Periprosthetic bone plate

Abstract

Prosthetic periprosthetic bone plates, including, for example, periprosthetic distal femoral plates, are disclosed. In use, the bone plates are configured for use in periprosthetic fractures. That is, the bone plates include one or more features to facilitate positioning and fixation of the bone plates onto a patient's bone that previously received a surgically implanted orthopedic implant, such as an intramedullary nail, a hip prosthesis, a knee prosthesis, etc. In use, the one or more features are designed and configured to facilitate avoidance of the previously surgically implanted orthopedic implant. Additionally, the bone plates are configured to facilitate percutaneous insertion of the bone plates against the patient's bone while minimizing soft tissue irritation. Additionally and / or alternatively, the bone plates are configured to provide improved contouring to facilitate better positioning of the bone plates against the patient's bone (e.g., better contouring adjacent to the patient's greater trochanter).

Description

[0001] Cross-reference to related applications

[0002] This application is a non-provisional application filed on May 19, 2020, entitled “Periprosthetic Bone Plate”, U.S. Provisional Patent Application No. 63 / 027,094, and claims the benefit of the application as of its filing date, the entire contents of which are incorporated herein by reference. Technical Field

[0003] This disclosure relates to orthopedic implants (e.g., bone plates) for attachment to bones, bone portions, bone blocks, etc., of one or more patients, and more specifically to bone plates for facilitating the stabilization of periprosthetic fractures. Background Technology

[0004] Fractures are typically repaired by fixing orthopedic implants or devices to one or more bones, bone segments, bone fragments, etc. (which can be used interchangeably and are not intended to limit the procedure). For example, it is not uncommon for patients to receive orthopedic knee prostheses, orthopedic hip prostheses, intramedullary (“IM”) nails, etc., to repair one or more fractures in their bones.

[0005] Sometimes, fractures can occur in the area surrounding a previously surgically implanted orthopedic implant or device. For example, a fracture may occur during the surgical implantation procedure. However, alternatively, as is the case in most situations, a patient may experience a periprosthetic fracture years after the initial surgical implantation procedure. In some cases, surgically implanted orthopedic implants may make a patient's bone more susceptible to later fractures. Additionally, for one or more reasons, it may be beneficial or necessary for an orthopedic implant adjacent to the surgically implanted implant to fix the bone plate to the patient's bone.

[0006] Regardless of the cause, periprosthetic fractures around previously implanted orthopedic implants present unique fixation challenges. For example, previously implanted orthopedic devices or implants may interfere with the placement of subsequently implanted orthopedic plates.

[0007] For example, in one scenario, a periprosthetic hip fracture may occur near or around a previously implanted hip replacement prosthesis, or a periprosthetic knee fracture may occur near or around a previously implanted knee replacement prosthesis. As the number of hip and knee replacement prostheses increases, so does the number of associated periprosthetic fractures. Once a fracture occurs in the region surrounding a previously implanted hip or knee replacement prosthesis, treatment can be complicated by osteoporosis, bone defects, and the presence of the previously implanted prosthesis. For instance, the stem, rod, screws, and bone cement associated with a previously implanted hip or knee replacement prosthesis may obstruct the patient's medullary canal, preventing intramedullary fixation of the subsequent fracture. Furthermore, the stem and rod may prevent screws from passing through the medullary canal to fix subsequent bone plates to the patient's bone. Therefore, periprosthetic fractures and the corresponding techniques for treating them are generally more challenging due to limited options.

[0008] However, periprosthetic fractures require treatment. For example, unstable periprosthetic fractures may require surgical stabilization and / or implant replacement to restore function. Surgical stabilization may involve implanting a bone plate to fix adjacent segments of the fractured bone to facilitate healing, which can occur with or without implant replacement.

[0009] Many currently known bone plate designs do not take into account periprosthetic fractures, and therefore they often exhibit one or more deficiencies or shortcomings.

[0010] In addition, attaching a bone plate to the patient's bone (e.g., the patient's femur) introduces several additional challenges that need to be overcome. For example, designing, contouring, and / or bending a bone plate that approximates the patient's femur along its entire length (e.g., along the shaft of the femur and extending proximally) can be challenging. However, bending a bone plate is not easy and can be challenging. A bone plate that is too thick may be difficult to bend. However, a bone plate that is flexible enough to bend more easily (before or during surgery) may not provide sufficient strength. Furthermore, bending a bone plate requires significant skill. For example, bending a bone plate to approximate the patient's bone (e.g., the femur) at both ends of the plate (e.g., proximal and distal) is difficult.

[0011] Furthermore, inserting and guiding a bone plate along the length of the femur from the distal end of the patient's femur to a point adjacent to the proximal end of the femur (e.g., adjacent to the greater trochanter) (all without irritating the patient's soft tissues) can be challenging. Many current bone plates are difficult to insert along, for example, the patient's femur without causing significant tissue damage.

[0012] To alleviate some of these problems, some manufacturers offer large sets or kits of bone plates, providing surgeons with different plate sizes and shapes. However, this in itself has drawbacks, increasing cost and complexity, as each set requires a large number of plates. Furthermore, designing bone plates with screw hole patterns (which can be adjusted over a considerable length of the plate, thus eliminating the need for a large number of plates) can be challenging.

[0013] This disclosure is made with this in mind. Summary of the Invention

[0014] This invention is provided to introduce a series of concepts in a simplified form, which will be further described in the detailed description section below. This invention is not intended to identify key or essential features of the claimed subject matter, nor is it intended to help determine the scope of the claimed subject matter.

[0015] This document discloses modified bone plates arranged and configured for periprosthetic fractures (e.g., bone plates arranged and configured to attach to the bone of a patient previously having an implant (e.g., a femoral stem, hip screw, fracture plate, suture, etc.) attached thereto). For example, in one embodiment, the bone plate may be in the form of a distal femoral plate for periprosthetic fractures, such as those surrounding a hip replacement prosthesis, knee replacement prosthesis, etc. In either case, the bone plate is designed and configured to fix subsequent fractures across the patient's bone, while also being designed and configured to have one or more features to avoid previously surgically implanted orthopedic implants.

[0016] In use, bone plates are arranged and constructed to fit or be easily bent before or during surgery to stabilize the patient's bones, such as the patient's femur.

[0017] In one embodiment, the bone plate may include a proximal end comprising a tapered portion (e.g., a longitudinal tapered portion extending from a location spaced apart from the end portion or anterior edge of the bone plate to the end portion or anterior edge of the bone plate). In use, the longitudinal tapered portion is arranged and configured to facilitate percutaneous insertion of the bone plate against the patient's femur while minimizing soft tissue irritation. Additionally, the bone plate may include a concave anterior edge at its end portion to facilitate percutaneous insertion against the patient's femur while minimizing soft tissue irritation. Furthermore, the concave anterior edge, as the bone plate advances along the convex surface of the patient's femur, tends to hold the end portion of the bone plate (e.g., the proximal portion of the distal femoral plate) centered on the patient's femur and provides improved contouring to better position the bone plate against the patient's bone (e.g., better contouring and / or positioning adjacent to the patient's greater trochanter).

[0018] In one embodiment, the end portion of the bone plate may also include a chamfer. The chamfer may include an arcuate or curved configuration that substantially approximates the concave anterior edge. It has been found that including a chamfer and a concave anterior edge facilitates insertion of the bone plate along the patient's femur while minimizing soft tissue irritation.

[0019] In one embodiment, a periprosthetic distal femoral plate is disclosed. The periprosthetic distal femoral plate includes a head portion and an axial portion. The axial portion includes a superior surface, a lower surface, a central longitudinal axis, a peripheral surface, and a proximal end positioned relative to the head portion, the proximal end defining an anterior edge, wherein the anterior edge further includes a concave surface defining an inwardly arched or curved anterior surface.

[0020] In one embodiment, the shaft portion further includes a chamfer extending from the leading edge. In one embodiment, the chamfer includes an arcuate or curved configuration that approximates an inwardly arcuate or curved front surface.

[0021] In one embodiment, the shaft portion further includes a longitudinal tapered portion extending from the leading edge to a location X spaced apart from the leading edge, the longitudinal tapered portion being arranged and configured to facilitate percutaneous insertion of the femoral plate against the patient.

[0022] In one embodiment, the longitudinal tapered portion is arranged and configured to provide an increased thickness at location X and a decreased thickness at the leading edge, wherein location X is approximately 3 inches from the leading edge. In one embodiment, the increased thickness at location X is approximately 0.225 inches, and the decreased thickness at the leading edge is approximately 0.145 inches.

[0023] In one embodiment, a periprosthetic distal femoral plate is disclosed. The periprosthetic distal femoral plate includes a head portion and an axial portion. The axial portion includes a superior surface, a inferior surface, a central longitudinal axis, a peripheral surface, and a proximal end positioned relative to the head portion, the proximal end defining an anterior edge. The axial portion further includes a longitudinal tapered portion extending from the anterior edge to a spaced-apart position, the longitudinal tapered portion being arranged and configured to facilitate percutaneous insertion of the plate against the patient's femur, wherein the anterior edge further includes a concave surface and a chamfer extending from the anterior edge.

[0024] In one embodiment, the distal femoral plate surrounding the prosthesis may further include a concave (e.g., curved) bone contact surface along its longitudinal length, the concave bone contact surface being arranged and configured to approximate the contour of the patient's femur upon implantation.

[0025] In one embodiment, the distal femoral plate surrounding the prosthesis may include a sufficient thickness at least along its main length to provide improved strength.

[0026] In one embodiment, the distal femoral plate surrounding the prosthesis may include a hole pattern arranged and configured to utilize variable-angle screw holes to facilitate the positioning of each plate along a longer bone length.

[0027] In one embodiment, the distal femoral plate surrounding the prosthesis may include a head portion and a shaft portion. The shaft portion includes a plurality of threaded locking screw openings for securing one or more locking screws to the shaft portion of the bone plate. Additionally, the shaft portion may include a plurality of variable-angle fastener openings for multi-axial reception of one or more bone fasteners. In one embodiment, the variable-angle fastener openings may be positioned along the periphery of the shaft portion, while the locking screw openings may be centrally positioned (e.g., substantially adjacent to the central longitudinal axis of the shaft portion).

[0028] In one embodiment, the threaded locking screw opening may be larger than, for example, a variable-angle fastener opening positioned along the periphery of the axial portion. For example, in one embodiment, the threaded locking screw opening may be sized and configured to receive, for example, a 4.5 mm locking screw. The variable-angle fastener opening may be sized and configured to receive, for example, a 3.5 mm bone screw. Alternatively, in some embodiments, the threaded locking screw opening and the variable-angle fastener opening may have the same size. For example, in some embodiments, the threaded locking screw opening and the variable-angle fastener opening may be sized and configured to receive, for example, a 3.5 mm bone screw.

[0029] In various embodiments, the axial portion of the bone plate may include a first region and a second region, the first region being positioned adjacent to the head portion of the bone plate (e.g., the distal portion of the distal femoral plate). The first region may include non-laterally aligned variable-angle fastener openings. The second region (e.g., for the distal femoral plate, positioned adjacent to the proximal end of the patient's femur) may include variable-angle fastener openings laterally aligned along the periphery of the second region of the axial portion (e.g., variable-angle fastener openings positioned on either side of a central longitudinal axis laterally aligned with each other). The variable-angle fastener openings in the first region alternate laterally with respect to each other (e.g., individual variable-angle fastener openings positioned in a row, alternating laterally as the axial portion moves proximally). This arrangement allows the second (proximal) region of the axial portion to include a greater number of variable-angle fastener openings, providing the surgeon with more options for placing variable-angle bone fasteners.

[0030] The embodiments of this disclosure offer numerous advantages. For example, by including one or more features of this disclosure, surgeons are provided with more options for fixing bone plates across subsequent fractures adjacent to orthopedic devices or implants placed in previous surgeries. Additionally and / or alternatively, by including one or more features of this disclosure, the bone plates are arranged and configured to facilitate easier insertion along the patient's bone (e.g., the patient's femur) and reduce soft tissue irritation. Additionally and / or alternatively, by including one or more features of this disclosure, the bone plates are arranged and configured to facilitate better positioning of the bone plates against the patient's bone (e.g., the end portions of the bone plates may be contoured to improve placement and / or positioning adjacent to the patient's greater trochanter).

[0031] The following describes in detail, with reference to the accompanying drawings, at least some of the additional features and advantages of embodiments of the invention, as well as the structure and operation of various embodiments of the invention. Attached Figure Description

[0032] The specific embodiments of the disclosed apparatus will now be described by way of example with reference to the accompanying drawings, in which:

[0033] Figure 1 This is a top view of bone plates of various lengths according to this disclosure;

[0034] Figure 2A This is a view of an example embodiment of the bone plate according to the present disclosure;

[0035] Figure 2B yes Figure 2A A detailed view of the end portion of the bone plate shown;

[0036] Figure 2C yes Figure 2A A cross-sectional view of the end portion of the bone plate shown, the cross-section being along... Figure 2B The provided line IIC-IIC cut;

[0037] Figure 3A This is a top view of an example embodiment of the bone plate according to the present disclosure;

[0038] Figure 3B yes Figure 3A A detailed view of the end portion of the bone plate shown;

[0039] Figure 3C yes Figure 3A The side view of the bone plate shown; and

[0040] Figure 3D yes Figure 3A The detailed perspective view of the end portion of the bone plate shown includes a concave leading edge and a chamfer, according to one or more features of this disclosure.

[0041] It should be understood that the accompanying drawings are not necessarily drawn to scale, and the disclosed embodiments are sometimes shown as schematic diagrams and partial views. In some cases, details that are not necessary for understanding the disclosed methods and apparatus or that make other details difficult to understand may be omitted. It should be further understood that this disclosure is not limited to the specific embodiments shown herein. In the drawings, unless otherwise stated, the same numbers refer to the same elements. Detailed Implementation

[0042] The various features of orthopedic bone plates will be described more fully below with reference to the accompanying drawings, in which one or more features of the bone plate will be shown and described. It should be understood that the various features can be used independently or in combination with each other. It should be understood that the bone plates disclosed herein can be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will convey certain aspects or features of the bone plates to those skilled in the art.

[0043] This document discloses a bone plate that includes one or more features for improving flexibility in attaching the bone plate adjacent to a previously surgically implanted orthopedic implant to the patient's bone. That is, as previously described, and as those skilled in the art will understand, many patients undergo surgery each year to have one or more orthopedic devices implanted. For example, knee replacement, hip replacement, and IM nail implantation are common. Sometimes, fractures may occur in the area surrounding the surgically implanted orthopedic implant or device. These fractures are often referred to as periprosthetic fractures because they occur near a previously surgically implanted orthopedic device or implant.

[0044] Periprosthetic fractures present unique fixation challenges. For example, previously implanted orthopedic devices or implants may interfere with the placement and / or fixation of the bone plate. In one scenario, for instance, the IM nail or shank portion of a previously implanted orthopedic device or implant may interfere with the positioning of the bone plate and / or the placement of the bone fasteners used to fix the bone plate to the patient's bone. Furthermore, bone degeneration around previously implanted orthopedic devices or implants, such as due to osteoporosis or defects in the bone, may further complicate the fixation and positioning of the bone plate on the patient's bone. Therefore, due to limited options, periprosthetic fractures and the corresponding techniques for treating them are generally more difficult.

[0045] Therefore, as will be described herein, this disclosure discloses a bone plate comprising one or more features that can be used in combination or individually, these features being designed and configured to provide increased flexibility, enabling surgeons to locate and fix the bone plate across the patient's bone adjacent to previously surgically implanted orthopedic devices or implants. Additionally and / or alternatively, one or more features may be provided to facilitate easier insertion of the bone plate along the patient's bone and to provide improved contouring for better positioning of the bone plate against the patient's bone (e.g., better contouring adjacent to the patient's greater trochanter).

[0046] As will be described herein, bone plates can have various shapes and / or configurations. It should be understood that bone plates can be provided in any suitable shape and / or configuration, as will be appreciated by those skilled in the art, depending on the location and type of bone being immobilized in the patient. For example, a bone plate may include an arched surface that conforms to the bone. Furthermore, bone plates can be arranged and configured to cross, contact, etc., the distal femur, proximal femur, distal tibia, proximal tibia, proximal humerus, distal humerus, fibula, ulna, radius, distal radius, foot bones, or hand bones, and diaphysis fractures of long bones, etc.

[0047] In addition, the bone plate may include any additional features now known or later developed, such as one or more openings or slots designed to receive, for example, surgical implantation tools, various fasteners (e.g., non-locking fasteners), etc.

[0048] The bone plate can be made of any suitable material now known or to be developed in the future, including, for example, metals, polymers, plastics, ceramics, absorbable composites, non-absorbable composites, etc. Suitable materials may include, for example, titanium, stainless steel, cobalt-chromium, polyetheretherketone (PEEK), polyethylene, ultra-high molecular weight polyethylene (UHMWPE), absorbable polylactic acid (PLA), polyglycolic acid (PGA), combinations or alloys of such materials, or any other suitable material that has sufficient strength to be fixed to and retain the bone, while having sufficient biocompatibility to be implanted into the patient's body. In some embodiments, the bone fastener may be made of the same material as the bone plate. In other embodiments, the fastener may be made of a different material than the bone plate.

[0049] The fastener can be any type of fastener now known or developed in the future. For example, the fastener can include any type of external thread, including standard or non-standard threads. For example, the external thread can be arranged as continuous ridges or discontinuous ridges. The external thread can form a portion of a revolution, a full revolution, multiple revolutions, a single lead, a multi-lead, or any other thread known in the art. Additionally and / or alternatively, in the case of a locking screw, the head portion of the fastener can include any surface that will engage with and lie within a locking screw opening formed in the bone plate. For example, the head portion can include threads. Alternatively, the head portion can include a series of recesses, ridges, protrusions, textured areas, or any other surface that can secure the fastener.

[0050] The fastener can be any typical fastener, made of any suitable material. The fastener may include an opening for receiving a driver to drive the fastener through the bone plate and into the patient's bone. The opening can be of any size and shape; for example, it may have a hexagonal configuration to receive a corresponding hexagonal driver, Phillips head, flathead, star configuration, Torx, or any other suitable configuration that can cooperate with the driver to drive the fastener through the bone plate and into the patient's bone.

[0051] The shaft of the fastener may be fully threaded, partially threaded, or helical, and / or may include one or more nails, deployable claws, expandable elements, or any feature that allows the shaft to engage with the patient's bone. The shaft may also be unthreaded, allowing the fastener to take the form of a nail or pin. In certain surgeries, for example, where the primary objective is to prevent bone segment tilting, or where there is no concern about the fastener being pulled out of the patient's bone, and therefore the shaft does not need to be threaded or otherwise constructed to engage with the patient's bone, this alternative implementation may be preferred. The end of the shaft may be a self-tapping or self-drilling tip.

[0052] In any event, as will be apparent from the remainder of the disclosure, the focus of this disclosure is on exemplary embodiments of bone plates, including one or more features arranged and configured to provide increased flexibility for positioning and fixing the bone plate in areas adjacent to orthopedic devices or implants previously surgically placed. Additionally, the bone plate may include one or more features arranged and configured to allow insertion of the bone plate against a patient's long bone (e.g., femur) while minimizing soft tissue irritation, and one or more features providing improved contouring to facilitate better positioning of the bone plate against the patient's bone (e.g., better contouring adjacent to the patient's greater trochanter). Therefore, it should be understood that, unless specifically stated otherwise, this disclosure is not limited to any particular construction of a bone plate. Furthermore, although this disclosure will be described and shown as relating to a periprosthetic distal femoral plate, it should be understood that the features of this disclosure are applicable and can be used in conjunction with other bone plates, such as non-periprosthetic bone plates, humeral plates, proximal femoral plates, tibial plates, etc. Thus, unless expressly stated otherwise, this disclosure is not limited to any particular bone plate or bone plate construction.

[0053] refer to Figure 1 Various embodiments of bone plates 100 of various lengths for repairing fractures in a patient's bone are disclosed. As will be described herein, the bone plate 100 may be in the form of a distal femoral plate. That is, the bone plate 100 is arranged and configured to be positioned adjacent to the patient's femur. Additionally, as will be described herein, the bone plate 100 includes one or more features that facilitate positioning and fixation of the bone plate 100 to the patient's femur previously implanted with a surgical orthopedic implant or device, such as, for example, an IM nail, a hip prosthesis, a knee prosthesis, etc. Thus, the bone plate 100 is arranged and configured for periprosthetic fractures and may therefore be referred to as a periprosthetic bone plate or a periprosthetic distal femoral plate.

[0054] Additionally, as will be described herein, the bone plate 100 includes one or more features that facilitate easier insertion (e.g., percutaneous insertion) and reduce soft tissue irritation. Additionally and / or alternatively, the bone plate 100 includes one or more features to provide improved contouring for better positioning of the bone plate against the patient's bone (e.g., better contouring adjacent to the patient's greater trochanter).

[0055] As will be described herein, in one or more embodiments, the bone plate 100 may include a concave cross-sectional shape along its length, the concave cross-sectional shape being arranged and configured to be positioned adjacent to the patient's femur upon implantation; an end portion (e.g., a proximal portion) that is tapered (from top to bottom); a concave anterior edge for reinforcing insertion along the patient's femur; a chamfer; sufficient thickness to provide adequate strength; and a hole pattern arranged and configured to receive variable-angle screws that allow each bone plate to be positioned along a longer length of the patient's bone, thus reducing the total number of plates required in a set or sleeve.

[0056] For further reference Figure 2A-3D As shown in the figure, the peripheral femoral distal plate 100 may include a lower surface, a lower surface or a bone-facing surface 102, and a upper surface 104. Additionally, the peripheral femoral distal plate 100 includes a head portion 110 and a axial portion 115. Furthermore, the peripheral femoral distal plate 100 includes a plurality of openings 120 formed therein for receiving a plurality of fasteners (not shown) for attaching the peripheral femoral distal plate 100 to the patient's bone.

[0057] As will be described herein, opening 120 may be in the form of a locking screw opening 122 or a variable-angle opening 124. That is, as those skilled in the art will understand, the locking screw opening 122 may include a plurality of threads formed on its inner surface for mating with threads formed on the outer surface of the head portion of the bone fastener. In this arrangement, the bone fastener is said to be locked to the prosthesis-periprosthetic distal femoral plate 100 via the locking screw opening 122. That is, as those skilled in the art will understand, the bone fastener is screwed through one of the locking screw openings 122 formed in the prosthesis-periprosthetic distal femoral plate 100 and into the patient's bone. The bone fastener is secured to the prosthesis-periprosthetic distal femoral plate 100 via threads formed on the head portion of the bone fastener, said threads cooperating with the threaded locking screw opening 122 formed in the prosthesis-periprosthetic distal femoral plate 100. This fixes the prosthesis-periprosthetic distal femoral plate 100 relative to the patient's bone and provides rigid fixation between the prosthesis-periprosthetic distal femoral plate 100 and the bone fastener. In other words, because the head portion of the bone fastener intersects with the threads formed in the locking screw opening 122 of the distal femoral plate 100 surrounding the prosthesis, the plate 100 and the fastener form a stable system or structure, and the stability of the fracture can depend on or be aided by the stiffness of the structure. Locking the bone fastener into the distal femoral plate 100 surrounding the prosthesis achieves angular and axial stability and eliminates the possibility of bone fastener shifting, sliding, or displacement, thereby reducing the risk of postoperative reduction loss.

[0058] As described above, the periprosthetic distal femoral plate 100 also includes a plurality of variable-angle openings 124 formed therein for receiving non-locking or variable-angle (e.g., multi-axial) bone fasteners. In use, the variable-angle openings 124 are arranged and configured such that bone fasteners inserted therein can achieve a greater range of insertion angles than, for example, conventional locking screws threaded to the periprosthetic distal femoral plate 100. For example, in one embodiment, the angular position of the bone fastener can be rotated through a range of approximately ±15 degrees, but the permissible range of multi-axial rotation can vary, including greater than and less than fifteen degrees. In use, the variable-angle openings 124 can be provided in any suitable manner, construction, etc., now known or developed hereafter, to enable the bone fasteners to be multi-axially positioned or angled relative to the periprosthetic distal femoral plate 100.

[0059] As shown in the figure, in one embodiment, the variable angle opening 124 may include fins or protrusions extending radially inward from the inner surface of the opening 124 and into the internal region of the opening 124, and configured to engage or cooperate with the head portion of a bone fastener. In use, the fins engage the head portion of the bone fastener to secure the bone fastener within the variable angle opening 124 at a desired position and angle. More information on the operation and construction of fins can be found in U.S. Patent Application No. 15 / 706,877, entitled "Systems and Methods for Using Polyaxial Plates," filed July 25, 2005; U.S. Patent Application No. 13 / 524,506, entitled "Variable Angle Locking Implant," filed June 15, 2012; and International PCT Patent Application No. WO20200247381, entitled "Orthopedic Implant with Improved Variable Angle Locking Mechanism," filed June 2, 2020, the entire contents of which are incorporated herein by reference.

[0060] In one embodiment, the locking screw opening 122 may be arranged and configured to receive a larger diameter bone fastener relative to the variable angle opening 124. That is, for example, the locking screw opening 122 may be arranged and configured to receive a 4.5 mm bone fastener, while the variable angle opening 124 may be arranged and configured to receive a 3.5 mm bone fastener; however, these dimensions are merely exemplary, and other sizes of bone fasteners are contemplated. By arranging and configuring the periprosthetic distal femoral plate 100 to receive a larger diameter locking screw, the periprosthetic distal femoral plate 100 can be better secured to the patient's bone. Simultaneously, by incorporating the smaller variable angle opening 124, the periprosthetic distal femoral plate 100 can better facilitate the positioning of non-locking screws around previously surgically implanted orthopedic devices or implants (e.g., smaller non-locking bone fasteners allow the surgeon to better navigate previously surgically implanted orthopedic devices or implants).

[0061] Additionally and / or alternatively, as shown in the figure, in one embodiment, the head portion 110 may include a plurality of locking screw openings 122 while having no variable angle screw openings 124 at all (e.g., the head portion 110 of the prosthesis-peripheral distal femoral plate 100 may include only locking screw openings 122), but it is conceivable that the head portion 110 may include one or more variable angle openings 124.

[0062] In one embodiment, as shown, the axial portion 115 of the periprosthetic distal femoral plate 100 may include a plurality of locking screw openings 122 and a plurality of variable-angle screw openings 124. For example, in one embodiment of the periprosthetic distal femoral plate 100, the locking screw openings 122 may be more centrally located compared to the variable-angle openings 124 formed in the axial portion 115. For example, in one embodiment, the axial portion 115 may include a central longitudinal axis C. L The locking screw opening 122 can be substantially along the central longitudinal axis C of the axial portion 115 of the distal femoral plate 100 surrounding the prosthesis. L Positioning, and the variable angle opening 124 (as shown) formed in the axial portion 115 can be positioned along and / or adjacent to the outer periphery or surface 106 of the axial portion 115 of the distal femoral plate 100 surrounding the prosthesis.

[0063] This arrangement allows the periprosthetic distal femoral plate 100 to better position variable-angle bone fasteners by positioning the variable-angle opening 124 along and / or adjacent to the outer periphery 106 of the axial portion 115, thus avoiding previously surgically implanted orthopedic devices or implants (e.g., the surgeon can better position and insert one or more bone fasteners through the variable-angle opening 124 formed in the periprosthetic distal femoral plate 100, while avoiding, for example, the stem portion or IM nail of a previously surgically implanted orthopedic device or implant in the patient's femur).

[0064] Additionally and / or alternatively, as shown, the axial portion 115 of the periprosthetic distal femoral plate 100 may include a first region 116 and a second region 118. As shown, the first region 116 may be positioned adjacent to the head portion 110 of the periprosthetic distal femoral plate 100, while the second region 118 may be positioned at its opposite end (e.g., the second region 118 may be arranged and configured to be positioned against the proximal end of the patient's femur (e.g., adjacent to the patient's trochanter)). In one or more embodiments, in the second region 118 of the axial portion 115, variable-angle openings 124 may be arranged and configured such that they are positioned laterally to each other. That is, as shown, the variable-angle openings 124 may be considered to be positioned in a transverse row, with two variable-angle openings 124 positioned in a row, one on each side or peripheral surface 106 of the periprosthetic distal femoral plate 100. Such an arrangement may be referred to as positioning the variable-angle openings 124 in the second region 118 of the axial portion 115 as a double row. Meanwhile, as shown in the figure, the variable-angle openings 124 formed in the first region 116 of the axial portion 115 of the distal femoral plate 100 surrounding the prosthesis can be arranged such that they alternate relative to each other. That is, as shown in the figure, the variable-angle openings 124 can be considered to be positioned in a transverse row, wherein only a single variable-angle opening 124 is positioned in a row, and the variable-angle openings 124 alternate on the side or peripheral surface 106 of the distal femoral plate 100 surrounding the prosthesis where they are positioned. By positioning the variable-angle openings 124 in a double row in the second region 118 of the axial portion 115, more options are provided to the surgeon when inserting variable-angle bone fasteners into the patient's bone near the intended stem portion of a previously surgically implanted orthopedic device or implant, or an IM nail.

[0065] With this arrangement, the end portion 119 of the bone plate 100 may include a plurality of variable-angle openings 124 (e.g., the end portion 119 may include most of the variable-angle openings 124). In use, the end portion 119 is designed to reach the proximal femur, where the bone is no longer the diaphysis, and the variable-angle openings 124 allow the screw to reach a more desired bone and length. For example, the screw may be targeted at the lesser trochanter, the femoral head, or some other desired area in the proximal femur. Meanwhile, the strength of the bone plate 100 is better maintained by providing only a single row of alternating variable-angle openings 124 in the first region 116 of the axial portion 115.

[0066] Although a particular bone plate construction has been shown and described, it should be understood that the combination of locking screw opening 122 and variable angle opening 124 may be varied in other embodiments, and this disclosure should not be limited to any particular construction unless expressly stated otherwise.

[0067] Additionally and / or alternatively, the proximal portion 119 of the bone plate 100 (e.g., the end portion opposite the head portion 110) may include a thinned portion. That is, the proximal portion 119 may include a reduced cross-sectional area to facilitate contouring of the proximal portion 119 relative to the patient's anatomy. Generally, as those skilled in the art will understand, during use, surgeons typically select bone plates of a certain length sized and constructed to bridge or span the entire region of a fracture. For example, it is not uncommon for bone plates to extend from the femoral condyle to the patient's trochanter or higher. In use, the head portion of the bone plate may be highly contoured to match the patient's anatomy. However, providing bone plates with contoured ends presents several problems. For example, generally, providing bone plates with anatomical constraints or contouring at both ends will not fit the individual patient as well as intended. Therefore, it is beneficial to release the anatomical constraints on one end of the bone plate so that the bone plate can be contoured to provide a better fit for each individual patient. Additionally and / or alternatively, providing bone plates with contoured ends presents several manufacturing problems. Therefore, the proximal portion 119 (e.g., the end portion opposite the head portion 110) may include a reduced cross-sectional area to better enable the surgeon to contour the proximal portion 119 to fit the patient's anatomy.

[0068] Additionally, refer to Figure 2A-3D According to one or more features of this disclosure, the bone plate 100 includes one or more features to facilitate percutaneous insertion of the bone plate 100 along the patient's bone (e.g., along the patient's femur) while minimizing soft tissue irritation. Additionally and / or alternatively, the bone plate 100 includes one or more features arranged and configured to provide improved contouring to better position the bone plate 100 against the patient's bone (e.g., the end portion 119 of the bone plate 100 may be contoured to improve placement and / or positioning adjacent to the patient's greater trochanter).

[0069] refer to Figure 2A-3D An example of an embodiment of a bone plate 100 according to one or more features of this disclosure is shown. Figure 2A , 3A As shown in Figure 3C, a full-length view of the bone plate 100 is presented. The bone plate 100 is arranged and configured to be aligned along the patient's femur and to be aligned proximally near the point where the patient's greater trochanter begins to open outward from the patient's femoral shaft. Figure 2B and 3B An enlarged view of the proximal portion 119 of the bone plate 100 (e.g., an end portion arranged and configured for implantation near the proximal femur of a patient) is shown.

[0070] As shown in the figure, in one embodiment, the bone plate 100 includes a concave anterior edge 150 (e.g., an inwardly arched or curved surface compared to a straight or outwardly curved or convex surface) to facilitate insertion along the patient's femur. For example, as shown, the end portion 119 (e.g., the proximal portion) includes the concave anterior edge 150, which is arranged and configured to enhance percutaneous insertion of the bone plate 100 along the patient's femur while minimizing soft tissue irritation. In use, as the bone plate 100 advances along the convex surface of the femur, the concave anterior edge 150 serves to keep the end portion 119 of the bone plate 100 centered on the patient's femur. Additionally, in use, the concave anterior edge 150 is arranged and configured to align with the proximal portion 119 of the bone plate 100 near the proximal portion of the patient's femur. That is, in use, the concave anterior edge 150 is arranged and configured to position itself adjacent to the patient's trochanter, thereby providing improved positioning of the bone plate 100 against the patient's femur (e.g., flush with the greater trochanter).

[0071] In other words, such as Figure 2B and 3B As shown, in one embodiment, the end portion 119 (e.g., a proximal portion) includes a lower surface or bone-facing surface 102, an upper surface 104, a first lateral surface 106a and a second lateral surface 106b, and an end surface 108 (e.g., anterior edge). In one embodiment, the end surface 108 includes extensions from the first lateral surface 106a and the second lateral surface 106b to a central longitudinal axis C. L The concave or arcuate surface provides a concave anterior edge 150. Reduced soft tissue irritation is achieved during insertion of the bone plate 100 along the patient's axis. Additionally, as the bone plate 100 advances along the convex surface of the patient's femur, the concave anterior edge 150 tends to keep the distal portion 119 of the bone plate 100 (e.g., the proximal portion of the distal femoral plate 100) centered on the patient's femur. Furthermore and / or alternatively, the concave anterior edge 150 facilitates better positioning of the bone plate 100 against the patient's bone (e.g., the concave anterior edge 150 is contoured to improve placement and / or positioning adjacent to the patient's greater trochanter).

[0072] For further reference Figure 3D According to one or more features of this disclosure, the end portion 119 of the bone plate 100 may also include a chamfer 160. As shown, in one embodiment, when used in conjunction with a concave anterior edge 150, the chamfer 160 may include an arcuate or curved configuration substantially approximating the concave anterior edge 150. It has been found that including the chamfer 160 and the concave anterior edge 150 facilitates insertion along the patient's femur while minimizing soft tissue irritation.

[0073] In addition, such as Figure 2C and 3DAs best shown, the end portion 119 of the bone plate 100 may include a tapered top surface 170. That is, for example, starting from a position X spaced apart from the end surface 108 (e.g., the proximal portion) of the bone plate 100, the axial portion 115 may taper from an increasing thickness to a decreasing thickness at the end surface 108.

[0074] By providing a tapering thickness from position X to end surface 108, the proximal portion 119 of the bone plate 100 is made easier to contour relative to the patient's anatomy. That is, according to a feature of this disclosure, the proximal portion 119 (e.g., the end portion opposite the head portion 110) may include a tapering or decreasing cross-sectional area along its longitudinal length to better enable the surgeon to contour the proximal portion 119 to accommodate the patient's anatomy (e.g., providing a tapered end portion allows the surgeon to bend (e.g., contour) the bone plate 100 perpendicular to the bone contact surface 102 to better contour the bone plate 100 to the patient's anatomy (e.g., such as the patient's trochanter). That is, for example, starting from position X spaced a distance from the end surface 108 of the bone plate 100, the axial portion 115 may taper from an increasing thickness to a decreasing thickness at the end surface 108. Furthermore, by providing a decreasing thickness taper to the proximal portion of the bone plate 100, the longitudinally tapering thickness makes insertion and sliding along the femur easier and reduces soft tissue damage and potential harm.

[0075] In one embodiment, position X (e.g., the distance from the start of the tapered portion) may be approximately 3 inches from the end surface 108 of the bone plate 100. Alternatively, in one embodiment, the bone plate 100 may taper from an initial thickness of approximately 0.225 inches or 5.7 mm to a decreasing thickness of 0.145 inches or 3.7 mm. However, those skilled in the art will understand that these dimensions are merely exemplary and other dimensions may be utilized.

[0076] The bone plate 100 may also include one or more additional features. For example, the bone plate 100 may include a plurality of undercuts or recesses 130 formed in the lower surface or the bone-facing surface 102. In one embodiment, the plurality of undercuts 130 may coincide with or co-locate with a variable-angle opening 124 formed in the axial portion 115 of the bone plate 100. That is, the variable-angle opening 124 formed in the axial portion 115 may be positioned within or reside in the undercuts 130 formed in the bone-facing surface 102. In use, the undercuts 130 may be sized and configured to provide clearance to allow cables to pass beneath the distal femoral plate 100 around the prosthesis.

[0077] Additionally and / or alternatively, one or more of the locking screw openings 122 formed in the proximal portion 119 of the shaft portion 115 may include a countersunk hole formed in its lower surface or bone-facing surface 102. In use, by providing a countersunk hole in the lower surface or bone-facing surface 102 of the locking screw opening 122 formed in the end portion 119 of the plate 100, the countersunk locking screw opening 126 can be used in combination with an instrument to grasp and compress the fracture site.

[0078] The axial portion 115 of the bone plate 100 may also include a plurality of Kirschner wire openings for allowing Kirschner wires to pass through. In use, the plurality of Kirschner wire openings allow surgeons to temporarily hold the plate 100 to the patient's bone after they have reduced the fracture.

[0079] Roughly as Figure 1 As shown, and as those skilled in the art will understand, the number of undercuts, variable-angle openings, locking screw openings, etc., will vary among various bone plates depending on the length of the plate. Additionally, depending on the side of the patient's bone being joined, the bone plate may be provided as a mirror image of itself.

[0080] According to the various features described herein, in use, a set or suite of bone plates is provided comprising a relatively reduced number of bone plates that can be implanted following one or more femoral implants. According to the features described herein, bone plates providing sufficient rigidity or strength are disclosed, while also providing sufficient flexibility to conform to the patient's femur proximally near the greater trochanteric opening without excessive plate bending. Additionally, the insertion end of the plate (e.g., the proximal portion of the distal femoral plate) is preferably configured to be inserted and guided along the patient's femur from the distal end of the femur and to a point adjacent to the patient's trochanter, and provides reduction in soft tissue irritation along the patient's femur through, for example, a top-to-bottom tapered portion and a side-to-side concave end shape. Furthermore, the bone plate may include a hole pattern comprising locking screw openings and variable-angle openings to reduce the number of different plate lengths required in the functional group.

[0081] The foregoing description has broad applicability. Therefore, the discussion of any embodiment is merely illustrative and is not intended to imply that the scope of this disclosure (including the claims) is limited to these exemplary embodiments. In other words, while illustrative embodiments of this disclosure have been described in detail herein, it should be understood that the inventive concept can be practiced and used in other ways, and the appended claims are intended to be construed as including such variations, unless limited by prior art.

[0082] As used herein, the term “a” or “an” entity refers to one or more of the entity. Therefore, the terms “a” (or “an”), “one or more”, and “at least one” are used interchangeably herein. As used herein, “comprising,” “including,” or “having,” and variations thereof, means including items listed herein and their equivalents, as well as other items. Therefore, the terms “comprising,” “including,” or “having,” and variations thereof, are open-ended expressions and are used interchangeably herein. As used herein, the phrases “at least one,” “one or more,” and “and / or” are open-ended expressions that combine and separate in operation.

[0083] All directional references (e.g., proximal, distal, upper, lower, down, upward, downward, left, right, lateral, longitudinal, front, rear, top, bottom, above, below, vertical, horizontal, radial, axial, clockwise, and counterclockwise) are used for identification purposes only to aid the reader's understanding of this disclosure and do not constitute limitation, particularly regarding the location, orientation, or use of this disclosure. Unless otherwise stated, connection references (e.g., attachment, link, connection, and engagement) should be interpreted broadly and may include intermediate members between sets of elements and intermediate members that move relatively between elements. Thus, a connection reference does not necessarily infer that two elements are directly connected and have a fixed relationship with each other. Identification references (e.g., first, second, first, third, fourth, etc.) are not intended to imply importance or priority but are used to distinguish one feature from another. The accompanying drawings are for illustrative purposes only, and the dimensions, positions, order, and relative sizes reflected in the accompanying drawings may vary.

Claims

1. A prosthesis-peripheral distal femoral bone plate, comprising: Head portion; as well as The shaft portion includes an upper surface, a lower surface, a central longitudinal axis, an outer peripheral surface, and a proximal end positioned relative to the head portion, the proximal end defining a leading edge; The leading edge further includes a concave surface defining an inwardly arcuate or curved front surface; The shaft portion further includes a plurality of variable angle fastener openings, which are respectively arranged and configured to receive a plurality of variable angle screws. Among them, a plurality of undercuts (130) are formed in the lower surface (102) of the axial portion (115) of the bone plate, and the plurality of undercuts (130) coincide with the plurality of variable angle fastener openings (124).

2. The distal femoral bone plate surrounding the prosthesis according to claim 1, wherein, The shaft portion further includes a chamfer extending from the leading edge.

3. The distal femoral bone plate surrounding the prosthesis according to claim 2, wherein, The chamfer includes an arc or bend structure that approximates the inward arc or bend front surface.

4. The distal femoral plate surrounding the prosthesis according to any one of claims 1-3, wherein, The axial portion further includes a longitudinal tapered portion extending from the leading edge to a position X spaced apart from the leading edge, the longitudinal tapered portion being arranged and configured to facilitate percutaneous insertion of the bone plate against the patient's femur.

5. The distal femoral bone plate surrounding the prosthesis according to claim 4, wherein, The longitudinal tapered portion is arranged and configured to provide increased thickness at position X and decreased thickness at the leading edge, wherein position X is approximately 3 inches from the leading edge.

6. The distal femoral bone plate surrounding the prosthesis according to claim 5, wherein, The increased thickness at position X is approximately 0.225 inches, and the decreased thickness at the leading edge is approximately 0.145 inches.

7. The distal femoral plate surrounding the prosthesis according to any one of claims 1-3, wherein, The lower surface includes a concave bone contact surface along the longitudinal length of the lower surface.

8. The distal femoral plate surrounding the prosthesis according to any one of claims 1-3, wherein, The shaft portion further includes: Multiple locking screw openings, each arranged and configured to receive a plurality of locking screws; and The plurality of variable angle fastener openings are positioned along the outer peripheral surface of the shaft portion, while the plurality of locking screw openings are positioned closer to the central longitudinal axis of the shaft portion.

9. The distal femoral plate surrounding the prosthesis according to claim 8, wherein, The plurality of locking screw openings include a first diameter, and the plurality of variable angle fastener openings include a second diameter, wherein the first diameter is larger than the second diameter.

10. The distal femoral plate surrounding the prosthesis according to any one of claims 1-3, wherein, The shaft portion includes a first region and a second region, the first region being positioned adjacent to the head portion of the bone plate, the second region being positioned adjacent to the leading edge, a plurality of variable angle fastener openings formed in the first region being arranged and configured to be non-laterally aligned, and a plurality of variable angle fastener openings formed in the second region being positioned in a lateral row.

11. The distal femoral plate surrounding the prosthesis according to claim 10, wherein: The plurality of variable-angle fastener openings in the first region are arranged and configured such that each alternates on both sides as it moves along the axis portion; The multiple variable angle fastener openings in the second region are arranged and configured such that the variable angle fastener openings in each row are positioned on either side of the central longitudinal axis with their lateral alignment to each other.

12. The distal femoral plate surrounding the prosthesis according to claim 10, wherein, The second region of the shaft portion includes a greater number of variable-angle fastener openings compared to the first region.

13. The distal femoral plate surrounding the prosthesis according to any one of claims 1-3, wherein, The head portion includes multiple locking screw openings, while having no variable angle screw openings whatsoever.

14. A prosthesis-peripheral distal femoral bone plate, comprising: Head portion; as well as The shaft portion includes an upper surface, a lower surface, a central longitudinal axis, an outer peripheral surface, and a proximal end positioned relative to the head portion, the proximal end defining a leading edge, the shaft portion further comprising: A longitudinal tapered portion extending from the anterior edge to a position spaced apart from the anterior edge, the longitudinal tapered portion being arranged and configured to facilitate percutaneous insertion of the bone plate against the patient's femur; The leading edge further includes a concave surface and a chamfer extending from the leading edge; The shaft portion further includes a plurality of variable angle fastener openings, which are respectively arranged and configured to receive a plurality of variable angle screws. Among them, a plurality of undercuts (130) are formed in the lower surface (102) of the axial portion (115) of the bone plate, and the plurality of undercuts (130) coincide with the plurality of variable angle fastener openings (124).

15. The distal femoral plate surrounding the prosthesis according to claim 14, wherein, The chamfer includes an arcuate or curved structure that approximates the concave surface of the leading edge.

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