Implantable joint prosthesis

Abstract

The invention relates to a surgical implant that provides an artificial diarthroidal-like joint, suitable for use in replacing any joint, but particularly suitable for use as an intervertebral disc endoprosthesis. The invention contains two rigid opposing shells, each having an outer surface adapted to engage the surfaces of the bones of a joint in such a way that the shells are immobilized by friction between their outer surfaces and the surfaces of the bone. These outer surfaces are sufficiently rough that large frictional forces strongly resist any slippage between the outer surface and the bone surfaces in the joint. They may be convex, and when inserted into a milled concavity, are immediately mechanically stable. Desirably, the outer surfaces of the shells are adapted to allow for bony ingrowth, which further stabilizes the shells in place. The inner surfaces of the shells are relatively smooth, and adapted to slide easily across a portion of the outer surface of a central body disposed between the shells. The central body has a shape that cooperates with the shape of the inner surface of the shell so as to provide a range of motion similar to that provided by a healthy joint. A flexible sheath extends between edges of the opposing shells. The inner surface of this sheath, together with the inner surfaces of the rigid shells, defines a cavity encasing the central body. At least a portion of this cavity is filled with a fluid lubricant, further decreasing the frictional force between inner surfaces of the shell and the surface of the central body.

1 - 119 . (canceled) 
     
     
         120 . A spinal implant suitable for use in an intervertebral disc space between two vertebrae of a spinal joint, comprising:
 two rigid opposing shells, each having:
 an outer surface, at least a portion of which is convex, adapted to engage an endplate of a vertebra in such a way that movement of the shell relative to the endplate is resisted by engagement between the outer surface and the endplate of the vertebra; 
 an articulating inner surface, at least a portion of which is concave, opposite the outer surface; and 
 an edge extending between the outer surface and the articulating inner surface; 
   a deformable, resilient central body disposed between and slidable with respect to the inner surfaces of the shells, the central body comprising an outer surface, at least a portion of which has a shape that complements and articulates with the shape of the articulating inner surfaces of both rigid opposing shells, including the concave portions, to allow the inner surfaces of the rigid opposing shells and the outer surface of the central body to move easily with respect to each other within a constrained range of motion that closely approximates the range of motion of a healthy spinal joint, but to resist such movement outside the constrained range of motion, the central body formed of a elastomeric biocompatible polymeric material; and   a flexible sheath extending between edges of the opposing shells, the flexible sheath having an inner surface that, together with the inner surfaces of the rigid shells, defines a cavity containing the central body.   
     
     
         121 . The spinal implant of  claim 120 , further comprising a liquid lubricant occupying at least a portion of the cavity between the central body and the opposing shells. 
     
     
         122 . The spinal implant of  claim 121 , wherein at least one of the rigid opposing shells further comprises a closable passage between its outer surface and its inner surface, the closable passage providing access into the cavity to facilitate introduction of the liquid lubricant into the cavity. 
     
     
         123 . The spinal implant of  claim 122 , further comprising a plug for sealing the closable passage. 
     
     
         124 . The spinal implant of  claim 123 , wherein the passage and the plug are each threaded such that the plug is threadingly engaged with the closable passage when sealing the closable passage. 
     
     
         125 . The spinal implant of  claim 120 , wherein at least one of the rigid opposing shells further comprises a first ridge disposed on the inner surface of the shell, and the central body further comprises a shoulder disposed on the outer surface of the central body, wherein engagement of the first ridge and the shoulder limits movement between the central body and the rigid opposing shells to the constrained range of motion. 
     
     
         126 . The spinal implant of  claim 125 , wherein the first ridge comprises an axial extension of at least a portion of the edge of the shell toward the central body, and circumscribes the area of the inner surface that can contact a convex articulation portion of the outer surface of the central body. 
     
     
         127 . The spinal implant of  claim 126 , wherein the shoulder circumscribes the convex articulation of the outer surface of the central body. 
     
     
         128 . The spinal implant of  claim 120 , wherein the edge of at least one of the shells comprises a circumferential groove adapted to be overlapped by the flexible sheath and to receive a retaining ring for securing the flexible sheath to the at least one of the shells. 
     
     
         129 . The spinal implant of  claim 128 , further comprising a retaining ring disposed in the circumferential groove and securing a portion of the flexible sheath into the groove. 
     
     
         130 . The spinal implant of  claim 120 , wherein the inner surface of at least one shells comprises a post extending toward the central body, and wherein the outer surface of the central body comprises at least one opening adapted to receive the post. 
     
     
         131 . A spinal implant suitable for use in an intervertebral disc space between a first vertebra and a second vertebra of a spinal joint, comprising:
 a first rigid shell comprising:
 a first outer surface, at least a portion of which is convex, sized and shaped to engage a first endplate of the first vertebra such that movement of the first shell relative to the first endplate is resisted by engagement between the first outer surface and the first endplate of the first vertebra; 
 a first articulating inner surface, at least a portion of which is concave, opposite the first outer surface; and 
 a first edge extending between the first outer surface and the first articulating inner surface; 
   a second rigid shell opposite the first rigid shell, the second rigid shell comprising:
 a second outer surface, at least a portion of which is convex, sized and shaped to engage a second endplate of the second vertebra such that movement of the second shell relative to the second endplate is resisted by engagement between the second outer surface and the second endplate of the second vertebra; 
 a second articulating inner surface, at least a portion of which is concave, opposite the second outer surface; and 
 a second edge extending between the second outer surface and the second articulating inner surface; 
   a flexible sheath extending between first and second edges of the first and second rigid shells such that an inner surface of the flexible sheath along with the first and second articulating inner surfaces of the first and second shells define a cavity; and   a deformable, resilient central body disposed within the cavity, the central body positioned between the first and second inner surfaces of the first and second shells, the central body comprising an outer surface having a first portion that is shaped to complement and articulate with the first articulating inner surface of the first shell, including the concave portion, and a second portion that is shaped to complement and articulate with the second articulating surface of the second shell, including the concave portion, wherein articulation of the outer surface of the central body with the first and second articulating inner surfaces allows the central body to move relative to the first and second shells within a constrained range of motion that closely approximates the range of motion of a healthy spinal joint, but resists movement outside the constrained range of motion;   wherein the first and second rigid shells are formed of a biocompatible metal and wherein the central body is formed of an elastomeric biocompatible polymeric material.   
     
     
         132 . The spinal implant of  claim 131 , wherein the first shell includes a first recess for receiving a first portion of the flexible sheath and wherein the second shell includes a second recess for receiving a second portion of the flexible sheath, and wherein the spinal implant further comprises a first retaining ring that secures the first portion of the flexible sheath within the first recess and a second retaining ring that secures the second portion of the flexible sheath within the second recess. 
     
     
         133 . The spinal implant of  claim 131 , wherein at least one of the first and second inner articulating surfaces includes a post, and wherein at least one of the first and second portions of the outer surface of the central body comprises an opening sized and shaped for receiving the post, wherein engagement between the opening and the post limits movement between the central body and the first and second shells to the constrained range of motion. 
     
     
         134 . A spinal implant suitable for use in an intervertebral disc space between two vertebrae of a spinal joint, comprising:
 two rigid opposing shells, each having:
 an outer surface, at least a portion of which is convex, adapted to engage an endplate of a vertebra in such a way that movement of the shell relative to the endplate is resisted by engagement between the outer surface and the endplate of the vertebra; 
 an articulating inner surface, at least a portion of which is concave, opposite the outer surface; and 
 an edge extending between the outer surface and the articulating inner surface; 
   a deformable, resilient central body disposed between and slidable with respect to the inner surfaces of the shells, the central body comprising an outer surface, at least a portion of which has a shape that complements and articulates with the shape of the articulating inner surfaces of both rigid opposing shells, including the concave portions, to allow the inner surfaces of the rigid opposing shells and the outer surface of the central body to move easily with respect to each other within a constrained range of motion that closely approximates the range of motion of a healthy spinal joint, but to resist such movement outside the constrained range of motion, the central body formed of a elastomeric biocompatible polymeric material; and   a flexible sheath extending between edges of the opposing shells, the flexible sheath having an inner surface, having a substantially concave shape, that, together with the inner surfaces of the rigid shells, defines a cavity containing the central body.   
     
     
         135 . The spinal implant of  claim 134 , further comprising a liquid lubricant occupying at least a portion of the cavity between the central body and the opposing shells. 
     
     
         136 . The spinal implant of  claim 135 , wherein at least one of the rigid opposing shells further comprises a closable passage between its outer surface and its inner surface, the closable passage providing access into the cavity to facilitate introduction of the liquid lubricant into the cavity. 
     
     
         137 . The spinal implant of  claim 134 , wherein at least one of the rigid opposing shells further comprises a first ridge disposed on the inner surface of the shell, and the central body further comprises a shoulder disposed on the outer surface of the central body, wherein engagement of the first ridge and the shoulder limits movement between the central body and the rigid opposing shells to the constrained range of motion. 
     
     
         138 . The spinal implant of  claim 134 , wherein the edge of at least one of the shells comprises a circumferential groove adapted to be overlapped by the flexible sheath and to receive a retaining ring for securing the flexible sheath to the at least one of the shells. 
     
     
         139 . The spinal implant of  claim 138 , further comprising a retaining ring disposed in the circumferential groove and securing a portion of the flexible sheath into the groove.