Modular Attachment Mechanism In Prosthetic Implants

Abstract

Disclosed is an apparatus that can be positioned in a subject to include, selectively, a modular connection portion. The modular connection portion can be provided to allow for soft tissue connection that replaces a greater trochanter of a natural femur. The soft tissue connection portion can include a plurality of regions to allow for reattachment of soft tissue in a plurality of position to mimic a natural anatomy. A method of using, selecting, and implanting the prosthesis is also disclosed.

What is claimed is: 
     
         1 . A method of implanting a prosthesis in a proximal femur, comprising:
 forming an incision in a patient;   evaluating a patient and resecting a proximal femur;   selecting a prosthesis including a connection for a soft tissue connection portion;   after forming the incision, determining whether a soft tissue connection portion is to be connected to the prosthesis;   if it is determined that a soft tissue connection portion is to be connected to the prosthesis, selecting and connecting the soft tissue connection portion; and   implanting the prosthesis into the patient.   
     
     
         2 . The method of  claim 1 , wherein the soft tissue connection portion is connected to the prosthesis, further comprising:
 connecting a soft tissue of the patient to the connected soft tissue connection portion.   
     
     
         3 . The method of  claim 2 , wherein connecting the soft tissue includes connecting with a locking member the soft tissue to a first soft tissue connection region of the soft tissue connection portion to immobilize a portion of the soft tissue to the soft tissue connection portion. 
     
     
         4 . The method of  claim 3 , further comprising;
 frictionally holding the soft tissue to the soft tissue connection portion with a porous portion at a second soft tissue connection region of the soft tissue connection portion.   
     
     
         5 . The method of  claim 4 , wherein connecting with the locking member includes:
 clamping between the first soft tissue connection region and a washer a portion of soft tissue to be immobilized; and   passing a screw through the washer to engage the soft tissue connection portion.   
     
     
         6 . The method of  claim 5 , wherein frictionally holding the soft tissue to the second soft tissue connection region occurs a distance from a location of the first soft tissue connection region. 
     
     
         7 . The method of  claim 2 , further comprising:
 selecting on the selected soft tissue connection portion at least a first soft tissue connection region and a second soft tissue connection region spaced apart from the first soft tissue connection region;   wherein connecting the soft tissue of the patient to the connected soft tissue connection portion includes connecting a first portion of the soft tissue to the first region and connecting a second portion of the soft tissue to the second region.   
     
     
         8 . The method of  claim 7 , wherein selecting and connecting the soft tissue connection portion includes connecting the soft tissue connection portion that includes at least two of an anterior facet (AF), a lateral facet (LF), a posterior facet (PF), or a superior posterior facet (SPF);
 wherein selecting at least the first soft tissue connection region and the second soft tissue connection region spaced apart from the first soft tissue connection region includes selecting for the first soft tissue connection region one of the anterior facet (AF), the lateral facet (LF), the posterior facet (PF), or the superior posterior facet (SPF) and selecting for the second soft tissue connection region a different one of the anterior facet (AF), the lateral facet (LF), the posterior facet (PF), or the superior posterior facet (SPF).   
     
     
         9 . A system of a prosthesis to replace a proximal femoral portion, comprising:
 a stem portion;   a neck portion including a head connection region;   a soft tissue connection mechanism formed by at least a portion of the neck portion including a male taper extending away from the head connection region; and   a soft tissue connection portion defining a female taper to engage the male taper and having at least a first tissue connection region spaced apart from a second tissue connection region.   
     
     
         10 . There system of  claim 9 , wherein the first region and the second region are substantially planar and meet at a raised region. 
     
     
         11 . There system of  claim 9 , wherein the first region is a first portion of a curve of the soft tissue connection portion and the second region is a second portion of the curve of the soft tissue connection portion. 
     
     
         12 . There system of  claim 11 , wherein the soft tissue connection portion extends superiorly of the head connection region. 
     
     
         13 . There system of  claim 9 , further comprising:
 a modular soft tissue connection portion configured to be connected to the soft tissue connection portion.   
     
     
         14 . There system of  claim 9 , wherein the stem portion and the neck portion are configured to be connected and implanted in an absence of the soft tissue connection portion. 
     
     
         15 . The system of  claim 9 , further comprising:
 a washer fixation system to immobilize soft tissue to the first region;   wherein the second region includes a porous surface to frictionally engage the soft tissue.   
     
     
         16 . A system of a prosthesis to replace a proximal femoral portion, comprising:
 a stem portion;   a neck portion including a head connection region;   a soft tissue connection mechanism formed by at least a portion of a lateral region of the neck portion including one of a tapered rail, wherein the tapered rail includes an edge that tapers outwardly from a central axis of the tapered rail or a groove to engage the tapered rail; and   a soft tissue connection portion defining the other of the tapered rail or the groove that engages the tapered rail to fix the soft tissue connection portion of the soft tissue connection mechanism;   wherein the soft tissue connection portion includes at least a first region for connection of soft tissue offset at an angle relative to a second region for connection of soft tissue.   
     
     
         17 . There system of  claim 16 , wherein the first region and the second region are substantially planar. 
     
     
         18 . There system of  claim 17 , wherein the first region is a first portion of a curve of the soft tissue connection portion and the second region is a second portion of the curve of the soft tissue connection portion. 
     
     
         19 . There system of  claim 16 , wherein the soft tissue connection portion extends superiorly of the head connection region. 
     
     
         20 . There system of  claim 16 , further comprising:
 a modular soft tissue connection portion configured to be connected to the soft tissue connection portion.   
     
     
         21 . There system of  claim 16 , wherein the stem portion and the neck portion are configured to be connected and implanted in an absence of the soft tissue connection portion. 
     
     
         22 . The system of  claim 16 , wherein the soft tissue connection portion extends from a first end to a second end, wherein the first end includes a bulbous region. 
     
     
         23 . A kit for a system of a prosthesis to replace a proximal femoral portion, comprising:
 a stem portion;   a neck portion including a head connection region;   a soft tissue connection mechanism formed by at least a portion of the neck portion; and   a plurality of soft tissue connection portions, wherein each of the plurality of soft tissue connection portions include a different external dimension to engage soft tissue.   
     
     
         24 . The kit of  claim 23 , wherein the neck portion includes a male taper;
 wherein each of the plurality of soft tissue connection portions includes a female taper to engage the male taper.   
     
     
         25 . The kit of  claim 23 , wherein the neck portion includes a soft tissue connection mechanism formed by at least a portion of the neck portion including a tapered rail, wherein the tapered rail includes an edge that tapers outwardly from a central axis of the tapered rail;
 wherein each of the plurality of soft tissue connection portions includes a groove to engage the tapered rail to fix the soft tissue connection portion of the soft tissue connection mechanism;   wherein each of the plurality of the soft tissue connection portion includes at least a first region for connection of soft tissue offset at an angle relative to a second region for connection of soft tissue.   
     
     
         26 . The kit of  claim 25 , wherein in each of the plurality of soft tissue connection portions the first region is at least one of a different size or spaced a different distance from the second region. 
     
     
         27 . The kit of  claim 24 , wherein each of the plurality of the soft tissue connection portion includes at least a first region for connection of soft tissue offset at a different angle relative to a second region for connection of soft tissue.