1US006200350B1 co) Uni ited States Patent (a0) Patent No: US 6,200,350 BL si (45) Date of Patent: Mar. 13, 2001 (4) ANTLIMPINGEMENT FEMORAL 80,352 * 12/1996 Seket 02372246 PROSTHE 5876459 3/1999 Powell e258 (75) Inventor: Michael A. Masini, Ann Arbor, Ml © cited by examiner ws) Primary Exaniner—David 3 Isabella (74) Attorney, Agent, or Firm—Gilford, Krass, Grob, (73) Assignee: Medldea, LLC, Ann Arbor, MI (US Ce ee pela we Chime, PC (*). Notice: Subject to any disclaimer, the term ofthis (57) ABSTRACT patent i extended or adjusted under 35 USC. 154b) by 0 days. ‘A proximal femoral prosthesis. minimizes impingement, thereby affording an enhanced range of motion as compared C1) Appl. No: 09/411,738 to existing devices. The central portion of the neck of a prosthesis according to the invention is oriented distally (22) Filed: Oct. 1, 1999 relative toa straight line drawn between the bal portion and 6) imc? [AGLE 2/36 &Pointof interconnection to the exposed portion ofthe sem. ‘Such a configuration reduces impingement in Mlexioa/ internal rotation and extensionjexternal rotation, assuming, an appropriately placed acetabular component. Ia the pre= ferred embodiment, the neck is curved between the head and the neck. In alternative embodiments, the neck may be USS. PATENT DOCUMENTS provided in straight and/or modular segments. The invention (2) US. cL 625/23.18; 62323.35, (68) Field of Search (623/23.11, 23.15 66) References Cited 's compatible with neck-shaft angles, offsets head sizes, and 4.822.370 41989 Schelhas ‘ther dimensions commonly designated with respect to 4538790 7/1000 Frey etal Swaine ropleos 4957510 © 9/1990 Cremascoli xyz, 4978.359 12/1990 Wilhelm et al 62323 S387244 2/1998 Bread 625723 20 Claims, 3 Drawing SheetsUS 6,200,350 BL Sheet 1 of 3 Mar, 13, 2001 U.S, Patent i Gav yoldd) | L-eimnblg gO “Sous OX) ece t Le 6,9.) | ’ ZZ | _ GS.) “zoL 1 80%U.S. Patent Mar. 13,2001 Sheet 2 of 3 US 6,200,350 B1 vt + 1 Y 2 WwUS 6,200,350 BL Sheet 3 of 3 Mar, 13, 2001 U.S, Patent OL - big q@Z- aD WZ - 614 =) g - ainbig v09 CQ, G - anbi4 Le,US 6,200,350 BI 1 ANTI-IMPINGEMENT FEMORAL PROSTHESES FIELD OF THE INVENTION ‘This invention relates generally to orthopaedic surgery and, more particularly, 10. proximal femoral prosthesis facilitating an enhanced range of motion. BACKGROUND OF THE INVENTION In total hip arthroplasty, the defective head and neck of the proximal femur are removed and replaced with a peos- thetic element. Although extramedullary units are available, intramedullary prostheses are more commonly employed, which feature an elongated stem adapred for insertion and fixation within the femoral canal FIG. 1 is a generalized representation of a prior-art proximal femoral endoprosthesis. A head portion 102 having fan outer surface 103 which isat least partially hemispherical is joined to 4 stem 106 through a aeck postion 104. Such inierconnections may be permanent and integral, or modular connections may be used in conjunction with tapered metal joints, for example, ‘The stem 106 defines a first axis 108 which is aligned more or est to the longitudinal axis ofthe femur, depending, °° ‘upon the style of the particular implant, ‘The acck 104 defines a second axis 110 which intersects with the first axis 108 at a neck/shaft angle which may be varied in accordance ‘with the physiology of the recipient or the desires of a given ‘manufacturer, Atypical neckyshaft angle cis on the order of | 135°. The offset, or distance from the head portion to the axis ofthe stem, may also varied to achieve a desired result. ‘A number of other variations exist, including cemented versus cementless interfaces, curved versus straight stem profiles, differently sized balls, and so forth, In all existing configurations, the neck is straight or, ia some cases, curved upwardly (or proximally) away from a plane transverse to the axis of the stem. That is to say, a centroid drawn from a central region 112 of the head 102 to ‘point of intersection TL with the stem axis 108 i siuight ff occasionally curved to create a convex neck surface in existing designs. Such a configuration bas several shorteom= ings. For one, as manufacturers decrease the neck-shaft dangle «to improve oflset and abductor tension, patients lose ‘movement in flexion secondary to impingement of the neck fn the acetabular component. ‘SUMMARY OF THE INVENTION ‘This invention resides in proximal femoral prostheses which minimize impingement, thereby affording an enhanced range of motion as compared to existing devices, Broadly, the central portion of the neck of the inventive prosthesis is oriented downwardly relative to a straight line ‘awn between the ball portion and the point of intercon nection to the exposed portion ofthe stem. Such a configu= ration reduces impingement in flexioniinternal rotation and extension/external rotation, assuming an appropriately placed acetabulae componeat. In the preferred embodiment, the neck is curved between the head and the neck, though, in alternative embodiments, the neck may be provided in straight and/or modular segments. The invention is compat- ible with neck-shaft angles, offsets, head sizes, and other dimensions commonly designated with respect to available implants. ‘The neck may also be curved in the transverse plane adding increased anteversion or retroversion 10 the rneck-shaft relationship. 0 6 2 [BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is @ front-view drawing of « prioraet proximal femoral endoprosthesis having a siraight neck; FIG. 2 is a froat-view drawing of a proximal femoral endoprosthesis according to the invention having a curved neck which reduces impingement; FIG. 3 is front-view drawing of an alternative embodi- ment of the invention having an anti-impingement neck provided in multiple straight segments; FIG. 4 is a fromt-view drawing of a further alternative embodiment of the invention having a modular peek; FIG. 5 isa front-view drawing of a different alternative embodiment of the invention including a modular connee= tion between an antisimpinging neck an d implant; FIG. 6 illustrates yet a different embodiment, wherein & modular ball component connects to an integral neck/stem; FIG. 7A is a top-view drawing illustrating how an anti- impinging neck may be curved only withia the coronal plane through the head, neck and stem; FIG. TB illustrates how a neck according tothe invention may be curved apart from, or in addition to a curve in the ‘coronal plane $0 as to avoid impingement; and FIG. 7€ illustrates how “curves” relative to the coronal plane need not be smooth and continuous, but may be piecewise DETAILED DESCRIPTION OF THE INVENTION Having discussed the prior-art design of FIG. 1 in the Background of the Invention, eference will now be made 10 FIG. 2, which illustrates a preferred embodiment of the invention. As with existing devices, a femoral endoprosthe= sis according to the invention features a stem (206), head or ball portion (202) and a neck 204. For tbe sake of reference, ‘straight line 210 has been dawa from a point 211 (-X") intersecting the axis 208 (°S")of the stem and the center 212 CC") of the head 202. In contrast to existing devices, ‘wherein the neck is either straight or curved upwardly or proximally relative to the siraight line, the neck 204 of a prosthesis utilizing the inveation curves dowawanlly ot distally relative to the lie 210, icularly, the centroid of the neck, whict as the centerline 220 through the center of ‘each eross section taken along the body of the neck is, at least the mid section (222), below or distal tothe straight line 210 between the intersection 211 with the axis 208 of the of| the stem and the center 212 of the ball ‘Not each point of the neck according to the invention aved be below or distal to the straight line 210, but rather, only a portion ofthe centerline, If one considers that tbe neck 204 Includes a first portion 201 connected to the stem 206, and a second portion 203 connected 1 the head 202, ifone draws. {ine tangent to the curve 220 atthe point “X" and a second Tine tangent to the curve 210 at the point “C,” they will imerseet at a point “P." and it atleast this point “P” which #8 distal or below the straight line 210, In addition, although the aeck according to the invention is said to be curved, it need not be a smooth, continuous curve as showa in FIG. 2, Dut rather, may be made up of one or more straight segments such as 302 and 304, as shown in FIG. 3. In this configuration, the frst segment 301 includes a substantially straight longitudinal axis 302 (“o,”), which intersects with the longitudinal axis(*s”) of the stem 300 at an angle a. The second segment ofthe neck, associated with connection withUS 6,200,350 BI 3 4 head 308, includes « scoond substantially straight longi- tudinal axis 304 (“n,"), which intersects with Ny atthe point py" without having {0 straight tangents to a curve. Note also, that in both ofthe embodiments of FIGS. 2and3, ifone extends the axis of the second segment of the neck associ- fated with interconnection to the bead or ball portion, the dangle formed between this line andthe stem “s" all times greater than the angle A, formed between the axis fof the first segment associated with interconnection to the stem, and the longitudinal axis of the stem “s.” This is contrast to existing devices, wherein these two angles are either the same, of wherein a, is greater than as, indicating that the neck curves downwardly as opposed 16 upwardly, therchy potentially exacerbating problems with impinge Furthermore, a prosthesis having a neck according to the invention need not be solid and integral but instead, may utilize modular segments. FIG. 4 is representative, wherein 4 module 402 fits to a stem through a joint having post 406, ‘and a bead portion 404 sttaches to the module 402 though & ‘mating connector 408, Other arrangements are possible, including additional and differently configured modules, $0 long a least a portion of the centroid through the finally assembled structure is below or distal toa straight line from the center ofthe ball toa point of intersection with the axis 25 of the stem, FIG. 5 illustrates a different alternative embodiment, wherein an anti-impinging neck component S02 is integral with a ball portion, but conneets 16 a stem through a joint ‘504, FIG. 6 illustrates a different configuration, wheceia the ‘neck and stem are integral, but a modular ball 602 connects to-an end of the stem through the joint 604. Although a femoral prosthesis aecording to the invention may be curved only i the coronal plane, which may be defined as that plane which intersects the central portions of| the bead, neck and stem, a8 shown in FIG. 2, in particular, the neck according to the invention may also be curved relative to the coronal plane whether in a simple or com pound configuration. Reference is made to FIG. 7A, which shows a top-down view of a femoral prosthesis whieh, according tothe invention, would have the Dall portion curve ywardly and away from the paper in a manner which is different from priot art configurations. But in adklition to such an upward curve in the coronal plane 702, in the neck ‘may also be curved relative tothe coronal plane, whether ot fot itis also curved within the coronal plane. ‘That is, the curve of the aeck may be piecewise as opposed to continuous, as shown in FIG. 7C. Telsim: I. An eahanced range-of-motion femoral prosthesis, com= prising a stem having a distal portion adapted for placement within an intramedullary canal, a proximal end, and longitudinal stem axis" ‘head configured to eo-ael with a corresponding acetabue lar component; and ‘4 neck connecting the head 10 the proximal end of the stem, the neck having a first segment wih @ longitu inal axis n, where the neck connects tothe stem, and second segment with a longitudinal axisns where the rncek coanects to the head, wherein n, forms an angle a with s, and ny forms an angle ay with s, and ay is, greater than a, 1 reduce impingement of the neck on the acetabular component 2. The femoral prosibesis of claim 1, wherein: the neck is curved; and 4 1 and n; are lines tangent to the curve where the neck ‘connects to the stem and to the head, respectively. 3. The femoral prosthesis of claim 1, wherein a, and ny are substantially straight segments. 4. The femoral prosthesis of claim 4, wherein the neck is modularly attached to the head '5. An enhanced range-of-motion femoral endoprosthesis, ‘comprising: an elongated stem component having a longitudinal axis wo sy" and a proximal-to-distal orientation when implanted; ‘4 head component having a center point “e"; and ‘a neck component connecting the heat! component to the stem component, the neck component having a first segment with & longitudinal axis n, that intersects with S ata point “x” ancl a second segment with a longitu dlinal axis ns that intersects with c, and wherein m, intersects n, at a point “p” distally below a sSiraigh line drawn between ¢ and x to reduce impinge ment of the neck on the acetabular component. 6, The femoral endoprosthesis of claim 5, where: the centerline of the neck is curved; and 'n and n; are lines tangent to the curve where the neck ‘connects tothe stem and to the head, respectively. 17. The Femoral endoprosthesis of elaim 8, wherein atleast the first and second segments are substantially stright '8, The femoral endoprosthesis of claim 8, including modular connection between the head and neck components 2 of between the neck and stem components. 9. The femoral endoprosthesis of claim §, wherein: 4 coronal plane is defined asa plane which intersects sad and » lies outside the coronal plane. 10. A femoral endoprosthesis, comprising 4 head portion having a center; 44siem portion having an axis ith an upwardly oriented ‘proximal end when installed and «4 neck portion interconnecting the head to the stem, the neck portion having a longitudinal axis which is curved ‘of angled celative (0 4 plane intersecting the center of the head and the axis of the stem such that at least a portion of the longitudinal axis of the neck lies outside the plane. AL. The femoral endoprosthesis of claim 10, wherein the head portion is modularly attached to the neck portion. 12. The femoral endoprosthesis of claim 10, wherein the neck postion is modularly altached to the stem portion. 13. The femoral endoprosthesis of claim 10, wherein the neck portion is also curved of angled upwardly within the plane’ 14. The femoral prosthesis of claim 4, wherein the neck. ‘extends from a body modularly attached to the stem. 15. The femoral prosthesis of claim 14, wherein the body is modularly attached to the stem by means of a Morse-type taper connection. 16. The femoral prosthesis of claim 14, wherein the head is modularly attached to the body by means of a Morse-type taper connection 17. An enhanced range-of-motion femoral prosthesis, ‘comprising stem having a distal portion adapted for placement ‘within an intramedullary canal, a proximal end with a modular connector, and longitudinal stem axis, s; head configured to co-act with a corresponding aeetabu- Jar component;US 6,200,350 BI 5 44 body attached to the modular connector, the body including a neck portion having a first segment with a longitudinal axis n, where the neck portion connects to the body, and a second segment with a longitudinal axis, fn, where the neck portion connects to the head, ‘wherein n, forms an angle a, with, and n, forms an angle a with s, and greater than a, to reduce impingement ofthe neat. 6 18, The femoral prosthesis of claim 17, wherein the modular connector includes a Morse-type taper 19. The femoral prosthesis of claim 17, wherein the head is modularly connected to the neck portion 20. The femoral prosibesis of claim 19, wherein the head §s modularly connected to the neck portion through a Morse~ type taper.