US2009287309A1PendingUtilityA1

Intra-articular joint replacement

59
Assignee: TORNIER SASPriority: Jan 30, 2007Filed: Dec 17, 2008Published: Nov 19, 2009
Est. expiryJan 30, 2027(~0.5 yrs left)· nominal 20-yr term from priority
Inventors:Gilles WalchYves-Alain Ratron
A61F 2002/4243A61F 2/4014A61F 2002/4085A61F 2/4612A61F 2002/30642A61L 27/042A61F 2/28A61F 2/4081A61F 2002/4233A61F 2002/30433A61B 17/1684A61F 2310/00359A61F 2002/4228A61F 2/4644A61F 2002/30911A61B 17/1686A61F 2/40A61B 17/86A61B 17/84A61F 2220/0041A61F 2002/30909A61F 2/30A61B 17/885A61F 2310/00017A61F 2002/3096A61L 27/18A61F 2310/00023A61B 17/1682A61B 17/8866A61B 17/1739A61L 27/10A61B 17/15A61F 2310/00131A61F 2310/00179A61F 2002/4251A61L 27/06A61B 17/842A61F 2002/4022A61F 2310/00161A61F 2002/4062A61B 2017/00951A61F 2002/30754A61F 2/4059A61L 27/52A61L 27/16A61B 17/0401A61L 27/047
59
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Claims

Abstract

A method for implanting an intra-articular shoulder prosthesis is provided. The method includes removing a proximal portion of a humerus. The proximal portion of the humerus preferably forms a resected portion. The resected portion has a convex outer surface and an inner surface. The method further includes engaging the convex outer surface of the resected portion with a cut surface of the proximal portion of the humerus. The cut surface of the proximal portion of the humerus and/or the inner surface of the resected portion are optionally processed to form a generally concave surface, such as by impacting. In one embodiment, the inner surface of the resected portion is impacted into engagement with the cut surface of the proximal portion of the humerus. The generally concave inner surface of the resected portion forms a concave articular surface to receive an interpositional implant.

Claims

exact text as granted — not AI-modified
1 . A method of forming a prosthesis at the intersection of at least two bones, the method comprising the steps of:
 removing a proximal or distal portion of a bone to comprise a resected portion with an outer convex surface and an inner surface;   processing the inner surface of the resected portion to comprise a concave articular surface;   implanting the outer convex surface of the resected portion in a cut surface of the bone; and   positioning an interpositional implant in the concave articular surface.   
     
     
         2 . The method of  claim 1  comprising the steps of:
 positioning a cutting template on the bone; and   cutting the bone according to the cutting template.   
     
     
         3 . The method of  claim 1  wherein the step of processing the inner surface of the resected portion comprises compacting cancellous bone. 
     
     
         4 . The method of  claim 1  wherein the step of processing the inner surface of the resected portion comprises removing at least a portion of cancellous bone in the resected portion. 
     
     
         5 . The method of  claim 1  comprising the step of implanting the outer convex surface of the resected portion in the cut surface before processing the inner surface of the resected portion. 
     
     
         6 . The method of  claim 1  wherein the resected portion comprises a unitary structure. 
     
     
         7 . The method of  claim 1  comprising the step of compacting the cut surface of the bone to form a recess with a shape generally corresponding to the outer convex surface of the resected portion. 
     
     
         8 . The method of  claim 1  comprising the step of reaming the cut surface of the bone to form a recess with a shape generally corresponding to the outer convex surface of the resected portion. 
     
     
         9 . The method of  claim 1  comprising the steps of:
 locating the outer convex surface of the resected portion on the cut surface of the bone; and   impacting the resected portion into the cut surface of the bone.   
     
     
         10 . The method of  claim 1  wherein the step of implanting the resected portion comprises the step of arranging a plurality of pieces of the resected portion in the cut surface of the bone. 
     
     
         11 . The method of  claim 1  comprising attaching the resected portion to the cut surface of the bone using one or more of fasteners, bone anchors, or sutures. 
     
     
         12 . The method of  claim 1  comprising the step of locating a reinforcing structure between the outer convex surface of the resected portion and the cut surface of the bone. 
     
     
         13 . The method of  claim 1  comprising the steps of:
 positioning a reinforcing structure across at least a portion of the cut surface of the bone; and   attaching the reinforcing structure to the bone.   
     
     
         14 . The method of  claim 1  comprising selecting the interpositional implant from one of a sphere or a disc. 
     
     
         15 . The method of  claim 1  comprising coating the interpositional implant with pyrolytic carbon. 
     
     
         16 . The method of  claim 1  comprising drilling apertures in the cut surface before implanting the resected portion. 
     
     
         17 . The method of  claim 1  wherein the bone comprises a proximal portion of a humerus. 
     
     
         18 . A method of forming a shoulder prosthesis, the method comprising the steps of:
 removing a proximal portion of a humerus to comprise a resected portion with an outer convex surface and an inner surface;   processing the inner surface of the resected portion to comprise a concave articular surface;   implanting the outer convex surface of the resected portion in a cut surface of the proximal portion of the humerus; and   positioning an interpositional implant in the concave articular surface.   
     
     
         19 . The method of  claim 18  comprising the steps of:
 positioning a cutting template on the proximal portion of the humerus; and   cutting the proximal portion of the humerus according to the cutting template.   
     
     
         20 . The method of  claim 18  wherein the step of implanting the resected portion comprises the step of arranging a plurality of pieces of the resected portion in the cut surface of the proximal portion of the humerus. 
     
     
         21 . The method of  claim 18  comprising attaching the resected portion to the cut surface of the proximal portion of the humerus using one or more of fasteners, bone anchors, or sutures. 
     
     
         22 . The method of  claim 18  comprising the step of locating a reinforcing structure between the outer convex surface of the resected portion and the cut surface of the proximal portion of the humerus. 
     
     
         23 . The method of  claim 18  comprising the steps of:
 positioning a reinforcing structure across at least a portion of the cut surface of the proximal portion of the humerus; and   attaching the reinforcing structure to the proximal portion of the humerus.   
     
     
         24 . The method of  claim 18  comprising the step of positioning a support stem in a medullary cavity to support the resected portion. 
     
     
         25 . The method of  claim 24  comprising the step of attaching the resected portion to the support stem. 
     
     
         26 . A method for replacing a joint between a first bone structure and a second bone structure, the method comprising:
 resecting a convex portion of the first bone structure to form a resected portion having a convex surface, wherein the first bone structure has a cut surface after resecting the convex portion;   positioning the convex surface of the resected portion against the cut surface of the first bone structure; and   driving the resected portion as a single piece into the cut surface of the first bone structure to form a concave articular surface.   
     
     
         27 . The method of  claim 26  comprising the step of processing the cut surface of the first bone structure to form a recess with a shape generally corresponding to the outer convex surface of the resected portion. 
     
     
         28 . The method of  claim 26  comprising the steps of:
 locating the outer convex surface of the resected portion on the cut surface of the first bone structure; and   impacting the resected portion into the cut surface of the first bone structure.   
     
     
         29 . The method of  claim 26  comprising locating an interpositional implant in the concave articular surface. 
     
     
         30 . The method of  claim 29  comprising coating the interpositional implant with pyrolytic carbon. 
     
     
         31 . The method of  claim 26  comprising engaging a convex surface of a glenosphere attached to the second bone structure with the concave articular surface of the first bone structure. 
     
     
         32 . The method of  claim 26  wherein the first bone structure and the second bone structure are located in one of a foot and a hand. 
     
     
         33 . The method of  claim 26  comprising replacing the joint by engaging a convex surface on the second bone with the concave articular surface. 
     
     
         34 . The method of  claim 26  comprising replacing the joint by engaging a prosthetic element on the second bone with the concave articular surface. 
     
     
         35 . A shoulder prosthesis comprising:
 a resected portion of a proximal portion of a humerus comprising an outer convex surface engaged with a cut surface of the humerus and an inner surface processed to comprise a concave articular surface; and   an interpositional implant positioned within the concave articular surface.   
     
     
         36 . The shoulder prosthesis of  claim 35  wherein the inner surface of the resected portion comprises compacting cancellous bone against cortical bone comprising the outer convex surface. 
     
     
         37 . The shoulder prosthesis of  claim 35  wherein the inner surface of the resected portion comprises cortical bone. 
     
     
         38 . The shoulder prosthesis of  claim 35  wherein the resected portion comprises one of a unitary structure or a plurality of pieces. 
     
     
         39 . The shoulder prosthesis of  claim 35  comprising one or more fasteners, bone anchors, or sutures adapted to attach the resected portion to a cut surface of the proximal portion of the humerus. 
     
     
         40 . The shoulder prosthesis of  claim 35  comprising a reinforcing structure located between the outer convex surface of the resected portion and a cut surface of the proximal portion of the humerus. 
     
     
         41 . The shoulder prosthesis of  claim 35  comprising a support stem adapted for insertion into a medullary cavity to support the resected portion. 
     
     
         42 . The shoulder prosthesis of  claim 35  comprising one or more fasteners attaching the resected portion to the support stem. 
     
     
         43 . The shoulder prosthesis of  claim 35  wherein the interpositional implant comprises one of a sphere or a disc. 
     
     
         44 . The shoulder prosthesis of  claim 35  wherein the interpositional implant comprises pyrolytic carbon. 
     
     
         45 . A prosthesis comprising:
 a resected portion of a bone structure comprising an outer convex surface and an inner surface processed to comprise a concave articular surface; and   an interpositional implant positioned within the concave articular surface.   
     
     
         46 . The prosthesis of  claim 45  wherein the interpositional implant comprises one of a sphere or a disc. 
     
     
         47 . The prosthesis of  claim 45  wherein the interpositional implant is located in one of a shoulder, a hip, an ankle, a foot, and a hand. 
     
     
         48 . A prosthesis joint between a first bone structure and a second bone structure comprising:
 a resected portion of the first bone structure comprising an outer convex surface engaged with a cut surface of the first bone, and an inner surface of the resected portion comprising a concave articular surface; and   a convex portion of the second bone engaged with the concave articular surface comprising the prosthetic joint.

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