Note: Descriptions are shown in the official language in which they were submitted.
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REVISION IMPLANT AUGMENTS, SYSTEMS, AND METHODS
FIELD OF DISCLOSURE
[0001] The disclosed augments, kits, systems, and methods relate to
orthopedic implants.
More particularly, the disclosed augments, kits, systems, and methods relate
to augment inserts
for orthopedic implant revisions.
BACKGROUND
[0002] Total joint replacements are orthopedic implants for repairing or
replacing a
natural joint. Examples of common joints that are replaced by a total joint
replacement include,
but are not limited to, hips, ankles, and shoulders. The ultimate goal with
any total joint
prosthesis is to approximate the function and structure of the natural,
healthy structures that the
prosthesis is replacing. In many instances, voids are formed in the patient's
bone adjacent to the
implant site as a result of osteolysis over a prolonged period of time. These
voids can loosen the
fixation of the prosthesis within the patient causing greater problems for the
patient.
SUMMARY
[0003] In some embodiments, a surgical method includes creating an
incision in a
patient, exposing a multi-component prosthesis implanted in a patient,
disassembling at least one
component of the multi-component prosthesis, and coupling a first revision
implant component
to a first component of the multi-component prosthesis. The revision implant
component has a
body including at least one of a projection or an opening that is
complementary to a feature of
the first component of the multi-component prosthesis for coupling the
revision implant
component to the first component of the multi-component prosthesis.
[0004] In some embodiments, a revision implant component includes a body
including an
upper side, a bottom side, and at least one side extending between the upper
side and the bottom
side. At least one of the upper side and the bottom side includes a feature
configured to engage
at least one component of a multi-component prosthesis. The shape of the
revision implant
component is different from each of the components of the multi-component
prosthesis.
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BRIEF DESCRIPTION OF THE DRAWINGS
[0005] FIG. lA is an isometric view of the front and underside of one
example of a
revision implant component in accordance with some embodiments.
[0006] FIG. 1B is an isometric view of the front and top side of the
revision implant
component/augment illustrated in FIG. 1A.
[0007] FIG. 2A is an isometric view of the front and top side of another
example of a
revision implant component/augment.
[0008] FIG. 2B is a bottom side isometric view of the revision implant
component/augment illustrated in FIG. 2A.
[0009] FIGS. 3A and 3B illustrate different view of another example of a
revision
implant component/augment.
[0010] FIG. 4 illustrates a revision implant component/augment in
accordance with
FIGS. lA and 1B coupled to components of an implant system.
[0011] FIGS. 5A and 5B illustrate a revision implant component/augment in
accordance
with FIGS. 2A and 2B coupled to components of an implant system.
[0012] FIGS. 6A and 6B illustrate a pair of revision implant
components/augments in
accordance with FIGS. 1A-2B coupled to a talar dome of an ankle replacement
system in
accordance with some embodiments.
[0013] FIGS. 7A and 7B illustrate another example of a revision implant
component/augment coupled to a talar dome of an ankle replacement system in
accordance with
some embodiments.
[0014] FIG. 8 illustrates another example of a revision implant
component/augment
coupled to a talar dome of an ankle replacement system in accordance with some
embodiments.
[0015] FIGS. 9A and 9B illustrate another example of a revision implant
component/augment coupled to a talar dome of an ankle replacement system in
accordance with
some embodiments.
[0016] FIGS. 10A and 10B illustrate another example of a revision implant
component/augment coupled to a talar dome of an ankle replacement system in
accordance with
some embodiments.
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[0017] FIGS. 11A and 11B illustrate another example of a revision implant
component/augment coupled to a talar dome of an ankle replacement system in
accordance with
some embodiments.
[0018] FIGS. 12A and 12B illustrate another example of a revision implant
component/augment coupled to a talar dome of an ankle replacement system in
accordance with
some embodiments.
[0019] FIG. 13 illustrates another example of a revision implant
component/augment
coupled to a talar dome of an ankle replacement system using screws in
accordance with some
embodiments.
[0020] FIGS. 14A and 14B provide different views of another example of a
revision
implant component/augment in accordance with some embodiments.
[0021] FIG. 14C illustrates a revision implant component/augment similar
to the revision
implant component/augment illustrated FIGS. 14A and 14B coupled to the tibial
component of
an ankle replacement system.
[0022] FIG. 15 illustrates another example of a revision implant
component/augment
coupled to the tibial component of an ankle replacement system using screws.
[0023] FIGS. 16A and 16B provide different views of another example of a
revision
implant component/augment in accordance with some embodiments.
[0024] FIG. 16C illustrates a revision implant component/augment in
accordance with
FIGS. 16A and 16B coupled to a tibial platform of a tibial component of ankle
replacement
system in accordance with some embodiments.
[0025] FIG. 16D illustrates another example of a revision implant
component/augment
coupled to the tibial component of an ankle replacement system using a screw.
[0026] FIGS. 17A and 17B illustrate another example of a revision implant
component/augment surrounding a tibial platform of a multi-component tibial
prosthesis.
[0027] FIGS. 18A and 18B illustrate another example of a revision implant
component/augment in accordance with some embodiments.
[0028] FIG. 18C illustrates a revision implant component/augment in
accordance with
FIGS. 18A and 18B coupled to a tibial platform of a tibial component of an
ankle replacement
system in accordance with some embodiments.
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[0029] FIGS. 19A and 19B illustrate another example of a revision implant
component in
accordance with some embodiments.
DETAILED DESCRIPTION
[0030] This description of the exemplary embodiments is intended to be
read in
connection with the accompanying drawings, which are to be considered part of
the entire
written description. The drawing figures are not necessarily to scale and
certain features may be
shown exaggerated in scale or in somewhat schematic form in the interest of
clarity and
conciseness. In the description, relative terms such as "horizontal,"
"vertical," "up," "down,"
"top" and "bottom" as well as derivatives thereof (e.g., "horizontally,"
"downwardly,"
"upwardly," etc.) should be construed to refer to the orientation as then
described or as shown in
the drawing figure under discussion. These relative terms are for convenience
of description and
normally are not intended to require a particular orientation. Terms including
"inwardly" versus
"outwardly," "longitudinal" versus "lateral" and the like are to be
interpreted relative to one
another or relative to an axis of elongation, or an axis or center of
rotation, as appropriate.
Terms concerning attachments, coupling and the like, such as "connected" and
"interconnected,"
refer to a relationship wherein structures are secured or attached to one
another either directly or
indirectly through intervening structures, as well as both movable or rigid
attachments or
relationships, unless expressly described otherwise. When only a single
machine is illustrated,
the term "machine" shall also be taken to include any collection of machines
that individually or
jointly execute a set (or multiple sets) of instructions to perform any one or
more of the
methodologies discussed herein. The term "operatively connected" is such an
attachment,
coupling or connection that allows the pertinent structures to operate as
intended by virtue of that
relationship. In the claims, means-plus-function clauses, if used, are
intended to cover the
structures described, suggested, or rendered obvious by the written
description or drawings for
performing the recited function, including not only structural equivalents but
also equivalent
structures.
[0031] The disclosed systems and methods advantageously enable revisions
of total ankle
implants by providing wedges and block designed to be coupled to the original
implant to fill in
any gaps formed in the bone from osteolysis. Although the disclosed systems
and methods are
described with reference to the INBONE total ankle system available from
Wright Medical
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Technology, Inc., of Arlington, TN, the disclosed systems and methods can be
adapted for other
multi-component prosthesis systems.
[0032] FIGS. lA and 1B illustrate one example of a revision implant
component 100A in
accordance with some embodiments. Referring first to FIG. 1A, revision implant
component
100A includes a body 102 having an oblong shape including a first side 104,
which is curved,
and a second side 106, which is also curved and disposed on the opposite side
of body 102 as
first side 104. A third side 108 is flat and defines a planar surface and is
disposed between first
and second sides 104 and 106. A fourth side 110 is also flat and defines a
planar surface that is
disposed opposite third side 108 and between first and second sides 104, 106.
Although revision
implant component 100A is described as including a plurality of sides 104,
106, 108, 110 that
extend between upper side 114 and bottom side 116, revision implant component
100A includes
a single side in the form of a circle, oval, or other continuous shape in some
embodiments as will
be understood by one of ordinary skill in the art.
[0033] A head or protection 112 extends from an upper side 114 and is
configured to
engage a second revision implant component 100A or a modular stem component of
an ankle
replacement or other prosthesis system. For example, in some embodiments, head
112 is tapered
such that it is configured to form a Morse taper with a corresponding recess
of another revision
implant component 100A or a modular stem component of an ankle replacement or
other implant
system. In some embodiments, projection 112 is cylindrical, i.e., not tapered,
and includes
threads, a bayonet coupling, or other attachment or coupling means for
engaging a
complementary feature of another revision implant component 100A or a
component of an ankle
replacement system. Other coupling means for coupling revision implant
component 100A to
another revision implant component or a component of multi-component
prosthesis such as, for
example, screws, bolts, or other fasteners can also be used.
[0034] Bottom side 116 of revision implant component 100A defines an
opening 118 that
is sized and configured to be complementary to head 112. For example, if head
112 is tapered,
then opening 118 is tapered such the engagement of head 112 within opening 118
forms a Morse
taper. In some embodiments when projection 112 is threaded, opening 118 is
also threaded. As
best seen in FIGS. lA and 1B, bottom side 116 can be angled (i.e., not
parallel) with respect to
upper side 114. However, one of ordinary skill will understand that upper side
114 and bottom
side 116 are parallel to one another in some embodiments.
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[0035] Revision implant component 100A also includes features for
coupling and
uncoupling revision implant component from other revision implant components
100A and/or a
component of an ankle replacement or other implant system. For example and as
best seen in
FIG. 1B, a notch 120 is defined by the top 122 of head 112. In some
embodiments, notch 120
has a diameter that is sized and configured to receive a screw driver or other
elongate tool
therein. As best seen in FIGS. lA and 1B, notch 120 is disposed at an angle
with respect to a
plane defined by flat sides 108, 110. In some embodiments, a recess 124 is
also defined in the
top 122 of head 112.
[0036] Hole 126 is defined along sides 108, 110, and in some embodiments
at the
interface between sides 108, 110 and sides 104, 106, and extends through the
body 102. As best
seen in FIG. 1A, hole 126 extends through body 102 and cavity 118 such that a
notch 128 is
defined in protrusion 130, which extends from end surface 132 of cavity 118.
The geometry of
hole 126 and notch 128 is sized and configured to receive a removal tool, such
as a shaft of a
screwdriver or dowel, for separating revision implant component 100A from an
engagement with
another revision implant component or a component of an ankle replacement
system.
[0037] As will be understood by one of ordinary skill in the art, the
size and shape of
revision implant components/augments can be varied. For example, FIGS. 2A and
2B illustrate
another example of a revision implant component 100B in accordance with some
embodiments.
The embodiment of a revision implant component 100B illustrated in FIGS 2A and
2B is similar
to the embodiment illustrated in FIGS. lA and 1B except that a plane defined
by upper side 114
is parallel to a plane defined by bottom side 116.
[0038] Referring now to FIGS. 3A and 3B, another example of a revision
implant
component 100C is illustrated including a body 102 having sides 104, 106, 108,
and 110. Sides
108 and 110 have a concave curvature (best seen in FIG. 3B) and sides 104 and
106 being
substantially flat and each defining a substantially planar surface. In some
embodiments, the
interfaces between adjacent sides 104, 106, 108, 110 can be rounded, although
one of ordinary
skill in the art will understand that the interfaces could be pointed or
chamfered.
[0039] A head or projection 112 extends from an upper side 114 and is
configured to
engage a second revision implant component 100B or a component of an ankle
replacement or
other implant system. As described above, head 112 can be tapered such that it
is configured to
form a Morse taper with a corresponding recess of another revision implant
component 100 or a
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component of an ankle replacement or other implant system in some embodiments.
However,
head 112 can also be implemented a threaded cylinder or include other
attachment means for
engaging a complementary feature of another revision implant component 100 or
a component of
an ankle replacement or other implant system.
[0040] An opening 118 sized and configured to be complementary to head
112 is defined
by bottom side 116 of revision implant component 100C. For example, if head
112 is tapered,
then opening 118 is tapered such the engagement of head 112 within opening 118
forms a Morse
taper. If, for example, projection 112 is threaded, opening 118 is also
threaded.
[0041] In some embodiments, head 112 defines a notch 120 in its top
surface 122. Notch
120 is sized and configured to receive a screw driver or other elongate tool
therein for separating
revision implant component from another revision implant component or from a
component of
an implant component. As best seen in FIG. 3A, notch 120 is disposed at an
angle such that an
axis defined by notch 120 extends diagonally across body 102. In some
embodiments, a recess
124 is also defined in the top 122 of head 112. Notch 124 assists a surgeon or
other medical
professional in orienting the Morse Taper for coupling with another revision
implant
component/augment or with a component of a multi-component ankle prosthesis.
[0042] A hole 126 is defined along sides 104, 106, and in some
embodiments at the
interface between sides 108, 110 and sides 104, 106. As best seen in FIG. 3B,
hole 126 extends
through the body 102 and intersects cavity 118. When cavity 118 includes a
protrusion 130
extending toward bottom surface 116 from cavity end surface 132, hole 126
forms a notch 128 in
protrusion 130. The geometry of hole 126 and notch 128 is sized and configured
to receive a
removal tool, such as a shaft of a screwdriver or dowel, for separating
revision implant
component 100C from an engagement with another revision implant component or a
modular
stem component of an ankle replacement system.
[0043] The revision implant components 100A, 100B, 100C described above
can be
coupled together or to components of an ankle replacement or other implant
system. For
example, FIG. 4 illustrates a revision implant component 100A coupled between
a talar dome 10
and a stem 20 of an ankle replacement system. Talar dome 10 includes a convex
or saddle-
shaped upper surface 12 and has a bottom surface 14 that defines an opening
(not shown) that is
sized and configured to receive enlarged and tapered head 22 of stem 20 and
head 112 of
revision implant component 100A. In some embodiments, talar dome 10 defines
one or more
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holes 16 in upper surface 12 of dome 10. Hole(s) 16 are sized and configured
to receive a
removal tool such as, for example, a screwdriver or dowel. At least one of
hole(s) 16 aligns with
notch 120 defined by head 112 of revision implant component 100A.
[0044] FIGS. 5A and 5B illustrate a revision implant component 100B
coupled to a talar
dome 10 and a stem 20 (FIG. 5A) and an exploded view of the same (FIG. 5B).
The arrows in
FIG. 5B identify that the geometry enlarged and tapered head 22 of stem 20 and
head 112 of
revision implant component 100B are similar to each other such that the
tapered head 22 of stem
20 and the tapered head 112 of revision implant component 100B are both
configured to lock to
talar dome 10.
[0045] Turning now to FIGS. 6A and 6B, a talar dome 10 is illustrated
being coupled to a
pair of revision implant components 100A and 100B. Revision implant component
100A
includes a bottom side 116 that defines a plane that is parallel to a plane
defined by upper side
114, and revision implant component 100B includes a bottom side 116 that
defines a planar
surface that is disposed at an angle (i.e., a non-zero degree angle) with
respect to a plane defined
by upper side 114. As best seen in FIG. 6A, the upper surface 12 of talar dome
10 is saddle
shaped with an inwardly extending depression 18. The depression 18 defines an
articulating
surface extending in an anterior-posterior direction, which is the same
direction in which the
angle opens between bottom side 116 and upper side 114 opens in FIG. 6A.
[0046] In some embodiments, such as the embodiment illustrated in FIGS.
7A and 7B,
the bottom side 116 of revision implant component 100A-1 does not define a
cavity 118 for
receiving a head 112 of another revision implant component 100, a tapered head
22 of a stem 20,
or a taper of another prosthesis implant component. Revision implant component
100A-1 can be
secured within an intramedullary cavity using bone cement, screws, other
fixation means, or
combinations thereof
[0047] The direction that the angle between bottom surface 116 and upper
surface 114
faces can be non-parallel to anterior-posterior direction. For example and as
illustrated in FIG. 8,
the direction in which the angle between bottom side 116 and upper side 114 of
revision implant
component 100D is parallel to the medial-lateral direction. The angle of
bottom face 116 can
vary in position when related to implant 10 as illustrated in FIGS. 7A, 7B,
and 8.
[0048] The physical dimensions and geometry of the revision implant
components can be
varied. For example, FIGS. 9A and 9B illustrate an embodiment of a revision
implant
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component 100E having length and width dimensions that approximately
correspond to the
length and width dimensions of talar dome 10. Revision implant component 100E
is illustrated
as having a planar surface defined by bottom side 116 that is disposed at an
angle with respect to
a planar surface defined by upper side 114, which is shown as being in
abutment with the
underside 14 of talar dome 10. However, as described above, a planar surface
defined by bottom
side 116 may also be disposed such that it is parallel to a planar surface
defined by upper side
114. Sides 104, 106, 108, 110 of revision implant component 100E are disposed
approximately
perpendicular to a plane defined by upper side 114.
[0049] In some embodiments, such as the embodiment illustrated in FIGS.
10A and 10B,
sides 104, 106, 108, 110 are disposed at angles, other than perpendicular
angles, with respect to
the plane defined by upper side 114. As best seen in FIG. 10A, sides 104, 106,
108 110 are
angled such that the length and width of bottom side 116 are greater than the
length and width of
upper side 114. In some embodiments, sides 104, 106, 108, 110 are angled such
that upper side
114 has a greater length and width dimension that bottom side 116. As best
seen in FIG. 10B,
sides 104, 106, 108, 110 can be concave such that a smooth transition is
provided between talar
dome 10 and revision implant component 100F.
[0050] Turning now to FIGS. 11A and 11B, which illustrate another
embodiment in
accordance with the present disclosure, revision implant component 100G
includes sides 104,
106, 108, 110 extending in a substantially perpendicular direction from a
planar surface defined
by upper side 114. The length and width of upper side 114 and bottom side 116
are greater than
the length and width dimensions of talar dome 10 such that upper side 114
includes areas 134
that extend beyond the boundaries of talar dome 10 as best seen in FIG. 11B.
[0051] FIGS. 12A and 12B illustrate another embodiment of a revision
implant
component 100H in which the length and width of upper side 114 and bottom side
116 are
greater than the length and width dimensions of talar dome 10 such that areas
134 extend beyond
the boundaries of talar dome 10. Sides 104, 106, 108, 110 are angled such that
the length and
width of bottom side 116 are greater than the length and width of upper side
114. In FIG. 12A,
the tapered head 112 can be seen between the bottom surface 14 of talar dome
10 and the upper
side 114 of revision implant component 100H.
[0052] FIG. 13 illustrates an embodiment of a revision implant component
1001 in which
screws are used to lock the revision implant component 1001 to a talar dome
10. As shown in
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FIG. 13, bottom side 110 of revision implant component 1001 defines
countersunk holes 136 that
are sized and configured to receive screws 24 therein. Although not visible in
FIG. 13, talar
dome 10 includes threaded holes that align with countersunk holes 136 of
revision implant
component 1001.
[0053] As described above, the geometry of the revision implant
components can vary
such that a revision implant component has a geometry that is complementary to
other implant
components or to the geometry to the intramedullary channels or cavities. For
example, FIGS.
14A-14C illustrate one example of such a revision implant component 100J
configured for use
with a tibial implant of an ankle replacement system. The bottom side 116 of
revision implant
component 100J includes a contoured surface 138 that complements the upper
surface of a tibial
platform 202 of a tibial stem component 202 of the ankle replacement system
200, which is
illustrated as an ankle replacement system in accordance with the system
described in U.S.
Patent Application No. 12,/410,978, filed March 25, 2009, the entirety of
which is herein
incorporated by reference.
[0054] Contoured surface 138 defines a channel 140 that extends inwardly
between legs
142. A groove 144 inwardly extends from the approximate midpoint of channel
140 and is sized
and configured to receive raised alignment guide 204 of tibial platform 202 as
best sent in FIG.
14C. A tapered head 112 extends from the upper side 114 of revision implant
component 100J
and is sized and configured to be received within a complementary opening
defined by a
prosthesis stem component, such as an intermediate stem component 210 or end
stem component
220 of ankle prosthesis 200.
[0055] FIG. 15 illustrates an embodiment of a revision implant component
100K that is
configured to be coupled to tibial platform 202 of ankle implant system 200
via screws 24.
Although not visible in FIG. 15, revision implant component 100K includes a
tapered head 112
extending from upper side 114 that engages intermediate component via a taper
lock. Bottom
side 116 includes contoured surface 138 that complements the upper surface of
a tibial platform
202 of a tibial implant 200 like contoured surface 138 of revision implant
component 100J
illustrated in FIGS. 14A-14C.
[0056] In some embodiments, such as the embodiments illustrated in FIGS.
16A-16D,
revision implant component 100L is configured as a spacer for insertion
between implant
components. As shown in FIG. 16A, revision implant component 100L has a
similar shape to
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the shape of revision implant component 100K except that revision implant
component 100L
does not include a tapered head 112 extending from the upper side 114. In FIG.
16B, a hole 146
is shown at the approximate middle of groove 144 and extends through revision
implant
component 100L. Hole 146 is sized and configured to receive tapered head 204
of tibial
platform 202 (FIG. 16C) in either a taper-locking engagement or in a non-
locking engagement.
[0057] As shown in FIG. 16D, a screw 24 is used to secure tibial platform
202 to revision
implant component 100L and to intermediate implant component 210 of ankle
replacement
system 200. For example, screw 24 passes through tibial platform 202 and
revision implant
component 100L and engages threads of a threaded hole (not shown) defined by
intermediate
implant component 210. Although a socket head screw 24 is illustrated, other
screw types are
possible including, but not limited to, pan head and flat head screws, to list
but only a couple
possible screw types.
[0058] FIGS. 17A and 17B illustrate another example of a revision implant
component
100N in which opening 146 defined by body 102 is sized and configured to
receive an
intermediate implant component 210 therein. In some embodiments, hole 146 is
sized to provide
a slip fit or a friction fit to an intermediate implant component 210.
[0059] FIGS. 18A-18C illustrate another example of a revision implant
component 100N
configured to be coupled to a tibial platform 202 and/or to other components
of a multi-
component implant. Revision implant component 100N is shaped as a rectangular
prism
includes sides 104, 106, 108, 110 that extend perpendicularly from bottom side
116 and upper
side 114. A tapered head 112 extends from upper side 112 and is sized and
configured to engage
another revision implant component or a replacement prosthesis component.
[0060] Bottom side 116 define a channel 140 that extends in a
longitudinal direction
across revision implant component 100N such that revision implant component
100N includes a
pair of legs 142. As best seen in FIG. 18B, a blind hole 146 is defined at the
approximate middle
of channel 140. Blind hole 146 is sized and configured to receive a tapered
head 114 of another
revision implant component or a tapered head of an implant system, such as a
tibial platform 202
of an ankle replacement system 200 as illustrated in FIG. 18C. As shown in
FIG. 18C, channel
140 is sized and configured to receive raised alignment guide 204 of tibial
platform 202.
[0061] FIGS. 19A and 19B illustrate another example of a revision implant
component
100P, which includes an upper side 114 that is disposed at an angle with
respect to bottom side
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116. Unlike revision implant component 100N, upper side 114 of revision
implant component
100P does not include a tapered head extending from upper side 114, and bottom
side 116 does
include a channel 140. In some embodiments, bottom side 116 define a hole 146
sized and
configured to receive a tapered head of another revision implant component or
prosthesis
component therein. In some embodiments, hole 146 can be omitted. As shown in
FIG. 19B,
revision implant component 100P includes a channel 140 defined by bottom side
116 that is
sized and configured to receive a raised alignment guide 204 of a tibial
platform 202.
[0062] As described above, the revision implant components/augments can
have a
variety of shapes and geometries. In some embodiments, the revision implant
components/augments are formed from a plasma sprayed titanium, although other
materials
including, but not limited to, BIOFOAMO, available from Wright Medical
Technology, Inc., and
other metal, ceramic, plastic, and bone growth materials.
[0063] The size and shape of the revision implant component/augment 100
can be
selected after pre-operative assessment using fluoroscopy to identify the
position of a multi-
component prosthesis that is implanted in bone, or the selection of the
appropriate revision
implant component/augment 100 can be performed intraoperatively by a surgeon
or other
healthcare provider after reviewing the implant site. In some embodiments, the
revision implant
components/augments 100 are individually sterilized and packaged while in some
embodiments
the implant components/augments 100 are provided in a kit. For example, when
provided in a
kit, each individual implant component/augment 100 may be individually
packaged and included
in a larger container or packaging. However, kits can also be formed without
packing multiple
implant components/augments 100 in a single package.
[0064] During a revision operation, a multi-component prosthesis that was
previously
implant in a patient may be partially or completely disassembled. For example,
if the multi-
component implant is a multi-component tibial prosthesis 200 including a
tibial platform 202,
one or more intermediate components 210, and an end component 220, then the
surgeon can
decouple the tibial platform 202 and/or one or more intermediate components
210 using a tool
such a screw driver, a dowel, or a specialized instrument as will be
understood by one of
ordinary skill in the art. For example, a tibial platform 202 can be separated
from an
intermediate implant component 210 by disengaging the Morse taper or
unscrewing the implant
components 202, 210. If, for example, the multi-component prosthesis is a
talar prosthesis, then
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the talar dome 10 can be decoupled from talar stem 20 by disengaging the Morse
taper coupling.
When completely disassembled, the entire multi-component prosthesis is removed
from the
patient.
[0065] With the multi-component implant at least partially disassembled,
one or more
revision implant components/augments 100 are assembled to the multi-component
prosthesis in
situ using the applicable attachment mechanism. In some embodiments, the in
situ attachment
includes inserting one or more revision implant components/augments 100 into a
pre-existing
intramedullary cavity and attaching the revision implant components/augments
100 to the
implanted component(s) of the multi-component prosthesis. It is also possible
to couple together
one or more revision implant components/augments 100 with one or more
components of the
multi-component prosthesis ex situ and then couple the resulting assemblage to
any components
of the multi-component prosthesis. For example, if the multi-component implant
is completely
removed from the patient, the surgeon or another medical professional or care
giver can implant
one or more components of a multi-component prosthesis with one or more
revision implant
components/augments 100.
[0066] As described above, the revision implant components/augments can
have different
shapes from each other and/or from the shapes of the components of the multi-
component
prosthesis such that the revision implant components/augments 100 can be
coupled together to
fill a void in a bone. Additionally, a single revision implant
component/augment can include
multiple attachment means such as, for example, a taper, threads, a bayonet
coupling, to list but
only a few possibilities.
[0067] Although the devices, kits, systems, and methods have been
described in terms of
exemplary embodiments, they are not limited thereto. Rather, the appended
claims should be
construed broadly, to include other variants and embodiments of the devices,
kits, systems, and
methods, which may be made by those skilled in the art without departing from
the scope and
range of equivalents of the devices, kits, systems, and methods.
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