CN109172053B - Double-compartment knee joint prosthesis - Google Patents

Double-compartment knee joint prosthesis

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Publication number
CN109172053B
CN109172053B CN201811214702.4A CN201811214702A CN109172053B CN 109172053 B CN109172053 B CN 109172053B CN 201811214702 A CN201811214702 A CN 201811214702A CN 109172053 B CN109172053 B CN 109172053B
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longitudinal
transverse
contour line
arc
inner contour
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CN201811214702.4A
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CN109172053A (en
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丁罡
申宝胜
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Shaanxi Dipperson Medical Equipment Co ltd
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Shaanxi Dipperson Medical Equipment Co ltd
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Abstract

The invention discloses a knee joint prosthesis with double compartments, which comprises: the two main body parts are respectively used for replacing the inner condyle joint surface and the outer condyle joint surface of the femoral condyle and are connected through a cross beam; wherein the longitudinal section of the main body part comprises a longitudinal inner contour line and a longitudinal outer contour line; the longitudinal inner contour line consists of a plurality of sections of longitudinal circular arcs, and adjacent longitudinal circular arcs are tangent; the longitudinal outer contour line has the same shape as the longitudinal inner contour line, and the two ends of the longitudinal outer contour line and the two ends of the longitudinal inner contour line are respectively connected through transition lines; the transverse cross section of the main body part comprises a transverse inner contour line and a transverse outer contour line; a transverse inner contour line, which is a straight line; and the transverse outer contour line consists of a plurality of sections of transverse circular arcs, and adjacent transverse circular arcs are tangent. The double-compartment knee joint prosthesis provided by the invention has the advantages that the inner surface is a smooth curved surface formed by a plurality of sections of arc surfaces, so that the bone mass of the femur of a patient can be reserved to the greatest extent, the stress concentration is reduced, and the fracture of the patient is prevented.

Description

Double-compartment knee joint prosthesis
Technical Field
The invention belongs to the technical field of medical orthopedic prostheses, and particularly relates to a double-compartment knee joint prosthesis.
Background
Knee joint prostheses currently existing on the market are largely divided into two categories: one class is unicompartmental knee prostheses, including unicompartmental prostheses that replace the unilateral femoral tibial articular surface and patellofemoral joint prostheses that replace the patellofemoral articular surface; the other is a three compartment knee prosthesis requiring replacement of the patellofemoral articular surfaces and both lateral femoral tibial articular surfaces.
A unicompartmental knee prosthesis may be used when the patient suffers from unicompartmental knee arthropathy, or a patellofemoral prosthesis may be used when the patient suffers from tricompartmental knee arthropathy; however, when the patient suffers from only a double compartment knee joint lesion on the medial and lateral femoral tibial articular surfaces, knee replacement can only be performed with a three compartment knee prosthesis due to the limitations of the type of knee prosthesis.
As shown in fig. 1, the inner surface of the currently marketed tri-compartment knee prosthesis consists of five planes angled with respect to each other. When the patient suffers from only medial and lateral femoral tibial articular surface lesions, but the patellofemoral joint is intact, the patellofemoral joint surface has to be replaced along with the patellofemoral joint surface due to the limitations of the type of knee prosthesis. As the non-diseased patellofemoral articular surface is replaced, the osteotomy level of the femoral condyle increases. Research data prove that if the tri-compartment knee joint prosthesis is used, the patient body patella (the patellofemoral joint surface of the patient body cannot be reserved at the same time) is reserved in the knee joint replacement process, and the design factors of the tri-compartment knee joint prosthesis patellofemoral joint surface easily cause the instability and even dislocation of the patient body patella, so that the knee joint cannot freely move. The occurrence rate of patella instability is 16.7% -28.6%, which is quite high. If the patellofemoral joint surface of the patient body can be reserved in the knee joint replacement process, the patellofemoral joint surface of the patient body moves in the femoral trochlear groove of the body, and the occurrence rate of patellar instability can be greatly reduced. Meanwhile, since the inner surface of the three-compartment knee prosthesis is generally formed of five planes at an angle, the structure cannot maintain the bone mass of the femur to the maximum extent, and since angles exist between the planes, a stress concentration phenomenon easily occurs, resulting in fracture of the femur.
The three compartment knee joint prosthesis is usually an alloy material, the hardness of the three compartment knee joint prosthesis is far greater than that of the patella cartilage, and long-term relative movement of the patella and the patella joint surface of the three compartment knee joint prosthesis can cause abrasion of the patella cartilage and even fracture of the patella.
In addition, knee prostheses are generally required to be used in combination with tibial inserts, and therefore the amount of wear of the knee prostheses on the tibial inserts is also an important indicator for performance.
Disclosure of Invention
The invention provides a double-compartment knee joint prosthesis, which does not need to replace the patellofemoral joint surface of a patient, and the inner side surface of the knee joint prosthesis is formed by a plurality of sections of tangent circular arcs; one of the purposes of the invention is to enable the patellofemoral strand to naturally move on a healthy femur slide surface, keep a normal movement track and avoid the problem of patella abrasion; simultaneously, the bone cutting amount of the femoral condyle is reduced, the stress concentration is reduced, and the fracture of a patient is prevented.
The invention provides a double-compartment knee joint prosthesis, and the second purpose is to reduce the abrasion loss of the knee joint prosthesis to the tibia pad by reasonably setting the shapes of the inner side surface and the outer side surface of the knee joint prosthesis.
The technical scheme provided by the invention is as follows:
A dual compartment knee prosthesis comprising:
two main body parts connected by a cross beam; wherein,
The longitudinal section of the main body part comprises a longitudinal inner contour line and a longitudinal outer contour line;
the longitudinal inner contour line consists of a plurality of sections of longitudinal circular arcs, and adjacent longitudinal circular arcs are tangent;
the longitudinal outer contour line has the same shape as the longitudinal inner contour line, and the two ends of the longitudinal outer contour line and the two ends of the longitudinal inner contour line are respectively connected through transition lines;
the transverse cross section of the main body part comprises a transverse inner contour line and a transverse outer contour line;
a transverse inner contour line, which is a straight line;
And the transverse outer contour line consists of a plurality of sections of transverse circular arcs, and adjacent transverse circular arcs are tangent.
Preferably, the cross member is connected to one end of the two main body parts in a lateral direction of the main body parts.
Preferably, the longitudinal inner contour line sequentially comprises a first longitudinal arc, a second longitudinal arc and a third longitudinal arc from one end far away from the cross beam to one end close to the cross beam; wherein,
The curvature radius of the first longitudinal arc is 30 mm-50 mm;
the curvature radius of the second longitudinal arc is 18 mm-26 mm;
The curvature radius of the third longitudinal arc is 13 mm-18 mm.
It is preferred that the composition of the present invention,
The central angle corresponding to the first longitudinal arc is 27-28 degrees;
the central angle corresponding to the second longitudinal arc is 62-63 degrees;
The central angle corresponding to the third longitudinal arc is 70-71 degrees.
Preferably, the transverse outer contour line sequentially comprises a first transverse circular arc and a second transverse circular arc from one side far away from the cross beam to one side close to the cross beam, wherein,
The curvature radius of the first transverse arc is 43 mm-44 mm;
The curvature radius of the second transverse circular arc is 27 mm-28 mm.
It is preferred that the composition of the present invention,
The central angle corresponding to the first transverse arc is 9-23 degrees;
the central angle corresponding to the second transverse arc is 35-36 degrees.
Preferably, the inner side surface of the cross member is an extension surface of the inner side surfaces of the two main body portions.
Preferably, the outer side surface of the cross beam is a curved surface, and the outer side surfaces of the two main body parts are in smooth transition, so that the thickness of the cross beam gradually decreases from two ends to the middle to form a concave part.
Preferably, the length of the cross beam is 16mm to 17mm.
Preferably, fixing pins are respectively provided on the inner sides of the two main body parts.
The beneficial effects of the invention are as follows:
(1) The double-compartment knee joint prosthesis provided by the invention is suitable for patients with pathological changes of the joint surfaces of the inner side and the outer side of the femoral shin only; the patellofemoral joint surface of the patient does not need to be replaced, so that the patellofemoral can naturally move on the healthy femur slide surface, the normal movement track is kept, and the problem of patella abrasion does not exist.
(2) The double-compartment knee joint prosthesis provided by the invention can reduce the bone cutting amount of the femoral condyle, furthest reserve the bone cutting amount of the femur of a patient, reduce stress concentration and prevent the fracture of the patient.
(3) The double-compartment knee joint prosthesis provided by the invention can reduce the incision size of skin and soft tissues, reduce the bone cutting quantity and bleeding quantity, and is suitable for minimally invasive surgery.
(4) The double-compartment knee joint prosthesis provided by the invention has small abrasion loss to the tibial gasket, and prolongs the service life of the tibial gasket, thereby prolonging the period of knee joint replacement operation.
Drawings
Fig. 1 is a schematic view of the structure of a conventional three compartment knee prosthesis.
Fig. 2 is a schematic view showing a medial structure of the dual compartment knee prosthesis according to the present invention.
Fig. 3 is a schematic view showing the lateral structure of the dual compartment knee prosthesis according to the present invention.
Fig. 4 is a schematic longitudinal cross-sectional view of a joint according to the present invention.
Fig. 5 is a schematic transverse cross-section of a joint according to the invention.
Detailed Description
The present invention is described in further detail below with reference to the drawings to enable those skilled in the art to practice the invention by referring to the description.
As shown in fig. 2 to 3, the present invention provides a dual compartment knee prosthesis comprising a body portion 110 and a body portion 120, the body portion 110 and the body portion 120 being used to replace a medial condyle articular surface and a lateral condyle articular surface of a femoral condyle, respectively, the body portion 110 and the body portion 120 being connected by a cross beam 130; the cross member 130 is disposed along a transverse direction of the main body, the cross member 130 is connected to one ends of the main body 110 and the main body 120, and the other ends of the main body 110 and the main body 120 are free ends. The outer edge line 130a of the cross member 130 does not extend beyond the end 111 of the main body portion 110 and the end 121 of the main body portion 120 in the longitudinal direction of the knee prosthesis. The main body 110 and the main body 120 have the same structure and are mirror-symmetrically arranged at both ends of the cross member 130. The inner sides of the body portion 110 and the body portion 120 are provided with fixing pins 110a and 120a, respectively, for preventing the rotation of the double compartment knee prosthesis on the femur.
The inner side 131 of the cross member 130 is an extension of the inner side of the main body 110 and the inner side of the main body 120. The outer side 132 of the cross member 130 is curved, and smoothly transitions between the outer side of the main body 110 and the outer side of the main body 112, so that the thickness of the cross member 130 gradually decreases from both ends to the middle, and a smooth recess 132a is formed at the middle position of the cross member 130 for cooperation with the tibial insert. The cross member 130 is provided in a rounded curve at an inner edge line 130b near the free ends of the body portion 110 and the body portion 120, and forms a smooth transition with the body 110 and the body 120.
In this embodiment, the length of the cross member 130 is 16mm to 17mm, the width of both ends (widest portion) of the cross member 130 is 15mm, and the width of the middle (narrowest portion) of the cross member 130 is 3mm.
As shown in fig. 4, taking the main body 110 as an example, a longitudinal section of the main body 110 includes a longitudinal inner contour line 112 and a longitudinal outer contour line 113; and transition lines 114 and 115 connected to both ends of the longitudinal inner contour line 112 and the longitudinal outer contour line 113; the transition line 114 at the free end of the body part 110 is composed of a rounded curve 114a connected to the longitudinal inner contour 112 and a rounded curve 114b connected to the longitudinal outer contour 113, and the rounded curve 114a and the rounded curve 114b form a rounded transition with the longitudinal inner contour 112 and the longitudinal outer contour 113, respectively. The transition line 115 near one end of the cross beam 130 is a multi-segment line that forms a rounded transition with the longitudinal inner contour 112 and the longitudinal outer contour 113 lines, respectively, the transition line 115 forming the end shape of the knee prosthesis. Wherein the longitudinal inner contour line 112 is composed of a plurality of longitudinal circular arcs, and adjacent longitudinal circular arcs are tangent; the longitudinal outer contour 113 and the longitudinal inner contour 112 are identical in shape and size.
In this embodiment, the longitudinal inner contour line 112 and the longitudinal outer contour line 113 are each composed of three tangential longitudinal arcs. Taking the longitudinal inner contour 112 as an example, it comprises a first longitudinal said first longitudinal arc 112a, a second longitudinal arc 112b and a third longitudinal arc 112c; the curvature radius of the first longitudinal arc 112a is 30-50 mm, and the corresponding central angle is 27-28 degrees; the curvature radius of the second longitudinal arc 112b is 18-26 mm, and the corresponding central angle is 62-63 degrees; the curvature radius of the third longitudinal arc is 13 mm-18 mm, and the corresponding central angle is 70-71 degrees. The first longitudinal arc 112a is connected to the transition line 114, and the third longitudinal arc 112c is connected to the transition line 115.
As shown in fig. 5, taking the main body 110 as an example, the transverse cross section of the main body 110 includes a transverse inner contour 116 and a transverse outer contour 117; the transverse inner contour line 116 and the transverse outer contour line 117 are connected through a transition line 118 and a transition line 119, the transition line 118 and the transition line 119 are straight lines, and the connection parts of the transition line 118 and the transition line 119 and the transverse outer contour line 117 are respectively rounded. The lateral inner contour line 116 is a straight line, and the lateral outer contour line 117 is formed by a plurality of sections of lateral circular arcs, and adjacent lateral circular arcs are tangent.
In this embodiment, the lateral outer contour line 117 sequentially includes, from a side far from the beam to a side near the beam 130, a first lateral arc 117a and a second lateral arc 117b, where the radius of curvature of the first lateral arc 117a is 43 mm-44 mm, and the central angle corresponding to the first lateral arc is 9 ° to 23 °; the curvature radius of the second transverse arc 117b is 27-28 mm, and the central angle corresponding to the second transverse arc is 35-36 degrees.
In knee prosthesis replacement surgery, a double compartment knee prosthesis is implanted by performing arc-shaped grinding treatment on the femoral condyle using a guide tool, a milling cutter, or a surgical robot and punching holes (fixing pins for inserting the double compartment knee prosthesis) on the inner and outer sides of the distal end of the femur. The knee joint prosthesis with double compartments can reduce the incision size of skin and soft tissues, reduce the bone cutting amount and bleeding amount, and is suitable for minimally invasive surgery. The inner surface of the double-compartment knee joint prosthesis is attached to the bone surface, and can be fixed through bone cement or natural bone ingrowth between the bone and the prosthesis, and the outer surface of the double-compartment knee joint prosthesis is used for replacing the inner and outer condyle articular surfaces of the femur. The fixation pins on both sides are used to prevent the rotation of the double compartment knee prosthesis on the femur. The outer surface of the dual compartment knee prosthesis contacts the tibial prosthesis to form a femoral tibial articular surface, and the relative motion between the prostheses is used to replace the knee joint motion of the patient's body. Because the joint surface of the patellofemoral joint is not replaced, the patellofemoral joint can naturally move on the healthy femur pulley surface, and the normal movement track is maintained.
The inner surface of the double-compartment knee joint prosthesis provided by the invention is a smooth curved surface formed by a plurality of sections of arc surfaces, and compared with a three-compartment knee joint prosthesis, the double-compartment knee joint prosthesis can reduce the osteotomy quantity of femoral condyles, furthest reserve the bone quantity of the femur of a patient, reduce stress concentration and prevent fracture of the patient.
Test example 1
After osteotomy is carried out on the artificial knee joint prosthesis, the double-compartment knee joint prosthesis is installed. The knee joint prosthesis is flexed to move the patella from top to bottom along the trochlear groove of the femur until the patella completely enters the intercondylar notch. The trajectory during patella movement was evaluated for good.
Test sample:
an artificial knee prosthesis model 10; a double compartment knee prosthesis 10.
Conclusion of the test:
The patella in the artificial knee joint false bone can keep a good movement track in the knee joint buckling process, and the phenomena of dislocation, instability and the like of the patella do not occur. When the knee joint is in high flexion, the patella can smoothly transition on the patellofemoral joint surface and the double-compartment knee joint prosthesis until the patella completely enters the intercondylar fossa.
Test example 2
And carrying out stress analysis on the conventional three-compartment femoral condyle prosthesis model and the double-compartment knee joint prosthesis model through finite element analysis software.
The test method comprises the following steps:
The state of the conventional three-compartment femoral condyle prosthesis and the double-compartment knee joint prosthesis after being implanted into a human body is simulated, the elastic modulus of the prosthesis is 225Gpa, the Poisson ratio is 0.3, the longitudinal load is applied to the prosthesis and the prosthesis to 1500N (equivalent to the weight of an adult 2 times), and the maximum Mises stress generated by the prosthesis and the double-compartment knee joint prosthesis is calculated through finite element analysis. The experiments were performed in two groups of 5 persons each, the first group calculating the maximum Mises stress for a conventional three compartment femoral condyle prosthesis and the second group calculating the maximum Mises stress for a dual compartment knee prosthesis.
Test results:
The specific test data are shown in Table 1.
Table 1 test results
Conclusion of the test:
The first set of maximum stresses is generally higher than the second set, the maximum stresses occurring at the intersection of the planes of the inner surface of the prosthesis (sharp corners).
As can be seen from test example 2, the double compartment knee prosthesis is uniformly stressed and can reduce stress generated from the prosthesis compared with the conventional knee prosthesis.
Test example 3
Wear comparison tests were performed on the dual compartment knee prosthesis and the tri-compartment knee prosthesis.
Test sample:
a dual compartment knee prosthesis 5 and a tibial insert 5 associated therewith.
Three compartment knee prosthesis 5 pieces with patellofemoral joint surfaces, and tibial inserts and patella components each 5 pieces mated therewith.
The specific test sample numbers are shown in Table 2.
Table 2 knee prosthesis numbering
The test method comprises the following steps:
The two groups of products were respectively subjected to wear testing according to ISO 14243-1 using the method of wear testing under load control.
The control group required loading of the patella component at the same time, the patella component load was 2500N.
The number of load cycles was 5×10 6.
Wear measurements were made according to the gravimetric method provided in ISO 14243-2.
Test results:
The specific test data are shown in Table 3.
Table 3 test data
Conclusion of the test:
the amount of wear to the tibial insert caused by the dual compartment knee prosthesis is much less than the three compartment knee prosthesis.
As can be seen from test example 3, the double-compartment knee joint prosthesis provided by the invention has small abrasion loss to the tibial insert, and can prolong the service life of the tibial insert, thereby prolonging the period of knee joint replacement operation.
Although embodiments of the present invention have been disclosed above, it is not limited to the details and embodiments shown and described, it is well suited to various fields of use for which the invention would be readily apparent to those skilled in the art, and accordingly, the invention is not limited to the specific details and illustrations shown and described herein, without departing from the general concepts defined in the claims and their equivalents.

Claims (8)

1.A dual compartment knee prosthesis comprising:
two main body parts connected by a cross beam; wherein,
The longitudinal section of the main body part comprises a longitudinal inner contour line and a longitudinal outer contour line;
the longitudinal inner contour line consists of a plurality of sections of longitudinal circular arcs, and adjacent longitudinal circular arcs are tangent;
the longitudinal outer contour line has the same shape as the longitudinal inner contour line, and the two ends of the longitudinal outer contour line and the two ends of the longitudinal inner contour line are respectively connected through transition lines;
the transverse cross section of the main body part comprises a transverse inner contour line and a transverse outer contour line;
a transverse inner contour line, which is a straight line;
The transverse outer contour line consists of a plurality of sections of transverse circular arcs, and adjacent transverse circular arcs are tangent;
The longitudinal inner contour line sequentially comprises a first longitudinal arc, a second longitudinal arc and a third longitudinal arc from one end far away from the cross beam to one end close to the cross beam; wherein,
The curvature radius of the first longitudinal arc is 30 mm-50 mm;
the curvature radius of the second longitudinal arc is 18 mm-26 mm;
the curvature radius of the third longitudinal arc is 13 mm-18 mm;
The central angle corresponding to the first longitudinal arc is 27-28 degrees;
the central angle corresponding to the second longitudinal arc is 62-63 degrees;
The central angle corresponding to the third longitudinal arc is 70-71 degrees.
2. The dual compartment knee prosthesis of claim 1, wherein the cross member is connected at one end of the two body portions in a transverse direction of the body portions.
3. The dual compartment knee prosthesis of claim 1 or 2, wherein the transverse outer contour comprises a first transverse arc and a second transverse arc in sequence from a side distal to the transverse beam to a side proximal to the transverse beam, wherein,
The curvature radius of the first transverse arc is 43 mm-44 mm;
The curvature radius of the second transverse circular arc is 27 mm-28 mm.
4. The dual compartment knee prosthesis of claim 3, wherein,
The central angle corresponding to the first transverse arc is 9-23 degrees;
the central angle corresponding to the second transverse arc is 35-36 degrees.
5. The dual compartment knee prosthesis of claim 1 or 2, wherein the medial side of the cross member is an extension of the medial sides of the two body portions.
6. The dual compartment knee prosthesis of claim 5, wherein the lateral side of the cross member is curved and smoothly transitions with the lateral sides of the two body portions such that the cross member thickness gradually decreases from both ends to the middle to form a recess.
7. The dual compartment knee prosthesis of claim 6, wherein the length of the cross beam is 16mm to 17mm.
8. The dual compartment knee prosthesis of any one of claims 1, 2,4, 6 or 7, wherein the inner sides of the two body portions are each provided with a fixation pin.
CN201811214702.4A 2018-10-18 Double-compartment knee joint prosthesis Active CN109172053B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201811214702.4A CN109172053B (en) 2018-10-18 Double-compartment knee joint prosthesis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN201811214702.4A CN109172053B (en) 2018-10-18 Double-compartment knee joint prosthesis

Publications (2)

Publication Number Publication Date
CN109172053A CN109172053A (en) 2019-01-11
CN109172053B true CN109172053B (en) 2024-07-09

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107280817A (en) * 2016-03-31 2017-10-24 温晓玉 Femur side inner side, the single condyle prosthese in outside and femoral bone pulley prosthese
CN209285835U (en) * 2018-10-18 2019-08-23 北京四正医疗器械有限责任公司 A kind of bicompartmental knee prosthesis

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107280817A (en) * 2016-03-31 2017-10-24 温晓玉 Femur side inner side, the single condyle prosthese in outside and femoral bone pulley prosthese
CN209285835U (en) * 2018-10-18 2019-08-23 北京四正医疗器械有限责任公司 A kind of bicompartmental knee prosthesis

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
刘斌,王永为,刘江.人工膝关节假体设计中股骨下端的形态学测量.《承德医学院学报》.2014,241-243. *

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