BR102016003921A2 - TARSE IMPLANT - Google Patents

Abstract

Tarsal sinus implantation in order to stabilize and restore movement between the talus and calcaneus while allowing normal movement and alignment. In a preferred embodiment, the implant consists of a titanium alloy which is a combination of a cylindrical part and an axially connected conical part. the cylindrical portion has a surface with multiple parallel grooves which are each parallel to the transverse axis of the cylinder. the grooves are formed exclusively with a perpendicular medial side and an angled lateral side. The implant is cannulated to allow the use of a guide wire that ensures proper alignment during insertion.

Description

(54) Title: IMPLANT OF TARSO (51) Int. Cl .: A61F 2/42 (73) Holder (s): MICHAEL GRAHAM (72) Inventor (s): MICHAEL GRAHAM (74) Attorney (s): HUGO SILVA & MALDONADO INTELLECTUAL PROPERTY SOCIEDADE CIVIL S / C LTDA.

(57) Abstract: Tarsal sinus implantation with the purpose of stabilizing and restoring the movement between the talus and calcaneus, while allowing normal movement and alignment. In a preferred embodiment 5, the implant consists of a titanium alloy which is a combination of a cylindrical part and a tapered part with axial connection. The cylindrical portion has a surface with multiple parallel grooves that are each parallel to the transverse axis of the cylinder. The grooves are formed exclusively with a perpendicular medial side and an angled side. The implant is cannulated to allow the use of a guidewire that ensures proper alignment during insertion.

THE

100

1/17 “TARSO IMPLANT”

DESCRIPTIVE REPORT [0001] This invention relates to a medical instrument for improving and mechanically correcting the skeleton. More specifically, this invention relates to the correction of certain bone alignment deformities that impair optimal mechanical bipeds.

[0002] excessive pronation (hyperpronation) is caused by abnormal movement between two bones of the foot; the ankle bone (talus) and the heel bone (calcaneus). This abnormal movement will eventually lead to anatomical misalignment, both proximal and distal. The abnormal movement is due to the partial displacement of the stem in the calcaneus resulting in the obliteration or closure of a naturally occurring space (sinus), formed between the stem and calcaneus.

[0003] This sinus is referred to anatomically as the sinus of the tarsus. In anatomical terms, the tarsal sinus is located anterior to the posterior talocalcaneal joint and posterior to the anterior and medial talocalcaneal joint. As will be described in more detail below, the joint is formed by talotarsal the joints of the talus in the calcaneus and both navicular bones. The posterior talar facet of the calcaneus and posterior calcaneal facet of the talus is the largest of the four joint talotarsal joints. Generally, when a human biped is walking or running, talus acts on the individual as a "torque converter" to transfer weight from the body to the foot. This weight transfer is achieved through the movement of the talotarsal joint. The normal mechanics of the talotarsal joint produces a triple-planar movement through all three anatomical planes. This movement consists of supination and pronation. Pronation occurs when the talus moves medially (inwardly), anteriorly (forwardly) and plantarly (inferiorly). Supination occurs when the talus moves laterally (outward), posteriorly (backward) and dorsal (upward). Normally,

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2/17 should be approximately a two-to-one pronation supination ratio.

[0004] Some individuals suffer as a result of abnormal movement of the subtalar joint. This partial displacement leads to excessive pronation or, more specifically, hyperpronation. The hyperpronation pathomechanics leads to significant deleterious effects on the bone architecture of the talus and calcaneus both proximal and distal. Hyperpronation is defined by excessive medial (inner) talar deviation, anteriorly (forward), and plantar (anteriorly).

[0005] Hyperpronation is detected and diagnosed through physical examination of the foot, both non-weight bearing and weight bearing examination, as well as radiographic evaluation of the foot. No weight bearing hyperpronation examination is achieved by applying pressure to the fifth metatarsal head region of the foot to dorsiflex the foot (pushing the foot to the front of the shin) and the foot turns out-the hyperpronation wing is present. In the weight-bearing examination, the person is on his / her feet and the examiner observes both pronation and supination of the subtalar joint. Normally, the foot should be in a "neutral" position, that is, neither pronated nor supinated. If the foot is in a prone position, while the total weight is on the foot, the foot is considered hyperpronated.

[0006] Radiographic assessment of partial talotarsal dislocation is seen by examining the antero-posterior weight-bearing (top to bottom) side view (side view). These two projections show the relationship of the talus to the other bones of the foot. If the talus is medial (interior) and / or anterior (forward), deviated and / or plantar flexion (inferiorly) partial tarsal talus dislocation is present [0007] The anterior implants were designed to be inserted into the tarsal sinus, in an attempt to treat foot disorders. In this, an included drawing imagined a mushroom-shaped implant, with

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3/17 a rod that protrudes from the bottom. The implant was kept in place by inserting the stem in a hole drilled in the back of the calcaneus. Unfortunately, perforation can weaken the calcaneus and often resulted in a direct or final fracture. In addition, the implant stem is subject to fracture which, obviously, again leads to failure of the process. In addition, the surgical procedures required for implantation are somewhat and subject to medical error.

[0008] In another previously known form, an implant is screwed on an external surface and screwed into the tarsus. This implant is usually composed of high molecular weight polyethylene. Unfortunately, this device can only be sterilized with gas. This allowed the device to deform under the compression pressure to which it is subjected under normal post-operative condition. In addition, it was difficult to accurately locate the device properly within the tarsal sinus.

[0010] In yet another design, a cylindrical implant made of a titanium alloy is threaded on its outer surface. However, this implant corrects only part of the deformity, while both the lateral and medial portions of the tarsal sinus need correction. In addition, a titanium implant is much more difficult than bone surrounding matter. This can lead to bone wear and / or deformation. In addition, fluoroscopy is necessary in order to verify the position that exposes the patient to radiation. The insertion procedure requires two separate incisions on the medial and lateral side of the foot and calls for a cast below the knee for two weeks post-op. The implant is placed in a number of sizes. These implants vary in size, one from the following, in specific increments. Gaps in this series can lead to under and over correction. Finally, prior art implants are threaded on their outer surface. Without any special structure for these segments, the implant can loosen and move out of place.

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4/17 [0011] The problems suggested in the previous are not intended to be exhaustive, but are among many that tend to impair the effectiveness of tarsal sinus implants known in the past. There may also be other noteworthy problems; however, those presented above should be sufficient to demonstrate that the previously known implant in the tarsal sinus will admit for the improvement of value.

OBJECTIVES OF THE INVENTION [0012] The following "objectives" apply to preferred embodiments of the invention and do not limit the invention in any way. It is a general objective to avoid limitations in the mechanical correction of abnormal feet of the type previously described.

[0013] One goal is to insure the proper movement of the foot, stabilizing the movement between the talus and calcaneus. A related goal is to ensure that both medial and lateral aspects of these bones are stabilized.

[0014] Another objective is to stabilize the movement between the talus and calcaneus and / or the navicular, while allowing the normal movement of the foot.

[0015] Another objective is to correct a misalignment, both proximal and distal, of the astragalus and calcaneus [0016] Another objective is to provide an implant that will not wear out or deform the talus and calcaneus over time.

[0017] Yet another objective is to provide an implant that will not wear out or deform over time and thus fail.

[0018] Another objective is to provide an implant that will remain in place after prolonged use, without a separate anchoring procedure.

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5/17 [0019] Another objective is a method of correctly placing an implant in the space between the talus and calcaneus bones, without having to check the correct position with a fluoroscope and, thus, exposing the user to radiation.

[0020] Another objective is to provide less invasive surgery for the insertion of an implant.

[0021] A related goal is to provide a tarsal sinus implant without the need for a post-operative plaster below the knee.

BRIEF SUMMARY OF THE INVENTION [0022] An embodiment of the present invention that is intended to carry out at least some of the foregoing objects comprises stabilizing or restoring the normal movement of the subtalar joint with an internally placed stent device. In medical terms, the present embodiment comprises a subtalar final orthosis implant system. The implant is called a subtalar or, more specifically, a tarsal sinus stent that keeps the tarsal sinus in anatomically correct alignment, allowing normal physiological movement to occur while minimizing the tendency for abnormal preoperative movement.

[0023] The tarsal sinus implant of the present invention is generally a conical shape with an integral extension of a cylindrical shape. The conical part is considered the superficial or lateral portion of the implant and can be operatively positioned inside the lateral or sinus region of the tarsus. The small cylindrical diameter portion of the implant is considered the medial side of the implant and will be operatively positioned within a deeper side of the tarsal sinus, the tarsal channels.

[0024] The implant surface optionally contains a series of parallel ribs and channels on the outer surface of the implant. It is

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The surface region will, in a preferred embodiment, interact with the surrounding tissue and increase the mechanical retention between the implant surface and the surrounding tissue and, thus, help to keep the implant in a correct anatomical position.

[0025] The tarsal sinus implant of the present invention is preferably constructed of a titanium alloy, the standard material used for implants. A medical grade polymer, however, will also work. The polymer composition will allow for less trauma to the outer surface of the bone, compared to the implant based on titanium alloy. The implant optionally has a hole drilled through its longitudinal axis (a cannula) that allows precise placement within the tarsus using a guide wire or peg guide.

BRIEF DESCRIPTION OF THE DRAWINGS [0026] Other objects and advantages of the present invention will become evident from the detailed description of preferred embodiments taken in conjunction with the accompanying drawings, as follows:

[0027] Figure 1 is a perspective view of the tarsal sinus implant.

[0028] Figure 2 is a side view of the implant.

[0029] Figure 3 is a cross-sectional view of the implant, taken along the cut line A-A in Figure 1.

[0030] Figure 4 is an enlarged view of detail “B” in Figure 3.

[0031] Figure 5 is a dorsal view of the bone structure of a human foot, with a tarsal sinus implant in situ that indicates the relative rotation axis of the subtalar joint to the midline.

DETAILED DESCRIPTION OF THE INVENTION

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7/17 [0032] Referring now to the drawings, in which numbers indicate the parts, Figure 1 is a perspective view of the implant 100.

[0033] Figure 2 represents a side view of the implant. A preferred length of the implant is about 17 to 19 mm, more preferably about 18.34 mm. The implant has a cylindrical body portion 104, preferably 11 to 14 mm in length, more preferably about 12.34 mm in length. The implant also has a constituent part of the tapered foot 122, 212. The foot has a relatively small top end 118 that is integrally connected to the cylindrical body. The gifts stand out to form a relatively larger circular base 124. Seen from the side (Figure 2) these two sides of the foot touch together to form an angle, θ. This angle, θ, is preferably about 15 ° to 25 °, or preferably, each angle from 15 ° to 25 ° in 0.1 degree increments, or more preferably about 19.8 °.

[0034] In order to adequately block abnormal movement, while allowing normal movement, implant 104 must have a carefully chosen outside diameter 116, 118, 124. The absolute size of the implant will vary depending on the size of the ankle for which the implant is inserted. The diameter at the top of the foot is preferable in the range of 5-14 mm, more preferably between 6 mm and 13 mm, even more preferably from 7 to 12 mm. The diameter of the base of the foot will be proportionally larger. To facilitate identification, these diameters can be attached to the implant, for example, on the outer surface of the foot. The standard error of these dimensions will be about 0.05 mm.

[0035] Moving now to the cylindrical body, the surface will have a plurality of parallel grooves, as shown in Figure 2, 114. In a preferred number of grooves it is 3-9, more preferred from 4 to 8, even more preferred , 5 to 7, but even more preferred, 6 slots. The groove bottom will have a preferable diameter 114 which maximizes the

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8/17 implant's ability to promote stability, for example, by allowing the internal growth of soft tissue, but without being as deep as to weaken the structural integrity of the body. A preferred diameter at the bottom of the groove is about 4 mm. In another preferred embodiment, the diameter at the bottom of the groove varies so that the depth of the grooves is kept constant as the size of the implant varies. A preferred wood depth is about 2 mm. In another preferred embodiment, the implant diameter is kept constant and the depth of the grooves varies with the size of the implant.

[0036] Interline portions of the body 116 will have approximately the same diameter as the junction between the body and the foot 118. At the medial end of the body a cannula (or tunnel) 112 can optionally be drilled into the implant. This allows the use of a guide wire that can be run through the cannula and promote the correct orientation of the implant during insertion. At the medial end of the body, on both sides of the cannula, the end surface of the implant will form an angle, β, as shown in Figure 2, which is preferably about 90 °.

[0037] Figure 3 illustrates a cross section taken along line A-A, as shown in Figure 1 highlighting some internal structures of the implant. The inner diameter of the cannula 204 is shown. In addition, at the medial end of the implant, the inner surface (cannula) extends outward to meet the inclined outer surface 106. In this way, the lateral end of the implant is not flat, but preferably in the form of a pointed circular groove .

[0038] The implant is normally slid in place without turning around. The lateral end of the implant may have a specialized structure to aid insertion. Located at the base of the foot portion 212, this end, in a preferred embodiment, is provided with a frame

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9/17 of recess and the inner surface 202, 220, 218, 216, 210, 208 which has a selected geometric shape. These structures are configured to accept the end of an insertion tool that has a complementary geometric shape. Preferably, the tool would be inserted into the recess and used to advance the implant into position. Any geometric shape can be used, preferably one in which the maximum torque can be applied without slippage. Examples of suitable shapes include straight grooves (flat heads), crossed (PHILLIPS heads), hexagonal, POSIDRIVE, TORX, Allen-type and others.

[0039] Figure 4 is an enlarged view of detail B of figure 3, highlighting one of the orchards on the outer surface of the implant's cylindrical body. A single groove 304 has a length that is the sum of the width of the gap in the surface 302 plus the width of the surface strip between the grooves 312. The medial side of a groove, which is perpendicular to the central axis of the implant, makes an angle, α, with the side of the groove, as shown. The lateral side adjacent to the implant foot preferably forms the angle, α with a line perpendicular to the central axis of the implant. The angle α is preferably about 45 °. The bottom of the groove is indicated 306. The medial corner 308 and side corner, 310 are preferably rounded rather than cut at sharp angles as shown.

[0040] Figure 5 illustrates the implant in situ. As previously described, implant 100 operates by arthrodesis (blocking movement) of the patient's subtalar joint. The subtalar joint is the joint between the talus 402 superiorly and the calcaneus 404 inferiorly. Figure 5 also illustrates a C-C axis of movement of the subtalar joint that is approximately 16 degrees, measured from a B-B axis in the midline of a human foot.

[0041] Moving now to the compositions from which the implant

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10/17 is done, the invention aims to provide a long-term implant with the expected life span ranging from a period of years to a period of decades. In addition, the present invention is intended to be a permanent implant operatively; one that rarely or preferably never needs replacement during the user's life. In this, the material selected from an implant 100 must be soft enough to avoid excessive wear and deformation of the surrounding bones causing undesirable side effects, but, at the same time, durable enough so that the implant itself does not excessively wear and deform and eventually fail or require premature replacement.

[0042] In a preferred embodiment, an implant is made entirely from a single substance. In another preferred embodiment, the implant composition preferably comprises a medical grade polymer suitable for insertion into the body where it is substantially inert to chemical reactions present in the body and is capable of causing adverse reactions, infections, reactions adverse immunological reactions such as allergic reactions or rejection. In another preferred embodiment, the implant is in a medical grade titanium alloy. Yet another preferred embodiment is a medical grade polymer suitable for long-term or permanent implantation, as defined above. it is currently envisaged that the implant composition will comprise suitable polymers, such as Medical Grade polyetheretherketone (PEEK), polyetherketoneketone (PEKK), polymethylmethacrylate (PMMA), polytetrafluoroethylene (PTFE), crystalline plastics, polyoxymethylene and DELRIN.

[0043] The implant composition does not need to be a single substance. Indeed, it is envisaged that compositions comprising mixtures of two or more substances will be suitable. Suitable blends include combinations of polymer fibers dispersed in resins, such as DELRIN AF, a mixture of dispersed PTFE fibers

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11/17 evenly in acetal resin DELRIN.

[0044] Polymer research has resulted in the development of a large number of high grade polymers. These polymers have physical properties that cover the full range of properties (such as durability and hardness) of metal and plastic. Therefore, it is anticipated that many other compositions will be suitable for use with this implant, as long as these compositions have the desired properties.

[0045] It is also contemplated that several substances can be combined to form a hybrid implant combining the advantageous properties of each of the substances. For example, more durable substances can be combined with more flexible substances. High coefficient of friction substances can be combined with low coefficient of friction of substances. These substances can be placed in specific parts of the implant where the corresponding property is most critical. Alternatively, the substances can be mixed together in a uniform ratio throughout the implant.

[0046] In addition, while the post-operative image (fluoroscopy, magnetic resonance, etc.) is not necessary for proper placement of the implant, imaging may be desired for special purposes. In such cases, an opaque structure can be embedded within the implant or an opaque substance added to the polymer for imaging.

[0047] It is important to note that in cases where the bone surrounding the implant is protected against wear, then harder, more durable materials can be used, including metal alloys. For example, biotechnological techniques to stimulate the growth of bone cells (osteogenesis) and, thus, replace worn regions of bone may allow the use of harder materials. Of course, if the

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12/17 implant is only needed for a short time, then the material from which the implant is made is less critical.

[0048] In the context of this invention, the terms such as "generally shaped", "generally shaped," "generally shaped cylindrical" etc. are intended to indicate that the implant can, but does not need to be conformed to conform to strict definitions of solid geometry for solids, such as "cylinders" and "cones".

[0049] Indeed, in order to provide an implant with the appropriate size and shape for each patient, a range of sizes and shapes are contemplated. At one extreme, a “standard set” is used, where a set of “consensus” sizes and implant shapes are prefabricated and supplied to healthcare providers and their patients. This particular embodiment has the advantage of being the most uniform and, therefore, the least expensive for the patient.

[0050] At the other extreme, a "personalized design" is provided that the size and exact shape is determined only after precise and detailed measurements on the internal dimensions of the patient's tarsal sinus. As a result, the generally cylindrical portions of the implant can be tapered or shaped if necessary; However, the overall cylindrical configuration will remain.

[0051] In one embodiment, a range of implant sizes will be provided. As described here, the size of the implant can be varied in different ways: (1) all implant dimensions vary proportionally; (2) the total size of the implant is varied, but the depth of the grooves is to be kept constant; and (3) as the global dimension of the implant increases the depth of the groove increases at a greater speed.

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13/17 [0052] The size and shape of the foot portion of the implant is critical only at the point where the implant contacts the surrounding ankle bones; calcaneus below the implant and the stem above the implant. Consequently, the sides of the constituent part of the foot, which are generally tapered, can be concave or convex in appropriate regions. (Note, however, that the overall funnel configuration will remain.) The sides can still be hemispherical. The radius of the sphere being the radius of the circular base portion. Thus, the overall size of the constituent part of the foot can be changed so that the hemispherical foot implant has the same dimensions as the tapered foot at the points where the foot contacts the surrounding bone.

[0053] In a preferred embodiment, the tapered sides of the constituent part of the foot 122 of the implant extend outwardly, from the top to the base 118 to 124. The sides of the firing foot together form an angle, θ. In a preferred embodiment θ is in the range of 25 to 15 °. In another preferred embodiment θ is in the range of 19.3 ° to 20.3 °. In yet another preferred embodiment, θ is selected from the group consisting of each of the angles from 15 ° to 25 in increments of 0.1 °. (A set of about 100 specific angles.) In another preferred embodiment, the angle, θ, is 19.8 °.

[0054] The lateral end of the implant, which is the base of the constitutive part of the foot, does not come into contact with the bones of the ankle. Because of this, additional material can be added for this purpose, in virtually any form, without significantly affecting function. Addition material here is not recommended, as it would just add expense without providing any functional improvement.

[0055] Indeed, with the personalized design method, there are so many different shapes and sizes, as there are patients. The incorporation of personalized design has advantages, such as the patient receiving

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14/17 a precise amount of arthroeresic correction (degree of abnormal movement block), which can be instrumental in special cases, for example, elite athletes, dancers and others whose occupations place unusual tensions in this region.

[0056] Thus, the effective number of different sizes and shapes of implants to be manufactured will ultimately depend on economic considerations. If the cost is the predominant factor, a relatively small number of different sized and shaped implants will be manufactured. In a preferred embodiment, the applicant will provide a set of implants, ranging in size from 5 mm to 14 mm, as measured from the upper end 118 of the foot. On the other hand, as the precision fit becomes a more dominant factor, then the number of different sizes and shapes available will increase accordingly, perhaps to a very large number.

[0057] In addition to the shape of the implant, in general, the shape of the transition between the cylinder and the frustum can also vary. This transition does not need to be abrupt, as shown, for example in Figure 2, on the line between the sides of the foot portion 108 and the lateral end of the cylindrical portion 118. Instead, the transition could be smooth and gradual, leaving no no sharp points ”.

SURGICAL PROCEDURES AND INSTRUMENTATION [0058] Instrumentation of this system includes a set of cannulated probing devices, a set of implants, a cannulated insertion tool and a guide wire or guide pin. In a preferred embodiment, the probing devices have a diameter ranging from 5 mm to 12 mm, to match the implant size required for correction. Each sounding device is a 1 mm diameter increase.

[0059] Tarsal sinus implants are preferably supplied in a

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15/17 set that varies in size. Measuring from the outside diameter of the narrow part of the implant (the second member) the assembly will preferably have a caliber from 0.5 cm to 1.2 cm. The implant size should preferably be increased by 1 mm in diameter from 0.5 cm to 1.2 cm.

[0060] The cannula insertion tool is also included to advance the implant to the tarsal sinus. In a preferred embodiment, the functions of the insertion tool are very similar to a conductive screw, as described below.

[0061] A preferred surgical procedure consists of making a 1 cm 2 cm linear incision along the tarsal sinus parallel to the relaxed skin tension lines. The incision is deepened by blunt dissection into the tarsal sinus.

[0062] The appropriate angle along which the implant is inserted into the patient's tarsal sinus is then determined with one of the probing devices. The cannulated 0.5 cm probing device is inserted into the tarsal sinus of the lateral distal dorsal to the proximal plantar medial until it is palpated out of the medial aspect of the tarsal sinus. The angle of the probing device is the appropriate angle through which the implant is inserted.

[0063] A guide (preferably a guide wire or a guide pin) is then inserted into the cannula of the probe and left in place until the end of the procedure. Starting with the smaller diameter probe (0.5 cm) subsequent larger size probes are inserted through the guide until the appropriate sized implant is determined.

[0064] As mentioned above, implant 100 is cannulated (formed with a central longitudinal hole, or cannula) 204, so that the implant can be placed in the guide, followed by the cannula insertion tool. Through the action of the insertion tool, the implant is

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16/17 then advanced into the tarsal sinus until proper placement is achieved. Correct placement of the implant occurs when the constituent part of the foot 108 adjoins the most lateral aspect of the canalis tarsus. (The beginning or outermost aspect of the canalso tarsus.) Alternatively, placement can be achieved when the cylindrical body portion 104 confines the lateral aspect of the stem, the tali groove.

[0065] After the implant is completely inserted, the incision is closed. The method of closing the incision is the surgeon's choice.

SUMMARY OF THE MAIN ADVANTAGES OF THE INVENTION [0066] After reading and understanding the previous description of preferred embodiments of the invention, together with the illustrative drawings, it should be understood that several distinct advantages of the object implant system are obtained.

[0067] Without wishing to expose all the characteristics and advantages of the implant and the desirable associated methods, at least some of the main advantages of the invention are the stabilization of both medial and lateral aspects of the stalk and calcaneus by the corresponding segments of the implant in contact with these regions, which results in hyperpronation blocking of the foot, allowing normal movement.

[0068] Another advantage is the long service life of the implant. When the implant is made of the correct material, it will wear neither the surrounding bones nor the wear of the implant.

[0069] A related advantage that also increases the lifetime of the implant to permanent anchorage is the implant through the peripheral channels and threading. Failure due to slip out of position will be rare or absent. In addition, the surrounding bones remain strong, compared to procedures in which anchoring is achieved by drilling a hole in the calcaneus or using other invasive anchoring methods. As a result, complications 870160037452, of 19/07/2016, p. 19/24

17/17 tions from weak surrounding bones are unlikely.

[0070] Yet another advantage of the implant system is the ability to precisely position the implant without irradiation. The implant is correctly positioned when the implant abuts the most lateral aspect of the tarsus or the canalis tali sulcus or both. Thus, there is no need for fluoroscopy (and user foot radiation) to check positioning.

[0071] Another advantage of the subject sinus tarsal implant is the primary correction of talotarsal displacement, hyperpronation, valgus talipes, flat feet, and other related hindfoot and forefoot deformities. The implant will also be used for the secondary correction of growth pains, shin splints, posterior tibial tendon dysfunction, plantar fasciitis, hallux abductus valgus, metatarsal varus primus and elevatus, metatarsal adducts, contracted toes, abnormal gait, intermetatarsal neuromas, as well as sciatica, patellofemoral pain, anterior varus genus of the pelvis inclination, lumbar lordosis, etc.

[0072] However, another advantage is that the implant is inserted through a minimally invasive procedure and casting is not necessary following the procedure so that there is a quick recovery.

[0073] In describing the invention, reference has been made to preferred embodiments. Those skilled in the art and familiar with the disclosure of the present invention, however, can recognize additions, deletions, substitutions, modifications and / or other changes that will fall within the scope of the invention as defined in the following Claims.

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Claims (14)

1. Tarsal sinus implant for use in correcting the anatomical alignment of a patient's ankle bone structure, characterized by: a cylindrical body portion consisting of a cylindrical side surface, a circular middle end and a circular side end, said medial and lateral ends perpendicular to the transverse axis of the body, said cylindrical side surface comprising a plurality of grooves each perpendicular to the transverse axis of the body and a tapered foot portion consisting of a lateral surface, generally tapered, an upper and circular base, said to stop being integrally connected, along a common transverse axis, with the lateral end of the body portion, said surfaces tapered sides widen outward to form an angle, θ, where θ is in the range of 15 ° 25 ° in which said implant is inserted into a patient's ankle and corrects the anatomical alignment of the patient's ankle bone structure . Tarsal sinus implant according to Claim 1, characterized by: said base is formed with a recess configured to accept a tool, so that when the tool is inserted into the tool recess it can be operated to advance the implant in the correct position. Tarsal sinus implant according to Claim 1, characterized by: a longitudinal hole that runs the entire length of the Petition 870160037452, of 7/19/2016, p. 21/24 2/3 implant along the central longitudinal axis of the implant and formed to allow placement of the implant in a guide to facilitate proper surgical implantation. 4. Tarsal sinus implant according to Claim 1, characterized by: an external diameter, measured at the top of the conical element, in a range of 5.0 mm to 12 mm. Tarsal sinus implant according to Claim 1, characterized by: each of said plurality of grooves consisting of a lateral side of the groove, a bottom of the groove and a medial side of the groove, said lateral groove being generally perpendicular to the central axis of the implant and said groove on the medial side inclined outwardly to from the side of the side groove, at an angle, α, where α is in the range of 35 ° 45 °. Tarsal sinus implant according to Claim 5, characterized by: the angle is about 40 °. Tarsal sinus implant according to Claim 6, characterized by: said cylindrical body portion has a diameter, measured at the top of the groove, in the range of 5.0 mm to 10.0 mm. Tarsal sinus implant according to Claim 6, characterized by: the bottom of the groove is about 0.8 mm wide. 9. Tarsal sinus implant according to Claim 1, characterization 870160037452, of 7/19/2016, p. 22/24 3/3 by: said plurality of grooves is in the range of four to eight grooves. Tarsal sinus implant according to Claim 1, characterized by: the plurality of grooves is six grooves. Tarsal sinus implant according to Claim 1, characterized by: said conical side surface is generally curved to form a convex surface. Tarsal sinus implant according to Claim 11, characterized by: said convex surface is hemispherical. Tarsal sinus implant according to Claim 1, characterized by: said tapered lateral surface is generally excavated inward to form a concave surface. 14. Method to correct the anatomical alignment of a patient's ankle bone structure, characterized by: inserting the implant according to Claim 1 into a breast of a patient's tarsus. Petition 870160037452, of 7/19/2016, p. 23/24 102 106 104 ί β) 112 1 ....... 114 108 Λ.- ~ - ~ - ·; / i j y Z O I 12 r- \ · ~ · ** χ \ ' ¹ i: 116 118 / \ (θ) V 122