CN1633265B - 髌股关节的置换方法和仪器使用 - Google Patents
髌股关节的置换方法和仪器使用 Download PDFInfo
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Abstract
本发明提供一种髌股关节假体(10),该关节假体可使接合表面平稳地进行整个范围的关节运动。同时本发明还提供了便于超强粘结到股头上的股骨植入物部件(12)新颖的结构。此外还提供一种髌股关节置换系统,该系统采用了精确的、可再现的骨头制备技术,该技术独特之处在于,可使以后的修复和完全的膝盖骨关节置换过程的复杂程度最小化。本发明还提供了一种钻头导向件(90)和一种切割导向件(44),其中每个的结构被设计成在手术期间能提供三点稳定。
Description
技术领域
本发明一般地涉及新颖的整形外科关节置换植入物和方法,具体地说,涉及通过用仪器化、可再现切口的更简单、较少创伤性外科手术方法,进行髌股关节置换的改进的方法和系统。
背景技术
髌股关节置换是人所共知的整形外科手术。自从七十年代以来,已经使用过各种传统的关节置换装置,然而,不同于通常用于整个膝关节置换外科手术的人工关节,传统的髌股关节置换装置在整形外科领域没有广泛地被接受。这或许是由于有些混合临床结果而导致,在有关的医学文献中,该结果已经为传统的髌股人工关节所证明。该传统的假体通常包括股骨部件,该部件为较大、较笨重的装置,其外形设计成能够嵌入到股骨滑车槽内。然而,它们的外部几何形状,使其几乎不可能形成制作股骨患病表面的精确方法,来与植入物几何形状相匹配。在使用传统的髌股关节置换装置时,外科医生通常必须使用电动磨锥对骨表面挖凿,以接纳植入物。这使得植入物配合和定位难以再现,同时不同病例也多少有些变化。如果或者当可能需要调整该植入物时,对于较大尺寸植入物,该方法也产生困难。当关节炎发展时,在以后需要把该植入物换成整个膝关节置换物也不是罕见的。为此,在没有过度损失骨头而轻易地进行修正手术的能力是关键的。
在八十年代早期,用于其它膝关节置换手术的精确切割引导件逐渐在整形外科实践中被采用。在用于髌股关节置换装置和方法中还没有看到类似的改进。在本发明之前,在髌股关节置换中,还没有允许精确、可再现的骨头切割方法或者外科器械。
早期的试图对用于髌股关节置换装置的改进包括在第4,007,495号和第4,151,615号美国专利中描述的那些。这两个早期专利描述了髌股关节置换,但没有提到植入产品需要的方法或者仪器的使用。同样地, 在第3,878,566号美国专利中描述了商业上成功的髌股关节装置,但由于只公开了通过在骨头上简单地磨出一个点而植入假体,因此,在植入装置的方法上没有改进。没有揭示指导或者引导外科医生对用于改进的装置移植的骨头制备的装置和方法。第5,609,644号美国专利中的权利要求书提出一种髌股关节,然而,只详细描述了膝盖骨置换部件,而没有公开辅助外科医生对装置进行精确植入的设备或者方法。
专利权人均为Stein(斯坦)的第5,571,196和第5,824,098号的美国专利试图通过描述一种仪器系统来满足这种需要,该系统包括一个髓内导杆和一个用于在前面股骨内制备一个槽的铣槽刀框架。Stein(斯坦)公开的该系统没有保持股骨解剖轮廓,并在该手术中需要几个额外的步骤,从而使过程更复杂以及更趋于复杂化。不象本发明,Stein(斯坦)的方法此外还具有创伤性,由于通过Stein的机械加工股骨槽使骨头损失更大,同时不能与标准的整个膝关节几何形状相吻合,因此,植入物将不能进行必要时的简单修复。
这些现有技术试图提供一种髌股关节置换系统,这些系统都没有采用低轮廓的股骨植入物设计,所述植入物设计带有成一定角度的表面,所述表面的几何的形状类似于整个膝关节置换件的形状,所述设计结合了一系列简单精确切割导轨,该导轨可形成准确而可重复的切口。
根据该需要,开发了在这里描述的本发明技术。
发明内容
本发明的总的目的是提供一种新颖的髌股关节置换系统和使用该系统的方法,在植入后,该系统和方法可允许修复的关节进行基本上正常、完整范围的运动。
本发明的又一个目的是提供一种比传统植入物较小、较低轮廓的股骨植入物,该植入物具有平的前表面的骨头-工作面,在股骨前表面和股骨植入物之间提供了增加的附着力、略微的上角以便于关节的完全范围的运动,所述骨头-工作面在骨头-工作面上包括表面粗糙的组织、凹穴和底切边缘,用于增强对骨头粘合剂的固接和保持力;一个与膝关节部件关节面配合的凹入的关节面;以及用于在股骨腔内对准 的髓内杆。
本发明的再一个目的是提供一种手术装置系统,该系统包括髓内导杆装置;一个前表面股骨的切割导向件,该导向件适应于髓内导杆,并基于髓内导杆;一个用于对股骨髓内腔进行精确钻削的导向件,该导向件具有使其相对于股骨前表面对准并定位的装置;一个对前表面的切口磨光并制备成适于接纳股骨植入物的圆锥形锉;一个用于准确地定位切口导向件的测隙规;以及一个本领域公知的冲击器,该冲击器用于辅助股骨植入物的最后定位。
本发明又一个目的是提供一种上面刚描述的作为套件的外科仪器的系统,该系统可带有使用说明、骨头粘合剂、可选择实施例或者部件尺寸,从而使外科医生能够调整该系统以适合患者的紧急需要。
发明的还一个目的是提供一种股骨植入物,该植入物作为本发明股骨重修表面部件,该植入物只需要一个为植入而制备骨头的切割步骤,该植入物采用便于将来必要时便于对整个膝关节进行修复的几何形状,同时与包括相匹配的、可互换的关节面的膝关节部件相接合。
本发明的又一个目的是提供一种用于髌股关节置换的方法,该方法包括在患者身上形成较小创伤性切口的过程;对在该股骨内的髓内导向孔进行精确钻削;把新颖的切割导向件与插入在该导向孔内的髓内杆对准;在股骨前表面上形成单个精确的切口;以及把本发明系统的股骨重修表面部件植入。
附图说明
当与附图结合考虑时,通过参考以下详细说明,本发明的实质特征及其目的和优点将变得更加明显,在全部附图中,相同的附图标号表示相同的部件,其中:
图1A、1B、1C分别示出了本发明股骨植入物部件一个实施例的前视图、侧视图和后视图。
图2A、2B示出了本发明膝盖骨植入物部件的一个实施例的前视图和侧视图。
图3示出了本发明的切割引导部件的一个实施例的等轴视图。
图4示出了图3所示本发明切割引导部件实施例的分解图。
图5示出了图3和4所示本发明切割引导部件,该切割引导部件可操作地与股骨末端接触。
图6A、6B示出了本发明测隙规部件的一个实施例的平面图和侧视图。
图7示出了本发明钻头引导部件的侧视图,其中该钻头引导部件靠在股骨末端用于钻削髓内腔。
图8示出了本发明骨锉部件一个实施例的末端部的立体图。
具体实施方式
本发明提供一种包括髌股关节置换装置、一系列仪器的系统,和利用所述仪器植入髌股关节置换装置的方法。
该髌股关节置换装置,大致包括两个连接部件、一个股骨植入物和在图2A-B中用12表示的膝盖骨植入物,其中股骨植入物在图1A-C中用附图标号10表示。
从图1A-C中清楚地看到,该股骨植入物10设计成能置换病人股骨远端部的前表面。该股骨植入物10包括一个在解剖学上成形的上表面14,其中该上表面带有一个在中心和纵向地定向的大致呈凹入形状的关节槽16。
从图1A中清楚地示出,该股骨植入物10的下侧18包括至少一个然而优选是多个的凹穴20、至少一个髓内杆22,和一个沿着四周布置的底切缘24。在通用地表示为股骨植入物10的18的下表面中,至少一部分,优选是大部分具有粗糙表面26。还可以使用多孔涂层或者通过利用至少一个优选是多个的突尖头或者定位针27,以提高附着以及粘合力。该凹穴20、底切缘24和粗糙表面26分别地以及共同提供一种有助于粘合剂的牢固和持久连接的结构,其中该粘合剂用来把股骨植入物10的下侧面18结合到所完成的股骨远端部的前表面上。
在本发明植入物方法的实践中,在患者身上使用任何粘合剂都在本发明原理范围内。优选的是,可采用骨头粘合剂。
从图1A、B中清楚地看到,关节槽16从上表面14没有中断地延续到远端延伸突出部分,突出部分在关节槽末端30略微向上倾斜地终止。通过提供一个略微向上的角度(superior angle),该末端30可使髌 股关节置换装置在关节槽16内具有光滑的轨道,该轨道贯穿关节运动的整个范围,也就是说到达弯曲的极限位置。
图2A、B中清楚地示出,该膝盖骨的植入物12包括接合表面32,该连接表面具有大致呈球冠形的几何形状,同时尺寸和结构设计成可以互补方式,可滑动地接合在股骨植入物10的关节槽16内。该接合表面32可包括沿着四周布置的环形边界34,该环形边界具有与该接合表面32稍有不同的几何形状,并与该接合表面32由不同的材料组成。
位于与膝盖骨的接合表面32另一面的固定表面36,设计成便于牢固固定到骨头上,并包括膝盖骨的粗糙表面38以便于粘合剂的粘合。该固定表面也包括至少一个骨头锚件40,该骨头锚件的结构设计成包括一个环形保持槽42。该膝盖骨的粗糙表面38、骨头锚件40和环形保持槽42独立地并且共同地促进膝盖骨的植入物12和骨质之间的强力粘合。在本发明原理范围内,膝盖骨的植入物12可在固定表面36上具有附加的定位针,以便于与骨质的强力粘合。
本发明的系统包括几种仪器,这些仪器为外科医生提供了以与股骨植入物10相接触的方式精确穿孔以及切割股骨远端部骨质材料的能力,这远远胜过传统的骨头制备方法。
从图3-5清楚地看到,本发明提供一种骨头切割导向装置,在图中用附图标号44表示,该装置包括一个髓内杆46,其尺寸和形状设计成可插入到股骨髓内空腔内,该空腔已经准备接纳该髓内杆46。该髓内杆46可具有一或多个凹槽48,以便提供沿着髓内杆46纵轴方向的凹槽表面。该凹槽表面有利于髓内杆46插入到骨头内,以便减少施加于骨髓上的压力,并因此减少或者避免由于强加到患者循环系统内物质而导致的压力。在本发明优选实施例中,髓内杆46固定连接到切割导向装置44上。然而,以下的情况也完全地处在本发明范围内,即,把髓内杆46设计成通过杆夹持元件50可释放地与切割导向装置44配合,其中该杆夹持元件50可通过夹持元件致动器52作有选择地固定。切割导向装置44的这样一个选择实施例,可允许去除髓内杆和用不同的结构或者不同尺寸杆来取代髓内杆46。
无论是与髓内杆46整体地形成,如优选实施例中,还是通过如夹持元件50的中间元件连接到其中,该髓内杆46都通过至少一个、优选是两个切割导向组件杆56被可释放连接到骨锯导向元件,其中该切割导向组件杆的尺寸和形状设计成可滑动地与相同数目的装配杆接收口58相配合。组件固定元件60设计成可释放地与固定元件口62啮合,其啮合方式使接收口58能够把组件杆56固定到该骨锯导向元件54上。
该骨锯导向元件54具有一个锚件口64,锚件口64尺寸和形状可接收管心针臂锚杆66。该管心针臂锚杆66可整体地连接到骨锯导向元件54上,或者优选的是,利用组件固定元件60穿过锚杆通道68被可释放地固定到锚口64中。
自由旋转的管心针70的尺寸和结构,能够在其末端提供管心针-股骨接触点72。该管心针70的近端以近似直角固定到管心针转动套管74上,该套管的尺寸和形状设计成可围绕管心针臂锚杆66圆周布置并能够随意旋转。管心针保持元件76可设计成可释放地把管心针70保持在可围绕该管心针臂锚杆66转动的状态。
该骨锯导向元件54优选通过一个骨锯导向槽78而局部分叉,而槽78的尺寸和结构设计成可形成一个骨锯滑动通道,所述骨锯为例如在本领域常见的那种。该骨锯导向元件54的分叉部末端包括导向连接元件80,该导向连接元件可以是在骨锯导向元件54的终端上或其附近的永久连接件,或者也可以是用来把该分叉骨锯导向元件54端部固定的销、螺钉、铆钉或者任何其它的连接装置。至少一个、优选是两个锚导向件82布置在该分叉骨锯导向元件54的外表面上,该导向件分别限定有锚导向口84。这些锚导向口的尺寸和形状设计成便于钻头通过,外科医生使用该钻头在患者骨头上钻锚定孔,如髓内腔。在从该锚导向口84上移去钻头后,该外科医生可采用锚导向口84作为固定点,固定接骨螺钉等部件可穿过该固定点,以便在手术期间,为到患者骨头上的切割引导件提供附加的固定点。这样,该外科医生可采用管心针股骨接触点72和两个锚导向口84,为切割引导元件提供到骨头上的三个独立的固定点。用这种方法,在通过骨锯导向槽78使用骨锯前,外科医生可确保稳定和良好定位的切割导向元件处在应有的位置上。
在图6A、6B中示出了本领域众所周知的测隙规88,其尺寸和形状可切割导向件44中骨锯导向槽78与股骨上的目标位置对准。
如图7中附图标号90所示,本发明的系统还可以包括钻孔导向件。该钻孔导向件90包括一个限定钻孔导路94的钻孔导块92。该钻孔导块92与一个钻孔导向把柄96连接,利用该把柄,在手术期间,外科医生可操纵该钻孔导向件90并使其稳固。钻孔导向管心针98可在一近端连接到钻孔导块92上,同时终止于末端的钻孔导向管心针-股骨接触点100。该钻孔导块可具有至少一个、优选是两个钻孔导向固定点102,利用该固定点,外科医生可在手术期间得到附加的稳定性。本发明的钻孔导向件90在手术期间可具有三个稳定点:该钻孔导向件管心针和该两个钻孔导向件固定点。一旦定位和固定,外科医生可使用该钻孔导向件90,以便于髓内腔的正确定位和精确钻孔。一旦正确地钻孔,本发明的该切割导向件44可插入并精确定位以便于使用。
本发明的系统还可包括一骨锉104。在本领域众所周知的是,该骨锉104可以是圆锥形状,并且该圆锥终端至少一部分具有研磨面。该骨锉104设计成在本发明方法中的切割步骤之后,便于去除任何毛刺、骨赘或者骨头的剩余突出部分。
在本发明的方法中,上面描述的每一部件都按照所述那样被使用,以便系统地制备股骨,用于接收在这里描述的髌股关节置换装置。该钻孔导向件90被正确地定位,并由外科医生使用来对股骨钻孔,且形成用于髓内杆46的接纳点,此后,该钻孔导向件被去除。在如上所述测隙规88的帮助下,本发明系统的切割导向件44随后被定位,并由外科医生使用以便于对骨头进行精确切割,以去除股骨末端的前面,从而在该骨头上提供大体上平坦的接收表面。在去掉切割导向件44后,该股骨植入物10定位并固定附着到股骨前面,其中股骨植入物10的髓内杆22此刻定位在外科医生先前钻出孔内,该孔较早时用于辅助固定切割导向件44。接着,由外科医生把膝盖骨植入物12植入,并放置到与股骨植入物10连接配合位置,从而提供了完全地连接和具有功能的髌股关节置换装置。
在这里描述的系统仪器与系统装置的制造中,部件可整体地形成;或者单独地形成,然后利用本领域众所周知的永久性或者临时连接件来装配。
在优选实施例中,该植入物部件可由可植入级的超高分子量聚乙烯和钴铬钼合金制造。该系统的仪器可由外科手术级不锈钢制造。在本发明原理范围内,该部件可由本领域已知的任何可植入材料或外科可接受的材料制造,这些材料为例如钛合金、陶瓷、复合材料等等。
重要的是要知道,由于说明书仅仅是对本发明的说明,在不脱离仅仅由所附权利要求书限制的发明原理的情况下,可对本发明上述描述形状和结构进行各种修改。
Claims (18)
1.一种用于植入到需要的患者身上的髌股关节置换装置,其包括:
一股骨植入物部件(10),所述股骨植入物部件(10)包括一个骨头工作面(18)和一个上表面(14),所述上表面(14)限定了沿着所述上表面(14)纵轴布置的关节槽(16),所述关节槽(16)具有一个远侧的末端(30),该末端的结构设计成具有上角翻边,以及
膝盖骨的植入物部件(12)包括一个与接合表面(32)相对的固定表面(36),所述接合表面(32)与所述股骨植入物(10)的所述关节槽(16)滑动接合,
其中所述装置具有髌股关节的完整范围的运动;
其中所述股骨植入物部件的关节槽(16)从上表面(14)延续到远端延伸突出部分,该远端延伸突出部分终止于所述末端(30),该末端(30)略微向上倾斜,并具有大概沿着所述关节槽(16)纵向地取向的凹入的形状;以及
所述膝盖骨的植入部件的接合表面(32)具有与所述股骨植入物部件的关节槽(16)大概互补的大概凸状形状。
2.如权利要求1所述的装置,其中所述股骨植入物骨头工作面(18)还包括一个髓内杆(22),所述杆(22)的尺寸和形状设计成用于插入到患者的股骨头腔内。
3.如权利要求1或2所述的装置,其中所述股骨植入物部件的骨头工作面(18)包括
一个沿着股骨植入物部件(10)最外边缘至少一部分圆周布置的底切边缘(24);
至少一个凹槽(20),其尺寸和形状设计成用以接受粘合材料的一部分;
一个粗糙表面(26),所述粗糙表面(26)可选择地额外包括至少一突尖头或者销子(27)和/或多孔涂层;
所述底切边缘(24)、至少一个凹槽(20)和粗糙表面分别地或一起地提供了有助于粘合剂的牢固和持久连接的结构,所述粘合剂用来把股骨植入物部件(10)的下侧面(18)粘接到准备好的股骨远端部分的前表面上。
4.如权利要求1或2所述的装置,其中所述膝盖骨的植入物部件(12)的所述固定表面(36)包括至少一个骨头锚定元件(40),其尺寸和形状设计成用于插入到骨头内。
5.如权利要求4所述的装置,其中所述骨头锚定元件(40)包括围绕所述骨头锚定元件(40)圆周布置的环形保持槽(42)。
6.如权利要求5所述的装置,其中所述膝盖骨的植入物部件的固定表面(36)除了所述骨头锚定元件(40)之外还包括至少一个销钉。
7.一种髌股关节置换系统,包括如权利要求1所述的髌股关节置换装置,一个用于精确引导骨锯的使用来切割患者股骨前表面的切割导向件(44),以及一个用于把骨头钻头精确引导到患者股骨内的钻头导向件(90)。
8.如权利要求7所述的系统,还包括一个测隙规(88),该测隙规的尺寸和形状设计成便于所述切割导向件(44)的定位,以便在使用者切割骨头之前准确地定位骨锯。
9.如权利要求7或8所述的系统,还包括一个骨锉(104),该骨锉的尺寸和形状可插入到进行髌股关节置换的患者身上的外科手术开口内,且至少局部地处理成能够提供用于制备骨头的研磨面,以接纳所述髌股关节置换装置。
10.如权利要求7或8所述的系统,其中所述钻头导向件(90)包括一个用于在所要钻孔的骨头进行定位的钻头导块(92),所述钻头导块(92)限定一个钻头导路(94),该导路的尺寸和形状可滑动地引导钻头,使该钻头从所述钻头导块(92)一侧入口穿入所述钻头导块(92)并从相对的一侧穿出,所述钻头到块(92)可提供稳定的引导,以便于对髓内腔进行钻削。
11.如权利要求10所述的系统,其中所述钻头导块(92)具有一个把柄(96),该把柄设计成使用户能够在手术期间对所述钻头导块(92)定位。
12.如权利要求10所述的系统,其中所述钻头导块(92)具有一个钻头引导管心针(98),所述钻头引导管心针(98)的尺寸和形状能够在患者股骨前表面和钻头引导管心针-股骨接触点(100)之间形成基准触点,其中钻头引导管心针-股骨接触点位于所述钻头引导管心针(98)的近端,所述钻头引导管心针(98)在所述钻头引导件(90)的操作期间为所述钻头导块(92)提供了稳定性。
13.如权利要求12所述的系统,其中所述钻头导块(92)具有至少一个钻头引导定位点,该定位点在手术期间从支靠在骨头上的钻头导块(92)表面伸出,所述定位点为所述钻头导向件(90)提供附加的稳定手段。
14.如权利要求7或8所述的系统,其中所述切割导向件(44)包括:
一个髓内杆(46),该髓内杆的尺寸和形状可插入到患者股骨上的髓内腔内,所述髓内杆(46)在其表面上具有至少一个槽(48),该槽沿着所述髓内杆(46)纵轴取向;
一个切割导引构件,该切割导引构件连接到所述髓内杆(46)的近端,所述切割导引构件沿着所述切割导引构件纵轴分叉,从而限定一个切割导槽,该切割导槽的尺寸和形状设计成在所述切割导向件(44)操作期间可滑动地引导一骨锯,以及
一管心针臂,该管心针臂活动地连接到所述切割导向件(44)的近端,同时其尺寸和形状可在所述管心针臂的管心针-股骨接触点和患者股骨前表面之间形成稳定接触点。
15.如权利要求14所述的系统,其中所述切割导向件(44)包括至少一个锚定导向件,该锚定导向件限定了一个相应的锚定导向件入口,所述至少一个锚定导向件位于骨锯导向元件上,以便提供锚定点,通过该锚定点,外科医生可在患者骨头上钻锚定孔,并可穿过所述锚定导向件入口把锚定件固定到患者的所述骨头上,以在手术中提供稳定性,所述管心针臂以及所述锚定导向件为所述切割导向件(44)提供了多个稳定点。
16.一种用于把髌股关节置换装置植入在患者体内的成套工具,所述成套工具包括:
如权利要求1所述的髌股关节置换装置,
在患者股骨内髓内腔进行钻削的操作中对钻头进行稳定和定位的钻头导向件(90),以及
一个切割导向件(44),该切割导向件用于在切割患者股骨前表面操作中使骨锯片稳定和定位。
17.如权利要求16所述的成套工具,还包括一个骨锉(104),用于制备患者股骨表面,以接纳所述髌股关节置换装置。
18.如权利要求17所述的成套工具,还包括一个冲击器,该冲击器用于把所述钻头导向件(90)、所述切割设备、以及所述髌股关节置换装置等部件强制地插入到所制备的患者股骨表面中。
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US60/356,876 | 2002-02-14 | ||
PCT/US2003/004621 WO2003068119A2 (en) | 2002-02-14 | 2003-02-14 | Method and instrumentation for patello-femoral joint replacement |
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CN1633265A CN1633265A (zh) | 2005-06-29 |
CN1633265B true CN1633265B (zh) | 2010-12-08 |
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EP (1) | EP1480582B1 (zh) |
JP (2) | JP4761240B2 (zh) |
CN (1) | CN1633265B (zh) |
AU (1) | AU2003219773B2 (zh) |
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ES (1) | ES2391148T3 (zh) |
PT (1) | PT1480582E (zh) |
WO (1) | WO2003068119A2 (zh) |
Families Citing this family (58)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8480754B2 (en) * | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US7635390B1 (en) | 2000-01-14 | 2009-12-22 | Marctec, Llc | Joint replacement component having a modular articulating surface |
US6702821B2 (en) | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US7708741B1 (en) | 2001-08-28 | 2010-05-04 | Marctec, Llc | Method of preparing bones for knee replacement surgery |
JP4761240B2 (ja) * | 2002-02-14 | 2011-08-31 | バイオメット スペイン オーソピーディクス エス.エル. | 膝蓋大腿関節置換部材および膝蓋大腿関節置換システム |
US20050171545A1 (en) * | 2004-01-30 | 2005-08-04 | Howmedica Osteonics Corp. | Knee computer-aided navigation instruments |
US8852195B2 (en) | 2004-07-09 | 2014-10-07 | Zimmer, Inc. | Guide templates for surgical implants and related methods |
EP1881791A2 (en) | 2005-05-20 | 2008-01-30 | Smith & Nephew, Inc. | Patello-femoral joint implant and instrumentation |
US20070021838A1 (en) * | 2005-07-22 | 2007-01-25 | Dugas Jeffrey R | Site specific minimally invasive joint implants |
US8070821B2 (en) * | 2005-12-27 | 2011-12-06 | Howmedica Osteonics Corp. | Hybrid femoral implant |
AU2007222102B2 (en) * | 2006-01-23 | 2013-09-26 | Smith & Nephew Inc. | Patellar components |
GB0606837D0 (en) * | 2006-04-05 | 2006-05-17 | Depuy Int Ltd | Cutting guide instrument |
US7695520B2 (en) | 2006-05-31 | 2010-04-13 | Biomet Manufacturing Corp. | Prosthesis and implementation system |
US20080015602A1 (en) * | 2006-06-22 | 2008-01-17 | Howmedica Osteonics Corp. | Cutting block for bone resection |
US8187280B2 (en) | 2007-10-10 | 2012-05-29 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8163028B2 (en) | 2007-01-10 | 2012-04-24 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
EP2104474B1 (en) | 2007-01-10 | 2012-08-29 | Biomet Manufacturing Corp. | Knee joint prosthesis system |
US8328873B2 (en) | 2007-01-10 | 2012-12-11 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8562616B2 (en) | 2007-10-10 | 2013-10-22 | Biomet Manufacturing, Llc | Knee joint prosthesis system and method for implantation |
US7582118B2 (en) * | 2007-02-06 | 2009-09-01 | Zimmer Technology, Inc. | Femoral trochlea prostheses |
US8128704B2 (en) | 2007-02-06 | 2012-03-06 | Zimmer, Inc. | Femoral trochlea prostheses |
US8328874B2 (en) | 2007-03-30 | 2012-12-11 | Depuy Products, Inc. | Mobile bearing assembly |
US8147558B2 (en) | 2007-03-30 | 2012-04-03 | Depuy Products, Inc. | Mobile bearing assembly having multiple articulation interfaces |
US8764841B2 (en) | 2007-03-30 | 2014-07-01 | DePuy Synthes Products, LLC | Mobile bearing assembly having a closed track |
US8147557B2 (en) | 2007-03-30 | 2012-04-03 | Depuy Products, Inc. | Mobile bearing insert having offset dwell point |
US8142510B2 (en) | 2007-03-30 | 2012-03-27 | Depuy Products, Inc. | Mobile bearing assembly having a non-planar interface |
JP5171193B2 (ja) | 2007-09-28 | 2013-03-27 | 株式会社 レキシー | 人工膝関節置換手術の術前計画用プログラム |
EP2271287A1 (en) * | 2008-02-06 | 2011-01-12 | Exactech Inc. | Femoral componment of knee prosthesis, the femoral component having anterior/posterios claw(s) for digging into bone and/or a raised rib with a bulbous terminus |
US8226658B2 (en) * | 2008-05-09 | 2012-07-24 | Depuy Products, Inc. | Instrument for guiding resection of a greater tubercle |
US8092544B2 (en) * | 2008-06-30 | 2012-01-10 | Depuy Products, Inc. | Implantable patella component having a thickened superior edge |
US7972383B2 (en) * | 2008-06-30 | 2011-07-05 | Depuy Products, Inc. | Implantable patella component having a thickened superior edge |
US8480753B2 (en) * | 2009-02-27 | 2013-07-09 | Howmedica Osteonics Corp. | Spot facing trochlear groove |
US20100222782A1 (en) * | 2009-02-27 | 2010-09-02 | Howmedica Osteonics Corp. | Spot facing trochlear groove |
US7984718B2 (en) * | 2009-09-29 | 2011-07-26 | Joshua C. Harrison | Method for cleaning or limiting adhesive |
JP2011078529A (ja) * | 2009-10-06 | 2011-04-21 | Biomet Japan Inc | 人工膝関節設置用ジグ |
GB2475491A (en) * | 2009-11-18 | 2011-05-25 | Biomet Uk Ltd | Alignment tool for a femoral drill guide |
RU2012157648A (ru) | 2010-06-08 | 2014-07-20 | Смит Энд Нефью, Инк. | Компонент имплантата и способ имплантации |
WO2012071609A1 (en) * | 2010-11-29 | 2012-06-07 | Bruce Lenord White | Device and method for attaching a prosthesis to a bone |
EP3141196B1 (en) | 2011-05-19 | 2020-04-08 | The Cleveland Clinic Foundation | Apparatus for providing a reference indication to a patient tissue |
JP2012045417A (ja) * | 2011-10-31 | 2012-03-08 | Lexi:Kk | 人工膝関節置換手術用治具 |
WO2014131007A1 (en) * | 2013-02-25 | 2014-08-28 | Stryker Corporation | Anatomically guided instrumentation for trochlear groove replacement |
US9949837B2 (en) | 2013-03-07 | 2018-04-24 | Howmedica Osteonics Corp. | Partially porous bone implant keel |
US9289306B2 (en) | 2013-03-15 | 2016-03-22 | Catalyst Orthopaedics Llc | Humeral arthroplasty |
USD735338S1 (en) | 2013-10-31 | 2015-07-28 | Catalyst Orthopaedics Llc | Humeral component for shoulder arthroplasty |
JP5710735B2 (ja) * | 2013-11-20 | 2015-04-30 | 株式会社 レキシー | 人工膝関節置換手術用治具 |
US9655727B2 (en) | 2013-12-12 | 2017-05-23 | Stryker Corporation | Extended patellofemoral |
CN103976808A (zh) * | 2014-05-28 | 2014-08-13 | 上海市杨浦区中心医院 | 单髁置换股骨假体植入指示器 |
JP6556432B2 (ja) * | 2014-08-25 | 2019-08-07 | 京セラ株式会社 | 人工膝関節置換術用手術器具 |
US20180116804A1 (en) * | 2015-02-08 | 2018-05-03 | Mahmoud Alm EL Din HAFEZ | A tool for custom-made instruments and implant for artificial knee joint of dogs |
CN105411648B (zh) * | 2015-12-30 | 2018-05-22 | 孙朝军 | 一种股骨髓外定位截骨模板 |
EP3459064A1 (en) | 2016-05-16 | 2019-03-27 | Arthrex Inc | Knee joint capsular disruption and repair |
US10893948B2 (en) | 2017-11-02 | 2021-01-19 | Howmedica Osteonics Corp. | Rotary arc patella articulating geometry |
CN108210130B (zh) * | 2018-01-08 | 2023-09-08 | 四川大学华西医院 | 距骨假体 |
EP3873381A4 (en) * | 2018-10-29 | 2022-07-27 | Arthrosurface Incorporated | ARTICULATING IMPLANTS WITH RECESSES |
CN111110313A (zh) * | 2020-01-13 | 2020-05-08 | 陈立军 | 一种用于粗隆柄型人工股骨头置换术的截骨导航工具 |
CN113456167B (zh) * | 2021-07-01 | 2022-08-30 | 珠海赛纳三维科技有限公司 | 一种截骨导板及其成型方法 |
EP4426235A1 (en) * | 2021-11-03 | 2024-09-11 | Actuos, LLC | Unicompartmental knee arthroplasty systems and methods |
CN116059013B (zh) * | 2023-03-29 | 2023-06-23 | 中国人民解放军联勤保障部队第九二〇医院 | 用于植入髌骨关节的可吸收囊式间隔器及其制造方法 |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4944756A (en) * | 1988-02-03 | 1990-07-31 | Pfizer Hospital Products Group | Prosthetic knee joint with improved patellar component tracking |
FR2740326A1 (fr) * | 1995-10-31 | 1997-04-30 | Osteal Medical Lab | Prothese femoro-patellaire du genou |
US5702459A (en) * | 1994-05-13 | 1997-12-30 | Smith & Nephew Richards France | Trochlea implant for a femoro-patellar prosthesis |
Family Cites Families (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3506982A (en) * | 1965-06-21 | 1970-04-21 | Cleveland Clinic | Endoprosthetic joints |
GB1305391A (zh) * | 1969-02-18 | 1973-01-31 | ||
US3694821A (en) * | 1970-11-02 | 1972-10-03 | Walter D Moritz | Artificial skeletal joint |
US3774244A (en) * | 1972-02-08 | 1973-11-27 | Relief Ruptured And Crippled S | Knee-joint prosthesis |
US3806961A (en) * | 1972-02-16 | 1974-04-30 | Sulzer Ag | Phosthetic patella implant |
US3760427A (en) * | 1972-03-24 | 1973-09-25 | R Schultz | Surgically implantable prosthetic joint |
US3878566A (en) | 1974-05-08 | 1975-04-22 | Richards Mfg Co | Patello-femoral prosthesis |
US4085466A (en) * | 1974-11-18 | 1978-04-25 | National Research Development Corporation | Prosthetic joint device |
US4007495A (en) * | 1976-05-28 | 1977-02-15 | Frazier Calvin H | Patello-femoral prothesis |
US4052753A (en) * | 1976-08-02 | 1977-10-11 | Dedo Richard G | Knee spacer and method of reforming sliding body surfaces |
US4151615A (en) * | 1977-06-29 | 1979-05-01 | Hall Thomas D | Prosthetic patello-femoral joint |
US4285070A (en) * | 1978-06-05 | 1981-08-25 | Minnesota Mining And Manufacturing Company | Prosthetic device |
USD272648S (en) * | 1981-08-03 | 1984-02-14 | Zimmer, Inc. | Reamer/rasp tool with disposable, debris retaining cutting surface |
US4524766A (en) * | 1982-01-07 | 1985-06-25 | Petersen Thomas D | Surgical knee alignment method and system |
US4474177A (en) * | 1983-03-09 | 1984-10-02 | Wright Manufacturing Company | Method and apparatus for shaping a distal femoral surface |
GB8501907D0 (en) * | 1985-01-25 | 1985-02-27 | Thackray C F Ltd | Surgical instruments |
US4787383A (en) * | 1985-12-19 | 1988-11-29 | Howmedica, Inc. | Prosthetic knee implantation |
US4759350A (en) * | 1986-10-17 | 1988-07-26 | Dunn Harold K | Instruments for shaping distal femoral and proximal tibial surfaces |
US4952213A (en) * | 1989-02-03 | 1990-08-28 | Boehringer Mannheim Corporation | Tibial cutting guide |
GB8912684D0 (en) * | 1989-06-02 | 1989-07-19 | Thackray Chas F | Improvements in and relating to patellar components |
US4979957A (en) * | 1989-09-11 | 1990-12-25 | Zimmer, Inc. | Textured prosthetic implant |
US5024670A (en) * | 1989-10-02 | 1991-06-18 | Depuy, Division Of Boehringer Mannheim Corporation | Polymeric bearing component |
GB9018737D0 (en) * | 1990-08-28 | 1990-10-10 | Goodfellow John W | Phosphetic patellar components |
JP2959867B2 (ja) | 1991-04-10 | 1999-10-06 | キヤノン株式会社 | プロセスカートリッジ再生方法 |
CH685369A5 (de) * | 1991-07-05 | 1995-06-30 | Sulzer Ag | Patella-Prothese. |
US5176684A (en) * | 1992-02-20 | 1993-01-05 | Dow Corning Wright | Modular shaping and trial reduction guide for implantation of posterior-stabilized femoral prosthesis and method of using same |
US5445642A (en) * | 1992-09-01 | 1995-08-29 | Depuy Inc. | Method for installing a femoral component |
US5350380A (en) * | 1993-01-15 | 1994-09-27 | Depuy Inc. | Method for securing a ligament replacement in a bone |
US5397360A (en) * | 1993-02-11 | 1995-03-14 | Osteonics Corp. | Modular components for prosthetic implants |
US5358529A (en) * | 1993-03-05 | 1994-10-25 | Smith & Nephew Richards Inc. | Plastic knee femoral implants |
US5720752A (en) * | 1993-11-08 | 1998-02-24 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
GB9405746D0 (en) * | 1994-03-23 | 1994-05-11 | Howmedica | Prosthetic patello femoral joint assembly |
US5643272A (en) * | 1994-09-02 | 1997-07-01 | Hudson Surgical Design, Inc. | Method and apparatus for tibial resection |
US5571196A (en) * | 1994-10-24 | 1996-11-05 | Stein; Daniel | Patello-femoral joint replacement device and method |
US5824098A (en) | 1994-10-24 | 1998-10-20 | Stein; Daniel | Patello-femoral joint replacement device and method |
US5601550A (en) * | 1994-10-25 | 1997-02-11 | Esser; Rene D. | Pelvic pin guide system for insertion of pins into iliac bone |
US5556433A (en) | 1994-12-01 | 1996-09-17 | Johnson & Johnson Professional, Inc. | Modular knee prosthesis |
US5593450A (en) * | 1995-02-27 | 1997-01-14 | Johnson & Johnson Professional, Inc. | Oval domed shaped patella prosthesis |
US5613971A (en) * | 1995-08-11 | 1997-03-25 | Depuy Inc. | Ratcheting tibial and femoral guide |
US5662656A (en) * | 1995-12-08 | 1997-09-02 | Wright Medical Technology, Inc. | Instrumentation and method for distal femoral sizing, and anterior and distal femoral resections |
US5683398A (en) * | 1996-02-20 | 1997-11-04 | Smith & Nephew Inc. | Distal femoral cutting block assembly |
US6702821B2 (en) * | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
JP4319337B2 (ja) * | 2000-07-27 | 2009-08-26 | 泉工医科工業株式会社 | 人工膝関節の大腿骨コンポーネント |
US6514259B2 (en) * | 2001-02-02 | 2003-02-04 | Carnegie Mellon University | Probe and associated system and method for facilitating planar osteotomy during arthoplasty |
JP4761240B2 (ja) | 2002-02-14 | 2011-08-31 | バイオメット スペイン オーソピーディクス エス.エル. | 膝蓋大腿関節置換部材および膝蓋大腿関節置換システム |
-
2003
- 2003-02-14 JP JP2003567307A patent/JP4761240B2/ja not_active Expired - Fee Related
- 2003-02-14 PT PT03716047T patent/PT1480582E/pt unknown
- 2003-02-14 US US10/366,415 patent/US20030181984A1/en not_active Abandoned
- 2003-02-14 WO PCT/US2003/004621 patent/WO2003068119A2/en active Application Filing
- 2003-02-14 ES ES03716047T patent/ES2391148T3/es not_active Expired - Lifetime
- 2003-02-14 DK DK03716047.0T patent/DK1480582T3/da active
- 2003-02-14 EP EP03716047A patent/EP1480582B1/en not_active Expired - Lifetime
- 2003-02-14 CN CN038040182A patent/CN1633265B/zh not_active Expired - Fee Related
- 2003-02-14 AU AU2003219773A patent/AU2003219773B2/en not_active Ceased
-
2009
- 2009-01-14 JP JP2009005913A patent/JP2009131638A/ja active Pending
- 2009-09-03 US US12/553,187 patent/US8226726B2/en not_active Expired - Fee Related
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4944756A (en) * | 1988-02-03 | 1990-07-31 | Pfizer Hospital Products Group | Prosthetic knee joint with improved patellar component tracking |
US5702459A (en) * | 1994-05-13 | 1997-12-30 | Smith & Nephew Richards France | Trochlea implant for a femoro-patellar prosthesis |
FR2740326A1 (fr) * | 1995-10-31 | 1997-04-30 | Osteal Medical Lab | Prothese femoro-patellaire du genou |
Also Published As
Publication number | Publication date |
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EP1480582A2 (en) | 2004-12-01 |
CN1633265A (zh) | 2005-06-29 |
JP2009131638A (ja) | 2009-06-18 |
JP4761240B2 (ja) | 2011-08-31 |
ES2391148T3 (es) | 2012-11-22 |
AU2003219773A1 (en) | 2003-09-04 |
WO2003068119A2 (en) | 2003-08-21 |
EP1480582B1 (en) | 2012-07-18 |
JP2005517470A (ja) | 2005-06-16 |
US8226726B2 (en) | 2012-07-24 |
US20090326660A1 (en) | 2009-12-31 |
DK1480582T3 (da) | 2012-10-22 |
AU2003219773B2 (en) | 2007-02-01 |
WO2003068119A3 (en) | 2003-12-04 |
US20030181984A1 (en) | 2003-09-25 |
EP1480582A4 (en) | 2008-12-03 |
PT1480582E (pt) | 2012-10-02 |
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