Abstract: A joint prosthesis with three components is disclosed. The prosthesis includes a first component, a composite component and a bearing component. The bearing can be mounted on and fixed to the composite component and has an articulation surface to articulate with an articulation surface of the first component. The composite component has an extension for stabilizing the component when implanted. The extension has an end opposite the bearing. The composite component includes a porous base or preform molded to a solid polymer portion. The solid polymer portion engages the bearing component and extends into the extension and defines the end of the extension. The bearing is made of a different polymer. The composite component may be made by injection molding.

Abstract: A joint prosthesis system has two metal implant components and a bearing. One of the metal implant components has an articulation surface for articulation with the bearing. The other metal implant component has a mounting surface for supporting the bearing. An extension extends out from a junction at the bone-engaging surface of one of the metal components to an exposed end. The extension has a thickness at the junction and comprises porous metal across the entire thickness of the extension at the junction.

Abstract: Methods and devices are disclosed relating improved articular models, implant components, and related guide tools and procedures. In addition, methods and devices are disclosed relating articular models, implant components, and/or related guide tools and procedures that include one or more features derived from patient-data, for example, images of the patient's joint. The data can be used to create a model for analyzing a patient's joint and to devise and evaluate a course of corrective action. The data also can be used to create patient-adapted implant components and related tools and procedures.

Abstract: A total knee prosthesis comprises a femoral component and a patellar component. The femoral component has a patellar flange into which is built a twist or roller coaster configuration. The patellar component has an off-set dome with respective lateral and medial facets. The configuration of the patellar flange resists forces from a medial to a lateral direction, whilst the lateral and medial facets of the patellar component are respectively shaped to allow area contact and line contact respectively with the femoral component. Also disclosed is a device for intra-operative checking of patellar tracking to allow correct insertion of the femoral and patellar components.

Abstract: A medical device having body contacting surfaces provided with a film of amorphous calcium phosphate having a thickness of 1 nm to 10000 nm and an average dissolution rate calculated as the time taken to remove 95% of the film of at least 1 nm h?1 as determined in accordance with ASTM Standard P1926-03. The characteristics of the film are such that the film is relatively rapidly dissolved from the surface by body fluids. This dissolution of the surface film of amorphous calcium phosphate is sufficiently fast to prevent the attachment of bacteria, thus preventing them forming a biofilm and keeping the cells in a planktonic (non-biofilm) state where they are more vulnerable to the body's defences. The invention is particularly applicable to implants (e.g. orthopaedic implants such as prosthetic hips) but may also be applied to “non-implanted” devices such as surgical instruments.

Abstract: The present invention relates to improved biomedical implantable material comprising a plurality of pores, of which one or more of the pores are interconnected below the surface of the material. The improved biomedical implantable material may be used in biomedical implant devices such as orthopedic implants, spinal implants, neurocranial implants, maxillofacial implants, and joint replacement implants. The present invention also relates to a method of preparing an improved biomedical implantable material, comprising subjecting an implantable material to a pore-forming treatment and optionally further subjecting the material to a surface-modifying treatment. The biomedical implantable material may be used in other applications, which as applications where two surfaces are contacted and bonding between the surfaces is required.

Abstract: A method includes the acts of sliding a first end of a flexible first line through a channel in a first bone anchor. A portion of the first line is connected to an implant having a top articular surface and an opposing bone apposition surface. The first line extending between the implant and the first bone anchor is then tensioned. While the tensioning force is maintained on the first line, the first line is secured to the first bone anchor.

Abstract: The present invention relates to methods for making oxidation resistant medical devices that comprise polymeric materials, for example, ultra-high molecular weight polyethylene (UHMWPE). The invention also provides methods of making antioxidant-doped medical implants, for example, doping of medical devices containing cross-linked UHMWPE with vitamin E by diffusion and materials used therein.

Abstract: An elongate, longitudinally oriented outer sleeve includes an outer sleeve surface and has a sleeve body. A stem-receiving cavity extends from a distal sleeve end into the sleeve body. The distal sleeve end includes a sleeve interference protrusion extending from the distal sleeve end away from the sleeve body. A joint articulating member includes an elongate, longitudinally oriented stem. The joint articulating member includes a joint articulating surface spaced apart from a distal stem end by an angularly extending connector neck. When the stem is inserted into the stem-receiving cavity, the stem and the outer sleeve are configured for selective relative rotation about a shared longitudinal axis, and the connector neck impinges upon the sleeve interference protrusion responsive to a predetermined amount of relative rotation between the stem and the outer sleeve to prevent relative rotation between the stem and the outer sleeve outside a predetermined range of allowable rotation.

Abstract: A trialing assembly for use during knee replacement procedures to determine size and position of a tibial plate implant as well as the size and thickness of the articular surface prior to implantation of the implant. The trialing assembly includes a broaching plate having a tibia engaging bottom surface adapted for placement atop a tibia and an opposite top surface, the bottom and top surfaces extending between an anterior edge and a posterior edge of the broaching plate. The broaching plate includes an anterior rail and a posterior rail protruding superiorly from the top surface and extending along the anterior and posterior edges, respectively. A trialing plate is configured to removably fit atop the broaching plate between the anterior and posterior rails. The trialing plate includes an engagement member extending from a superior surface of the trialing plate and adapted to engage with an articular surface provisional.

Abstract: The present invention is directed to novel contact sensors. The contact sensors of the invention include a conductive composite material formed of a polymer and a conductive filler. In one particular embodiment, the composite materials can include less than about 10 wt % conductive filler. Thus, the composite material of the contact sensors can have physical characteristics essentially identical to the polymer, while being electrically conductive with the electrical resistance proportional to the load on the sensor. If desired, the sensors can be formed of the same polymeric material as the bearing that is being examined. The sensors can provide real time dynamic contact information for joint members under conditions expected during use. In one particular embodiment, the sensors can be used to examine dynamic wear characteristics of artificial joint bearings such as artificial knee, hip, or shoulder bearings.

Abstract: A method for unicompartmental knee replacement. Replacement of a medial or lateral compartment may be through a limited incision and patellofemoral replacement may be through the same incision or another incision. An embodiment may include a trochlear implant and medial implant. Implants may be dimensioned and configured so that bone is located between the implants. Implants may be modular, being assembled inside the body or outside the body prior to implantation.

Abstract: A prosthetic device includes one or more components configured to be disposed in a joint. The component includes at least one feature configured to provide information about the component. The information can be used to determine or create the relationship between the component and the joint and/or other components. This relationship may be used to evaluate and/or modify the expected performance of the prosthetic device and assist in determining the optimal relationship between one or more components and a patient's anatomy.

Abstract: A total stabilized femoral knee prosthesis is disclosed. Such prosthesis is capable of being formed with varying condyle thicknesses, and may include a stem, stabilizer box and articular surface. Methods of implanting such a prosthesis, as well as of manufacturing same are also disclosed herein.

Abstract: A method is provided for performing a total knee arthroplasty. The method includes making a primary incision near a knee joint of a patient and resecting medial and lateral condyles of the femur of the leg to create at least one femoral cut surface. The resecting step is performed without dislocating the knee joint. The method also includes balancing various ligament tensions to obtain desired tension and moving a femoral component of a total knee implant through the primary incision. The method further includes positioning the femoral component with respect to the at least one femoral cut surface.

Abstract: Systems and methods for providing deeper knee flexion capabilities, more physiologic load bearing and improved patellar tracking for knee prosthesis patients. Such systems and methods include (i) adding more articular surface to the antero-proximal posterior condyles of a femoral component, including methods to achieve that result, (ii) modifications to the internal geometry of the femoral component and the associated femoral bone cuts with methods of implantation, (iii) asymmetrical tibial components that have an unique articular surface that allows for deeper knee flexion than has previously been available, (iv) asymmetrical femoral condyles that result in more physiologic loading of the joint and improved patellar tracking and (v) modifying an articulation surface of the tibial component to include an articulation feature whereby the articulation pathway of the femoral component is directed or guided by articulation feature.

Abstract: The present invention provides molds and methods for producing articulating spacers that are custom-fit to the bone and can be used in two-stage revision knee arthroplasty and other orthopaedic surgery.

Abstract: A femoral prosthesis may be formed as a femoral component incorporating a base material and an articulating material. In one exemplary embodiment, the base material is a metal and the articulating material is a polymer. Specifically, the base material provides strength and rigidity to the femoral component, while the articulating material contacts a tibial prosthesis or natural tibia during joint articulation. In one exemplary embodiment, the articulating material forms the articulating surface of one or more condyle portions of the femoral component.

Abstract: A method is provided for performing a total knee arthroplasty. The method includes making a primary incision near a knee joint of a patient and resecting medial and lateral condyles of the femur of the leg to create at least one femoral cut surface. The resecting step is performed without dislocating the knee joint. The method also includes balancing various ligament tensions to obtain desired tension and moving a femoral component of a total knee implant through the primary incision. The method further includes positioning the femoral component with respect to the at least one femoral cut surface.

Abstract: The invention relates to a method for precipitating mono or multiple layers of a mixture of organophosphoric acids of the general formula I (A) Y—B—OPO3H2 ??(IA) or of organophosphonic acids of the general formula I (B) Y—B—PO3H2 ??(IB) and the salts thereof, wherein Y and B are defined in the specification. According to the invention, precipitation occurs on substrate surfaces of pure or mixed oxides, nitrides or carbides of metals and semiconductors, in particular as surfaces of sensor platforms, implants and medical accessory devices. The invention also relates to the use thereof as part of coated sensor platforms, implants and medical accessory devices.

Abstract: The present invention relates to processes involving contacting articles that include titanium or titanium alloy with a solution comprising hydrochloric acid and chloride-containing compound for a time and at a temperature effective to form a plurality of indentions that, independently, have a diameter of from about 200 nm to 10 microns.

Abstract: A knee prosthesis comprises a femoral component, a tibial component and a bearing component between the femoral and tibial components. The femoral component defines medial and lateral condyles and an intercondylar box, and the bearing component has respective surfaces matching the condylar surfaces and engaging therewith when the knee is extended over a first range of flexion. The femoral component defines at the area of the intercondylar box a cam and a follower is defined by the bearing component, the cam and following engaging over a second range of flexion.

Abstract: The present disclosure relates to prosthetic implants, components of prosthetic implants, and methods of fixating the components to one another and, especially fixation of the implants to bone.

Abstract: The present invention provides an irradiated crosslinked polyethylene containing reduced free radicals, preferably containing substantially no residual free radical. Disclosed is a process of making irradiated crosslinked polyethylene by irradiating the polyethylene in contact with a sensitizing environment at an elevated temperature that is below the melting point, in order to reduce the concentration of residual free radicals to an undetectable level. A process of making irradiated crosslinked polyethylene composition having reduced free radical content, preferably containing substantially no residual free radicals, by mechanically deforming the polyethylene at a temperature that is below the melting point of the polyethylene, optionally in a sensitizing environment, is also disclosed herein.

Abstract: A method of synthetic grafting of bone-tendon-bone autograft harvest sites using preformed synthetic trapezoidal implants. The implants are formed of tricalcium phosphate, an osteoconductive bone graft substitute and filler, which allows for simultaneous controlled absorption and promotion of osteogenesis. The implants are preferably pretreated or presoaked intraoperatively in autologous blood, or autologous conditioned plasma, or bone marrow aspirate products to enhance healing ability. The implants are trimmed to match the patellar pole shape, pressed into place in the bone voids, and oversewn to complete the procedure.

Abstract: Knee prostheses are provided. In some embodiments, the knee prostheses include a body formed of a resilient polyurethane having contact surface area that changes during use according to physical loading factors. In some embodiments, the knee prostheses include a femoral component configured for secure engagement with a lower portion of a femur without penetrating the femur and a tibial component configured for secure engagement with an upper portion of a tibia without penetrating the tibia. In that regard, the tibial component is also configured for moving engagement with the femoral component in some instances.

Abstract: The present invention provides partial and complete shielding approaches to alter the cross-linking characteristics of irradiated polymers, such as polyethylene. Irradiated polymers and fabricated articles, such as medical prosteses, comprising irradiated polymers also are provided.

Abstract: A prosthetic device made of a first specific type of polyarylene, taken alone or in combination with a second specific type of polyarylene, featuring some unexpected advantages such as a very high strength and stiffness, good elongation properties, high chemical resistance, good biocompatibility as well as an outstanding impact resistance.

Abstract: A prosthetic device, method for planning bone removal, and a robotic system for implantation of a prosthetic device in bone are disclosed. The prosthetic device can include a body portion for attachment to a bone, wherein the body portion includes an implantation surface configured to face the bone upon implantation, and a constraint structure. The prosthetic device, method, and robotic system can be configured to cause the constraint structure and bone to interact so as to constrain the prosthetic device in the bone.

Abstract: The use of biologic and/or biologically reabsorbable materials to provide temporary stability after a surgical joint procedure is provided. Exemplary embodiments of the invention provide biologic and/or biologically reabsorbable cam and/or post linings mounted to respective knee prosthesis components. Such linings are reabsorbed after a time sufficient for patient tissue formation to provide permanent stability. Likewise, the invention has application in any joint reconstruction where the integrity of the stabilizing tissue has been compromised by injury or as a result of the surgical procedure itself. Further aspects of the present invention include using biologic and/or biologically reabsorbable materials loaded with agents that may promote tissue formation, fight infection, and promote clotting. Still further aspects of the present invention are directed to the use of biologically reabsorbable snaps or other fasteners to attach a lining to the femoral component and/or the tibial component.

Abstract: A total knee arthorplasty in accordance with the teachings of the present invention is accomplished by surgically removing the meniscus and adjacent joint end portions of the femur and tibia and then replacing the first one of the removed joint end portions with a first prosthetic component. Thereafter a flexible protector shim is temporally inserted between the first prosthetic component and the other of the joint end portions. Then the other of the removed joint end portions is replaced with a second prosthetic component while the protector shim is maintained in position between the prosthetic components for thereby preventing scarring, scratching and minimizing movement during the cement curing phase of the insertion process. The protector shim is thereafter removed and a prosthetic meniscus is inserted between the two prosthetic components.

Abstract: The invention provides a multi-polymer hydrogel article having a first polymeric, water-swellable material and a second polymeric material, organized such that a first region substantially comprises the first polymeric, water-swellable material, a second region adjacent the first region comprises a mixture of the first polymeric, water-swellable material and the second polymeric material, and a third region adjacent the second region substantially comprises the second polymeric material. The article exhibits an increasing concentration gradient of the second polymeric material moving from the first region, through the second region, to the third region.

Abstract: Methods and apparatus for knee arthroplasty, including implants, positioning and alignment guides, cutting guides, cutting tools and techniques for the femur and/or tibia.

Abstract: A composition, a medical implant constructed from the composition, and a method of making the composition are described. The composition comprises a porous-coated substrate, the porous coating comprising a reticulated particle coating, the coating being formed by fusing the reticulated particle to the surface, preferably by sintering.

Abstract: A plastic implant device for a mammal that contains a rare earth metal compound tracer and a method for detecting degradation such as wear of the implanted device are disclosed. The tracer can also be present with a separate antioxidant or the tracer compound can be can be the salt of a C6-C22 unsaturated carboxylic acid. The rare earth metal compound tracer is released when the prosthetic is worn down or otherwise degraded in the mammalian body in which it was implanted. The presence and amount of released tracer present in a body fluid or tissue sample measured and is proportional to the degree of degradation of the implant.

Abstract: A prosthetic knee system includes a tibial tray, a non-rotating tibial insert, and a rotating tibial insert. The non-rotating tibial insert and the rotating tibial insert are selectively couplable to the tibial tray such that a fixed or a mobile orthopaedic prosthesis may be configured. In some embodiments, the tibial tray may be a fixed or mobile tibial tray. Additionally, in some embodiments, the prosthetic knee system may include a femoral component.

Abstract: A knee prosthesis includes a femoral component and a stem for implanting in a femur. A modular junction is provided for attaching the stem to the femoral component. The femoral component may include a boss having a slot for receiving the components of the modular junction. A portion of the modular junction may be placed within the slot and the modular junction may be tightened in place on the boss by threading the stem into engagement with a portion of the modular junction. Accordingly, the stem may be connected to the femoral component by a single threaded engagement and the position of the stem may be adjusted to any desired location along the anterior-posterior direction on the femoral component.

Abstract: A surgical kit includes an orthopaedic implant, an orthropaedic trial and a bone protector. All three components have bone-contacting surfaces sized and shaped to be placed against a resected bone surface. The orthopaedic implant and trial are thicker than the bone protector. The bone protector has a flat bearing surface while the implant and trial have curved articulating surfaces. In use, the bone protector is temporarily mounted on the resected bone surface to cover and protect the resected bone surface while other bones of the joint are resected. A retractor can be placed against the bone protector and used as a lever to move other bones of the joint for greater access during surgery. The bone protector serves as the fulcrum of the lever and protects the resected bone from damage. The kit, bone protector and method should be useful in minimally invasive total joint arthroplasty.

Abstract: Disclosed is a trial implant having a body and a tab. The body may include a recess and may be sized to closely approximate a permanent implant. The tab may be more durable than the body, and may be disposed within the body and wholly contained within the recess. Also disclosed is a method of performing a trialing procedure including providing a trial implant as described, providing a tool to attach to the tab, inserting the implant onto a resected joint, evaluating and extracting the implant. The same procedure may then be performed with a second implant. The method may further include a tool having an attachment portion that is substantially or wholly contained within the recess. A kit is disclosed including a plurality of trial implants of incrementally different shapes and sizes. The kit may further include a tool. Also disclosed is a method of making the described implant.

Abstract: An implant for replacing a portion of an articular surface including a load bearing surface and a bone contacting region. The load bearing surface had a contour defined by a first curve string which is based on a contour of the articular surface being replaced in a first plane. The load bearing surface of the implant is further defined by the contour of the articular surface being replaced in a second plane, in which the first and second planes are mutually intersection planes.

Abstract: A system and method for sharing and absorbing energy between body parts. In one aspect, the method involves identifying link pivot locations, fixing base components and minimally invasive insertion techniques. In one particular aspect, the system facilitates absorbing energy between members forming a joint such as between articulating bones.

Abstract: A post-operative pain inhibitor system (100) comprises a controller (32) and leads (25, 27). Neuro-stimulator circuitry may be included within the patient controller 32 or within one or more prosthetic components (12, 13, 14) for generating a signal. The topical leads (27), percutaneous leads (25), subcutaneous leads (26), intraosseous leads (22) or leads placed on or within prosthetic components are coupled to neuro-stimulation circuitry (44) to stimulate peripheral nerve fibers such that the signal blocks body generated action potentials. Controller (32) can modify the pulse width, pulse shape, pulse repetition rate, and pulse amplitude of the signal thereby allowing the patient to adapt the signal to minimize their perceived pain.

Abstract: At least one embodiment is directed to a system for measuring parameters of a skeletal system in positions of optimal alignment for implantation of an orthopedic device. The system comprises one or more position sensors (202, 204, 206, 208, 210, and 212), one or more measurement sensors (606), a processing unit (506), and a screen (502). The position and measurement sensors are in communication with the processing unit. Position and relational positioning information in conjunction with one or more parameter measurements is used to determine proper seating of an implant, device balance over a range of motion, and device stability. For example, measurement of loading over a range of motion can be used to determine the amount and type of adjustment required for an implant. The positional and measurement data is stored in a database and accessible to the processing unit (506) to aid the surgeon, hospital, and implant manufacturer.

Abstract: A knee joint prosthesis can include a tibial component that can have a tibial tray. The tibial tray can include a platform-like tray that defines a superior surface and an inferior surface. The platform-like tray can have a tray perimeter and a raised wall formed on the inferior surface. The raised wall can be offset inboard relative to the tray perimeter. Porous material can be disposed on the inferior surface of the platform-like tray at a location generally between the raised wall and the tray perimeter.

Abstract: Various assemblies for replacing at least a proximal portion of a tibia are provided. One assembly includes a tibial tray including a superior bearing engaging surface and an inferior bone engaging surface and having a truncated posterior region; a bearing including an articulating surface, a tray mating surface, and an overhang. The tray mating surface of the bearing is in mating engagement with the inferior bone engaging surface of the tibial tray such that the overhang of the bearing extend beyond the tibial tray truncated posterior region. Related surgical methods are also provided.

Abstract: A knee joint prosthesis can include a tibial component that can have a tibial tray. The tibial tray can include a platform-like tray that defines a superior surface and an inferior surface. The platform-like tray can have a tray perimeter and a raised wall formed on the inferior surface. The raised wall can be offset inboard relative to the tray perimeter. Porous material can be disposed on the inferior surface of the platform-like tray at a location generally between the raised wall and the tray perimeter.

Abstract: A prosthetic device for a knee joint includes a body portion and a first keel. The body portion attaches to a bone of a knee joint. The body portion can have a bearing surface configured to replace at least a portion of the bone and an implantation surface configured to face the bone upon implantation. The first keel can be configured to be inserted into a corresponding first keel void formed in the bone. The first feel can be configured to project outwardly from the implantation surface by an amount sufficient to inhibit movement of the body portion relative to the bone in both medial and lateral directions upon insertion into the first keel void. The first keel can extend along a longitudinal direction of the body portion and is offset from a longitudinal centerline of the body portion. Methods of implanting and removing the prosthetic device are also provided.

Abstract: Shaped parts of ultra high molecular weight polyethylene (UHMWPE) are made by a process comprising melt processing, wherein a) the UHMWPE has a weight average molecular weight (Mw) of at least 1*106 g/mol, b) during the shaping the storage plateau modulus of the UHMWPE (G*) is kept at a value of at most 1.5 MPa, c) whereafter, before the cooling, the G* is raised to its final value. The shaped parts may advantageously be used in medical applications, e.g., as an element of a hip or knee prosthesis.

Abstract: A method for setting the internal-external rotational position of a prosthetic femoral component with respect to the tibial comprises: forming a cylindrical surface on the posterior femoral condyles. The cylindrical surface is formed about an axis extending in a proximal distal direction with respect to the femur. A template is placed on the distal femur which has a cylindrical guide surface for engaging the posterior femoral condyles. When placed against a planar resected surface of the distal femur the guide surfaces contact the cylindrically shaped posterior condyles. The template is rotated on the cylindrical guide surface as the knee joint is moved from flexion to extension until the template cylindrical guide surfaces are in a position with respect to the tibial condyle surfaces to properly balance the knee ligaments.

Abstract: A tibial tuberosity advancement implant with first and second arms pivotally joined at an apex. Tabs including anchor apertures extend from each arm for attachment of the arms in a traverse osteotomyized tibia. A selection of various width keys are each insertable between the arms for setting the distance between the arms and the width of the osteotomyized tibia.