CA2173577A1 - Prosthesis for replacement of joints between long bones in the hand - Google Patents
Prosthesis for replacement of joints between long bones in the handInfo
- Publication number
- CA2173577A1 CA2173577A1 CA002173577A CA2173577A CA2173577A1 CA 2173577 A1 CA2173577 A1 CA 2173577A1 CA 002173577 A CA002173577 A CA 002173577A CA 2173577 A CA2173577 A CA 2173577A CA 2173577 A1 CA2173577 A1 CA 2173577A1
- Authority
- CA
- Canada
- Prior art keywords
- lateral
- bones
- stem
- articulating
- joint prosthesis
- 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.)
- Abandoned
Links
Classifications
-
- 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
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
-
- 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
- A61F2002/30138—Convex polygonal shapes
- A61F2002/30156—Convex polygonal shapes triangular
-
- 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
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30242—Three-dimensional shapes spherical
-
- 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
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
-
- 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
- A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
- A61F2002/30649—Ball-and-socket joints
- A61F2002/30662—Ball-and-socket joints with rotation-limiting means
-
- 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
- A61F2002/30878—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
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4241—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers
- A61F2002/4251—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for hands, e.g. fingers for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0023—Angular shapes triangular
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0071—Three-dimensional shapes spherical
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
A joint prosthesis for replacing a joint between two elongated bones of the hand.
A first member is provided with an elongated stem for reception in one of the elongated bones and includes a head remote from the stem, the head having a convex articulating surface and lateral articulating surfaces adjacent the convex surface and on each side thereof. A second member has a stem for reception in the other bone and a base remote from the stem, the base having a concave articulating surface and lateral articulating surfaces on each side thereof, the concave and lateral surfaces being adapted to engage and articulate with the respective convex and lateral articulating surfaces of the first member. The lateral articulating surfaces of the first and second members being positioned to fully engage and articulate with each other to thereby restrain lateral articulation only when the bones are articulated through at least 30 degrees of flexion, and at 90 degrees of flexion, the force between said members is borne primarily by said lateral articulating surfaces.
A first member is provided with an elongated stem for reception in one of the elongated bones and includes a head remote from the stem, the head having a convex articulating surface and lateral articulating surfaces adjacent the convex surface and on each side thereof. A second member has a stem for reception in the other bone and a base remote from the stem, the base having a concave articulating surface and lateral articulating surfaces on each side thereof, the concave and lateral surfaces being adapted to engage and articulate with the respective convex and lateral articulating surfaces of the first member. The lateral articulating surfaces of the first and second members being positioned to fully engage and articulate with each other to thereby restrain lateral articulation only when the bones are articulated through at least 30 degrees of flexion, and at 90 degrees of flexion, the force between said members is borne primarily by said lateral articulating surfaces.
Description
PROSTHESIS FOR REPLACEMENT OF JOINTS
BETWEEN LONG BONES IN THE HAND
BACKGROUND OF THE INVENTION
This invention relates to joint prosth~ses particularly adapted for replacing -a joint between two of the long bones of the hand such as the joint between the met~r~rpal and the first ph~l~nx that articulates with the met~r~rpal.
The joints between elong~ted bones of the hand can be damaged by accident or by di-cP~ces such as rheum~toid arthritis and osteoarthritis and often need to be surgically replaced. Procedures for replacing damaged or rlice~ced joints often have involved surgical removal of substantial portions of the bone adjacent a joint's articul~tin~ surfaces and implantation of an articul~tin~
prosthesis. The surgical procedure often involved removing not only substantial portions of bone but also of soft tissue ~tt~rhments between the bony ends of the joint. This, in turn, has often required that the articul~ting ends of the prosthesis be f~ctened together in such a manner that they are not readily separated. Pivoting of the joint in the lateral (that is, in the radial/ulnar direction) was pe~ led in some prosthesis variations and not permitted in others, the degree of pivoting generally being independent of the degree of flexure of the fingers. A finger joint of this general type is shown in Lewis, U.S. patent 4,231,121 issued November 4,1980, which shows a prosthesic having a spherical bearing surface that articulates in a spherical recess.
Certain finger joint prostheses have been provided in which the prostheses were provided with stems having articulating, opposed heads and in which the heads were permitted limited lateral pivoting movement with respect to one another. One such prosthesis is shown in White, U.S. patent 4,242,759, issued January 6, 1981. The articulating heads described in the White patent contained _ 2 mating ridges and troughs, the contact between the ridges and troughs varying asthe joint was flexed.
It is desired to provide a prosthesis so configured and arranged that its surgical implantation does not involve substantial disruption of soft tissue connections between the articulating bones nor removal of substantial portions of the bones themselves. Desirably, such prostheses duplicate closely the articulation afforded by a natural joint.
SUMMARY OF THE INVEN llON
A joint prosthesis is provided which can readily be implanted without substantial removal of bone nor disruption of soft tissue connections between the bones. Mimicking the movement of normal physiological joints, the prostheses of the invention permit limited lateral pivoting of one bone with respect to the other when the bones are substantially aligned (that is, when the fingers are extended) but restrain such lateral movement when the bones are flexed through a predetermined angle.
The prosthesis includes a first member having an elongated stem for reception in one of the elongated bones, and a head remote from the stem. The head is provided with a convex articul~ting surface and also lateral articulating surfaces positioned on each side of the convex surface. A second member of the prosthecic has a stem for reception in the other of the two çlong~ted bones, andincludes a base remote from the stem. The base of the second member has a concave articulating surface and also lateral articul~ting surfaces on each side of the concave articulating surface. The concave and lateral articul~ting surfaces of the second member are adapted to engage and articulate with the respecli~e convex and lateral articulating surfaces of the first member. The concave and convex surfaces enable articulation of the joint both in extension/flexion and in the radial/ulnar direction. Of importance, the lateral articul~tinv surfaces of the first and second members are positioned to fully engage and articulate with each otherto restrain lateral articulation only when the bones are articulated through a predetermined minimum degree of flexion, preferably at least 30. Moreover, the articulating surfaces are so positioned that at 90 of flexion, the force between the members is bome primarily by the lateral articulating surfaces rather than by the convex and concave surfaces. In this manner, the phalanx is permitted a range ofradial/ulnar (referred to sometimeS herein as "lateral") articulation when the phalanx is extended, but is restrained from substantially all lateral movement when the joint is flexed through 90. Preferably, the lateral articulating surfaces are so positioned as to contact one another when the fingers are extended only as the phalanges undergo a predetermined degree of lateral pivoting with respect to them~t~ rpals, the amount of such pivoting decreasing as the fingers are flexed through a predetermined arc, such as from 60 to 90, such that subst~nti~lly nopivoting movement is permitted when flexure has reached the end of that àrc.
Prostheses of the invention may be provided in kit form that includes several first members and several second members, the first members varying from one another by virtue of the orientation of their stems, the lateral angle between the stem axes of one prosthesis varying by at least 5 from the lateral angle between the stem axes of another prosthesis in the kit. Particularly, the stems of the first and second members have longitlldin~l axes that lie in planes that are generally pa~llel to the dorsal surfaces of the bones in which they are received. However, the axes of the first and second members may not be aligned or parallel, but may deviate from par~llelicm through up to about 15 in the dorsal plane to more closely match the angle between different ones of the elongated bones of the hand.
The head of the first member and the base of the second member are sufficiently narrow, measured in the radial/ulnar direction, as to avoid int~Çerence with the collateral lig~ments of the joint, thereby enabling these lig~mellt~ to be preserved.
DESCRIPI ION OF THE DRAWINGS
Figures lA, lB and lC are dorsal, lateral and distal end views of a first member of a prosthesis of the invention;
Figures 2A, 2B and 2C are dorsal, lateral and distal end views of a modified version of a first member of a prosthesis of the invention;
Figures 3A, 3B and 3B are dorsal, lateral and proximal end views of a second member of the prosthesis of the invention;
Figures 4A and 4B are perspective views showing different degrees of ar~iculation of a prosthecis of the invention employing the first member of Figures lA, lB and lC;
Figures SA and SB are pe.~ ive views showing different degrees of S articulation of a prosthesis of the invention employing the member shown in Figures 2A, 2B and 2C; and Figure 6 is a dorsal view of the bones of the hand with a prosthesic of the invention as implanted.
DESCRIPTION OF THE PREFERRED EMBODIMENT
For ease of understanding, the invention is described below with reference to the mrt~r~rpal/phalanx joint.
Referring first to Figures 4A, 4B and 6, a prosthesis of the invention is shown at 10 as comprising a first member 12 and a second member 14. Member 12 includes a stem 16 for reception in the marrow cavity at the distal end of a met~c~rpal, and has an articulating convex head design~ted generally as 18.
Member 14 includes a stem 20 for reception in the marrow cavity at the proximal end of a phalanx, and includes a concave base portion shown generally at 22 thatis curved to articulate with the head portion 18 of the first member.
Member 12 shown in Figures 4A and 4B is depicted in greater detail in Figures lA, lB and lC. Stem 16 has a sharpened proximal end 24, and desirably, is generally triangular in cross section as shown at 26 in Figure lC. The stem has dorsal and volar surfaces 28, 30 (Figure lB), and extends generally in a plane parallel to the dorsal surface of the bone (not shown) of the met~r~rpal into which is to be inserted.
At its distal end, the stem 16 is provided with an enlarged head 18 having a generally spheroidal distally facing surface 32. Surface 32 extends toward the palmar direction and then more sharply proximally as shown at 34 in Figure lB.
The palmar and dorsal facing portions of the surface 32 are provided with elongated grooves 36, 37 to aid in proper orientation of the member 12 during implantation and also to receive the extensor and flexor mechanism soft tissues.Spherical surface 32 is formed about an axis 38 as shown in Figures lA
and lB, and it will be noted from Figure lB that the stem 16 is spaced dorsally ._ s from the axis 3~ so as to more closely approach the normal anatomy of the distalend of the metacarpal. If desired, the head 18 may be formed as a generally hemispherical shell having a recessed, inner surface 40 (Figure lB) to which theproximal end of the stem 16 is ~tt~the~, as by welding or, more preferably, by being machined from a single blank of material. The distal end of the metacarpalmay be surgically sculpted so as to be received within the recessed head 18, thereby reducing the amount of bone that must be removed. If desired, the head may be made solid, that is, not be recessed, for the purpose of re~ucing dlfficulty of m~chining the head shape.
Extending laterally (that is, in the radial/ulnar direction) from the side of the spheroidal surface 32, and spaced proximally from the distal end of that surface, are lateral articul~ting surfaces 42, 44. These surfaces, as shown best in Figure lB, are distally facing near the axis 38 and then curve volarly and proximally (in the direction of the stem) as shown at 46 in Figure lB. Note thatlS the surface 46 merges proximally into the surface 34.
Figures 3A, 3B and 3C depict the second member 14 of the prosthesis, this member having a base 22 and a stem 20. Stem 20 is generally oblong in cross section, tapering distally to a sharpened end 50 receivable in the marrow canal at the proximal end of a proximal or first phalanx. The stem termin~tes distally (with respect to the anatomy of the hand) in the base 22, the latter having a concave, desirably generally spheroidal and proximally facing articulating surface 52. Stem S0 has generally broad, flat dorsal and volar sides 54, 56 and narrower, distally converging lateral sides 58, 60. Viewed from the dorsal side as in Figure 3A, the stem and typically the base 22 are symmetrical with respect to the axis 62 of the spheroidal, proximally facing ar~ic~ ting surface 52. As shown in Figure 3B, however, the stem 20 is offset dorsally from the axis 62 so as to better conform to the anatomy of the proximal end of the proximal (first) phalanx.
The base 22 of the second member 14 includes a longitu-lin~lly eYten~ing groove 64 to aid in proper orientation of the member 14 during implantation and also to receive the extensor mech~nism soft tissues. The proximally facing surface of the base 22 extending around about the spheroidal recess 52 includes proximally facing, generally planar surfaces 66, 68 about the periphery of the base near the 2 t 735 77 dorsal-facing edge 70 of the base, and curved portions extending dorsally and distally as shown at 72 and 74 in Figure 3C.
Referring now to Figure 4A, the concave, preferably spheroidal surface 52 of the base 22 of second member 14 is shaped to receive in articulating contact the convex, desirably spheroidal distally facing surface 32 of the head 18 when the members 12 and 14 are suitably implanted in the confronting ends of the mto~ rpal and proximal (first) ph~l~nx bones of the hand. The distally facing portions of the lateral surfaces 42, 44 closely confront but are slightly spaced from the proximally facing surfaces 66, 68 of the base 22 of the second member`so that when the stems 16, 20 of these members are generally aligned (as when the fingers are extended), some lateral pivoting movement of the phalanx is permitted as shown by arrow A in Figure 4A. Contact between the surfaces 68, 44 and 66, 42, respectively, limit the amount of radial/ulnar lateral movement afforded thestem 20 when the fingers are extended.
As the finger is flexed from the position shown at zero degrees flexion in Figure 4A to the position at 90 degrees flexion shown in Figure 4B, the respective curved surfaces 72, 74 of the second member approach and contact the curved volarly and proximally extending portions 46 of the lateral ar~icul~sing surfaces 42, 44 of the first member. When flexion of the finger has reached 90 degrees, the primary load between the two members is borne by the lateral articulating surfaces 42, 44 of the first member, and as such, radialJulnar lateral pivoting of the second member 14 with respect to the first member is subst~n~ y and desirably completely restrained.
Referring again to Figure lA, it will be noted that the stem 16 extends proximally in the dorsal plane at an angle B from the axis 38. Desirably, the prosthesis of the invention is provided in a kit form that includes at least prosthçses specifically designed for fitting different ones of the me~ rpal!phalanx joints. The angle B, for example, can range up to 15 on either side of the axis38, the angle being measured in a plane parallel to the dorsal surface 28. The purpose of the offset indicated by the arrow B in Figure lA is to more accurately position the head 18 of the first member with respect to the axis of the metac~rpal within which the stem 16 is received. It is here noted that the second, third, fourth and fifth met~r~rpals vary in angulation of the articulating head to the long axis of the metacarpal bone in the coronal plane of the arm. Depending on the met~ rpal chosen, as much as a fifteen degree angle is prevalent.
The embodiment shown in Figures 2A, 2B and 2C is identical to that S shown in Figures lA, lB and lC except for two features, and similar elements are given the same identifying numerals. First, it will be noted that the stem 16 when viewed dorsally as in Figure 2A does not deviate in the dorsal plane from the axis 38. As taught above, the first mp-mber typified in Figures 2A, 2B and 2C may appropliately be implanted in the middle or ring finger m~t~ rpal. Second, it will be noted that the lateral articulating surfaces 42, 44 are of full width laterally of the portion 46 of the surface that extends generally volarly and proximally in the direction of the stem. However, near the axis 38 of the member, the lateral articulating surfaces become subst~nti~lly narrower in the dorsal direction, as shown at 80, 82 in Figure 2C.
The purpose of narrowing the lateral articul~ting surfaces in this manner is to enable greater radial/ulnar swinging movement of the phalanges when the fingers are extended, and this feature is shown particularly in Figure SA by arrow A. Here, the second member 14 may be swung laterally through a greater arc when the fingers are extended. However, as the joint is pivoted through 90 degrees, as shown in Figure SB, the curved surfaces 72, 74 of the second member come into contact to an increasing extent with the lateral articul~ting surfaces of the first member such that at 90 degrees, the force between the articul~ting members is borne primarily by the lateral articul~ting surfaces.
The first and second members of the prostheci~ of the invention may be manufactured from any of the materials that have been found acceptable for use in articulating joint prostheses, including, for example, ultra high molecular weight polyethylene, stainless steel, and various metal alloys. The first member, for example, can be made from metal material and the second from ultra high molecular weighe polyethylene. For strength, it is desired that the members of the prostheses be integrally formed, as by m~chining, from solid blanks of material rather than being formed by joining together preformed portions of such members.
For implantation, a straightforward surgical procedure is employed.
Access to the metacarpal/phalanx joint is performed dorsally. The bony joint segments are exposed, care being taken to preserve as much as possible soft tissue connections. The opposing bone ends are surgically sculpted to receive the head 18 and base 22 of the first and second members, respectively, care being taken again to avoid damage to soft tissue connections. Surgical access also is gained to the marrow cavities of the respective bones, and the stems are then implanted inthe marrow cavities using bone cement in the usual fashion. It is contemplated that it may be appropliate in some circumstances to cause the stems of the prosthesis members to fit fairly tightly in the marrow cavities of the bones in which they are implanted, omitting the need for bone cement. In this event, the surfaces of the stems desirably are shaped or treated to encourage bone ongrowthor ingrowth, as by providing the stems with porous surfaces, by applying to the stems a cell adhesion promoter such as collagen or the like, etc.
While a preferred embodiment of the present invention has been described, it should be understood that various changes, adaptations and modifications may be made therein without departing from the spirit of the invention and the scope ofthe appended claims.
BETWEEN LONG BONES IN THE HAND
BACKGROUND OF THE INVENTION
This invention relates to joint prosth~ses particularly adapted for replacing -a joint between two of the long bones of the hand such as the joint between the met~r~rpal and the first ph~l~nx that articulates with the met~r~rpal.
The joints between elong~ted bones of the hand can be damaged by accident or by di-cP~ces such as rheum~toid arthritis and osteoarthritis and often need to be surgically replaced. Procedures for replacing damaged or rlice~ced joints often have involved surgical removal of substantial portions of the bone adjacent a joint's articul~tin~ surfaces and implantation of an articul~tin~
prosthesis. The surgical procedure often involved removing not only substantial portions of bone but also of soft tissue ~tt~rhments between the bony ends of the joint. This, in turn, has often required that the articul~ting ends of the prosthesis be f~ctened together in such a manner that they are not readily separated. Pivoting of the joint in the lateral (that is, in the radial/ulnar direction) was pe~ led in some prosthesis variations and not permitted in others, the degree of pivoting generally being independent of the degree of flexure of the fingers. A finger joint of this general type is shown in Lewis, U.S. patent 4,231,121 issued November 4,1980, which shows a prosthesic having a spherical bearing surface that articulates in a spherical recess.
Certain finger joint prostheses have been provided in which the prostheses were provided with stems having articulating, opposed heads and in which the heads were permitted limited lateral pivoting movement with respect to one another. One such prosthesis is shown in White, U.S. patent 4,242,759, issued January 6, 1981. The articulating heads described in the White patent contained _ 2 mating ridges and troughs, the contact between the ridges and troughs varying asthe joint was flexed.
It is desired to provide a prosthesis so configured and arranged that its surgical implantation does not involve substantial disruption of soft tissue connections between the articulating bones nor removal of substantial portions of the bones themselves. Desirably, such prostheses duplicate closely the articulation afforded by a natural joint.
SUMMARY OF THE INVEN llON
A joint prosthesis is provided which can readily be implanted without substantial removal of bone nor disruption of soft tissue connections between the bones. Mimicking the movement of normal physiological joints, the prostheses of the invention permit limited lateral pivoting of one bone with respect to the other when the bones are substantially aligned (that is, when the fingers are extended) but restrain such lateral movement when the bones are flexed through a predetermined angle.
The prosthesis includes a first member having an elongated stem for reception in one of the elongated bones, and a head remote from the stem. The head is provided with a convex articul~ting surface and also lateral articulating surfaces positioned on each side of the convex surface. A second member of the prosthecic has a stem for reception in the other of the two çlong~ted bones, andincludes a base remote from the stem. The base of the second member has a concave articulating surface and also lateral articul~ting surfaces on each side of the concave articulating surface. The concave and lateral articul~ting surfaces of the second member are adapted to engage and articulate with the respecli~e convex and lateral articulating surfaces of the first member. The concave and convex surfaces enable articulation of the joint both in extension/flexion and in the radial/ulnar direction. Of importance, the lateral articul~tinv surfaces of the first and second members are positioned to fully engage and articulate with each otherto restrain lateral articulation only when the bones are articulated through a predetermined minimum degree of flexion, preferably at least 30. Moreover, the articulating surfaces are so positioned that at 90 of flexion, the force between the members is bome primarily by the lateral articulating surfaces rather than by the convex and concave surfaces. In this manner, the phalanx is permitted a range ofradial/ulnar (referred to sometimeS herein as "lateral") articulation when the phalanx is extended, but is restrained from substantially all lateral movement when the joint is flexed through 90. Preferably, the lateral articulating surfaces are so positioned as to contact one another when the fingers are extended only as the phalanges undergo a predetermined degree of lateral pivoting with respect to them~t~ rpals, the amount of such pivoting decreasing as the fingers are flexed through a predetermined arc, such as from 60 to 90, such that subst~nti~lly nopivoting movement is permitted when flexure has reached the end of that àrc.
Prostheses of the invention may be provided in kit form that includes several first members and several second members, the first members varying from one another by virtue of the orientation of their stems, the lateral angle between the stem axes of one prosthesis varying by at least 5 from the lateral angle between the stem axes of another prosthesis in the kit. Particularly, the stems of the first and second members have longitlldin~l axes that lie in planes that are generally pa~llel to the dorsal surfaces of the bones in which they are received. However, the axes of the first and second members may not be aligned or parallel, but may deviate from par~llelicm through up to about 15 in the dorsal plane to more closely match the angle between different ones of the elongated bones of the hand.
The head of the first member and the base of the second member are sufficiently narrow, measured in the radial/ulnar direction, as to avoid int~Çerence with the collateral lig~ments of the joint, thereby enabling these lig~mellt~ to be preserved.
DESCRIPI ION OF THE DRAWINGS
Figures lA, lB and lC are dorsal, lateral and distal end views of a first member of a prosthesis of the invention;
Figures 2A, 2B and 2C are dorsal, lateral and distal end views of a modified version of a first member of a prosthesis of the invention;
Figures 3A, 3B and 3B are dorsal, lateral and proximal end views of a second member of the prosthesis of the invention;
Figures 4A and 4B are perspective views showing different degrees of ar~iculation of a prosthecis of the invention employing the first member of Figures lA, lB and lC;
Figures SA and SB are pe.~ ive views showing different degrees of S articulation of a prosthesis of the invention employing the member shown in Figures 2A, 2B and 2C; and Figure 6 is a dorsal view of the bones of the hand with a prosthesic of the invention as implanted.
DESCRIPTION OF THE PREFERRED EMBODIMENT
For ease of understanding, the invention is described below with reference to the mrt~r~rpal/phalanx joint.
Referring first to Figures 4A, 4B and 6, a prosthesis of the invention is shown at 10 as comprising a first member 12 and a second member 14. Member 12 includes a stem 16 for reception in the marrow cavity at the distal end of a met~c~rpal, and has an articulating convex head design~ted generally as 18.
Member 14 includes a stem 20 for reception in the marrow cavity at the proximal end of a phalanx, and includes a concave base portion shown generally at 22 thatis curved to articulate with the head portion 18 of the first member.
Member 12 shown in Figures 4A and 4B is depicted in greater detail in Figures lA, lB and lC. Stem 16 has a sharpened proximal end 24, and desirably, is generally triangular in cross section as shown at 26 in Figure lC. The stem has dorsal and volar surfaces 28, 30 (Figure lB), and extends generally in a plane parallel to the dorsal surface of the bone (not shown) of the met~r~rpal into which is to be inserted.
At its distal end, the stem 16 is provided with an enlarged head 18 having a generally spheroidal distally facing surface 32. Surface 32 extends toward the palmar direction and then more sharply proximally as shown at 34 in Figure lB.
The palmar and dorsal facing portions of the surface 32 are provided with elongated grooves 36, 37 to aid in proper orientation of the member 12 during implantation and also to receive the extensor and flexor mechanism soft tissues.Spherical surface 32 is formed about an axis 38 as shown in Figures lA
and lB, and it will be noted from Figure lB that the stem 16 is spaced dorsally ._ s from the axis 3~ so as to more closely approach the normal anatomy of the distalend of the metacarpal. If desired, the head 18 may be formed as a generally hemispherical shell having a recessed, inner surface 40 (Figure lB) to which theproximal end of the stem 16 is ~tt~the~, as by welding or, more preferably, by being machined from a single blank of material. The distal end of the metacarpalmay be surgically sculpted so as to be received within the recessed head 18, thereby reducing the amount of bone that must be removed. If desired, the head may be made solid, that is, not be recessed, for the purpose of re~ucing dlfficulty of m~chining the head shape.
Extending laterally (that is, in the radial/ulnar direction) from the side of the spheroidal surface 32, and spaced proximally from the distal end of that surface, are lateral articul~ting surfaces 42, 44. These surfaces, as shown best in Figure lB, are distally facing near the axis 38 and then curve volarly and proximally (in the direction of the stem) as shown at 46 in Figure lB. Note thatlS the surface 46 merges proximally into the surface 34.
Figures 3A, 3B and 3C depict the second member 14 of the prosthesis, this member having a base 22 and a stem 20. Stem 20 is generally oblong in cross section, tapering distally to a sharpened end 50 receivable in the marrow canal at the proximal end of a proximal or first phalanx. The stem termin~tes distally (with respect to the anatomy of the hand) in the base 22, the latter having a concave, desirably generally spheroidal and proximally facing articulating surface 52. Stem S0 has generally broad, flat dorsal and volar sides 54, 56 and narrower, distally converging lateral sides 58, 60. Viewed from the dorsal side as in Figure 3A, the stem and typically the base 22 are symmetrical with respect to the axis 62 of the spheroidal, proximally facing ar~ic~ ting surface 52. As shown in Figure 3B, however, the stem 20 is offset dorsally from the axis 62 so as to better conform to the anatomy of the proximal end of the proximal (first) phalanx.
The base 22 of the second member 14 includes a longitu-lin~lly eYten~ing groove 64 to aid in proper orientation of the member 14 during implantation and also to receive the extensor mech~nism soft tissues. The proximally facing surface of the base 22 extending around about the spheroidal recess 52 includes proximally facing, generally planar surfaces 66, 68 about the periphery of the base near the 2 t 735 77 dorsal-facing edge 70 of the base, and curved portions extending dorsally and distally as shown at 72 and 74 in Figure 3C.
Referring now to Figure 4A, the concave, preferably spheroidal surface 52 of the base 22 of second member 14 is shaped to receive in articulating contact the convex, desirably spheroidal distally facing surface 32 of the head 18 when the members 12 and 14 are suitably implanted in the confronting ends of the mto~ rpal and proximal (first) ph~l~nx bones of the hand. The distally facing portions of the lateral surfaces 42, 44 closely confront but are slightly spaced from the proximally facing surfaces 66, 68 of the base 22 of the second member`so that when the stems 16, 20 of these members are generally aligned (as when the fingers are extended), some lateral pivoting movement of the phalanx is permitted as shown by arrow A in Figure 4A. Contact between the surfaces 68, 44 and 66, 42, respectively, limit the amount of radial/ulnar lateral movement afforded thestem 20 when the fingers are extended.
As the finger is flexed from the position shown at zero degrees flexion in Figure 4A to the position at 90 degrees flexion shown in Figure 4B, the respective curved surfaces 72, 74 of the second member approach and contact the curved volarly and proximally extending portions 46 of the lateral ar~icul~sing surfaces 42, 44 of the first member. When flexion of the finger has reached 90 degrees, the primary load between the two members is borne by the lateral articulating surfaces 42, 44 of the first member, and as such, radialJulnar lateral pivoting of the second member 14 with respect to the first member is subst~n~ y and desirably completely restrained.
Referring again to Figure lA, it will be noted that the stem 16 extends proximally in the dorsal plane at an angle B from the axis 38. Desirably, the prosthesis of the invention is provided in a kit form that includes at least prosthçses specifically designed for fitting different ones of the me~ rpal!phalanx joints. The angle B, for example, can range up to 15 on either side of the axis38, the angle being measured in a plane parallel to the dorsal surface 28. The purpose of the offset indicated by the arrow B in Figure lA is to more accurately position the head 18 of the first member with respect to the axis of the metac~rpal within which the stem 16 is received. It is here noted that the second, third, fourth and fifth met~r~rpals vary in angulation of the articulating head to the long axis of the metacarpal bone in the coronal plane of the arm. Depending on the met~ rpal chosen, as much as a fifteen degree angle is prevalent.
The embodiment shown in Figures 2A, 2B and 2C is identical to that S shown in Figures lA, lB and lC except for two features, and similar elements are given the same identifying numerals. First, it will be noted that the stem 16 when viewed dorsally as in Figure 2A does not deviate in the dorsal plane from the axis 38. As taught above, the first mp-mber typified in Figures 2A, 2B and 2C may appropliately be implanted in the middle or ring finger m~t~ rpal. Second, it will be noted that the lateral articulating surfaces 42, 44 are of full width laterally of the portion 46 of the surface that extends generally volarly and proximally in the direction of the stem. However, near the axis 38 of the member, the lateral articulating surfaces become subst~nti~lly narrower in the dorsal direction, as shown at 80, 82 in Figure 2C.
The purpose of narrowing the lateral articul~ting surfaces in this manner is to enable greater radial/ulnar swinging movement of the phalanges when the fingers are extended, and this feature is shown particularly in Figure SA by arrow A. Here, the second member 14 may be swung laterally through a greater arc when the fingers are extended. However, as the joint is pivoted through 90 degrees, as shown in Figure SB, the curved surfaces 72, 74 of the second member come into contact to an increasing extent with the lateral articul~ting surfaces of the first member such that at 90 degrees, the force between the articul~ting members is borne primarily by the lateral articul~ting surfaces.
The first and second members of the prostheci~ of the invention may be manufactured from any of the materials that have been found acceptable for use in articulating joint prostheses, including, for example, ultra high molecular weight polyethylene, stainless steel, and various metal alloys. The first member, for example, can be made from metal material and the second from ultra high molecular weighe polyethylene. For strength, it is desired that the members of the prostheses be integrally formed, as by m~chining, from solid blanks of material rather than being formed by joining together preformed portions of such members.
For implantation, a straightforward surgical procedure is employed.
Access to the metacarpal/phalanx joint is performed dorsally. The bony joint segments are exposed, care being taken to preserve as much as possible soft tissue connections. The opposing bone ends are surgically sculpted to receive the head 18 and base 22 of the first and second members, respectively, care being taken again to avoid damage to soft tissue connections. Surgical access also is gained to the marrow cavities of the respective bones, and the stems are then implanted inthe marrow cavities using bone cement in the usual fashion. It is contemplated that it may be appropliate in some circumstances to cause the stems of the prosthesis members to fit fairly tightly in the marrow cavities of the bones in which they are implanted, omitting the need for bone cement. In this event, the surfaces of the stems desirably are shaped or treated to encourage bone ongrowthor ingrowth, as by providing the stems with porous surfaces, by applying to the stems a cell adhesion promoter such as collagen or the like, etc.
While a preferred embodiment of the present invention has been described, it should be understood that various changes, adaptations and modifications may be made therein without departing from the spirit of the invention and the scope ofthe appended claims.
Claims (11)
1. A joint prosthesis for replacing a joint between two elongated bones of the hand, comprising a first member having an elongated stem for reception in one of the elongated bones, and a head remote from the stem, the head having a convex articulating surface and lateral articulating surfaces adjacent the convex surface and on each side thereof; and a second member having a stem for reception in the other bone, and a base remote from the stem, the base having a concave articulating surface and lateral articulating surfaces on each side thereof, the concave and lateral surfaces being adapted to engage and articulate with the respective convex and lateral articulating surfaces of the first member;
the lateral articulating surfaces of the first and second members being -positioned to fully engage and articulate with each other to thereby restrain lateral articulation only when the bones are articulated through at least 30 degrees of flexion and wherein at 90 degrees of flexion the force between said members is borne primarily by said lateral articulating surfaces.
the lateral articulating surfaces of the first and second members being -positioned to fully engage and articulate with each other to thereby restrain lateral articulation only when the bones are articulated through at least 30 degrees of flexion and wherein at 90 degrees of flexion the force between said members is borne primarily by said lateral articulating surfaces.
2. The joint prosthesis of claim 1 wherein said lateral articulating surfaces are positioned to limit lateral articulation between the bones when the bones are generally aligned.
3. The joint prosthesis of claim 1 wherein said lateral articulating surfaces are positioned so as not to restrict lateral articulation between the bones when the bones are generally aligned.
4. The joint prosthesis of claim 3 wherein said lateral articulating surfaces are positioned so as to come into articulating contact and gradually reduce the degree of permitted lateral articulation of the bones as the latter are flexed through a predetermined arc of flexion.
5. The joint prosthesis of claim 4 wherein said predetermined arc of flexion ranges from about 60° to about 90° degrees of flexion.
6. The joint prosthesis of claim 1 wherein the stems of the first and second members have longitudinal axes lying in plains generally parallel to the dorsal surfaces of the bones in which they are to be received, said stems being positioned such that when said planes are general parallel and said convex and concave surfaces are engaged, the stem axes lie at a predetermined lateral angle to each other.
7. The joint prosthesis of claim 6 wherein said angle ranges from about -15° to about +15° degrees.
8. A kit for use in surgical replacement of one or more joints between elongated bones of the hand, comprising a plurality of the prostheses of claim 6 wherein said lateral angle between the stem axes of one prosthesis varies by at least 5° from the lateral angle between the stem axes of another prosthesis in said kit.
9. The joint prosthesis of claim 1 wherein said convex articulating surface includes a spheroidal surface through which perpendicularly passes an axis parallel to but spaced in the volar direction from the axis of the stem.
10. The joint prosthesis of claim 1 wherein the lateral surfaces of the first member extend laterally outwardly from said convex articulating surface and are formed on radii about laterally extending axes.
11. The joint prosthesis of claim 10 wherein said convex articulating surface includes a spheroidal surface formed at a predetermined radius from a point, and wherein said lateral articulating surfaces have curved articulating surfaces curving in the volar direction and then away from the spheroidal surface and which are formed about one or more lateral axes spaced further from the spheroidal surface than said point.
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US08/132,300 US5405401A (en) | 1993-10-05 | 1993-10-05 | Prosthesis for replacement of joints between long bones in the hand |
US08/132,300 | 1993-10-05 |
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CA2173577A1 true CA2173577A1 (en) | 1995-04-13 |
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CA002173577A Abandoned CA2173577A1 (en) | 1993-10-05 | 1994-10-04 | Prosthesis for replacement of joints between long bones in the hand |
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GB1582974A (en) * | 1975-11-06 | 1981-01-21 | Schuett & Grundei Sanitaet | Finger joint endoprostheses |
US3991425A (en) * | 1975-11-20 | 1976-11-16 | Minnesota Mining And Manufacturing Company | Prosthetic bone joint devices |
US4158893A (en) * | 1976-10-12 | 1979-06-26 | Swanson Alfred B | Protective sleeve for implantable prosthesis and method of protecting the prosthesis |
US4106128A (en) * | 1976-12-06 | 1978-08-15 | Greenwald A Seth | Endoprosthetic bone joint |
US4059854A (en) * | 1977-01-03 | 1977-11-29 | Laure Prosthetics, Inc. | Ribbed finger joint implant |
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US4231121A (en) * | 1979-07-05 | 1980-11-04 | Wright Dow Corning | Metacarpal-phalangeal prosthesis |
JPS56501034A (en) * | 1979-08-17 | 1981-07-30 | ||
FR2484826B1 (en) * | 1980-06-19 | 1985-10-04 | Gauthier Georges | IMPROVEMENT TO JOINT PROSTHESES |
US4304011A (en) * | 1980-08-25 | 1981-12-08 | Whelan Iii Edward J | Semi-constrained metacarpophalangeal prosthesis |
EP0057597B1 (en) * | 1981-01-30 | 1985-06-26 | Oec Europe Limited | A joint prosthesis |
US4516569A (en) * | 1982-05-06 | 1985-05-14 | National Research Development Corporation | Intramedullary orthopaedic devices |
US4634444A (en) * | 1984-02-09 | 1987-01-06 | Joint Medical Products Corporation | Semi-constrained artificial joint |
US5007932A (en) * | 1985-01-08 | 1991-04-16 | Ngk Spark Plug Co., Ltd. | Artificial bone joint |
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EP0278184A1 (en) * | 1987-02-11 | 1988-08-17 | Thierry Hermann | Joint prosthesis, in particular a finger joint prosthesis |
JPS6446019U (en) * | 1987-09-18 | 1989-03-22 | ||
FR2620932A1 (en) * | 1987-09-28 | 1989-03-31 | Saffar Philippe | PROSTHESIS OF METACARPO-PHALANGIAN OR INTERPHALANGIAN ARTICULATION OF FINGERS |
DE3738436C1 (en) * | 1987-11-12 | 1988-11-24 | Bayern Chemie Gmbh Flugchemie | Electrical ignition device |
US4959071A (en) * | 1988-02-03 | 1990-09-25 | Biomet, Inc. | Partially stabilized knee prosthesis |
US4955916A (en) * | 1989-05-01 | 1990-09-11 | Techmedica, Inc. | Thumb joint prosthesis |
DE59003145D1 (en) * | 1989-09-28 | 1993-11-25 | Sulzer Ag | Finger joint prosthesis. |
GB9018737D0 (en) * | 1990-08-28 | 1990-10-10 | Goodfellow John W | Phosphetic patellar components |
FR2670109B1 (en) * | 1990-10-15 | 1995-07-07 | Lacaffiniere Jean Yves De | TOTAL TRAPEZO-METACARPIAN PROSTHESIS WITH INTERMEDIATE PIECE. |
GB9102633D0 (en) * | 1991-02-07 | 1991-03-27 | Finsbury Instr Ltd | Knee prosthesis |
US5133761A (en) * | 1991-06-12 | 1992-07-28 | Research Development Foundation | Finger joint prosthesis |
DE69222004D1 (en) * | 1991-06-25 | 1997-10-09 | Microaire Surgical Instr Inc | PROSTHESIS FOR A METATARSAL-PHALANGEAL JOINT |
FR2691357A1 (en) * | 1992-05-25 | 1993-11-26 | Tornier Sa | Total prosthesis for the metacarpophalangeal joint. |
-
1993
- 1993-10-05 US US08/132,300 patent/US5405401A/en not_active Expired - Lifetime
-
1994
- 1994-10-04 EP EP94930024A patent/EP0746275A4/en not_active Ceased
- 1994-10-04 AU AU79278/94A patent/AU683100B2/en not_active Ceased
- 1994-10-04 WO PCT/US1994/011238 patent/WO1995009588A1/en not_active Application Discontinuation
- 1994-10-04 JP JP7510978A patent/JPH09506010A/en active Pending
- 1994-10-04 CA CA002173577A patent/CA2173577A1/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
AU683100B2 (en) | 1997-10-30 |
JPH09506010A (en) | 1997-06-17 |
EP0746275A1 (en) | 1996-12-11 |
AU7927894A (en) | 1995-05-01 |
EP0746275A4 (en) | 1997-11-12 |
WO1995009588A1 (en) | 1995-04-13 |
US5405401A (en) | 1995-04-11 |
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Legal Events
Date | Code | Title | Description |
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FZDE | Discontinued |