component including one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge, wherein the shim component is sized and shaped to allow passage of the base component engagement feature or the bearing component engagement feature such that the base component engagement feature and the bearing component engagement feature remain mated together when the bearing component and the base component are engaged with each other and the shim component is slid therebetweeen.

2. The tibial prosthesis system of claim 1, wherein an inferior surface of the shim component includes a medial to lateral angle of between +3 degrees and −

3 degrees, inclusive, or an anterior to posterior angle of between +3 degrees and −

3 degrees, inclusive.

3. The tibial prosthesis system of claim 1, wherein the inferior surface of the bearing component includes a slot, and a superior surface of the shim component includes a rail configured to slidably engage the slot.

4. The tibial prosthesis system of claim 1, wherein the base component includes a first component, having a superior surface and an inferior surface, and a second component configured to receive and engage the inferior surface of the first component.

5. The tibial prosthesis system of claim 4, wherein the first component includes at least one ramped surface extending between its inferior surface and superior surface, the at least one ramped surface configured to engage an undercut of the second component, and wherein a projection extending from the inferior surface of the first component is configured to engage with a cavity of the second component.

6. The tibial prosthesis system of claim 4, wherein the second component is one of a sizing plate component, a provisional plate component, or a permanent plate component.

7. The tibial prosthesis system of claim 1, wherein the different height of the medial and lateral edges or of the anterior and posterior edges is measured in a proximal/distal direction.

8. The tibial prosthesis system of claim 1, wherein the shim component is configured to secure a position of the bearing component and the base component relative to each other.

9. The tibial prosthesis system of claim 1, wherein the bearing component engagement feature of the base component includes a projection and the base component engagement feature of the bearing component includes a cavity, the projection configured to at least partially engage within the cavity.

10. The tibial prosthesis system of claim 9, wherein the engagement of the projection of the base component at least partially within the cavity of the bearing component is configured to inhibit at least one of relative anterior/posterior movement or relative medial/lateral movement between the base and bearing components.

11. The tibial prosthesis system of claim 1, further comprising:

one or more sensors coupled to or integrated with at least one of the bearing component, the base component, or the shim component.

12. The tibial prosthesis system of claim 11, wherein the one or more sensors include a plurality of sensors coupled to or integrated with the bearing component.

13. The tibial prosthesis system of claim 12, wherein the plurality of sensors are positioned between the superior articulating surface and the inferior surface of the bearing component.

14. The tibial prosthesis system of claim 1, wherein the shim component can be removed from engagement with the at least one of the bearing component and the base component, when the bearing component and the base component are engaged with each other, without disengaging the base component and bearing component from one another.

15. A tibial prosthesis system, comprising:

a provisional bearing component having a base component engagement feature;

a provisional base component having a bearing component engagement feature configured to mate with the base component engagement feature such that the provisional bearing component and the provisional base component can be removably engaged with each other, whereby mating of the base component engagement feature and the bearing component engagement feature restrains at least one of anterior/posterior movement or medial/lateral movement between the provisional bearing component and the provisional base component; and

a set of different sized shim components, at least one of the shim components including one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge, wherein each shim component is configured to be insertable between the provisional bearing component and the provisional base component to removably engage the shim component with at least one of the provisional bearing component and the provisional base component,

whereby the shim component does not disturb the mating of the base component engagement feature and the bearing component engagement feature when the provisional bearing component and the provisional base component are engaged with each other and the shim component is inserted therebetween such that the provisional bearing component and the provisional base component retain engagement with each other when the shim component is inserted therebetween.

16. The tibial prosthesis system of claim 15, wherein an inferior surface of at least one shim component, from the set of different sized shim components, includes a medial to lateral angle of between +3 degrees and −

3 degrees, inclusive, or an anterior to posterior angle of between +3 degrees and −

3 degrees.

17. The tibial prosthesis system of claim 15, further comprising:

instructions for inserting at least one shim component, from the set of different sized shim components, between the provisional bearing component and the provisional base component.

18. The tibial prosthesis system of claim 17, wherein each shim component provides a spacing between the provisional bearing component and the provisional base component in a range between 10 mm and 20 mm, inclusive.

19. The tibial prosthesis system of claim 15, further comprising:

one or more sensors integrated with the shim component.

20. The tibial prosthesis system of claim 15, further comprising:

a set of different sized base components.

21. The tibial prosthesis system of claim 15, further comprising:

a shim handling instrument including an interface configured to engage with a front end portion of each of the set of different sized shim components.

22. The tibial prosthesis system of claim 21, wherein the shim handling instrument is used for insertion and removal of each shim component between the provisional bearing component and the provisional base component, when the bearing component and the base component are engaged with each other, without disengaging the provisional base component and the provisional bearing component from one another.

23. A tibial prosthesis system, comprising:

a bearing component having a superior articulating surface and an inferior surface, the inferior surface having a base component engagement feature;

a base component having a superior surface and an inferior surface the superior surface having a bearing component engagement feature configured to mate with the base component engagement feature such that the bearing component and the base component can be removably coupled to each other;

one or more shim components configured to be slidable between the inferior surface of the bearing component and the superior surface of the base component to removably engage at least one of the bearing component and the base component,

at least one of the one or more shim components including one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge,

wherein the one or more shim components do not disrupt the mating of the base component engagement feature and the bearing component engagement feature when the provisional bearing component and the provisional base component are coupled to each other and the one or more shim components is slid therebetween,

whereby the coupling of the bearing component and the base component is not disturbed when the one or more shim components is slid therebetween.

24. The tibial prosthesis system of claim 23, wherein the one or more shim components include a first shim and a second shim.

25. The tibial prosthesis system of claim 23, wherein the bearing component includes a post extending from the superior articulating surface.

26. The tibial prosthesis system of claim 23, further comprising:

a screw configured to extend partially through each of the bearing component and the base component, in a distal direction from the superior articulating surface, to attach the bearing component to the base component.

27. The tibial prosthesis system of claim 26, wherein the one or more shim components are configured to be slidable between the inferior surface of the bearing component and the superior surface of the base component when the screw attaches the bearing component to the base component.

28. The tibial prosthesis system of claim 26, wherein the spacer component is removable from the tibial prosthesis system prior to sliding the one or more shim components between the inferior surface of the bearing component and the superior surface of the base component.

29. The tibial prosthesis system of claim 23, wherein each of the one or more shim components can be removed from engagement with the at least one of the bearing component and the base component, when the bearing component and the base component are engaged with each other, without disengaging the base component and the bearing component from one another.

30. The tibial prosthesis system of claim 23, further comprising a spacer component configured to be inserted between the inferior surface of the bearing component and the superior surface of the base component to removably engage at least one of the bearing component and the base component in the absence of the one or more shim components therebetween.

31. A tibial prosthesis system, comprising:

a bearing component having a base component engagement feature;

a base component having a bearing component engagement feature,

whereby the base component engagement feature and the bearing component engagement feature are configured to mate with each other to removably couple the bearing component with the base component,

and whereby mating of the base component engagement feature with the bearing component engagement feature restrains at least one of anterior/posterior movement or medial/lateral movement between the bearing component and the base component; and

a shim component configured to be inserted between the bearing component and the base component, the shim component including one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge,

whereby the shim component provides spacing between the bearing component and the base component when the shim component is inserted therebetween,

whereby the shim component is removably engageable with at least one of the bearing component and the base component,

whereby the shim component includes a posterior recess that allows the base component engagement feature and the bearing component engagement feature to remain mated together when the bearing component and the base component are coupled to each other and the shim component is inserted therebetween,

and whereby the shim component does not disturb coupling of the bearing component and the base component when the shim component is inserted therebetween.

32. A tibial prosthesis system, comprising:

a bearing having a superior surface and an inferior surface, the inferior surface having a base engagement feature;

a base having a superior surface and an inferior surface, the superior surface having a bearing engagement feature,

whereby the bearing and the base can be removably coupled to each other through mating of the bearing engagement feature with the base engagement feature, and

whereby mating of the base engagement feature with the bearing engagement feature restrains at least one of anterior/posterior movement or medial/lateral movement between the bearing and the base; and

a shim including one or both of a medial edge having a different height than a lateral edge or an anterior edge having a different height than a posterior edge, the shim having at least one mating feature configured for engagement with a shim mating feature on at least one of the bearing and the base,

whereby the shim is slidable between the bearing and the base, when the bearing and the base are coupled to each other, to removably engage the at least one mating feature on the shim with the shim mating feature on the at least one of the bearing and the base,

whereby the shim provides spacing between the bearing and the base, and

whereby the shim does not disturb the coupling of the bearing engagement feature and the base engagement feature, and

whereby the bearing and the base remain coupled to each other when the shim is slid therebetween.