US20100198354A1 - Method and system for patella tendon realignment - Google Patents
Method and system for patella tendon realignment Download PDFInfo
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- US20100198354A1 US20100198354A1 US12/671,478 US67147808A US2010198354A1 US 20100198354 A1 US20100198354 A1 US 20100198354A1 US 67147808 A US67147808 A US 67147808A US 2010198354 A1 US2010198354 A1 US 2010198354A1
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- patellar
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- patellar implant
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Definitions
- patella-femoral joint problems of the patella-femoral joint are a common cause of knee pain.
- the pain may arise from issues such as poor alignment of the patella or from cartilage breakdown (chondromalacia or arthritis) behind the patella or on the opposing articular surface of the femoral groove (trochlea).
- Conventional surgical options for treating patella-femoral pain caused by malalignment, chondromalacia or arthritis may include realignment of the patella. For example tracking of the patella may be changed by tilting the patella or by moving the patella to one side or the other. Moving the patella forward (i.e., anteriorly) through a surgical procedure provides another conventional option for treating these conditions. This conventional technique is thought to decrease force across the patella-femoral joint and thus diminish the pain arising from excess force against a worn-out patellar or trochlear cartilage.
- patella-femoral joint problems such as patella-femoral pain, chondromalacia, and/or arthritis is desired.
- the patellar implant includes a superior portion, an inferior portion opposite to the superior portion, and an anterior portion.
- the superior portion being configured to reside below a patellar tendon and to elevate and/or tilt the patellar tendon.
- the inferior portion is configured to be seated in proximity to a tibia.
- the anterior portion is between the superior portion and the inferior portion.
- the anterior portion is placed in proximity to a patella.
- the method includes inserting the implant beneath the patellar tendon and between the patella and a position at which the patellar tendon is affixed to the tibia.
- the method also includes affixing the implant.
- the patellar implant may be used to realign, for example by elevating and/or tilting, the patellar tendon.
- various the patella-femoral joint problems may be alleviated.
- FIG. 1 depicts an exemplary embodiment of a patellar implant.
- FIG. 2 depicts another exemplary embodiment of a patellar implant.
- FIG. 3 depicts another exemplary embodiment of a patellar implant.
- FIG. 4 depicts another exemplary embodiment of a patellar implant.
- FIG. 5 depicts another exemplary embodiment of a patellar implant.
- FIG. 6 depicts another exemplary embodiment of a patellar implant.
- FIG. 7 depicts an exemplary embodiment of one option for placement of an exemplary embodiment of a patellar implant to reposition the patellar tendon and patella.
- FIGS. 8-9 depict another exemplary embodiment of a patellar implant.
- FIGS. 10-11 depict another exemplary embodiment of a patellar implant.
- FIG. 12 depicts another exemplary embodiment of a patellar implant.
- FIG. 13 depicts another exemplary embodiment of a patellar implant.
- FIGS. 14-17 depict other exemplary embodiments of patellar implants positioned beneath a patellar tendon.
- FIGS. 18-22 depict another exemplary embodiment of a patellar implant.
- FIG. 23 depicts an exemplary embodiment of a method for placing a patellar implant.
- the method and system relate to medical devices, particularly implants.
- the following description is presented to enable one of ordinary skill in the art to make and use the invention and is provided in the context of a patent application and its requirements.
- Various modifications to the embodiments and the generic principles and features described herein will be readily apparent to those skilled in the art.
- the method and system are not intended to be limited to the embodiments shown, but is to be accorded the widest scope consistent with the principles and features described herein.
- the method and system are mainly described in terms of particular systems provided in particular implementations. However, one of ordinary skill in the art will readily recognize that this method and system will operate effectively in other implementations.
- the particular shape of the patellar implant may take a number of different forms depending upon, for example, the specific anatomy of a patient and the problem desired to be addressed.
- the method and system will also be described in the context of particular methods having certain steps. However, the method and system operate effectively for other methods having different and/or additional steps not inconsistent with the method and system.
- FIG. 1 depicts an exemplary embodiment of a patellar implant 100 .
- the patellar implant includes a superior portion 102 , an inferior portion 104 , and an anterior portion 106 .
- the patellar implant 100 includes a posterior portion (not shown) that is opposite to the anterior portion 106 .
- the posterior portion is substantially the same as and parallel to the anterior portion 106 .
- lateral surfaces 108 and 110 are also shown as well as edges 112 and 114 .
- the superior portion 102 is shown having a convex upper surface. In addition, the superior portion is symmetric. The superior portion 102 is to reside in proximity to the patellar tendon, while the inferior portion 104 is to reside in proximity to the tibia. The inferior portion 104 of the patellar implant 100 is substantially flat. The superior portion 102 is thus configured to lift and/or tilt the patellar tendon, while the surface of the inferior portion 104 is configured to fit the tibia. The amount of lift and/or tilt provided may depend upon the shape of the implant 100 as well as the positioning of the implant 100 in the patient. Consequently, the size and/or shape of the implant 100 may vary.
- the height, h, of the patellar implant 100 may be between 0.5 and 3 centimeters. In other embodiments, the height may vary between 1 and 2 centimeters. In some embodiments, the width, w, of the patellar implant 100 may be between 1 and 3.5 centimeters. In other embodiments, the width of the patellar implant 100 may vary between 2 and 3 centimeters. Similarly, in some embodiments, the length, I, of the patellar implant may vary between one and 3.5 centimeters. In other embodiments, the length may vary between 1and three centimeters. In other embodiments, other heights, widths, lengths, and/or angles between components may differ.
- the patellar implant 100 may be inserted through an incision in proximity to the patella.
- the patellar implant 100 is placed below the patellar tendon (not shown in FIG. 1 ) between the patella (not shown in FIG. 1 ) and a distal attachment of the patella (not shown in FIG. 1 ).
- the patellar implant 100 is placed between the patellar tendon and the tibia and between the patella and a location at which the patellar tendon attaches to the tibia.
- the location of the patellar implant 100 is selected to achieve the desired tilt and/or elevation of the patellar tendon and thus the desired repositioning of the patella.
- the inferior portion 104 is flat.
- a slot or flat region may be formed in the tibia at the desired position of the patellar implant 100 .
- the patellar implant 100 is then fitted on the slot such that the inferior portion 104 meets the flat region of the tibia.
- the patellar implant may be fixed in place, through a variety of mechanisms, described below. In some embodiments.
- the patellar implant 100 may then be affixed to the tibia, the patellar tendon, or both.
- the patellar implant 100 may include various materials. Particular embodiments may include natural materials, synthetic materials, or a combination thereof.
- the patellar implant 100 or portions thereof may be constructed using plastics, metals, synthetic bone materials, allografts and/or other materials. Examples of representative materials may include, but are not limited to, stainless steel, titanium, cobalt chrome, polyethylene, polyetheretherketone, and other materials.
- the patellar implant 100 may be formed as a composite.
- the superior portion 102 may be made of different materials than the inferior portion 104 .
- the superior portion 102 and inferior portion 104 may be made of the same material(s). However, in either embodiment, the portions 102 and 104 may be formed as separate pieces, then joined together.
- composite patellar implant 100 may include a superior portion 102 fabricated from a polymeric material, with a metal inferior portion 104 . This allows the polymeric material of the superior portion 102 to be in contact with the patellar tendon, while a textured surface on the metal of the inferior portion 104 contacts bone. Other arrangements and combinations might also be used. Coatings, adhesives, surfaces, and/or other features may be used, for example on the surface of the superior portion 102 and/or the surface of the inferior portion 104 . Such treatments may be provided to facilitate local affixation, growth of the tendon and/or bone to the patellar implant 100 , healing, and/or other desired outcomes. As an example, a bone ingrowth surface using metal beads, a bone morphogenic protein, or the like may be provided.
- the implant 100 and/or its components may take any shape that is anatomically acceptable for positioning beneath the patellar tendon and/or patella.
- some edges of the patellar implant 100 such as the edge 112 , is shown as being sharp.
- Other edges, such as the edge 114 are shown as being rounded.
- the particular shape of an edge may be altered.
- the edge 112 might be rounded and/or the edge 114 sharp. Rounding of edges 112 and 114 may reduce stresses placed on the implant 100 during physiological use.
- the surfaces of the implant 100 may be modified to conform to the anatomic position where the implant 100 is to be used.
- portions 102 , 104 , 106 , 108 , and 110 may have different shapes, placements, and/or angles with respect to each other.
- the superior portion 102 is shown having a symmetric, convex upper surface, the superior portion 102 may have a different shape.
- Other such shapes may include ridges that may be configured to position or adhere the patellar implant 100 to the portion(s) of the patient's anatomy. In other embodiments, ridges may be omitted.
- the inferior portion 104 of the patellar implant is depicted as substantially flat. However, in another embodiment, the inferior portion 104 may have a different shape.
- lateral surfaces 108 and 110 are shown, in another embodiment, the surface 108 and/or 110 may be omitted, may not be planar, and/or may have a different shape.
- the patella may be repositioned.
- the patella may be elevated and/or tilted.
- the elevation and/or tilting of the patella may alter patellar tracking and decrease forces on the patella, thereby treating patients with patella pain, chondromalacia of the patella or patellar malalignment. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- some patellar-femoral joint problems are due to the patella contacting the tibia or femur.
- Elevating or tilting the patella a desired amount using the implant 100 may provide space between the patella and the tibia or femur.
- the elevation of the patella may also decrease force loads across the patellar-femoral joint.
- patellar pain, malalignment, chondromalacia, arthritis, and/or other issues involving the patellar-femoral joint may be treated.
- FIG. 2 depicts another exemplary embodiment of a patellar implant 100 ′.
- FIG. 2 is not drawn to scale.
- the components of the patellar implant 100 ′ are analogous to the patellar implant 100 and are, therefore, labeled similarly.
- the patellar implant 100 ′ includes a superior portion 102 ′, an inferior portion 104 ′, anterior portion 106 ′, and posterior portion (not shown in FIG. 2 ). Also shown are lateral surfaces 108 ′ and 110 ′ as well as edges 112 ′ and 114 ′.
- the amount of lift and/or tilt of the patellar tendon may vary between patients.
- the size, angles between, degree of rounding, and/or specific shape of the patellar implant 100 ′ and portions 102 ′, 104 ′, 106 ′, 107 , 108 ′, 110 ′, 112 ′, and 114 ′ may also vary.
- lateral surfaces 108 ′ and 110 ′ are shown, in another embodiment, the surface 108 ′ and/or 110 ′ may be omitted.
- the concave superior portion 102 ′ may simple terminate at an edge 112 ′ that is adjacent to the inferior portion 104 ′.
- the patellar implant 100 ′ is used in a similar manner to and may be made from similar material(s) as the patellar implant 100 .
- the superior portion 102 ′ is shown having a convex upper surface and being symmetric.
- the superior portion 102 ′ is still configured to lift and/or tilt the patellar tendon.
- the superior portion 102 ′ is still to reside in proximity to the patellar tendon, while the inferior portion 104 ′ is configured to be placed in proximity to the tibia.
- the inferior portion 104 ′ of the patellar implant 100 ′ has a convex portion 107 .
- the convex portion 107 is configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 100 ′ may be avoided.
- the patellar implant 100 ′ may be affixed in place through a variety of mechanisms, described below.
- the patellar implant 100 ′ might be affixed to the tibia, the patellar tendon, or both.
- the patella may be repositioned. For example, the patella may be elevated and/or tilted. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated. In addition, because cutting or other alteration of the tibia may be avoided, recovery time and ease of use of the patellar implant 100 ′ may be improved.
- FIG. 3 depicts another exemplary embodiment of a patellar implant 100 ′′.
- FIG. 3 is not drawn to scale.
- the components of the patellar implant 100 ′′ are analogous to the patellar implants 100 and 100 ′.
- the components of the patellar implant 100 ′′ are labeled similarly.
- the patellar implant 100 ′′ includes a superior portion 102 ′′, an inferior portion 104 ′′, anterior portion 106 ′′, and posterior portion (not shown in FIG. 3 ).
- the patellar implant 100 ′′ is wedge shaped.
- lateral surface 108 / 108 ′ has been replaced with a rounded edge 108 ′′.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 100 ′′ and portions 102 ′′, 104 ′′, 106 ′′, 107 ′′, 108 ′′, 112 ′′, and 114 ′′ may also vary.
- the patellar implant 100 ′′ is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′.
- the superior portion 102 ′′ has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 102 ′′ is still to reside in proximity to the patellar tendon, while the inferior portion 104 ′′ is configured to be placed in proximity to the tibia.
- the inferior portion 104 ′′ has a convex portion 107 ′′ configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 100 ′′ may be avoided. However, in another embodiment, the concave portion 107 ′′ may be omitted.
- the patellar implant 100 ′′ may be affixed in place through a variety of mechanisms, described below. The patellar implant 100 ′′ might be affixed to the tibia, the patellar tendon, or both.
- the patellar implant 100 ′′ Through the use of the patellar implant 100 ′′, the patellar tendon may be lifted and/or tilted and the patella repositioned.
- the patellar implant 100 ′′ is wedged shaped.
- the lateral surface 110 ′′ is wider than the rounded edge 108 ′′.
- the patellar implant 100 ′′ tends to tilt the patellar tendon toward the rounded edge 108 ′′. Consequently, the ability of the patellar implant 100 ′′ to tilt the patellar tendon is improved. A greater tilt of the patellar tendon, as well as the patella, may thus be achieved. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated. Because cutting or other alteration of the tibia may be avoided if the concave portion 107 ′′ is provided, recovery time and ease of use of the patellar implant 100 ′′ may be improved.
- FIG. 4 depicts another exemplary embodiment of a patellar implant 100 ′′′.
- the components of the patellar implant 100 ′′′ are analogous to the patellar implants 100 , 100 ′, and 100 ′′.
- the patellar implant 100 ′′′ includes a superior portion 102 ′′′, an inferior portion 104 ′′′, anterior portion 106 ′′′, and posterior portion (not shown in FIG. 4 ).
- the patellar implant 100 ′′′ is tapered.
- lateral surfaces 108 ′′′ and 110 ′′′ are thicker near the anterior portion 106 ′′.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 100 ′′′ and portions 102 ′′′, 104 ′′′, 106 ′′′, 107 ′′, 108 ′′, 110 ′′, 112 ′′′, and 114 ′′′ may also vary.
- the patellar implant 100 ′′′ is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′/ 100 ′′.
- the superior portion 102 ′′′ has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 102 ′′′ is still to reside in proximity to the patellar tendon, while the inferior portion 104 ′′′ is configured to be placed in proximity to the tibia.
- the inferior portion 104 ′′′ has a convex portion 107 ′′ configured to fit the tibia of the patient.
- cutting, grinding, or other altering of the tibia in order to fit the implant 100 ′′′ may be avoided.
- the concave portion 107 ′′ may be omitted.
- the patellar implant 100 ′′′ may be affixed in place through a variety of mechanisms, described below.
- the patellar implant 100 ′′′ might be affixed to the tibia, the patellar tendon, or both.
- the patellar implant 100 ′′′ is tapered.
- the superior portion 102 ′′′ is higher at the anterior portion 106 ′′′ (nearer to the patella) than at the posterior portion (closer to the distal attachment of the patellar tendon).
- the elevation and/or tilt provided by the patellar implant 100 ′′′ may place less stress on the patellar tendon. Consequently, the comfort and/or usability of the patellar implant 100 ′′′ may be improved.
- the patellar implant 100 ′′′ may be used to tilt and/or lift the patellar tendon and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIG. 5 depicts another exemplary embodiment of a patellar implant 200 .
- FIG. 5 is not drawn to scale.
- the components of the patellar implant 200 are analogous to the patellar implants 100 / 100 ′/ 100 ′′′.
- the patellar implant 200 includes a superior portion 202 , an inferior portion 204 , anterior portion 206 , and posterior portion (not shown in FIG. 5 ) corresponding to the superior portion 102 / 102 ′/ 102 ′′/ 102 ′′′, inferior portion 104 / 104 ′/ 104 ′′/ 104 ′′′, and anterior 106 / 106 ′.
- 106 ′′/ 106 ′′′ anterior portion
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 200 and portions 202 , 204 , 206 , 207 , 208 , 210 , 212 , and 214 may also vary.
- the patellar implant 200 is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′/ 100 ′′/ 100 ′′′.
- layers 220 , 222 , 224 and 226 are shown.
- the layers 220 and 222 are configured to be added to the superior portion 204 .
- the layers 224 and 226 are configured to be added to the inferior portion 202 .
- the height, h, of the patellar implant 100 ′′ may be increased.
- the layers 220 and 222 do not extend across the width, w, of the patellar implant 200 .
- the layers 220 , 222 , 224 , and/or 226 may be used to adjust the tilt to the patellar tendon provided by the patellar implant 200 .
- the layers 220 and 222 do not extend along the entire length of the patellar implant and/or may be tapered.
- the layers 220 and 222 may be used to alter the height of the patellar implant 200 along its length.
- the taper of the patellar implant 200 may be configured using the layers 220 and/or 222 .
- the amount each of the layers 220 , 222 , 224 , and/or 226 extend along the height, width, and length of the patellar implant 200 as well as the location of the layers 220 , 222 , 224 , and/or 226 on the patellar implant 200 may be selected.
- the patellar implant 200 may be configured by the surgeon or other qualified individual when being prepared for use in a patient.
- the superior portion 202 has a convex upper surface, is symmetric, and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 202 is still to reside in proximity to the patellar tendon, while the inferior portion 204 is configured to be placed in proximity to the tibia.
- the inferior portion 204 has a convex portion 207 configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 100 ′′ may be avoided.
- the patellar implant 200 may be affixed in place through a variety of mechanisms, described below.
- the patellar implant 200 might be affixed to the tibia, the patellar tendon, or both.
- the height, tilt, and/or taper of the patellar implant 200 may be configured for the needs of a particular patient.
- the patellar tendon may be lifted and/or tilted and the patella repositioned in a desired fashion. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- recovery time and ease of use of the patellar implant 200 may be improved.
- use of the layers 220 , 222 , 224 , and 226 may be used to adjust the elevation and/or tilt provided as well as the fit of the patellar implant 200 to the tibia. Consequently, use of the patellar implant 200 may be improved.
- FIG. 6 depicts another exemplary embodiment of a patellar implant 200 ′.
- FIG. 6 is not drawn to scale.
- the components of the patellar implant 200 ′ are analogous to the patellar implants 200 and 100 / 100 ′/ 100 ′′. Thus, the components of the patellar implant 200 ′ are labeled similarly.
- the patellar implant 200 ′ includes a superior portion 202 ′, an inferior portion 204 ′, anterior portion 206 ′, and posterior portion (not shown in FIG. 6 ). Also shown are lateral surfaces 108 ′ and 110 ′ as well as the edges 212 ′ and 214 ′.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 200 ′ and portions 202 ′, 204 ′, 206 ′, 207 ′, 208 ′, 210 ′, 212 ′, and 214 ′ may also vary.
- the patellar implant 200 ′ is used in a similar manner to the patellar implants 100 / 100 ′/ 100 ′′/ 100 ′′ 200 .
- nested sections 220 ′, 222 ′, 224 ′, 226 ′, 228 , and 230 are shown.
- the sections 220 ′ and 222 ′ are configured to be telescoped from the superior portion 204 ′.
- the sections 224 ′ and 226 ′ are configured to be, and shown as, telescoped from the inferior portion 202 ′.
- the sections 228 and 230 may be telescoped from the anterior portion 206 .
- the sections 220 ′, 222 ′, 224 ′, and/or 226 ′ might be used to adjust the tilt to the patellar tendon provided by the patellar implant 200 ′.
- the sections 220 ′ and 222 ′ do not extend along the entire length of the patellar implant and/or may be tapered.
- the sections 220 ′ and 222 ′ may be used to alter the height of the patellar implant 200 ′ along its length.
- the taper of the patellar implant 200 ′ may be configured using the sections 220 ′ and/or 222 ′.
- the sections 224 ′ and 226 ′ may be used adjust the fit of the patellar implant 200 ′ to the tibia.
- the sections 228 and 230 may be used to alter the length of the patellar implant 200 ′.
- the amount each of the sections 220 ′, 222 ′, 224 ′, 226 ′, 228 , and/or 230 extend along the height, width, and length of the patellar implant 200 ′ may be selected. Consequently, the patellar implant 200 ′ may be configured by the surgeon or other qualified individual when being prepared for use in a patient.
- the superior portion 202 ′ has a convex upper surface, is symmetric, and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 202 ′ is still to reside in proximity to the patellar tendon, while the inferior portion 204 ′ is configured to be placed in proximity to the tibia.
- the inferior portion 204 ′ has a convex portion 207 ′ configured to fit the tibia of the patient. This fit may be improved using the sections 224 ′ and 226 ′. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 200 ′ may be avoided.
- the patellar implant 200 ′ may be affixed in place through a variety of mechanisms, described below.
- the patellar implant 200 ′ might be affixed to the tibia, the patellar tendon, or both.
- the height, tilt, and/or taper of the patellar implant 200 ′ may be configured for the needs of a particular patient.
- the patellar tendon may be lifted and/or tilted and the patella repositioned in a desired fashion. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIG. 7 depicts an exemplary embodiment of one option for placement of an exemplary embodiment of a patellar implant 100 .
- FIG. 7 is not drawn to scale.
- the patellar implant 100 depicted in FIG. 1 is described.
- other patellar implants including but not limited to the patellar implants 100 ′, 100 ′′, and 100 ′′′ may be used.
- a patient may experience pain and other patellar-femoral joint problems when the patella tendon 156 and patella 154 are in their native positions.
- the patellar implant 100 is inserted between the patellar tendon 156 and the tibia 150 , as well as between the patella 154 and the distal attachment 158 of the patellar tendon 156 .
- the position of the patellar implant 100 , as well as the shape and size of the patellar implant 100 may be selected in order to elevate and/or tilt the patellar tendon 156 in the desired manner. For example, for a smaller change in elevation, an implant having a lower height may be selected and/or a patellar implant 100 may be moved closer to the patella 154 and further from the distal attachment 158 .
- a wedge shaped patellar implant such as the implant 100 ′′′, may be selected and/or the patellar implant 100 may be placed at a different angle on the tibia 150 (e.g. further into or out of the plane of the page in FIG. 5 ).
- the patellar tendon 156 ′ is moved to the elevated/tilted position.
- the change in position of the patellar tendon 156 ′ causes a respositioning of the patella 154 ′ to the elevated/tilted position.
- the patella 156 ′ may be repositioned in order to alleviate pain or other patellar-femoral joint issues.
- FIGS. 8-9 depict another exemplary embodiment of a patellar implant 300 .
- FIGS. 8-9 are not drawn to scale.
- the components of the patellar implant 300 are analogous to the patellar implants 100 , 100 ′, 100 ′′, 100 ′′′, 200 , and 200 ′.
- the components of the patellar implant 300 are labeled similarly.
- only a superior portion 302 , an inferior portion 304 , and anterior portion 306 are labeled.
- the patellar implants 100 , 100 ′, 100 ′′, 100 ′′′, 200 , and 200 ′ the amount of lift and/or tilt of the patellar tendon may vary between patients.
- the size, angles between, degree of rounding, and/or specific shape of the patellar implant 300 and portions 302 , 304 , and 306 may also vary.
- the patellar implant is used in a similar manner to and made from similar material(s) as the patellar implants 200 / 200 ′/ 200 ′′.
- the superior portion 302 has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 302 is still to reside in proximity to the patellar tendon, while the inferior portion 304 is configured to be placed in proximity to the tibia.
- the inferior portion 304 has a convex portion (not separately labeled) configured to fit the tibia of the patient.
- the concave portion may be omitted.
- the patellar implant 100 ′′′ may be affixed in place through a variety of mechanisms, described below.
- the patellar implant 300 might be affixed to the tibia, the patellar tendon, or both.
- the patellar implant 300 may be used to tilt and/or lift the patellar tendon and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated. Because cutting or other alteration of the tibia may be avoided if the concave portion provided, recovery time and ease of use of the patellar implant 300 may be improved.
- FIGS. 10-11 depict another exemplary embodiment of a patellar implant 400 that includes a mechanism for affixing the patellar implant.
- FIGS. 10-11 are not drawn to scale.
- the components of the patellar implant 400 are analogous to the patellar implants 100 , 100 ′, 100 ′′, 100 ′′′, 200 , 200 ′, and 300 .
- the components of the patellar implant 300 are labeled similarly.
- some components such as the through holes 408 and 410 are shown.
- only a superior portion 402 , an inferior portion 404 , anterior portion 406 , and through holes 408 and 410 are labeled.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 400 and portions 402 , 404 , 406 , 408 , and/or 410 may also vary.
- the patellar implant 400 is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′/ 100 ′′/ 100 ′′′/ 200 / 200 ′/ 300 .
- the superior portion 402 has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 402 is still to reside in proximity to the patellar tendon, while the inferior portion 404 is configured to be placed in proximity to the tibia.
- the inferior portion 404 has a convex portion (not separately labeled) configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 400 may be avoided.
- the concave portion may be omitted.
- the patellar implant 400 may be affixed in place through a variety of mechanisms.
- through holes 408 and 410 may be used to affix the patellar implant 400 .
- the through holes 408 and 410 extend through the top portion 402 and the inferior portion 404 .
- the holes 408 and 410 may be screw holes.
- the patellar implant 400 may be screwed to the tibia.
- the through holes 408 and 410 might be suture holes used to suture the patellar implant to the patellar tendon.
- a mixture of screw holes and suture holes might be used.
- the through holes 408 and 410 permit the patellar implant 400 to be mounted to various tissue adjacent to the implant's location.
- the patellar implant 400 may be used to tilt and/or lift the patellar tendon and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIG. 12 depicts another exemplary embodiment of a patellar implant 500 that includes a mechanism for affixing the patellar implant.
- FIG. 12 is not drawn to scale.
- the components of the patellar implant 500 are analogous to the patellar implants 100 , 100 ′, 100 ′′, 100 ′′′, 200 , 200 ′, 300 , and 400 .
- the components of the patellar implant 500 are labeled similarly.
- only a superior portion 502 , an inferior portion 504 , anterior portion 506 , and affixation spikes 508 are labeled.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 500 and portions 502 , 504 , 506 , and/or 508 may also vary.
- the patellar implant 500 is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′/ 100 ′′/ 100 ′′′/ 200 / 200 ′/ 300 / 400 .
- the superior portion 502 has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 502 is still to reside in proximity to the patellar tendon, while the inferior portion 504 is configured to be placed in proximity to the tibia.
- the inferior portion 504 has a convex portion (not separately labeled) configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 500 may be avoided.
- the concave portion may be omitted.
- the patellar implant 500 may be affixed in place through a variety of mechanisms.
- affixation spikes 508 may be used to affix the patellar implant 500 .
- the affixation spikes 508 may be mounted the patellar implant 500 to adjacent tissue, such as bone.
- the patellar implant 500 may be used to tilt and/or lift the patellar tendon and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIG. 13 depicts another exemplary embodiment of a patellar implant 600 that includes a mechanism for affixing the patellar implant.
- FIG. 13 is not drawn to scale.
- the components of the patellar implant 600 are analogous to the patellar implants 100 , 100 ′, 100 ′′, 100 ′′′, 200 , 200 ′, 300 , 400 , and 500 .
- the components of the patellar implant 600 are labeled similarly.
- only a superior portion 602 , an inferior portion 604 , anterior portion 606 , and bone growth enhancement device 608 are labeled.
- the amount of lift and/or tilt of the patellar tendon may vary between patients. Consequently, the size, angles between, degree of rounding, and/or specific shape of the patellar implant 600 and portions 602 , 604 , 606 , and/or 608 may also vary.
- the patellar implant 500 is used in a similar manner to and made from similar material(s) as the patellar implants 100 / 100 ′/ 100 ′′/ 100 ′′′/ 200 / 200 ′/ 300 / 400 / 500 .
- the superior portion 602 has a convex upper surface and is still configured to lift and/or tilt the patellar tendon.
- the superior portion 602 is still to reside in proximity to the patellar tendon, while the inferior portion 604 is configured to be placed in proximity to the tibia.
- the inferior portion 604 has a convex portion (not separately labeled) configured to fit the tibia of the patient. As a result, cutting, grinding, or other altering of the tibia in order to fit the implant 600 may be avoided.
- the concave portion may be omitted.
- the patellar implant 600 may be affixed in place through a variety of mechanisms.
- the bone growth enhancement device 608 includes affixation beads 608 .
- the affixation beads 608 are used to promote growth of bone, such as the tibia, with the patellar implant 608 .
- the patellar implant 600 may be affixed in place and used to tilt and/or lift the patellar tendon and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIG. 14-16 depicts other exemplary embodiments of patellar implants 700 , 710 , and 720 positioned beneath a patellar tendon 702 , 712 , and 722 , respectively, and on a tibia 704 , 714 , and 724 , respectively.
- FIGS. 14-16 are not drawn to scale.
- patellar implants which have a convex inferior surface 700 which are wedge shaped 710 , or which are have a flat inferior surface 720 are shown.
- the patellar tendon 702 may be elevated
- the patellar tendon 712 may be elevated and tilted
- the tibia 724 may be processed to provide a flat upper surface for affixing the patellar implant 722 .
- patellar implants 700 , 710 , and 720 may be affixed in place and used to tilt and/or lift the patellar tendon 702 , 712 , 714 and reposition the patella. Consequently, pain and/or other issues related to patellar-femoral joint problems may be alleviated.
- FIGS. 17-22 depict another exemplary embodiment of a patellar implant 750 .
- Front, perspective, side, bottom, top, and rear views are shown in FIGS. 17-22 , respectively.
- FIGS. 17-22 are not drawn to scale.
- the patellar implant 750 is substantially wedge shaped, has a concave inferior portion, a substantially convex superior portion, and through holes. Consequently, the benefits of the patellar implants discussed herein may be achieved.
- FIG. 23 depicts an exemplary embodiment of a method 800 for placing a patellar implant, such as a patellar implant described herein.
- the method 800 is described in the context of the patellar implant 100 .
- the bone is optionally prepared for the implant, via step 802 .
- step 802 might include cutting a slot or flat portion in the tibia, for example to be flat as is shown in FIG. 16 .
- preparing the bone may be performed in another manner or may be omitted.
- the patellar implant 100 is inserted between the patellar tendon and the tibia, as well as between the patella and the distal attachment of the patellar tendon to the tibia, via step 804 .
- Step 804 may include providing a surgical incision, for example 2-3 cm in length.
- step 804 is performed using minimally invasive techniques. Further, the prepatellar fat pad may be removed.
- arthroscopic evaluation may be performed to assess tracking and assist with intraopertaive decision making.
- Step 804 may also include determining the desired tilt and/or elevation for the patellar implant 100 . Although an assessment may have been made prior to surgery, the final decisions on elevation and tilt, as well as size, shape, placement and other relevant characteristics of the patellar implant 100 may be made during surgery. Step 802 , therefore, may also include selecting and/or adjusting the patellar implant as well as determining the final placement of the implant 100 . For example, the patellar implant 100 at or near a desired size and shape may be selected in step 804 In addition, if layers are to be added, sections telescoped or other adjustments made, these adjustments are preferably completed in step 802 , prior to the patellar implant 100 being affixed within the patient. In another embodiment, the configuration of the patellar implant 100 may still be adjusted at a later time.
- the patellar implant 100 may be affixed, via step 804 .
- the patellar implant 100 is fixated to the proximal tibia, to the patellar tendon, or both. Fixation may be accomplished by using any fixation device, including but not limited to those described herein. For example, fixation may be achieved using a screw, sutures, nail(s), bone cement or other adhesives, or direct attachment to the patella tendon.
- a patellar implant such as the implants 100 , 100 ′, 100 ′′, 100 ′′, 200 , 200 ′, 400 , 500 , and/or 600 may be placed in a patient. Consequently, the therapeutic benefits of the implant may be achieved.
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Physical Education & Sports Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Prostheses (AREA)
Priority Applications (1)
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US12/671,478 US20100198354A1 (en) | 2007-08-01 | 2008-07-30 | Method and system for patella tendon realignment |
Applications Claiming Priority (3)
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US95332507P | 2007-08-01 | 2007-08-01 | |
PCT/US2008/071629 WO2009018365A1 (fr) | 2007-08-01 | 2008-07-30 | Procédé et système pour le réalignement de ligament rotulien |
US12/671,478 US20100198354A1 (en) | 2007-08-01 | 2008-07-30 | Method and system for patella tendon realignment |
Related Parent Applications (1)
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PCT/US2008/071629 A-371-Of-International WO2009018365A1 (fr) | 2007-08-01 | 2008-07-30 | Procédé et système pour le réalignement de ligament rotulien |
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Application Number | Title | Priority Date | Filing Date |
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US12/698,895 Continuation-In-Part US20100131069A1 (en) | 2007-08-01 | 2010-02-02 | Method and system for patella tendon realignment |
US13/653,936 Division US9808287B2 (en) | 2007-08-01 | 2012-10-17 | Method and system for patella tendon realignment |
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US20100198354A1 true US20100198354A1 (en) | 2010-08-05 |
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US12/671,478 Abandoned US20100198354A1 (en) | 2007-08-01 | 2008-07-30 | Method and system for patella tendon realignment |
US13/653,936 Active US9808287B2 (en) | 2007-08-01 | 2012-10-17 | Method and system for patella tendon realignment |
US13/657,139 Abandoned US20130060343A1 (en) | 2007-08-01 | 2012-10-22 | Method and System for Patella Tendon Realignment |
US15/728,209 Abandoned US20180028229A1 (en) | 2007-08-01 | 2017-10-09 | Method and system for patella tendon realignment |
US16/380,649 Active 2028-09-03 US10918416B2 (en) | 2007-08-01 | 2019-04-10 | Method and system for patella tendon realignment |
US16/380,635 Active 2028-09-03 US10918415B2 (en) | 2007-08-01 | 2019-04-10 | Method and system for patella tendon realignment |
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Application Number | Title | Priority Date | Filing Date |
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US13/653,936 Active US9808287B2 (en) | 2007-08-01 | 2012-10-17 | Method and system for patella tendon realignment |
US13/657,139 Abandoned US20130060343A1 (en) | 2007-08-01 | 2012-10-22 | Method and System for Patella Tendon Realignment |
US15/728,209 Abandoned US20180028229A1 (en) | 2007-08-01 | 2017-10-09 | Method and system for patella tendon realignment |
US16/380,649 Active 2028-09-03 US10918416B2 (en) | 2007-08-01 | 2019-04-10 | Method and system for patella tendon realignment |
US16/380,635 Active 2028-09-03 US10918415B2 (en) | 2007-08-01 | 2019-04-10 | Method and system for patella tendon realignment |
Country Status (3)
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US (6) | US20100198354A1 (fr) |
EP (1) | EP2178468B1 (fr) |
WO (1) | WO2009018365A1 (fr) |
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WO2021182944A1 (fr) * | 2020-03-09 | 2021-09-16 | Khay Yong Saw | Manette de rotule et son procédé d'utilisation |
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EP2452641A1 (fr) * | 2010-11-12 | 2012-05-16 | Kyon AG | Espaceur de ligament patellaire pour blessures du ligament croisé antérieur |
JP6093708B2 (ja) | 2010-12-07 | 2017-03-08 | ジンマー,インコーポレイティド | 人工膝蓋骨 |
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US20210205067A1 (en) * | 2020-01-02 | 2021-07-08 | Zkr Orthopedics, Inc. | Patella tendon realignment implant with fixation |
WO2021231253A1 (fr) * | 2020-05-11 | 2021-11-18 | Zkr Orthopedics, Inc. | Implant de réalignement de tendon rotulien réglable |
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Also Published As
Publication number | Publication date |
---|---|
US10918415B2 (en) | 2021-02-16 |
US20190231392A1 (en) | 2019-08-01 |
US20190231391A1 (en) | 2019-08-01 |
US20180028229A1 (en) | 2018-02-01 |
US10918416B2 (en) | 2021-02-16 |
WO2009018365A1 (fr) | 2009-02-05 |
EP2178468A1 (fr) | 2010-04-28 |
EP2178468B1 (fr) | 2016-06-22 |
US20130060343A1 (en) | 2013-03-07 |
US20130060342A1 (en) | 2013-03-07 |
EP2178468A4 (fr) | 2014-02-19 |
US9808287B2 (en) | 2017-11-07 |
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