Elbow replacement apparatus and methods

Patent metadata

Field	Value
Publication number	US-10195039-B2
Application number	US-201615174617-A
Country	US
Kind code	B2
Filing date	Jun 6, 2016
Priority date	Nov 16, 2009
Publication date	Feb 5, 2019
Grant date	Feb 5, 2019

Abstract

Apparatus and methods for total elbow replacement are provided to allow a surgeon to intraoperatively select a linked or unlinked constraint by utilizing a connection located on the body of the ulnar and/or humeral stem. Additional modularity also allows the selection of a cemented or cementless stem as described herein. The modularity and adjustability provides a number of advantages.

First claim

What is claimed is:

1. A modular elbow prosthesis comprising:
a humeral component ( 119 ) comprising a humeral stem ( 101 ) and a humeral condyle body ( 102 ) detachably connected to the humeral stem ( 101 ), the humeral condyle body ( 102 ) comprising two distally extending condyle portions ( 118 ) each having a condylar bearing surface ( 121 ), a bushing hole ( 117 ) extending through the condyle portion ( 118 ), and a humeral bushing ( 103 ) retained inside the bushing hole ( 117 ), the humeral bushings ( 103 ) configured to receive a hinging axle ( 106 ) along a hinging axis ( 112 );
an ulnar component ( 104 ) comprising an ulnar stem ( 110 ), ulnar body ( 107 ) detachably connected to the ulnar stem ( 110 ), and an ulnar bearing ( 105 ) detachably coupled to the ulnar body ( 107 ),the ulnar body ( 107 ) comprising a central fin ( 137 ) provided with an ulnar coupling hole ( 143 ), the ulnar bearing ( 105 ) comprising a central covering fin ( 130 ) provided, on opposite sides of the central covering fin ( 130 ), with two respective articulation housings ( 139 ) defining complementary bearing surfaces that receive and articulate with the condylar bearing surfaces ( 121 ) of the humeral condyle portions ( 118 ); and
a hinging axle ( 106 ) comprising a barrel-shaped end portion ( 153 ), an opposite barrel-shaped end portion ( 155 ), and a threaded and tapered, or conical shaped, midportion ( 106 a ) extending between the barrel-shaped end portions ( 153 , 155 );
wherein the condyle portions ( 118 ) and the ulnar bearing ( 105 ) being configured for reciprocal articulation about the hinging axis ( 112 ) in an articulation condition;
wherein the central covering fin ( 130 ) of the ulnar bearing ( 105 ) comprises a coupling slot ( 141 ) configured to receive the central fin ( 137 ) of the ulnar body ( 107 );
wherein the central covering fin ( 130 ) of the ulnar bearing ( 105 ) comprises an ulnar hinging hole ( 145 ), which is axially aligned, when the ulnar bearing ( 105 ) is coupled to the ulnar body ( 107 ), with the ulnar coupling hole ( 143 );
wherein the hinging axle ( 106 ) passes through the humeral bushings ( 103 ), through the ulnar hinging hole ( 145 ), and through the ulnar coupling hole ( 143 ), and
wherein the mid-portion ( 106 a ) of the hinging axle ( 106 ) is fixedly attachable to said ulnar coupling hole ( 143 );
wherein said ulnar coupling hole ( 143 ) is provided with a threaded and tapered, or conical shaped, portion ( 143 a ) mating with said threaded and tapered, or conical shaped, mid-portion ( 106 a) of said hinging axle ( 106 );
wherein the threaded and tapered, or conical shaped, portion ( 143 a ) of the ulnar coupling hole ( 143 ) comprises a inner threaded surface ( 147 ) and a taper connection surface ( 149 ),
and the threaded and tapered, or conical shaped, mid-portion ( 106 a ) of the hinging axle ( 106 ) comprises a mating threaded surface ( 151 ) and a tapered surface ( 152 ) configured to screw fit respectively with the inner threaded surface ( 147 ) and the taper connection surface ( 149 ).

2. The elbow prosthesis according to claim 1 , wherein the ulnar body ( 107 ) is releasably connectable to the ulnar stem ( 110 ) by mechanical connection.

3. The elbow prosthesis according to claim 2 , wherein said mechanical connection is a taper connection.

4. The elbow prosthesis according to claim 1 , said prosthesis comprising an ulnar screw ( 109 ) to connect the ulnar body ( 107 ) and the ulnar stem ( 110 ).

5. The elbow prosthesis according to claim 4 , wherein the ulnar screw ( 109 ) is made of metal.

6. The elbow prosthesis according to claim 1 , wherein the ulnar body ( 107 ) and the ulnar stem ( 110 ) are made of metal.

7. The elbow prosthesis according to claim 1 , wherein the humeral stem ( 101 ) and/or the ulnar stem ( 110 ) are provided with one or more surfaces or portions configured to promote cementless fixation to bone.

8. The elbow prosthesis according to claim 1 , wherein the ulnar stem ( 110 ) is provided with an end portion ( 162 ) having an ulnar extending body ( 163 ) mating with an ulnar seat ( 165 ) provided in the ulnar body ( 107 ).

9. The elbow prosthesis according to claim 8 , wherein said ulnar extending body ( 163 ) and said ulnar seat ( 165 ) are configured to define a reciprocal geometric coupling.

10. The elbow prosthesis according to claim 8 , said prosthesis comprising an ulnar screw ( 109 ) to connect the ulnar body ( 107 ) and the ulnar stem ( 110 ), wherein said ulnar extending body ( 163 ) and said ulnar seat ( 165 ) are provided with respective holes ( 163 A, 165 A) for inserting said ulnar screw ( 109 ).

11. The elbow prosthesis according to claim 8 , wherein said ulnar extending body ( 163 ) and said ulnar seat ( 165 ) are provided each with an asymmetric double-curved shape.

12. The elbow prosthesis according to claim 11 , wherein said asymmetric double-curved shape is delimited by an asymmetric double-curved outer peripheral profile ( 169 C, 169 D).

13. The elbow prosthesis according to claim 12 , wherein said peripheral profile ( 169 C, 169 D) is defined by two spaced circumferences with different diameters, joined by a joining surface profile.

14. The elbow prosthesis according to claim 8 , wherein the end portion ( 162 ) of the ulnar stem ( 110 ) is configured to promote cementless fixation to bone.

15. The elbow prosthesis according to claim 14 , wherein an outer surface of the end portion ( 162 ) of the ulnar stem ( 110 ) is coated with plasma spray or provided with porous metal by additive manufacturing.

16. The elbow prosthesis according to claim 14 , wherein, the end portion ( 162 ) of the ulnar stem ( 110 ) is provided at least in part with a trabecular structure.

17. The elbow prosthesis according to claim 1 , wherein the humeral condyle body ( 102 ) is detachably connectable to the humeral stem ( 101 ), thereby establishing modularity of both the humeral component ( 119 ) and the ulnar component ( 104 ).

18. The elbow prosthesis according to claim 17 , wherein the condyle body ( 102 ) is detachably connectable to the humeral stem ( 101 ) by mechanical connection.

19. The elbow prosthesis according to claim 18 , wherein said mechanical connection is a taper connection.

20. The elbow prosthesis according to claim 17 , said prosthesis comprising a humeral screw ( 108 ) to connect the condyle body ( 102 ) and the humeral stem ( 101 ).

21. The elbow prosthesis according to claim 20 , wherein the humeral screw ( 108 ) is made of metal.

22. The elbow prosthesis according to claim 17 , wherein the humeral condyle body ( 102 ) is provided with a humeral extending body ( 157 ) mating with a humeral seat ( 159 ) provided in an end portion ( 161 ) of the humeral stem ( 101 ).

23. The elbow prosthesis according to claim 22 , wherein the end portion ( 161 ) of the humeral stem ( 101 ) is configured to promote cementless fixation to bone.

24. The elbow prosthesis according to claim 23 , wherein an outer surface of the end portion ( 161 ) of the humeral stem ( 101 ) is coated with plasma spray or provided with porous metal by additive manufacturing.

25. The elbow prosthesis according to claim 23 , wherein the end portion ( 161 ) of the humeral stem ( 101 ) is provided at least in part with a trabecular structure.

26. The elbow prosthesis according to claim 22 , wherein said humeral extending body ( 157 ) and said humeral

Assignees

• Limacorporate Spa
• New York Soc For The Ruptured And Crippled Maintaining The Hospital For Scpecial Surgery

Inventors

• Pressacco Michele
• Del Negro Nicola
• Fattori Andrea
• Hotchkiss Robert N
• Figgie Mark P
• Wright Timothy M
• Lipman Joseph D
• Lo Darrick

Classifications

• B22F10/28

  Powder bed fusion, e.g. selective laser melting [SLM] or electron beam melting [EBM] · CPC title

• A61F2002/3813

  for ulno-humeral joints · CPC title

• A61F2002/30286

  barrel-shaped · CPC title

• A61F2/384

  hinged, i.e. with transverse axle restricting the movement · CPC title

• C23C4/134

  Plasma spraying · CPC title