US20170367831A9 - Elbow prosthesis - Google Patents
Elbow prosthesis Download PDFInfo
- Publication number
- US20170367831A9 US20170367831A9 US14/672,616 US201514672616A US2017367831A9 US 20170367831 A9 US20170367831 A9 US 20170367831A9 US 201514672616 A US201514672616 A US 201514672616A US 2017367831 A9 US2017367831 A9 US 2017367831A9
- Authority
- US
- United States
- Prior art keywords
- articulating
- component
- humeral
- unlinked
- medial
- 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.)
- Granted
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Classifications
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- 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
- A61F2/38—Joints for elbows or knees
- A61F2/3804—Joints for elbows or knees for elbows
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- 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
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- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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- A—HUMAN NECESSITIES
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Landscapes
- Health & Medical Sciences (AREA)
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Abstract
Description
- This application is a divisional of U.S. patent application Ser. No. 13/465,690, filed on May 7, 2012, which is a continuation-in-part of U.S. patent application Ser. No. 12/562,616, filed on Sep. 18, 2009, which is a continuation-in-part of U.S. patent application Ser. No. 12/391,904, filed on Feb. 24, 2009, which is a continuation-in-part of U.S. patent application Ser. No. 11/384,943, filed on Mar. 17, 2006 (now U.S. Pat. No. 8,585,768), which is a continuation-in-part of U.S. patent application Ser. No. 10/333,140, filed on Jan. 15, 2003 (now U.S. Pat. No. 7,247,170), which is a National Stage of International Application No. PCT/US01/22338 (published as WO 02/05728), filed Jul. 17, 2001, which claims priority to U.S. Provisional Application No. 60/219,103, filed Jul. 18, 2000. This application also claims priority to U.S. Provisional Application No. 61/505,360 filed, on Jul. 7, 2011. Each of these applications is incorporated herein by reference in its entirety.
- U.S. patent application Ser. No. 11/780,365 filed on Sep. 19, 2007 which is now U.S. Pat. No. 7,625,406 and U.S. patent application Ser. No. 11/780,370 filed on Sep. 19, 2007 which is now U.S. Pat. No. 7,604,666 disclose related subject matter. These applications are also incorporated by reference.
- The present teachings relate generally to prosthetic devices used in arthroplasty and more particularly to a modular elbow prosthesis.
- The present teachings relate generally to prosthetic devices used in arthroplasty and more particularly to a modular elbow prosthesis.
- Linked or constrained elbow prostheses are known which comprise simple hinge arrangements, one component of which is attached to the end of the humerus and the other component of which is attached to the end of the ulna. The humeral component includes a shaft, which is cemented into a prepared cavity in the end of the humerus, and the ulnar component includes a shaft, that is cemented to the end of the ulna. The components of the prosthesis are connected together by means of a hinge pin so that the prosthesis allows a single degree of freedom of movement of the ulna relative to the humerus.
- One example of a linked elbow prostheses is disclosed in U.S. Pat. No. 6,027,534 to Wack et al. In several respects, the linked embodiment of the '534 patent is typical of the designs for linked elbow prostheses in that it includes a humeral stem that terminates at a yoke at its distal end, a bearing component, a retaining pin and an ulna stem. The bearing component includes an oversized hole that is aligned with the longitudinal axis of the bearing and adapted to accept the retaining pin in a slip-fit condition. The distal end of the bearing component is coupled to the ulna stem. Despite the relatively widespread use of designs of this type, several drawbacks have been noted.
- One significant drawback concerns the assembly of the elbow prosthesis after the surgeon has cemented the humeral and ulna stems to their respective bones. In using such conventionally configured linked elbow prosthesis devices, it is frequently necessary for the surgeon to drill a fairly large hole through the humerus so that the retaining pin may be inserted to the yoke of the humeral stem and the humeral bearing component. As a high degree of accuracy is typically required to ensure proper alignment between the hole in the humerus and the hole in the yoke of the humeral stem, a significant cost can be associated with this step in the installation of an elbow prosthesis due to the cost of the tooling used and the amount of time required to complete this step. The other method for attaching the prosthetic device includes inserting the device in its linked condition or placing the remaining piece into the yoke prior to fully seating the humeral component into the bone. This later method is typically somewhat difficult, given the limited amount of joint space that is available and the time constraints associated with the use of a PMMA bone cement.
- Unlinked, or unconstrained, elbow prostheses are known which are similar to linked elbow prostheses but do not have a specific component which mechanically couples the humeral and ulnar stems together. Rather, the prosthetic device is held together by the patient's natural soft tissues. One example of an unlinked elbow prostheses is also disclosed in U.S. Pat. No. 6,027,534 to Wack et al. In several respects, the unlinked embodiment of the '534 patent is similar to the linked embodiment discussed above in that it includes a humeral stem that terminates at a yoke at its distal end, a humeral bearing component, a retaining pin, an ulnar bearing component and a ulnar stem. The outer surface of the humeral bearing is contoured to match the contour of the ulnar bearing component. Despite the relatively widespread use of designs of this type, several drawbacks have been noted.
- For instance, a retaining pin that is transverse to the longitudinal axis of the patient is employed, thereby making its removal difficult if a bearing needs to be replaced.
- An elbow prosthesis can comprise a stem structure and an articulating component. The stem structure can be operable to be positioned in a bone of a joint. The stem structure can include a stem portion and a C-shaped body portion. The stem portion can be operable to be positioned in the bone. The C-shaped body portion can have a first articulating surface that is bound by a medial wall and a lateral wall that are separated by a first distance. The articulating component can have a second articulating surface positioned between a medial side surface and a lateral side surface that are separated by a second distance. The first distance can be greater than the second distance. The second articulating surface of the articulating component can be configured to slidably communicate in a medial/lateral direction along the first articulating surface of the C-shaped body portion. The articulating component can be limited from further medial movement by engagement of the medial side surface with the medial wall and limited from further lateral movement by engagement of the lateral side surface with the lateral wall.
- According to one aspect of the present disclosure, an elbow prosthesis is provided. The elbow prosthesis includes a stem structure and an articulating component. The stem structure is operable to be positioned in a bone of a joint and includes a stem portion and a C-shaped body portion. The stem portion is operable to be positioned in the bone. The C-shaped body portion includes a first articulating surface bound by a medial wall and a lateral wall. The medial and lateral walls are separated by a first distance. The articulating component includes a second articulating surface positioned between a medial side surface and a lateral side surface. The medial and lateral side surfaces are separated by a second distance that is less than the first distance. The second articulating surface is configured to slidably communicate in a medial/lateral direction along the first articulating surface of the C-shaped body portion. The articulating component is limited from further medial movement by engagement of the medial side surface with the medial wall and limited from further lateral movement by engagement of the lateral side surface with the lateral wall.
- According to another aspect of the present disclosure, an elbow prosthesis is provided. The elbow prosthesis includes a stem structure, an articulating component, and an unlinked humeral component. The stem structure includes a stem portion and a C-shaped body portion. The stem portion is operable to be positioned in a bone. The C-shaped body portion includes a first articulating surface. The articulating component includes a humeral opposing articulating surface and a second articulating surface opposite the humeral opposing articulating surface. The second articulating surface engages the first articulating surface. The humeral opposing articulating surface includes first and second pairs of diagonally opposed articulating surfaces. The unlinked humeral component includes a humeral articulating surface configured to engage the first pair of diagonally opposed articulating surfaces in a first position, and configured to engage the second pair of diagonally opposed articulating surfaces in a second position.
- According to yet another aspect of the present disclosure, an elbow prosthesis is provided. The elbow prosthesis includes a stem structure, an articulating component, and an unlinked humeral component. The stem structure includes a stem portion and a C-shaped body portion. The stem portion is operable to be positioned in a bone. The C-shaped body portion includes a first articulating surface bound by a medial wall and a lateral wall. The articulating component includes a humeral opposing articulating surface and a second articulating surface opposite the humeral opposing articulating surface. The second articulating surface is configured to slidably communicate along the first articulating surface between the medial and lateral walls. The unlinked humeral component is configured to engage the humeral opposing articulating surface, and is operable to form a first angle relative to the second articulating surface in a first position, and operable to form a second angle relative to the second articulating surface in a second position.
- Further areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
- Additional advantages and features of the present teachings will become apparent from the subsequent description and the appended claims, taken in conjunction with the accompanying drawings, wherein:
-
FIG. 1 is a perspective view of a modular unlinked ulnar stem assembly constructed in accordance to one example of the present teachings; -
FIG. 2 is an assembled view of the modular unlinked ulnar stem assembly ofFIG. 1 ; -
FIG. 3 is an exploded perspective view of another modular unlinked ulnar stem assembly constructed in accordance to the present teachings; -
FIG. 4 is an assembled view of the modular unlinked ulnar stem assembly ofFIG. 3 ; -
FIG. 5 is an exploded perspective view of another modular unlinked ulnar stem assembly constructed in accordance to the present teachings; -
FIG. 6 is an assembled view of the modular unlinked ulnar stem assembly ofFIG. 5 ; -
FIG. 7 is an exploded medial side view of a stemless modular unlinked ulnar prosthesis according to the present teachings; -
FIG. 8 is a medial side view of the stemless modular unlinked ulnar prosthesis shown inFIG. 7 and implanted into an ulna; -
FIG. 9 is an exploded medial side view a modular ulnar stem assembly that incorporates a universal stem and is shown with a linked bearing component; -
FIG. 10 is a medial side assembled view of the modular unlinked ulnar stem assembly shown with an unlinked bearing component in an assembled position; -
FIG. 11 is a medial side assembled view of the modular ulnar stem assembly ofFIG. 9 shown with the linked bearing component secured to the universal stem; -
FIG. 12 is an exploded medial side view of a modular ulnar prosthesis that incorporates a mobile bearing; -
FIG. 13 is a medial side view of the modular ulnar prosthesis shown with the mobile bearing in an engaged position with the ulnar stem component; -
FIG. 14 is a perspective view of the mobile bearing ofFIG. 12 ; -
FIG. 15 is an anterior view of the mobile bearing ofFIG. 14 ; -
FIG. 16 is a cross-sectional view of the modular ulnar stem assembly taken alongline 16 ofFIG. 13 and shown with the mobile bearing in an intermediate position between a medial and lateral wall of the ulnar stem; -
FIG. 17 is a cross-sectional view of the modular ulnar prosthesis ofFIG. 13 and shown with the mobile bearing slidably translated into engagement with the medial wall of the ulnar prosthesis; -
FIG. 18 is a cross-sectional view of the modular ulnar prosthesis ofFIG. 13 and shown with the mobile bearing slidably translated into engagement with the lateral wall of the ulnar prosthesis; -
FIG. 19 is a cross-sectional view of the modular ulnar prosthesis ofFIG. 13 and shown with an exemplary humeral component and radial component; -
FIG. 20 is a cross-sectional view of the assembly ofFIG. 19 and shown with the arm rotated into a varus position; and -
FIG. 21 is a cross-sectional view of the assembly ofFIG. 19 and shown with the arm rotated into a valgus position. - The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. It should be understood that throughout the drawings, corresponding reference numerals indicate like or corresponding parts and features.
- With reference to
FIGS. 1, 2 and 3 of the drawings, an unlinked prosthetic joint device constructed in accordance with the teachings of a first aspect is generally indicated byreference number 2500. The following description is directed to various linked and unlinked prosthetic elbow joints. Additional features suitable for implementation with the following examples may be found in commonly owned and copending U.S. Ser. No. 12/780,424, filed May 14, 2010, which is expressly incorporated herein by reference. Although the particular prostheses illustrated and discussed relate to prosthetics for use in reconstructing an elbow, it will be understood that the teachings have applicability to other types of linked and unlinked prosthetic devices. As such, the scope of the present teachings will not be limited to applications involving elbow prosthesis but will extend to other prosthetic applications. - With reference now to
FIGS. 1 and 2 , a modular unlinkedulnar stem assembly 2500 constructed in accordance to one example of the present teachings will be described. In general, the modular unlinkedulnar stem assembly 2500 can include astem structure 2502, an articulatingcomponent 2504 and afastener 2506. As will become appreciated from the following discussion, the articulatingcomponent 2504 can be modular, such that a series or set of articulating components can be provided that are each selectively attachable to thestem structure 2502 according to a specific patient's needs. Such examples can include articulating components having different shapes, surfaces, sizes, constraints, etc. The modular unlinkedulnar stem assembly 2500 can be favorable in some circumstances as it has the potential to remove less native bone than other elbow prostheses, such as a semi-constrained total elbow, for example. Furthermore, the modular unlinkedulnar stem assembly 2500 can be favorable in circumstances where one side of the elbow joint includes satisfactory bone and/or cartilage and it is only desirable to replace the other side of the elbow joint. - With specific reference now to
FIG. 1 , exemplary features of thestem structure 2502 will be described. Thestem structure 2502 can generally include astem portion 2510 and a C-shapedbody portion 2512. In this regard, thebody portion 2512 can generally include anulnar ring 2514 that is in the form of a partial or semi-circular cylinder. Thebody portion 2512 can generally extend between afirst end 2516 and asecond end 2518. Thebody portion 2512 can further comprise afirst retaining mechanism 2520 formed thereon. Thefirst retaining mechanism 2520 can include anextension portion 2522 and afirst anti-rotation portion 2524. Theextension portion 2522 can generally be in the form of a rail or keel that extends between thefirst end 2516 and thesecond end 2518 of thebody portion 2512. Thefirst anti-rotation portion 2524 can generally include a series offirst undulations 2526 having a series of peaks and valleys. In the example shown, thefirst undulations 2526 can be generally in the form of a wave-like pattern formed around theulnar ring 2514. The specific geometry and wave-like pattern is merely exemplary and can consist of other formations that are configured to cooperatively engage complementary structure on the articulatingcomponent 2504 as will be described in detail herein. - The
first end 2516 of thebody portion 2512 can include a threadedbore 2530 formed therein. Thesecond end 2518 of thebody portion 2512 can include acatch 2532. As will be become appreciated from the following discussion, thefirst retaining mechanism 2520 that includes thefirst anti-rotation portion 2524 and theextension portion 2522 can cooperatively mate with complementary features formed on the articulatingcomponent 2504 and therefore inhibit rotation of the articulatingcomponent 2504 around theulnar ring 2514 as well as inhibit medial/lateral translation of the articulatingcomponent 2504 on theulnar ring 2514. Thecatch 2532 can also assist in confining the articulatingcomponent 2504 to a fixed position relative to theulnar ring 2514. The configuration of thefirst retaining mechanism 2520 can be particularly advantageous during assembly of the articulatingcomponent 2504 onto thestem structure 2502 to maintain the articulatingcomponent 2504 in a static position relative to theulnar ring 2514 prior to securing the articulatingcomponent 2504 further to thestem structure 2502 with thefastener 2506. - The articulating
component 2504 will now be described in greater detail. In general, the articulatingcomponent 2504 can include abody 2534 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 2514. Thebody 2534 can extend between afirst end 2536 and asecond end 2538. Thefirst end 2536 of thebody 2534 can define apassage 2540 therein for receiving thefastener 2506 in the assembled position. Thesecond end 2538 of thebody 2534 can include arelief 2542. The articulatingcomponent 2504 can further comprise asecond retaining mechanism 2544 that has agroove 2546 configured to receive theextension portion 2522 on theulnar ring 2514 and asecond anti-rotation portion 2548 for mating with thefirst anti-rotation portion 2524 on theulnar ring 2514. - The
second anti-rotation portion 2548 can include a series ofsecond undulations 2550 having a series of peaks and valleys that may be in the form of a wave-like pattern or other geometry that can suitably mate or nest with thefirst anti-rotation portion 2524 on theulnar ring 2514. In one example, the articulatingcomponent 2504 can be formed of UHMWPE or PEEK. In other examples, however, the articulatingcomponent 2504 may be a combination of a first polyethylene portion on the articulating side and a molded metallic substrate that forms thesecond anti-rotation portion 2548. The molded configuration can be similar to the combination polyethylene and metallic component described in pending U.S. Ser. No. 12/780,424, filed May 14, 2010 identified above. - With specific reference to
FIG. 2 , assembly of the articulatingcomponent 2504 to thestem structure 2502 according to one example of the present teachings will be described. At the outset, a surgeon can advance thesecond retaining mechanism 2544 of the articulatingcomponent 2504 onto thefirst retaining mechanism 2520 of thestem structure 2502. In this regard, thesecond anti-rotation portion 2548 can cooperatively mate with thefirst anti-rotation portion 2524 as theextension portion 2522 of thefirst retaining mechanism 2520 nests within thegroove 2546 of thesecond retaining mechanism 2544. At this time, thecatch 2534 on theulnar ring 2514 can locate partially into therelief 2542 of the articulatingcomponent 2504. Those skilled in the art will readily appreciate that the cooperatively mating structures formed on thestem structure 2502 and the articulatingcomponent 2504 may be reversed. For example, theextension portion 2522 may alternatively be provided on the articulatingcomponent 2504 while thegroove 2546 may alternatively be located on thebody portion 2512 of thestem structure 2502. Likewise, thecatch 2532 and therelief 2542 may be provided on opposite components. - Nonetheless, once the first and
second retaining mechanisms FIG. 2 ), translation of the articulatingcomponent 2504 in the medial/lateral direction can be inhibited by the interaction of theextension portion 2522 and thegroove 2546. Likewise, rotation of the articulatingcomponent 2504 around theulnar ring 2514 can be inhibited by the interaction of the first and secondanti-rotation portions catch 2532 can assist in further inhibiting rotational movement of the articulatingcomponent 2504. Moreover, as thecatch 2532 is angled toward thesecond end 2538 of the articulatingcomponent 2504, the articulatingcomponent 2504 can be inhibited from lift-off from thestem structure 2502. Next, thefastener 2506 can be advanced through thepassage 2540 in the articulatingcomponent 2504 and threadably advanced into the threadedbore 2530 of thestem portion 2510 to couple the articulatingcomponent 2504 to thestem portion 2510. - Turning now to
FIGS. 3 and 4 , another modular unlinkedulnar stem assembly 2600 according to the present teachings will be described. In general, the modular unlinkedulnar stem assembly 2600 can include astem structure 2602, an articulatingcomponent 2604 and afastener 2606. Thestem structure 2602 can generally comprise astem portion 2610 and a generally C-shapedbody portion 2612. Thestem structure 2602 can generally include anulnar ring 2614 that is in the form of a partial or semi-circular cylinder. Theulnar ring 2614 can generally extend between afirst end 2616 and asecond end 2618. Thebody portion 2612 can further comprise afirst retaining mechanism 2620. Thefirst retaining mechanism 2620 can include agroove 2622 and afirst anti-rotation portion 2624. Thefirst anti-rotation portion 2624 can be in the form offirst undulations 2626. A threadedbore 2630 can be formed on thestem structure 2602 at thefirst end 2616 of thebody portion 2612. - The articulating
component 2604 will now be further described according to one example. The articulatingcomponent 2604 can be modular, such that a series of articulating components can be provided that are selectively attachable to thestem structure 2602 according to a specific patient's needs. In general, the articulatingcomponent 2604 can include abody 2634 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 2614. Thebody 2634 can generally extend between afirst end 2636 and asecond end 2638. Thebody 2634 can define apassage 2640 configured to receive thefastener 2606 at thefirst end 2636. The articulatingcomponent 2604 can further comprise asecond retaining mechanism 2644 that can comprise anextension portion 2646 in the form of a rail or keel and asecond anti-rotation portion 2648. Thesecond anti-rotation portion 2648 can be in the form of a series ofsecond undulations 2650 that are provided with a geometry suitable to cooperatively mate or nest with thefirst undulations 2626 of thefirst anti-rotation portion 2624. Again, it will be appreciated that the configuration and location of some or all of the various structures of the first andsecond retaining mechanisms component 2604 can be formed of UHMWPE or PEEK. In other examples, however, the articulatingcomponent 2604 may be a combination of a first polyethylene portion on the articulating side and a molded metallic substrate that forms thesecond anti-rotation portion 2648. The molded configuration can be similar to the combination polyethylene and metallic component described in pending U.S. Ser. No. 12/780,424, filed May 14, 2010 identified above. - Assembly of the articulating
component 2604 to thestem structure 2602 will now be described according to one example. Initially, a surgeon can locate thesecond retaining mechanism 2644 onto thefirst retaining mechanism 2620. In this regard, theextension portion 2646 can be nestingly received by thegroove 2622 on thebody portion 2612 of thestem structure 2602. Concurrently, thesecond undulations 2650 on thesecond anti-rotation portion 2648 can be matingly engaged with thefirst undulations 2626 of thefirst anti-rotation portion 2624. Again, the interaction of theextension portion 2646 and thegroove 2622 can inhibit medial/lateral translation of the articulatingcomponent 2604 relative to thestem structure 2602. Similarly, the interaction of the first and secondanti-rotation portions component 2604 around thebody 2612 of thestem structure 2602. Next, thefastener 2606 can be advanced through thepassage 2640 and threadably mated into the threadedbore 2630 of thestem structure 2602 to couple the articulatingcomponent 2604 to thestem structure 2602. - Turning now to
FIGS. 5 and 6 , another modular unlinkedulnar stem assembly 2700 according to the present teachings will now be described. In general, the modular unlinkedulnar stem assembly 2700 can include astem structure 2702, an articulatingcomponent 2704 and afastener 2706. Again, as with the other examples discussed herein, the articulatingcomponent 2704 can be modular, such that a series of articulating components having various geometries can be provided that are selectively attachable to thestem structure 2702 according to a specific patient's needs. Thestem structure 2702 can include astem portion 2710 and abody portion 2712. Thebody portion 2712 can be in the form of anulnar ring 2714 that extends between afirst end 2716 and asecond end 2718. Thebody portion 2712 can comprise afirst retaining mechanism 2720 that can include agroove 2722 and afirst anti-rotation portion 2724. Thefirst anti-rotation portion 2724 can be in the form of a series ofdepressions 2726. In one example, thedepressions 2726 can be perpendicular to thegroove 2722. Thebody portion 2712 can include a threadedbore 2730 formed at thefirst end 2516. - The articulating
component 2704 can include abody 2734 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 2714. Thebody 2734 can extend between afirst end 2736 and asecond end 2738. The articulatingcomponent 2704 can further define apassage 2740 formed therethrough at thefirst end 2736 for receiving thefastener 2706. The articulatingcomponent 2704 can further comprise asecond retaining mechanism 2744 that can include anextension portion 2746 and asecond anti-rotation portion 2748. Thesecond anti-rotation portion 2748 can be in the form of a series offingers 2750 that are shaped to be cooperatively received into thedepressions 2726 of thefirst retaining mechanism 2720. In one example, theextension portion 2746 can be perpendicular to thefingers 2750. Again, it is appreciated that some or all of the features of the first andsecond retaining mechanisms stem structure 2702 and the articulatingcomponent 2704. Moreover, while the number ofdepressions 2726 shown around theulnar ring 2714 is four, fewer oradditional depressions 2726 may be used for cooperatively mating with a like amount offingers 2750. Additionally, some or all features of thesecond retaining mechanism 2744 on the articulatingcomponent 2704 can be formed of a metallic material while the remainder of the articulatingcomponent 2704 can be formed of UHMWPE. - Assembly of the articulating
component 2704 with thestem portion 2710 will now be described. Initially, a surgeon can locate thesecond retaining mechanism 2744 of the articulatingcomponent 2704 onto thefirst retaining mechanism 2720 of thestem structure 2702. In this regard, theextension portion 2746 and thefingers 2750 can cooperatively nest into thegroove 2722 anddepressions 2726, respectively. As with the other examples described above, the interaction of theextension portion 2746 and thegroove 2722 can inhibit medial/lateral translation of the articulatingcomponent 2704 relative to thestem structure 2702. Similarly, interaction of thefingers 2750 and thedepressions 2726 can inhibit rotation of the articulatingcomponent 2704 around theulnar ring 2714. Next, thefastener 2706 can be located through thepassage 2740 and threadably advanced into the threadedbore 2730 of thestem portion 2710. - With reference now to
FIGS. 7 and 8 , a modular unlinkedulnar prosthesis assembly 2800 constructed in accordance to one example of the present teachings will be described. In general, the modular unlinkedulnar prosthesis assembly 2800 can include atray structure 2802, an articulatingcomponent 2804, afastener 2806 and a securingmember 2808. As will become appreciated from the following discussion, the articulatingcomponent 2804 can be modular, such that a series of articulating components can be provided that are each selectively attachable to thetray structure 2802 according to a specific patient's needs. The modular unlinkedulnar prosthesis assembly 2800 can be favorable in some circumstances as it has the potential to remove less native bone than other elbow prostheses, such as a semi-constrained total elbow, for example. Moreover, the modular unlinkedulnar prosthesis assembly 2800 has the potential to remove less native bone than other unlinked ulnar prosthesis assemblies that require the use of a stem, such as disclosed herein. In this regard, the modular unlinkedulnar prosthesis assembly 2800 can be referred to as a “stemless” ulnar prosthesis as the only structure that ultimately is required to penetrate into the native bone is a boss portion 2810 and related securingmember 2808 as will be discussed in greater detail. As such, a conventional stem that may be configured to pass into an IM canal of the ulna is not required for the modular unlinkedulnar prosthesis assembly 2800. As with some of the modular unlinked ulnar prostheses discussed above, the modular unlinkedulnar prosthesis assembly 2800 can be favorable in circumstances where one side of the elbow joint includes satisfactory bone and/or cartilage and it is only desirable to replace the other side of the elbow joint. - With specific reference now to
FIG. 7 , exemplary features of thetray structure 2802 will be described. Thetray structure 2802 can generally include a boss portion 2810 and a C-shapedbody portion 2812. In this regard, thebody portion 2812 can generally include anulnar ring 2814 that is in the form of a partial or semi-circular cylinder. Thebody portion 2812 can generally extend between afirst end 2816 and asecond end 2818. Thebody portion 2812 can further comprise afirst retaining mechanism 2820 formed thereon. Thefirst retaining mechanism 2820 can include a receiving portion orarcuate groove 2822 and afirst anti-rotation portion 2824. Thegroove 2822 can generally be in the form of a centrally positioned channel that extends between thefirst end 2816 and thesecond end 2818 of thebody portion 2812. Thefirst anti-rotation portion 2824 can generally include a series offirst undulations 2826. In the example shown, thefirst undulations 2826 can be generally in the form of a wave-like pattern formed around theulnar ring 2814 and project perpendicular to thegroove 2822. The specific geometry and wave-like pattern is merely exemplary and can consist of other formations that are configured to cooperatively engage complementary structure on the articulatingcomponent 2804 as will be described in detail herein. - The
first end 2816 of thebody portion 2812 can include a threadedbore 2830 therein. As will become appreciated from the following discussion, thefirst retaining mechanism 2820 that includes thefirst anti-rotation portion 2824 and thegroove 2822 can cooperatively mate with complementary features formed on the articulatingcomponent 2804 and therefore inhibit rotation of the articulatingcomponent 2804 around theulnar ring 2814 as well as inhibit medial/lateral translation of the articulatingcomponent 2804 on theulnar ring 2814. The configuration of thefirst retaining mechanism 2820 can be particularly advantageous during assembly of the articulatingcomponent 2804 onto thetray structure 2802 to maintain the articulatingcomponent 2804 in a static position relative to theulnar ring 2814 prior to securing the articulatingcomponent 2804 further to thetray structure 2802 with thefastener 2806. - The articulating
component 2804 will now be described in greater detail. In general, the articulatingcomponent 2804 can include abody 2834 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 2814. Thebody 2834 can extend between afirst end 2836 and asecond end 2838. Thefirst end 2836 of thebody 2834 can define apassage 2840 therein for receiving thefastener 2806 in the assembled position (FIG. 8 ). The articulatingcomponent 2804 can further comprise asecond retaining mechanism 2844 that has an arcuate keel orextension portion 2846 configured to be nestingly received into thegroove 2822 on theulnar ring 2814. Similarly, thesecond retaining mechanism 2844 can also include asecond anti-rotation portion 2848 for mating with thefirst anti-rotation portion 2824 on theulnar ring 2814. Thesecond anti-rotation portion 2848 can include a series ofsecond undulations 2850 that may be in the form of a wave-like pattern or other geometry that can suitably mate with thefirst anti-rotation portion 2824 on theulnar ring 2814. Thekeel 2846 can extend generally perpendicular to thesecond undulations 2850. In one example, the articulatingcomponent 2804 can be formed of UHMWPE or PEEK. In other examples, however, the articulatingcomponent 2804 may be a combination of a first polyethylene portion on the articulating side and a molded metallic substrate that forms thesecond anti-rotation portion 2848. The molded configuration can be similar to the combination polyethylene and metallic component described in pending U.S. Ser. No. 12/780,424, filed May 14, 2010 described above. - The securing
member 2808 will now be described in greater detail. In general, the securingmember 2808 can include abody 2860 that extends between a firstterminal end 2862 and a secondterminal end 2864. Thebody 2860 can have ashank 2866 and ahead 2868. At least portions of theshank 2866, initiating at the firstterminal end 2862 can havethreads 2869 formed thereon. The securingmember 2808 can extend a length L1 between the respective first and second terminal ends 2862 and 2864. - Additional features of the boss portion 2810 of the
tray structure 2802 will be described. The boss portion 2810 can have abore 2870 that has acountersink 2872 and ashaft receiving portion 2874. The boss portion 2810 can have a length L2 that extends from thebody portion 2812 of thetray structure 2802 to a terminal end of the boss portion 2810. The boss portion 2810 can be roughened, porous coated and/or plasma sprayed to facilitate boney ingrowth. - Locating the
tray structure 2802 relative to anulna 2880 according to one example will now be described. In some examples, theulna 2880 may be minimally reamed to create acounterbore 2882 for receipt of the boss portion 2810. Nevertheless, once theulna 2880 has been suitably prepared for receipt of thetray structure 2802, thetray structure 2802 can be located onto theulna 2880 to resurface theulna 2880. Next, the surgeon can select the securingmember 2808 and pass theshank 2866 into thebore 2870 formed in the boss portion 2810 of thetray structure 2802. It will be appreciated that a plurality of distinct length securing members may be provided such that a surgeon can select an appropriate length according to the application. - The surgeon can then threadably advance the securing
member 2808 into theulna 2880 until thehead 2868 can locate into thecountersink 2872 while theshank 2866 is received through theshaft receiving portion 2874 of the boss portion 2810. In this regard, because the length L1 of the securingmember 2808 is greater than the length L2 of the boss portion 2810, at least a portion of theshank 2866 having thethreads 2869 can extend proud through the boss portion 2810 and into thehost ulna 2880. Preferably, thehead 2868 can be advanced to a distance where the secondterminal end 2864 of the securingmember 2808 is at least flush with or recessed into thecountersink 2872 of the boss portion 2810 so as not to interfere with the articulatingcomponent 2804. - With continued reference to
FIGS. 7 and 8 , assembly of the articulatingcomponent 2804 to thetray structure 2802 according to one example of the present teachings will be described. At the outset, a surgeon can advance thesecond retaining mechanism 2844 of the articulatingcomponent 2804 onto thefirst retaining mechanism 2820 of thetray structure 2802. In this regard, thesecond anti-rotation portion 2848 can cooperatively mate with thefirst anti-rotation portion 2824 as theextension portion 2846 of thesecond retaining mechanism 2844 nests within thegroove 2822 of thefirst retaining mechanism 2820. Again, those skilled in the art will readily appreciate that some or all of the cooperatively mating structure formed on thetray structure 2802 and the articulatingcomponent 2804 may be reversed. Once the first andsecond retaining mechanisms component 2804 and the medial/lateral direction can be inhibited by the interaction of theextension portion 2846 and thegroove 2822. Likewise, rotation of the articulatingcomponent 2804 around theulnar ring 2814 can be inhibited by the interaction of the first and secondanti-rotation portions - With reference now to
FIGS. 9-11 , a modularulnar stem assembly 3000 constructed in accordance to one example of the present teachings will be described. In general, the modularulnar stem assembly 3000 can include auniversal stem structure 3002, an unlinked bearing component 3004 (FIG. 10 ), a linked bearing component 3006 (FIG. 9 ) and afastener 3008. As will be described herein, theuniversal stem 3002 can be configured to selectively and alternatively couple with either of theunlinked bearing component 3004 or the linkedbearing component 3006. In this regard, in some instances where a patient may have theuniversal stem 3002 implanted with theunlinked bearing component 3004 and, over time, it may become desirable to convert the prosthesis to a configuration having a linked bearing component, a surgeon can access the elbow and merely replace theunlinked bearing component 3004 with a linkedbearing component 3006. In doing so, the surgeon need not substantially disturb theuniversal stem 3002 as it is configured to selectively and alternatively couple with either of theunlinked bearing component 3004 and the linkedbearing component 3006. As with the other modular ulnar assemblies described herein, theunlinked bearing component 3004 and the linkedbearing component 3006 can both be modular, such that a series of unlinked and linked bearing components can be provided that are each selectively attachable to theuniversal stem 3002 according to specific patient's needs. - With specific reference now to
FIGS. 9 and 10 , exemplary features of theuniversal stem 3002 will be described. Theuniversal stem 3002 can generally include astem portion 3010 and a C-shapedbody portion 3012. In this regard, thebody portion 3012 can generally include anulnar ring 3014 that is in the form of a partial or semi-circular cylinder. Thebody portion 3012 can generally extend between afirst end 3016 and asecond end 3018. Thebody portion 3012 can further comprise afirst retaining mechanism 3020 thereon. Thefirst retaining mechanism 3020 can include anextension portion 3022 and afirst anti-rotation portion 3024. Theextension portion 3022 can generally be in the form of an arcuate rail or keel that centrally extends between thefirst end 3016 and thesecond end 3018 of thebody portion 3012. Thefirst anti-rotation portion 3024 can generally include a series offirst undulations 3026. In the example shown, thefirst undulations 3026 can be generally in the form of a wave-like pattern formed around theulnar ring 3014. The specific geometry and wave-like pattern is merely exemplary and can consist of other formations that are configured to cooperatively engage complementary structure on either of theunlinked bearing component 3004 and the linkedbearing component 3006 as will be described in detail herein. - The
first end 3016 of thebody portion 3012 can include a threadedbore 3030 formed therein. Thesecond end 3018 of thebody portion 3012 can include acatch 3032. As will become appreciated from the following discussion, thefirst retaining mechanism 3020 that includes thefirst anti-rotation portion 3024 and theextension portion 3022 can cooperatively mate with complementary features formed on either of theunlinked bearing component 3004 or the linkedbearing component 3006. In this regard, the cooperating geometries can therefore inhibit rotation of the unlinked bearing component 3004 (or the linked bearing component 3006) around theulnar ring 3014, as well as inhibit medial/lateral translation of the unlinked bearing component 3004 (or the linked bearing component 3006) on theulnar ring 3014. Both ends of the linkedbearing component 3006 can therefore be positively secured to theuniversal stem 3002. Thecatch 3032 can also assist in confining theunlinked bearing component 3004 or the linkedbearing component 3006 to a fixed position relative to theulnar ring 3014. The configuration of thefirst retaining mechanism 3020 can be particularly advantageous during assembly of either of theunlinked bearing component 3004 or the linkedbearing component 3006 onto theuniversal stem 3002. For example, thefirst retaining mechanism 3020 can maintain the respective unlinked or linkedbearing components ulnar ring 3014 prior to securing the respective unlinked or linkedbearing components universal stem 3002 with thefastener 3008. - The
unlinked bearing component 3004 will now be described in greater detail. In general, theunlinked bearing component 3004 can include abody 3034 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 3014. Thebody 3034 can extend between afirst end 3036 and asecond end 3038. Thefirst end 3036 of thebody 3034 can define a passage 3040 therein for receiving thefastener 3008 in the assembled position (FIG. 10 ). Thesecond end 3038 of thebody 3034 can include a notch orrelief 3042. Theunlinked bearing component 3004 can further comprise asecond retaining mechanism 3044 that has agroove 3046 configured to receive theextension portion 3022 on theulnar ring 3014 and asecond anti-rotation portion 3048 for cooperatively mating with thefirst anti-rotation portion 3024 on theulnar ring 3014. - The
second anti-rotation portion 3048 can include a series ofsecond undulations 3050 that may be in the form of a wave-like pattern or other geometry that can suitably mate with thefirst anti-rotation portion 3024 on theulnar ring 3014. Thesecond undulations 3050 can be perpendicular to thegroove 3046. In one example, theunlinked bearing component 3004 can be formed of UHMWPE or PEEK. In other examples, however, theunlinked bearing component 3004 may be a combination of a first polyethylene portion on the articulating side and a molded metallic substrate that forms thesecond anti-rotation portion 3048. The molded configuration can be similar to the combination of polyethylene and metallic component described in pending U.S. Ser. No. 12/780,424, filed May 14, 2010 described above. - With specific reference now to
FIG. 10 , assembly of theunlinked bearing component 3004 to theuniversal stem 3002 according to one example of the present teachings will be described. At the outset, a surgeon can advance thesecond retaining mechanism 3044 of theunlinked bearing component 3004 onto thefirst retaining mechanism 3020 of theuniversal stem 3002. In this regard, thesecond anti-rotation portion 3048 can cooperatively mate with thefirst anti-rotation portion 3024 as theextension portion 3022 of thefirst retaining mechanism 3020 nests within thegroove 3046 of thesecond retaining mechanism 3044. At this time, thecatch 3032 on theulnar ring 3014 can locate partially into therelief 3042 of theunlinked bearing component 3004. Those skilled in the art will readily appreciate that the cooperatively mating structures formed on theuniversal stem 3002 and theunlinked bearing component 3004 may be reversed. For example, theextension portion 3022 may alternately be provided on the unlinked bearing component 3004 (and the linked bearing component 3006) while thegroove 3046 may alternatively be located on thebody portion 3012 of theuniversal stem 3002. Likewise, thecatch 3032 and therelief 3042 may be provided on opposite components. - Nonetheless, once the first and
second retaining mechanisms unlinked bearing component 3004 in the medial/lateral direction can be inhibited by the interaction of theextension portion 3022 and thegroove 3046. Likewise, rotation of theunlinked bearing component 3004 around theulnar ring 3014 can be inhibited by the interaction of the first and secondanti-rotation portions catch 3032 can assist in further inhibiting rotational movement of theunlinked bearing component 3004. Next, thefastener 3008 can be advanced through the passage 3040 in theunlinked bearing component 3004 and threadably advanced into the threadedbore 3030 of thestem portion 3010 to further secure theunlinked bearing component 3004 to thestem portion 3010. - With specific reference now to
FIG. 9 , the linkedbearing component 3006 will be described in greater detail. In general, the linkedbearing component 3006 can include a substrate orbody 3054 that generally takes the shape of a closed ring that has amating portion 3055 that is complementary to the shape of theulnar ring 3014. Thebody 3054 can generally include abearing portion 3056 that is molded to thebody 3054. The bearingportion 3056 can have a closedbearing surface 3058. Thebody 3054 can further include a notch orrelief 3064 andretaining mechanism 3066 that has agroove 3068 configured to receive theextension portion 3022 of theuniversal stem 3002 and asecond anti-rotation portion 3070 configured to mate with thefirst anti-rotation portion 3024 on theulnar ring 3014. - The
second retaining mechanism 3066 can include a series ofsecond undulations 3074 that may be in the form of a wave-like pattern or other geometry that can suitably mate with thefirst anti-rotation portion 3024 on theulnar ring 3014. In one example, the bearingportion 3056 can be formed of UHMWPE or PEEK that is molded over thebody 3054. The remainder of thebody 3054, such as including themating portion 3055, can be formed of a metallic substrate that can encompass thebearing portion 3056. Thebody 3054 can include apassage 3080 therein for receiving thefastener 3008 in the assembled position (seeFIG. 11 ). - With reference now to
FIGS. 9 and 11 , assembly of the linkedbearing component 3006 to theuniversal stem 3002 according to one example of the present teachings will be described. Again, it will be appreciated that it may be desirable to replace theunlinked bearing component 3004 with a linkedbearing component 3006 to provide increased constraint. At the outset, a surgeon may remove theunlinked bearing component 3004 from theuniversal stem 3002. In this regard, thefastener 3008 can be threadably retracted from the threadedbore 3030 and theuniversal stem 3002 and theunlinked bearing component 3004 subsequently removed from theuniversal stem 3002. It will be appreciated that in other examples, a surgeon can intra-operatively decide whether to select theunlinked bearing component 3004 or the linkedbearing component 3006 based on a given patient. - Once the
unlinked bearing component 3004 has been suitably removed, the linkedbearing component 3006 can be coupled to theuniversal stem 3002. Again, as with the other embodiments described herein, a linkedbearing component 3006 can be selected from a plurality of linked bearing components according to the needs of a particular patient. The surgeon can advance thesecond retaining mechanism 3066 of the linkedbearing component 3006 onto thefirst retaining mechanism 3020 of theuniversal stem 3002. In this regard, thesecond anti-rotation portion 3070 can cooperatively mate with thefirst anti-rotation portion 3024 as theextension portion 3022 of thefirst retaining mechanism 3020 nests within thegroove 3068 of thesecond retaining mechanism 3066. At this time, thecatch 3032 on theulnar ring 3014 can locate partially into thenotch 3064 of the linkedbearing component 3006. Those skilled in the art will readily appreciate that the cooperatively mating structure is formed on theuniversal stem 3002 and the linkedbearing component 3006 may be reversed. Moreover, it will be appreciated that the complementary mating surfaces of the universal stem and theunlinked bearing component 3004 and linkedbearing component 3006 can be formed with various geometries as long as the complementary mating surfaces of both theunlinked bearing component 3004 and the linkedbearing component 3006 can selectively and alternatively locate onto thefirst retaining mechanism 3020 of theuniversal stem 3002. - Once the first and
second retaining mechanisms bearing component 3006 in the medial/lateral direction can be inhibited by the interaction of theextension portion 3022 and thegroove 3068. Likewise, rotation of the linkedbearing component 3006 around theulnar ring 3014 can be inhibited by the interaction of the first and secondanti-rotation portions catch 3032 can assist in further inhibiting rotational movement of the linkedbearing component 3006. Next, thefastener 3008 can be advanced through thepassage 3080 in the linkedbearing component 3006 and threadably advanced into the threadedbore 3030 of theuniversal stem 3002 to further secure the linkedbearing component 3006 to theuniversal stem 3002. - With reference now to
FIGS. 12-18 , a modular unlinkedulnar stem assembly 3100 constructed in accordance to one example of the present teachings will be described. In general, the modular unlinkedulnar stem assembly 3100 can include astem structure 3102 and amobile ulnar bearing 3104. As will become appreciated from the following discussion, themobile ulnar bearing 3104 can be configured to slidably communicate along a surface of thestem structure 3102 in a medial/lateral direction. In addition, themobile ulnar bearing 3104 can be configured to include dedicated surface areas that can be adapted to articulate against a surface of a distal unlinked humeral component 3106 (FIG. 19 ). Themobile ulnar bearing 3104 therefore can be configured to provide two articulations. A first articulation provided during medial/lateral translation of themobile ulnar bearing 3104 along an opposing surface of thestem structure 3102 and a second articulation with the distal unlinkedhumeral component 3106. Again, as with the other embodiments disclosed herein, themobile ulnar bearing 3104 can be modular, such that a series ofmobile ulnar bearings 3104 can be provided that are each selectively configured for slidable movement along thestem structure 3102 according to a specific patient's needs. The modular unlinkedulnar stem assembly 3100 can be favorable in some circumstances as it has the potential to remove less native bone than other elbow prostheses, such as a semi-constrained total elbow, for example. - With specific reference now
FIGS. 12, 13 and 16 exemplary features of thestem structure 3102 will be described. Thestem structure 3102 can generally include astem portion 3110 and a C-shapedbody portion 3112. In this regard, thebody portion 3112 can generally include anulnar ring 3114 that is in the form of a partial or semi-circular cylinder. Thebody portion 3112 can generally extend between afirst end 3116 and asecond end 3118. Thebody portion 3112 can further comprise afirst wall 3120 arranged at thefirst end 3116 and asecond wall 3122 arranged at thesecond end 3118. Thebody portion 3112 can further comprise amedial wall 3124 and a lateral wall 3126 (FIG. 16 ). Thefirst wall 3120,second wall 3122,medial wall 3124 andlateral wall 3126 can cooperate to provide a boundary that confines themobile ulnar bearing 3104 as will be described more fully herein. A width W1 can be defined between themedial wall 3124 and thelateral wall 3126. Thebody portion 3112 can further provide an ulnarring articulation surface 3130 that themobile ulnar bearing 3104 slidably communicates therealong. As with the other examples provided herein, thestem structure 3102 can be formed of a biocompatible material, such as cobalt or titanium. The ulnarring articulation surface 3130 of thestem structure 3102 can be highly polished to facilitate smooth translation of themobile ulnar bearing 3104 therealong. - With general reference now to
FIGS. 12-21 and specific reference toFIGS. 14 and 15 , themobile ulnar bearing 3104 will be described in greater detail. In general, themobile ulnar bearing 3104 can include abody 3150 that generally takes the shape of a partial or semi-circular cylinder complementary to the shape of theulnar ring 3114. Thebody 3150 can extend between afirst end 3152 and asecond end 3154. Thebody 3150 can further include amedial side surface 3156 and alateral side surface 3158. Thebody 3150 can include an ulnar opposing articulatingsurface 3160 that slidably communicates along the ulnar ring articulating surface 3130 (FIG. 12 ) and a humeral opposing articulatingsurface 3162 that articulates with a humeral articulatingsurface 3166 of the distal unlinked humeral component 3106 (FIG. 19 ). The ulnar opposing articulatingsurface 3160 can be linear or spherical along a cross-section taken through a medial/lateral plane of themobile ulnar bearing 3104. Likewise, the ulnarring articulation surface 3130 can have a similar cross-sectional profile that matches the ulnar opposing articulatingsurface 3160. - The humeral opposing articulating
surface 3162 can be collectively formed by a first articulatingsurface 3170, a second articulatingsurface 3172, a third articulatingsurface 3174 and a fourth articulatingsurface 3176. In the example shown, the first and second articulatingsurfaces surfaces surfaces surface 3166 according to a given varus or valgus movement. The configuration of the first, second, third and fourth articulatingsurfaces surface 3166 of the distal unlinkedhumeral component 3106 as compared to a general line-to-line contact that may be achieved from other conventional mobile ulnar bearing configurations as will be described in detail herein. - With reference now to
FIGS. 16-18 , movement of themobile ulnar bearing 3104 relative to theulnar ring 3114 will be described. As identified above, themobile ulnar bearing 3104 can be configured to slidably translate along the ulnarring articulating surface 3130 in a medial/lateral direction. In this regard, themobile ulnar bearing 3104 can define a width W2 between themedial side surface 3156 and thelateral side surface 3158. The width W2 can be less than the width W1 provided between opposing medial andlateral walls ulnar ring 3114, such that themobile ulnar bearing 3104 can slidably communicate along the ulnarring articulating surface 3130 between themedial wall 3124 and thelateral wall 3126 of theulnar ring 3114. As shown inFIG. 17 , themobile ulnar bearing 3104 can translate to a medial-most position where themedial side surface 3156 of themobile ulnar bearing 3104 is in contact with themedial wall 3124 of theulnar ring 3114. As can be appreciated, further translation of themobile ulnar bearing 3104 in the medial direction is precluded by contact with themedial wall 3124. Similarly, themobile ulnar bearing 3104 is shown in a lateral-most position inFIG. 18 where thelateral side surface 3158 is moved into contact with thelateral wall 3126 of theulnar ring 3114. Again, further translation of themobile ulnar bearing 3104 in the lateral direction is precluded by contact with thelateral wall 3126. - With reference now to
FIGS. 14 and 19-21 , articulation of themobile ulnar bearing 3104 with the distal unlinkedhumeral component 3106 will be further described. By way of example, the modular unlinkedulnar stem assembly 3100 is shown with the distal unlinkedhumeral component 3106 in a neutral position inFIG. 19 . Anexemplary radial component 3180 can be implanted if desired. InFIG. 20 , the distal unlinkedhumeral component 3106 is shown during varus arm movement. In the exemplary configuration, the varus arm position can have anangle 3184 of about 3.5 degrees. InFIG. 21 , the distal unlinkedhumeral component 3106 is shown in a valgus arm position. More specifically, the distal unlinkedhumeral component 3106 is shown rotated inangle 3186 of about 3.5 degrees. When the arm is in the varus position shown inFIG. 20 , the humeral articulatingsurface 3166 of the distal unlinkedhumeral component 3106 can engage the first and second articulation surfaces 3170 and 3172 of themobile ulnar bearing 3104. The surface profile of the first and second articulation surfaces 3170 and 3172 can provide a diagonally opposed surface contact with the humeral articulatingsurface 3166. Explained further, thecross-hatched surface areas surface 3166 thereby providing a supportive interface between themobile ulnar bearing 3104 and the distal unlinkedhumeral component 3106 in the varus position. Such a configuration can provide a more stable surface-to-surface contact versus a line-to-line contact. Similarly, when the distal unlinkedhumeral component 3106 is moved to the corresponding valgus arm position shown inFIG. 21 , the third and fourth articulation surfaces 3174 and 3176 of themobile ulnar bearing 3104 can communicate with thehumeral articulation surface 3166 of the distal unlinkedhumeral component 3106. Again, the surface profile of the third and fourth articulation surfaces 3174 and 3176 provided by themobile ulnar bearing 3104 can provide a surface contact with thehumeral articulation surface 3166 that can improve stability. Explained further, thecross-hatched surface areas surface 3166 thereby providing a supportive interface between themobile ulnar bearing 3104 and the distal unlinkedhumeral component 3106 in the valgus position. - While the description in the specification and illustrated in the drawings are directed to various embodiments, it will be understood that various changes may be made and equivalents may be substituted for elements thereof without departing from the scope of the teachings and the appended claims. In addition, many modifications may be made to adapt a particular situation or material to the teachings without departing from the scope thereof. Therefore, it is intended that the teachings and claims are not to be limited to any particular embodiment illustrated in the drawings and described in the specification, but that the teachings and claims can include any embodiments falling within the foregoing description and the appended claims.
Claims (20)
Priority Applications (3)
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US15/614,245 US10596006B2 (en) | 2000-07-18 | 2017-06-05 | Elbow prosthesis |
US16/825,262 US11213400B2 (en) | 2012-05-07 | 2020-03-20 | Elbow prosthesis |
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US10/333,140 US7247170B2 (en) | 2000-07-18 | 2001-07-17 | Elbow prosthesis |
US11/384,943 US8585768B2 (en) | 2000-07-18 | 2006-03-17 | Elbow prosthesis |
US11/780,370 US7604666B2 (en) | 2000-07-18 | 2007-07-19 | Elbow prosthesis |
US11/780,365 US7625406B2 (en) | 2000-07-18 | 2007-07-19 | Elbow prosthesis |
US12/391,904 US10231839B2 (en) | 2000-07-18 | 2009-02-24 | Elbow prosthesis |
US12/562,616 US9561110B2 (en) | 2000-07-18 | 2009-09-18 | Elbow prosthesis |
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-
2012
- 2012-05-07 US US13/465,690 patent/US8998995B2/en not_active Expired - Lifetime
- 2012-07-02 WO PCT/US2012/045207 patent/WO2013006536A1/en active Application Filing
- 2012-07-02 ES ES12737417.1T patent/ES2694410T3/en active Active
- 2012-07-02 EP EP12737417.1A patent/EP2729090B1/en active Active
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2015
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US20120221113A1 (en) | 2012-08-30 |
US8998995B2 (en) | 2015-04-07 |
WO2013006536A1 (en) | 2013-01-10 |
EP2729090A1 (en) | 2014-05-14 |
US20150289982A1 (en) | 2015-10-15 |
ES2694410T3 (en) | 2018-12-20 |
US9901453B2 (en) | 2018-02-27 |
EP2729090B1 (en) | 2018-08-15 |
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