Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/38—Joints for elbows or knees
  • A61F2/3804—Joints for elbows or knees for elbows
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
  • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
  • A61F2002/30339—Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
  • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
  • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
• • 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
  • A61F2002/3809—Joints for elbows or knees for elbows for radio-humeral joints
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/38—Joints for elbows or knees
  • A61F2/3804—Joints for elbows or knees for elbows
  • A61F2002/3813—Joints for elbows or knees for elbows for ulno-humeral joints

Definitions

• the present disclosure relates to an elbow prosthesis and more particularly to an elbow prosthesis incorporating an articulating condyle.
• Elbow prostheses provide articulation between the proximal radius and the distal humerus following total elbow arthroplasty.
• One such elbow prosthesis is a linked or constrained elbow prosthesis that includes a first component attached to the humerus and a second component attached to the ulna.
• a joint or hinge disposed at a junction of the first component and the second component permits relative movement between the first component and the second component and, thus, permits movement between the humerus and the ulna at the proximal radius and the distal humerus.
• Conventional elbow prostheses sometimes include a pair of condyle components extending from the medial and lateral sides of the joint, respectively.
• the condyle components are designed to approximate the function of the lateral epicondyle and the medial epicondyle and are intended to provide increased articular surface contact at the proximal radius and the distal humerus once the prosthesis is installed in the humerus and the ulna.
• An elbow prosthesis may include a first stem component attached to one of a humerus and an ulna, a second stem component attached to the other of the humerus and the ulna, and a joint disposed between and coupling the first stem component and the second stem component to permit relative movement between the first stem component and the second stem component about a first axis.
• the elbow prosthesis may additionally include a condyle extending from the joint and including an axis of rotation that is eccentric from the first axis.
• an elbow prosthesis may include a first stem component attached to one of a humerus and an ulna, a second stem component attached to the other of the humerus and the ulna, and a joint disposed between and coupling the first stem component and the second stem component to permit relative movement between the first stem component and the second stem component about a first axis.
• the elbow prosthesis may additionally include a first condyle component rotatable with one of the first stem component and the second stem component about the first axis and a second condyle component rotatable relative to the first condyle component about a second axis.
• FIG. 1 is a perspective view of an elbow prosthesis in accordance with the principles of the present disclosure
• FIG. 2 is an exploded view of the elbow prosthesis of FIG. 1 ;
• FIG. 3 is a partial side view of the elbow prosthesis of FIG. 1 ;
• FIG. 4 is a partial side view of the elbow prosthesis of FIG. 1 ;
• FIG. 5 is a partial cross-sectional view of the elbow prosthesis of
• FIG. 1 taken along line 5-5 of FIG. 3;
• FIG. 6 is a partial cross-sectional view of the elbow prosthesis of FIG. 1 showing a lateral condyle in an articulated state
• FIG. 7 is a side view of the elbow prosthesis of FIG. 5 showing the lateral condyle in the neutral state
• FIG. 8 is a side view of the elbow prosthesis of FIG. 6 showing the lateral condyle in the articulated state
• FIG. 9 is a perspective view of a condyle assembly of the elbow prosthesis of FIG. 1 in a neutral state
• FIG. 10 is a perspective view of a condyle assembly of the elbow prosthesis of FIG. 1 in an articulated state
• FIG. 1 1 is a cross-sectional view of an alternate condyle assembly for use in conjunction with the elbow prosthesis of FIG. 1 ;
• FIG. 12 is a cross-sectional view of an alternate condyle assembly for use in conjunction with the elbow prosthesis of FIG. 1 .
• Example embodiments are provided so that this disclosure will be thorough, and will fully convey the scope to those who are skilled in the art. Numerous specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to those skilled in the art that specific details need not be employed, that example embodiments may be embodied in many different forms and that neither should be construed to limit the scope of the disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail.
• first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer or section from another region, layer or section. Terms such as “first,” “second,” and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the example embodiments.
• Spatially relative terms such as “inner,” “outer,” “beneath,” “below,” “lower,” “above,” “upper,” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. Spatially relative terms may be intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
• an elbow prosthesis 10 may include a first stem component 12, a second stem component 14, and a hinge assembly 16 disposed generally between the first stem component 12 and the second stem component 14.
• the hinge assembly 16 may join the first stem component 12 and the second stem component 14 and may facilitate relative movement between the first stem component 12 and the second stem component 14.
• the first stem component 12 may be received within a cavity (not shown) formed in a distal humerus 18 (FIG. 1 ) and may include an elongate, tapered body 20, a first arm 22, a second arm 24, and a hook portion 26.
• the tapered body 20 may extend in an opposite direction than the first arm 22 and the second arm 24 and may be received within a channel formed in the humerus 18.
• the tapered body 20 may be secured within the channel formed in the humerus 18 by applying a force to the body 20 along a longitudinal axis thereof. [0032] Applying a force to the body 20 in the foregoing manner causes the body 20 to be secured within the humerus 18 via a friction fit.
• the channel formed in the humerus 18 may include a female taper that decreases in size in a direction extending from the distal humerus to the proximal humerus.
• the female taper formed in the channel of the humerus 18 may cooperate with the male taper of the tapered body 20 to allow the tapered body 20 to frictionally engage the female taper of the humerus 18, thereby fixing the body 20 within and relative to the humerus 18.
• Bone cement and/or other suitable adhesives may also be used to secure the body 20 within the humerus 18.
• the first arm 22 and the second arm 24 may extend in an opposite direction than the tapered body 20 and may cooperate to provide the first stem component 12 with a substantially U-shaped channel 28.
• the U- shaped channel 28 may be formed by a side surface 30 of the first arm 22, a side surface 32 of the second arm 24, and an arcuate surface 34 that extends generally between and connects the side surfaces 30, 32.
• the first arm 22 may include a bore 36 and a distal end surface 38.
• the second arm 24 may include a bore 40 and a distal end surface 42.
• the bores 36, 40 of the first arm 22 and the second arm 24, respectively, may cooperate with the hinge assembly 16 to position and retain the hinge assembly 16 between the side surface 30 of the first arm 22 and the side surface 32 of the second arm 24, as will be described in greater detail below.
• the hook portion 26 may extend from a junction of the tapered body 20 and the first and second arms 22, 24. Further, the hook portion 26 may be spaced apart and separated from the tapered body 20 and may include an attachment aperture 44. Spacing the hook portion 26 from the tapered body 20 may permit a portion of the humerus 18 to be received generally between the tapered body 20 and the hook portion 26. As such, the hook portion 26 may oppose a portion of the humerus 18, which may permit a fastener (not shown) to be received through the attachment aperture 44 to secure the hook portion 26 and, thus, the first stem component 12, to the humerus 18.
• the second stem component 14 may be joined to the first stem component 12 via the hinge assembly 16 and may include an elongate, tapered body 46 and an attachment feature 48.
• the tapered body 46 may be received within a channel (not shown) formed in the ulna 50 (FIG. 1 ).
• the channel formed in the ulna 50 may include a female taper such that when the male taper of the body 46 is inserted into the channel and a force is applied along a longitudinal axis of the body 46, the male taper of the body 46 engages the female taper of the channel, thereby joining the body 46 to the ulna 50 via a friction fit.
• the tapered body 46 may further be attached to the channel of the ulna 50 via a suitable bone cement and/or other adhesive.
• the attachment feature 48 may be formed at one end of the second stem component 14 and may include a bore 52 and an outer, arcuate surface 54.
• the bore 52 may include a series of retention features 56 that cooperate with the hinge assembly 16 to retain a portion of the hinge assembly 16 within the attachment feature 48.
• the attachment feature 48 may include an attachment aperture 58 that is formed through a wall of the attachment feature 48 and extends generally between the arcuate surface 54 and the bore 52.
• the attachment aperture 58 may provide communication with the bore 52 from an area outside the attachment feature 48.
• the attachment aperture 58 may receive a fastener (not shown) to secure a portion of the hinge assembly 16 within the attachment feature 48, as will be described in greater detail below.
• the hinge assembly 16 may be disposed at a junction of the first stem component 12 and the second stem component 14 and may include a first condyle 60, a second condyle 62, and a bearing member 64.
• the first condyle 60 may include an articulating surface 66, a channel 68, and a bore 70 formed in a substantially flat surface 72.
• the articulating surface 66 may provide the first condyle 60 with a substantially hemispherical shape that is matingly received by the bearing member 64 to allow the first condyle 60 to articulate within and relative to the bearing member 64 about the articulating surface 66.
• the channel 68 may be formed on an opposite side of the first condyle 60 from the articulating surface 66 and may include a shape that matingly receives the distal end surface 42 of the second arm 24. Providing the channel 68 with the same shape as the distal end surface 42 of the second arm 24 allows the second arm 24 to be properly positioned relative to and within the channel 68 when the second arm 24 is received by the first condyle 60.
• the bore 70 of the first condyle 60 may be aligned with the bore 40 of the second arm 24. Alignment between the bore 40 formed in the second arm 24 and the bore 70 formed in the first condyle 60 allows a fastener (not shown) to be inserted into and through the bores 40, 70 to fix the first condyle 60 for movement with the second arm 24.
• the second condyle 62 may include a medial component 74 and a lateral component 76.
• the terms “medial” and “lateral” are used to describe components 74 and 76 relative to a bone axis and are not necessarily “medial” and “lateral” to the body.
• the medial component 74 may include an articulating surface 78, a pocket 80, and a bore 82 formed in a substantially flat surface 84.
• the medial component 74 may additionally include a projection 86 extending from an opposite side of the medial component 74 than the articulating surface 78.
• the articulating surface 78 may be rotatably attached to the bearing member 64 to rotatably support the medial component 74 relative to the bearing member 64.
• the pocket 80 may be formed into the articulating surface 78 (FIGS. 9 and 10) and may receive the first arm 22 therein. Specifically, the first arm 22 may be inserted into the pocket 80 until the distal end surface 38 of the first arm 22 contacts an end surface 88 of the pocket (FIGS. 5 and 6). At this point, the first arm 22 is fully inserted into the pocket 80 such that the bore 82 of the second condyle 62 is aligned with the bore 36 of the first arm 22.
• alignment between the bore 36 of the first arm 22 and the bore 82 of the second condyle 62 allows a fastener (not shown) to be inserted into and through the bores 36, 82 to fix the medial component 74 for movement with the first arm 22.
• the projection 86 may extend from the medial component 74 and may be offset from an axis of rotation (R) of the medial component 74. Specifically, a central axis (C) extending through a center of the projection 86 may be offset from the axis of rotation (R) of the medial component 74 by a distance (D), as shown in FIGS. 5 and 6. In short, the projection 86 may be eccentric from the axis of rotation (R) of the medial component 74.
• the lateral component 76 may be rotatably attached to the medial component 74 and may include an engagement surface 90 and a blind bore 92 formed on an opposite side of the lateral component 76 than the engagement surface 90.
• the blind bore 92 may include a female taper that receives the projection 86 of the medial component 74.
• the projection 86 may include a male taper that rotatably receives the female taper of the blind bore 92 to rotatably attach the lateral component 76 to the medial component 74.
• the blind bore 92 may be formed in the lateral component 76 such that the blind bore 92 is eccentric from a central axis of the lateral component 76 (axis of rotation (R) in FIG. 5) in a similar fashion as the projection 86 is eccentric to the axis of rotation (R) of the medial component 74.
• the blind bore 92 may include a central axis that is concentric with the central axis (C) of the projection 86.
• the central axis of the blind bore 92 may be offset relative to the central axis of the lateral component 76 by the distance (D), as represented in FIGS. 5 and 7 (FIGS. 5 and 7 show the central axis of the lateral component 76 as being concentric with the axis of rotation (R) of the medial component 74 when the lateral component 76 is in the neutral state).
• the blind bore 92 is eccentric from the central axis of the lateral component 76 and, further, because the projection 86 is eccentric from an axis of rotation of the medial component 74, rotation of the lateral component 76 relative to the medial component 74 about the projection 86 causes the lateral component 76 to move from a neutral state (FIG. 5) to an articulated state (FIG. 6).
• the offset of the blind bore 92 from the central axis of the lateral component 76 and the offset of the projection 86 from the axis of rotation of the medial component 74 are equal, which allows the lateral component 76 to be positioned in neutral state.
• Rotation of the lateral component 76 about the projection 86 results in a net offset (i.e., in the plane of FIG. 6) of the lateral component 76 in the direction (Y).
• a net offset i.e., in the plane of FIG. 6
• Such adjustment of the lateral component 76 relative to the medial component 74 allows the engagement surface 90 of the lateral component 76 to be properly positioned relative to the head of the proximal radius 94 (FIG. 1 ) when the elbow prosthesis 10 is installed by a surgeon.
• the bearing member 64 may be received by the attachment feature 48 and may include a first bearing surface 96, a second bearing surface 98, a central bore 100, and a series of retention features 102.
• the bearing member 64 may be positioned within and received by the bore 52 of the attachment feature 48 such that the retention features 102 cooperate with the retention features 56 to retain and position the bearing member 64 within the bore 52.
• a fastener (not shown) may be received through the attachment aperture 58 and may engage the bearing member 64 to retain the bearing member 64 in a desired position within the bore 52.
• the first bearing surface 96 may oppose the first condyle 60 such that the articulating surface 66 is in contact with the first bearing surface 96. Accordingly, when the first condyle 60 is moved with the second arm 24 of the first stem component 12 relative to the second stem component 14, the articulating surface 66 moves relative to and is in engagement with the first bearing surface 96 of the bearing member 64.
• the second bearing surface 98 may oppose and receive the second condyle 62 such that the articulating surface 78 of the medial component 74 engages and is in contact with the second bearing surface 98. Accordingly, when the medial component 74 moves with the first arm 22 of the first stem component 12 relative to the second stem component 14, the articulating surface 78 moves relative to and is engagement with the second bearing surface 98.
• the central bore 100 may extend between the first bearing surface 96 and the second bearing surface 98 and may include a series of extensions 104 (FIG. 2) that are formed into the bearing member 64.
• the extensions 104 may radiate from the central bore 100 and may extend into the first bearing surface 96 and the second bearing surface 98.
• the extensions 104 may cooperate with the central bore 100 to provide the bearing member 64 with a degree of flexibility at the first bearing surface 96 and the second bearing surface 98 proximate to the central bore 100.
• the flexibility provided by the central bore 100 and the extensions 104 allows the first bearing surface 96 and the second bearing surface 98 to flex during movement of the first condyle 60 and the second condyle 62 relative to the bearing member 64 during relative movement between the first stem component 12 and the second stem component 14.
• the first stem component 12 may be received by a channel formed in the humerus 18 and the second stem component 14 may be received in a channel formed in the ulna 50, as described above.
• the hinge assembly 16 may be assembled to the first stem component 12 and to the second stem component 14 to permit relative movement between the first stem component 12 and the second stem component 14.
• the hinge assembly 16 may be assembled to the first stem component 12 and to the second stem component 14 prior to installation of the first stem component 12 into the humerus 18 and prior to installation of the second stem component 14 into the ulna 50. Nonetheless, attachment of the hinge assembly 16 to the first stem component 12 and to the second stem component 14 will be described hereinafter following installation of the first stem component 12 into the humerus 18 and following installation of the second stem component 14 into the ulna 50.
• a surgeon may initially create an incision proximate to an elbow joint of a patient to gain access to the distal end of the humerus 18, the proximal end of the ulna 50, and the head of the proximal radius 94.
• the humerus 18 may be prepared by forming a channel therein.
• the channel formed into the humerus 18 may include a female taper that receives the male tapered body 20 of the first stem component 12.
• a force may be applied to the tapered body 20 of the first stem component 12 to insert the first stem component 12 into the channel of the humerus 18, thereby creating a friction fit between the tapered body 20 of the first stem component 12 and the channel.
• Bone cement and/or a suitable adhesive may also be used to secure the first stem component 12 within the humerus 18.
• the second stem component 14 may be inserted into a channel formed in the ulna 50 in a similar fashion as described above with respect to the first stem component 12. Namely, a channel having a female taper may be formed in the ulna 50 and may receive the male tapered body 46 of the second stem component 14. A force may be applied in a direction substantially along a longitudinal axis of the second stem component 14 to drive the second stem component 14 into the channel formed in the ulna 50.
• the hinge assembly 16 may be attached to the first stem component 12 and the second stem component 14.
• the bearing member 64 of the hinge assembly 16 may initially be positioned relative to the second stem component 14 such that the bearing member 64 opposes the bore 52 formed in the attachment feature 48.
• the bearing member 64 may be properly aligned relative to the attachment feature 48 by aligning the retention features 102 of the bearing member 64 relative to the retention features 56 of the bore 52. Once the retention features 102 of the bearing member 64 are properly aligned with the retention features 56 of the bore 52, the bearing member 64 may be moved into the attachment feature 48 of the second stem component 14.
• a fastener (not shown) may be inserted into the attachment aperture 58 of the attachment feature 48 and may engage the bearing member 64 to fix a position of the bearing member 64 relative to and within the bore 52 of the attachment feature 48.
• the bearing member 64 is fixed relative to the second stem component 14 and is restricted from being removed from the bore 52 by the fastener received through the attachment aperture 58 and is restricted from rotating within the bore 52 due to engagement between the retention features 102 of the bearing member 64 and the retention features 56 of the bore 52.
• the first condyle 60 may be attached to the second arm 24 of the first stem component 12 by inserting the second arm 24 into the channel 68.
• the second arm 24 may be advanced into the channel 68 until the distal end surface 42 of the second arm 24 abuts a distal end of the channel 68.
• the bore 40 formed through the second arm 24 may be aligned with the bore 70 formed through the first condyle 60.
• a fastener (not shown) may be inserted through the bore 70 of the first condyle 60 and may be inserted through the bore 40 formed in the second arm 24 to fix the first condyle 60 for movement with the second arm 24 of the first stem component 12.
• the first condyle 60 may be positioned relative to and received by the first bearing surface 96 of the bearing member 64 such that the articulating surface 66 of the first condyle 60 opposes and is in contact with the first bearing surface 96 of the bearing member 64. Accordingly, when the first stem component 12 is moved relative to the second stem component 14, the articulating surface 66 may be in contact with and may bear against the first bearing surface 96 of the bearing member 64.
• the second condyle 62 may be attached to the first arm 22 of the first stem component 12 by inserting the first arm 22 into the pocket 80 formed in the medial component 74.
• the first arm 22 may be advanced into the pocket 80 until the distal end surface 38 of the first arm 22 contacts the end surface 88 of the pocket 80.
• the bore 36 formed through the first arm 22 may be aligned with the bore 82 of the medial component 74.
• a fastener (not shown) may be received through the bore 82 of the medial component 74 and may be received through the bore 36 of the first arm 22 such that the medial component 74 is fixed for movement with the first stem component 12. Accordingly, when the first stem component 12 is moved relative to the second stem component 14, the medial component 74 is likewise moved relative to the second stem component 14.
• the medial component 74 may be positioned relative to and may be received by the second bearing surface 98 of the bearing member 64. Specifically, the articulating surface 78 of the medial component 74 may be received by and may be in contact with the second bearing surface 98 such that when the medial component 74 is moved relative to the second stem component 14, the articulating surface 78 of the medial component 74 is in contact with and bears against the second bearing surface 98 of the bearing member 64.
• the lateral component 76 may be attached to the medial component 74 by aligning the blind bore 92 of the lateral component 76 with the projection 86 of the medial component 74. A force may be applied to the lateral component 76 to cause the projection 86 of the medial component 74 to be received within the blind bore 92.
• the lateral component 76 When the lateral component 76 is initially installed on the medial component 74, the lateral component 76 may be in a neutral state (FIG. 7) such that the axis of rotation (R) of the medial component 74 is aligned with the central axis of the lateral component 76.
• a force may be applied to the lateral component 76 to cause the lateral component 76 to rotate relative to the medial component 74 about the projection 86. Because the center (C) of the projection 86 is offset from the axis of rotation (R) of the medial component 74 and, further, because a center of the blind bore 92 is offset from the central axis of the lateral component 76, rotation of the lateral component 76 about the projection 86 causes the lateral component 76 to articulate and move relative to the medial component 74 in a linear direction.
• rotation of the lateral component 76 about the projection 86 may result in a net offset (i.e., in the plane of FIG. 6) of the lateral component 76 in the direction (Y).
• Such movement may be performed by the surgeon when installing the elbow prosthesis 10 to allow the lateral component 76 of the second condyle 62 to be properly tensioned and in contact with the head of the proximal radius 94.
• a force may be applied to the lateral component 76 to fully insert the projection 86 into the blind bore 92 of the lateral component 76.
• the projection 86 may include a male taper and the blind bore 92 may include a female taper. Accordingly, when the projection 86 is driven into the blind bore 92, engagement between the male taper of the projection 86 and the female taper of the blind bore 92 fixes a rotational position of the lateral component 76 relative to the medial component 74 and prevents further movement of the lateral component 76 relative to the medial component 74.
• the surgeon may apply a force to one or both of the first stem component 12 and the second stem component 14 to ensure that the hinge assembly 16 provides a desired range of motion.
• Applying a force to one or both of the first stem component 12 and the second stem component 14 causes the first condyle 60 to move relative to the bearing member 64 and causes the second condyle 62 to move relative to the bearing member 64.
• the articulating surface 66 of the first condyle 60 engages and moves relative to the first bearing surface 96 of the bearing member 64.
• the articulating surface 78 of the medial component 74 engages and moves relative to the second bearing surface 98 of the bearing member 64.
• the foregoing movement likewise causes the engagement surface 90 of the lateral component 76 to engage and move relative to the head of the proximal radius 94.
• Engagement between the engagement surface 90 of the lateral component 76 and the head of the proximal radius 94 provides stability to the medial component 74 and enhances articulation of the lateral component 76 with the head of the proximal radius 94.
• Providing the lateral component 76 with a degree of adjustment relative to the medial component 74 allows the surgeon to adjust the position of the lateral component 76 relative to the head of the proximal radius 94 during surgery and, therefore, ensures that the lateral component 76 will adequately support and articulate relative to the head of the proximal radius 94 during use of the elbow prosthesis 10 and through the range of motion.
• a second condyle 62a is provided for use with the elbow prosthesis 10.
• the second condyle 62a replaces the second condyle 62 and may include a medial component 74a, a lateral component 76a, and an intermediate component 106 disposed generally between the medial component 74a and the lateral component 76a.
• like reference numerals are used hereinafter and in the drawings to identify like components while like reference numerals containing letter extensions are used to identify those components that have been modified.
• the intermediate component may include a first projection 108, a second projection 1 10, and a main body 1 12 disposed between the first projection 108 and the second projection 1 10.
• the first projection 108 may include a male taper and may be received within a blind bore 1 14 formed in the medial component 74a.
• the blind bore 1 14 may include a female taper and may matingly receive the male taper of the first projection 108.
• the first projection 108 may be offset from an axis of rotation (Ra) of the medial component 74a.
• a central axis (Ca-i) of the first projection 108 may be spaced apart and separated from the axis of rotation (Ra) of the medial component 74a by a distance (D-i). Because the central axis (Ca-i) of the first projection 108 may be offset from the axis of rotation (Ra) of the medial component 74a, the first projection 108 and, thus, the blind bore 1 14, are eccentric from the axis of rotation (Ra) of the medial component 74a.
• the second projection 1 10 may be received by a blind bore 1 16 formed into the lateral component 76a.
• the blind bore 1 16 may include a female taper that receives a male taper of the second projection 1 10 when the second projection 1 10 is inserted into the blind bore 1 16.
• the second projection 1 10 may include a central axis (Ca 2 ) that is offset from a central axis of the lateral component 76a by a distance (D 2 ).
• a central axis (Ca 2 ) that is offset from a central axis of the lateral component 76a by a distance (D 2 ).
• the central axis of the lateral component 76a is concentric with the axis of rotation (Ra) of the medial component 74a. Accordingly, the distance (D 2 ) is shown relative to the axis of rotation (Ra) of the medial component 74a. Because the second projection 1 10 and, thus, the blind bore 1 16, are offset from the central axis of the lateral component 76a, the second projection 1 10 and the blind bore 1 16 are eccentric from the central axis of the lateral component 76a.
• a force may be applied to the lateral component 76a to rotate the lateral component 76 about the second projection 1 10. Because the second projection 1 10 is offset from the axis of rotation (Ra) of the medial component 74a and from a central axis of the lateral component 76a, rotation of the lateral component 76a about the second projection 1 10 results in a net offset (i.e., in the plane of FIG. 1 1 ) of the lateral component 76 in the direction (Y).
• such rotation of the lateral component 76a may be performed by the surgeon to properly position the lateral component 76a relative to the head of the proximal radius 94 to allow the engagement surface 90 to properly engage the head of the proximal radius 94.
• the surgeon may additionally apply a rotational force to the intermediate component 106, thereby causing the intermediate component 106 to rotate relative to the medial component 74a.
• Such rotation of the intermediate component 106 relative to the medial component 74a causes the intermediate component 106 to rotate about the first projection 108.
• the first projection 108 is eccentric from the axis of rotation of the medial component 74a
• rotation of the intermediate component 106 relative to the medial component 74a results in a net offset (i.e., in the plane of FIG. 1 1 ) of the intermediate component 106 in the direction (Z).
• the net offset of the intermediate component 106 in the direction (Z) likewise causes a net offset (i.e., in the plane of FIG. 1 1 ) of the lateral component 76a in the direction (Y), as the lateral component 76a is attached to the first projection 108 of the intermediate component 106 via the second projection 1 10.
• the surgeon may rotate the lateral component 76 about the second projection 1 10 relative to the intermediate component 106 and may likewise rotate the lateral component 76a along with the intermediate component 106 about the first projection 108 relative to the medial component 74a. While the surgeon may rotate the lateral component 76a relative to the intermediate component 106 and may rotate the intermediate component 106 relative to the medial component 74a, the surgeon could alternatively rotate only the lateral component 76a relative to the intermediate component 106 or could rotate only the intermediate component 106 relative to the medial component 74a. In short, the surgeon could rotate the lateral component 76a relative to the intermediate component 106 and/or may rotate the intermediate component 106 relative to the medial component 74a. Any or all of the foregoing operations may be performed by the surgeon to properly position the engagement surface 90 of the lateral component 76 relative to the head of the proximal radius 94 during surgery.
• a force may be applied to the lateral component 76 to drive the second projection 1 10 into the blind bore 1 16 to allow the male taper of the second projection 1 10 to fully engage the female taper of the blind bore 1 16 to fix the lateral component 76 for movement with the intermediate component 106.
• a force may be applied to the intermediate component 106 (via the lateral component 76a) to drive the first projection 108 into the blind bore 1 14 to allow the male taper of the first projection 108 to fully engage the blind bore 1 14 of the medial component 74a.
• full engagement of the first projection 108 of the intermediate component 106 and the female taper of the blind bore 1 14 results in the intermediate component 106 being fixed for movement with the medial component 74a.
• the lateral component 76a is fixed for movement with the intermediate component 106 and the intermediate component 106 is fixed for movement with the medial component 74a, the lateral component 76a is fixed for movement with the medial component 74a.
• the relative position of the engagement surface 90 of the lateral component 76a relative to the head of the proximal radius 94 is likewise fixed.
• Adjustment of the engagement surface 90 of the lateral component 76 relative to the medial component 74a and the resulting contact of the engagement surface 90 with the head of the proximal radius 94 results in the lateral component 76a adequately supporting the elbow prosthesis 10 relative to the head of the proximal radius 94 while concurrently providing a desired articulation of the lateral component 76a relative to the head of the proximal radius 94.
• a second condyle 62b is provided for use with the elbow prosthesis 10.
• the second condyle 62b replaces the second condyle 62 and may include a medial component 74b and a lateral component 76b.
• like reference numerals are used hereinafter and in the drawings to identify like components while like reference numerals containing letter extensions are used to identify those components that have been modified.
• the lateral component 76b may be attached to the medial component 74b by an intermediate component 1 18.
• the intermediate component 1 18 may include a projection 120 extending from a main body 122.
• the projection 120 may be received by an insert 124 positioned within a blind bore 126 formed in the lateral component 76b.
• the projection 120 may include a male taper that is matingly received by a tapered aperture 128 formed in the insert 124.
• the projection 120 may be offset from an axis of rotation (Rb) of the medial component 74b. Specifically, a central axis (Cb-i) of the projection 120 may be offset from the axis of rotation (Rb) of the medial component 74b by a distance (D 3 ). Accordingly, the projection 120 may be eccentric from the axis of rotation (Rb) of the medial component 74b.
• the insert 124 may likewise be offset from the axis of rotation (Rb) of the medial component 74b. Accordingly, a central axis (Cb 2 ) of the insert 124 may be offset from the axis of rotation (Rb) of the medial component 74b by a distance (D 4 ). Accordingly, the insert 124 may be eccentric from the axis of rotation (Rb) of the medial component 74b.
• a surgeon may apply a force to the lateral component 76b to rotate the lateral component and the insert 124 relative to and about the projection 120.
• Such rotation of the lateral component 76b and the insert 124 relative to and about the projection 120 results in the lateral component 76b moving in the direction (Y) due to the insert 124 being eccentric from the axis of rotation (Rb) of the medial component 74b.
• the force applied to the lateral component 76b may also cause rotation of the insert 124 relative to and about the projection 120, which may further result in movement of the lateral component 76b in the direction (Y).
• movement of the lateral component 76b in the direction (Y) allows the surgeon to properly position the engagement surface 90 of the lateral component 76b relative to the head of the proximal radius 94.
• a force may be applied to the lateral component 76b to cause the male taper of the projection 120 to fully engage the tapered aperture 128 of the insert 124 and may cause the male taper of the insert 124 to fully engage the female taper of the blind bore 126 to fix a position of the lateral component 76b relative to the intermediate component 1 18.
• Fixing a position of the lateral component 76b relative to the intermediate component 1 18 likewise fixes a position of the lateral component 76b relative to the medial component 74b and, thus, maintains the adjusted position of the lateral component 76b performed by the surgeon. Accordingly, use of the second condyle 62b in conjunction with the elbow prosthesis 10 ensures that the lateral component 76b supports the elbow prosthesis 10 relative to the head of the proximal radius 94 to provide a desired range of articulation.

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• Health & Medical Sciences (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Physical Education & Sports Medicine (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
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• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
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• Animal Behavior & Ethology (AREA)
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• Public Health (AREA)
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