# US 2014/0156011 A1 · Modified Reverse Joint and Revision Prosthesis > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0156011 A1 - Document ID: US20140156011A1 - Status: Published application - Kind: A1 - Application number: 13/895,712 - Filed: 2013-05-16 - Published: 2014-06-05 - Earliest claimed: 2010-03-08 - Assignees: Hip Innovation Techonology LLC - Applicants: Hip Innovation Techonology LLC - Inventors: Zafer Termanini - Web page: https://patentgrep.com/patent/US20140156011A1 ## CPC - A61F 2/34: Acetabular cups - A61F 2/3609: {Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts (A61F2/3601 takes precedence)} - A61F 2002/30332: {Conically- or frustoconically-shaped protrusion and recess} - A61F 2002/30578: {having apertures, e.g. for receiving fixation screws} - A61F 2002/3401: {with radial apertures, e.g. radial bores for receiving fixation screws} - A61F 2002/3483: {having a convex shape, e.g. hemispherical heads} - A61F 2002/349: {Shell having a wavy or undulated peripheral rim} - A61F 2002/3615: {having a concave shape, e.g. hemispherical cups} - A61F: FILTERS 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 (dental prosthetics A61C) ## Abstract A reverse joint prosthesis to replace a “ball and socket” joint such as a hip or shoulder. In the case of a hip, the prosthesis comprises an acetabular cup for implanting in an acetabular socket. The acetabular cup is secured to the acetabular socket of the pelvis. The acetabular cup has a stem extending from the center of a concave portion thereof and an acetabular ball is attached to the stem. A femoral implant is provided with a femoral cup attached to the proximal end thereof. The femoral cup has a stem which can be constructed in a modular fashion with several stem lengths to accommodate different size patients. After implantation of the acetabular cup and ball and the femoral cup, the members are assembled together so that the femoral cup can articulate on the acetabular ball. The prosthesis of the invention has substantially reduced likelihood of dislocation during extreme ranges of motion. ## Claims ### Claim 1 A reverse hip prosthesis comprising a unitary acetabular cup having an outer non-articulating surface adapted for attachment to an acetabular socket in a pelvic bone and a concave surface located opposite to the non-articulating surface, the concave surface having an acetabular cup stem firmly affixed therein and projecting outwardly therefrom, an acetabular ball firmly affixed to the acetabular cup stem, the acetabular ball having a surface, the concave surface of the acetabular cup and the surface of the acetabular ball are spaced from one another, thereby defining a gap therebetween, a femoral implant for implantation in a medullary canal of a proximal end of a femur, a femoral cup firmly affixed to a proximal end of the femoral implant, the femoral cup sized for articulation in the gap, such that the femoral cup has a concave surface sized for articulation on the surface of the acetabular ball and a convex surface opposite the concave surface of the femoral cup sized for articulation on the concave surface of the acetabular cup, the gap being sized and configured to permit said articulations while constraining the femoral cup within the gap throughout an entire range of said articulations of the femoral cup as it articulates within the gap, thereby reducing the risk of dislocation, and the acetabular cup has a notch in the circumferential outer edge thereof to permit maximum inflection when the prosthesis is implanted in a patent. ### Claim 2 (depends on 1) The prosthesis of claim 1 wherein the femoral cup further comprises a notch in the circumferential outer edge thereof. ### Claim 3 (depends on 1) The prosthesis of claim 1 wherein the concave surface of the acetabular cup has a center and the acetabular cup stem is affixed to and in the center. ### Claim 4 (depends on 1) The prosthesis of claim 1 wherein the acetabular ball has an acetabular ball recess sized to receive the acetabular cup stem. ### Claim 5 (depends on 1) The prosthesis of claim 1 wherein the femoral cup has a femoral cup stem projecting outwardly therefrom in a direction opposite the concave surface thereof and the femoral implant has at its proximal end a recess sized to receive the femoral cup stem. ### Claim 6 (depends on 1) The prosthesis of claim 1 wherein the femoral implant has a femoral implant stem extending proximally therefrom and the femoral cup has a recess sized to receive the femoral implant stem. ### Claim 7 (depends on 4) The prosthesis of claim 4 wherein the acetabular ball has a center, the acetabular cup stem has a longitudinal center line and the acetabular ball recess has a longitudinal center line, both longitudinal center lines being colinear and passing through the center of the acetabular ball. ### Claim 8 (depends on 5) The prosthesis of claim 5 wherein the femoral cup has a concave hemispherical portion having a center line, the femoral cup stern has a longitudinal center line and the femoral implant recess has a longitudinal center line wherein all of the center ones are colinear. ### Claim 9 (depends on 1) The prosthesis of claim 1 wherein the concave surface of the femoral cup is fully in contact with the surface of the acetabular ball during articulation of said concave surface of the femoral cup on the acetabular ball. ### Claim 10 (depends on 1) The prosthesis of claim 1 further comprising an articulating protective sheath disposed between the concave surface of the acetabular cup and the convex surface of the femoral cup. ### Claim 11 (depends on 1) A method of implanting in a patient the prosthesis of claim 1 comprising preparing an acetabular socket in a pelvis and affixing the acetabular cup therein, preparing a medullary canal at the proximal end of a femur and affixing the femoral implant therein, affixing the acetabular ball to the acetabular cup stem, affixing the femoral cup to the proximal end of the femoral implant and aligning the concave surface of the femoral cup with the acetabular ball so that the femoral cup will articulate in the gap and the concave surface of the femoral cup will articulate on the surface of the acetabular ball. ### Claim 12 (depends on 11) The method of claim 11 further comprising disposing a protective shield in the acetabular cup prior to affixing the acetabular ball to the acetabular cup stem. ### Claim 13 (depends on 1) A revision surgery method of implanting in a patient the prosthesis of claim 1, the patient having an implant in need of revision which comprises a hip joint prosthesis with an implanted acetabular cup and a femoral stem having an articulating femoral ball affixed to the proximal end thereof, the implanted acetabular cup having a concave articulating surface, the method comprising removing the femoral stern and articulating femoral ball, affixing to the concave articulating surface of the implanted acetabular cup the acetabular cup of claim 1, preparing a medullary canal at the proximal end of a femur and affixing the femoral implant therein, affixing the acetabular ball to the acetabular cup stem, affixing the femoral cup to the proximal end of the femoral implant and aligning the concave surface of the femoral cup with the acetabular ball so that the concave surface of the femoral cup will articulate on the acetabular ball. ### Claim 14 (depends on 11) The method of claim 11 further comprising disposing a protective shield in the acetabular cup prior to affixing the acetabular ball to the acetabular cup stem. ### Claim 15 (depends on 5) A kit comprising the prosthesis of claim 5 and further comprising one or more additional femoral cups, wherein the femoral cup stems have different lengths. ### Claim 16 (depends on 6) A kit comprising the prosthesis of claim 6 wherein the femoral cup recess is disposed in a neck projecting outwardly from the femoral cup in a direction opposite the concave surface thereof, further comprising one or more additional femoral cups, wherein the femoral cup necks have different lengths. ### Claim 17 A reverse shoulder prosthesis comprising a unitary glenoid cup having an outer non-articulating surface adapted for attachment to a glenoid fossa and a concave surface located opposite to the non-articulating surface, the concave surface having a glenoid cup stem firmly affixed therein and projecting outwardly therefrom, a glenoid ball firmly affixed to the glenoid cup stem, the glenoid ball having a surface, the concave surface of the glenoid cup and the surface of the glenoid ball are spaced from one another, thereby defining a gap therebetween, a humeral stem for implantation in a medullary canal of a proximal end of a humerus, and a humeral cup firmly affixed to a proximal end of the humeral stem, the humeral cup sized for articulation in the gap, such that the humeral cup has a concave surface sized for articulation on the surface of the glenoid ball and a convex surface opposite the concave surface of the humeral cup sized for articulation on the concave surface of the glenoid cup, the gap being sized and configured to permit said articulations while constraining the humeral cup within the gap throughout an entire range of said articulations of the humeral cup as it articulates within the gap, thereby reducing the risk of dislocation. ### Claim 18 (depends on 17) The prosthesis of claim 17 wherein the concave surface of the glenoid cup has a center and the glenoid cup stem is affixed thereto and in the center. ### Claim 19 (depends on 17) The prosthesis of claim 17 wherein the glenoid ball has a glenoid ball recess sized to receive the glenoid cup stem. ### Claim 20 (depends on 17) The prosthesis of claim 17 wherein the humeral cup has a humeral cup stem projecting outwardly therefrom in a direction opposite the concave surface thereof and the humeral stem has at its proximal end a recess sized to receive the humeral cup stem. ### Claim 21 (depends on 17) The prosthesis of claim 17 wherein the humeral implant has a humeral implant stem extending proximally therefrom and the humeral cup has a recess sized to receive the humeral implant stem. ### Claim 22 (depends on 19) The prosthesis of claim 19 wherein the glenoid ball has a center, the glenoid cup stem has a longitudinal center line and the glenoid ball recess has a longitudinal center one, both longitudinal center lines being colinear and passing through the center of the glenoid ball. ### Claim 23 (depends on 20) The prosthesis of claim 20 wherein the humeral cup has a concave hemispherical portion having a center line, the humeral cup stem has a longitudinal center line and the humeral implant recess has a longitudinal center line wherein all of the center lines are colinear. ### Claim 24 (depends on 17) The prosthesis of claim 17 wherein the concave surface of the humeral cup is fully in contact with the surface of the glenoid ball during articulation of said concave surface of the humeral cup on the glenoid ball. ### Claim 25 (depends on 17) The prosthesis of claim 17 further comprising an articulating sheath disposed between the concave surface of the glenoid cup and the convex surface of the humeral cup. ### Claim 26 (depends on 17) The prosthesis of claim 17 further comprising a notch in the circumferential outer edge of the glenoid cup. ### Claim 27 (depends on 26) The prosthesis of claim 26 wherein the humeral cup has a notch in the circumferential outer edge thereof. ### Claim 28 (depends on 17) A method of implanting in a patient the prosthesis of claim 17 comprising preparing a glenoid fossa and affixing the glenoid cup therein, preparing a medullary canal at the proximal end of a humerus and affixing the humeral stem therein, affixing the glenoid ball to the glenoid cup stem, affixing the humeral cup to the proximal end of the humeral stem and aligning the concave surface of the humeral cup with the glenoid ball so that the humeral cup will articulate in the gap and the concave surface of the humeral cup will articulate on the surface of the glenoid ball. ### Claim 29 (depends on 28) The method of claim 28 further comprising disposing a protective shield in the glenoid cup prior to affixing the glenoid ball to the glenoid cup stem. ### Claim 30 (depends on 17) A revision surgery method of implanting in a patient the prosthesis of claim 17, the patient having an implant in need of revision which comprises a shoulder joint prosthesis with an implanted glenoid cup and a humeral stem having an articulating humeral ball affixed to the proximal end thereof, the implanted glenoid cup having a concave articulating surface, the method comprising removing the humeral stem and articulating humeral ball, affixing to the concave articulating surface of the implanted glenoid cup the glenoid cup of claim 17, preparing a medullary canal at the proximal end of a humerus and affixing the humeral implant therein, affixing the glenoid ball to the glenoid cup stem, affixing the humeral cup to the proximal end of the humeral implant and aligning the concave surface of the humeral cup with the glenoid ball so that the concave surface of the humeral cup will articulate on the glenoid ball. ### Claim 31 (depends on 28) The method of claim 28 further comprising disposing a protective shield in the glenoid cup prior to affixing the glenoid ball to the glenoid cup stem. ### Claim 32 (depends on 20) A kit comprising the prosthesis of claim 20 and further comprising one or more additional humeral cups, wherein the humeral cup stems have different lengths. ### Claim 33 (depends on 21) A kit comprising the prosthesis of claim 21 wherein the humeral cup recess is disposed in a neck projecting outwardly from the humeral cup in a direction opposite the concave surface thereof, further comprising one or more additional humeral cups, wherein the humeral cup necks have different lengths.