US3906550A - Prosthetic device having a porous fiber metal structure - Google Patents

Prosthetic device having a porous fiber metal structure Download PDF

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US3906550A
US3906550A US428763A US42876373A US3906550A US 3906550 A US3906550 A US 3906550A US 428763 A US428763 A US 428763A US 42876373 A US42876373 A US 42876373A US 3906550 A US3906550 A US 3906550A
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metal structure
fiber
prosthetic device
fiber metal
bone
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William Rostoker
Jorge Galante
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30907Nets or sleeves applied to surface of prostheses or in cement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0012Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3607Femoral heads ; Femoral endoprostheses including proximal or total replacement of the femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02Inorganic materials
    • A61L27/04Metals or alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30599Special structural features of bone or joint prostheses not otherwise provided for stackable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • A61F2002/30968Sintering
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/006Additional features; Implant or prostheses properties not otherwise provided for modular
    • A61F2250/0063Nested prosthetic parts
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00Metal working
    • Y10T29/49Method of mechanical manufacture
    • Y10T29/49801Shaping fiber or fibered material
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T428/00Stock material or miscellaneous articles
    • Y10T428/12All metal or with adjacent metals
    • Y10T428/12424Mass of only fibers
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T428/00Stock material or miscellaneous articles
    • Y10T428/12All metal or with adjacent metals
    • Y10T428/12479Porous [e.g., foamed, spongy, cracked, etc.]

Definitions

  • the prosthetic devices may be a fiber metal structure of sufficient section to support loads adequately or may include a solid load carrying member having a fiber metal structure secured to the surface thereof.
  • the fiber metal structure is sintered and open-pored so that the bone and tissue into which the prosthetic device is implanted will grow into such fiber metal structure.
  • the individual fiber strands are prekinked prior to cutting into the desired length.
  • the kink pattern should be substantially sinusoidal.
  • Preferably such kink pattern should have an amplitude (H) to period (W) relationship, H/W of 0.24 or greater.
  • FIG 2 x vv O O O O O m m 8 6 A 2 H O m 363! mmw m mzmmwmniou 2 Mn 2 2 E,
  • This invention relates toprosthctic devices for .re-
  • Polymethyl methacrylate has also produced acceptable limited term attachments. Howebver, doubtsstill exist as to the overall safety of itsuse from a biological point of view partly from damage to surrounding tissue from monomer and heat interaction, and partly thatthe plastics may age in the body fluid thereby becoming brittle and tending to crack or erumblei An open -pore material into which bone could grow should provide ideal skeletal fixation. Numerous materials and processes for producing porous aggregates have been disclosed which serve-this purpose. For example, see US. Pat. No. 3,314,420. Typically these aggregates are powder metalsor powder ceramics which are compressed and sintered to propufeep porous but relatively strong body.
  • the subject invention provides aprosthetic device which is non-toxic, compatible and not subject to loosening or movement after implantation, and furtherineludes the provision of an open-pore attachment for bone ingrowth which attachment is highly compliant, not brittle, resistant to crack propagation and has a broad range of readily controllable pore sizes.
  • a prosthetic device including a porous aggregate produced by molding and sintering short metal fibers.
  • the sintering process creates metallurgical bonds at the points of contact of the fibers.
  • the fiber metal aggregate has considerable mechanical strength due to mechanical interlock of the fibers and the sintered bonds.
  • the degree of mechanical interlock and mechanical strength of the porous aggregate. is appreciably improved if the wire is kinked prior to being cutinto the short metal fibers.
  • the kinking pattern should be sinusoidal.
  • the ratio of amplitude and period of the sine wave should be 0.24 or greater.
  • the pore size can; be readily controlled by the pressing and forming parameters, the density of the sintered composite can approximate the density of the bone to which the prosthetic device is implanted.
  • FIG. 1 is a vertical sectional view illustrating an ex- .FlG. Z is a stress-strain diagram for a moldedand sintered Co Cr.-W, alloy fiberaggregate;
  • FIG, 3 illustrates a sinusoidal kinking. pattern of a molded fiber, metal structure
  • FIG. 5 is a vertical sectional view depicting a femur having a bone segment reconstruction prosthesis
  • FIG. 6 is a vertical view of a mountingfor a dental prosthesis.
  • the reference numeral 10 indicates generally a hip joint prosthesis which is exemplary of the prosthetic devices embodying the principles of the subject invention.
  • the joint prosthesis 10 comprises two individual prosthesis. a femur prosthesis l2 and a acetabulum prosthesis 14.
  • the femur prosthesis 12 comprises a load carrying means 16 of solid construction and a sintered fiber metal attachment structure indicated generally by the reference numeral 18.
  • the solid load carrying means 16 includes a ball carried on a flange 22, which in turn is mounted to a rod 24 having a cup-shaped bottom end member 26.
  • the fiber metal attachment structure 18 includes a plurality' of tubular fiber metal segments 28a, 28b, 28c. 28d. and 2st I
  • the rod 24 and segments 281! through 280 are inserted into the medullary cavity of the femur which is appropriately reamed and is thus fixed in place so that the ball 20 is properly orientated with respect to the hip socket 32.
  • the bone which is adjacent the fiber metal segments 280 through 280 grows into the attachment 18. It has been observed that after the bone ingrowth has proceeded to a substantial degree. a secure fixation is produced between the ingrown bone and the fiber metal implant.
  • the attachment segments 281: through 280 can be secured to the rod 24 in a number of ways. The most effective way is to metallurgically bond the fibers contacting the surface of the rod thereto; however. it will be appreciated that the flange 22 and end member 26 when tightened also act to hold the attachment segments 28 in place. Other methods by which the segments 28 are mounted to the rod 24, include cementing or the like or meehnical fixation; however. as indicated above metallurgical attachment is preferred.
  • the solid load carrying rod 24 or a similar member is normally used when tension and bending loads may be anticipated. However. where only compressive loads are experienced. the fiber metal structure 18 may be used without such rod 24. However, in some situations where stresses and strains are realized. a fiber metal structure of substantial area may be used without the rod 24.
  • the acetabulum prosthesis 14 includes fiber metal attachment component 34 and a solid wear insert 36.
  • the fiber metal attachment is molded into the proper shape and then fitted into a cavity formed in the acetabulum during surgery. Bone ingrowth'will hold the fiber component 34 rigidly in place. Since a fiber metal surface is probably not particularly wear resistant. the wear insert 36 is molded integral with the fiber component 34. Furthermore. the insert 36 not subject to bone ingrowth can be held in place mechanically so that it can be subsequently removed and replaced if necessary.
  • a union may be accomplished between the upper and lower portions 38 and 40 ofa severed femur 30 generally as shown in FIG. 5.
  • the severance space 41 is filled with a cylindrical sintered fiber metal member 42 having a center core hole 44 through which a sintered fiber-sleeved shaft 46 is passed. to provide fixation to the extremities of the femur 30.
  • the shaft 46' ineludes a solid center member 48, sintered fiber metal sleeves 50a, 50b, 50c, 50! and 50c, and end members 52 and 54.
  • Shaft 46 is fitted into the medullary cavity 56 of the femur 30 which is appropriately reamed.
  • a device 58 may be implanted in the jawbones 60 of humans or animals as a basis for mounting artificial teeth or dentures.
  • the dental prosthesis 58 comprises a monolithic sintered fiber metal member 62, and a solid center shaft 64 passing centrally through the fiber member 62.
  • Shaft 64 includes a flanged bottom 65.
  • the fiber metal segments 28, and the fiber metal attachment component 34 shown in FIG. 1, and the fiber metal member 42 and sleeves 50 shown in FIG. 5, and the fiber metal member 62 shown in FIG. 6 are all porous aggregates produced by molding and sintering short metal fibers. The points of contact between fibers become metallurgical bonded during sintering. Thus, the fiber metal aggregate has considerable mechanical strength due to the sintered bonds and the mechanical interlocks.
  • Short lengths of fine wire such as stainless steel, unalloyed titanium or Co-Cr-W alloy. are mechanically molded into the desired precise shapes using constraining dies and moving punches.
  • the long axes thereof should be on the most part coaxial with the punch motion.
  • the degree of interlock and unsintered or green strength of a pressing with the dies. is substantially increased if the original wire is prekinked prior to cutting the wire into the short fibers.
  • the desired kinking can be accomplished by passing the wire through a set of meshing gears.
  • the wire should be prekinked into a sinusoidal pattern to provide the greatest mechanical interlock. as shown in FIG. 3. Thereafter, the kinked sinusoidal wire is cut into the desired short fiber lengths.
  • the kink pattern should have an amplitude (H) to period relationship (W). H/W of 0.24 or greater.
  • the kinked short fiber strands of 316 L stainless steel; unalloyed titanium and Co-Cr-W'alloy wire. are molded into the precise shape for the fiber metal aggregate as aforestated. using constraining dies and moving punches. The choice of the wire size and the density of the fiber strands loaded in the dies will govern the final parameter dimensions of the fiber metal aggregate.
  • Repressing, using the same die and punch tooling, of the sintered metal fiber aggregate must be done to enable the aggregate to be formed into precise and reprodueible dimensions which are necessary for good clinical responses.
  • the sintered fiber metal aggregates shown in FIGS. 1, 5 and 6 may be molded having void or a porosity of 40 to 50 percent per unit area. A porosity of 60% could also be achieved, but the green strength is generally too fragile, and therefore, could effect the dimensional control because of elastic recovery. Also fiber metal aggregate having such greater porosities are not sufficiently firm at the edges and tend to crumble.
  • Wire sizes as fine as 0.013 centimeters in diameter and as coarse as 0.030 centimeters in diameter have been satisfactorily molded.
  • the metal fibers are completely interconnected.
  • the largest .prineipal dimension of the pores is approximately equal to the wire diameter when the void content is about 50 percent.
  • pressing or molding to higher densities would lead to more constricted pore sizes.
  • Wire is cut to lengths ranging from 1.3 to 3.8 centimeters. The longer the wire, the more difficult it is to feed into dies. On the other hand, long wire lengths give more interlock and better molded strengths.
  • FIG. 2 a graphical representation of a reversible (elastic) stress strain cycle is shown for Co- Cr-W alloy wire of 0.023 centimeters in diameter, molded to 50 percent porosity and sintered at 1240 C for 3 hours. Before testing and obtaining the data for FIG. 2, the sintered specimen was recompressed to a 7% reduction in height.
  • the elastic properties of Co-Cr-W alloy and other metal of the same class, such as stainless steel and titanium have elastic properties more like an elastomer than a metal.
  • a sintered specimen shows a purely plastic strain range of about 3-10 percent on the application of very small loads. Thereafter, there is an elastic strain range of about 3 percent in which the modulus is a continuous function of strain (FIG. 2). For the strain range of about 1 percent, the modulus is about 10"kg/cm2 for the sintered fiber metal structure.
  • the sintered porous fiber metal structure disclosed herein has an elastic modulus substantially less than the elastic modulus for porous metals produced by sintered powders. This enables the sintered porous fiber metal structure to be an effective interface between bone tissue and a load-bearing prosthesis; and it further provides a very high compliance (large strains per unit applied stress), which is a safeguard against high localized stresses at the prothesis-tissue interface.
  • the external dimensions of prostheses may be precisely regulated to the excavation so that a zero clearance fit exists.
  • the zero clearance fit is vital to the clinical success of fixation by bone and soft tissue. In the absence of a zero clearance fit, the
  • prothesis is isolated by fibrous or non-functional tissue. For a tooth root prosthesis this leads to loosening. Other porous materials cannot easily be sized to precise dimensions.
  • a prosthetic device for incorporation into the skeletal structure of a human or animal including:
  • a porous fiber metal structure formed from a plurality of substantially, sinusoidally shaped fiber strands, each of said fibers having a ratio of amplitude to period of substantially 0.24 or greater, said strands being metallurgically bonded to each other at their points of contact, said fiber metal structure providing at least a portion of the surface of said prosthetic device adjacent said skeletal structure to enable bone and soft tissue growth into said metal structure, said period being substantially the length of a cycle of said sinusoidal fiber strand and said amplitude being substantially the height/2 between a positive peak and a negative peak of said sinusoi dal fiber strand.
  • prosthetic device of claim 1 wherein said fiber metal structure is between 10% and porous.
  • the prosthetic device of claim 1 wherein the diameter of said fiber strands is between about 0.013 centimeters and 0.030 centimeters.
  • the prosthetic device of claim I wherein the length of said fiber strands is between about 1.3 centimeter and 3.8 centimeters.
  • the prosthetic device of claim 1 includes a noncompressible rod, said fiber metal structure being sccured to the outside of said rod.
  • said fiber metal structure is selected from the group consisting of titanium, Co-CrW altoy, stainless steel, tantalum and zirconium.
  • the prosthetic device of claim 1 includes:
  • said fiber metal structure being mounted on said wear member, said fiber metal structure adapted to be in contact with said skeletal structure when. implanted therein.
  • said fiber metal structure comprises a plurality of cylindrical segments mounted on and surrounding said rod.
  • the prosthetic device of claim 8 further includes:
  • a second porous fiber metal structure having a bore therein, said bore being dimensioned to receive said rod with said segments thereon.
  • the prosthetic device of claim I wherein said device is a dental prosthesis.
  • said device is a dental prosthesis.
  • said device including an upstanding mounting member mounted in said fiber metal structure and extending outward therefrom, said fiber metal structure extending around said upstanding member for operatively contacting the jaw bone to receive the growth of said jaw bone and gingival soft tissue.

Abstract

Prosthetic devices for replacement, attachment and reconstruction of bone structure in the skeletal systems of humans and animals. The prosthetic devices may be a fiber metal structure of sufficient section to support loads adequately or may include a solid load carrying member having a fiber metal structure secured to the surface thereof. The fiber metal structure is sintered and open-pored so that the bone and tissue into which the prosthetic device is implanted will grow into such fiber metal structure. To provide the proper interlock between fibers, the individual fiber strands are prekinked prior to cutting into the desired length. The kink pattern should be substantially sinusoidal. Preferably such kink pattern should have an amplitude (H) to period (W) relationship, H/W of 0.24 or greater.

Description

United States Patent [191 Rostoker et al.
1 PROSTHETIC DEVICE HAVING A POROUS FIBER METAL STRUCTURE [76] Inventors: William Rostoker, 2052 W. 108th Pl., Chicago, 111. 60643; Jorge Galante, One Brighton Ln., Oakbrook, 111. 60521 [22] Filed: Dec. 27, 1973 [21] Appl. No.: 428,763
[52] U.S. Cl. 3/1.912; 3/1913; 3/19; 128/92 C; 128/92 BC; 32/10 A; 29/419 [51] Int. Cl. A61F 1/24; A61C 13/30 [58] Field of Search 3/1, 1.9-1.913; 128/92 C, 92 CA, 92 BC, 92 R; 32/10 A [56] References Cited UNlTED STATES PATENTS 3,127,668 4/1964 Troy 128/92 C UX 3,685,058 8/1972 Tronzo 3/1 3,790,507 2/1974 Hodosh 1. 128/92 C X FOREIGN PATENTS OR APPLICATIONS 1,042,834 11/1958 Germany 128/92C OTHER PUBLICATIONS Sintered Fiber Metal Composites as a Basis for At- 1 1 Sept. 23, 1975 tachment of Implants to Bone," by J. Galante et al., The Journal ofBone and Joint Surgery, V01. 53-A, No. 1, January 1971, pp. 101-1 14, Mar. 1.
Primary Examiner-Ronald L. Frinks Attorney, Agent, or FirmAlbert Siegel 57 ABSTRACT Prosthetic devices for replacement, attachment and reconstruction of bone structure in the skeletal systems of humans and animals. The prosthetic devices may be a fiber metal structure of sufficient section to support loads adequately or may include a solid load carrying member having a fiber metal structure secured to the surface thereof. The fiber metal structure is sintered and open-pored so that the bone and tissue into which the prosthetic device is implanted will grow into such fiber metal structure.
To provide the proper interlock between fibers, the individual fiber strands are prekinked prior to cutting into the desired length. The kink pattern should be substantially sinusoidal. Preferably such kink pattern should have an amplitude (H) to period (W) relationship, H/W of 0.24 or greater.
10 Claims, 6 Drawing Figures mas-Kmart, was;
US atfint P 3,1975 Sheet 1 of 2 3%};
l 12 STRAIN PERCENT CON-FRACTION FIG 2 x vv O O O O O m m 8 6 A 2 H O m 363! mmw m mzmmwmniou 2 Mn 2 2 E,
2 til IE1 H Pamm Sept. 23,1975 Sheet 2 of2 3 96 5 DEVICE HAVING A POROUS FIBER PROSTHETIC v j METAL STRUCTURE There is reserved to the government of theiUnited State'sof America a non-exclusive, irrevocable and Toyalty-free license to make and use ,-and' to sell asiprovided by law, embodiments of the invention. as hereinafter described and'claims, with the power to sublicense for all governmental purposes.
BACKGROUND OF T INVENTION v This invention relates toprosthctic devices for .re-
placement, reconstruction and attachment in the skele- There are four principal methods by which the device can be attached to the bone. These methods include:
(1). lmpaction of the prosthetic stem into. the medallary cavity of the bone; (2). Mechanical internalfixation, e.g., screws; (3). Methyl methacrylatepolymerizing in situ used as a cement or. filler between the prosthesis and the bone and (4,). Porous materials into which the bone can grow. Each of these methods presents problems that can cause .failure of theprosthetic implant. V I
The devices which are impacted into the medullary cavity are held in place by a compressive residualstress interaction which may be more commonly-referredto as a force fit. lf this stress interaction is relaxed in the surrounding bone, due to physicalor biological processes, the attachment is lost and the device becomes loose, thereby requiring surgical removal and refitting of the prosthesis. I v I Mechanical internal fixation produces acceptable limited term attachments.. However, in long term use the device may become loose and thereby require replacement. I
Polymethyl methacrylate has also produced acceptable limited term attachments. Howebver, doubtsstill exist as to the overall safety of itsuse from a biological point of view partly from damage to surrounding tissue from monomer and heat interaction, and partly thatthe plastics may age in the body fluid thereby becoming brittle and tending to crack or erumblei An open -pore material into which bone could grow should provide ideal skeletal fixation. Numerous materials and processes for producing porous aggregates have been disclosed which serve-this purpose. For example, see US. Pat. No. 3,314,420. Typically these aggregates are powder metalsor powder ceramics which are compressed and sintered to propufeep porous but relatively strong body. In order to obtain'the high level of porosity and acceptable green strength; rather fine powders are required, 'the use ofiwhichg'substantially limits the size of theip ores During sintering much of the porosity ceases to become interconnecting and thus a high proportion of the pores at the surface become isolated .from the interior of the body. This'isolfation limits bone ingrowth and results. in lals ituation similar to the roughened surface of a solid Furthermore, the mechanical propertiesflof si nteredpojwders are not'ideal; for example/porous consolidated"ceramiesf are very weak and brittle, .and;,cracks propagate *quickly throughout the whole body of the porous aggregate at low stresses or with small -.impact-energies. Consolidated metal powders with p orosities in the range of 4060% void, are stronger than the consolidated ceramics but still are've'ry brittleand have poor toughness. Moreover, sinte red me tal powders are susceptible to fatigue failure Both sintered ceramics and metal powders have compliances which more closely approx.- imate the pore free material. Compliance is defined as .the change in elasticstrain per unit change in stress.
The subject invention provides aprosthetic device which is non-toxic, compatible and not subject to loosening or movement after implantation, and furtherineludes the provision of an open-pore attachment for bone ingrowth which attachment is highly compliant, not brittle, resistant to crack propagation and has a broad range of readily controllable pore sizes.
SUMMARY OFYTHE INVENTION .There is provided by thisinvention a prosthetic device including a porous aggregate produced by molding and sintering short metal fibers. The sintering process creates metallurgical bonds at the points of contact of the fibers. Thus, the fiber metal aggregate has considerable mechanical strength due to mechanical interlock of the fibers and the sintered bonds.
The degree of mechanical interlock and mechanical strength of the porous aggregate. is appreciably improved if the wire is kinked prior to being cutinto the short metal fibers. The kinking pattern should be sinusoidal. Preferably,,the ratio of amplitude and period of the sine wave should be 0.24 or greater. After the kinking is formed, the wire is cut into the desired lengths.
By using fiber metals the range of pore .sizes can be readily controlled and the attachment is not subject to the crack propagation and low strength problems associated with ceramics or powdered metal attachments.
tachment is not subject to the aging problems or reac tion problems of the plastics of the prior art. Since the pore size can; be readily controlled by the pressing and forming parameters, the density of the sintered composite can approximate the density of the bone to which the prosthetic device is implanted.
'BRlEF DESCRlPTlQN OF THE DRAWINGS Referring to the drawingsin .which the same characters of reference are employed to indicate correspondemplary hip oint prosthes1s;
:drawings:
ing, similar parts throughout the several figures of the FIG. 1 isa vertical sectional view illustrating an ex- .FlG. Z is a stress-strain diagram for a moldedand sintered Co Cr.-W, alloy fiberaggregate;
FIG, 3 illustrates a sinusoidal kinking. pattern of a molded fiber, metal structure;
FIG. 5 is a vertical sectional view depicting a femur having a bone segment reconstruction prosthesis; and FIG. 6 is a vertical view of a mountingfor a dental prosthesis.
DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to FIG. 1 of the drawings, the reference numeral 10 indicates generally a hip joint prosthesis which is exemplary of the prosthetic devices embodying the principles of the subject invention. The joint prosthesis 10 comprises two individual prosthesis. a femur prosthesis l2 and a acetabulum prosthesis 14. The femur prosthesis 12 comprises a load carrying means 16 of solid construction and a sintered fiber metal attachment structure indicated generally by the reference numeral 18.
The solid load carrying means 16 includes a ball carried on a flange 22, which in turn is mounted to a rod 24 having a cup-shaped bottom end member 26. The fiber metal attachment structure 18 includes a plurality' of tubular fiber metal segments 28a, 28b, 28c. 28d. and 2st I The rod 24 and segments 281! through 280 are inserted into the medullary cavity of the femur which is appropriately reamed and is thus fixed in place so that the ball 20 is properly orientated with respect to the hip socket 32. As the healing process takes place. the bone which is adjacent the fiber metal segments 280 through 280 grows into the attachment 18. It has been observed that after the bone ingrowth has proceeded to a substantial degree. a secure fixation is produced between the ingrown bone and the fiber metal implant.
The attachment segments 281: through 280 can be secured to the rod 24 in a number of ways. The most effective way is to metallurgically bond the fibers contacting the surface of the rod thereto; however. it will be appreciated that the flange 22 and end member 26 when tightened also act to hold the attachment segments 28 in place. Other methods by which the segments 28 are mounted to the rod 24, include cementing or the like or meehnical fixation; however. as indicated above metallurgical attachment is preferred.
The solid load carrying rod 24 or a similar member is normally used when tension and bending loads may be anticipated. However. where only compressive loads are experienced. the fiber metal structure 18 may be used without such rod 24. However, in some situations where stresses and strains are realized. a fiber metal structure of substantial area may be used without the rod 24.
The acetabulum prosthesis 14 includes fiber metal attachment component 34 and a solid wear insert 36. The fiber metal attachment is molded into the proper shape and then fitted into a cavity formed in the acetabulum during surgery. Bone ingrowth'will hold the fiber component 34 rigidly in place. Since a fiber metal surface is probably not particularly wear resistant. the wear insert 36 is molded integral with the fiber component 34. Furthermore. the insert 36 not subject to bone ingrowth can be held in place mechanically so that it can be subsequently removed and replaced if necessary.
In another prosthetic system. a union may be accomplished between the upper and lower portions 38 and 40 ofa severed femur 30 generally as shown in FIG. 5.
As is seen, the severance space 41 is filled with a cylindrical sintered fiber metal member 42 having a center core hole 44 through which a sintered fiber-sleeved shaft 46 is passed. to provide fixation to the extremities of the femur 30. The shaft 46'ineludes a solid center member 48, sintered fiber metal sleeves 50a, 50b, 50c, 50! and 50c, and end members 52 and 54. Shaft 46 is fitted into the medullary cavity 56 of the femur 30 which is appropriately reamed.
In still another prosthetic application, a device 58, as shown in FIG. 6, may be implanted in the jawbones 60 of humans or animals as a basis for mounting artificial teeth or dentures. The dental prosthesis 58 comprises a monolithic sintered fiber metal member 62, and a solid center shaft 64 passing centrally through the fiber member 62. Shaft 64 includes a flanged bottom 65. When bone or tissue grows into the fiber member 62, the upper end of the shaft 40 is securely held in place and an artificial tooth 66 can then be mounted thereon. The ingrowth of gingival tissue provides a bacterial seal.
The fiber metal segments 28, and the fiber metal attachment component 34 shown in FIG. 1, and the fiber metal member 42 and sleeves 50 shown in FIG. 5, and the fiber metal member 62 shown in FIG. 6 are all porous aggregates produced by molding and sintering short metal fibers. The points of contact between fibers become metallurgical bonded during sintering. Thus, the fiber metal aggregate has considerable mechanical strength due to the sintered bonds and the mechanical interlocks.
Short lengths of fine wire such as stainless steel, unalloyed titanium or Co-Cr-W alloy. are mechanically molded into the desired precise shapes using constraining dies and moving punches. When loading the wire charge of short metal fibers in the die during molding, the long axes thereof, should be on the most part coaxial with the punch motion. Upon applying the proper pressure with the dies and punches. at threedimensional mechanically interlocked network of fibers is formed.
The degree of interlock and unsintered or green strength of a pressing with the dies. is substantially increased if the original wire is prekinked prior to cutting the wire into the short fibers. The desired kinking can be accomplished by passing the wire through a set of meshing gears.
It has been found that the wire should be prekinked into a sinusoidal pattern to provide the greatest mechanical interlock. as shown in FIG. 3. Thereafter, the kinked sinusoidal wire is cut into the desired short fiber lengths.
To provide the optimum interlock the kink pattern should have an amplitude (H) to period relationship (W). H/W of 0.24 or greater.
The kinked short fiber strands of 316 L stainless steel; unalloyed titanium and Co-Cr-W'alloy wire. are molded into the precise shape for the fiber metal aggregate as aforestated. using constraining dies and moving punches. The choice of the wire size and the density of the fiber strands loaded in the dies will govern the final parameter dimensions of the fiber metal aggregate.
The molding operation is followed by a sintering stage in which points of contact become actual metallurgical bonds. Adequate bonding has been obtained with oven temperatures within the range of [070 I240 C for approximately 2 hours.
Repressing, using the same die and punch tooling, of the sintered metal fiber aggregate must be done to enable the aggregate to be formed into precise and reprodueible dimensions which are necessary for good clinical responses.
The sintered fiber metal aggregates shown in FIGS. 1, 5 and 6 may be molded having void or a porosity of 40 to 50 percent per unit area. A porosity of 60% could also be achieved, but the green strength is generally too fragile, and therefore, could effect the dimensional control because of elastic recovery. Also fiber metal aggregate having such greater porosities are not sufficiently firm at the edges and tend to crumble.
Wire sizes as fine as 0.013 centimeters in diameter and as coarse as 0.030 centimeters in diameter have been satisfactorily molded. In the molded and sintered fiber metal aggregate, the metal fibers are completely interconnected. The pore shapes as may be seen from FIG. 4, which is a magnification of a portion of a sintered-molded fiber metal aggregate, cannot be deb scribed in any simple geometric shape. The largest .prineipal dimension of the pores is approximately equal to the wire diameter when the void content is about 50 percent. However, pressing or molding to higher densities would lead to more constricted pore sizes.
Wire is cut to lengths ranging from 1.3 to 3.8 centimeters. The longer the wire, the more difficult it is to feed into dies. On the other hand, long wire lengths give more interlock and better molded strengths.
Turning now to FIG. 2, a graphical representation of a reversible (elastic) stress strain cycle is shown for Co- Cr-W alloy wire of 0.023 centimeters in diameter, molded to 50 percent porosity and sintered at 1240 C for 3 hours. Before testing and obtaining the data for FIG. 2, the sintered specimen was recompressed to a 7% reduction in height.
The elastic properties of Co-Cr-W alloy and other metal of the same class, such as stainless steel and titanium have elastic properties more like an elastomer than a metal. A sintered specimen shows a purely plastic strain range of about 3-10 percent on the application of very small loads. Thereafter, there is an elastic strain range of about 3 percent in which the modulus is a continuous function of strain (FIG. 2). For the strain range of about 1 percent, the modulus is about 10"kg/cm2 for the sintered fiber metal structure.
The sintered porous fiber metal structure disclosed herein has an elastic modulus substantially less than the elastic modulus for porous metals produced by sintered powders. This enables the sintered porous fiber metal structure to be an effective interface between bone tissue and a load-bearing prosthesis; and it further provides a very high compliance (large strains per unit applied stress), which is a safeguard against high localized stresses at the prothesis-tissue interface.
By repressing procedures the external dimensions of prostheses may be precisely regulated to the excavation so that a zero clearance fit exists. The zero clearance fit is vital to the clinical success of fixation by bone and soft tissue. In the absence of a zero clearance fit, the
prothesis is isolated by fibrous or non-functional tissue. For a tooth root prosthesis this leads to loosening. Other porous materials cannot easily be sized to precise dimensions.
The foregoing specification and description are intended as illustrative of the invention, the scope of which is defined in the following claims.
We claim:
1. A prosthetic device for incorporation into the skeletal structure of a human or animal including:
a porous fiber metal structure formed from a plurality of substantially, sinusoidally shaped fiber strands, each of said fibers having a ratio of amplitude to period of substantially 0.24 or greater, said strands being metallurgically bonded to each other at their points of contact, said fiber metal structure providing at least a portion of the surface of said prosthetic device adjacent said skeletal structure to enable bone and soft tissue growth into said metal structure, said period being substantially the length of a cycle of said sinusoidal fiber strand and said amplitude being substantially the height/2 between a positive peak and a negative peak of said sinusoi dal fiber strand.
2. The prosthetic device of claim 1, wherein said fiber metal structure is between 10% and porous.
3. The prosthetic device of claim 1, wherein the diameter of said fiber strands is between about 0.013 centimeters and 0.030 centimeters.
4. The prosthetic device of claim I, wherein the length of said fiber strands is between about 1.3 centimeter and 3.8 centimeters.
5. The prosthetic device of claim 1 includes a noncompressible rod, said fiber metal structure being sccured to the outside of said rod.
6. The prosthetic device of claim 1, wherein said fiber metal structure is selected from the group consisting of titanium, Co-CrW altoy, stainless steel, tantalum and zirconium.
7. The prosthetic device of claim 1, includes:
a wear resistant member, said fiber metal structure being mounted on said wear member, said fiber metal structure adapted to be in contact with said skeletal structure when. implanted therein.
8. The prosthetic device of claim 5, wherein said fiber metal structure comprises a plurality of cylindrical segments mounted on and surrounding said rod.
9. The prosthetic device of claim 8 further includes:
a second porous fiber metal structure having a bore therein, said bore being dimensioned to receive said rod with said segments thereon.
10. The prosthetic device of claim I wherein said device is a dental prosthesis. including an upstanding mounting member mounted in said fiber metal structure and extending outward therefrom, said fiber metal structure extending around said upstanding member for operatively contacting the jaw bone to receive the growth of said jaw bone and gingival soft tissue.
=l =l l

Claims (10)

1. A PROSTHETIC DEVICE FOR INCORPORATION INTO THE SKELETAL STRUCTURE OF A HUMAN OR ANIMAL INCLUDING: A POROUS FIBER METAL STRUCTURE FORMED FROM A PLURALITY OF SUBSTANTIALLY, SINUSOIDALLY SHAPED FIBER SRANDS, EACH OF SAID FIBERS HAVING A RATIO OF AMPLITUDE TO PERIOD OF SUBSTANTIALLY 0.24 OR GREATER, SAID STRANDS BEING METALLURGICALLY BONDED TO EACH OTHER AT THEIR POINTS OF CONTACT, SAID FIBER METAL STRUCTURE PROVIDING AT LEAST A PORTION OF THE SURFACE OF SAID PROSTHETIC DEVICE ADJACENT SAID SKELETAL STRUCTURE TO ENABLE BONE AND SOF TISSUE GROWTH INTO SAID METAL STRUCTURE, SAID PERIOD BEING SUBSTANTIALLY THE LENGTH OF A CYCLE OF SAID SINUSODIAL FIBER STRAND AND SAID AMPLITUDE BEING SUBSTANTIALLY THE HEIGHT/2 BETWEEN A POSITIVE PEAK AND A NEGATIVE PEAK OF SAID SINUSOIDAL FIBER STRAND.
2. The prosthetic device of claim 1, wherein said fiber metal structure is between 10% and 70% porous.
3. The prosthetic device of claim 1, wherein the diameter of said fiber strands is between about 0.013 centimeters and 0.030 centimeters.
4. The prosthetic device of claim 1, wherein the length of said fiber strands is between about 1.3 centimeter and 3.8 centimeters.
5. The prosthetic device of claim 1 includes a noncompressible rod, said fiber metal structure being secured to the outside of said rod.
6. The prosthetic device of claim 1, wherein said fiber metal structure is selected from the group consisting of titanium, Co-Cr-W alloy, stainless steel, tantalum and zirconium.
7. The prosthetic device of claim 1, includes: a wear resistant member, said fiber metal structure being mounted on said wear member, said fiber metal structure adapted to be in contact with said skeletal structure when implanted therein.
8. The prosthetic device of claim 5, wherein said fiber metal structure comprises a plurality of cylindrical segments mounted on and surrounding said rod.
9. The prosthetic device of claim 8 further includes: a second porous fiber metal structure having a bore therein, said bore being dimensioned to receive said rod with said segments thereon.
10. The prosthetic device of claim 1 wherein said device is a dental prosthesis, including an upstanding mounting member mounted in said fiber metal structure and extending outward therefrom, said fiber metal structure extending around said upstanding member for operatively contacting the jaw bone to receive the growth of said jaw bone and gingival soft tissue.
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