Modular humeral prosthesis and method

Abstract

A modular humeral prosthesis for replacement of the humeral head of a humerus. The prosthesis generally comprises a stem to be fitted to a resected humerus; a head sized and configured to approximate the humeral head; and an intermediate connecting member for connecting the stem to the head. The intermediate connecting member provides a desired angle of inclination or offset between stem and head. The head may be a traditional humeral head, or it may be an eccentric humeral head, with its mating portion being offset. The head may also comprise a groove or milled trench at least partially surrounding or otherwise defining mating portion. Also disclosed is a modular humeral prosthesis kit comprising a variety of different intermediate connecting members that may be selected to tit the prosthesis to the patient, and a method of replacing a humeral head in a patient.

What is claimed is:  
     
         1 . A modular humeral prosthesis for replacement of the humeral head of a humerus, comprising: 
 (a) a stem adapted to be fitted to a resected humerus;    (b) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;    (c) an intermediate connecting member for connecting the stem to the head, the intermediate connecting member including: 
 a first connecting surface that is adapted to cooperate with structure forming part of the stem in order to mount the intermediate connecting member to the stem; and  
 a second connecting surface adapted to cooperate with structure forming part of the head in order to mount the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface and the first and second surfaces being surfaces of rotation having axes of rotation, the axis of rotation of the first surface non-collinear with the axis of rotation of the second surface.  
   
     
     
         2 . A prosthesis according to claim I in which both connecting surfaces are adapted to lock to corresponding structure using a tapered locking mechanism.  
     
     
         3 . A prosthesis according to    claim 1    in which the second connecting surface is inclined at an angle relative to the first connecting surface.  
     
     
         4 . A prosthesis according to    claim 1   , in which each of the first connecting surface and the second connecting surface has an axis, and in which said axes are offset from each other in order to cause the first connecting surface to be offset from the second connecting surface.  
     
     
         5 . A prosthesis according to    claim 1    in which (a) the second connecting surface is inclined at an angle relative to the first connecting surface; and (b) the second connecting surface is offset from the first connecting surface.  
     
     
         6 . A modular humeral prosthesis according to    claim 1    in which the first connecting surface is a female connecting surface and the second connecting surface is a male connecting surface.  
     
     
         7 . A modular humeral prosthesis according to    claim 1    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         8 . A modular humeral prosthesis for replacement of the humeral head of a humerus, comprising: 
 (a) a stem adapted to be fitted to a resected humerus;    (b) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;    (c) an intermediate connecting member for connecting the stem to the head, the intermediate connecting member including: 
 a first connecting surface forming a tapered, generally frustoconically shaped, cavity that is adapted to cooperate with a structure forming part of the stem in order to mount and lock the intermediate connecting member to the stem; and  
 a second connecting surface that is generally frustoconically shaped, tapered, and adapted to cooperate with structure forming part of the head in order to mount and lock the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface and the first and second surfaces being surfaces of rotation having axes of rotation, the axis of rotation of the first surface non-collinear with the axis of rotation of the second surface.  
   
     
     
         9 . A prosthesis according to    claim 8    in which the second connecting surface is inclined at an angle relative to the first connecting surface.  
     
     
         10 . A prosthesis according to    claim 8    in which each of the first connecting surface and the second connecting surface has an axis, and in which said axes are offset from each other in order to cause the first connecting surface to be offset from the second connecting surface.  
     
     
         11 . A prosthesis according to    claim 8    in which (a) the second connecting surface is inclined at an angle relative to the first connecting surface; and (b) the second connecting surface is offset from the first connecting surface.  
     
     
         12 . A modular humeral prosthesis according to    claim 8    in which the first connecting surface is a female connecting surface and the second connecting surface is a male connecting surface.  
     
     
         13 . A modular humeral prosthesis according to    claim 8    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         14 . A modular humeral prosthesis kit for replacement of the humeral head of a humerus, comprising: 
 (a) a stem to be fitted to a resected humerus;    (b) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;    (c) a plurality of intermediate connecting members of which one may be selected to connect the stem to the head, each intermediate connecting member comprising: 
 a first connecting surface forming a cavity that is adapted to receive a structure that protrudes from the stem in order to mount the intermediate connecting member to the stem; and  
 a second connecting surface adapted to be received in a cavity in the head in order to mount the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface;  
 the intermediate connecting members of the kit comprising: 
 at least one intermediate connecting member in which the first and second connecting surfaces share an axis of rotation;  
 at least one intermediate connecting member in which the first and second connecting surfaces are offset from each other; and  
 at least one intermediate connecting member in which the first and second connecting surfaces are inclined at an angle relative to each other.  
 
   
     
     
         15 . A prosthesis kit according to    claim 14    in which both connecting surfaces are adapted to lock to corresponding structure using a tapered locking mechanism.  
     
     
         16 . A prosthesis kit according to    claim 14    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         17 . A method of replacing a humeral head in a patient, comprising: 
 (a) resecting the proximal end of the humerus to remove the head and expose the medullary canal of the humerus;    (b) inserting a stem of a prosthesis into the medullary canal of the resected humerus, the prosthesis comprising: 
 (i) the stem;  
 (ii) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;  
 (iii) one of a plurality of intermediate connecting members for connecting the stem to the head, each intermediate connecting member including: 
 a first, female, connecting surface forming a cavity that is adapted to receive a structure that protrudes from the stem in order to mount the intermediate connecting member to the stem; and  
 a second, male, connecting surface adapted to be received in a cavity in the head in order to mount the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface;  
 the plurality of intermediate connecting members including at least some members having the first and second surfaces being surfaces of rotation having axes of rotation, the axis of rotation of the first surface non-collinear with the axis of rotation of the second surface;  
 
   (c) selecting a particular intermediate connecting member to provide a desired angle of inclination of the head relative to the humerus; and    (d) mounting and locking the intermediate connecting member to the stem, and mounting and locking the intermediate connecting member to the head, the mounting and locking of the intermediate connecting member to the stem and head imparting any desired angle of inclination of the head relative to the humerus.    
     
     
         18 . A method according to    claim 17    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         19 . A modular humeral prosthesis for replacement of the humeral head of a humerus, comprising: 
 (a) a stem adapted to be fitted to a resected humerus;    (b) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;    (c) an intermediate connecting member for connecting the stem to the head, the intermediate connecting member including: 
 a first, female, connecting surface forming a cavity that is adapted to receive structure that protrudes from the stem in order to mount the intermediate connecting member to the stem; and  
 a second, male, connecting surface adapted to be received in a cavity in the head in order to mount the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface and the first and second surfaces being non-coaxial.  
   
     
     
         20 . A modular humeral prosthesis according to    claim 19    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         21 . A modular humeral prosthesis for replacement of the humeral head of a humerus, comprising: 
 (a) a stem adapted to be fitted to a resected humerus;    (b) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;    (c) an intermediate connecting member for connecting the stem to the head, the intermediate connecting member including: 
 a first, female, connecting surface forming a tapered, generally frustoconically shaped, cavity that is adapted to receive a structure that protrudes from the stem in order to mount and lock the intermediate connecting member to the stem; and  
 a second, male, connecting surface that is generally frustoconically shaped, tapered, and adapted to be received in a cavity in the head in order to mount and lock the head to the intermediate connecting member,  
 the second connecting surface at least partially nested with the first connecting surface and the first and second surfaces being non-coaxial.  
   
     
     
         22 . A modular humeral prosthesis according to    claim 21    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         23 . A method of replacing a humeral head in a patient, comprising: 
 (a) resecting the proximal end of the humerus to remove the head and expose the medullary canal of the humerus;    (b) inserting a stem of a prosthesis into the medullary canal of the resected humerus, the prosthesis comprising: 
 (i) the stem;  
 (ii) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;  
 (iii) one of a plurality of intermediate connecting members for connecting the stem to the head, each intermediate connecting member including: 
 a first connector formed as a surface of rotation and adapted to cooperate with the stem in order to mount the intermediate connecting member to the stem,  
 a second connector formed as a surface of rotation and adapted to cooperate with the head in order to mount the head to the intermediate connecting member,  
 the plurality of intermediate connecting members including at least some members having different angles of inclination between their first and second connectors;  
 
   (c) selecting a particular intermediate connecting member to provide a desired angle of inclination of the head relative to the humerus; and    (d) mounting the intermediate connecting member to the stem, mounting the intermediate connecting member to the head, the mounting of the intermediate connecting member to the stem and head imparting the desired angle of inclination of the head relative to the humerus.    
     
     
         24 . A method according to    claim 23    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.  
     
     
         25 . A method of replacing a humeral head in a patient, comprising: 
 (a) resecting the proximal end of the humerus to remove the head and expose the medullary canal of the humerus;    (b) inserting a stem of a prosthesis into the medullary canal of the resected humerus, the prosthesis comprising: 
 (i) the stem;  
 (ii) an eccentric head adapted to approximate the size and shape of a humeral head, having an eccentric mating portion adapted to interface with an intermediate connecting member;  
 (iii) one of a plurality of intermediate connecting members for connecting the stem to the head, each intermediate connecting member including: 
 a first connector formed as a surface of rotation and adapted to cooperate with the stem in order to mount the intermediate connecting member to the stem,  
 a second connector formed as a surface of rotation and adapted to cooperate with the head in order to mount the head to the intermediate connecting member,  
 the plurality of intermediate connecting members including at least some members with each of the first connector and second connector having an axis, and in which said axes are offset from each other in order to cause the first connector to be offset from the second connector,  
 
   (c) selecting a particular intermediate connecting member to provide a desired offset of the head relative to the stem; and    (d) mounting the intermediate connecting member to the stem, mounting the intermediate connecting member to the head, the mounting of the intermediate connecting member to the stem and head imparting the desired offset of the head relative to the humerus.    
     
     
         26 . A method according to    claim 25    in which the eccentric head comprises a trench at least partially surrounding the eccentric mating portion.