CN101401750A - 固定衬垫型膝关节假体 - Google Patents

固定衬垫型膝关节假体 Download PDF

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CN101401750A
CN101401750A CNA2008101756114A CN200810175611A CN101401750A CN 101401750 A CN101401750 A CN 101401750A CN A2008101756114 A CNA2008101756114 A CN A2008101756114A CN 200810175611 A CN200810175611 A CN 200810175611A CN 101401750 A CN101401750 A CN 101401750A
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hurdle
fixed
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platform
knee
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CN101401750B (zh
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S·A·哈泽布鲁克
D·L·德芬鲍夫
P·S·兰达尔
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DePuy Products Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/389—Tibial components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3859—Femoral components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The 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
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2/00—Filters 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Abstract

一种固定衬垫型膝关节假体包括具有内侧髁突表面和外侧髁突表面的股骨构件。该膝关节假体还包括衬垫，该衬垫具有构造为与股骨构件的内侧髁突表面关节连接的内侧支承面，和构造为与股骨构件的外侧髁突表面关节连接的外侧支承表面。胫骨托盘被固定到衬垫上。该胫骨托盘包括具有从其下表面向下延伸的伸长杆的平台。外栏沿着胫骨托盘的平台周长的至少前面一部分延伸。该外栏从该平台的上表面向上延伸。固定栏从平台上表面向上延伸并且从外栏向后延伸。

Description

固定衬垫型膝关节假体
技术领域
本申请的披露内容主要涉及一种可植入的骨科假体，并且特别是涉及一种可植入的膝关节假体。
背景技术
在患者的生命周期中，由于诸如患病或创伤，可能需要为患者实施关节置换手术。关节置换手术可包括使用植入到一个或多个患者骨中的假体。在膝关节置换手术的情形中，胫骨托盘被植入到患者胫骨中。然后将衬垫固定到胫骨托盘(tibial tray)上。患者股骨的髁突表面或者置换股骨构件的髁突表面，抵靠在胫骨衬垫上。
一类膝关节假体为固定衬垫型膝关节假体。正如它的名称所暗示地：固定衬垫型膝关节假体的衬垫不会相对于胫骨托盘移动。固定衬垫型设计通常在患者软组织(也就是膝关节韧带)的状况不允许使用具有活动型衬垫时使用。
发明内容
一方面，固定衬垫型膝关节假体包括具有内侧(medial)髁突表面和外侧(lateral)髁突表面的股骨构件。膝关节假体还包括衬垫，该衬垫具有构造为与股骨构件的内侧髁突表面关节连接的内侧支承面，和构造为与股骨构件的外侧髁突表面关节连接的外侧支承表面。胫骨托盘被紧固到衬垫上。胫骨托盘包括具有从其下表面向下延伸的伸长杆的平台。外栏(peripheral rail)沿着托盘平台的周长的至少前面一部分延伸。外栏从平台的上表面向上延伸。固定栏(retainingrail)从外栏向后延伸。
在一些实施例中，固定栏具有由固定栏的最后边缘的外侧端及后端之间的距离确定的后宽度，和由从胫骨托盘的前边缘延伸到位于外侧端和内侧端中间的最后边缘的中点的假想中心线段的距离确定的长度。固定栏的后宽度小于或者等于固定栏的长度。
在某些实施例中，外栏沿着平台的整个周长延伸。此外，固定栏可与外栏相邻接。
外栏可具有至少一个形成在其中的底切槽，衬垫具有至少一个定位在外栏的至少一个底切槽中的突出部。
平台的下表面可具有形成在其中的凹部，固定栏被定位在凹部中。说明性地，凹部由接触固定栏的侧壁限定。
依照另一方面，可植入的骨科构件包括构造为固定到患者手术准备的胫骨上的胫骨托盘。胫骨托盘具有包括从其下表面向下延伸的伸长杆的平台。外栏沿着托盘平台的周长的至少前面一部分延伸。外栏从平台的上表面向上延伸。固定栏从外栏向后延伸。
在一些实施例中，固定栏具有由固定栏的最后边缘的外侧端及后端之间的距离确定的后宽度，和由从胫骨托盘的前边缘延伸到位于外侧端和内侧端中间的最后边缘的中点的假想中心线段的距离确定的长度。固定栏的后宽度小于或者等于固定栏的长度。
在某些实施例中，外栏沿着平台的整个周长延伸。此外，固定栏可与外栏相邻接。
外栏可具有至少一个形成在其中的底切槽，衬垫具有至少一个定位在外栏的至少一个底切槽中的突出部。
平台的下表面可具有形成在其中的凹部，固定栏定位在凹部中。说明性地，凹部由接触固定栏的侧壁限定。
依照一方面，固定衬垫型膝关节假体包括具有内侧髁突表面和外侧髁突表面的股骨构件。膝关节假体还包括衬垫，该衬垫具有构造为与股骨构件的内侧髁突表面关节连接的内侧支承面，和构造为与股骨构件的外侧髁突表面关节连接的外侧支承表面。胫骨托盘被固定到衬垫上。胫骨托盘包括具有从其下表面向下延伸的伸长杆的平台。外栏沿着托盘平台的周长的至少前面一部分延伸。外栏从平台的上表面向上延伸。固定栏从外栏向后延伸。
在一些实施例中，外栏具有包括外侧端和内侧端的最后边缘、从外栏上第一个点线性延伸到最后边缘的外侧端的最外侧边缘，及从外栏上第二个点线性延伸到最后边缘的内侧端的最内侧边缘。
在某些实施例中，外栏沿着平台的整个周长延伸。此外，固定栏可与外栏相邻接。
外栏可具有至少一个形成在其中的底切槽，衬垫具有至少一个定位在外栏的至少一个底切槽中的突出部。
平台的下表面可具有形成在其中的凹部，固定栏定位在凹部中。说明性地，凹部由接触固定栏的侧壁限定。
附图说明
详细描述具体参照下列附图，其中：
图1为固定衬垫型膝关节假体的分解透视图；
图2为图1所示膝关节假体的衬垫的底部透视图；
图3为图1所示膝关节假体的胫骨托盘的透视图；
图4为组装好的图1所示膝关节假体沿图1中的线4-4以箭头的方向所示的横截面示图；
图5为组装好的图1所示膝关节假体沿图1中的线5-5以箭头的方向所示的横截面示图；
图6为图1所示膝关节假体的分解图，注意胫骨托盘在平面示图中示出而衬垫在底部示图中示出；以及
图7-13类似于图6，但图中示出了胫骨托盘及衬垫不同的实施例。
具体实施方式
本申请披露内容的概念适于不同改变和变型，本发明的特定实施例已通过实例的方式在附图中示出，并且在此将对其进行详细描述。然而，应当理解：目的并不是旨在将本申请披露内容的概念限制为所披露的特定形式，相反地，目的在于覆盖落入由所附权利要求书限定的本发明的精神和范围内的所有修改、等效方式和变型。
表示解剖参考的术语，诸如前面、后面、内侧、外侧、上面、下面等等，可关于在此描述的骨科植入物及患者自然解剖在全部本申请披露内容中使用。这些术语在解剖研究和骨科领域中具有很好理解的含义。除非有其它注释，这种解剖参考术语在说明书及权利要求书中的使用旨在与它们易于理解的含义一致。
现在参考图1-6，图中示出一种固定衬垫型膝关节假体10。膝关节假体10包括股骨构件12、胫骨托盘14和衬垫16。胫骨托盘14包括具有从其下表面22延伸的杆20的平台18。胫骨杆20构造为可植入在患者胫骨的手术制备末端(surgically prepared end)(图中未示出)。衬垫16能够被固定在胫骨托盘14上。特别地，如下文中将要更详细描述地，衬垫16可以扣合到胫骨托盘14上。按照这种方式，衬垫16相对于胫骨托盘14被固定住(即，它在前/后或内侧/外侧方向上不可旋转或移动)。
衬垫16包括外侧支承表面26和内侧支承面28。支承表面26、28构造为分别与股骨构件1 2的外侧髁突表面30和内侧髁突表面32关节连接。特别地，股骨构件12构造为可植入到患者胫骨的手术制备末端(图中未示出)，并且构造为仿效患者天然股骨髁突的构造。同样地，外侧髁突表面30和内侧髁突表面32以模仿天然股骨髁突的方式构造(如：弯曲)。外侧髁突表面30和内侧髁突表面32彼此间隔开从而限定位于其中间的髁间凹口。
啮合到自然骨上的膝关节假体10的构件，诸如股骨构件12及胫骨托盘14，可由诸如钴铬合金等生物适应金属构成，尽管也可使用其它材料。这些构件的骨啮合表面可粗糙化以利于将构件接合到骨上。这种表面同样可以是多孔涂层以为了永久固定而促进骨的内生。
衬垫16可由允许在衬垫16和股骨构件12之间实现平滑关节连接的材料如聚合材料构成。一种该聚合材料是聚乙烯，例如超高分子量聚乙烯(UHMWPE)。
如图2和3所示，衬垫16的下表面36包括底座34。底座34具有多个限定在其中的后部突出部38。多个前部突出部40同样被限定在衬垫16中。
如图3所示，膝关节假体10具有外围锁定机构。特别地，外栏42从胫骨托盘14的上表面24向上延伸。在此描述的示意性实施例中，外栏42围绕胫骨托盘14的整个周长延伸。然而，可以想象外栏可仅围绕胫骨托盘14的周长的特定部分延伸，诸如位于胫骨托盘14前侧的周长一部分。外栏42具有多个限定在其中的后部底切槽46。此外，多个前部底切槽48被限定在外栏42的前部分中。
为了将胫骨衬垫16固定到胫骨托盘14上，衬垫16的后部突出部38被定位在胫骨托盘14的后部底切槽46中。其后，然后衬垫16的前部分向下向着胫骨托盘14前进从而衬垫的下表面36的底座34被捕捉在外栏42中。而衬垫16的前部以这样的方式前进：衬垫16的前部突出部40被外栏42偏转并且其后扣入外栏的前部底切槽48中从而将衬垫16固定到托盘14。
托盘的平台18的上表面24具有从其向上延伸的固定栏50。在此描述的示意性实施例中，固定栏50被体现为从胫骨托盘14的前边缘52向后延伸的伸长舌状物或凸缘。在此所描述的示意性实施例中，固定栏50与外栏42相邻接，尽管两个栏50、42可分开配备。另外，在此描述的固定栏50具有与外栏相似的高度，尽管构件可配备为具有不同的高度。
衬垫16的下表面36具有限定在其中的互补形状的凹部54。凹部54由侧壁56限定。如图4、5的横截面示图所示，当衬垫16固定到胫骨托盘14上时，凹部54的侧壁56接触固定栏50的边缘。选择凹部54和固定栏50的尺寸以获得相对紧的配合。在这种方式中，衬垫16相对于胫骨托盘14固定。特别地，形成在衬垫16下表面36上的外栏42和底座34的构造阻止衬垫16相对于胫骨托盘14在前/后方向及内侧/外侧方向上运动。另外，定位在底切槽46、48中的突出部38、40阻止衬垫16上升离开胫骨托盘14。如果不是全部阻止的话，通过胫骨托盘14的固定栏50相对较紧地配合到衬垫凹部54中而减少图1中箭头58方向上的旋转微动。
如上面提到的，在此描述的示意性实施例中，固定栏50配备为从胫骨托盘14的前边缘52以朝着胫骨平台18的中心的方向而向后延伸的伸长舌状物或凸缘。如图6所示，固定栏50包括具有外侧端62和内侧端64的最后边缘60。固定栏50的后宽度(Wp)由栏的最后边缘60的外侧端62与后端64之间的距离确定。固定栏50的长度(L)由其最后边缘60与胫骨托盘14的前部边缘52之间的距离确定。特别地，如图6所示，中点66位于最后边缘60的外侧端62和最后边缘60的内侧端64的中间。假想中心线段68从胫骨托盘14的前边缘52延伸到中点66。如图6所示，假想中心线段68将固定栏50切成两段。由于固定栏50配置为伸长舌状物或凸缘，固定栏50的后宽度(Wp)(即最后边缘60的端62、64之间的距离)小于或等于固定栏50的长度(L)。如图7-13所示，均为固定栏50的各种示意性实施例的情形。
如图6所示，胫骨托盘14的固定栏50具有最外侧边缘76，该最外侧边缘76从位于托盘14前侧上的外栏42上一个点72线性延伸到最后边缘60的外侧端62(即，沿着从外栏42上的点72到最后边缘60的外侧端62的直线延伸)。固定栏50同样最内侧边缘78，该最内侧边缘78从位于托盘14前侧上的外栏42上另一个点74线性延伸到最后边缘60的内侧端64(即，沿着从外栏42上的点74到最后边缘60的内侧端64的直线延伸)。
如图6所示，在此描述的示意性实施例中，固定栏50沿着其长度逐渐变细。特别地，固定栏50的宽度在其最后边缘60处最小，但在朝胫骨托盘14的前边缘52的方向上逐渐变大。然而，应当理解可考虑固定栏50的多种其它设计。例如，如图7所示，可使用一种反向的设计。在图7的情形中，固定栏50的最后边缘60比固定栏50沿着胫骨托盘14的前边缘52的边缘宽。换句话说，图7所示的固定栏50在与图6所示的固定栏50相反的方向上逐渐变细。应当理解限定在衬垫16下表面36中的凹部54在图7的实施例中同样也变形了，以与不同形状的固定栏50一致。换句话说，当考虑可以改变固定栏50的设计时，同样考虑改变凹部54的设计从而互补于固定栏50的构造。
如图8-10所示，固定栏50的非锥形构造可同样使用。在这种情形中，固定栏50在其整个长度上具有基本一致的宽度。如图8-10的实施例所示，这种非锥形栏的长度(L)同样地可改变。然而，在每个情形中，固定栏50的后宽度(Wp)小于或等于固定栏50的长度(L)。应当理解在此描述的任何固定栏包括图6、7的锥形固定栏的长度(L)，可同样改变以适应给定植入设计的需要。
在图8-10所示的每个实施例中，调整限定在衬垫16的下表面36中的相应凹部54的构造和尺寸以获得需要的与相应固定栏50的紧配合。
如图11所示，同样考虑固定栏50的其它构造和改变。例如，固定栏50的最外侧边缘76和最内侧边缘78可配置为与外栏42交叉的弓形线(与直线相对)。另外，如图12所示，固定栏50的最后边缘60可以是圆形的。在这种情形中，固定栏50的后宽度(Wp)(即最后边缘60的外侧端62和最后边缘60的内侧端64之间的距离)由弧段的弧形长度确定。与在此描述的其它实施例一样，固定栏50的最外侧边缘76和最内侧边缘78各自从外栏42上的点72、74线性延伸到弓形最后边缘60。
除了固定栏50的变化之外，同样考虑固定衬垫型膝关节假体10的其它变型。例如，如图13所示，在胫骨托盘14的前侧上的外栏42的一部分可相对于在此描述的其它设计加宽。此外，同样如图13所示，可同样使用后突出部38及相应后底切槽46的不同设计。
如在此所描述地，固定栏50的功能在于限制衬垫16和胫骨托盘14之间的相对旋转运动。这种旋转中心大概与股骨构件12施加在衬垫16上的扭矩的瞬间中心一致。将固定栏50定位在外栏42的前侧部分(相对于后侧部分)有效地增加离该旋转中心的距离，从而增强了固定栏50限制旋转的能力。固定栏50的功能还在于阻止大量负载作用在前侧保持元件(例如前侧突出部40)上。
固定栏50还在于起到对准引导的作用以便于将衬垫16组装到胫骨托盘14上。如上所述，使用者可全部从前面(即：从前到后)将衬底16组装到胫骨托盘14上。另一种可选方式是，使用者可从前面装载衬垫16，而在后外侧啮合并且随后衬垫16旋入其锁定位置。
虽然在附图和前面的说明书中已举例说明并具体描述了本申请的披露内容，但是这种举例说明和描述应当理解为示例性的而并非在特征上进行限制，应当理解其仅仅示出并描述了示例性的实施例，而要求保护所有落入本申请披露内容的精神范围内的改变及修改。
在此描述的装置、系统及方法的不同特征带来本申请披露内容的多个优点。将要注意的是：本申请披露内容的装置、系统及方法的备选实施例可不包括描述的所有特征，而仍然从这些特征的至少一些优点中得益。本领域的技术人员可容易地实施他们自己的合并了一个或多个本发明特征并落入如随附权利要求书所限定的本申请披露内容的精神和范围内的装置、系统及方法。

Claims (7)

1、一种固定衬垫型膝关节假体，包括：
具有内侧髁突表面和外侧髁突表面的股骨构件，
衬垫，该衬垫具有(i)构造为与股骨构件的内侧髁突表面关节连接的内侧支承面，和(ii)构造为与股骨构件的外侧髁突表面关节连接的外侧支承表面，以及
被固定到衬垫上的胫骨托盘，该胫骨托盘包括具有从其下表面向下延伸的伸长杆的平台，该平台具有(i)沿着平台周长的至少前面一部分延伸并且从平台的上表面向上延伸的外栏，和(ii)从平台上表面向上延伸并且从外栏向后延伸的固定栏，
其中(i)固定栏具有由固定栏的最后边缘的外侧端与后端之间的距离确定的后宽度，(ii)固定栏具有由从胫骨托盘的前边缘延伸到位于外侧端和内侧端中间的最后边缘的中点的假想中心线段的距离确定的长度，并且(iii)固定栏的后宽度小于或者等于固定栏的长度。
2、如权利要求1所述的膝关节假体，其中外栏沿着平台的整个周长延伸。
3、如权利要求1所述的膝关节假体，其中外栏具有至少一个形成在其中的底切槽。
4、如权利要求3所述的膝关节假体，其中衬垫具有至少一个定位在外栏的至少一个底切槽中的突出部。
5、如权利要求1所述的膝关节假体，其中：
衬垫具有上表面和下表面，
内侧支承面和外侧支承面都被限定在衬垫的上表面中，
衬垫的下表面接触平台的上表面，
平台的下表面具有形成在其中的凹部，并且
固定栏被定位在凹部内。
6、如权利要求5所述的膝关节假体，其中：
凹部由侧壁限定，并且
侧壁接触固定栏。
7、如权利要求1所述的膝关节假体，其中固定栏与外栏相邻接。
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