Modular Humeral Component for Use in a Universal Shoulder Prosthesis System
20240398577 ยท 2024-12-05
Inventors
Cpc classification
A61F2002/3092
HUMAN NECESSITIES
A61F2002/4085
HUMAN NECESSITIES
A61F2002/30616
HUMAN NECESSITIES
A61F2/30734
HUMAN NECESSITIES
A61F2002/30607
HUMAN NECESSITIES
A61F2/4014
HUMAN NECESSITIES
A61F2002/30332
HUMAN NECESSITIES
A61F2002/30736
HUMAN NECESSITIES
A61F2002/30329
HUMAN NECESSITIES
A61F2002/4022
HUMAN NECESSITIES
International classification
Abstract
A universal shoulder prosthesis system includes a baseplate, a shoulder base, which may be a baseplate, and modular components that are exchangeable between ta-TSR and r-TSR. The system may further include wedges for use with the baseplate when the baseplate is implanted on the glenoid side. An example of a modular component is a modular humeral component (500) for use in ta-TSR that includes an outer shell (510) and an inner head (520) that fits into the outer shell (510) and attaches to the shoulder base. In at least one embodiment, there is a means for engagement between the outer shell (510) and the inner head (520), which may be a ring protrusion (518A) encircling an interior cavity (514A) of the outer shell (510A) that fits into a channel (529) around the exterior of the inner head (520A).
Claims
1. A modular humeral component for use in a modular shoulder prosthesis system having a shoulder base with or without notches and/or attachment points, the modular humeral component comprising: an inner head having a base, a dome on said base, and an optional plug extending away from said base; and a shell configured to fit over said inner head, said shell having a body having an exterior surface configured for engagement with a concave surface of a glenoid component, said body defining an interior cavity configured to receive said dome, and an interiorly facing engagement means for attachment of said shell to said inner head where said engagement means is in the interior cavity.
2. The modular humeral component according to claim 1, wherein said shell fits over the shoulder base and an inner diameter of an opening of the interior cavity is slightly larger than a diameter of the shoulder base and/or wherein said shell includes an outer lower edge that is beveled, convex, or arcuate-shaped.
3. (canceled)
4. The modular humeral component according to claim 1, wherein said dome is a hemi-spherical dome and a surface of said interior cavity of said shell is hemi-spherical, said shell is configured to slide relative about said dome to allow for dual mobility between said shell and said inner head such that any pivoting between them is limited by a ledge or said shell is configured to freely rotate relative to said inner head.
5. The modular humeral component according to any claim 1, wherein said inner head is bonded to said shell.
6. (canceled)
7. The modular humeral component according to claim 1, wherein said inner head includes cobalt-chromium and said shell includes a high-density polyethylene.
8. The modular humeral component according to claim 1, wherein said inner head includes Ti6Al4V, a titanium-aluminum alloy, or cobalt-chromium, and/or said shell includes UHMWPE-highly crosslinked, a Vitamin E doped polyethylene, or Vitamin E HDPE.
9. The modular humeral component according to claim 1, wherein said engagement means includes a ring protrusion that engages a channel around a peripheral lower edge of said base.
10. (canceled)
11. The modular humeral component according to claim 9, wherein said base further includes a shoulder above said channel and a lower shoulder below said channel that together said shoulders define a groove as said channel.
12. The modular humeral component according to claim 9, wherein said ring protrusion and said channel have complementary shapes configured to allow for rotation of said shell relative to said inner head.
13. The modular humeral component according to claim 9, wherein said ring protrusion and said channel have an approximate semi-circular cross-section or a partial elliptical shape.
14. (canceled)
15. (canceled)
16. The modular humeral component according to claim 1, wherein an opening of said interior cavity includes a beveled or tapered edge with a reducing diameter from its outer edge and optionally a diameter at a top of said beveled or tapered edge is slightly larger than a diameter of the shoulder base onto which said modular humeral component is configured to fit over or said inner cavity includes a semi-spherical section configured to receive said dome of said inner head where said semi-spherical section is interior to said engagement means and an optional beveled section prior to said engagement means.
17. (canceled)
18. The modular humeral component according to claim 1, wherein said engagement means includes a ledge configured to hook over said inner head or a ledge with a top surface beveled in a direction of its free edge.
19. The modular humeral component according to claim 18, wherein a bottom exterior edge of said inner head is beveled to correspond to the bevel of said ledge.
20. (canceled)
21. The modular humeral component according to claim 1, wherein after said modular humeral component is installed on the shoulder base, a gap between a free edge of said ledge and the shoulder base is approximately 1 mm.
22. A modular component for use in a modular shoulder prosthesis system having a shoulder base, such as a baseplate or a humeral stem, with notches and/or attachment points, the modular humeral component comprising: an inner head having a base, and a dome on said base; and a shell configured to fit over said inner head, said outer shell having a body having a convex surface, said body defining an interior cavity configured to receive said dome, and an interiorly facing ledge along a bottom of said body and/or a ring protrusion that is parallel to a bottom of said body configured to engage a complimentary channel below said dome of said inner head.
23. (canceled)
24. The modular component according to claim 22, wherein a top surface of said ledge is beveled in a direction of its free edge.
25. The modular component according to claim 24, wherein a bottom exterior edge of said inner head base is beveled to correspond to the bevel of said ledge.
26. The modular component according to claim 22, wherein said inner head includes a plug is-tapered in a direction from said base to its free tip to define a Morse taper.
27. (canceled)
28. The modular component according to claim 22, wherein said dome is a hemi-spherical dome and said interior cavity of said shell is hemi-spherical, said shell is configured to slide relative about said dome to allow for dual mobility between said shell and said inner head such that any pivoting between them is limited by said ledge or said shell is configured to freely rotate relative to said inner head.
29. (canceled)
30. (canceled)
31. The modular component according to claim 22, wherein said inner head includes cobalt-chromium and said shell includes a high-density polyethylene.
32. (canceled)
33. (canceled)
34. (canceled)
35. (canceled)
36. (canceled)
37. (canceled)
38. (canceled)
39. (canceled)
40. (canceled)
41. (canceled)
42. (canceled)
43. (canceled)
44. (canceled)
45. (canceled)
46. (canceled)
47. (canceled)
48. (canceled)
49. (canceled)
50. (canceled)
51. (canceled)
52. (canceled)
53. A modular shoulder prosthesis system comprising: a humeral stem having a mounting surface into which a receiving cavity extends; and a central stem extending from said mounting surface; said modular component according to claim 1 configured to be removably attached to said mounting surface, and wherein said humeral stem is capable of attachment to different modular components to facilitate both traditional anatomic total shoulder replacement and reverse total shoulder replacement with a change in the modular component.
54. (canceled)
Description
IV. BRIEF DESCRIPTION OF THE DRAWINGS
[0013] Any cross-hatching or shading present in the figures is not intended to identify or limit the type of material present for the element shown in cross-section. In figures that include multiple elements shown in cross-section, the cross-hatching will be different directions for the different elements. Some features are illustrated as dashed or phantom lines in the figures.
[0014]
[0015]
[0016]
[0017]
[0018]
[0019]
V. DETAILED DESCRIPTION OF THE DRAWINGS
[0020] The invention in at least one embodiment includes a humeral modular component for use with baseplates disclosed in U.S. Pat. No. 10,583,012, issued on Mar. 10, 2020, and PCT Application No. PCT/US21/20492, published as WO 2021/178418 A1 on Sep. 10, 2021 and filed on Mar. 2, 2021, which are hereby both incorporated by reference for their teachings regarding different baseplates.
[0021] The baseplate has a mounting surface for engagement of a modular component. The mounting surface refers to the substantially planar surface of the baseplate opposite the glenoid (or humerus) after being implanted. The modular humeral component illustrated and described in this disclosure is an example of a modular component. The attachment in at least one embodiment between the modular component and the baseplate is through, for example, a Morse taper, which may be a dual threaded Morse taper that is axially located with reference to the baseplate. In an alternative embodiment with or without the Morse taper, a torque limiting fastener, such as a screw or a bolt, is used to further secure the modular glenoid component to the baseplate by engaging the baseplate and/or the central attachment mechanism anchored in the patient's glenoid/humerus. In a further embodiment, the attachment is facilitated with a threaded connection where the modular component is screwed into the baseplate.
[0022]
[0023] Although the stem 120 illustrated as a cylinder with a slight taper, in at least one embodiment, the stem 120 has tapered sides to match the modular component plugs. In a further embodiment, the stem 120 is substantially cylindrical.
[0024] The base 110 includes amounting surface 111 on a side opposite of an implantation surface 113, which faces the bone after implantation and from which the stem 120 extends. In at least one embodiment, the mounting surface 111 is substantially planar. The plane defined by the mounting surface 111 is approximately parallel to the resection plane after implantation.
[0025] The illustrated base 110 of
[0026] The illustrated base 110 includes a pair of attachment points, which are illustrated as notches 112, 112. In at least one other embodiment illustrated in
[0027] The illustrated base 110 includes five mounting passageways 114A-114E passing from the mounting surface 111 to the implantation surface 113 (or through the stem 120) with an axially centered passageway 114A and four evenly spaced perimeter passageways 114B-114E around the mounting surface 111. The passageways 114A-114E may include a shoulder at or near the bottom of the passageway on which a screwhead, which screw is an example of an attachment mechanism, will make contact after insertion into the baseplate 100. Although five passageways are illustrated, the number of passageways could be reduced, including omission of the perimeter passageways, or increased. In at least one embodiment, the central passageway 114A defines a chamber 124 for receiving a modular component plug. In at least one embodiment, the passageways 114B-114E are offset from the notches 112, 112 as illustrated, for example, in
[0028] In at least one embodiment, one or more variable angle locking screws are used to attach the baseplate 100 to the patient's glenoid bone. Examples of screw diameters include 4.5 mm to 5.0 mm and in a further example including the end points of that range, and more particularly 5.0 mm. Although there are five passageways illustrated, during a particular procedure, all five passageways may not be utilized. In at least one embodiment, the flexibility in which passageways 114A-114E to use and the variable angle locking screws provides flexibility to the orthopedic surgeon in securing the baseplate 100 to the patient's bone. Examples of locking screw angles includes between 20 degrees and 30 degrees (with or without the end points) or perpendicular to the base 110.
[0029] In at least one embodiment, the central axial passageway 114A passes from the base 110 into and through the stem 120 to allow for the top of the locking screw to be deeper into the baseplate 100 and to provide the chamber 124 for receiving a plug, e.g., the Morse taper, of the modular component being mounted onto the baseplate 100.
[0030]
[0031]
[0032]
[0033] The central hole 314 passes through the wedge body 310 to allow for the stem 120 to pass through for anchoring the system to the patient's bone. In at least one embodiment, the central hole 314 has an interference fit with the stem 120.
[0034] The wedge body 310 includes a mounting surface 311 onto which the attached baseplate abuts and/or is against. The opposed surface to the mounting surface 311 is a bone facing surface 312 that is designed to abut and/or be against the patient's bone. The bone facing surface 312 is angled relative to the mounting surface 311, and the angle between the two surfaces may be a variety of angles including those between 10 and 30 degrees, between 15 and 30 degrees, and between 10 and 25 degrees, and further including 10, 25, and 30 degrees. The angle leads to a peripheral wall for the wedge that tapers from its highest height at its top to its lowest height at its bottom as viewed after implantation.
[0035]
[0036] In at least one alternative embodiment, the fastening holes 319 are omitted from the wedge 300A. In a further embodiment, the anchoring holes 314A include threads along at least a portion of the length of the opening to being completed threaded for engagement of the anchoring mechanism.
[0037] In at least one embodiment, the angle between the mounting surface and the bone facing surface of the wedge is 10 degrees, 25 degrees, between 10 and 30 degrees, between 15 and 30 degrees, and/or between 10 and 25 degrees.
[0038] In at least one embodiment, the illustrated wedges are integrated into the baseplate as oppose to being a separate component. In an alternative embodiment, the wedge is affixed to the baseplate to form one structure to implant in the patient. In at least one embodiment to the other wedge embodiments, both the wedge and the baseplate are manufactured from metal for implantation on the glenoid bone.
[0039] In at least one embodiment, the 10-degree posterior angulation of the wedges facilitate the correction of any bony deformity of the glenoid by reconstruction of the idealized glenoid version in the anterior-posterior and sup-inf planes. The wedges mitigate the need for removal for a revision to occur. In at least one embodiment, the glenoid component in traditional TSR with 7-degree anterior build-up may improve anterior stability.
[0040]
[0041] The body 410 includes a central opening 414 through which the stem 120 of the baseplate may pass through for anchoring the system to the patient's bone as illustrated in
[0042] The partial wedge body 410 includes a mounting surface 411 onto which the attached baseplate abuts and/or is against as illustrated, for example, in
[0043] As illustrated in
[0044]
[0045] In at least one alternative embodiment, the fastening holes 419 are omitted from the partial wedge 400A. In a further embodiment, the anchoring holes 414A include threads along at least a portion of the length of the opening to being completed threaded for engagement of the anchoring mechanism.
[0046] In at least one embodiment, the wedges 300, 300A, 400, and 400A are made, for example, of the same material as the baseplate to be attached to it, a hydroxyapatite-coated (HA-coated) substrate and/or porous material.
[0047]
[0048]
[0049] As illustrated in
[0050] The illustrated inner head 520 includes a dome 522, a base 524, an optional flange 526, and an optional plug 528 for insertion into a receiving cavity 120 of the shoulder base implanted into the patient's humeral bone. In at least one embodiment, the flange 526 is omitted. In at least one embodiment, the exterior bottom peripheral edge of the inner head is beveled to match the beveling of the shell ledge 516. In at least one embodiment, the plug 528 is tapered in a direction from the base to its free end (or tip) as illustrated, for example, in
[0051] As illustrated in
[0052] In at least one embodiment, the inner head 520 will have a centrally located plug 528 that is capable of being manually offset or is physically offset from the axial center to allow best coverage of the proximal humeral anatomic neck and metaphysis. The physical offset includes an eccentrically located plug, which when the modular humeral component is rotated provides different amounts of coverage to the humeral side.
[0053] In at least one embodiment, the outer shell 510 and/or the inner head 520 will include protrusions extending outwardly from their exterior peripheral sides to allow for an instrument to be used to pry the outer shell 510 and/or the inner head 520 from the humeral base. In an alternative embodiment, the outer shell 510 and/or the inner head 520 will include slots along their bottom structure that are configured to align with notches 112 and/or attachment points 112 of the baseplate.
[0054]
[0055] As illustrated in
[0056]
[0057] The illustrated inner head 520A includes a dome 522A, a base 524A, and a plug 528A for insertion into a receiving cavity of the shoulder base embedded into the patient's humeral bone. In at least one embodiment as illustrated in
[0058]
[0059]
[0060] In at least one embodiment for either of the described modular humeral components, the inner head provides a universal connection between the baseplate and different size of shells. For example, this allows for a reduced inventory of humeral components for TSR while providing flexibility.
[0061] In at least one embodiment, the largest humeral head diameter at a minimum thickness is 58 mm18 mm. Examples of humeral head diameters include 38 mm to 52 mm, and more particularly 38 mm, 40 mm, 42 mm, 44 mm, 46 mm, 48 mm, 50 mm, and 52 mm with thicknesses being 15 mm-18 mm or 18 mm-21 mm.
[0062] In an alternative embodiment, the outer shell 510, 510A is a dual mobility shell. Dual mobility reduces the presence of polyethylene and other wear particles in the joint and between the shell 510, 510A and the inner head 520, 520A compared to traditional approaches, which helps mitigate loosening and device failure. Dual mobility also facilitates improved range of motion for the patient. Both of these lead to better patient outcomes. In an alternative embodiment, the outer shell 510 is removable from the inner head 520 to facilitate replacement, for example when the outer shell 510 is worn down from biomechanical movement about the shoulder joint.
[0063] In at least one embodiment, the inner head 520 will be made from Co-Cr while the outer shell 510 will be made from high-density polyethylene, which will avoid the issue of having metal components rub against other metal components, which could lead to a faster wear on the components and potentially create loose metal shavings within the shoulder socket. Additional examples of material for the shell include UHMWPE-highly crosslinked, a Vitamin E doped polyethylene, and Vitamin E HDPE. Additional examples of material for the inner head include Ti6Al4V, a titanium-aluminum alloy, and cobalt-chromium. In a further embodiment, the inner head 520A may be manufactured and bonded to the outer shell 510A to provide a single fabricated component. In a further embodiment, the bonding is present in the channel 529 and/or on the protrusion 518A.
[0064] Although particular materials have been identified for particular components and structural elements, one of ordinary skill in the art will appreciate that other materials may be substituted without departing from the scope of the invention. In at least one embodiment, modules attached to the humeral side and the glenoid side will not both be the same material at the point of interaction.
[0065] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms a, an and the are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the root terms include and/or have, when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.
[0066] The corresponding structures, materials, acts, and equivalents of all means plus function elements in the claims below are intended to include any structure, or material, for performing the function in combination with other claimed elements as specifically claimed. The description of the present invention has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to the invention in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the invention.
[0067] As used above substantially, generally, approximately, and other words of degree are relative modifiers intended to indicate permissible variation from the characteristic so modified particularly when relating to manufacturing and production tolerances. It is not intended to be limited to the absolute value or characteristic which it modifies but rather possessing more of the physical or functional characteristic than its opposite, and preferably, approaching or approximating such a physical or functional characteristic.
[0068] Those skilled in the art will appreciate that various adaptations and modifications of the embodiments described above can be configured without departing from the scope and spirit of the invention. Therefore, it is to be understood that, within the scope of the appended claims, the invention may be practiced other than as specifically described herein.