Acetabular device for hip revision surgery

Abstract

Prostheses, acetabular devices, and methods of use are disclosed. In some embodiments, an acetabular device includes an acetabular cup and an acetabular cage disposed within an interior of the acetabular cup. The acetabular cage can include a central portion including a first segment and a second segment rotatably coupled together and a first flange extending from the first segment and a second flange extending from the second segment. The acetabular prosthesis can also include a fastener extending through each of the acetabular cup and the central portion of the acetabular cage.

Description

[0001] Cross Reference to Related Applications

[0002] This application is a non-provisional of and claims the benefit of the filing date of pending U.S. Provisional Patent Application No. 62 / 823,343, filed March 25, 2019, entitled “Acetabular Apparatuses for Hip Revision Surgery,” which is incorporated herein by reference in its entirety. TECHNICAL FIELD

[0003] The present disclosure relates generally to orthopedic apparatuses and methods for addressing, for example, acetabular defects, and in particular to acetabular apparatuses for hip revision surgery. BACKGROUND

[0004] Articulating regions of anatomy can include regions where two bone segments move relative to one another. For example, an acetabulum can provide a region for articulation with a femoral head. However, articulating regions can be injured or worn, but can be replaced with various prostheses. Such prostheses can replace the acetabulum, the femoral head, and various other portions of the femur, or other combinations thereof. Replacement of both the acetabulum and the femoral head is commonly referred to as a total joint replacement.

[0005] Acetabular apparatuses or prostheses (used interchangeably herein) are one type of prosthesis currently used to address acetabular defects where a large portion of the medial wall is missing. Generally, acetabular apparatuses include an acetabular cage coupled to an acetabular cup via, for example, cement. Acetabular apparatuses (e.g., cages) generally have a central segment that separates an upper flange and a lower flange. Current surgical techniques involve bending the upper and lower flanges in a manner that somewhat matches the patient’s iliac and ischial anatomy. The recent introduction of locking screws and their use practices in revision acetabular surgery have changed the way surgeons perform these types of reconstructions. For example, lower locking screws that are fixed to the ischium and pubis have greatly reduced the need for a lower flange on the cage. As a result, surgeons sometimes completely remove the lower half of the cage and only fix the upper half of the cage and the upper flange. When a full cage is needed, surgeons often struggle with flange orientation because the angles of the upper and lower flanges are fixed and must be forced to match the patient’s anatomy.

[0006] Accordingly, it would be beneficial to provide acetabular apparatuses and methods that address the deficiencies of the prior art. SUMMARY

[0007] This summary is provided to introduce a selection of concepts that are further described below in the detailed description section. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to determine the scope of the claimed subject matter.

[0008] The present disclosure provides an acetabular prosthesis including an acetabular cup and an acetabular cage disposed within an interior of the acetabular cup. The acetabular cage can include a central portion including a first segment and a second segment rotatably coupled together and a first flange extending from the first segment and a second flange extending from the second segment. The acetabular prosthesis can further include a fastener extending through each of the first segment and the second segment of the acetabular cup and the central portion of the acetabular cage.

[0009] The present disclosure provides an apparatus including an acetabular cup and an acetabular cage disposed within an interior of the acetabular cup. The acetabular cage can include a central portion including a first segment and a second segment rotatably coupled together, wherein an end of the first segment overlaps an end of the second segment. The acetabular cage can further include a first flange extending from the end of the first segment and a second flange extending from the end of the second segment. The apparatus can further include a fastener extending through each of the acetabular cup and the overlapping ends of the first segment and the second segment.

[0010] The present disclosure provides a prosthesis or implant, including, for example, a femoral implant coupled to an acetabular assembly, but it is contemplated that the prosthesis or implant can be any suitable prosthesis or implant. In one embodiment, the acetabular assembly can include an acetabular cup and an acetabular cage disposed within an interior of the acetabular cup. The acetabular cage can include a central portion including a first segment and a second segment rotatably coupled together, wherein an end of the first segment overlaps an end of the second segment. The acetabular cage can further include a first flange extending from the end of the first segment and a second flange extending from the end of the second segment. The apparatus can further include a fastener extending through each of the acetabular cup and the overlapping ends of the first segment and the second segment.

[0011] The present disclosure provides a method including positioning an acetabular cage within an interior of an acetabular cup and positioning a first segment of the acetabular cage relative to a second segment of the acetabular cage. The first segment and the second segment can be rotatably coupled together. The method can further include securing the first segment and the second segment of the acetabular cage to the acetabular cup.

[0012] In one embodiment, a hip implant is disclosed that includes an acetabular cup and an acetabular cage. The acetabular cup includes a body extending from an equatorial rim to an apex, the body having a generally convex outer surface and an inner cavity having a generally concave inner surface. The acetabular cage includes a central portion disposed within the inner cavity of the acetabular cup, the central portion including a first segment and a second segment rotatably coupled together, the first segment including a first flange arranged and configured to extend from the rim of the acetabular cup, the second segment including a second flange arranged and configured to extend from the rim of the acetabular cup.

[0013] In one embodiment, the acetabular implant further includes a fastener extending through the acetabular cup and each of the first segment and the second segment of the acetabular cage, the fastener, in use, coupling the acetabular cage to the acetabular cup and securing a position of the first segment relative to the second segment.

[0014] In one embodiment, the first segment and the second segment, in use, are arranged and configured to rotate relative to one another to effect adjustable placement of the first flange and the second flange.

[0015] In one embodiment, the first segment and the second segment of the acetabular cage are arranged and configured to slide relative to one another to effect variable placement of the first segment and the second segment within the inner cavity of the acetabular cup.

[0016] In one embodiment, the first segment of the acetabular cage includes a first end extending from the first flange and a second end arranged and configured to be positioned proximate the apex of the acetabular cup. The second segment of the acetabular cage includes a first end extending from the second flange and a second end arranged and configured to be positioned proximate the apex of the acetabular cup.

[0017] In one embodiment, the second end of the first segment is arranged and configured to overlap the second end of the second segment such that, in use, a fastener is inserted through an opening formed in the acetabular cup, the first segment of the acetabular cage, and the second segment of the acetabular cage.

[0018] In one embodiment, each of the second ends of the first segment and the second segment of the acetabular cage includes a slotted opening arranged and configured to receive a fastener therethrough.

[0019] In one embodiment, the second end of the first segment includes a first recess and the second end of the second segment includes a second recess, the first recess and the second recess being arranged and configured to provide clearance for the second ends of the first and second segments to slide relative to one another.

[0020] In one embodiment, each of the first and second segments of the acetabular cage includes one or more cutouts arranged and configured to provide increased flexibility to facilitate bending of the first and second flanges, respectively.

[0021] In one embodiment, the acetabular cup includes one or more screw holes extending through the body, the one or more screw holes being arranged and configured to receive a fastener; and each of the first and second segments of the acetabular cage includes one or more openings to enable access to the one or more screw holes formed in the acetabular cup.

[0022] In one embodiment, the acetabular cage includes an outer convex surface, the outer convex surface including one or more surface features adapted and configured to ensure a minimum distance between an inner surface of the cup and an outer surface of the cage.

[0023] In one embodiment, the body of the acetabular cup can include a plurality of screw holes arranged and configured to receive a fastener; and the first and second segments of the acetabular cage each include an elongated slot formed therein, the elongated slot being arranged and configured to align with one or more of the plurality of screw holes formed in the acetabular cup such that a fastener can be inserted through one of the elongated slots and one of the plurality of screw holes.

[0024] In one embodiment, the elongated slots formed in the first and second segments of the acetabular cage are arranged and configured such that a head of the fastener engages a perimeter of the elongated slots.

[0025] In one embodiment, the elongated slots formed in the first and second segments of the acetabular cage each include a recessed surface defining an inner edge arranged and configured to engage a head of the fastener.

[0026] In one embodiment, the recessed surface extends along an upper portion and a lower portion of the perimeter of the elongated slot such that, in use, the inner edge engages the head of the fastener on opposite sides thereof.

[0027] In one embodiment, a method of implanting a acetabular implant into an acetabulum of a patient is disclosed. The method includes preparing the acetabulum of the patient as needed; positioning an acetabular cup into the acetabulum of the patient; positioning an acetabular cage within an inner cavity of the acetabular cup, the acetabular cage including a first segment having a first flange and a second segment having a second flange; and adjusting a position of the first segment and the second segment relative to each other to position the first flange and the second flange in a desired position.

[0028] In one embodiment, adjusting the position of the first segment and the second segment relative to each other includes rotating the first segment relative to the second segment.

[0029] In one embodiment, the method further includes fixing the position of the first segment and the second segment relative to each other and relative to the acetabular cup.

[0030] In one embodiment, fixing the position of the first segment and the second segment includes inserting a fastener through an opening formed in the first segment, through an opening formed in the second segment, and through an opening formed in the acetabular cup.

[0031] In one embodiment, the opening formed in the acetabular cup is formed at an apex of the acetabular cup.

[0032] In one embodiment, positioning an acetabular cage within an inner cavity of the acetabular cup, the acetabular cage including a first segment having a first flange and a second segment having a second flange, includes selecting one of the first segment and the second segment; positioning the selected first segment or second segment into the inner cavity of the acetabular cup; and discarding the other of the first segment and the second segment of the acetabular cage.

[0033] Embodiments of the present disclosure provide a number of advantages. For example, providing an acetabular cage having multiple segments provides ease of use and variability, which enables patient-matched flange orientation (e.g., iliac and ischial). Thus, a surgeon can choose to use all or part of the acetabular cage during surgery. Further, the variability of the halves eliminates the need for left and right acetabular cages. When using an apex fastener (e.g., a screw), rigid or temporary attachment of the acetabular cage and acetabular cup is achieved. In some embodiments, the apex fastener floats within the half cage until fastened to the acetabular cup. This allows the acetabular cup and acetabular cage to be positioned as an assembly. Further, the acetabular cage can be provided with one or more perforations to further aid in removal of one or more portions of the acetabular cage.

[0034] The foregoing and other features and advantages of at least some of the embodiments of the present disclosure are described in detail below with reference to the attached drawings. Attached Figure Description

[0035] Specific embodiments of the apparatus of this disclosure will now be described by way of example only in the accompanying drawings, in which:

[0036] Figure 1A A perspective view showing an example embodiment of the device according to the present disclosure;

[0037] Figure 1B Showing according to this disclosure Figure 1A A perspective view of an example embodiment of the acetabular cage of the device;

[0038] Figure 1C This illustrates the inclusion of a lining according to the present disclosure. Figure 1A A top view of an example embodiment of the device;

[0039] Figure 2A A perspective view showing an example embodiment of the device according to the present disclosure;

[0040] Figure 2B Showing according to this disclosure Figure 2A A perspective view of an example embodiment of the acetabular cage of the device;

[0041] Figure 2C This shows the relationship with the present disclosure. Figure 2A A cross-sectional view of an example embodiment of fasteners used with the equipment;

[0042] Figure 3A A perspective view showing an example embodiment of the device according to the present disclosure;

[0043] Figure 3B Showing according to this disclosure Figure 3A A perspective view of an example embodiment of the acetabular cage of the device;

[0044] Figure 4A A perspective view showing an example embodiment of the device according to the present disclosure;

[0045] Figure 4B One aspect of this disclosure is shown. Figure 4A A bottom perspective view of an example embodiment of the acetabular cage of the device, which includes multiple surface features;

[0046] Figure 4C One aspect of this disclosure is shown. Figure 4B A perspective view of an example embodiment of the acetabular cage;

[0047] Figure 4D This illustrates the inclusion of a lining according to the present disclosure. Figure 4C A perspective view of an example embodiment of the acetabular cage;

[0048] Figure 5 a side cross-sectional view of an example embodiment of an apparatus according to the present disclosure;

[0049] Figure 6 a perspective view of an example acetabular cage according to the present disclosure;

[0050] Figure 7A a top view of an example embodiment of an apparatus according to the present disclosure;

[0051] Figure 7B a side cross-sectional view of an example embodiment of an apparatus according to the present disclosure; Figure 7A

[0052] Figure 8 a perspective view of an example prosthesis according to the present disclosure;

[0053] Figure 9 a method according to an embodiment of the present disclosure; and

[0054] Figure 10 a perspective view of an example embodiment of a bone plate according to the present disclosure.

[0055] The drawings are not necessarily to scale. The drawings are merely schematic representations, not intended to portray specific parameters of the disclosure. The drawings are intended to depict only typical embodiments of the disclosure, and therefore should not be considered as limiting the scope of the disclosure. In the drawings, like numbering denotes like elements.

[0056] Additionally, for clarity some of the drawings can omit certain elements or not be to scale. Cross-sectional views can be in the form of "sliced" or "near- sighted" cross-sectional views that omit certain background lines that would otherwise be visible in a "true" cross-sectional view for the sake of clarity. Additionally, some reference numbers can be omitted from certain drawings for the sake of clarity. DETAILED DESCRIPTION

[0057] ​Embodiments of improved acetabular devices for hip revision surgery will now be described more fully below in connection with the accompanying drawings, in which preferred embodiments of the disclosure are shown. As will be described and shown, in some embodiments, the improved acetabular devices, implants, assemblies, prostheses, etc. (terms used herein interchangeably without intending to be limiting) include an acetabular shell or cup (terms used herein interchangeably without intending to be limiting) and an acetabular cage. In one embodiment, as will be described in greater detail, the cage is adapted and configured to provide variability in the orientation of the flanges by incorporating separate upper and lower cage portions or halves that can be used together as an assembly or separately. Additionally and / or alternatively, the cage can be coupled, secured or the like to the cup by aligning holes formed at the apex of the dome of the cage and cup. Appropriate fasteners, such as screws, can then be inserted through the aligned holes. The fasteners can be used to hold permanently or temporarily, for example, in positioning one or more flanges of the cage. Although the various cages described herein include a pair of flanges, in alternative embodiments there can be a greater or lesser number of flanges. For example, it is contemplated that various cages can include one, three, four or more flanges.

[0058] As will be described and shown, in some embodiments, the improved acetabular devices include a cage having surface features adapted and configured to allow for improved cementation between the cup and the cage. The surface features can be provided in any appropriate manner now known or later developed, including, for example, grooves, recesses, indentations, etc. formed along the outer surface of the cage. The surface features can be oriented radially, spherically or radially-spherically. In various embodiments, the surface features can be arranged and configured to ensure a minimum distance between the cup and the cage for receiving cement.

[0059] Additionally and / or alternatively, as will be described and shown, in some embodiments, the improved acetabular devices include a cup and a cage (used herein interchangeably without intending to be limiting) that includes a slot or opening for coupling the cage to the cup with a fastener. In one example, the slot can be provided along the inner diameter (ID) of the cage. The slot is configured to align with a screw hole or slot in the cup so that a screw or screws can be inserted through the slots / openings formed in the cage and cup without having to drill holes in the cage. In one embodiment, the slot formed in the cage can be sized so that the head of the screw engages the perimeter of the slot. Thus, the screw will bias the two implants together while engaging the host bone.

[0060] In another embodiment, the slot or opening formed in the cage can include a recessed surface or tab configured to engage the head of the screw. The head of the screw can also engage a locking tab or pin that surrounds the opening(s) through the cup when the screw is being inserted into the host bone.

[0061] Reference Figures 1A-1CFIG. 1 shows a non-limiting example embodiment of an acetabular prosthesis or device 100. As shown, the device 100 can include an acetabular cage (hereinafter "cage") 102 that is insertable within an interior or inner cavity (used interchangeably herein) of an acetabular cup (hereinafter "cup") 104. The cup 104 can include a hollow body (hereinafter "body") 106 that extends from a meridian edge 108 to its apex or pole. As shown, the body 106 can define a generally convex outer surface 110 and a generally concave inner surface 112. The meridian edge 108 defines a circular opening for receiving a central portion 114 of the cage 102 therein. In some embodiments, the cage 102 and cup 104 can be fixed together using cement. For example, cement can be disposed between an outer surface 111 of the central portion 114 of the cage 102 and the inner surface 112 of the cup 104. In other embodiments, the cage 102 and cup 104 can be mechanically / molded coupled at one or more interfaces. Embodiments herein are not limited in this context.

[0062] As shown, the cup 104 can also include a plurality of openings 116 (also referred to herein as screw holes) through the body 106 between the outer surface 110 and the inner surface 112. In use, the plurality of openings 116 can receive fasteners (not shown) therein, as will be described in greater detail below. In use, the fasteners extend through the plurality of openings 116 for engagement with host bone (not shown). As will be appreciated by one of ordinary skill in the art, in other embodiments, there can be a greater or lesser number of openings 116. The openings can be locking or non-locking, and additionally, the locking openings can be fixed or polyaxial.

[0063] Although non-limiting, the cup 104 can be made of many different materials, including titanium, cobalt chrome, stainless steel, ceramic, or other biocompatible materials. In some embodiments, the outer surface 110 can be porous and can be constructed of titanium, cobalt chrome, polymer, or other biocompatible materials. Additionally, the cup 104 can be a combination of different biocompatible materials. For example, the cup 104 can be cobalt chrome with a porous titanium coating on the outer surface 110. Various manufacturing techniques can be used to manufacture the cup and / or cage. For example, either implant can be cast and machined or printed, e.g., by selective laser sintering.

[0064] The cage 102 can include a first or upper flange 118 extending from the edge 120 of the cage 102, and a second or lower flange 122 also extending from the edge 120. In some embodiments, the bone-contacting sides of the first flange 118 and the second flange 122 can be solid or porous. Each of the upper flange 118 and the lower flange 122 can include a plurality of openings 124 for receiving corresponding fasteners (not shown). The openings 124 can be locking or non-locking screw holes. In use, the fasteners extend through the openings 124 for engagement with host bone (not shown). As will be appreciated by one of ordinary skill in the art, in other embodiments, the upper flange 118 and the lower flange 122 can include a greater or lesser number of openings 124. Furthermore, the cage 102 is not limited to a pair of flanges (e.g., the upper flange 118 and the lower flange 122), and in other embodiments can include a greater or lesser number of flanges. For example, it is contemplated that the cage 102 can include one, three, four, or more flanges.

[0065] Figure 1B The cage 102 of the apparatus 100 is also shown Figure 1A As shown, the cage 102 can include an apex aperture 128 extending through the body 106, where the apex aperture 128 can align with an opening (not shown) formed at the apex of the cup 104. In some embodiments, the apex aperture 128 can be threaded for engagement with a fastener, such as a screw. As will be described in further detail below, the fastener can extend through the apex aperture 128 and the opening of the cup 104 to couple the cage 102 and the cup 104 together.

[0066] As also shown, the cage 102 can include one or more slots 132 extending between the outer surface 111 and the inner surface 113 of the central portion 114. The slots 132 can be defined by a perimeter 134 and separated from one another by one or more support members 136. The slots 132 are operable to receive one or more fasteners therethrough. As Figure 1A As best shown in FIG. 1, the slots 132 facilitate alignment through the body 106 of the cup 104 with one or more of the openings 116. In some embodiments, the slots 132 can allow the cage 102 to be rotated relative to the cup 104 prior to fixation, while still enabling the slots 132 to align with the openings 116 formed in the cup 104. The fasteners can extend through the slots 132 and the openings 116 for engagement with host bone. In the case where the fasteners are screws, the perimeter 134 of the slots 132 can be sized to engage the head of each screw. Thus, as the screws are further fixed into the host bone, the cup 104 and the cage 102 are more tightly fixed together.

[0067] As Figure 1CAs shown in FIG. 1, the device 100 can also include a liner 140 within the cage 102. The liner 140 can include a hollow body 142 that generally conforms to the interior shape of the cage 102. The liner 140 can be formed of any suitable material now known or later developed, including, for example, polyethylene materials, such as ultra-high molecular weight polyethylene, ceramic materials, or even metal in some cases, which can be coupled within the cage 102 to provide an inner bearing surface for receiving, mating, etc. an articulating prosthetic femoral head, for example, in articulating relationship so as to track and accommodate relative movement between the femur and the acetabulum. Although not limiting, the liner 140 can be secured to the cage 102 by any suitable mechanism now known or later developed, including, for example, cement, various mechanical / molded connectors, etc.

[0068] Reference is made to Figures 2A-2C FIG. 2, which shows a non-limiting example embodiment of an acetabular prosthesis or device 200. As shown, the device 200 can include a cage 202 that is insertable within the interior of a cup 204. The device 200 can be the same or similar in many respects to the device 100 shown in FIG. 1 and described above. Accordingly, for the sake of brevity, only certain features of the device 200 will be described below. Figures 1A-1C

[0069] As shown, the cup 204 can include a hollow body 206 that extends from a median edge 208 to an apex or pole thereof. As shown, the body 206 can define a generally convex outer surface 210 and a generally concave inner surface 212. The median edge 208 defines a circular opening for receiving a central portion 214 of the cage 202 therein. As shown, the cup 204 can also include a plurality of openings 216 through the body 206, for example, between the outer surface 210 and the inner surface 212.

[0070] Although not limited to any particular number of flanges, the cage 202 can include a first or upper flange 218 that extends from an edge 220 of the cage 202, as well as a second or lower flange 222 that also extends from the edge 220. Each of the upper flange 218 and the lower flange 222 can include a plurality of openings 224 for receiving a corresponding fastener. In use, the fasteners extend through the openings 224 for engagement with the host bone.

[0071] The cage 202 can include an apical aperture 228 that extends through the central portion 214, where the apical aperture 228 can be aligned with an opening 229 formed in the apex of the cup 204. In some embodiments, the apical aperture 228 can be threaded for engagement with a fastener, such as a screw, where the fastener can extend through the apical aperture 228 of the cage 202 and the opening 229 of the cup 204 to secure the cage 202 and the cup 204 together. Although not shown, the cage 202 can also include a liner disposed along the inner surface 213 of the central portion 214 as previously described.​

[0072] In some embodiments, the cage 202 can include one or more slots 232 extending between the outer surface 211 and the inner surface 213 of the central portion 214. The slots 232 can be defined by a perimeter 234 and separated from one another by a support member 236. The slots 232 can be aligned with one or more of the openings 216 disposed through the body 206 of the cup 204. One or more fasteners 240 can extend through the slots 232 and the openings 216 for engagement with the host bone. As shown, the slots 232 can include one or more recessed surfaces 242 configured to engage the fasteners 240. In particular, as shown in FIGS. 2 and 3, the recessed surfaces 242 define an inner edge 241 that is operable to engage a head 243 of the fastener 240. Further, the recessed surfaces 242 can define a locking or non-locking hole. Figure 2A and Figure 2C As best shown in FIGS. 2 and 3, the recessed surfaces 242 define an inner edge 241 that is operable to engage a head 243 of the fastener 240. Further, the recessed surfaces 242 can define a locking or non-locking hole.

[0073] In the illustrated non-limiting embodiment, the recessed surfaces 242 extend along the upper and lower portions of the perimeter 234 of the slots 232. So arranged, the inner edge 241 can thus engage the head 243 of the fastener 240 on opposite sides. As shown, the recessed surfaces 242 are recessed from the inner surface 213 of the central portion 214 of the cage 202. In other words, the inner diameter of the recessed surfaces 242 is greater than the inner diameter of the inner surface 213 taken along a plane perpendicular to the plane defined by the equatorial edge 208. This allows the head 243 of the fastener 240 to recess below the ID of the cage 202 defined by the inner surface 213, thereby preventing interference with a liner subsequently implanted inside the cage 202 as previously described.

[0074] The head 243 of the fastener 240 is configured to engage the recessed surfaces 242, which biases the cage 202 toward the cup 204. The fastener 240 can continue through the openings 216 of the body 206 into the host bone. In some embodiments, the head 243 of the fastener 240 is externally threaded, i.e., a locking screw. The openings 216 through the body 206 of the cup 204 can also be threaded to engage the threaded head 243 of the fastener 240. In other embodiments, the head 243 of the fastener 240 is non-locking.

[0075] As shown in FIGS. 2 and 3, the recessed surfaces 242 define an inner edge 241 that is operable to engage a head 243 of the fastener 240. Further, the recessed surfaces 242 can define a locking or non-locking hole. Figure 2A and Figure 2CAs shown in the middle, the opening 216 through the body 206 and / or the openings 224 of the upper and lower flanges 218, 222 can include fins 245 or protrusions that extend radially inward from an inner surface 246 of the opening 216 and into an interior region of the opening 216 and are configured to engage or cooperate with the head 243 of the fastener 240. In use, the fins 245 engage the head 243 of the fastener 240 so as to secure the fastener 240 at a desired location and desired angular orientation within the opening 216. As described in U.S. Patent No. 10,092,337 entitled “Systems and Methods for Using Polyaxial Plates,” the entirety of which is hereby incorporated by reference, the opening 216 can be provided with an opposing jagged or undulating inner circumference formed by the inwardly projecting fins 245, and a recess or indentation is formed between adjacent pairs of fins that extend to a location adjacent the inner surface 246 of the opening 216. Additionally, the inner surface 246 can have a generally circular configuration with the fins 245 defining convex protrusions that extend inward into the opening 216. However, other shapes and configurations of the opening 216 and / or flexible fins 245 are also contemplated.

[0076] Reference Figures 3A-3B A non-limiting example embodiment of an acetabular prosthesis or device 300 is shown. As shown, the device 300 can include a cage 302 that is insertable within an interior of a cup 304. The device 300 can be identical or similar to the devices 100, 200 described above in many respects. Accordingly, for the sake of brevity, only certain features of the device 300 will be described below.

[0077] As shown, the cup 304 can include a hollow body 306 that extends from a median edge 308 to an apex or pole thereof. As shown, the body 306 can define a generally convex outer surface 310 and a generally concave inner surface 312. The median edge 308 defines a circular opening for receiving a central portion 314 of the cage 302 therein. As shown, the cup 304 can also include a plurality of openings 316 through the body 306, for example, between the outer and inner surfaces 310, 312.

[0078] While not limited to any particular number of flanges, the cage 302 can include a first or upper flange 318 that extends from an edge 320 of the cage 302, and a second or lower flange 322 that also extends from the edge 320. Each of the upper and lower flanges 318, 322 can include a plurality of openings 324 that receive corresponding fasteners (not shown). In use, the fasteners extend through the openings 324 for engagement with host bone.

[0079] Cage 302 may include a vertex aperture 328 extending through the central portion 314, wherein the vertex aperture 328 may be aligned with an opening formed at the vertex of cup 304. In some embodiments, the vertex aperture 328 may be threaded into a fastener such as a screw, wherein the fastener may extend through the vertex aperture 328 of cage 302 and the opening of cup 304 to secure cage 302 and cup 304 together. Although not shown, cage 302 may also include a liner disposed along the inner surface 313 of the central portion 314 as previously described.

[0080] As also shown, cage 302 may include one or more central apertures 350 extending between the outer surface 311 and the inner surface 313 of the central portion 314. The central apertures 350 may be aligned with one or more of the openings 316 provided through the body 306 of cup 304. One or more fasteners (not shown) may extend through the central apertures 350 and the openings 316 for engagement with host bone. Figure 3A As shown, the opening 316 through the body 306 may include fins 345 or protrusions that extend radially inward from the inner surface 346 of the opening 316 and into its interior region, as previously described.

[0081] refer to Figures 4A-4D The figure illustrates a non-limiting example embodiment of an acetabular prosthesis or device 400. As shown, device 400 may include a cage 402 that can be inserted into the interior of a cup 404. Device 400 may be identical or similar in many respects to devices 100, 200, and 300 described above. Therefore, for the sake of brevity, only certain features of device 400 will be described below.

[0082] While not limited to any particular number of flanges, cage 402 may include a first or upper flange 418 extending from edge 420 of cage 402, and a second or lower flange 422 also extending from edge 420. Each of the upper flange 418 and lower flange 422 may include a plurality of openings 424 for receiving corresponding fasteners (not shown). As shown, cage 402 may also include one or more openings 444 operable to receive instruments (not shown) for positioning and retaining cage 402. In use, fasteners extend through openings 424 for engagement with host bone. Furthermore, as... Figure 4D As shown, the cage 402 may include a liner 440 disposed along the inner surface 413 of the central portion 414 as previously described. Although not limiting, the liner 140 may be secured to the cage 102 by any suitable mechanism now known or developed in the future, including, for example, adhesives, various mechanical / modular connectors, etc.

[0083] As further shown, the cage 402 can include one or more surface features 454 that allow for improved cement adhesion when the cage 402 is coupled to the cup 404. The surface features 454 can be formed along the outer surface 411 of the cage 402 (e.g., on the outer diameter of the dome portion of the cage 402). In some embodiments, the surface features 454 can be in the form of spherical or radial beads, tubes, grooves, tabs, bumps, slots, roughened surfaces, abnormal shapes, etc. As will be appreciated by one of ordinary skill in the art, the surface features 454 can take a variety of alternative forms in other embodiments. In various embodiments, the surface features 454 can be arranged and configured to ensure a minimum distance between the cup 404 and the cage 402 for receiving a minimum thickness of, for example, cement. For example, the surface features 454 can be in the form of ridges, shrouds, etc. to ensure a minimum thickness between the cup 404 and the cage 402.

[0084] Reference is made to Figure 5 FIG. 5 shows a non-limiting example embodiment of an acetabular prosthesis or device 500. As shown, the device 500 can include a cage 502 that is insertable within the interior of a cup 504. The device 500 can be identical or similar to the devices 100, 200, 300, and 400 described above in many respects. Accordingly, for the sake of brevity, only certain features of the device 500 will be described below.

[0085] As shown, the cup 504 can include a hollow body 506 that extends from a median-limb edge 508 to its apex or vertex 556. As shown, the body 506 can define a generally convex outer surface 510 and a generally concave inner surface 512.

[0086] The cage 502 can include an apex aperture 528 that extends through a central portion 514 thereof, where the apex aperture 528 can be aligned with an apex opening 529 formed in the cup 504. As shown, the apex aperture 528 and the apex opening 529 are generally aligned at the vertex 556 of the cup 504. In some embodiments, the apex aperture 528 can be threaded for engagement with a fastener 560, such as a threaded screw, where the fastener 560 can extend through the apex aperture 528 of the cage 502 and the apex opening 529 of the cup 504 to secure the cage 502 and the cup 504 together. As shown, the fastener 560 can be flush with or recessed below the ID of the cage 502 defined by the inner surface 513, thus preventing interference with a liner (not shown) that can be subsequently implanted inside the cage 502. In other embodiments, the cage 502 and the cup 504 can be secured together using a threaded rod (not shown) that is part of the cup 504 that protrudes toward the interior of the cup 504.

[0087] Reference is made to Figure 6FIG. 6, shows a non-limiting example embodiment of an acetabular cage 602 that can be inserted within the interior of a cup (not shown). The cage 602 can be identical or similar in many respects to the cages 102, 202, 302, 402, and 502 described above. Thus, for the sake of brevity, only certain features of the cage 602 will be described below. The cup can be identical or similar in many respects to the cups 104, 204, 304, 404, and 504 described above.

[0088] While not limited to any particular number of flanges, the cage 602 can include a first or upper flange 618 extending from the rim 620 of the cage 602, and a second or lower flange 622 also extending from the rim 620. Each of the upper flange 618 and the lower flange 622 can include a plurality of openings 624 for receiving a corresponding fastener (not shown). In use, the fasteners extend through the openings 624 for engagement with the host bone.

[0089] The cage 602 can include an apex aperture 628 extending through the central portion 614, where the apex aperture 628 can align with an opening, e.g., an apex opening, formed in the cup. In some embodiments, the apex aperture 628 can be threaded for engagement with a fastener, e.g., a screw, where the fastener can extend through the apex aperture 628 of the cage 602 and the opening of the cup to secure the cage 602 and the cup together.

[0090] As also shown, the cage 602 can include one or more central apertures 650 extending between the outer surface 611 and the inner surface 613 of the central portion 614. The central apertures 650 can align with one or more of the openings disposed through the body of the cup. One or more fasteners (not shown) can extend through the central apertures 650 for engagement with the host bone.

[0091] The cage 602 can include one or more perforations 660 to allow for sectioning of the central portion 614. For example, the perforations 660 can assist a user wishing to section portions of, e.g., the central portion 614 and the lower flange 622. In the non-limiting embodiment shown, two linear perforations 660 can be disposed on opposite sides of the apex aperture 628. Depending on whether a fastener is to be disposed through the apex aperture 628, the user can select between the two perforations 660. As will be appreciated by one of ordinary skill in the art, the perforations 660 can take a variety of alternative arrangements in other embodiments. For example, perforations can also be provided through the upper flange 618 and / or the lower flange 622 to provide increased versatility.

[0092] Reference Figures 7A-7BFIG. 7 shows a non-limiting example embodiment of a hip joint prosthesis or device 700. As shown, the device 700 can include a cage 702 insertable within an interior of a cup 704. The cup 704 can include a hollow body 706 extending from a median edge 708 to an apex 756 or extreme thereof. As shown, the body 706 can include an inner cavity 705. The body 706 can define a generally convex outer surface 710 and a generally concave inner surface 712. The median edge 708 defines a circular opening for receiving a central portion 714 of the cage 702 therein. Although not shown, the cup 704 can also include a plurality of openings through the body 706, for example, between the outer surface 710 and the inner surface 712.

[0093] Although not limited to any particular number of flanges, the cage 702 can include a first or upper flange 718 extending from an edge 720 of the cage 702, and a second or lower flange 722 also extending from the edge 720. Each of the upper flange 718 and the lower flange 722 can include a plurality of openings 724 receiving corresponding fasteners. In use, the fasteners, which can be locking or non-locking, extend through the openings 724 for engagement with host bone.

[0094] As shown, the cage 702 can include two or more segments, for example, a first segment 770 and a second segment 772, connected together. It should be understood that although example embodiments will be described and shown as including two segments, it is contemplated that the cage 702 can include three, four, or more segments, each segment including one or more flanges.

[0095] As illustrated in example embodiments, the first segment 770 can include a first end 773 extending from the lower flange 722 and a second end 774 adjacent the apex 756 of the cup 704. One or more cutouts 780 can be provided at the intersection of the first end 773 and the lower flange 722 to increase flexibility. The second end 774 can include a slotted opening 775 configured to receive a fastener 760 therethrough.

[0096] The second segment 772 can include a first end 776 extending from the upper flange 718, and a second end 777 proximate the apex 756 of the cup 704. One or more cutouts 782 can be provided at the intersection of the first end 776 and the upper flange 718 to increase flexibility. The second end 777 can include a slotted opening 778 configured to receive the fastener 760 therethrough. As shown, the second end 777 of the second segment 772 can overlap the second end 774 of the first segment 770, or vice versa. Accordingly, the first segment 770 and the second segment 772 can be rotated relative to one another (e.g., as shown by arrow 784) about a central axis 'CA' extending through the slotted openings 775, 778 and through the fastener 760 (e.g., the first segment 770 and the second segment 772 can be moved relative to one another prior to tightening of the fastener 760 so that the upper flange 718 and the lower flange 722 can be positioned as desired). The overlap of the respective second ends 774, 777 can hold the first segment 770 and the second segment 772 in the same plane while also minimizing the thickness of the cage 702. Alternatively and / or additionally, the openings, such as the opening 778, can be used to facilitate cement bonding between the cage 702 and the cup 704 as cement can be injected into the openings.

[0097] Further, as Figure 7B As best shown, the first segment 770 and the second segment 772 can be arranged and configured so that the first segment and the second segment can be moved, slid, etc. relative to one another as shown by arrow 787. For example, in one embodiment, the first segment 770 can include a first cutout or recess 785 and the second segment 772 can include a second cutout or recess 786. The first cutout or recess 785 and the second cutout or recess 786 can be centrally located. The first cutout or recess 785 and the second cutout or recess 786 provide clearance for the second ends 774, 777 to slide relative to one another, for example, in the direction shown by arrow 787. In use, the slotted openings 775, 778, as well as the first and second cutouts or recesses 785, 786, help to increase the flexibility in positioning the first segment 770 and the second segment 772 relative to one another and relative to the cup 704. For example, the slotted openings 775, 778, as well as the first and second cutouts or recesses 785, 786, allow the outer diameter of the cage 702 to be more conforming to the inner diameter of the cup 704, and allow one cage 702 to be installed with multiple different cups 704 (e.g., a single cage 702 can be installed with three different cup 704 sizes).

[0098] In use, the first and second sections 770, 772 can be arranged in a desired position and then secured in place by the fasteners 760. The slotted openings 775, 778 can be threaded or non-threaded. As shown, the slotted openings 775, 778 are aligned with the openings 729 of the cup 704, wherein the fasteners 760 can extend through the slotted openings 775, 778 and through the openings 729 of the cup 704 to secure the cage 702 and cup 704 together. In the non-limiting embodiment shown, the openings 724 of the upper and lower flanges 718, 722 can include fins 745 or protrusions that extend radially inward from the inner surface 746 of the openings 724 and into the interior region thereof. The fins 745 are configured to engage or cooperate with the head of a fastener (not shown) so as to secure the fastener in a desired position and a desired angular orientation within the openings 724. In some embodiments, the openings 724 can be provided with an opposing jagged or undulating inner circumference formed by the inwardly projecting fins 745, and between adjacent pairs of fins form a pocket or indentation that extends to a location near the inner surface 746 of the openings 724. Additionally, the inner surface 746 can have a generally circular configuration with the fins 745 defining a convex protrusion that extends inward into the openings 724. However, other shapes and configurations of the openings 724 and / or flexible fins 745 are also contemplated.

[0099] In some embodiments, each of the first and second sections 770, 772 can include one or more openings or windows 788. In use, the openings or windows 788 enable access to one or more screw holes (not shown) formed in the cup 704. Although shown as a series of circles, other configurations of the windows 788 are possible in various alternative embodiments. For example, in one embodiment, a single larger opening or window 788 can be formed in each of the first and second sections 770, 772. It should also be understood that while the openings or windows 788 are shown as circular, the openings or windows can have any shape, including, for example, square, rectangular, trapezoidal, etc. Moreover, the openings or windows on the first section 770 need not be the same as the openings or windows on the second section 772.

[0100] As Figure 8 As shown in FIG. 8, the devices described herein can be a portion of a prosthesis 801, such as a hip joint implant. The prosthesis 801 can include a femoral implant 803 having a prosthetic femoral head 805 extending from a femoral stem 807. As shown, the femoral head 805 can be inserted into a hip cup prosthesis or device 800. The device 800 can be the same or similar in many respects to the devices 100, 200, 300, 400, 500, 600, and 700 described above. When the femoral implant 803 is coupled with the device, the femoral head 805 can rotate / articulate relative to the inner surface of the liner 840 of the device 800.

[0101] Referring to Figure 9 , a non-limiting example embodiment of the method 900 is shown. In use, the acetabulum can be exposed and evaluated, thereby identifying the location of quality bone. The acetabulum can be reconstructed using various instruments, e.g., impactors, reamers, etc., as desired. Next, at block 901, the method 900 can include positioning and securing an acetabular cup into the target host bone. The acetabular cup can be impacted into the target host bone, and in some embodiments, one or more optional fasteners can be inserted through the cup into the host bone. At block 903, the method 900 can include positioning an acetabular cage within the interior of the acetabular cup. In use, the lower and upper flanges of the cage can be appropriately positioned, and in some embodiments, the cage can be appropriately contoured as desired. In some embodiments, the cup can include a hollow body extending from a mid- latitude edge to its apex or pole. Although non-limiting, the body can define a generally convex outer surface and a generally concave inner surface. The mid-latitude edge defines a circular opening for receiving a central portion of the cage therein. The cup can further include a plurality of openings through the body between the outer and inner surfaces. In use, the plurality of openings can receive corresponding fasteners.

[0102] In some embodiments, the cage can include an upper flange extending from an edge of the cage, and a lower flange also extending from the edge. Each of the upper and lower flanges can include a plurality of openings receiving corresponding fasteners. In use, the fasteners extend through the openings for engagement with the host bone.

[0103] At block 905, if the acetabular cage includes a first movable section and a second movable section, the method 900 can include positioning the first section of the acetabular cage relative to the second section of the acetabular cage. The first and second sections can be rotatably coupled together. In some embodiments, the first section can include a first end extending from the lower flange, and a second end proximate the apex of the cup. The second end of the first section can include an opening configured to receive a fastener therethrough. The second section can include a first end extending from the upper flange, and a second end proximate the apex of the cup. The second end of the second section can include an opening configured to also receive a fastener therethrough. In some embodiments, the second end of the second section can overlap the second end of the first section. Thus, the first and second sections can be rotated relative to each other about a central axis extending through the openings and through the fasteners.

[0104] At block 907, the method 900 can also include securing the acetabular cage to the cup. For example, the first and second segments of the acetabular cage can be coupled to the acetabular cup. In other embodiments, the acetabular cage can be a single continuous component secured to the cup. In some embodiments, fasteners extend through the first and second segments of the acetabular cage, and the openings of the cup are tightened. Once tightened, the first and second segments of the acetabular cage and the acetabular cup are secured in place. The acetabular cage can then be secured to the host bone.

[0105] After the cage has been properly positioned relative to the cup, cement can be inserted, injected, and the like into the cage to, among other things, facilitate better coupling between the cage and the cup. Alternatively, it should be appreciated that the cement can be inserted, injected, or the like prior to inserting the cage into the cup. It should be appreciated that the cement can be inserted, injected, or the like into the cage before, after, or both before and after the time of placement relative to the cage. Finally, a liner can be inserted into the cage if desired.

[0106] With reference to Figure 10 , a non-limiting example embodiment of an implant 1070 is shown. The implant 1070 can be a bone plate for coupling to a patient's bone. The implant 1070 can include an outer surface 1071, a bone-contacting surface (not shown), a first end 1072, a second end 1074, and a central longitudinal axis 1076. As shown, the implant 1070 also includes one or more slots 1075. The one or more slots 1075 may, for example, extend through the implant 1070 from the upper surface 1071 to the bone-contacting surface. In some embodiments, the implant 1070 can have a variety of different shapes and sizes. For example, one or more segments of the implant 1070 can have a profile or curve that generally corresponds to a similar profile or curve of a portion of a bone, the bone-contacting surface of the implant 1070 can abut or otherwise be located adjacent to the profile or curve. Moreover, the implant 1070 can be composed of a variety of materials, including, for example, stainless steel, titanium, polymers, and / or ceramics, among other materials.

[0107] As shown, the slots 1075 can be defined by a perimeter 1034 and one or more recessed surfaces 1042, similar to the configuration of the slots 232 described in connection with Figures 2A-2C As shown, the slots 1075 can be defined by a perimeter 1034 and one or more recessed surfaces 1042, similar to the configuration of the slots 232 described in connection with

[0108] In the non-limiting embodiment shown, the recessed surfaces 1042 extend along opposite sides of the central longitudinal axis 1076. So arranged, the inner edges 1041 can thus engage the heads of fasteners on opposite sides (as shown in FIG. 10B). In various embodiments, the recessed surfaces 1042 can define locking or non-locking holes.Figure 2C In some embodiments, the size of the slot 1075 is set to allow the head of the fastener to recess below the outer surface 1071 of the implant 1070.

[0109] Although the implant 1070 is shown and described in the context of a bone plate, embodiments herein are not limited thereto. The slot 1075 can be used with various different types of medical implants.

[0110] While the present disclosure sets forth certain embodiments, numerous modifications, alterations, and changes to the described embodiments are possible without departing from the sphere and scope of the present disclosure, as defined in the appended claims. Accordingly, it is intended that the present disclosure not be limited to the described embodiments, but that it has the full scope defined by the language of the following claims, and equivalents thereof. Discussion of any embodiments is meant only to be illustrative of the present disclosure and is not intended to suggest that the scope of the present disclosure, including claims, is limited to these embodiments. In other words, although illustrative embodiments of the present disclosure have been described in detail, it is anticipated that alterations, permutations, and equivalents of these illustrative embodiments could readily be effected by those skilled in the art. The scope of the present disclosure is intended to encompass all such alterations, permutations, and equivalents.

[0111] The foregoing discussion has been presented for the purpose of illustration and description, and is not intended to limit the disclosure to the form or forms disclosed herein. For example, for purposes of simplification of the present disclosure, various features of the present disclosure have been grouped together in one or more embodiments or configurations. However, it should be understood that various features of certain embodiments or configurations of the present disclosure can be combined in alternative embodiments or configurations.

[0112] As used herein, the recitation of binaries and the word "a / an" preceding an element or step is to be understood as not excluding plural elements or steps unless such exclusion is explicitly recited. Also, reference to "one embodiment" of the present disclosure is not intended to be interpreted as excluding the presence of additional embodiments that also incorporate the recited feature.

[0113] As used herein, the phrases "at least one", "one or more", and "and / or" are open-ended expressions that are both conjunctive and disjunctive in operation. The terms "one" and "a" and "an" as used herein, can mean "one or more" or "at least one", depending on the context. All directional references (e.g., proximal, distal, upper, lower, upward, downward, left, right, lateral, longitudinal, anterior, posterior, top, bottom, above, below, up, down, clockwise and counterclockwise directions) are used for identification purposes only and do not create limitations on the position, orientation, or use of the disclosure.

[0114] Unless otherwise stated, connecting references (e.g., engaging, attaching, coupling, connecting, and joining) should be construed broadly and can include intermediate members between sets of elements and intermediate members relative to the movement between elements. As such, connecting references do not necessarily infer that two elements are directly connected and in fixed relation to one another. All rotational references describe the relative movement between various elements. Identifying references (e.g., primary, secondary, first, second, third, fourth, etc.) are not intended to imply importance or priority, but are used to distinguish one feature from another. The drawings are for purposes of illustration only, and the dimensions, positions, sequences, and relative sizes reflected in the attached drawings herein can vary.

Claims

1. An acetabular implant, comprising: An acetabular cup comprising a body extending from a mid-latitude edge to a apex, the body having a generally convex outer surface and an inner cavity having a generally concave inner surface; as well as An acetabular cage includes a central portion disposed within the cavity of the acetabular cup, the central portion including separate first and second segments rotatably connected together, the first segment including a first flange arranged and configured to extend from an edge of the acetabular cup, and the second segment including a second flange arranged and configured to extend from an edge of the acetabular cup.

2. The acetabular implant of claim 1 further includes a fastener extending through each of the first and second sections of the acetabular cup and the acetabular cage, wherein, in use, the fastener connects the acetabular cage to the acetabular cup and secures the position of the first section relative to the second section.

3. The acetabular implant of claim 1, wherein in use, the first segment and the second segment are arranged and configured to rotate relative to each other to achieve adjustable placement of the first flange and the second flange.

4. The acetabular implant of claim 3, wherein the first and second segments of the acetabular cage are arranged and configured to slide relative to each other to achieve variable placement of the first and second segments within the cavity of the acetabular cup.

5. The acetabular implant according to claim 1, wherein: The first section of the acetabular cage includes a first end and a second end, the first end of the first section extending from the first flange, and the second end of the first section being arranged and configured to be positioned near the apex of the acetabular cup; and The second section of the acetabular cage includes a first end and a second end, the first end of the second section extending from the second flange, and the second end of the second section being arranged and configured to be positioned near the apex of the acetabular cup.

6. The acetabular implant of claim 5, wherein the second end of the first segment is arranged and configured to overlap with the second end of the second segment, such that in use, a fastener is inserted through an opening formed in the acetabular cup, the first segment of the acetabular cage, and the second segment of the acetabular cage.

7. The acetabular implant of claim 6, wherein each of the second ends of the first segment and the second segment of the acetabular cage includes a slotted opening, the slotted opening being arranged and configured to receive the fastener through the slotted opening.

8. The acetabular implant of claim 7, wherein the second end of the first segment includes a first recess, and the second end of the second segment includes a second recess, the first recess and the second recess being arranged and configured such that the second ends of the first segment and the second segment provide a gap relative to each other for sliding.

9. The acetabular implant of claim 5, wherein each of the first and second segments of the acetabular cage includes one or more incisions arranged and configured to provide increased flexibility to facilitate bending of the first and second flanges, respectively.

10. The acetabular implant according to claim 1, wherein: The acetabular cup includes one or more screw holes extending through the body, the one or more screw holes being arranged and configured to receive fasteners; as well as Each of the first and second sections of the acetabular cage includes one or more openings to allow access to one or more screw holes formed in the acetabular cup.

11. The acetabular implant of claim 1, wherein the acetabular cage includes an external convex surface, the external convex surface including one or more surface features adapted and configured to ensure a minimum distance between the inner surface of the cup and the outer surface of the cage.

12. The acetabular implant according to claim 1, wherein: The body of the acetabular cup includes a plurality of screw holes arranged and configured to receive fasteners; as well as The first and second sections of the acetabular cage each include an elongated slot formed therein, the elongated slot being arranged and configured to align with one or more of a plurality of screw holes formed in the acetabular cup, such that a fastener can be inserted through one of the elongated slots and one of the plurality of screw holes.

13. The acetabular implant of claim 12, wherein the elongated groove formed in the first and second sections of the acetabular cage is arranged and configured such that the head of the fastener engages the periphery of the elongated groove.

14. The acetabular implant of claim 13, wherein each of the elongated slots formed in the first and second sections of the acetabular cage includes a recessed surface defining an inner edge arranged and configured to engage the head of the fastener.

15. The acetabular implant of claim 14, wherein the recessed surface extends along the upper and lower portions of the periphery of the elongated groove, such that in use, the inner edge engages the head of the fastener on its opposite side.

Images