CN105853028A - 具有可互换组件的固定支承膝关节假体 - Google Patents
具有可互换组件的固定支承膝关节假体 Download PDFInfo
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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
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- A—HUMAN NECESSITIES
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- 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
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- A61F2/3877—Patellae or trochleae
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- A—HUMAN NECESSITIES
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- 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
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- 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
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- 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
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- 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
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- 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
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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
- 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
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- 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
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- 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
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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
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- 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
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- A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
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- A—HUMAN NECESSITIES
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- 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
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- 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
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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
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- A—HUMAN NECESSITIES
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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Abstract
本发明提供了一种固定支承膝关节假体,所述固定支承膝关节假体包括具有内侧髁关节表面和外侧髁关节表面的股骨组件。所述膝关节假体还包括支承,所述支承具有被构造为与所述股骨组件的所述内侧髁关节表面关节连接的内侧支承表面和被构造为与所述股骨组件的所述外侧髁关节表面关节连接的外侧支承表面。胫骨托被固定到所述支承。所述胫骨托具有平台,所述平台具有从所述平台下表面向下延伸的细长的杆。后支柱沿着所述胫骨托的平台周边的后部分延伸,前支柱沿着所述胫骨托的平台周边的前部分延伸。不同尺寸的胫骨托可与不同尺寸的支承互换。
Description
本申请是于2010年11月17日提交的专利申请(中国国家申请号为201010564754.1,发明名称为“具有可互换组件的固定支承膝关节假体”)的分案申请。
技术领域
本公开总体上涉及可植入的整形外科假体,更具体地讲涉及可植入的膝关节假体。
背景技术
在患者的一生中,由于(例如)疾病或创伤原因,可能需要对患者进行关节置换手术。关节置换手术可能涉及使用植入患者一个或多个骨骼内的假体。在膝关节置换手术中,将胫骨托植入患者胫骨。支承被固定到胫骨托。置换的股骨组件的髁突表面支撑在胫骨支承上。
一种膝关节假体为固定支承膝关节假体。顾名思义,固定支承膝关节假体的支承不会相对于胫骨托移动。固定支承设计通常是在患者的软组织(即膝关节韧带)状况不允许使用具有活动支承的膝关节假体的情况下使用。
固定支承膝关节假体的组件通常由制造商按匹配的尺寸提供。具体地讲,目前最常见的固定支承膝关节假体允许外科医生将多个支承尺寸用于具体尺寸的股骨组件,但每个支承尺寸通常都匹配具体尺寸的胫骨托。
发明内容
根据一个方面,固定支承膝关节假体包括具有内侧髁关节表面和外侧髁关节表面的股骨组件。该假体还包括支承,支承具有被构造为与股骨组件的内侧髁关节表面关节连接的内侧支承表面和被构造为与股骨组件的外侧髁关节表面关节连接的外侧支承表面。胫骨托被固定到支承。胫骨托具有平台,平台具有从其下表面向下延伸的细长的杆。平台具有后支柱,后支柱沿着平台周边的后部分延伸,并且从平台的上表面向上延伸。前支柱沿着平台周边的前部分延伸,并且从平台的上表面向上延伸。
后支柱大致呈Y形,并且具有第一臂,第一臂沿平台的后边缘延伸,并且具有限定在其中的第一底切。第二臂沿平台的后边缘朝远离第一臂的方向延伸,并且具有限定在其中的第二底切。第三臂朝远离第一臂和第二臂的方向向前延伸。
第一假想线沿第一臂的最外侧边缘延伸,第二假想线沿第二臂的最内侧边缘延伸,并且与第一假想线相交以限定二者之间的相交角。
在一些示例性实施例中,假想线的相交角在45-145°之间。在一些示例性实施例中,假想线的相交角在60-120°之间。在一个具体的示例性实施例中,假想线的相交角为大约90°。
在一些示例性实施例中,前支柱大致为T形。在这些情况下,前支柱包括第一臂和第二臂,其中第一臂沿平台前边缘延伸并具有限定在其中的第一底切,第二臂在远离第一臂的方向沿平台前边缘延伸并具有限定在其中的第二底切。第三臂朝远离第一臂和第二臂的方向向后延伸。
后支柱的第三臂可以邻接前支柱的第三臂。
支承可包括设置在后支柱的第一臂内限定的第一底切内的第一后凸块、设置在后支柱的第二臂内限定的第二底切内的第二后凸块、设置在前支柱的第一臂内限定的第一底切内的第一前凸块、以及设置在前支柱的第二臂内限定的第二底切内的第二前凸块。
内侧支承表面和外侧支承表面都限定在支承的上表面内。支承的下表面接触平台的上表面并包括形成于其中的后凹槽和前凹槽。后支柱设置在后凹槽内,前支柱设置在前凹槽内。后凹槽可以邻接前凹槽。
根据另一个方面,固定支承膝关节假体包括具有内侧髁关节表面和外侧髁关节表面的股骨组件。该假体还包括支承,支承具有被构造为与股骨组件的内侧髁关节表面关节连接的内侧支承表面和被构造为与股骨组件的外侧髁关节表面关节连接的外侧支承表面。胫骨托被固定到支承。胫骨托具有平台,平台具有从其下表面向下延伸的细长的杆。平台具有后支柱,后支柱沿着平台周边的后部分延伸,并且从平台的上表面向上延伸。前支柱沿着平台周边的前部分延伸,并且从平台的上表面向上延伸。
后支柱大致为Y形,并且具有第一臂和第二臂,其中第一臂沿平台后边缘延伸并具有限定在其中的第一底切,第二臂在远离第一臂的方向沿平台后边缘延伸并具有限定在其中的第二底切。第三臂朝远离第一臂和第二臂的方向向前延伸。
前支柱包括沿平台的前边缘延伸并具有限定在其中的第一底切的第一臂。前支柱的第二臂沿平台的前边缘朝远离前支柱的第一臂的方向延伸,并且具有限定在其中的第二底切。
第一假想线沿前支柱的第一臂的最后边缘和前支柱的第二臂的最后边缘延伸。第二假想线沿后支柱的第三臂的纵向轴线延伸,并且与第一假想线相交以限定二者之间的相交角。相交角为大约90°。
前支柱可包括第三臂,第三臂在平行于第二假想线的方向上远离第一臂和第二臂向后延伸。后支柱的第三臂可以邻接前支柱的第三臂。
支承可包括设置在后支柱的第一臂内限定的第一底切内的第一后凸块、设置在后支柱的第二臂内限定的第二底切内的第二后凸块、设置在前支柱的第一臂内限定的第一底切内的第一前凸块、以及设置在前支柱的第二臂内限定的第二底切内的第二前凸块。
内侧支承表面和外侧支承表面都限定在支承的上表面内。支承的下表面接触平台的上表面并包括形成于其中的后凹槽和前凹槽。后支柱设置在后凹槽内,前支柱设置在前凹槽内。后凹槽可以邻接前凹槽。
根据另一个方面,固定支承膝关节假体包括具有内侧髁关节表面和外侧髁关节表面的股骨组件,以及具有平台的胫骨托,其中平台具有从其下表面向下延伸的细长杆。平台具有从平台的上表面向上延伸的大致Y形的后支柱。后支柱的一对臂沿平台周边的后部分延伸。一对臂中的每一个都具有限定在其中的底切。平台还具有沿平台周边的前部分延伸并沿平台的上表面向上延伸的前支柱。膝关节假体还包括多个被构造为固定到胫骨托的支承。多个支承中每一个都具有不同于多个支承中其他至少一些支承的宽度。多个支承中每一个都具有上表面,上表面具有被构造为关节连接股骨组件的内侧髁关节表面的内侧支承表面,和被构造为关节连接股骨组件的外侧髁关节表面的外侧支承表面。多个支承中每一个的下表面都具有限定在其中的至少一个凹槽,用来接纳后支柱和前支柱。多个支承中的每一个还包括一对后凸块,这对后凸块被设置为分别接纳到后支柱的一对臂内限定的底切中。
支承的凹槽可以限定接纳后支柱和前支柱的单个邻接的凹槽。
前支柱可大致为T形,并且具有沿平台的前边缘延伸的一对臂。前支柱的一对臂中的每一个都可具有限定在其中的底切。多个支承中每一个还可包括一对前凸块,这对前凸块被设置为分别接纳到前支柱的一对臂内限定的底切中。
后支柱可以邻接前支柱。
附图说明
特别参照下图进行详细说明,下图中:
图1为固定支承膝关节假体的分解透视图;
图2为图1的膝关节假体支承的底部透视图;
图3为图1的膝关节假体的胫骨托的透视图;
图4为图1的膝关节假体的胫骨托的平面图;
图5为图1的膝关节假体的多个不同尺寸的胫骨托的图解平面图;
图6-9类似于图4,不同的是示出了胫骨托的不同实施例;以及
图10-14分别类似于图1-5,不同的是示出了固定支承膝关节假体的另一个实施例。
具体实施方式
虽然本发明的概念易于具有各种修改形式和替代形式,但其具体示例性实施例已在附图中以举例的方式示出,并且将在本文中详细说明。然而应当理解,本文无意将本发明的概念限制为所公开的具体形式,而是相反,目的在于涵盖所附权利要求限定的本发明的精神和范围内的所有修改形式、等同形式和替代形式。
在本公开中有关本文所述的整形外科植入物和患者的自然解剖部分使用了表示解剖学参考的术语,例如前侧、后侧、内侧、外侧、上、下等。这些术语在解剖学和整形外科领域都具有公知的含义。除非另外指明,否则说明书和权利要求中使用的此类解剖参考术语旨在符合其公知的含义。
现在参见图1-4,图中示出了固定支承膝关节假体10。膝关节假体10包括股骨组件12、胫骨托14和支承16。胫骨托14包括平台18,平台18具有远离其下表面22延伸的固定构件,例如细长的杆20。细长的胫骨杆20被构造为植入经过外科手术准备的患者胫骨端(未示出)。应当理解,可使用其他固定构件(例如一个或多个栓或柱)代替细长的杆20。支承16可以固定到胫骨托14。具体地讲,如下文更详细讨论的那样,支承16可以搭扣配合到胫骨托14。通过这种方式,支承16与胫骨托14相对固定(即,其不会在前/后或内侧/外侧方向旋转或移动)。
支承16包括外侧支承表面26和内侧支承表面28。支承表面26和28被构造为分别与股骨组件12的外侧髁关节表面30和内侧髁关节表面32关节接合。具体地讲,股骨组件12被构造为植入外科手术准备的患者股骨端(未示出),并且被构造为仿效患者的自然股骨髁的构型。因此,外侧髁关节表面30和内侧髁关节表面32以一定方式构造(例如弯曲),使其仿效自然股骨髁。外侧髁关节表面30和内侧髁关节表面32彼此间隔开,从而在二者之间限定了髁间凹。
膝关节假体10与自然骨骼接合的组件(例如股骨组件12和胫骨托14)可以由生物相容性金属(例如钴铬合金)构成,但也可以采用其他材料。这些组件的骨接合表面可以被纹理化,以有利于将组件粘合到骨骼。这种表面也可以具有多孔涂层,以促进骨骼内生,从而永久固定。
支承16可以由允许支承16和股骨组件12之间平滑地关节连接的材料(例如聚合材料)构成。一种此类聚合材料是聚乙烯,例如超高分子量聚乙烯(UHMWPE)。
如图2所示,支承16的下表面36包括外侧基座34和内侧基座38。基座34和38具有限定在其中的多个后凸块40。支承16中还限定了多个前凸块42。
如图3和4所示,大致Y形的后支柱44从胫骨托14的上表面24向上延伸。在本文所述的示例性实施例中,后支柱44具有沿着胫骨托的平台18周边的后部分延伸的一对臂46、48。具体地讲,后支柱44的外侧臂46沿着平台18外侧的后边缘50延伸,而后支柱44的内侧臂48以远离外侧臂46的方向沿着平台18内侧的后边缘50延伸。后支柱44的第三臂52远离外侧臂46和内侧臂48的交线向前延伸(即在朝平台18中央的方向上)。
后支柱44具有限定在其中的一对底切54、56。具体地讲,外侧底切54被限定在后支柱44的外侧臂46中,而内侧底切56被限定在后支柱44的内侧臂48中。
如图3和4所示,大致T形的前支柱64从胫骨托14的上表面24向上延伸。在本文所述的示例性实施例中,前支柱64具有沿着胫骨托的平台18周边的前部分延伸的一对臂66、68。具体地讲,前支柱64的外侧臂66沿着平台18外侧的前边缘70延伸,而前支柱64的内侧臂68以远离外侧臂66的方向沿着平台18内侧的前边缘70延伸。后支柱64的第三臂72远离外侧臂66和内侧臂68的交线向后延伸(即在朝平台18中央的方向上)。
前支柱64具有限定在其中的一对底切74、76。具体地讲,外侧底切74被限定在前支柱64的外侧臂66中,而内侧底切76被限定在前支柱64的内侧臂68中。
在图1-4的示例性实施例中,胫骨托14的后支柱44与胫骨托的前支柱64邻接。具体地讲,如图4所示,后支柱44的第三臂52与前支柱64的第三臂72邻接。然而,如下文将更详细讨论的那样,可以想到其他实施例,其中包括支柱不邻接的构造。此外,虽然44、64这两个支柱在本文中被描述为具有相似的高度,但是这两个支柱可被实施为具有相异的高度。
为了将胫骨支承16固定到胫骨托14,支承16的后凸块40被设置在胫骨托14的后底切54、56中。这之后,将胫骨支承16的前部分朝胫骨托14向下推进,使得前支柱64将胫骨支承16的前凸块42偏斜,之后前凸块42卡入前支柱的前底切74、76中从而将支承16固定到胫骨托14。
随着支承件16的前部分以这种方式向下推进,胫骨托14的支柱44、64就被捕集在该支承的下表面36的基座34、38之间。具体地讲,支承16的下表面36具有限定在其中的后凹槽78和前凹槽80。后凹槽78被构造为补充胫骨托14的后支柱44的形状。也就是说,当支承16被固定到胫骨托14时,限定后凹槽78的基座34、38的侧壁接触后支柱44的边缘。同样,前凹槽80被构造为补充胫骨托14的前支柱64的形状—即当支承16被固定到胫骨托14时,限定前凹槽80的基座34、38的侧壁接触前支柱64的边缘。选择凹槽78、80和支柱44、64的尺寸使得实现相对紧密的贴合。通过这种方式,支承16就相对于胫骨托14固定。具体地讲,支承16的下表面36中所形成的支柱44、46和基座34、38的构型防止支承16相对于胫骨托14在前/后方向和内侧/外侧方向上移动。此外,设置在底切54、56中的后凸块和设置在底切74、76中的前凸块42防止支承16从胫骨托14中脱离。通过胫骨托14的支柱44、64相对紧地贴合到支承16的凹槽78、80(尤其是沿着后支柱44的第三臂52和/或前支柱64的第三臂72),将减少(如果没有完全避免的话)旋转性微移动。
如上所提到的,在本文所述的示例性实施例中,后支柱44被实施为大致Y形的结构,其具有沿着胫骨托的平台18的后边缘50在相对的方向延伸的一对臂46、48,并且具有从胫骨托14的后边缘50向前(即在朝胫骨托的平台18中央的方向上)延伸的第三臂52。如图4所示,后支柱44的外侧臂46包括最外侧边缘86,而后支柱44的内侧臂48具有最内侧边缘88。假想线82沿最外侧边缘86延伸,并且与沿最内侧边缘88延伸的假想线84相交,以限定相交角(α)。在本文所述的示例性实施例中,相交角(α)在45-145°之间。在更具体的示例性实施例中,相交角(α)在60-120°之间。在一个此类具体的示例性实施例中,相交角(α)为大约90°。图6-9示出了后支柱44的此类示例性实施例的实例。
应当理解,增加相交角(α)会减少微移动,而减小相交角(α)则会增加胫骨托14的承载表面的面积。虽然可以采用其他构型,但已经发现的是,按上述方式布置后支柱44的臂46、48(即具有60-120°的相交角(α))在这两种考虑之间提供了意料之外的有益的良好平衡。具体地讲,后支柱44良好平衡的构造可见于相交角(α)为大约90°的示例性实施例。
如上所提到的,在本文所述的示例性实施例中,前支柱64被实施为大致T形的结构,其具有沿着胫骨托的平台18的前边缘70在相对的方向延伸的一对臂66、68,并且具有从胫骨托14的前边缘70向前(即在朝胫骨托的平台18中央的方向上)延伸的第三臂64。如图4所示,前支柱64的外侧臂66包括最外侧边缘90,而前支柱64的内侧臂68具有最内侧边缘92。假想线94沿外侧臂66的最后边缘90和内侧臂68的最后边缘92延伸。假想中线96沿后支柱44的第三臂52的纵向轴线延伸。如图4所示,假想中线96对分后支柱44的第三臂52。沿前支柱64的臂66、68的最后边缘90、92延伸的假想线94与沿后支柱44的第三臂52的纵向轴线延伸的假想中线96相交,以限定相交角(β)。在本文所述的示例性实施例中,前支柱64的臂66、68(以及相应的底切74、76)被构造为在内侧/外侧方向上延伸。因此,在本文所述的示例性实施例中,相交角(β)为大约90°。如图6-9所示,这正是前支柱64的多个示例性实施例中的情况。
固定支承膝关节假体的给定设计通常以各种不同尺寸、尤其是以各种不同宽度的形式市售。这样做是为了适应群体中患者体型和骨骼的许多不同情况。然而,本公开的固定膝关节假体10的构型考虑了在确定胫骨托14和支承16的尺寸方面的高灵活度。具体地讲,图5是彼此层叠的多个不同尺寸的胫骨托14的图示。由图可知,虽然各胫骨托14中的每一个的尺寸(如宽度)不同于该组中的其他胫骨托14,但在该系列不同尺寸的胫骨托14中,后支柱44和前支柱64的基本构型保持相同。具体地讲,在该系列不同尺寸的胫骨托14中,限定在后支柱44中的底切54、56的位置分别保持相同。即使后底切54、56在该系列不同尺寸的胫骨托14中保持相同的位置,臂46、48的宽度仍可以改变以适应给定胫骨托14的整个宽度。按照类似的方式,虽然限定在前支柱64中的底切74、76在该系列不同尺寸的胫骨托14中分别保持相同的位置,但臂66、68的宽度可以改变以适应给定胫骨托14的整个宽度。如图5所示,后支柱44的第三臂52和前支柱64的第三臂72的尺寸和构型在该系列不同尺寸的胫骨托14中分别保持不变。
也可以这种方式构建不同尺寸的支承16。具体地讲,可将多个支承16设计为这多个支承16中的每一个均具有不同的尺寸,尤其是具有不同的宽度。然而,这些不同尺寸的支承16中的每一个可包括这样的配合结构:其尺寸和位置均分别与上述胫骨托14的尺寸通用且位置通用的结构通用。具体地讲,在该系列不同尺寸的支承16中,其中每一个支承16可包括后凹槽78和前凹槽80,后凹槽和前凹槽被设置和成型为分别紧密贴合该系列不同尺寸的胫骨托14中的每一个胫骨托14的后支柱44和前支柱64的边缘。
后凸块40在该系列不同尺寸的支承16中尺寸通用且位置通用,使得它们被分别设置在该系列不同尺寸的胫骨托14中的每一个胫骨托14的后底切54、56中。同样,前凸块42在该系列不同尺寸的支承16中尺寸通用且位置通用,使得它们被分别设置在该系列不同尺寸的胫骨托14中的每一个胫骨托14的前底切74、76中。
根据以上讨论应当理解,在该系列不同尺寸的胫骨托14中,支柱44、64的大体构型(包括其邻接变体)相同。同样,在该系列不同尺寸的支承16中,凹槽78、80的大体构型(包括其邻接变体)和凸块40、42的大体构型相同。因此,可以将任何尺寸的支承16固定到任何尺寸的胫骨托14上。这为整形外科医生在将膝关节假体10与具体病人的骨骼相配合方面提供了更大的自由度。
如图6-9所示,还构想了后支柱44和前支柱64的其他构型。例如,在图6的示例性实施例中,后支柱44的第三臂52和前支柱64的第三臂72被构造成限定在其整个长度上具有基本上恒定的宽度的邻接结构。应当理解,限定在支承16的下表面36内的凹槽78、80同样在图6的实施例中重新构造,以适应胫骨托14的不同形状的支柱44、64。换句话讲,虽然可以想到,支柱44、64的设计可以改变,但也应该想到相应地改变凹槽78、80的设计,以补充支柱44、64的构型。也应该想到,图6的支柱44、64的总体构型与互补支承16的凹槽78、80和凸块40、42的对应构型对于一系列不同尺寸的胫骨托14和支承16也可以保持相同,以通过上文结合图5所述的类似方式适应各种尺寸的胫骨托和支承的互换能力。
如图7的示例性实施例所示,后支柱44的第三臂52与前支柱64的第三臂72不邻接。换句话讲,臂52和72之间存在间隙。应当理解,限定在支承16的下表面36内的凹槽78、80同样在图7的实施例中重新构造,以适应胫骨托14的不同形状的支柱44、64。换句话讲,改变凹槽78、80的设计以补充分隔的支柱44、64的构型。也应该想到,图7的分隔的支柱44、64的总体构型与互补支承16的凹槽78、80和凸块40、42的对应构型对于一系列不同尺寸的胫骨托14和支承16也可以保持相同,以通过上文结合图5所述的类似方式适应各种尺寸的胫骨托和支承的互换能力。
返回图8的实施例,前支柱64被构造为不具有第三臂72。此外,前支柱的外侧臂66与内侧臂68间隔开,即臂66和68之间存在间隙。应当理解,限定在支承16的下表面36内的凹槽78、80同样在图8的实施例中重新构造,以适应胫骨托14的不同形状的支柱44、64。换句话讲,改变凹槽78、80的设计以补充支柱44、64的构型。也应该想到,图8的支柱44、64的总体构型与互补支承16的凹槽78、80和凸块40、42的对应构型对于一系列不同尺寸的胫骨托14和支承16也可以保持相同,以通过上文结合图5所述的类似方式适应各种尺寸的胫骨托和支承的互换能力。
图9示出了膝关节假体10的又一个实施例。类似图8的实施例,前支柱64被构造为不具有第三臂72。然而,与图8的设计不同,前支柱的外侧臂66未与内侧臂68隔开,而是与之邻接。此外,后支柱44的第三臂52比图8所示实施例中的长。对于本文所述的其他实施例,应当理解,限定在支承16的下表面36内的凹槽78、80同样在图9的实施例中重新构造,以适应胫骨托14的不同形状的支柱44、64。换句话讲,改变凹槽78、80的设计以补充支柱44、64的构型。也应该想到,图9的支柱44、64的总体构型与互补支承16的凹槽78、80和凸块40、42的对应构型对于一系列不同尺寸的胫骨托14和支承16也可以保持相同,以通过上文结合图5所述的类似方式适应各种尺寸的胫骨托和支承的互换能力。
图10-14示出了膝关节假体10的另一个实施例。类似图8和9的实施例,前支柱64被构造为不具有第三臂72。类似图9的设计,前支柱64的外侧臂66与前支柱64的内侧臂68邻接。具体地讲,如图13所示,前支柱64限定连续的一体式结构,其中外侧臂66和内侧臂68的近端在胫骨托的平台18的前边缘70上的最前点98的位置处连接(即空间上彼此固定)。外侧臂66远离胫骨托的平台的最前点98横向延伸,并且终止于点102处的其外侧端100,该点位于胫骨托的平台最前点98和胫骨托的平台最外侧点104之间的平台18的前边缘70上。内侧臂68远离胫骨托的平台的最前点98横向延伸,并且终止于点108处的其内侧端106,该点位于胫骨平台最前点98和胫骨平台最内侧点110之间的平台18的前边缘70上。
与图9的设计不同,在图10-14的设计中,前支柱64的最后边缘是弯曲的,即弓形的。具体地讲,如图13最清楚示出的,沿外侧臂66的最后边缘90和内侧臂68的最后边缘92延伸的假想线94沿恒定的半径弯曲。应当理解,由于前支柱64的臂66、68邻接,因此外侧臂66的最后边缘90和内侧臂68的最后边缘92限定了单个连续的不间断边缘。
此外,在图10-14所示膝关节假体10的设计中,前支柱64包括单个前底切74(即已经省去了第二底切76)。前底切74居中于限定前支柱64的两臂66和68的交线。换句话讲,沿外侧臂66的最后边缘90和内侧臂68的最后边缘92延伸的假想线94具有中点112。前底切74居中于中点112。应当理解,支承16的下表面36包括单个前凸块42,前凸块42的尺寸和位置可以接纳到单个前底切74内(参见图11)。
类似于图7-9的设计,图10-14所示膝关节假体10的前支柱64不与后支柱44邻接。换句话讲,支柱44和64彼此隔开,使得二者之间存在间隙。对于本文所述的其他实施例,应当理解,限定在支承16的下表面36内的凹槽78、80同样在图10-14的实施例中(相对于图1-9的实施例中)重新构造,以适应胫骨托14的不同形状的支柱44、64。换句话讲,如图11所示,改变凹槽78、80的设计以补充支柱44、64的构型。
此外,如图14所示,图10-13的支柱44、64的总体构型与互补支承16的凹槽78、80和凸块40、42的对应构型对于一系列不同尺寸的胫骨托14和支承16保持相同,以通过上文结合图5所述的类似方式适应各种尺寸的胫骨托和支承的互换能力。
如本文所述,膝关节假体10的各种设计允许改善不同尺寸组件的互换能力。具体地讲,多个不同尺寸的支承中任何一个都可以固定到多个不同尺寸胫骨托中的任何一个上。因此,可以根据每个股骨组件的尺寸改善支承的关节连接表面的几何形状和其他特征。这种互换能力也允许在设计一系列股骨组件时更少地增加尺寸。
尽管在附图和上述说明中已经对本发明进行了详细的图示和描述,但此类图示和描述应视为示例性的,而不是限制性的,应当理解的是,仅示出和描述了示例性的实施例,并且本发明精神范围内的所有变更和修改形式都应受到保护。
本文所述装置、系统和方法的多个特征使本发明具有多个优点。应当注意的是,本发明的装置、系统和方法的替代实施例可以不包括所有所述特征,但仍然可以受益于这些特征的至少某些优点。本领域的普通技术人员可以轻松设计出其自己装置、系统和方法的实施方式,该实施方式可整合本发明特征中的一项或多项,并且落在由权利要求限定的本发明的精神和范围内。
Claims (17)
1.一种固定支承膝关节假体(10),包括:
胫骨托(14),所述胫骨托具有带有固定构件(20)的平台(18),所述固定构件从所述平台的下表面(22)向下延伸,所述平台具有(i)大致为Y形的后支柱(44),所述后支柱从所述平台的上表面(24)向上延伸并且具有沿着所述平台的周边的后部分延伸的一对臂(46,48),所述一对臂中的每一个均具有限定在其中的底切(54,56),和(ii)前支柱(64),所述前支柱沿着所述平台的周边的前部分延伸并且从所述平台的所述上表面向上延伸;以及
支承(16),所述支承包括具有至少一个凹槽(78,80)和一对后锁紧凸块(40)的下表面(36),所述至少一个凹槽限定在所述支承的下表面中用来接纳所述后支柱和所述前支柱,所述一对后锁紧凸块布置成分别接纳到限定在所述后支柱的所述一对臂中每一个内的所述底切内;
其特征在于:
股骨组件(12),所述股骨组件具有内侧髁关节表面(32)和外侧髁关节表面(30);以及
所述膝关节假体包括多个被构造成分别地固定到所述胫骨托的所述支承(16),其中,多个所述支承中的每一个都具有(i)不同于多个所述支承中至少一些其他支承的宽度,(ii)具有内侧支承表面(28)和外侧支承表面(26)的上表面,所述内侧支承表面被构造成与所述股骨组件的所述内侧髁关节表面成关节连接,所述外侧支承表面被构造成与所述股骨组件的所述外侧髁关节表面成关节连接。
2.根据权利要求1所述的膝关节假体(10),其特征在于,所述支承(16)的所述至少一个凹槽(78,80)限定接纳所述后支柱(44)和所述前支柱(64)二者的单个邻接的凹槽。
3.根据权利要求1所述的膝关节假体(10),其特征在于:
所述前支柱(64)大致为T形并且具有沿着所述平台(18)的前边缘(70)延伸的一对臂(66,68),
所述前支柱的所述一对臂中的每一个均具有限定在其中的底切(74,76),以及
多个所述支承(16)中的每一个还包括一对前锁紧凸块(42),所述一对前锁紧凸块布置成分别接纳到限定在所述前支柱的所述一对臂中每一个内的所述底切内。
4.根据权利要求1所述的膝关节假体(10),
其特征在于,所述后支柱(44)具有(i)第一臂(46),所述第一臂沿着所述平台(18)的后边缘(50)延伸,并且具有限定在所述第一臂内的第一底切(54),(ii)第二臂(48),所述第二臂在远离所述第一臂的方向上沿着所述平台的所述后边缘延伸,并且具有限定在所述第二臂内的第二底切(56),和(iii)第三臂(52),所述第三臂远离所述第一臂和所述第二臂向前延伸,以及
其中,(i)第一假想线沿着所述第一臂的最外侧边缘延伸,(ii)第二假想线沿着所述第二臂的最内侧边缘延伸并且与所述第一假想线相交以限定所述第一假想线与所述第二假想线之间的相交角,并且(iii)所述相交角在45°-145°之间。
5.根据权利要求4所述的膝关节假体(10),其特征在于,所述相交角为大约60°-120°。
6.根据权利要求4所述的膝关节假体(10),其特征在于,所述相交角为大约90。
7.根据权利要求4所述的膝关节假体(10),其特征在于,所述前支柱(64)大致为T形并且具有:
第一臂(66),所述第一臂沿着所述平台(18)的前边缘(70)延伸并且具有限定在所述第一臂中的第一底切(74),
第二臂(68),所述第二臂在远离所述第一臂的方向上沿着所述平台的所述前边缘延伸并且具有限定在所述第二臂中的第二底切(76),以及
第三臂(72),所述第三臂远离所述第一臂和所述第二臂向后延伸。
8.根据权利要求4所述的膝关节假体(10),其特征在于,所述支承(16)包括:
第一后凸块(40),所述第一后凸块定位在限定于所述后支柱(44)的所述第一臂(46)内的所述第一底切(54)内,以及
第二后凸块(40),所述第二后凸块定位在限定于所述后支柱的所述第二臂(48)内的所述第二底切(56)内。
9.根据权利要求1所述的膝关节假体(10):
其特征在于,所述后支柱(44)具有(i)第一臂(46),所述第一臂沿着所述平台(18)的后边缘(50)延伸,并且具有限定在所述第一臂内的第一底切(54),(ii)第二臂(48),所述第二臂在远离所述第一臂的方向上沿着所述平台的所述后边缘延伸,并且具有限定在所述第二臂内的第二底切(56),和(iii)第三臂(52),所述第三臂远离所述第一臂和所述第二臂向前延伸,
其中,所述前支柱(64)包括(i)第一臂(66),所述第一臂沿着所述平台(18)的前边缘(70)延伸并且具有限定在所述第一臂中的第一底切(74),(ii)第二臂(68),所述第二臂在远离所述前支柱的所述第一臂的方向上沿着所述平台的所述前边缘延伸并且具有限定在所述第二臂中的第二底切(76),以及
(i)第一假想线沿着所述前支柱的所述第一臂的最后边缘和所述前支柱的所述第二臂的最后边缘延伸,(ii)第二假想线沿着所述后支柱的所述第三臂的的纵向轴线延伸并且与所述第一假想线相交以限定所述第一假想线与所述第二假想线之间的相交角,并且(iii)所述相交角为大约90°。
10.根据权利要求9所述的膝关节假体(10),其特征在于,所述前支柱(64)具有第三臂(72),所述第三臂在平行于所述第二假想线的方向上远离所述第一臂(66)和所述第二臂(68)向后延伸。
11.根据权利要求7或权利要求10所述的膝关节假体(10),其特征在于,所述后支柱(44)的所述第三臂(52)邻接所述前支柱(64)的所述第三臂(72)。
12.根据权利要求7或权利要求9所述的膝关节假体(10),其特征在于,每个支承(16)均包括:
第一后凸块(40),所述第一后凸块定位在限定于所述后支柱(44)的所述第一臂(46)内的所述第一底切(54)内,
第二后凸块(40),所述第二后凸块定位在限定于所述后支柱的所述第二臂(48)内的所述第二底切内(56),以及
第一前凸块(42),所述第一前凸块定位在限定于所述前支柱(64)的所述第一臂(66)内的所述第一底切(74)内,以及
第二前凸块(42),所述第二前凸块定位在限定于所述前支柱的所述第二臂(68)内的所述第二底切(76)内。
13.根据权利要求4或权利要求9所述的膝关节假体(10),其特征在于:
每个支承(16)均具有上表面和下表面(36),
所述内侧支承表面(28)和所述外侧支承表面(26)二者都限定在每个支承的所述上表面内,
每个支承的所述下表面均构造成接触所述平台(18)的所述上表面(24),以及所述平台的所述下表面(22)具有形成在其中的后凹槽(78)和前凹槽(80),以及
所述后支柱(44)构造成定位在所述后凹槽中以及所述前支柱(64)构造成定位在所述前凹槽中。
14.根据权利要求13所述的膝关节假体(10),其特征在于:
所述后凹槽(78)由后侧壁界定,并且所述后侧壁接触所述后支柱(44),以及
所述前凹槽(80)由前侧壁界定,并且所述前侧壁接触所述前支柱(64)。
15.根据权利要求13所述的膝关节假体(10),其特征在于:
所述后支柱(44)邻接所述前支柱(64),以及
所述后凹槽(78)邻接所述前凹槽(80)。
16.根据权利要求1所述的膝关节假体(10),其特征在于:
所述前支柱(64)具有限定在其中的底切,以及
所述多个所述支承(16)中的每一个还包括前锁紧凸块,所述前锁紧凸块布置成接纳到所述前支柱的所述底切内。
17.根据权利要求1所述的膝关节假体(10),其特征在于,多个所述支承中的每一个都具有(i)不同于多个所述支承中至少一些其他支承的宽度和前后方向的长度。
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CN109925100B (zh) * | 2019-04-17 | 2024-03-29 | 嘉思特医疗器材(天津)股份有限公司 | 生物型膝关节机械锁紧胫骨平台 |
WO2021233025A1 (zh) * | 2020-05-21 | 2021-11-25 | 苏州微创关节医疗科技有限公司 | 胫骨托假体 |
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EP2322119B1 (en) | 2012-06-20 |
US8128703B2 (en) | 2012-03-06 |
EP2322119A1 (en) | 2011-05-18 |
CN102058448B (zh) | 2016-04-27 |
AU2010241400B2 (en) | 2015-06-25 |
US20100063594A1 (en) | 2010-03-11 |
AU2010241400A1 (en) | 2011-06-02 |
JP2011104374A (ja) | 2011-06-02 |
CN102058448A (zh) | 2011-05-18 |
CN105853028B (zh) | 2019-12-10 |
JP5714305B2 (ja) | 2015-05-07 |
ZA201008211B (en) | 2012-10-31 |
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