CN101351172B - 模块化固定和活动承座假体系统 - Google Patents
模块化固定和活动承座假体系统 Download PDFInfo
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Abstract
本发明涉及模块化固定和活动承座假体系统。一种膝部假体系统包括股骨部件、固定胫骨承座部件、活动胫骨承座部件和统合的或共用的胫骨基座部件。所述固定胫骨承座部件或所述活动胫骨承座部件可与相同的胫骨基座部件一起使用。所述固定承座部件和胫骨基座部件具有相匹配的防止旋转的特征。所述活动承座部件的一个实施例并不与所述胫骨基座部件的所述防止旋转的特征相接合。另一实施例则与所述防止旋转的特征相接合以便允许进行受限旋转。
Description
对相关申请的交叉参考
要求以下申请的优先权:由Adam I.Hayden和Luke J.Aram于2005年10月31日申请的题目为“模块化固定和活动承座(bearing)假体系统”的序号为60/732,000的美国临时专利申请(案卷号为DEP5602USPSP)。
技术领域
本发明主要涉及用于人体关节的假体,且特别是,本发明涉及用于人体膝部的假体。
背景技术
当人的骨关节由于事故或疾病而受损时,可能需要用假体置换受损关节以便缓解疼痛并使关节恢复正常的使用。通常通过外科手术过程来置换整个关节,该外科手术过程涉及去除相应受损骨骼的端部并用假体植入物置换这些端部。这种用假体关节置换原生关节的过程被称作初次全关节成形术(primary total joint arthroplasty)。
对于受损的人体膝部而言,通常用假体部件来置换整个膝部,所述假体部件被制成一定形状以便置换远侧股骨、近侧胫骨和膝盖骨的多个部分。用于置换远侧股骨的假体部件被制成一定形状以便置换内侧髁、外侧髁和滑车的由关节连接的表面,且用于置换近侧胫骨的假体部件被制成一定形状以便置换胫骨平台。通常情况下,胫骨部件是两件式部件:
胫骨托盘(tibial tray)被附到骨骼上且承座被接收在该胫骨托盘上。该托盘通常由金属如钴-铬合金或钛合金制成,且该承座通常由聚合物材料如超高分子量聚乙烯制成。
以往已经做出了用于整个膝部假体的多种其它可选设计。一些膝部假体被设计成在保持着十字形韧带时被利用;一些膝部假体被设计成在去除十字形韧带时被利用。这些其它可选膝部假体中的一些膝部假体可通过所使用的胫骨部件的类型进行区分:一些设计提供了固定承座,其中承座部件的位置相对于胫骨托盘被锁定;其它设计允许承座相对于胫骨托盘进行移动。允许承座部件相对于胫骨托盘移动的设计通常被称作活动承座设计或旋转平台设计。
在固定承座设计中,胫骨托盘通常具有侧壁、突部、凸缘或燕尾榫,所述侧壁、突部、凸缘或燕尾榫与承座部件上的特征相匹配以便将胫骨托盘和承座部件锁定在一起。相反地,在旋转平台或活动承座设计中,胫骨托盘的上部或近侧表面通常并不包括这种侧壁或表面特征;而是,托盘的近侧表面通常呈平面且是平滑的,以便使得承座插入件能够旋转。在典型的固定承座设计中,其中承座和基座在其周部周围被锁定,承座部件的尺寸由胫骨基座部件的尺寸和特征决定,从而使得承座部件被适当地固定在基座上的适当位置处;因此,股骨部件与承座部件之间的匹配可能并不理想。在活动承座设计中,由于承座部件并不需要与承座或基座周部周围的任何锁定机构相匹配,因此外科医生有更大的灵活性来确保在承座部件与股骨部件之间实现理想匹配。
采用固定承座设计或是活动承座设计的这种决定是基于多种因素做出的,所述多种因素包括外科医生的偏好以及各个病人的需要。例如,采用活动承座设计可能为病人提供更自然的关节感觉。然而,如果膝关节的软组织状况不良(例如,侧韧带受损),则可建议采用固定承座设计以便为病人提供更高稳定性。有时候可能直到在手术过程中对病人的软组织状况做出评价后才能决定是采用固定承座设计还是采用活动承座设计。
有时候,初次假体会失效。失效可能由多种原因造成,这其中包括磨损、无菌性松动、骨质溶解、韧带不稳定性、关节粘连和髌股关节并发症。当失效造成衰弱(debilitating)时,可能需要进行翻修手术。在翻修过程中,初次假体通常被去除并被翻修假体系统的部件置换。
在初次膝部假体采用活动承座设计的情况下,翻修过程可能涉及将假体变为利用固定承座设计。这种变化可能由多种因素引起,例如膝部韧带的劣化。由于固定和活动承座设计的胫骨基座部件的特征截然不同,因此对于现有植入系统而言,从活动承座设计翻修为固定承座设计通常需要去除胫骨基座部件并用适用于固定承座构型的胫骨基座部件来置换。
因此,需要提供一种允许外科医生在手术过程中选择利用固定承座或活动承座植入物系统的假体膝部系统。此外,这种系统需要允许外科医生集中于在固定承座选择方案中在胫骨插入件与股骨部件之间提供最优匹配,而不是需要外科医生选择特定胫骨插入件承座尺寸而与胫骨托盘匹配。此外,需要提供一种允许在不从胫骨中去除胫骨基座部件的情况下从活动承座设计变为固定承座设计的假体膝部系统。相反地,需要提供一种允许从固定承座系统设计转换为活动承座设计的系统。这可能出现在如果外科医生在翻修手术中通过x射线观察到大量关节空间狭窄的情况下。在这种情况下,外科医生可决定用磨损更低的活动承座插入件来替换固定承座插入件。
现有技术中的提供用于形成固定承座或活动承座的设计的这种系统包括题目为“模块化关节假体系统”的美国专利No.6,709,462和题目为“旋转/非旋转胫骨基座板/插入件系统”的美国专利公开No.US20040215345A1。
发明内容
在一个方面中,本发明提供了一种假体膝部系统,所述假体膝部系统包括股骨部件、胫骨基座部件、第一胫骨承座部件和第二胫骨承座部件。所述股骨部件具有承座表面。所述胫骨基座部件包括托盘和茎杆。所述托盘具有平的近侧表面和远侧表面。所述茎杆从所述托盘的所述远侧表面向远侧延伸。所述茎杆具有纵向轴线和与所述托盘隔开的远端。所述胫骨基座部件具有被包含在所述茎杆内的纵向孔。所述纵向孔从所述茎杆延伸通过所述托盘且通过所述托盘的所述近侧表面。所述纵向孔沿所述茎杆内的所述纵向孔的轴向长度的一部分具有圆形横截面。所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的茎杆。所述第一承座部件的所述茎杆具有纵向轴线和与所述平的远侧表面隔开的远端。所述第二胫骨承座部件具有近侧承座表面、远侧表面和从所述平的远侧表面向远侧延伸的茎杆。所述第二胫骨承座部件的所述茎杆具有纵向轴线和与所述远侧表面隔开的远端。所述第一胫骨承座部件和第二胫骨承座部件都被制成一定尺寸和形状,以便能够在所述承座部件的所述茎杆被接收在所述纵向孔中的情况下与所述胫骨基座部件选择性地组装在一起。所述胫骨基座部件和其中一个所述胫骨承座部件包括相匹配的防止旋转的特征以便在所述胫骨承座部件与所述胫骨基座部件组装时固定所述胫骨承座部件相对于所述胫骨基座部件的旋转位置;另一胫骨承座部件被制成一定形状以便在与所述胫骨基座部件组装在一起时可围绕所述茎杆的所述纵向轴线进行旋转。
在另一方面中,本发明提供了一种假体膝部系统,所述假体膝部系统包括股骨部件、胫骨基座部件、第一胫骨承座部件和第二胫骨承座部件。所述股骨部件具有承座表面。所述胫骨基座部件包括托盘和茎杆。所述托盘具有呈平面的近侧表面和远侧表面。所述茎杆从所述托盘的所述远侧表面向远侧延伸,且具有纵向轴线、与所述托盘隔开的远端和限定出被包含在所述茎杆内的纵向孔的内表面。所述内表面从所述托盘的所述近侧表面向远侧延伸进入所述茎杆内。所述纵向孔从所述茎杆延伸通过所述托盘且通过所述托盘的所述近侧表面。所述纵向孔沿其轴向长度的一部分具有非圆形横截面且沿其轴向长度的其余部分具有圆形横截面。所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的茎杆。所述茎杆具有纵向轴线和与所述平的远侧表面隔开的远端。所述第一胫骨承座部件的所述茎杆沿其轴向长度的至少一部分具有非圆形横截面。所述第二胫骨承座部件具有近侧承座表面、远侧表面和从所述平的远侧表面向远侧延伸的茎杆。所述茎杆具有纵向轴线和与所述远侧表面隔开的远端。所述第二胫骨承座部件的所述茎杆沿所述茎杆的整个轴向长度具有圆形横截面。每个胫骨承座部件能够在所述胫骨承座部件的所述茎杆被接收在所述胫骨基座部件的所述纵向孔中的情况下与所述胫骨基座部件选择性地组装在一起。所述纵向孔的具有非圆形横截面的部分与所述第一胫骨承座部件的所述茎杆的具有非圆形横截面的部分具有相匹配的形状,以便在所述第一胫骨承座部件的所述茎杆被接收在所述胫骨基座部件的所述纵向孔中时固定所述第一胫骨承座部件相对于所述胫骨基座部件的旋转位置。所述胫骨基座部件的所述纵向孔和所述第二胫骨承座部件的所述茎杆被制成一定尺寸和形状,从而使得当所述第二胫骨承座部件的所述茎杆被接收在所述胫骨基座部件的所述茎杆的所述纵向孔中时,所述第二胫骨承座部件可围绕所述茎杆的所述纵向轴线进行旋转。
在另一方面中,本发明提供了一种用于膝部关节成形术中的胫骨基座部件。所述胫骨基座部件包括托盘和茎杆。所述托盘具有平的近侧表面和远侧表面。所述茎杆从所述托盘的所述远侧表面向远侧延伸。所述茎杆具有纵向轴线和与所述托盘隔开的远端。所述胫骨基座部件还具有从所述托盘的所述近侧表面向远侧延伸进入所述茎杆内的内表面。所述内表面限定出被包含在所述茎杆内的纵向孔。所述纵向孔沿所述纵向孔的轴向长度的一部分具有圆形横截面。所述内表面具有被定位在所述托盘的所述近侧表面的远侧的径向凹部和径向止挡部。
在另一方面中,本发明提供了一种用于膝部关节成形术中的胫骨基座部件,所述胫骨基座部件包括托盘和茎杆。所述托盘具有平的近侧表面和远侧表面。所述茎杆从所述托盘的所述远侧表面向远侧延伸,且具有纵向轴线和与所述托盘隔开的远端。所述胫骨基座部件还具有内表面,所述内表面限定出被包含在所述茎杆内的纵向孔。所述纵向孔从所述茎杆延伸至所述托盘的所述近侧表面。所述纵向孔沿所述纵向孔的轴向长度的一部分具有圆形横截面且沿所述纵向孔的所述轴向长度的一部分具有非圆形横截面。
在另一方面中,本发明提供了一种胫骨承座部件,所述胫骨承座部件具有近侧承座表面、平的远侧表面和从所述远侧表面向远侧延伸的一体的茎杆。所述茎杆包括外表面、纵向轴线、远端、具有圆形横截面的部分、和从所述茎杆的所述外表面向外延伸且从所述远侧表面向远侧延伸的突起。所述茎杆在所述突起处具有最大横向尺寸且在所述茎杆的远端处具有最小横向尺寸。
在另一方面中,本发明提供了一种胫骨承座部件,所述胫骨承座部件包括近侧承座表面、平的远侧表面和从所述远侧表面向远侧延伸的一体的茎杆。所述茎杆具有外表面和纵向轴线。所述茎杆的所述外表面的一部分具有非圆形横截面且所述茎杆的所述外表面的一部分具有圆形横截面。
附图说明
图1是胫骨基座部件和胫骨承座部件的组件的透视图;
图2是图1所示组件的顶部平面图;
图3是图1-图2所示组件的前视图;
图4是可与图1和图3所示胫骨基座部件组装在一起的其中一个胫骨承座部件的透视图;
图5是图1-图3所示胫骨基座部件的透视图;
图6是沿图2所示线6-6截取的图1-图3所示组件的剖视图;
图7是沿图3所示线7-7截取的图1-图3所示组件的横截面图;
图8是沿图3所示线8-8截取的图1-图3所示组件的横截面图;
图9是本发明的系统的另一胫骨承座部件的透视图;
图10是与图6所示剖视图相似的剖视图,但图10中示出了与胫骨基座部件组装在一起的图9所示胫骨承座部件;
图11是与图7所示横截面图相似的横截面图,但图11中示出了与胫骨基座部件组装在一起的图9所示胫骨承座部件;
图12是与图8所示横截面图相似的横截面图,但图12中示出了与胫骨基座部件组装在一起的图9所示胫骨承座部件;
图13是可与本发明的假体膝部系统一起使用的股骨植入物部件的前视图;和
图14是与图7和图11所示剖视图相似的剖视图,图中示出了允许进行受限旋转的另一可选胫骨承座部件。
具体实施方式
本发明提供了一种假体膝部系统,所述假体膝部系统包括股骨植入物部件10(如图13所示)、共用的胫骨基座部件12(如图1-3、5-8和10-12所示)和可互换的承座部件14、16,所述可互换的承座部件可分别与共用的胫骨基座部件12选择性地组装在一起。第一承座部件14是固定承座部件;第二承座部件16是活动承座部件。
图13所示的股骨部件10包括两个凸起承座表面18、20。股骨部件10可由标准材料例如钴-铬合金或钛合金制成且可包括用于这种股骨植入物的标准特征。例如,面向骨骼的部分22可以是多孔的以使骨骼向内生长或可具有凹部以便增强水泥固定。除非在权利要求书中进行清晰地阐明,否则本发明不限于任何特定类型的股骨部件或任何特定特征。
如图1、图3和图5所示,胫骨基座部件12包括托盘24和一体的茎杆26。托盘24具有平的或呈平面的近侧或上部表面28以及远侧或下部表面30。为了获得作为活动承座系统的一部分的优化性能,可对托盘24的呈平面的近侧或上部表面28进行高度抛光。茎杆26从托盘24的远侧表面30向远侧延伸。茎杆26具有中心纵向轴线32和与托盘24隔开的远端34。
如图5所示,胫骨基座部件12还具有纵向孔36,所述纵向孔沿茎杆26的中心纵向轴线32进行延伸、延伸通过托盘24且通过托盘24的近侧表面28。纵向孔36由内表面37限定,所述内表面与托盘24的上部或近侧表面28是连续的。内表面37从托盘24的近侧表面28向远侧延伸进入茎杆26内。
如图5-6和图10所示,胫骨基座部件12的内表面37限定出位于纵向孔36的近端处的两个径向凹部39、41。径向凹部39、41包括径向表面43、45,所述径向表面位于共同的平面中,所述共同的平面与茎杆26的中心纵向轴线32垂直。如图5所示,胫骨基座部件的内表面37还限定出四个隔开的止挡部表面47、49、51、53。止挡部表面47、49、51、53通常是平的且与径向表面43、45垂直。止挡部表面47、49、51、53被定向在纵向平面中,在所示实施例中,所述纵向平面通常是径向对齐的。径向表面43、45和止挡部表面47、49、51、53都被定位在胫骨基座部件12的上部或近侧表面28的水平下面,且在所示实施例中在远侧或下部表面30的水平下面进行延伸。
在所示实施例中,茎杆26的远端34是封闭的且纵向孔36限定出盲孔。应该理解,茎杆26的远端34可具有允许茎杆延伸件(未示出)被附接到茎杆基座部件上的特征,在这种情况下,纵向孔36可延伸通过茎杆26的整个长度。在所示实施例中,限定出纵向孔36的内表面37在径向表面43、45与胫骨基座部件12的远端34之间沿远侧方向渐细。
胫骨基座部件12的纵向孔36的相当大的部分接收了承座部件14、16中的任一承座部件的细长茎杆38、40的相当大的部分。两个承座部件14、16共同拥有多个共同特征。两个承座部件14、16都具有近侧或上部承座表面42、44。这些承座表面42、44包括凹进区域,所述凹进区域被制成一定形状以便接收股骨部件10的承座表面18、20。两个承座部件14、16还具有远侧或下部表面46、48;这些远侧表面46、48是平的或呈平面,以便被接收在胫骨基座部件12的呈平面的上部或近侧表面28上。两个承座部件14、16的茎杆38、40从远侧或下部表面46、48向远侧延伸至与该远侧或下部表面46、48隔开的远端50、52。茎杆38、40具有中心纵向轴线54、56。
承座部件14、16中的每个承座部件被制成一定尺寸和形状以便能够与胫骨基座部件12选择性地组装在一起。承座部件的茎杆38、40通常被制成一定尺寸和形状以使得它们可被接收在胫骨基座部件12的茎杆26中的纵向孔36中。图6和图10示出了被接收在基座部件12的纵向孔36中的承座部件14、16的茎杆38、40。通常情况下,在承座茎杆38、40与基座部件12的内表面37之间存在相对紧密的配合以便实现稳定性,尽管如此,至少一个承座部件16的配合允许茎杆40围绕其中心纵向轴线56进行旋转。茎杆38、40的部分的外表面是渐细的以便与纵向孔36的渐细相匹配。承座部件14、16的远侧或下部表面46、48呈平面以便与基座部件12的呈平面的近侧或上部表面28相匹配。胫骨基座12和固定承座14还可具有用来防止承座14被提升离开胫骨基座12的相匹配的特征。在所示实施例中,胫骨基座具有一对底切部55、57且固定承座突起58、60被制成一定形状以便配合在底切部内。应该理解,这些防提升特征仅作为实例被提供;本发明还可利用其它防提升特征。
图示实施例中的固定承座部件14和活动承座部件16的主要区别之处在于,在茎杆38、40与承座的远侧或下部表面46、48的接合处的部件形状有所不同。首先考虑图4和图6-7所示的固定承座部件14,承座部件具有一对隔开的弯曲突起或突片58、60。突起或突片58、60从茎杆38的外表面向外延伸且从承座的远侧或下部表面46向下或向远侧延伸。突起或突片58、60包括径向表面62、64(参见图4),所述径向表面位于与茎杆38的纵向轴线54和四个止挡部表面66、68、70、72(参见图7)垂直的平面中,所述四个止挡部表面与径向表面62、64垂直。如图7所示,突起或突片58、60的形状与胫骨基座部件12中的凹部39、41互补,从而使得当固定承座14与胫骨基座部件12组装在一起时,承座的径向表面62、64被支承在基座部件的径向表面43、45上且承座止挡部表面66、68、70、72承靠在基座部件的止挡部表面47、49、51、53上。茎杆38的最大横向尺寸位于突起或突片58、60处,且纵向孔36的最大横向尺寸位于凹部39、41处;在相同的横向平面内,茎杆38和纵向孔36的横向尺寸在突起之间的空间和凹部之间的空间处更小。因此,突起或突片58、60和凹部39、41限定出相匹配的键和键槽。当固定承座14与胫骨基座12组装在一起时,突起58、60和凹部39、41限定出相匹配的防止旋转的特征,所述相匹配的防止旋转的特征固定了承座14相对于胫骨基座部件12的旋转位置。
应该意识到:固定承座部件和胫骨基座部件的防止旋转的特征可具有不同于所述的那些构型的构型。典型地,基座部件12的纵向孔36沿其轴向长度的一部分具有非圆形横截面且固定承座部件14的茎杆38沿其长度的至少一部分具有非圆形横截面(参见图7)。这些非圆形部分位于相同的轴向位置处以使得它们可相互作用以便限制或防止互补的茎杆38、26围绕轴线32、54进行相对旋转。根据基座部件12的托盘部分24的厚度,防止旋转的特征可被定位在托盘的近侧或上部表面28与托盘的远侧或下部表面30之间。然而,典型的方式是,防止旋转的特征并不延伸超出托盘的近侧或上部表面28,从而使得它们不会妨碍到基座部件12与活动承座如活动承座16在一起使用。
基座茎杆26的纵向孔36的相当大部分具有圆形横截面(参见图8和图12),以使得相同的基座部件12可与活动承座部件16一起使用。活动承座部件的茎杆40沿其整个轴向长度具有圆形横截面;茎杆中没有横截面呈非圆形的部分。活动承座部件的茎杆40的最大外径小于基座部件12的径向表面43、45的内边缘之间的距离;因此,活动承座部件16中没有被接收在胫骨基座部件12的凹部39、41中的部分。因此,活动承座部件16在与胫骨基座部件12组装在一起时可围绕茎杆40的中心纵向轴线56自由旋转。
固定和活动承座部件14、16可由标准承座材料制成。例如,可利用聚合物如超高分子量聚乙烯。如果利用超高分子量聚乙烯,则可希望利用该材料的交联形式。利用这种聚合物应该是有利的,原因在于对于固定承座14和胫骨基座12的刚性组件而言,固定承座14的突起或突片可以是柔性的。
应该意识到:利用本发明的特征的假体膝部系统将包括部件10、12、14、16中的每种部件的多种尺寸。典型地,每种尺寸的胫骨基座部件12的茎杆的尺寸和形状和每种尺寸的承座部件14、16的茎杆的尺寸和形状在整个系统中将优选是相同的,从而使得具有不同尺寸或形状的承座表面的承座部件可与不同尺寸的基座部件12一起使用。不同尺寸或形状的胫骨插入件可在单一尺寸的胫骨基座部件上可互换地使用。例如,两种不同尺寸的固定承座胫骨插入件可在单一尺寸的胫骨基座部件上使用且两种不同尺寸的活动承座插入件可在单一尺寸的胫骨基座部件上使用。因此,固定承座和活动承座都可选用提供了用于股骨部件的最优接触表面的承座部件。与由于股骨部件与固定胫骨承座的失配导致产生的接触面积减小、边缘负载、接触应力以及聚乙烯磨损相关的问题应该会被减轻或消除。
此外,在固定承座应用和活动承座应用都利用共用的或统合的胫骨基座部件的情况下,存货量应该会大大减少,这降低了存货成本。出售共用或统合的胫骨基座部件带来的经济性也应该会降低制造成本。在共用或统合的胫骨基座部件具有高度抛光的近侧或上部表面28的情况下,固定和活动承座部件14、16的背部磨损应该会被减轻。
本发明的假体膝部系统的部件可具有工业中普遍采用的其它特征,且假体膝部系统可包括附加的部件。例如,股骨和胫骨增强件可被包括在系统中且股骨部件10和胫骨基座部件12可包括允许将增强件固定到部件10、12上的特征。干骺端软骨套管(metaphyseal sleeves)和茎杆延伸件也可被包括在系统中,对于共用或统合的胫骨基座部件而言,可利用共同的成组的增强件、套管和茎杆。股骨和胫骨基座部件10、12可以是多孔的以使骨骼向内生长,或可包括凹部以便进行水泥固定。胫骨基座部件可具有位于远侧上的龙骨。承座部件的承座表面可不同于所示的承座表面。总体而言,被包括作为现有假体膝部系统(初次和翻修的假体膝部系统)的一部分的特征可被包括在本发明的假体膝部系统内,所述现有假体膝部系统例如为P.F.C.SigmaTM膝部系统、LCSCompleteTM膝部系统、S-ROMNoilesTM旋转铰链膝部系统和Warsaw,Indiana的DePuy Orthopaedics,Inc.的LPS(保肢系统)系统以及与之竞争的系统。
在使用中,整形外科医生可利用标准器具和过程对远侧股骨和近侧胫骨进行制备以便接收股骨部件10和胫骨基座部件12。仅需要单一的一套器具就可植入共用或统合的胫骨基座部件12。
外科医生具有选择固定承座部件14或活动承座部件16的选择权。如果选择固定承座部件14,则外科医生可选择最适当的尺寸以便用于被选定的股骨部件。如果选择活动承座部件16,则外科医生可在手术过程中评价活动承座是否适用于特定病人:如果外科医生观察到了不正确的承座回旋或者不希望出现的关节平衡,则外科医生可易于切换到固定承座以便适合于特定病人。
在手术后,如果病人出现了承座回旋或关节不稳定问题,或如果外科医生确定对膝部进行翻修是适当做法,则如果胫骨基座部件12并不松散的话就不需要去除该胫骨基座部件。而是,外科医生可在不去除胫骨基座部件的情况下将活动承座膝部翻修为固定承座膝部;可在不改变基座部件12的情况下用固定承座部件14替换活动承座部件16。相似地,如果外科医生确定原始植入的固定承座胫骨插入件已经过度磨损,则外科医生可在不改变胫骨基座部件的情况下在翻修手术中用活动承座胫骨插入件替换固定承座胫骨插入件。
应该理解,胫骨基座部件和胫骨插入件可被设计成提供偏移的茎杆。此外,尽管在所示实施例中胫骨基座和胫骨插入件都包括细长茎杆,但托盘和插入件可包括具有更短长度的凸起或凸部来代替细长茎杆。例如,托盘和插入件,或单独的插入件,可终止于横向平面处的远侧处,所述横向平面延伸通过径向表面43、45、62、64。
此外,胫骨承座部件可包括与标记58、60所示的那些突起或突片相似但具有比胫骨基座中的凹部39、41更短的弧长的突起或突片。这种胫骨承座插入件如图14所示,且将会允许进行受限旋转。如图所示,胫骨插入件14′包括具有四个止挡部表面66′、68′、70′、72′的两个突起或突片58′、60′,所述四个止挡部表面与突片58′、60′的径向表面垂直。这种胫骨插入件可被提供作为图9-图11所示活动插入件的另一种可选方式,或者可被提供作为第三种可选的插入件。
尽管仅对本发明的特定实施例进行了描述和图示,但应该清楚:可对本发明的特定实施例做出各种其它可选方式和变型。此外,本领域技术人员还将认识到:可对这些实施例做出特定的添加。
可对所示实施例做出的变型和添加的实例可见于下面的美国临时专利申请中,所述美国临时专利申请的整体披露内容在此作为参考被引用:由Stephen A.Hazebrouck,Joel T.Out ten和Gary To于2006年10月13日申请的题目为“活动/固定假体膝部系统”的序号为60/829,430的美国临时专利申请(案卷号为DEP-5848和265280-200891);和由Luke J.Aram,Adam I.Hayden,Stephen A.Hazebrouck,Anthony D.Zannis,Gary D.Barnett,Thomas S.Camino,Daniel D.Auger,Joseph G.Wyss,John A.Bonitati和Scott E.Dutiel于2006年10月13日申请的题目为“活动/固定假体膝部系统”的序号为60/829,432的美国临时专利申请(案卷号为DEP-5710和265280-79480)。
所附权利要求书旨在覆盖可落入本发明的真实范围内的所有这种其它可选方式、变型和添加。
Claims (12)
1.一种假体膝部系统,所述假体膝部系统包括:
股骨部件,所述股骨部件具有承座表面;
胫骨基座部件,所述胫骨基座部件包括托盘和茎杆,所述托盘具有平的近侧表面和远侧表面,所述茎杆从所述托盘的所述远侧表面向远侧延伸,所述茎杆具有纵向轴线和与所述托盘隔开的远端;
所述胫骨基座部件具有纵向孔,所述纵向孔被包含在所述茎杆内且从所述茎杆延伸通过所述托盘且通过所述托盘的所述近侧表面,其中所述纵向孔沿所述茎杆内的所述纵向孔的轴向长度的一部分具有圆形横截面;
第一胫骨承座部件,所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的茎杆,所述第一胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述茎杆具有纵向轴线和与所述平的远侧表面隔开的远端;和
第二胫骨承座部件,所述第二胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的茎杆,所述第二胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述茎杆具有纵向轴线和与所述远侧表面隔开的远端;
其中所述胫骨基座部件包括限定出所述纵向孔的内表面,且其中:
所述内表面从所述托盘的所述近侧表面向远侧延伸且延伸进入所述茎杆内;所述内表面的一部分包括径向凹部,
其中所述第一胫骨承座部件被制成一定尺寸和形状,以便能够在所述茎杆的至少一部分被接收在所述纵向孔中的情况下与所述胫骨基座部件选择性地组装在一起,且所述第二胫骨承座部件被制成一定尺寸和形状以便能够在所述茎杆的至少一部分被接收在所述纵向孔中的情况下与所述胫骨基座部件选择性地组装在一起;并且
其中所述胫骨基座部件和所述第一胫骨承座部件包括相匹配的防止旋转的特征以便在所述第一胫骨承座部件与所述胫骨基座部件组装时固定所述第一胫骨承座部件相对于所述胫骨基座部件的旋转位置,所述第二胫骨承座部件的所述茎杆的一部分包括径向突起或突片,该突起或突片具有比胫骨基座中的凹部更短的弧长,以便在与所述胫骨基座部件组装在一起时可围绕所述茎杆的所述纵向轴线进行受限旋转。
2.根据权利要求1所述的假体膝部系统,其中所述胫骨基座部件和所述第一胫骨承座部件包括相匹配的键和键槽。
3.根据权利要求1所述的假体膝部系统,
其中所述第一胫骨承座部件的所述茎杆的一部分包括径向突起,所述径向突起被制成一定尺寸和形状以便与所述胫骨基座部件的所述内表面中的所述径向凹部相匹配。
4.一种假体膝部系统,所述假体膝部系统包括:
股骨部件,所述股骨部件具有承座表面;
胫骨基座部件,所述胫骨基座部件包括托盘和茎杆,所述托盘具有呈平面的近侧表面和远侧表面,所述茎杆从所述托盘的所述远侧表面向远侧延伸,所述茎杆具有纵向轴线、与所述托盘隔开的远端和限定出被包含在所述茎杆内的纵向孔的内表面;
所述内表面从所述托盘的所述近侧表面向远侧延伸进入所述茎杆内,且所述内表面的一部分包括径向凹部;
所述纵向孔从所述茎杆延伸通过所述托盘且通过所述托盘的所述近侧表面;
其中所述纵向孔沿其轴向长度的一部分具有非圆形横截面且沿其轴向长度的其余部分具有圆形横截面;
第一胫骨承座部件,所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的茎杆,所述第一胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述茎杆具有纵向轴线和与所述平的远侧表面隔开的远端,其中所述第一胫骨承座部件的所述茎杆沿其轴向长度的至少一部分具有非圆形横截面;和
第二胫骨承座部件,所述第二胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的茎杆,所述第二胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述茎杆具有纵向轴线和与所述远侧表面隔开的远端;
其中所述第一胫骨承座部件和第二胫骨承座部件被分别制成一定尺寸和形状,以使得能够在所述胫骨承座部件的所述茎杆的至少一部分被接收在所述胫骨基座部件的所述纵向孔中的情况下与所述胫骨基座部件选择性地组装在一起;
其中所述纵向孔的具有非圆形横截面的所述部分与所述第一胫骨承座部件的所述茎杆的具有非圆形横截面的所述部分具有相匹配的形状,以便在所述第一胫骨承座部件的所述茎杆被接收在所述胫骨基座部件的所述纵向孔中时固定所述第一胫骨承座部件相对于所述胫骨基座部件的旋转位置;并且
其中所述第二胫骨承座部件的所述茎杆的一部分包括径向突起或突片,该突起或突片具有比胫骨基座中的凹部更短的弧长,以便在与所述胫骨基座部件组装在一起时可围绕所述茎杆的所述纵向轴线进行受限旋转。
5.根据权利要求4所述的假体膝部系统,其中所述胫骨基座部件的所述纵向孔的具有非圆形横截面的所述部分与所述胫骨基座部件的所述茎杆的所述远端是隔开的,且所述第一胫骨承座部件的所述茎杆的具有非圆形横截面的所述部分与所述第一胫骨承座部件的所述茎杆的所述远端是隔开的。
6.根据权利要求5所述的假体膝部系统,其中所述胫骨基座部件的所述纵向孔的具有非圆形横截面的所述部分和所述第一胫骨承座部件的所述茎杆的具有非圆形横截面的所述部分包括相匹配的键和键槽。
7.根据权利要求所述的假体膝部系统,其中:
所述第一胫骨承座部件的所述茎杆的一部分包括径向突起,所述径向突起被制成一定尺寸和形状以便与所述胫骨基座部件的所述内表面中的所述径向凹部相匹配。
8.一种假体膝部系统,所述假体膝部系统包括:
股骨部件,所述股骨部件具有承座表面;
胫骨基座部件,所述胫骨基座部件包括托盘,所述托盘具有平的近侧表面、远侧表面和限定出孔的表面,所述孔沿所述孔的长度的一部分具有圆形横截面,所述胫骨基座部件包括茎杆且其中所述孔延伸进入所述茎杆内;
第一胫骨承座部件,所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的凸部,所述第一胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述凸部具有纵向轴线和与所述平的远侧表面隔开的远端;和
第二胫骨承座部件,所述第二胫骨承座部件具有近侧承座表面、远侧表面和从所述平的远侧表面向远侧延伸的一体的凸部,所述第二胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述凸部具有纵向轴线和与所述远侧表面隔开的远端;
其中所述第一胫骨承座部件被制成一定尺寸和形状,以便能够在所述凸部的至少一部分被接收在所述孔中的情况下与所述胫骨基座部件选择性地组装在一起,且所述第二胫骨承座部件被制成一定尺寸和形状以便能够在所述凸部的至少一部分被接收在所述孔中的情况下与所述胫骨基座部件选择性地组装在一起;并且
其中所述胫骨基座部件包括限定出所述纵向孔的内表面,且其中:
所述内表面从所述托盘的所述近侧表面向远侧延伸且延伸进入所述茎杆内;所述内表面的一部分包括径向凹部,
其中所述胫骨基座部件和所述第一胫骨承座部件包括相匹配的防止旋转的特征以便在所述第一胫骨承座部件与所述胫骨基座部件组装时固定所述第一胫骨承座部件相对于所述胫骨基座部件的旋转位置,且第二胫骨承座部件的所述凸部的一部分包括径向突起或突片,该突起或突片具有比胫骨基座中的径向凹部更短的弧长,以便在与所述胫骨基座部件组装在一起时可围绕所述茎杆的所述纵向轴线进行受限旋转。
9.根据权利要求8所述的假体膝部系统,其中所述胫骨基座部件包括茎杆且其中所述孔延伸进入所述茎杆内。
10.根据权利要求9所述的假体膝部系统,其中所述第一胫骨承座部件的所述凸部包括茎杆且所述第二胫骨承座部件的所述凸部包括茎杆。
11.一种假体膝部系统,所述假体膝部系统包括:
股骨部件,所述股骨部件具有承座表面;
胫骨基座部件,所述胫骨基座部件包括托盘,所述托盘具有平的近侧表面、远侧表面和限定出孔的表面,所述孔沿所述孔的长度的一部分具有圆形横截面,所述胫骨基座部件包括茎杆且其中所述孔延伸进入所述茎杆内;
第一胫骨承座部件,所述第一胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的凸部,所述第一胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述凸部具有纵向轴线和与所述平的远侧表面隔开的远端;和
第二胫骨承座部件,所述第二胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的一体的凸部,所述第二胫骨承座部件的远侧表面被接收在托盘的近侧表面上,所述凸部具有纵向轴线和与所述远侧表面隔开的远端;
其中所述第一胫骨承座部件的所述近侧承座表面与所述第二胫骨承座部件的所述近侧承座表面在以下特征中的至少一个特征方面是不同的:尺寸和形状;
其中两个胫骨承座部件的所述凸部具有相同的尺寸和形状;
其中两个胫骨承座部件的所述凸部被制成一定尺寸和形状,以便能够在所述凸部的至少一部分被接收在所述胫骨基座部件的所述孔中的情况下与所述胫骨基座部件选择性地组装在一起;并且
其中所述胫骨基座部件包括限定出所述纵向孔的内表面,且其中:
所述内表面从所述托盘的所述近侧表面向远侧延伸且延伸进入所述茎杆内;所述内表面的一部分包括径向凹部,
其中所述胫骨基座部件和所述第一胫骨承座部件包括相匹配的防止旋转的特征以便在所述胫骨承座部件与所述第一胫骨基座部件组装时固定所述胫骨承座部件相对于所述胫骨基座部件的旋转位置,所述第二胫骨承座部件的所述凸部的一部分包括径向突起或突片,该突起或突片具有比胫骨基座中的径向凹部更短的弧长,以便在与所述胫骨基座部件组装在一起时可围绕所述茎杆的所述纵向轴线进行受限旋转。
12.根据权利要求11所述的假体膝部系统,进一步包括第三胫骨承座部件,所述第三胫骨承座部件具有近侧承座表面、平的远侧表面和从所述平的远侧表面向远侧延伸的凸部,其中所述第三胫骨承座部件被制成一定尺寸和形状,以便能够在所述凸部的至少一部分被接收在所述胫骨基座部件的所述孔中的情况下与所述胫骨基座部件选择性地组装在一起,且其中所述第三胫骨承座部件的所述凸部被制成一定形状以使得所述第三胫骨承座部件在与所述胫骨基座部件组装在一起时可围绕所述凸部进行旋转。
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- 2006-10-31 EP EP06827110A patent/EP1945151A4/en not_active Withdrawn
- 2006-10-31 CN CN200680049871.6A patent/CN101351172B/zh active Active
- 2006-10-31 WO PCT/US2006/042366 patent/WO2007053572A2/en active Application Filing
- 2006-10-31 AU AU2006308865A patent/AU2006308865B2/en active Active
- 2006-10-31 US US11/554,631 patent/US8403993B2/en active Active
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2008
- 2008-05-30 ZA ZA200804733A patent/ZA200804733B/xx unknown
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Also Published As
Publication number | Publication date |
---|---|
EP1945151A4 (en) | 2009-09-09 |
EP1945151A2 (en) | 2008-07-23 |
AU2006308865B2 (en) | 2012-10-25 |
JP2009513275A (ja) | 2009-04-02 |
WO2007053572A2 (en) | 2007-05-10 |
WO2007053572A3 (en) | 2007-10-18 |
AU2006308865A1 (en) | 2007-05-10 |
ZA200804733B (en) | 2009-10-28 |
CN101351172A (zh) | 2009-01-21 |
US8403993B2 (en) | 2013-03-26 |
US20070100463A1 (en) | 2007-05-03 |
JP5265372B2 (ja) | 2013-08-14 |
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