[go: up one dir, main page]

WO2025174836A1 - Système de remplacement total de cheville - Google Patents

Système de remplacement total de cheville

Info

Publication number
WO2025174836A1
WO2025174836A1 PCT/US2025/015529 US2025015529W WO2025174836A1 WO 2025174836 A1 WO2025174836 A1 WO 2025174836A1 US 2025015529 W US2025015529 W US 2025015529W WO 2025174836 A1 WO2025174836 A1 WO 2025174836A1
Authority
WO
WIPO (PCT)
Prior art keywords
component
talar
fixation
tibial
top surface
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.)
Pending
Application number
PCT/US2025/015529
Other languages
English (en)
Inventor
Adam Garlock
Maris PRIEDITIS
Braham Dhillon
Brandton FERRIN
Mihaela Morar
Scott DOODY
Ryan Keefer
John Lambert
Jake CHARLES
Benjamin Chan
Scott Smyth
Darin Ewer
Trevor Lewis
Ernst RACHLITZ
Steven IDEN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Arthrex Inc
Original Assignee
Arthrex Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Arthrex Inc filed Critical Arthrex Inc
Publication of WO2025174836A1 publication Critical patent/WO2025174836A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1613—Component parts
    • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1659—Surgical rasps, files, planes, or scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1682—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the foot or ankle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1775—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4606—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of wrists or ankles; of hands, e.g. fingers; of feet, e.g. toes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0206—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors with antagonistic arms as supports for retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/025—Joint distractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1604—Chisels; Rongeurs; Punches; Stamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • A61B17/848—Kirschner wires, i.e. thin, long nails
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4684—Trial or dummy prostheses
    • 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
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/30004—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis
    • A61F2002/30011—Material related properties of the prosthesis or of a coating on the prosthesis the prosthesis being made from materials having different values of a given property at different locations within the same prosthesis differing in porosity
    • 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
    • A61F2002/30108—Shapes
    • A61F2002/3011—Cross-sections or two-dimensional shapes
    • A61F2002/30159—Concave polygonal shapes
    • A61F2002/30161—Concave polygonal shapes arrow-shaped
    • 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
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/30387—Dovetail connection
    • 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
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30784—Plurality of holes
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30841—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
    • A61F2002/30845—Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes with cutting edges
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/3092—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth having an open-celled or open-pored structure
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/3093—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth for promoting ingrowth of bone tissue
    • 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
    • A61F2/3094—Designing or manufacturing processes
    • A61F2002/30985—Designing or manufacturing processes using three dimensional printing [3DP]
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4205—Tibial components
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4202—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for ankles
    • A61F2002/4207—Talar components
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4627—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4625—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use
    • A61F2002/4628—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof with relative movement between parts of the instrument during use with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles
    • 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
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4681—Special tools for implanting artificial joints by applying mechanical shocks, e.g. by hammering

Definitions

  • Total ankle replacement requires fixation of the tibial component to the tibia of a patient, and further requires fixation of the talar component to the talus of the patient. Improving time zero fixation by the inclusion of high retention force features may aide in the long term survival of the tibial component. Accordingly, disclosed herein are total ankle replacement systems that provide a high retention force to aid in preventing loosening after initial implantation.
  • Total ankle replacement requires a prosthesis to replace resected bone and eroded joint cartilage.
  • the component that replaces the distal tibia historically has left room for improvement for initial fixation (time zero fixation) to bone.
  • Some of the challenges lay within the exposure required to use instruments that would adequately prepare the bone for the final implant.
  • Fixation that includes vertical pegs are the most difficult to prepare due to lack of exposure in the ankle joint space .
  • Angled pegs have been used to solve the issue of exposure : however, the time zero fixation for such design leaves room for improvement.
  • Other previous designs have used an anterior approach where the anterior cortex is breached using drills and osteotomes.
  • the present disclosure provides a tibial tray that incorporates an anterior approach but with a minimal breach of bone tissue.
  • the fixation would also be designed in a manner that when impacted to final position, the tibial tray provides compression with respect to the resected bone, thereby helping to improve time zero fixation.
  • the system includes a tibial component having a top surface and a bottom surface opposite the top surface.
  • the tibial component includes at least one fixation component extending away from the top surface of the tibial component.
  • the at least one fixation component includes a first end and a second end opposite the first end.
  • the system also includes a talar component comprising having a top surface and a bottom surface opposite the top surface.
  • the top surface of the talar component includes a groove extending from a posterior side of the talar component to an anterior side of the talar component.
  • the system also includes an articulation component having a top surface and a bottom surface opposite the top surface.
  • the top surface of the articulation component is configured to mate with the bottom surface of the tibial component.
  • the bottom surface of the articulation component is configured to contact the top surface of the talar component when in use.
  • a method can include (i) forming a channel in an anterior side of a tibia, and (ii) positioning the fixation component of the tibial component of the first aspect into the channel, (iii) positioning the bottom surface of the talar component of the first aspect onto a talar of the patient, (iv) positioning the top surface of the articulation component of the first aspect in contact with the bottom surface of the tibial component to thereby secure the tibial component to the articulation component such that the articulation component is positioned between the talar component and the tibial component.
  • Figures 1A-1E provide a plurality of views of an example tibial component of a total ankle replacement system.
  • Figures 2A-2D provide a plurality of views of another example tibial component of a total ankle replacement system.
  • Figure 3 provides another example tibial component of a total ankle replacement system.
  • Figure 4 provides a plurality of fixation components for an example tibial component of a total ankle replacement system.
  • Figures 5A-5D provide a plurality of views of another example tibial component of a total ankle replacement system.
  • Figures 6A-6D provide a plurality of views of another example tibial component of a total ankle replacement system.
  • Figures 8A-8F provide a plurality of views of an example talar component of a total ankle replacement system.
  • Figures 9A-9F provide a plurality of views of another example talar component of a total ankle replacement system.
  • Figures 10A-10F provide a plurality of views of another example talar component of a total ankle replacement system.
  • Figures 11A-11E provide a plurality of views of another example talar component of a total ankle replacement system.
  • Figures 12A-12D provide a plurality of views of an articulation component of a total ankle replacement system configured to be coupled to a tibial component.
  • Figure 13 provides a gutter sword for use in a total ankle replacement procedure .
  • Figure 14A provides a pin targeter for use in a total ankle replacement procedure.
  • Figure 14B provides another pin targeter for use in a total ankle replacement procedure.
  • Figure 15A provides a distal targeting and alignment guide for use in a total ankle replacement procedure.
  • Figure 15B provides another distal targeting and alignment guide for use in a total ankle replacement procedure.
  • Figure 16 provides an angel wing for use in a total ankle replacement procedure.
  • Figure 17A provides a tibia outline for use in a total ankle replacement procedure.
  • Figure 17B provides another tibia outline for use in a total ankle replacement procedure.
  • Figure 18A provides a sagittal aligner for use in a total ankle replacement procedure.
  • Figure 18B provides another a sagittal aligner for use in a total ankle replacement procedure.
  • Figure 18C provides another a sagittal aligner for use in a total ankle replacement procedure.
  • Figure 19A provides a top view of the angle wing, tibia outline, and sagittal aligner for use in a total ankle replacement.
  • Figure 19B provides a perspective view of the angle wing, tibia outline, and sagittal aligner for use in a total ankle replacement.
  • Figure 20 provides a reaming guide for use in a total ankle replacement procedure.
  • Figure 21 provides another reaming guide for use in a total ankle replacement procedure.
  • Figures 22A-22E provides views of a saw cut guide for use in a total ankle replacement procedure.
  • Figures 23A-23E provides a saw cut comer pin and various cut guide components for use in a total ankle replacement procedure.
  • Figure 24 provides a tibial rasping guide for use in a total ankle replacement procedure.
  • Figure 25 provides a side cutting ridge reaming guide for use in a total ankle replacement procedure.
  • Figures 26A-26B provide a rasp for use in a total ankle replacement procedure.
  • Figure 27 provides another rasp for use in a total ankle replacement procedure.
  • Figures 28A-28B provide a tibia tray trial for use in a total ankle replacement procedure.
  • Figure 29 provides a starting broach for use in a total ankle replacement procedure.
  • Figure 30 provides a finishing broach for use in a total ankle replacement procedure.
  • Figure 31A provides an articulation component trial for use in a total ankle replacement procedure.
  • Figure 32A provides an articulation component trial handle for use in a total ankle replacement procedure.
  • Figure 33A provides a flat cut talus trial for use in a total ankle replacement procedure.
  • Figure 33B provides another flat cut talus trial for use in a total ankle replacement procedure.
  • Figure 33C provides another flat cut talus trial for use in a total ankle replacement procedure.
  • Figure 33D provides a drill guide for use with the flat cut talus trial of Figure 33C for use in a total ankle replacement procedure.
  • Figure 33E provides the flat cut talus trial of Figure 33C with the drill guide of Figure 33D for use in a total ankle replacement procedure.
  • Figure 35 provides a talar reaming guide for use in a total ankle replacement procedure.
  • Figures 36A-36D provide a plurality of views of a chamfer cutting guide for use in a total ankle replacement procedure
  • Figure 38 provides a recut guide for use in a total ankle replacement procedure.
  • Figure 39 provides a chamfer cut trial for use in a total ankle replacement procedure.
  • Figure 40 provides an uncoupled talus guide for use in a total ankle replacement procedure.
  • Figure 42 provides a cut guide spacer for use in a total ankle replacement procedure.
  • Figure 44 provides a talus inserter for use in a total ankle replacement procedure.
  • Figure 48 provides a parallel distractor for use in a total ankle replacement procedure.
  • Figure 50 provides a talus distractor for use in a total ankle replacement procedure.
  • Figure 51 provides another articulation component inserter for use in a total ankle replacement procedure.
  • Figure 52 provides a capsule release tool for use in a total ankle replacement procedure.
  • Figure 53 provides a tibia trial removal tool for use in a total ankle replacement procedure.
  • Figure 54 provides a parallel distractor for use in a total ankle replacement procedure.
  • Figure 55 provides a driver and minimum resection height tool for use in a total ankle replacement procedure.
  • Figure 56 provides a tibia tray protective insert for use in a total ankle replacement procedure.
  • Figures 1A-12D illustrate various components of a system for use in total ankle replacement procedures.
  • the system includes a tibial component 102 having a top surface 104 and a bottom surface 106 opposite the top surface 104.
  • the tibial component 102 includes at least one fixation component 108 extending away from the top surface 104 of the tibial component 102.
  • the at least one fixation component 108 includes a first end 110 and a second end 112 opposite the first end 110.
  • the system also includes a talar component 202 having a top surface 204 and a bottom surface 206 opposite the top surface 204.
  • the top surface 204 of the talar component 202 includes a groove 208 extending from a posterior side 210 of the talar component 202 to an anterior side 212 of the talar component 202.
  • the system also includes an articulation component 302 having a top surface 304 and a bottom surface 306 opposite the top surface 304.
  • the top surface 304 of the articulation component 302 is configured to mate with the bottom surface 106 of the tibial component 102.
  • the bottom surface 306 of the articulation component 302 is configured to contact the top surface 204 of the talar component 202 when in use.
  • Figures 1A-7D each illustrate various examples of the tibial component 102, which is configured to be positioned within a tibia of a patient when in use.
  • Each of the tibial components 102 of Figures 1A-7D are designed for fixation to a bone (e.g., atibia) of a patient using an anterior approach.
  • the first end 110 of the at least one fixation component 108 has a first width
  • the second end 112 of the at least one fixation component 108 has a second width that is greater than the first width.
  • the first end 110 of the at least one fixation component 108 comprises a cutting surface.
  • the tibial component 102 includes a first end 114 and a second end 116 opposite the first end 114, and the first end 110 of the at least one fixation component 108 is offset from the first end 114 of the tibial component 102.
  • the second end 112 of the at least one fixation component 108 is offset from the second end 116 of the tibial component 102.
  • the tibial component 102 comprises a first material, and the at least one fixation component 108 comprises a second material that is different from the first material.
  • the first material comprises titanium
  • the second material comprises a nickel-titanium alloy.
  • the tibial component 102 comprises a single-piece design that is 3D printed with a porous structure.
  • the tibial component 102 comprises a two or three-piece design that is supplied to user as an assembled system.
  • tibial component 102 comprises a two or three-piece design that is supplied to user in parts and is assembled on the back table by a medical professional prior to use.
  • the at least one fixation component 108 includes one or more through-holes 118 between the first end 110 and the second end 112.
  • the at least one fixation component 108 includes a first side 120 and a second side 122 opposite the first side 120, and the first side 120 and the second side 122 of the at least one fixation component 108 each include a plurality of indents 124 positioned between the first end 110 and the second end 112.
  • the plurality of indents 124 may act as anti-backout features to prevent the tibial component 102 from moving in an anterior direction after insertion into the tibia of the patient.
  • the at least one fixation component 108 includes a first side 120 and a second side 122 opposite the first side 120, and the first side 120 and the second side 122 of the at least one fixation component 108 each include a plurality of channels 126 extending from the first end 110 to the second end 112.
  • the at least one fixation component 108 includes a first side 120 and a second side 122 opposite the first side 120, and the first side 120 and the second side 122 of the at least one fixation component 108 each include a plurality of angled surfaces 128 extending from the first end 110 to the second end 112.
  • the at least one fixation component 108 may be parallel to the top surface 104 of the tibial component 102, then instrumentation providing an upward/superior force may be required during impaction.
  • the at least one fixation component 108 may be designed such that the geometry provides a slope allowing for upward pressure to be applied while the implant is being impacted.
  • a height of the first end 110 of the at least one fixation component 108 is greater than a height of the second end 112 of the at least one fixation component 108 to thereby provide dynamic compression after implantation. Further compression can be achieved by the at least one fixation component 108 bending slightly during impaction, thereby acting like a spring and therefore providing dynamic compression after impact.
  • the porous structure may act as bone cement retaining feature for the tibial component 102.
  • Figure 3 illustrates another example of the fixation component 108 of the tibial component 102. As shown in Figure 3, the fixation component 108 includes a portion with a triangular cross-section, and a cutting surface at one end of the fixation component.
  • Figure 4 illustrates a variety of cross-sections for the fixation component 108 of the tibial component 102.
  • Figures 5A-5D illustrate another example of the fixation component 108 of the tibial component 102.
  • the fixation component 108 includes a curved keel with a needle point 134 to help reduce stress shielding.
  • the fixation component 108 may further include anti-backout features (e.g., idents 124).
  • FIGS 6A-6D illustrate another example of the fixation component 108 of the tibial component 102.
  • the fixation component 108 includes a curved keel for a portion of the fixation component 108 with a needle point 134 to help reduce stress shielding.
  • the fixation component 108 may further include indents 124 as well as a curved feature 136 adjacent the second end 112. The curved feature 136 prevents posterior migration of the tibial component 102.
  • each of the first side surface 130 and the second side surface 132 include a groove 138 positioned along at least a portion of the length of the first side surface 130 and the second side surface 132.
  • the groove 138 provides additional stability of the tibial component 102 within the tibia.
  • the bottom surface 106 of the tibial component 102 includes a recess 140 configured to receive the top surface 304 of the articulation component 302.
  • the recess 140 may include a first end 142 and a second end 144 opposite the first end 142, and a width of the first end 142 may be greater than a width of the second end 144 to ease insertion of the articulation component 302 into the recess 140.
  • the recess 140 further includes a locking component 146 that is configured to interact with a protrusion 308 of the articulation component 302 to thereby secure the articulation component 302 to the tibial component 102.
  • Figures 8A-11E each illustrate various examples of the talar component 202, which is configured to be positioned within a talus of a patient when in use.
  • the bottom surface 206 of the talar component 202 is substantially flat.
  • the bottom surface 206 of the talar component includes one or more interosseous fixation elements 214 extending away from the bottom surface 206.
  • the one or more interosseous fixation elements 214 comprise a pair of talar pegs, and each of the pair of talar pegs are angled between 0 and 90 degrees with respect to the bottom surface 206 of the talar component 202.
  • each of the pair of talar pegs are perpendicular to the bottom surface 206 of the talar component 202.
  • at least a portion of the one or more interosseous fixation elements 214 include a porous structure positioned thereon.
  • at least a portion of the bottom surface 206 of the talar component includes a porous structure positioned thereon.
  • the porous structure may advantageously promote bone ingrowth/on growth of the talar component 202.
  • the porous structure may act as bone cement retaining feature for the talar component 202.
  • the talar component 202 may further include a peg extending from at least one side surface.
  • the bottom surface 206 of the talar component 202 is substantially flat and includes three interosseous fixation elements 214 extending away from the bottom surface 206 at a non-zero angle with respect to the bottom surface 206.
  • the talar component 202 may further include a peg extending from at least one side surface.
  • the bottom surface of the talar component 202 is substantially flat and includes two interosseous fixation elements 214 extending away from the bottom surface 206 at a non-zero angle with respect to the bottom surface 206 and a spike 216 extending from the bottom surface 206 of the talar component 202.
  • the spike 216 may include a pointed tip configured to enter the talus of the patient during installation of the talar component 202 to further aid in securing the talar component 202 to the talus of the patient.
  • the talar component 202 may further include a peg extending from at least one side surface.
  • the bottom surface 206 of the talar component 202 includes a first angled surface 218 adjacent the anterior side 212 of the talar component 202, a second angled surface 220 adjacent the posterior side 210 of the talar component 202, and a substantially flat surface 222 positioned between the first angled surface 218 and the second angled surface 220.
  • at least a portion of the first angled surface 218, the second angled surface 220, and the substantially flat surface 222 of the talar component 202 each include a porous structure positioned thereon.
  • the one or more interosseous fixation elements 214 comprise three talar pegs, and each of the three talar pegs are angled between 0 and 90 degrees with respect to the first angled surface 218 of the talar component 202. In one particular example, each of the three talar pegs are not perpendicular to the first angled surface 218 of the talar component 202. In an example, at least a portion of the one or more interosseous fixation elements 214 include a porous structure positioned thereon.
  • the bottom surface 206 of the talar component 202 of Figures 11A-11E includes two interosseous fixation elements 214 extending away from the bottom surface 206 at a non-zero angle with respect to the first angled surface 218 of the talar component and a spike 216 extending from the second angled surface 220 of the talar component 202.
  • the spike 216 may include a pointed tip configured to enter the talus of the patient during installation to further aid in securing the talar component 202 to the talus of the patient.
  • Figures 28A-28B provide a tibia tray trial 432 for use in a total ankle replacement procedure.
  • the tibia tray trial 432 includes a slot to guide the starting and finishing broaches.
  • the tibia tray trial 432 also includes dovetail to hold the articulation component trial 438.
  • the tibia tray trial 432 also includes grooves to indicate implant length and keel position.
  • the tibia tray trial 432 also includes holes allowing it to slide over tibial pins.
  • Figures 32A-32B provide examples of an articulation component trial handle 440 for use in a total ankle replacement procedure.
  • the articulation component trial handle 440 attaches to the articulation component trial 438 and releases the spring -loaded feature in the articulation component trial 438 when inserted, and can be disengaged by pressing the button.
  • Figures 33A-33B provides a flat cut talus trial 442 for use in a total ankle replacement procedure.
  • the flat cut talus trial 442 includes a lollipop handle, guidewires or shouldered pin holes and peg prep guide holes.
  • the flat cut talus trial 442 has fully or semi constrained geometry with the articulation component trial 438.
  • Figures 33C-33E show an alternative embodiment of the flat cut talus trial 442 including a drill guide 444 that slides into the flat cut talus trial 442 and can be used to drill peg holes.
  • Figure 34 provides a peg drill guide 446 for use in a total ankle replacement procedure.
  • Figure 35 provides a reaming guide 448 for use in a total ankle replacement procedure.
  • the reamer insert hole pattern varies with size for anterior chamfer.
  • Figures 36A-36D provide a plurality of views of a chamfer cutting guide 450 for use in a total ankle replacement procedure .
  • the chamfer cutting guide 450 includes a spacer 451 that attaches to tibial component 102/tibia tray trial 432 and to the chamfer cut trial 456.
  • the chamfer cutting guide 450 allows the tibia to drive the location of the talus.
  • the chamfer cutting guide 450 is pinned and all other components are removed.
  • the posterior chamfer cut is performed with a sawblade.
  • Figure 37 provides an uncoupled talus guide 452 for use in a total ankle replacement procedure.
  • the uncoupled talus guide 452 generates tension in the ligaments prior to cutting the talus.
  • Figure 40 provides another example uncoupled talus guide 452 for use in a total ankle replacement procedure.
  • the talus guide 452 is configured to be used with the talus distractor 478.
  • the talus guide 452 may include removable spacers to combat bony defects.
  • the talus guide 452 includes chamber and flat cut saw slots.
  • the talus guide 452 may include a short and a long version for various patient sizes.
  • Figure 41 provides another example recut guide 454 for use in a total ankle replacement procedure.
  • the recut guide 454 allows for additional 2mm to be removed from the talus.
  • the talus guide 452 is configured to be used with the talus distractor 478.
  • Figures 43 A-43B provide examples of a tibia inserter 460 for use in a total ankle replacement procedure.
  • the tibia inserter 460 includes actuated detents to hold tibial component 102 implant in place.
  • actuation of the tibia inserter 460 is done by knob rotation.
  • actuation of the tibia inserter 460 is done by a lever.
  • the tibia inserter 460 includes a metal inserter with size specification polymer impaction spacers.
  • Figure 44 provides a talus inserter 462 for use in a total ankle replacement procedure.
  • the talus inserter 462 includes a handle with interchangeable angled tips, for flat/chamfer implants.
  • the talus inserter 462 includes tips with grip features to hold talar component 202 implants.
  • the grip features of the talus inserter 462 are positioned in the first cutout 224 and the second cutout 226 of the talar component 202 during installation.
  • Figure 45 provides a talus impactor 464 for use in a total ankle replacement procedure.
  • Figure 46 provides an articulation component inserter 466 for use in a total ankle replacement procedure.
  • the articulation component inserter 466 mates with the tibial component 102, and includes a screw driven with a ratchet.
  • the articulation component inserter 466 may also be a shaft attached to a standard handle.
  • Figure 48 provides a parallel distractor 474 for use in a total ankle replacement procedure.
  • the parallel distractor 474 shown in Figure 48 is used to aid in insertion of the tibial component 102 by providing an upward pressure during broaching/insertion of the tibial component 102.
  • Figure 54 provides a parallel distractor 484 for use in a total ankle replacement procedure.
  • the parallel distractor can be used to distracts two edges parallel.
  • the parallel distractor can be used to place tibial trials or final tibial component implant.
  • Figure 55 provides a driver and minimum resection height tool 486 for use in a total ankle replacement procedure. Parallel edges of the handle driver and minimum resection height tool 486 can be inserted into final resection to determine if it meets the minimum resection height.
  • the driver and minimum resection height tool 486 may include a hexalobe or a hex style tip.
  • Figure 56 provides a tibia tray protective insert 488 for use in a total ankle replacement procedure.
  • the tibia tray protective insert 488 protects the talar component 202 from contact with the tibial component 102 implant during insertion.
  • Figures 57A-57B provide a hybrid guide 490 with reaming drill sleeve for use in a total ankle replacement procedure in a total ankle replacement procedure .
  • the hybrid guide 490 contains reamed superior comers and medial-lateral walls. The top two holes on each side are vertical, and the bottom two holes on each side are angled.
  • the hybrid guide 490 further contains a superior saw blade cut, coupled with chamfer and flat cut talus saw slots.
  • the hybrid guide 490 further includes central holes for 3.2 mm and 2.4 mm threaded headed pin placement to hold guide to bone.
  • a method can include drilling a channel in an anterior side of a tibia. In an example, the channel does not extend entirely through the tibia.
  • the method can also include positioning the fixation component of the tibial component of the system of any one of the embodiments described above into the channel.
  • the method can also include positioning the bottom surface of the talar component of the system of any one of the embodiments described above onto a talar of the patient.
  • the method can also include positioning the top surface of the articulation component of the system of any one of the embodiments described above in contact with the bottom surface of the tibial component to thereby secure the tibial component to the articulation component such that the articulation component is positioned between the talar component and the tibial component.
  • positioning the fixation component of the tibial component into the channel comprises using one or more impaction instruments.
  • the channel is formed using a sharp broach.
  • Coupled means associated directly as well as indirectly.
  • a member A may be directly associated with a member B, or may be indirectly associated therewith, e.g., via another member C. It will be understood that not all relationships among the various disclosed elements are necessarily represented.
  • first,” “second,” etc. are used herein merely as labels, and are not intended to impose ordinal, positional, or hierarchical requirements on the items to which these terms refer. Moreover, reference to, e.g., a “second” item does not require or preclude the existence of, e.g., a “first” or lower-numbered item, and/or, e.g., a “third” or higher-numbered item.
  • references herein to “one embodiment” or “one example” means that one or more feature, structure, or characteristic described in connection with the example is included in at least one implementation.
  • the phrases “one embodiment” or “one example” in various places in the specification may or may not be referring to the same example.
  • a system, apparatus, structure, article, element, component, or hardware “configured to” perform a specified function is indeed capable of performing the specified function without any alteration, rather than merely having potential to perform the specified function after further modification.
  • the system, apparatus, structure, article, element, component, or hardware “configured to” perform a specified function is specifically selected, created, implemented, utilized, programmed, and/or designed for the purpose of performing the specified function.
  • “configured to” denotes existing characteristics of a system, apparatus, structure, article, element, component, or hardware which enable the system, apparatus, structure, article, element, component, or hardware to perform the specified function without further modification.
  • a system, apparatus, structure, article, element, component, or hardware described as being “configured to” perform a particular function may additionally or alternatively be described as being “adapted to” and/or as being “operative to” perform that function.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Dentistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un système comprenant : un composant tibial ayant une surface supérieure et une surface inférieure opposée à la surface supérieure, le composant tibial comprenant au moins un composant de fixation s'étendant à l'opposé de la surface supérieure du composant tibial, et le ou les composants de fixation comprenant une première extrémité et une seconde extrémité opposée à la première extrémité ; un composant astragalien comprenant une surface supérieure et une surface inférieure opposée à la surface supérieure, la surface supérieure du composant astragalien comprenant une rainure s'étendant d'un côté postérieur du composant astragalien à un côté antérieur du composant astragalien ; et un composant d'articulation ayant une surface supérieure et une surface inférieure opposée à la surface supérieure, la surface supérieure du composant d'articulation étant configurée pour s'accoupler avec la surface inférieure du composant tibial.
PCT/US2025/015529 2024-02-12 2025-02-12 Système de remplacement total de cheville Pending WO2025174836A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US202463552487P 2024-02-12 2024-02-12
US63/552,487 2024-02-12
US202463650034P 2024-05-21 2024-05-21
US63/650,034 2024-05-21

Publications (1)

Publication Number Publication Date
WO2025174836A1 true WO2025174836A1 (fr) 2025-08-21

Family

ID=96773473

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2025/015529 Pending WO2025174836A1 (fr) 2024-02-12 2025-02-12 Système de remplacement total de cheville

Country Status (1)

Country Link
WO (1) WO2025174836A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150320567A1 (en) * 2014-05-12 2015-11-12 Integra Lifesciences Corporation Total Ankle Replacement Prosthesis
US20230115254A1 (en) * 2020-06-10 2023-04-13 Paragon 28, Inc. Implants and methods of use, assembly and fabrication

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150320567A1 (en) * 2014-05-12 2015-11-12 Integra Lifesciences Corporation Total Ankle Replacement Prosthesis
US20230115254A1 (en) * 2020-06-10 2023-04-13 Paragon 28, Inc. Implants and methods of use, assembly and fabrication

Similar Documents

Publication Publication Date Title
US12426899B2 (en) Femoral surgical instrument and method of assembling same
JP7699683B2 (ja) 膝関節形成方法及び器械
US10736747B2 (en) Knee joint prosthesis system and method for implantation
US6258095B1 (en) Methods and tools for femoral intermedullary revision surgery
US8187280B2 (en) Knee joint prosthesis system and method for implantation
US9730706B2 (en) Method of using a femoral surgical instrument
US6056754A (en) Method and apparatus for patella resection and guide handle
EP2787901B1 (fr) Instrument d'alésage chirurgical pour la formation d'une cavité osseuse
US8114083B2 (en) Methods and apparatus for improved drilling and milling tools for resection
AU2019200315A1 (en) Ankle replacement system and method
KR101764518B1 (ko) 의료 공구 시스템
WO2025174836A1 (fr) Système de remplacement total de cheville

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 25755539

Country of ref document: EP

Kind code of ref document: A1