Glenoid component with improved fixation stability
View Patent ↗A glenoid component is provided to reduce glenoid loosening when implanted in orthopedic joint replacement/reconstruction, such for a shoulder. The glenoid component can include pegs or a keel and articulating surface geometry that uses complex, non-spherical geometry to recreate a level of constraint that is adequate, but not excessive, to thereby mitigate loosening of the glenoid component after implantation. In addition, some embodiments provide that peak stresses both within cement and at an interface of the cement and a supportive component can be reduced. Further, geometry of the pegs can allow stresses to be evenly applied to a cement mantle formed in the supportive component. Finally, the pegs can be configured to desired lengths in order to avoid placement in areas of the supportive component, for example, that have insufficient bone stock.
1. An orthopedic device for implantation in a supportive substrate of a scapula prepared with at least one hole, the orthopedic device comprising:
a glenoid component including a front articulating surface adapted to articulate with a humeral head, and a back surface adapted to engage with the supportive substrate; and
at least one peg extending from the back surface of the glenoid component, the peg comprising:
a proximal portion extending from the back surface along a longitudinal axis of the peg, the proximal portion comprising a maximum cross-sectional diameter adapted to provide a proximal press fit with a proximal portion of the hole in the supportive substrate of the scapula; and
a distal portion extending from the proximal portion, the distal portion comprising a maximum cross-sectional diameter with respect to the longitudinal axis of the peg that is less than the maximum cross-sectional diameter of the proximal portion such that the proximal portion is adapted to help ensure cement fills around the distal portion of the peg, wherein the distal portion tapers such that a cross-section of the distal portion increases distally.
2. The orthopedic device of claim 1 wherein the front surface of the glenoid component comprises at least one complex surface.
3. The orthopedic device of claim 2 wherein the at least one complex surface is a surface selected from the group consisting of a continuously variable curvature surface, a multi-radii surface, and an asymmetric surface.
4. The orthopedic device of claim 1 comprising a reverse curvature in a peripheral region of the glenoid component that transmits a load applied to a peripheral region by the humeral head downwardly through substantially all of the glenoid component and into the supportive substrate.
5. The orthopedic device of claim 1 comprising a reverse curvature in a peripheral region of the glenoid component that directs a load applied to a peripheral region by the humeral head through the back surface of the glenoid component and into the supportive substrate.
6. The orthopedic device of claim 1 comprising a reverse curvature in a peripheral region of the glenoid component that directs a load applied to a peripheral region by the humeral head to the supportive substrate engaged with the back surface of the glenoid component.
7. The orthopedic device of claim 1 comprising a reverse curvature in a peripheral region of the glenoid component that substantially eliminates overhanging loads.
8. The orthopedic device of claim 1 wherein the front surface of the glenoid component comprises at least one contoured pathway configured to direct motion of the humeral head along a directional path.
9. The orthopedic device of claim 1 wherein the front surface of the glenoid component comprises at least one eminence where motion of the humeral head along the front surface is discouraged.
10. The orthopedic device of claim 1 wherein the proximal portion of the peg is substantially cylindrical.
11. The orthopedic device of claim 1 wherein the at least one peg ranges from about 3 mm to about 20 mm in length.
12. The orthopedic device of claim 1 comprising at least three pegs configured asymmetrically on the back surface to engage with inferior, central, and superior regions respectively of the scapula.
13. The orthopedic device of claim 1 wherein the at least one peg comprises:
a first peg of a first length positioned to engage an inferior region of the scapula;
a second peg of a second length less than the first length positioned to engage with a central region of the scapula;
a third peg of a third length less than the second length positioned to engage with a superior region of the scapula.
14. The orthopedic device of claim 1 wherein the at least one peg comprises:
a first peg configured to engage an inferior region of the scapula; and
a second peg configured to engage with a superior region of the scapula.
15. The orthopedic device of claim 1 further comprising at least one attachment structure located on the distal portion adapted to mechanically interlock with a cement mantle located in a distal portion of the hole in the supportive substrate of the scapula.
16. The orthopedic device of claim 15 wherein the cement mantle is located substantially along only the distal portion of the peg.
17. The orthopedic device of claim 15 wherein the cement mantle experiences significantly reduced peak tensile stresses compared to a cement mantle extending the length of the peg.
18. The orthopedic device of claim 15 wherein the cement mantle is interdigitated with the supportive substrate.
19. The orthopedic device of claim 15 wherein the attachment structure is selected from the group comprising at least one of a radial groove, an annular groove, a linear groove, an axial groove, a step, a flute, radial holes, annular holes, and linear holes.
20. An orthopedic device for implantation in a supportive substrate of a scapula prepared with at least one hole, the orthopedic device comprising:
a glenoid component including a front articulating surface adapted to articulate with a humeral head, a back surface adapted to engage with the supportive substrate, and at least three pegs arranged asymmetrically on the back surface of the glenoid component, the three pegs including:
a first peg of a first length positioned to engage with an inferior region of the scapula;
a second peg of a second length less than the first length positioned to engage with a central region of the scapula;
a third peg of a third length less than the second length positioned to engage with a superior region of the scapula;
wherein each of the first, second and third peg has a proximal portion and a distal portion having a first cross-sectional diameter and a second cross-sectional diameter, respectively, wherein the first cross-sectional diameter is spaced from the back surface at a distance less than a distance the second cross-sectional diameter is spaced from the back surface, and wherein the second cross-sectional diameter is substantially less than the first cross-sectional diameter; and
a plurality of cement mantles for securing the glenoid component to the supportive substrate including a first, a second, and a third cement mantle each located substantially only along the distal portions of each of the first, second, and third pegs, respectively, and secured to the distal portions of each of the first, second, and third pegs, respectively.