GB2324250A

GB2324250A - Shoulder prosthesis

Info

Publication number: GB2324250A
Application number: GB9808312A
Authority: GB
Inventors: Clifford Alain Stossel
Original assignee: Headcorn Instrumentation Ltd
Current assignee: Headcorn Instrumentation Ltd
Priority date: 1997-04-18
Filing date: 1998-04-20
Publication date: 1998-10-21
Anticipated expiration: 2018-04-20
Also published as: GB2324250B; GB9808312D0

Abstract

A shoulder prosthesis comprises a shaft 1 and, at the head of the shaft 1, a member 4 having a surface that is hemispherical and extends continuously beyond the base of the hemisphere to provide, in use, at least 210‹ of internal rotation. The member 4 is offset with respect to the long axis 1 of the shaft by about 30‹ to 60‹ and may be fixed to the head of the shaft 1 by means of co-operating male and female parts.

Description

PROSTHESIS Field of the Invention This invention relates to a prosthesis, in particular for the shoulder.

Backaround of the Invention In about 1969, when shoulder replacements using the Neer type of prosthesis were coming into widespread use, the humeral head was an integral part of the prosthesis.

As shoulder replacement became more widely used, modular systems were introduced. Humeral heads of different sizes were available, with plastic trial shapes, to ensure that the best size was chosen.

Available information reports that normal movements of the shoulder showed a range of 90C internal rotation to 90" of external rotation, i.e. a total range of 1800.

Accordingly, known humeral head prostheses, such as those described above, were based on a hemisphere. This appeared to be close to the anatomical shape, and was therefore entirely suitable. However, the long head of the biceps muscle which passes over the anterior aspect of the shoulder impinges against the angular shape of a hemispherical humeral head. This causes pain and fraying of the tendon.

Summarv of the Invention This invention is based at least in part on measurements of actual shoulder movements which showed that, if it is intended to reach the back of the opposite shoulder, the arm is flexed at the shoulder joint and that, with this flexion, a further 300 of internal rotation is required beyond the conventional range. This makes a total rotation of 2100. These measurements help to explain why known protheses are unsatisfactory, in that there is the disadvantage that the humeral head prosthesis rests on its edge against the glenoid, where it can become locked against a rough portion or itself damage the articular cartilage.

According to the present invention, a shoulder prosthesis comprises a shaft and a head, and the head comprises a continuous surface allowing for at least 2100 of internal rotation. Thus, the present invention allows the prosthesis to be fixed to the humerus, in a position 300 backwards from the coronal to anatomical position, and to rotate fully within the glenoid.

Description of the Drawings In the accompanying drawings, Figs. 1A and 1B are respective mutually-orthogonal side views of a prosthesis that is a preferred embodiment of the present invention.

Descrintion of the Invention The invention will now be described by way of example only with respect to the accompanying drawings. Figs. 1A and 1B show a prosthesis that comprises a shaft 1 having a head 2 and, positioned at intervals along the shaft, fixation holes 3. The holes 3 are suitable for fixing the prosthesis to the patient's humerus. On the head 3 of the shaft 2, a member generally indicated at 4 is mounted.

The member 4 comprises a hemispherical part 5 and a base part 6 that provides a smooth surface continuous with the surface of the hemisphere. This extended surface is itself generally part-spherical or part of an annulus. It provides a surface extending for at least 300 beyond the 1800 provided by the hemisphere.

The member 4 is offset with respect to the longitudinal axis of the shaft. The offset angle (between the two dashed lined shown in Fig. 1B) may be 300 to 600, and is preferably about 450, but this angle is not critical, provided that the surface of the member allows the rotation of at least 2100, and preferably at least 2700. The hemispherical member is conveniently fixed to the head by means of co-operating male and female parts.

The illustrated design provides a surface extending essentially through a total of 3600, with the extension beyond the hemisphere being of a smaller radius. This leaves a central aperture 6, within which a stem 7 is mounted. This stem fits into a corresponding recess in the top of the shaft.

The illustrated head gives continuous full articulation with the structures of the scapula throughout the fullest possible range of anatomical movement. Tests have shown that, in the fullest internal rotation, the centre of the axis of the humeral head actually points laterally. Because of the unique shape of the illustrated head, there is still a full articulation with the glenoid in this fully internally rotated position.

The completeness of the head means that in the other quadrant and plane, simultaneously the long head of biceps tendon is in its natural course.

Claims

1. A shoulder prosthesis comprising a shaft and, at the head of the shaft, a member having a surface that is hemispherical and extends continuously beyond the base of the hemisphere to provide, in use, at least 2100 of internal rotation.

2. A prosthesis according to claim 1, wherein the angle of internal rotation that is provided is at least 2700.

3. A prosthesis according to claim 1, wherein the angle of internal rotation that is provided is essentially 3600.

4. A prosthesis according to any preceding claim, wherein the continuous extension is essentially annular.

5. A prosthesis according to claim 4, wherein the member defines an aperture within which means for fixing the member to the shaft is provided.

6. A prosthesis according to any preceding claim, wherein the axis of symmetry of the member and the longitudinal axis of the shaft are offset by about 450.