ORTHOPAEDIC FRICTION PLATE
20220323125 · 2022-10-13
Inventors
- Matthew DUFFIN (Charlotte, NC, US)
- Vance GARDNER (Irvine, CA, US)
- Robert S. GORAB (Newport Beach, CA, US)
- Carlos A. PRIETTO (Laguna Beach, CA, US)
- Edward QUILLIGAN (Huntington Beach, CA, US)
Cpc classification
A61B17/80
HUMAN NECESSITIES
B33Y80/00
PERFORMING OPERATIONS; TRANSPORTING
A61F2002/30841
HUMAN NECESSITIES
B22F2999/00
PERFORMING OPERATIONS; TRANSPORTING
B22F2999/00
PERFORMING OPERATIONS; TRANSPORTING
A61B17/809
HUMAN NECESSITIES
A61B17/8014
HUMAN NECESSITIES
B22F2005/005
PERFORMING OPERATIONS; TRANSPORTING
International classification
Abstract
Disclosed are devices, systems and related surgical methods for improving the fixation and/or durability of bone implants and/or components thereof for fracture fixation and/or other orthopedic procedures.
Claims
1. A surgical plate capable of fixation across a bone fracture using a plurality of bone screws, comprising: an elongated plate body having a first bone facing side and an opposing second side, a plurality of screw openings formed through the elongated plate body from the first bone facing side to the opposing second side, a portion of the first bone facing side proximate to at least one of the plurality of openings including a first textured surface.
2. The surgical plate of claim 1, wherein the first textured surface comprises a plurality of projections extending outward from the elongated plate body.
3. The surgical plate of claim 2, wherein the plurality of projections increases the static coefficient of friction of the first textured surface by at least 5% as compared to a smooth surface of a similar size.
4. The surgical plate of claim 2, wherein the plurality of projections increases the static coefficient of friction of the first textured surface by at least 25% as compared to a smooth surface of a similar size.
5. The surgical plate of claim 2, wherein the plurality of projections increases the static coefficient of friction of the first textured surface by at least 35% as compared to a smooth surface of a similar size.
6. The surgical plate of claim 2, wherein each of the plurality of projections comprise a pyramid shape.
7. The surgical plate of claim 2, wherein each of the plurality of projections comprise a ridged shape.
8. The surgical plate of claim 2, wherein each of the plurality of projections comprise a treadplate.
9. The surgical plate of claim 2, wherein the plurality of projections are distributed uniformly across the first textured surface.
10. The surgical plate of claim 2, wherein the plurality of projections are distributed symmetrically across the first textured surface.
11. The surgical plate of claim 2, wherein the plurality of projections are non-uniformly distributed across the first textured surface.
12. The surgical plate of claim 2, wherein the plurality of projections are non-uniformly distributed across the first textured surface.
13. The surgical plate of claim 1, wherein the portion of the first bone facing side includes a second textured surface proximate to a second of the plurality of openings, the second texture surface having a different bone facing surface configuration than the first textured surface.
14. The surgical plate of claim 2, wherein the plurality of projections are formed on the elongated plate using 3-D printing techniques.
15. The surgical plate of claim 2, wherein the plurality of projections are formed on the elongated plate by subtractive machining techniques.
16. A method of improving a coefficient of friction between a bone facing surface of a surgical plate and a bone against which the plate is implanted, the method comprising the steps of: altering a surface finish on the bone facing surface by forming a plurality of projections extending outward of the bone facing surface, the plurality of projection increasing the effective coefficient of static friction of the bone facing surface with the bone by at least 10%; securing the surgical plate against the bone using a plurality of fixation devices.
17. The method of claim 16, wherein the plurality of fixation devices comprises a plurality of bone screws, each of the plurality of bone screws penetrating a surface of the bone.
18. The method of claim 17, wherein each of the plurality of bone screws extends through one of a plurality of openings extending through the surgical plate, the plurality of projections formed on the bone facing surface at a location proximate to at least one of the plurality of openings extending through the surgical plate.
19. The method of claim 18, wherein the step of altering a surface finish on the bone facing surface comprises altering the surface finish on the bone facing surface by adding material to the bone facing surface without significantly altering the overall dimensions or rigidity of the surgical plate.
20. The method of claim 18, wherein the step of altering a surface finish on the bone facing surface comprises altering the surface finish on the bone facing surface by removing material from the bone facing surface without significantly altering the overall dimensions or rigidity of the surgical plate.
Description
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0016] The foregoing and other features and advantages of the present subject matter will become apparent to those skilled in the art to which the present subject matter relates upon reading the following description with reference to the accompanying drawings.
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[0039] The following description and the annexed drawings set forth in detail certain illustrative aspects of the subject matter. These aspects are indicative, however, of but a few of the various ways in which the principles of the subject matter may be employed and the present subject matter is intended to include all such aspects and their equivalents. Other objects, advantages and novel features of the subject matter will become apparent from the following detailed description of the subject matter when considered in conjunction with the drawings.
DETAILED DESCRIPTION OF THE INVENTION
[0040] The disclosure and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments and examples that are described and/or illustrated in the accompanying drawings and detailed in the following description. It should be noted that the features illustrated in the drawings are not necessarily drawn to scale, and features of one embodiment may be employed with other embodiments as the skilled artisan would recognize, even if not explicitly stated herein. Descriptions of well-known components and processing techniques may be omitted so as to not unnecessarily obscure the embodiments of the disclosure. The examples used herein are intended merely to facilitate an understanding of ways in which the disclosure may be practiced and to further enable those of skill in the art to practice the embodiments of the disclosure. Accordingly, the examples and embodiments herein should not be construed as limiting the scope of the disclosure. Moreover, it is noted that like reference numerals represent similar parts throughout the several views of the drawings.
[0041] The terms “including,” “comprising” and variations thereof, as used in this disclosure, mean “including, but not limited to,” unless expressly specified otherwise. The terms “a,” “an,” and “the,” as used in this disclosure, mean “one or more,” unless expressly specified otherwise.
[0042] Devices and/or device components that are disclosed in communication with each other need not necessarily be in continuous communication with each other, unless expressly specified otherwise. In addition, devices that are in direct contact with each other may contact each other directly or indirectly through one or more intermediary articles or devices.
[0043] Although process steps, method steps, or the like, may be described in a sequential order, such processes and methods may be configured in alternate orders. In other words, any sequence or order of steps that may be described does not necessarily indicate a requirement that the steps be performed in that order. The steps of the processes or methods described herein may be performed in any order practical. Further, some steps may be performed simultaneously.
[0044] When a single device or article is described herein, it will be readily apparent that more than one device or article may be used in place of a single device or article. Similarly, where more than one device or article is described herein, it will be readily apparent that a single device or article may be used in place of the more than one device or article. The functionality or the features of a device or article may be alternatively embodied by one or more other devices or articles which are not explicitly described as having such functionality or features.
[0045] Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
[0046] The present invention provides various devices, systems and methods for treating various anatomical structures of long bones and/or other areas of human and/or animal bodies. While the disclosed embodiments may be particularly well suited for use during surgical procedures for the repair, fixation and/or support of long bones, it should be understood that various other anatomical locations of the body may benefit from various features of the present invention.
[0047] In various disclosed embodiments, a primary objective of the disclosed invention can be to increase the resistance of a bone plate to various types of sliding motion relative to the bone surface, for both conventional, non-locked plates as well as locked plates, which will desirably create more stable fixation constructs and prevent unwanted motion in a targeted anatomical region. In various embodiments, this will desirably preserve an anatomic reduction and/or preserving the blood supply of the treated region, while providing for an early and safe mobilization of the affected anatomy.
[0048] In fracture fixation, creating a stable construct is generally desirable to allow the broken bones and/or bone fragments to reattach and/or heal. In some scenarios, if there is excessive motion between the elements of the fixation construct and/or the treated anatomy, the bones will not heal and/or the construct fails. In many examples, fracture fixation with construct failure can occur where the screws and/or plates have lost “purchase,” and in some cases, the hardware itself has broken. Such failures can include screw toggle; screw backout; fatigue, strain and/or work hardening of various components, plate bending and/or fracture, various combinations thereof and/or a variety of other failure modes.
[0049] In some instances, commercially available fixation plates and/or related components might benefit from modification in light of the inventions disclosed herein, and the modification of such plates to incorporate the concepts of the present intention are contemplates herein. Such modifications may include a variety of steps, which can include the addition and/or removal of material to create a plurality of projections, including roughened and/or textured features, to the bone facing surface proximate to one or more fixation devices or securement locations on the plate. Desirably, the addition and/or removal of such material to form such features will not affect the overall dimensions of the fixation plate and/or the plate rigidity to a significant degree, yet these features can dramatically improve the fatigue performance and/or overall durability of the plate and related fixation elements post surgery.
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[0057] As best shown in
[0058] In various studies using conventional stainless steel or titanium bone plates, an average coefficient of friction between the plate and human or animal long bones has been experimentally determined to be μ=0.37, with an average torque applied to bone screws by a trauma surgeon of T=5.6 in-lb or 0.632 N-m. In many instances, this amount of torque has a limitation due to overall bone strength, and thus the Normal force from
[0059] As depicted in
[0060] In various embodiments, a bone plate or components thereof can be formed using a variety of techniques, including by forging, casting, milling and/or extruding into sheet, tube and/or pipe form, as well as by weaving and/or braiding of component thread or “rope” into an implant by a variety of techniques. Plate shapes or surface features therein may be manufactured using subtractive manufacturing techniques (i.e., machining, milling and/or surface roughening), as well as by using additive manufacturing techniques (i.e., surface coating, brazing, welding, bonding, deposition on various material surfaces and/or even by 3D laser printing of structures). If desired, a bone plate or portions thereof may even be formed using curing or other light/energy activation techniques, such as where a slurry of liquid polymer, ceramic and/or metal particles may be UV cured to create a 3-dimensional structure and/or layer on the bone plate. In various embodiments, materials may be utilized in block form, in sheets, columns and bars, in cable or braided form, in mesh form, or in a textured surface coating, in powder form, in granular form and/or as a surface filler and/or coating. In some cases, a surface layer may be formed, placed and/or deposited on an external surface of an existing bone implant.
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[0062] An experimental comparison of smooth and textured bone plates similar to those depicted in
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[0066] In various embodiments, features of the disclosed invention could be incorporated into virtually any type of plate currently used to achieve bony stability, including traditional compression plates, limited contact compression plates, locking plates, spine plates such as anterior vertebral plates, reconstruction plates, etc. It is believed that almost any bone contacting plate or implant could potentially benefit from the higher force of resistive friction provided by the present invention, and such improvements to existing device designs are contemplated herein.
[0067] It should also be understood that the specific materials comprising the disclosed bone plates may not be critical in some embodiments, as these improvements may be useful in devices comprising materials such as stainless steel, titanium, cobalt chromium, as well as newer materials such as amorphous metals and bulk metallic glass. Virtually any implant material may have the potential to be improved as described herein, and some materials may further incorporate some or all of the benefits described herein due to ease of manufacturing in order to achieve optimal friction patterning.
[0068] Desirably, the enhancement of the coefficient of friction between the plate and bone by changing the surface of the plate that is contacting the bony surface will greatly enhance the resulting force of resistive friction, both statically and dynamically. Many possible textures or surface features, including external projections such as “pyramid type” points, ridges, chevrons, treads, etc., may significantly improve such friction, while other patterns such as inward facing or “negative” patterns (i.e., inward or “relief” type patterns machined into a bone-facing surface of the implant) may similarly be useful in various embodiments, and these patterns are contemplated herein as well.
[0069] While the plate to bone fixation herein is described in conjunction with screw fixation, it should be understood that various other fixation modalities may be utilized with the various embodiments described herein, including the use of other fixation devices (i.e., pins, staples, etc.) as well as adhesives and/or non-penetrating securement mechanism such as clamps, etc. In various embodiments, the disclosed screws may function in the same way as existing plate and screw fixation constructs by achieving unicortical or bicortical compression through torque, translating to a normal force between the plate and bone to “squeeze” these two materials together. Compression of the plate to the bone may also be achieved by clamps in certain fixation scenarios, which could then be secured by traditional non-locking or locking screws.
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[0073] Statistical analysis of this experimental data was performed with a 2-tailed T-test, which demonstrated that roughening and/or texturing the bone contact surface of the plate had a significant impact on increases of the coefficient of friction, and also on increased force of friction (See
[0074] Desirably, the disclosed surface enhancement of orthopedic surgical plates and/or similar devices will increase the securement due to the force of resistive friction at the bone/plate interface in order to create a more stable construct and greatly reduce wear to and/or fracture of the system components. In addition to allowing the plate to accommodate higher loading, the present invention can significantly reduce toggle and/or fracture of the bone screws—greatly enhancing the utility of the disclosed devices and well as existing system forces that may be modified in accordance with various teachings of the present invention.
[0075] In various embodiments, a proposed design may include the creation of a “textured” surface proximate to a securement device (i.e., bone screw) in order to enhance the coefficient of friction between the plate and the bone near that location in order to limit motion and increase stability of various fixation constructs.
[0076] In various embodiments, the implants and/or portions may comprise a variety of surgically acceptable materials, including radiopaque and/or radiolucent materials, other materials or combinations of such materials. Radiolucent materials can include, but are not limited to, polymers, carbon composites, fiber-reinforced polymers, plastics, combinations thereof and the like. Radiopaque materials are traditionally used to construct devices for use in the medical device industry. Radiopaque materials can include, but are not limited to, metal, aluminum, stainless steel, titanium, titanium alloys, cobalt chrome alloys, combinations thereof and the like.
[0077] In accordance with various aspects of the present subject matter, bone-contacting surfaces of the various implant components described herein may optionally include coatings that are highly osteo-inductive and/or osteoconductive to desirably facilitate and/or promote fixation to adjacent living bone surfaces, if desired.
[0078] If desired, a surgical “kit” could include bone plate components of differing shapes and/or sizes constructed from the same or a variety of different materials, including plates having a variety of different bone anchors and/or interface surfaces, including bone ingrowth surfaces. If desired, such implants and/or the components thereof could be provided in a kit form for selection and/or assembly in situ during a surgical procedure. If desired, various components may be removable and/or replaceable.
[0079] In accordance with another aspect of the present subject matter, various methods for manufacturing implants and/or components thereof, as set for within any of the details described with the present application, may be provided.
[0080] While embodiments and applications of the present subject matter have been shown and described, it would be apparent that other embodiments, applications and aspects are possible and are thus contemplated and are within the scope of this application.
[0081] In various embodiments, a surgical tool kit could include a plurality of bone plate implants and one or more modular components for the system. The various components of these systems could optionally be provided in kit form, with a medical practitioner having the option to select an appropriately sized and/or shaped implant and/or modular components to address a desired surgical situation.
[0082] Note that, in various alternative embodiments, variations in the position and/or relationships between the various figures and/or modular components are contemplated, such that different relative positions of the various modules and/or component parts, depending upon specific module design and/or interchangeability, may be possible. In other words, different relative adjustment positions of the various components may be accomplished via adjustment in separation and/or surface angulation of one of more of the components to achieve a variety of resulting implant configurations, shapes and/or sizes, thereby accommodating virtually any expected anatomical variation.
[0083] Of course, method(s) for manufacturing the various modular components and/or surgical devices and related components and implanting a bone plate into a patent are contemplated and are part of the scope of the present application.
[0084] While embodiments and applications of the present subject matter have been shown and described, it would be apparent to those skilled in the art that many more modifications are possible without departing from the inventive concepts herein. The subject matter, therefore, is not to be restricted except in the spirit of the appended claims.
[0085] All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
[0086] The various headings and titles used herein are for the convenience of the reader and should not be construed to limit or constrain any of the features or disclosures thereunder to a specific embodiment or embodiments. It should be understood that various exemplary embodiments could incorporate numerous combinations of the various advantages and/or features described, all manner of combinations of which are contemplated and expressly incorporated hereunder.
[0087] The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., i.e., “such as”) provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
[0088] Preferred embodiments of this invention are described herein, including the best mode known to the inventor for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventor intends for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.