Hip Cone De-Escalation for Bone-Sparing Femoral Revision
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Solution Overview
Problem
Existing total hip arthroplasty procedures often require invasive and technically demanding femoral revision techniques that increase the risk of infection, dislocation, and fracture, necessitating longer surgery times and poorer functional outcomes.
Innovation Solution
A de-escalation system for total hip arthroplasty that includes a femoral stem, hip cone, and acetabular cup, utilizing bone cement and biologic fixation coatings to minimize bone removal and invasiveness, promoting biologic fixation through porous materials and coatings.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional femoral revision techniques are used, then the hip implant can be replaced, but the invasiveness increases and bone removal becomes more extensive
Solution Approach 1:
The femoral stem is divided into multiple segments: a proximal portion, an intermediate portion, and a distal portion. This segmentation allows the proximal portion to engage with the femoral head while the distal portion extends into the femoral canal, enabling replacement without requiring extensive bone removal from the femur. The segmented design distributes the mechanical load across multiple sections, maintaining implant reliability while reducing invasiveness.
Solution Approach 2:
The proximal portion of the femoral stem is positioned within the femoral head, and the intermediate portion extends into the femoral canal. This nested arrangement allows the implant to be housed within existing bony structures rather than requiring creation of new spaces, thereby reducing the need for aggressive bone removal while still achieving secure implant placement.
2Reliability
If longer constructs and more bone removal are performed, then the hip revision can be achieved, but surgery time increases
Solution Approach 1:
The segmented femoral stem design allows for modular assembly and simplified surgical steps. Each segment can be independently positioned and secured, reducing the overall surgical time compared to monolithic constructs that require more extensive preparation and alignment procedures.
Solution Approach 2:
The proximal portion of the femoral stem incorporates a headless design with a reduced diameter that fits within the femoral head, while the distal portion has a larger diameter for engagement with the femoral canal. This local differentiation of geometry allows for secure fixation without requiring extensive bone removal, thereby reducing surgery time.
3Reliability
If escalation of invasiveness is applied, then the hip revision can be performed, but the risk of infection and fracture increases
Solution Approach 1:
The segmented construction with proximal, intermediate, and distal portions allows the implant to be inserted through existing canals and spaces without requiring aggressive bone removal. This reduces the creation of open wounds and exposure to contaminants, thereby lowering infection risk while avoiding fracture from excessive bone removal.
Solution Approach 2:
The proximal portion features a headless design with reduced diameter for insertion through the femoral head, while the distal portion has increased diameter for engagement with the femoral canal. This localized geometric variation enables secure fixation without requiring extensive bone removal, thereby reducing the risk of infection and fracture.
4Reliability
If un-resectable constructs are created, then the hip implant can be secured, but the femur cannot be fully removed without significant damage
Solution Approach 1:
The proximal portion of the femoral stem is nested within the femoral head, and the intermediate portion extends into the femoral canal. This nested arrangement allows the implant to be housed within existing bony structures rather than requiring creation of new spaces, thereby reducing the need for aggressive bone removal while still achieving secure implant placement.
Solution Approach 2:
The proximal portion of the femoral stem incorporates a headless design with a reduced diameter that fits within the femoral head, while the distal portion extends with a larger diameter for engagement with the femoral canal. This local differentiation of geometry allows for secure fixation without requiring extensive bone removal, thereby avoiding significant femoral damage.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Reduces the invasiveness of hip revision surgery, decreases bone removal, and potentially lowers the risks of infection and fracture while maintaining functional outcomes by using biologic fixation and less invasive techniques.
Implementation Method 1
The hip cone includes a porous coating that promotes biologic fixation
Implementation Method 2
The hip cone includes a porous coating that promotes biologic fixation
Implementation Method 3
a first annular-type region is filled with bone cement so that the second portion of the femoral stem... is surrounded by the bone cement
Data Source
AI summary
De-escalation revision systems and methods for total hip arthroplasty (THA), or total hip replacement, according to which a hip cone is installed in a femur, and a femoral stem is installed through the hip cone via bone cement, unitizing the femoral stem to the hip cone. The hip cone experiences mechanical fixation due to the bone cement, as well as long-term biologic fixation due to, for example, bony ingrowth into the hip cone. The systems and methods are suitable for complex primary, conversion, or revision total hip replacement, and are suitable from any approach such as, for example, direct anterior (DA), posterior, or lateral approaches.