Arthroscopic shoulder arthroplasty, components, instruments, and method thereof
A novel method and instrumentation for insertion of humeral and glenoid total shoulder implant using arthroscopic visualization for bony preparation as well as insertion of components through small incisions. Mini instruments and cannulated guides and reamers are used in order to perform the procedure under direct arthroscopic visualization. For ease of insertion, the components are inserted separately and assembled in situ. Securing the humeral components in place is accomplished with bicortical screw transfixing the central peg of component. Also disclosed are components, parts thereof and instruments used therewith.
1. A system of parts configured for use in resecting a humeral head and glenoid fossa of shoulder joint and replacing it with a total shoulder prosthesis, the system comprising:
an implantable humeral component which comprises a head part affixable to or affixed to a base part, a central peg having a base, an axial threaded recess extending inwardly from the base, and an alignment recess extending inwardly from the base, which alignment recess has a complementary geometry to the geometry of an engaging tip of an instrument, which instrument is insertable through a part of the humerus to allow engagement of the alignment recess with the engaging tip of the inserted instrument;
an implantable glenoid component which comprises an articular glenoid part affixable or affixed to a glenoid base plate part;
optionally, at least one of:
an osteotomy guide;
a guide instrument;
a compression instrument;
a locator instrument;
one or more reciprocating mini saw blades; and
one or more boring reamers.
2. The system of claim 1 , wherein the humeral component further comprises a head having an articular bearing surface having a flat back surface and a central recess configured to receive and retain within it an insert portion of a fixation portion.
3. The system of claim 2 , wherein the base part of the humeral component comprises a fixation portion having the insert portion configured to be received within the central recess, and at least one transverse hole within the central peg for receiving a locking fixation screw.
4. The system of claim 3 , wherein the base part of the humeral component includes a circular disc which extends radially outwardly from the base part and is situated between the insert part and central peg.
5. The system of claim 1 , wherein the base plate of the glenoidal component includes a generally flat glenoid base plate and a cavity configured to receive and retain within it the base of an articular glenoid part.
6. The system of claim 1 which comprises a guide instrument which includes a center locating part having squeezable claws, an attachment channel and a detachable outrigger.
7. The system of claim 1 which comprises an osteotomy guide having a centering device at a distal end of an arm which has lateral expandable brackets and proximal end of arm includes a bracket part to which is affixed a cutting guide having a lateral slot angled between about 30°-70° of inclination with respect to a center line of the arm.
8. The system of claim 1 which comprises a compression instrument having a slideable shaft having threads at opposite ends thereof, a sleeve body having a distal end, a shoulder at a proximal end, and a rotation knob, wherein the shaft is insertable within the sleeve body, threads at one end thereof are configured to engage with the axial threaded recess of the base part of a humeral component implanted within a humerus, and threads at the opposite end thereof are configured to engage the rotation knob, and wherein rotation of the knob urges the shoulder against a part of the humerus, and causes the base part to move into a central recess present in the humerus.
9. The system of claim 1 which comprises a locator instrument having a hollow locating sleeve having a proximal part having at its proximal end thereof an engaging tip, which has a complementary geography to that of the alignment recess of the base part, and a distal part thereof conjoined with the proximal part, and a locator outrigger removably affixed to a part of the distal part, the locator outrigger having a locator hole which overlays the position of a hole of a base part implanted within a humerus when locator outrigger is mounted relative to a hole reference position present on the locating sleeve.
10. An implantable humeral component which comprises a head part affixable to or affixed to a base part, a central peg having a base, an axial threaded recess extending inwardly from the base, and an alignment recess extending inwardly from the base, which alignment recess has a complementary geometry to an engaging tip of an instrument, which instrument is insertable through a part of the humerus to allow engagement of the alignment recess with the engaging tip of the inserted instrument.
11. The implantable humeral component of claim 10 , which further comprises a head having an articular bearing surface having a flat back surface and a central recess configured to receive and retain within it an insert portion of a fixation portion.
12. The implantable humeral component of claim 11 , which further comprises at least one transverse hole within the central peg for receiving a locking fixation screw.
13. A total shoulder prosthesis comprising:
an implantable humeral component which comprises a head part affixable to or affixed to a base part, a central peg having a base, an axial threaded recess extending inwardly from the base, and an alignment recess extending inwardly from the base, which alignment recess has a complementary geometry to the geometry of an engaging tip of an instrument, which instrument is insertable through a part of the humerus to allow engagement of the alignment recess with the engaging tip of the inserted instrument;
an implantable glenoid component which comprises an articular glenoid part affixable or affixed to a glenoid base plate part.
14. The total shoulder prosthesis of claim 13 , wherein the humeral component further comprises a head having an articular bearing surface having a flat back surface and a central recess configured to receive and retain within it an insert portion of a fixation portion.
15. The total shoulder prosthesis of claim 13 , wherein the base part of the humeral component comprises a fixation portion having the insert portion configured to be received within the central recess, and at least one transverse hole within the central peg for receiving a locking fixation screw.
16. The total shoulder prosthesis of claim 13 , wherein the base part of the humeral component includes a circular disc which extends radially outwardly from the base part and is situated between the insert part and central peg.