EP1809210A2 - Mittelfussimplantat - Google Patents

Mittelfussimplantat

Info

Publication number
EP1809210A2
EP1809210A2 EP05817035A EP05817035A EP1809210A2 EP 1809210 A2 EP1809210 A2 EP 1809210A2 EP 05817035 A EP05817035 A EP 05817035A EP 05817035 A EP05817035 A EP 05817035A EP 1809210 A2 EP1809210 A2 EP 1809210A2
Authority
EP
European Patent Office
Prior art keywords
implant
stem
shaped body
metatarsal
bone
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP05817035A
Other languages
English (en)
French (fr)
Inventor
Inc. Small Bone Innovations
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Small Bone Innovations Inc
Original Assignee
Small Bone Innovations Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Small Bone Innovations Inc filed Critical Small Bone Innovations Inc
Publication of EP1809210A2 publication Critical patent/EP1809210A2/de
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30138—Convex polygonal shapes
    • A61F2002/30151—Convex polygonal shapes rhomboidal or parallelogram-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • A61F2002/30785—Plurality of holes parallel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/3082—Grooves
    • A61F2002/30822—Circumferential grooves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30843—Pyramidally-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30904—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves serrated profile, i.e. saw-toothed
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • A61F2002/4228—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes for interphalangeal joints, i.e. IP joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0017—Angular shapes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00029—Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00035—Other metals or alloys
    • A61F2310/00047—Aluminium or Al-based alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures

Definitions

  • the present invention relates to devices and methods for the repair of defects and/or diseases of the first metatarsal joint.
  • the component joints replacing the base of the proximal phalanx as well as the head of the metatarsal have been subject to extreme failure due to limited motion, implant failure, loosening and displacement of the implant, plantar pain, and disruption of the sesamoid apparatus. Implantation of these implants typically requires the removal of healthy joint tissue; the base of the proximal phalanx is often resected and replaced as part of the hemi implantation to decompress the joint and provide a material, other than hyaline cartilage, that can articulate with the head of the metatarsal with degenerative changes.
  • Prior art implants have typically used serrations, grooves, or some similar method of preventing slippage of the implant. Such prior methods are either ineffective at preventing slippage of the implant or require a protected weight-bearing arrangement (i.e. a traditional cast, walking cast, or other type of external stabilization) for a period of time before the patient can place their full weight on the implant site.
  • a protected weight-bearing arrangement i.e. a traditional cast, walking cast, or other type of external stabilization
  • United States Patent No. 5,458,648 to Berman et al. describes a two-component implant for the replacement of metatarsophalangeal joints. These implants require prosthetic implantation into both the metatarsal and phalangeal bones. Further, implantation therein described requires extensive resection of both the metatarsal and phalangeal bones. Grooves on the surface of the implant stem are the only means by which the implant becomes secured.
  • United States Patent No. 6,679,917 to Ek describes a one component implant for repairing defects in articular cartilage. These implants do not maintain the natural shape of the metatarsal bone and implantation requires extensive reaming. Threads on the stem of the implant are the only mechanical means by which the implant becomes secured.
  • the present invention comprises a metatarsal head implant for use in the reconstruction of damaged or diseased metatarsal joints of the great toe.
  • the implant has a one-piece construction, comprising a generally convex, hollow portion that fits over the metatarsal head of the great toe, a serrated stem, and one or more locking screws.
  • the implant of the present invention is designed to conform to the patient's existing (natural) phalanx, thus eliminating the need for a phalanx implant that is specifically designed to work in conjunction with the metatarsal implant. To reach this goal, the design of the p ⁇ eseht ' mve ⁇ i ⁇ Ms su ⁇ ri'thaf fh'e shape of the implant is more convex than that of previous metatarsal implants.
  • the metatarsal implant is designed so that it may work in conjunction with either the patient's existing phalanx or one- piece phalanx implants designed and/or manufactured independently from the metatarsal implant.
  • An additional advantage of the one-piece design of the present invention is the ability to maintain the health and integrity of the existing sesamoid bones, which has previously been difficult when using two-piece metatarsophalangeal implants.
  • the implant maybe adapted for use in the hand as well as for other joints of the foot.
  • Locking screws have previously been used in the orthopedic profession, but not in conjunction with implants that allow a range of motion, i.e., implants of the foot or hand, hi the present invention, one or more locking screws are employed to prevent rotation and backing- out of the implant and provide stability in more than one plane.
  • the use of a serrated stem in conjunction with one or more locking screws, as in the present invention, allows immediate and full weight-bearing on the affected joint.
  • a hollow stem having preferred fenestrations is used.
  • the hollow stem is preferably filled with a material which supports, stimulates, or facilitates bone ingrowth through the stem.
  • FIG. IA is a perspective, posterior side elevational view showing the metatarsal implant of the present invention.
  • FIG. IB is a perspective, side elevational view showing the metatarsal implant of the present invention.
  • FIG. 1C is a perspective, anterior side elevational view showing the metatarsal implant of the present invention.
  • FIG. 2A is a perspective, plantar side elevational view showing the metatarsal implant of the present invention
  • FIG. 2B is a perspective, dorsal side elevational view of the metatarsal implant of the present invention.
  • FIG. 3 A is a detailed view showing a hollow stem of the present invention, having fenestrations
  • FIG. 3B is a detailed view showing a hollow stem of the present invention, having apertures; "FlG!3 ' C “ ls 1 a”detairefl. * ci f ⁇ " ss-sectional view of a hollow stem of the present invention, filled with osteogenic or osteostimulatory material;
  • FIG. 4 A is a side elevational view, illustrating the implantation of the implant of the present invention into the first metatarsal bone
  • FIG. 4B is a side elevational view, illustrating the full range of motion of the metatarsophalangeal joint, after implantation of the implant of the present invention
  • FIG. 4C is a cross-sectional view of the first metatarsal bone, showing the implantation of the implant of the present invention, including fasteners securing the implant to the bone.
  • a metatarsal implant 1 has a head 2 that on the posterior side 3, defines a concave surface 4.
  • the concave surface 4 is generally spherically shaped, having degrees of concavity that substantially conform to the shape of the distal joint end of a metatarsal bone, either naturally occurring or sculpted.
  • the degrees of concavity substantially conform to the shape of the distal joint end of the first metatarsal bone.
  • the joint end of a metatarsal bone may also be shaped into a standard form that conforms to the concave surface 4 of the implant. Such shaping may be necessary when the defect or disease of the metatarsal bone distorts the bone from the natural shape of the joint end of healthy metatarsal bone. Such shaping may be accomplished using a bone shaping tool such as a reamer and techniques generally known in the art.
  • the anterior face 6 defines a convex surface 8.
  • the convex surface 8 is generally spherically shaped, having a degree of convexity that substantially conforms to the shape of the joint end of a phalanx. More preferably, the degree of convexity substantially conforms to the shape of the joint end of the first phalanx of the foot.
  • the head of the implant maintains a substantially uniform degree of thickness throughout, m other embodiments, the head of the implant maintains varied degrees of thickness.
  • the thinnest areas of the head are along the edges of the head.
  • the plantar edge 24 is truncated, truncated being defined as replacement of an edge by a plane, so as to avoid disturbance of the sesamoid apparatus by the implant head 2.
  • At least one stem 10 projects from the concave surface 4 of the implant away from the convex surface 8.
  • the stem projects generally normal to the concave surface of the implant. More preferably, the stem is positioned in the concave surface so as to allow the head 2 of the implant to project substantially over the stem 10.
  • Th ' e stem ⁇ O ' may ' Be present in a variety of shapes.
  • the stem has a substantially square cross-section.
  • the stem can have a substantially rectangular, triangular, or rounded cross-section (not shown).
  • the stem maintains a uniform diameter along the longitudinal axis of the stem. In other embodiments, the stem diameter progressively decreases along the longitudinal axis of the stem, the largest diameters being located near to the head of the implant.
  • the stem 10 includes a plurality of serrations 14, serrations being defined as notches, barbs, or teeth, on one or more sides of the stem 10.
  • the serrations 14 are preferably canted to provide for easy insertion of the stem 10 into the bone, yet resist removal or backing out of the stem from the cancellous portion of the metatarsal bone.
  • the serrations 14 further provide a surface in which optional bone cement, or over time, bone tissue, will anchor the stem into the bone.
  • Bone cement materials are known in the art and include materials such as those that are based on polymethylmethacrylate and calcium phosphate and others.
  • the stem 10 may also have a textured surface.
  • the textured surface serves to encourage new bone growth to form on the implant to further secure the implant into the bone.
  • the stem may be coated with or comprise osteogenic or osteofacilitative material, likewise known in the artier se, to facilitate intimate bonding with the patient's own bone.
  • the stem 10 may also comprise at least one aperture 18 for accepting one or more fasteners (20), apertures being defined as channels or holes.
  • the aperture 18 may be positioned in the stem such that one or more fasteners 20 may be inserted laterally into or through the stem (see FIGS. 4A, 4B, 4C).
  • the apertures may be positioned in the stem such that the fasteners may be inserted from the dorsal side 12 of the stem to the plantar side 13 of the stem.
  • the stem 10 comprises a plurality of apertures such that fasteners may be inserted both laterally through the stem 10 and from dorsal (12) to plantar (13) sides of the stem 10.
  • a template may be used to locate the stem apertures to facilitate fastener insertion.
  • the template may comprise a plurality of markings indicating the distance from the anterior face 6 to an aperture 18. By positioning the template against the anterior surface of the implant, one may determine where inside the bone the apertures are located. Once the location of the apertures is determined, a hole may be drilled through the bone to allow for a fastener to be inserted through the bone, through the aperture, and through the stem.
  • " lift" one em'bb ' timi ⁇ ht the tasteners 20 may be screws.
  • the fasteners may be self-locking screws.
  • the fasteners may be rods or pins, including structures which may be bioresorbable.
  • the stem 10 may also include a tip 22.
  • the tip 22 may be in the shape of a trocar, a trocar being defined as a sharp, pyramidal shape.
  • the tip 22 may be a sharp, four-pointed, pyramidal shape.
  • the tip 22 provides a surface capable of piercing or cutting tissue and bone to facilitate insertion of the stem into the bone.
  • the stem 10 may be hollow and may comprise a plurality of fenestrations 28, fenestrations being defined as openings.
  • the hollow stem may comprise a plurality of apertures 18.
  • the hollow stem may further comprise an end portion 32, the end portion being distal to the head of the implant.
  • the end portion may comprise a plurality of cutting surfaces 34, capable of cutting through tissue and bone so as to facilitate the implantation of the stem into the bone.
  • the hollow stem may be filled with osteogenic or osteostimulatory materials (36) in order to facilitate bone tissue growth to anchor the stem into the bone. Osteostimulatory materials are known in the art and include such materials as hydroxyapatite.
  • VITOS S ® sold by the Orthovita Company, Malvern, PA.
  • Such material may be mixed with blood and/or marrow harvested from the metatarsal site in order to facilitate bone regrowth. See e.g., U.S. Pat. No. 6,736,799.
  • the metatarsal implants of the present invention can be made of any suitable material.
  • the implant is made from medical-grade titanium alloy.
  • Other acceptable materials include cobalt chromium, cobalt chromium molybdenum, stainless steel, aluminum, and ceramic.
  • the metatarsal implants of the present invention may also be optionally coated.
  • a number of different sized implants e.g., three or four sizes, be provided to account for different foot sizes.
  • the implant of the present invention may be implanted using techniques generally known to those skilled in the field.
  • One method of implantation is provided by way of example.
  • a dorsal linear incision is initially made medial to the extensor hallucis longus tendon to expose and provide access to the metatarsal head and base, including the joint capsule and periosteum.
  • Joint arthroplasty is then performed through the exposed first metatarsophalangeal joint to remove arthritic, diseased, and/or otherwise damaged bone.
  • a K- wire is centrally placed into the shaft of the first metatarsal bone and a conical reamer is placed over the K-wire.
  • the first metatarsal head is then reamed to a rounded, contoured, anatomical shape" "
  • the reamer and K- wire are then removed and a sharp broach is placed centrally through the metatarsal head, down the metatarsal shaft, in preparation for the placement of the implant stem of the present invention.
  • the broach is removed and implant sizers are placed into the metatarsal shaft. After an appropriate sizer has been determined, the sizer is removed and a likewise appropriately sized implant of the present invention is placed into the shaft of the first metatarsal bone.
  • the implant is tamped to secure it in place.
  • a metatarsal implant 1 constructed in accordance with the present invention is shown implanted into a first metatarsal bone.
  • the implant 1 is implanted into the first metatarsal bone 40, abutting the joint end of the first phalanx of the toe 42.
  • the anterior face 6 of the implant cooperates with the concave surface of the first phalanx 42, allowing a full range of motion about the metatarsophalangeal joint (FIG. 4B) without disturbing the sesamoid apparatus 44.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
EP05817035A 2004-11-08 2005-11-08 Mittelfussimplantat Withdrawn EP1809210A2 (de)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US62598704P 2004-11-08 2004-11-08
PCT/US2005/040260 WO2006052874A2 (en) 2004-11-08 2005-11-08 Metatarsal implant

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EP1809210A2 true EP1809210A2 (de) 2007-07-25

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EP (1) EP1809210A2 (de)
AU (1) AU2005304745A1 (de)
WO (1) WO2006052874A2 (de)

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US20090105840A1 (en) * 2007-10-18 2009-04-23 Inbone Technologies, Inc. Fibular stiffener and bony defect replacer
DE102016224483A1 (de) * 2015-12-09 2017-06-14 Ceramtec Gmbh Großzehengrundgelenksersatz, insbesondere auf keramischer Basis
US10898348B2 (en) 2016-12-13 2021-01-26 Tornier Surgical shoulder articulation replacement method
SE2151181A1 (en) 2021-09-27 2023-03-28 Metatarsal implant

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US2622592A (en) * 1952-01-05 1952-12-23 Rosenstein Max X-ray marker for artificial femoral heads
US4883488A (en) * 1988-06-13 1989-11-28 Harrington Arthritis Research Center Tibial component for a knee prosthesis
US5458648A (en) * 1994-02-24 1995-10-17 Kinetikos Medical, Inc. Great toe joint implant and method of implantation
US5609641A (en) * 1995-01-31 1997-03-11 Smith & Nephew Richards Inc. Tibial prosthesis
US6533788B1 (en) * 2001-11-01 2003-03-18 Hand Innovations, Inc. Locking device for intramedullary pin fixation

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Title
See references of WO2006052874A2 *

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AU2005304745A1 (en) 2006-05-18
WO2006052874A3 (en) 2007-08-23
WO2006052874A2 (en) 2006-05-18

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