Prosthetic joint
A prosthetic joint includes: (a) a bone-implantable first member comprising a rigid material and including a body having an annular flange extending outward at a first end thereof, the first end of the body and the flange cooperatively defining a wear-resistant concave first contact surface having a protruding rim and a recessed central portion; and (b) a bone-implantable second member comprising a rigid material with a wear-resistant convex second contact surface; (c) where the first and second contact surfaces bear directly against each other so as to transfer axial and lateral loads from one of the members to the other, while allowing pivoting motion between the two members; (d) wherein the flange is shaped so as to deform elastically and permit the first contact surface to conform to the second contact surface when the joint is placed under a predetermined load.
This application is a Continuation-in-Part of application Ser. No. 11/936,601, filed Nov. 7, 2007, which is currently pending.
BACKGROUND OF THE INVENTIONThis invention relates generally to medical implants, and more particularly to prosthetic joints having conformal geometries and wear resistant properties.
Medical implants, such as knee, hip, and spine orthopedic replacement joints and other joints and implants have previously consisted primarily of a hard metal motion element that engages a polymer contact pad. This has usually been a high density high wear resistant polymer, for example Ultra-High Molecular Weight Polyethylene (UHMWPE), or other resilient material. The problem with this type of configuration is the polymer eventually begins to degrade due to the caustic nature of blood, the high impact load, and high number of load cycles. As the resilient member degrades, pieces of polymer may be liberated into the joint area, often causing accelerated wear, implant damage, and tissue inflammation and harm.
It is desirable to employ a design using a hard member on a hard member (e.g. metals or ceramics), thus eliminating the polymer. Such a design is expected to have a longer service life. Extended implant life is important as it is now often required to revise or replace implants. Implant replacement is undesirable from a cost, inconvenience, patient health, and resource consumption standpoint.
Implants using two hard elements of conventional design will be, however, subject to rapid wear. First, a joint having one hard, rigid element on another will not be perfectly shaped to a nominal geometry. Such imperfections will result in points of high stress, thus causing localized wear. Furthermore, two hard elements would lack the resilient nature of a natural joint. Natural cartilage has a definite resilient property, absorbing shock and distributing periodic elevated loads. This in turn extends the life of a natural joint and reduces stress on neighboring support bone and tissue. If two rigid members are used, this ability to absorb the shock of an active lifestyle could be diminished. The rigid members would transmit the excessive shock to the implant to bone interface. Some cyclical load in these areas stimulates bone growth and strength; however, excessive loads or shock stress or impulse loading the bone-to-implant interface will result in localized bone mass loss, inflammation, and reduced support.
BRIEF SUMMARY OF THE INVENTIONThese and other shortcomings of the prior art are addressed by the present invention, which provides a prosthetic joint having wear-resistant contacting surfaces with conformal properties.
According to one aspect of the invention, a prosthetic joint includes: (a) a first bone-implantable member comprising a rigid material and including a body having an annular flange extending outward at a first end thereof, the first end of the body and the flange cooperatively defining a wear-resistant, concave first contact surface having a protruding rim and a recessed central portion; and (b) a second bone-implantable member comprising a rigid material with a wear-resistant, convex second contact surface; (c) where the first and second contact surfaces bear directly against each other so as to transfer axial and lateral loads from one of the members to the other, while allowing pivoting motion between the two members; and (d) wherein the flange is shaped so as to deform elastically and permit the first contact surface to conform to the second contact surface when the joint is placed under a predetermined load.
The invention may be best understood by reference to the following description taken in conjunction with the accompanying drawing figures in which:
The present invention provides a specialized implant contact interface (implant geometry). In this geometry, an implanted joint includes two typically hard (i.e. metal or ceramic) members; however, at least one of the members is formed such that it has the characteristics of a resilient member, such as: the ability to absorb an impact load; the ability to absorb high cycle loading (high endurance limit); the ability to be self cleaning; and the ability to function as a hydrodynamic and/or hydrostatic bearing.
Generally, the contact resilient member is flexible enough to allow elastic deformation and avoid localized load increases, but not so flexible as to risk plastic deformation, cracking and failure. In particular, the resilient member is designed such that the stress levels therein will be below the high-cycle fatigue endurance limit. As an example, the resilient member might be only about 10% to about 20% as stiff as a comparable solid member. It is also possible to construct the resilient member geometry with a variable stiffness, i.e. having a low effective spring rate for small deflections and a higher rate as the deflections increase, to avoid failure under sudden heavy loads.
The Z7 region may be local to the contact member 34 or may be one of several. In any case, it may contain a means of providing fluid pressure to the internal contact cavity to produce a hydrostatic interface. A passive (powered by the regular motion of the patient) or active (powered by micro components and a dedicated subsystem) pumping means and optional filtration may be employed to provide the desired fluid interaction.
A hydrodynamic interface is desirable as, by definition, it means the contact member 34 is not actually touching the mating joint member. The lead-in and lead-out shapes Z1, Z2, Z5, Z6 are configured to generate a shear stress in the working fluid so as to create the fluid “wedge” of a hydrodynamic support.
The contact member 34 includes an osseointegration surface “S”, which is a surface designed to be infiltrated by bone growth to improve the connection between the implant and the bone. Osseointegration surfaces may be made from materials such as TRABECULAR METAL, textured metal, or sintered or extruded implant integration textures. TRABECULAR METAL is an open metal structure with a high porosity (e.g. about 80%) and is available from Zimmer, Inc., Warsaw, Indiana 46580 USA.
It may be desirable to create a return passage 62 from the seal void region 60 back into the internal zone 64 in order to stabilize the pressure between the two and to allow for retention of the internal zone fluid if desired. This is especially relevant when the hydrostatic configuration is considered.
The first member 102 includes a body 106 with a perimeter flange 116 extending in a generally radially outward direction at one end. Optionally, a disk-like base 108 may be disposed at the end of the body 106 opposite the flange 116, in which case a circumferential gap 111 will be defined between the base 106 and the flange 116. The first member 102 is constructed from a rigid material. As used here, the term “rigid” refers to a material which has a high stiffness or modulus of elasticity. Nonlimiting examples of rigid materials having appropriate stiffness for the purpose of the present invention include stainless steels, cobalt-chrome alloys, titanium, aluminum, and ceramics. By way of further example, materials such as polymers would generally not be considered “rigid” for the purposes of the present invention. Generally, a rigid material should have a modulus of elasticity of about 0.5×106 psi or greater. Collectively, one end of the body 106 and the flange 116 define a wear-resistant, concave first contact surface 118. As used herein, the term “wear-resistant” refers to a material which is resistant to surface material loss when placed under load. Generally the wear rate should be no more than about 0.5 μm (0.000020 in.) to about 1.0 μm (0.000040 in.) per million cycles when tested in accordance with ASTM Guide F2423. As a point of reference, it is noted that any of the natural joints in a human body can easily experience one million operating cycles per year. Nonlimiting examples of wear-resistant materials include solid metals and ceramics. Known coatings such as titanium nitride, chrome plating, carbon thin films, and/or diamond-like carbon coatings may be used to impart wear resistance to the first contact surface 118. Optionally, the first contact surface 118 could comprise a separate face layer (not shown) of a wear-resistant material such as ultra-high molecular weight (UHMW) polyurethane.
The first contact surface 118 includes a protruding peripheral rim 120 (see
The annular configuration of first contact surface 118 with the protruding rim 120 results in a configuration which permits only pivoting and rotational motion, and is statically and dynamically determinate for the life of the joint 100. In contrast, prior art designs employing mating spherical shapes, even very accurate shapes, quickly reach a statically and dynamically indeterminate condition after use and wear. This condition accelerates wear, contributes to the fretting corrosion wear mechanism, and permits undesired lateral translation between the joint members.
The second member 104 is also made from a rigid material and has a wear-resistant, convex second contact surface 124. The first and second contact surfaces 118 and 124 bear directly against each other so as to transfer axial and lateral loads from one member to the other while allowing pivoting motion between the two members 102 and 104.
Nominally the first and second members 102 and 104 define a “ring” or “band” contact interface therebetween. In practice it is impossible to achieve surface profiles completely free of minor imperfections and variations. If the first and second members 102 and 104 were both completely rigid, this would cause high Hertzian contact stresses and rapid wear. Accordingly, an important feature of the illustrated joint 100 is that the flange 116 (and thus the first contact surface 118) of the first member 102 is conformable to the second contact surface 124 when the joint is placed under load.
The conformable nature of the flange 116 is explained in more detail with reference to
For comparative purposes,
To achieve this controlled deflection, the flange 116 is thin enough to permit bending under working loads, but not so thin as to allow material yield or fatigue cracking. The deflection is opposed by the elasticity of the flange 116 in bending, as well as the hoop stresses in the flange 116. To achieve long life, the first member 102 is sized so that stresses in the flange 116 will be less than the endurance limit of the material, when a selected external load is applied. In this particular example, the joint 100 is intended for use between two spinal vertebrae, and the design average axial working load is in the range of about 0 N (0 lbs) to about 1300 N (300 lbs.). These design working loads are derived from FDA-referenced ASTM and ISO standards for spinal disc prostheses. In this example, the thickness of the flange 116, at a root 126 where it joins the body 106 (see
The joint members may include multiple rims. For example,
If present, the circumferential gap between the flange and the base of the joint member may be filled with resilient nonmetallic material to provide damping and/or additional spring restoring force to the flange.
As discussed above, the joint may incorporate a wiper seal. For example,
The joint construction described above can be extended into a three-part configuration. For example,
The first member 602 is hollow and includes a disk-like base 606 and a cup 608, interconnected by a peripheral wall 610. An interior cavity 612 is defined between the base 606 and the cup 608. The cup 608 is constructed from a rigid material and defines a wear-resistant, concave first contact surface 614. The first contact surface 614 includes a protruding peripheral rim 616, and a recessed central portion 618, which may also be considered a “pocket” or a “relief”. The rim 616 may have a conical or curved cross-sectional shape.
The second member 604 is constructed from a rigid material and has a wear-resistant, convex second contact surface 620. The first and second contact surfaces 614 and 616 bear directly against each other so as to transfer axial and laterals loads from one member to the other while allowing pivoting motion between the two members 602 and 604.
As described above with reference to the prosthetic joint 100, the cup 606 of the first member 602 is thin enough to permit bending under working loads, but not so thin as to allow material yield or fatigue cracking. The first contact surface 614 is thus conformable to the second contact surface 620 when the prosthetic joint 600 is placed under external load.
An inverted configuration of hollow members is also possible. For example,
The second member 704 is hollow and includes a dome 714 connected to a peripheral wall 716. An interior cavity 718 is defined behind the dome 714. The dome 714 defines a wear-resistant, convex second contact surface 720, which is shaped and sized enough to permit bending under working loads, but not so as to allow material yield or fatigue cracking. The second contact surface 720 is thus conformable to the first contact surface 708 when the prosthetic joint 700 is placed under external load.
The first and second contact surfaces 708 and 720 bear directly against each other so as to transfer axial and lateral loads from one member to the other while allowing pivoting motion between the two members 702 and 704.
Any of the contact surfaces described above may be provided with one or more grooves formed therein to facilitate flow of fluid or debris. For example,
As noted above, known coatings such as titanium nitride, chrome plating, carbon thin films, and/or diamond-like carbon coatings may be used to impart wear resistance or augment the wear resistance of any of the first contact surfaces described above. To the same end, it may be desirable to surface treat either or both interfaces of any of the above-described implants or joints with a laser, shot peen, burnishing, or water shock process, to impart residual compressive stresses and reduce wear. The benefit could be as much from surface annealing and microstructure and microfracture elimination as smoothing itself.
The foregoing has described medical implants and prosthetic joints with wear-resistant properties and conformal geometries. While specific embodiments of the present invention have been described, it will be apparent to those skilled in the art that various modifications thereto can be made without departing from the spirit and scope of the invention. Accordingly, the foregoing description of the preferred embodiment of the invention and the best mode for practicing the invention are provided for the purpose of illustration only and not for the purpose of limitation.
Claims
1. A prosthetic joint, comprising:
- (a) a bone-implantable first member comprising a rigid material and including a body having an annular flange extending outward at a first end thereof; the first end of the body and the flange cooperatively defining a wear-resistant, concave first contact surface having a protruding rim and a recessed central portion; and
- (b) a bone-implantable second member comprising a rigid material with a wear-resistant, convex second contact surface;
- (c) where the first and second contact surfaces bear directly against each other so as to transfer axial and lateral loads from one of the members to the other, while allowing pivoting motion between the two members; and
- (d) wherein the flange is shaped and sized so as to deform elastically and permit the first contact surface to conform in an irregular shape to the second contact surface when the joint is placed under a predetermined load.
2. The prosthetic joint of claim 1 wherein the rim has a curved cross-sectional shape.
3. The prosthetic joint of claim 1, wherein the rim has a substantially conical surface.
4. The prosthetic joint of claim 3 wherein the rim has a free shape defining a first contact area with the second contact surface and a loaded shape defining a second contact area with the second contact surface which is substantially larger than the first contact area.
5. The prosthetic joint of claim 1 wherein:
- (a) the first member further includes a disk-like base disposed at a second end of the body opposite the first end, such that a circumferential gap is defined between the base and the flange; and
- (b) the circumferential gap filled with a resilient nonmetallic material.
6. The prosthetic joint of claim 1, wherein a resilient sealing lip protrudes from the rim and engages the second contact surface in a sealing relationship.
7. The prosthetic joint of claim 1 wherein the contact surfaces comprise a ceramic material, a metal, or a combination thereof.
8. The prosthetic joint of claim 1 wherein the first contact surface includes more than one protruding rim, with a circumferential relief area defined between adjacent rims.
9. The prosthetic joint of claim 1, wherein a thickness of the flange, at a root where it joins the neck, is about 0.04 mm to about 5.1 mm.
10. The prosthetic joint of claim 1, where the flange is sized so as to permit elastic deflection of the flange while limiting stresses in the flange to less than the endurance limit of the material from which the flange is constructed, when an external load in the range of about 0 to 300 lbs. is applied to the joint.
11. The prosthetic joint of claim 1, wherein the first contact surface has a pattern of grooves formed therein, comprising:
- (a) one or more circular grooves; and
- (b) one or more generally radially-aligned grooves which intersect the circular grooves.
Type: Application
Filed: Feb 26, 2010
Publication Date: Jun 24, 2010
Inventors: Franz W. Kellar (Gastonia, NC), Harold Lloyd Crowder (Concord, NC)
Application Number: 12/714,288