CN1655739A - 用于膝关节成形术的模块化的股骨部件 - Google Patents
用于膝关节成形术的模块化的股骨部件 Download PDFInfo
- Publication number
- CN1655739A CN1655739A CNA038119102A CN03811910A CN1655739A CN 1655739 A CN1655739 A CN 1655739A CN A038119102 A CNA038119102 A CN A038119102A CN 03811910 A CN03811910 A CN 03811910A CN 1655739 A CN1655739 A CN 1655739A
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- Prior art keywords
- femoral component
- femur
- cutting
- artificial limb
- articular surface
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
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- 210000000629 knee joint Anatomy 0.000 claims description 36
- 210000002303 tibia Anatomy 0.000 claims description 19
- 210000004417 patella Anatomy 0.000 claims description 18
- 210000000988 bone and bone Anatomy 0.000 abstract description 11
- 239000007943 implant Substances 0.000 abstract 2
- 230000000399 orthopedic effect Effects 0.000 abstract 1
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Abstract
一种用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统,其包括适于配合经切削的关节表面的股骨部件和固定元件。当股骨部件与股骨的经切削的关节表面配合时,以及当第一固定元件穿过经切削的股骨表面的中部侧或侧部侧时,股骨部件的内表面构造成连接第一固定元件。该股骨部件可以以单件系统实现。本发明也公开了配套股骨部件(例如锥形或带有与凹槽互锁的边缘)。
Description
技术领域
本发明涉及一种用于全膝关节成形术的股骨部件。
背景技术
在典型的膝关节成形术操作过程中,为了形成经切削的股骨部分,用手术装置切削股骨,所述经切削的股骨部分也称为经切削的股骨。典型地具有金属盖形式的股骨部件然后放置到该经切削的股骨上。股骨部件典型地设计成与胫骨部件相互作用并与其连接,胫骨部件固定在经切削的胫骨上。
在关节成形术操作过程中,股骨部件通过切口插入到经切削的股骨上。股骨部件越大,需要的切口就越大,从而延长病人的愈合期,因此增加了手术带来的疼痛和造成病人的康复期延长。
图1和图2中示出的是假肢股骨部件10的一个实施例,其中该股骨部件具有内表面12和外表面14。内表面12由多个基本上平坦的交叉面组成,其中所述交叉面对应于股骨上分离的切面。栓16a-b设计成植入到经切削的股骨中,从而将股骨部件锚固到股骨上。外表面14连接胫骨部件。
然而,由于所述栓使用压配合固定到经切削的股骨上并从外表面突出,因此增加了股骨部件的体积和尺寸,所以在手术过程中需要更大的切口。
发明内容
因此,为解决上述技术问题,提供一种用于膝关节成形术操作过程中的股骨部件以及用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统。该股骨部件体积不大,不需要在手术过程中产生大切口。该股骨部件紧密地附着在经切削的股骨上,并且便于固定到上面。
本发明解决技术问题的技术方案是这样的,即提供一种用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统,该假肢系统包括:最终用途的股骨部件,其具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面。该最终用途股骨部件进一步包括:第一部分,其包括关节接合表面的第一断面;第二部分,其包括关节接合表面的第二断面,第二部分选择性地与第一部分配合;和用于选择性地连接第一部分和第二部分的装置。
在上述股骨膝关节假肢系统中,第一部分包括髌骨,第二部分包括胫骨。
在上述股骨膝关节假肢系统中,第一部分包括基本上U形的内髁,第二部分包括基本上U形的外髁。
在上述股骨膝关节假肢系统中,用于选择性地连接第一部分和第二部分的装置包括在第一部分和第二部分之间延伸的螺钉。
在上述股骨膝关节假肢系统中,其进一步包括用于将股骨部件固定到股骨末端经切削的关节表面的装置。
在上述股骨膝关节假肢系统中,用于将股骨部件固定到股骨末端经切削的关节表面的装置包括螺钉。
在上述股骨膝关节假肢系统中,第一部分位于第二部分的侧部上。
在上述股骨膝关节假肢系统中,第一部分安装在第二部分的上方。
在上述股骨膝关节假肢系统中,第一部分具有隆起和凹槽,它们对应于第二部分中的锁定隆起和凹槽。
在上述股骨膝关节假肢系统中,股骨部件的第二部分包括突起,其构造成选择性地配合第一部分。
在上述股骨膝关节假肢系统中,用于选择性地连接第一部分和第二部分的装置包括螺钉。
在上述股骨膝关节假肢系统中,多个突起从第二部分延伸并选择性地配合在第一部分中的多个孔各个孔中。
根据本发明的另一方面,还提供一种用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统,该假肢系统包括:最终用途的股骨部件,其具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面。该最终用途的股骨部件进一步包括:第一部分,其包括关节接合表面的第一断面;第二部分,其包括关节接合表面的第二断面,第一部分选择性地连接第二部分。
在上述股骨膝关节假肢系统中,第一部分包括髌骨,第二部分包括胫骨。
在上述股骨膝关节假肢系统中,第一部分包括基本上U形的内髁,第二部分包括基本上U形的外髁。
在上述股骨膝关节假肢系统中,用于选择性地连接第一部分和第二部分的装置包括在第一部分和第二部分之间延伸的螺钉。
根据本发明进一步的方面,还提供一种用于重修股骨末端经切削的关节表面的膝关节假肢的股骨部件,该股骨部件包括:外髁,其具有基本上U形的构造,并具有侧部侧和相对的中部侧,每侧都在前端和相对的后端之间延伸;和内髁,其具有基本上U形的构造,并具有侧部侧和相对的中部侧,每侧都在前端和相对的后端之间延伸,内髁的侧部侧构造成配合外髁的中部侧,从而在内髁和外髁之间形成槽,其中内髁选择性地连接到外髁。
根据本发明更进一步的方面,还提供一种用于重修股骨末端经切削的关节表面的膝关节假肢的最终用途股骨部件,该股骨部件包括:髌骨,其构造成髌骨的至少一部分对应于经切削的关节表面的前部;和胫骨,其构造成选择性地连接髌骨,从而组合的髌骨和胫骨共同形成最终用途股骨部件,该股骨部件具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面。
在上述股骨部件中,胫骨具有至少一个从那里伸出的突起。
在上述股骨部件中,髌骨具有至少一个用于容纳突起的孔。
附图说明
现在将参考附图论述本发明的各种实施例。应当理解,这些附图仅仅描述本发明的典型实施例,因此并不意味着限定本发明的范围。
图1是现有技术股骨部件的前透视图;
图2是图1所示的现有技术股骨部件的后透视图;
图3是本发明股骨部件的后透视图,该股骨部件的特征在于:形成于其内表面上的至少一个螺纹孔,所述孔构造成容纳通过经切削的股骨延伸的固定元件;可选的第二螺纹孔和固定元件如虚线所示;所述固定元件可以延伸通过内侧和/或外侧;
图4是本发明另一股骨部件的后透视图,该股骨部件的特征在于:至少一个啮合、接收凹窝,其中充满接收、啮合材料,以接收和啮合至少一个通过经切削的股骨延伸的固定元件;可选的附加接收表面和固定元件(多个)如虚线所示;
图5是图3的股骨部件安装到经切削的股骨上的透视图;虚线示出了用于股骨部件的可选板29的接收表面66;
图6是图3和图5的股骨部件安装到图5经切削的股骨上的透视图,股骨部件具有通过经切削的股骨延伸并进入股骨部件的固定元件(主要以虚线示出),从而将股骨部件固定在股骨上。
图7是股骨部件另一实施例的侧向横截面图,其中股骨部件具有向内的突出边缘,该边缘显示为固定在经切削的股骨的对应切槽中,从而将股骨部件固定在经切削的股骨中;
图8是具有锥形内表面的股骨部件的透视图,该锥形内表面固定到具有互补锥形配合表面的经切削的股骨上,从而将股骨部件固定到经切削的股骨上;
图8a是安装到经切削的股骨上的股骨部件另一实施例的侧向横截面图,其中股骨部件具有不倾斜的弯曲表面,这说明具有向内的突出边缘的股骨部件可以具有各种不同的内表面。
图9是从侧部向中间分离的两件套股骨部件的另一实施例的透视图;
图10是图9所示的股骨部件安装后状态的透视图;
图11是具有啮合齿并侧部向中部分离的两件套股骨部件的透视图;
图12是从前后分离的两件套股骨部件的透视图;
图13是图12所示的股骨部件安装后状态的透视图;
图14是从前后分离并具有啮合齿的股骨部件的透视图;
图15A-16B显示了本发明另一两件套股骨部件的安装和分解图;
具体实施例方式
图3-6描述了用于膝关节成形术的股骨膝关节假肢系统的例子,其中股骨部件能够容易地通过切口从内侧或外侧滑动到股骨切削部分60上(图5)。固定元件,例如螺钉或螺栓然后可以通过股骨一直插入,直到接触股骨部件。该操作过程最低限定地受创,不需要图1和图2中具有栓16a-b的股骨部件那么大的切口。螺钉、螺栓或其它元件牢固地将股骨部件固定在经切削的股骨上,而不是仅仅依靠压配合。
图7-8A描述了用于膝关节成形术的股骨部件70、80,其中配合关系,例如配合边缘78a-b和槽79a-b(图7)或配合锥形表面(图8),将股骨部件保持在经切削的股骨上。
图9-14描述了用于膝关节成形术的可连接的两件套最终用途的股骨部件102、131、161和191,其中这两个部分能够容易地、独立地通过切口从内侧或外侧进入,然后连接和安装到股骨切削部分。可选地,一个部分可以安装到股骨切削部分,接着另一个部分安装到那里。这两个部分也可以先安装,然后将它们连接在一起。固定元件,例如螺钉或螺栓然后可以通过股骨一直插入,直到接触股骨部件。可选地,可以使用骨粘合剂将股骨部件粘合到经切削的股骨上。
连接元件,例如螺钉或螺栓,将股骨部件的一部分和另一部分连接在一起。该操作过程最低限度地受创,不需要象单件部件那样大的切口,因为股骨部件的一部分可以通过切口置入,随后置入股骨部件的另一部分。股骨部件的单独件本身也可以使用,而不需要相应的配合件,例如当该部件仅仅一部分(例如胫骨部分)需要特定处理时。
图15A-16B描述了用于膝关节成形术的两件套最终用途的股骨部件210,其中这两个部分能够容易地、独立地通过切口从内侧或外侧进入,然后连接和安装到股骨切削部分。可选地,一个部分可以安装到股骨切削部分,接着另一个部分安装到那里。从一个部分突出的整个突起将股骨部件的一部件和另一部件连接在一起。该操作过程最低限度地受创,不需要象单件部件那样大的切口,因为股骨部件的一部分可以通过切口置入,随后置入股骨部件的另一部分。使用栓将该部件锚固在股骨切削部分上。
现在将更详细地论述这些股骨部件中的每一个,首先参考图3、5和6。图3是股骨膝关节假肢系统20的后透视图,该假肢系统用于重修股骨60末端62的经切削的关节表面64。如图5所示,股骨60末端62的经切削的关节表面64具有内侧61和相对的外侧63。
图3的假肢系统20包括:(i)U形股骨部件22,其具有(i)适于配合经切削的表面64的内表面26和(ii)相对的关节接合表面24;(ii)第一固定元件,例如具有螺纹端的延长螺钉36;和(iii)形成于股骨部件22的内表面26上的螺纹孔32。
当股骨部件22和股骨60的经切削的关节表面64配合在一起以及当第一固定元件36穿过经切削的关节表面64的内侧或外侧时,螺纹孔32是在股骨部件22的内表面26上形成的、用于连接第一固定元件36和股骨部件22的部件的一个示例。
螺纹孔32的角度定位成当股骨部件22与股骨60的经切削的关节表面配合在一起时,螺钉36能够穿过经切削的关节表面64的内侧61或外侧63,从而与螺纹孔32螺纹啮合(参见图5-6)。
股骨部件22包括连接到基本上U形的外髁30的基本上U形的内髁28。股骨部件具有前端35和后端37。内髁28连接到外髁30,从而延长槽39形成于外髁和内髁之间。然而在另一个实施例中,本发明的股骨部件仅包括基本上U形的外髁或基本上U形的内髁,这取决于特定的操作。
股骨部件22的可选板29可以用来提供不同的表面区域,以用于啮合假肢上的互补表面。
进一步如图3所示,系统20包括(i)可选的第二固定元件38;和(ii)当股骨部件22和股骨60的经切削的关节表面64配合在一起以及当第二固定元件38穿过经切削的关节表面64的内侧或外侧时,在股骨部件22的内表面26上形成的用于连接第二固定元件38和股骨部件22的部件(例如第二螺纹孔34)。
可选地,如果需要,另一固定元件可以伸入中部、外表面,进入邻近孔32的另一螺纹孔。
螺栓、螺钉、销或能够穿过股骨60从而啮合股骨部件22的内表面26的其它形式的固定装置都是本发明固定元件的示例。一个或多个固定元件36、38可以分别连接至一个或多个孔32、34。在一个实施例中,这些固定元件互相位于股骨部件的相对侧,如图3所示。如上文所述,在另一个实施例中,固定元件安装在股骨部件的相同侧(也参见图4)。这些固定元件可以通过具有螺纹孔(图3)或通过在内表面42上放置接收、啮合材料来啮合内表面26,其中固定装置可以穿过该材料并与之啮合,现在将参考图4进行论述。
图4是另一股骨膝关节假肢系统40的后透视图,其包括:(i)股骨部件41,其包括适于配合经切削的关节表面64的内表面42和相对的关节接合表面43;(ii)第一固定元件,例如具有螺纹端的延长螺钉52;和(iii)形成于股骨部件41的内表面42上的凹窝48。
股骨部件41具有至少一个凹窝48(其中充满啮合、接收材料49),该凹窝容纳至少一个通过经切削的股骨60延伸的固定元件52;可选的附加凹窝50和附加的对应固定元件54如图中虚线所示。充满该材料的凹窝48、50是形成于股骨部件41的内表面42上、用于连接固定元件和股骨部件的补充示例。
凹窝48、50形成于股骨部件22的内表面26上并充满啮合、接收材料,例如粘合剂(例如聚甲基丙烯酸甲酯)或其它材料,该材料足够柔软从而接收固定元件,同时也能够将固定元件保持在其中。该接收、啮合材料的其它例子包括柔性聚合体,例如迭尔林(Delrin聚甲醛树酯)或聚醚醚酮(polyetheretherketetone),其能够接收和变形为第一固定元件的形状。
在一个实施例中,除了使用螺钉或螺栓将股骨部件固定到假肢上,还可以使用骨粘合剂来进一步增强股骨部件与经切削的股骨的粘附。骨粘合剂可以在股骨部件的安装之前和/或安装时应用。例如,股骨部件可以部分地固定,然后可使用注射器或其它形式的输送管将骨粘合剂注入股骨部件和股骨之间。另外,多孔或纤维材料例如线网可以固定到股骨部件22的内表面26,从而促进股骨部件22和经切削的股骨60之间的骨生长和提供用于将骨粘合剂固定在股骨部件和经切削的股骨之间的表面区域。
图5是图3的股骨部件22安装到经切削的股骨60上的透视图。用于股骨部件的可选板29的互补接收表面66如图中虚线所示。
图6是图3和图5的股骨部件22安装到图5经切削的股骨60上的透视图,股骨部件22具有通过经切削的股骨60延伸并进入股骨部件22的固定元件36(主要以虚线示出),从而将股骨部件22固定在股骨60上。该固定紧紧地将股骨部件22拉向股骨60并拉在股骨60上。
图5和6也描述了作为手术过程一部分的重修股骨表面的方法,其包括:(i)切削股骨60末端62的关节接合表面64,从而形成在中侧61和后侧63之间延伸的经切削的关节结合表面64;(ii)将具有内表面26的股骨部件22安装到经切削的关节表面64至少一部分上;(iii)使第一固定元件36穿过经切削的关节表面64的外侧或内侧;和(iv)将第一固定元件连接到股骨部件22,从而第一固定元件36将股骨部件22固定到经切削的关节表面64。
在一个实施例中,切削关节表面的操作包括切削股骨末端的内髁和外髁。在图5中,股骨60的内外髁已经被切削。如上文所述,股骨部件22包括连接基本上U形的内髁的基本上U形的外髁。
在另一个实施例中,切削关节表面64的操作包括仅仅切削股骨60末端62的内髁或外髁。在该可替换的实施例中,将股骨部件安装到经切削的关节表面64至少一部分上的操作包括为unicondular外髁或内髁的股骨部件。
在一个实施例中,使第一固定元件36穿过经切削的关节表面64的外侧部或中侧部的操作包括:(i)穿过股骨钻孔;和(ii)使第一固定元件36穿过该孔。所述孔能够以斜角α穿过股骨,如图3和6所示。通过在邻近股骨的皮肤上开口,正确地定向管状准直导向件,然后用钻头穿过准直导向件打孔,从而得到该孔。可选地,最初不在其中打孔,而是第一固定元件通过股骨沿角α推进(例如穿过用于定位第一固定元件的管状准直导向件推进)。在一个实施例中,角α在大约15至45度的范围,例如大约30度,但也可以是其它各种不同的角度,只要这些角度能够获得将股骨部件固定到股骨上的效果。
重修股骨表面的方法进一步包括:(i)使第二固定元件38(图3)穿过经切削的关节表面的外侧或中侧;和(ii)将第二固定元件38连接到股骨部件22,从而第二固定元件38将股骨部件22固定到经切削的关节表面。
如上文所述,图7-8A描述了股骨部件70,80的示例,其中股骨部件和经切削的股骨之间的配合关系将股骨部件保持在经切削的股骨上。该假肢股骨部件能够以各种可替换的构造出现。
图7是股骨部件70的侧向横截面图,该股骨部件包括“U”形主体71,该主体具有内表面73、外表面75、前端77a和后端77b,以及前后端向内突出的边缘78a、78b,其分别从主体71的内表面73伸出。如图所示,边缘78a-b安装于经切削的股骨74上切开的对应槽79a,79b中,从而将股骨部件70固定到股骨74的切削部分72。在一个实施例中,主体71具有与图3、5和6中所示的股骨部件22相同或基本上相同的构造,但不同之处在于其具有分别从前后端77a-b的内表面73向内突出的边缘78a-b。凹槽79a形成于股骨的前表面72a,而凹槽79b形成于股骨的后表面72b。
边缘78a-b可以从一个或多个踝向内突出。例如,一个后边缘78b可以从内髁延伸,而另一个后边缘78被从外髁延伸。可选地,后边缘78b可以从内外髁延伸。图7是后边缘78b从外髁和/或内髁的内表面延伸的典型示例。
类似地,前边缘78a可以从外髁或内髁的前端77a的内表面73延伸,或作为单独的边缘同时从内髁前端和外髁前端的内表面延伸。
因此,在一个实施例中,股骨部件70包括:(i)外髁(例如类似于图3的踝),其具有基本上U形的构造,并具有内表面76和相对的外表面77,每个表面都在前端73和相对的后端75之间延伸;和(ii)内髁(例如类似于图3的踝28),其具有基本上U形的构造,并具有内表面76和相对的外表面77,每个表面都在前端73和相对的后端75之间延伸,该内髁连接到外髁,从而在内髁和外髁之间形成延长槽。
第一啮合边缘78a在前端77a从至少外髁或内髁的内表面71突出,第二啮合边缘78b在后端77b从至少外髁或内髁的内表面突出。
配合边缘78a-b和凹槽是用于将股骨部件70保持在经切削的股骨74上的股骨部件70与经切削的股骨74之间配合关系的示例。其它这种配合关系的示例包括实施例中单独的配合边缘从U形主体伸出并进入经切削的股骨上的单独凹槽中。
因此,股骨部件70包括主体71,该主体具有内表面73和相对的外表面75,每个表面都在外侧和内侧之间延伸,内表面73具有基本上U形的横截面;和至少一个边缘,优选为第一和第二边缘78a-b,其从主体76的内表面73前端或后端向内突出。
切面形成于经切削的股骨表面72上,与内表面71互补,并分别带有互补配合凹槽79a-b,所述凹槽构造成接收各自的边缘78a-b。在该构造中,股骨部件76能够侧向滑动到股骨74上,这样边缘78a-b容纳在股骨74上的对应凹槽79a-b中,从而将股骨部件70固定到股骨74上。
另一种用于重修股骨表面的方法因此包括:(i)切削股骨74末端的关节表面64,从而形成具有前表面和后表面的经切削的关节表面72,每一个表面在内侧和外侧之间延伸,至少前表面和后表面中的一个在其上具有凹槽79a-b;和(ii)将股骨部件70滑动到经切削的关节表面72上,股骨部件70的边缘78a-b与凹槽79a-b配合,股骨部件70从内向外滑动或从外向内滑动。
如图7所示,重修关节接合表面的步骤优选包括:在经切削的关节表面形成第一和第二相对凹槽79a-b,其中股骨部件70的第一和第二边缘78a-b进入各自的凹槽79a-b,第一和第二边缘78a-b从内向外或从外向内滑动。
图8显示了股骨部件80和经切削的股骨90之间的锥形关系,这是股骨部件80和经切削的股骨90之间配合关系的另一示例,其将股骨部件80保持在经切削的股骨90的锥形切削表面88上。
图8是股骨部件80的透视图,其中该股骨部件具有外表面82和锥形内表面84,其沿箭头方向被固定到具有互补锥形配合表面88的经切削的股骨90上,从而将股骨部件80固定到经切削的股骨90上。
更特别地,部件80包括具有内表面84和相对的关节接合表面82的主体82,其中每个表面都在外侧82和内侧83之间延伸。内表面84具有基本上U形的朝内逐渐变小的横截面。该锥度可以从中部侧向侧部侧产生或从侧部侧向中部侧产生。
在图8的实施例中,这样形成U形股骨部件80,其中股骨部件限定的U形腔从中部向侧部收缩,即尺寸减小。(在另一个实施例中,股骨部件从侧部向中部尺寸减小,并且内表面84构造有配合面)。股骨90按照配合构造进行切削,这样股骨部件80从外向内楔入到股骨90上,从而将股骨部件保持在股骨90上。
由图8可知,重修股骨90表面的方法包括:(i)切削股骨90末端的关节接合表面,从而形成具有前表面92和后表面94的经切削的关节表面88,每一个表面在侧部侧92和中部侧98之间延伸,至少前表面92和后表面94之中的一个相对于另一个倾斜,从而前表面92和后表面朝外侧96或内侧98会聚;和(ii)使股骨部件80滑动到经切削的关节表面88上,股骨部件80如图所示从侧部向中部滑动或从中部向侧部滑动。
图8a是股骨部件80a另一实施例的横截面图,该股骨部件具有关节接合表面82a和不倾斜的弯曲内表面84a,其显示为安装到经切削的股骨上86a上。前后边缘88a-b与股骨86a中的对应凹槽89a-b配合。图7和8A说明了具有向内的突出边缘88a-b的股骨部件可以具有各种不同的内表面。图8A股骨部件的内表面84a也可以类似于图7为锥形,从而与互补锥形经切削的股骨配合,这已参考图7进行了论述。
作为本发明的另一特征,图9-14描述了用于膝关节成形术的可连接的最终用途的股骨部件102、131、161和191,其中这两个部分容易地、独立地通过切口从中部侧或侧部侧进入,然后连接和安装到股骨切削部分。可选地,一个部分可以安装到股骨切削部分,接着另一个部分安装到那里。固定元件例如螺钉或螺栓将股骨部件的一个部分和另一个部分连接在一起。该操作过程最低限度地受创,不需要象单件部件那样大的切口,因为股骨部件的一部分可以通过切口置入,随后置入股骨部件的另一部分。
图9是从侧部向中部分离的两件套股骨部件102的透视图,而图10是该股骨部件102安装后状态的透视图。股骨部件102构造成用于“最终用途”,这是因为在重修表面操作中它构造成永久安装到经切削的关节表面上,从而连接胫骨和/或假肢胫骨部件,并设计成使经受该手术的病人能进行实际的日常使用,以代替膝关节的至少一部分。
因此图9显示了用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统100,该假肢系统包括:最终用途股骨部件102,其具有(A)适于配合经切削的关节表面的内表面105和(B)相对的关节接合表面107。
最终用途的股骨部件进一步包括:(i)第一部分,即髌骨103,其包括关节接合表面的第一断面;(ii)第二部分,即胫骨104,其包括关节接合表面的第二断面,第二部分104选择性地与第一部分103配合;和(iii)螺钉106、108,其构造成选择性地连接第一部分和第二部分。螺钉106、108是选择性地连接第一部分和第二部分的装置的示例。螺钉124将股骨部件103固定到股骨上。然而,可以使用其它各种方法将股骨部件固定到股骨上,例如使用骨粘合剂或压入到经切削的股骨中的栓。在一个实施例中,髌骨103的至少一部分对应经切削的股骨的前部,而胫骨104的至少一部分对应经切削的股骨的后部。
如图所示,螺钉106、108分别通过孔110a-b、112a-b、114a-b、116a-b沿定位线118a-b连接部分103和105,从而组合的骨部分103和105共同形成如图10所示的股骨部件102。
U形股骨部件102沿接缝119分离,从而股骨部件102包括前部分103和后部分105。至少一个通道,优选孔110a-b、112a-b、114a-b、116a-b限定的第一和第二通道延伸通过前部分103和后部分105,从而当部分103和105对齐时,螺钉106、108能够侧向拧入通道,从而固定配合部分。
在重修表面操作过程中,第一和第二部分103、105容易地、独立地通过切口从中部侧或侧部侧进入,然后连接和安装到股骨切削部分上。可选地,一部分103或105可以安装到股骨切削部分上,接着配合部分与其连接并安装到股骨切削部分上。
重修使用股骨部件102的股骨表面的方法,其包括:(i)切削股骨末端关节接合表面,从而形成经切削的关节表面;(ii)将最终用途的股骨部件的第一部分103定位到经切削的关节表面上或与之靠近,其中第一部分103包括最终用途的股骨部件102的关节接合表面的第一断面;(iii)将最终用途股骨部件102的第二部分104定位到经切削的关节表面上或与之靠近,其中第二部分104包括最终用途股骨部件102的关节接合表面的第二断面;(iv)将最终用途股骨部件102的第一部分103固定到最终用途股骨部件的第二部分;和(v)将最终用途股骨部件102连接到经切削的关节表面,例如通过使用螺钉124,螺栓、销或其它固定装置。
图11是系统130的透视图,该系统包括基本上类似的股骨部件131,其具有啮合齿136、138,并从侧部向中部分离。部件131包括:(i)第一部分,即髌骨132,其包括关节接合表面的第一断面;(ii)第二部分,即胫骨134,其包括关节接合表面的第二断面,第二部分134选择性地与第一部分132配合;和(iii)螺钉142、144,其构造成通过分别穿过孔146、148和其它未示出的孔来选择性地连接第一部分132和第二部分134。螺钉142、144是选择性地连接第一部分和第二部分的装置的示例。螺钉150是将股骨部件103固定到股骨上的装置的示例。
与图8中的接缝119相反,股骨部件131可以形成具有互补配合齿136、138的接缝。
在又一个实施例中,参考图12和13进行叙述,第一部分包括基本上U形的内髁(162)和第二部分包括基本上U形的外髁(164)。
图12是系统160的股骨部件161从前后分离的透视图,图13是图12所示股骨部件161安装后状态的透视图。
股骨部件161包括:(i)外髁162,其具有基本上U形的构造,并具有侧部侧163和相对的中部侧166,每侧都在前端165和相对的后端167之间延伸;(ii)内髁164,其具有基本上U形的构造,并具有外部侧168和相对的中部侧169,每侧都在前端171和相对的后端173之间延伸。内髁164的侧部侧168构造成配合外髁162的中部侧166,从而槽179形成于内髁和外髁之间的后端。
螺钉170、172是当内外髁配合时连接外髁和内髁的装置的示例。螺钉178将股骨部件161固定到股骨上。然而,各种其它方法也可以用于将股骨部件固定到股骨上,例如使用骨粘合剂或压入到经切削的股骨中的栓。
股骨部件161沿线性接缝180从中央前后分离,从而股骨部件161包括中部部分和侧部部分。至少一个通道,优选由孔174a-b、176a-b限定的第一和第二通道延伸通过中部部分和侧部部分,从而当这两个部分对齐时,螺钉170、172能够侧向拧入各自的通道,从而将这两个部分固定在一起。
图14是股骨部件的透视图,该股骨部件从前后分离并具有啮合齿。图14显示了系统190,该系统包括基本上类似的股骨部件191,该股骨部件具有啮合齿并从前后分离。部件191包括:(i)第一部分,即外髁192,其包括关节接合表面的第一断面;(ii)第二部分,即内髁194,其包括关节接合表面的第二断面,第二部分194选择性地与第一部分132配合;和(iii)螺钉196、198,其构造成选择性地连接第一部分和第二部分。螺钉196、198是选择性地连接第一部分和第二部分的装置的示例。螺钉206或其它固定方法也能够用于将股骨部件191固定到股骨上。
如图14所示,与具有线性接缝相比,股骨部件191可以形成具有互补配合齿的接缝,这些配合齿形成于每个部分上。
图15A-D显示了本发明另一两件套股骨部件的安装和分解图,其中使用突出来连接股骨部件的各部分。这两个部分能够容易地、独立地通过切口从中部侧或侧部侧进入,然后连接和安装到股骨切削部分上。可选地,一个部分可以安装到股骨切削部分,接着另一个部分连接到那里并安装到股骨切削部分。
图15显示了股骨膝关节假肢系统210,该假肢系统用于重修股骨末端经切削的关节表面,其包括:(i)最终用途股骨部件211,其具有(i)适于配合经切削的关节表面的内表面215和(ii)相对的关节接合表面217。
最终用途股骨部件211包括:(i)第一部分,即髌骨214,其包括关节接合表面的第一断面;(ii)第二部分,即胫骨212,其包括关节接合表面的第二断面,第二部分212选择性地与第一部分214配合。从胫骨212伸出的突出224-230构造成容纳在第一部分214中,从而使第一和第二部分配合在一起。栓220-222是将股骨部件103固定到股骨上的装置的另外示例。
股骨膝关节假肢系统210进一步包括螺钉240、240a或螺栓,其构造成为一旦突出224-230安装到第一部分212上就将第一部分214连接到第二部分212。在一个实施例中,仅仅在膝关节的一侧制造切口。因此,仅仅使用螺钉240或240a来连接第一部分214和第二部分212。
如图所示,突出224-230延伸通过各自的孔232、238、240(第四个孔未示出),而且螺钉240延伸通过孔242进入螺孔244,从而组合的髁部分214、212共同形成如图15B和16B的股骨部件210。使用突出224-230和至少一个螺钉240在第一和第二部分212、214之间形成牢固的连接。螺钉24a延伸通过孔242a并进入部分214中的螺孔。
如上文所述,本发明的股骨部件能够容易地通过切口从中部侧或侧部侧进入。另外,本发明的股骨部件可以方便地通过中部侧和侧部侧之间的切口进入(作为单件或两件套部件)。该股骨部件设计成连接胫骨和/或假肢胫骨部件。
应当理解本发明的上述各种构造、结构和方法可以组合和配合,以形成其它独特的构造、结构和方法。
涉及本发明的装置和方法的其它公开内容可以从本发明相同的申请日2003年5月23日申请的、发明名称为“用于膝关节成形术的股骨部件”、发明人为Daniel F.Justin和E.Marlowe Goble的美国专利申请得到,该申请的代理人编号为13447.22.2,快递信件标签为EV 203 529 716 US,该申请作为引用全部包含在本发明中。
本发明可以有其它各种形式的实施例,这些实施例不超出本发明的精神或基本特征。所述的实施例在任何方面来说只能认为是举例而非限定。因此本发明的范围由附带的权利要求限定而不是前面的描述。在权利要求相同的范围和含意内的所有变化也包含在这些范围内。
Claims (21)
1、一种用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统,该假肢系统包括:
最终用途的股骨部件,其具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面,该最终用途股骨部件进一步包括:
第一部分,其包括关节接合表面的第一断面;
第二部分,其包括关节接合表面的第二断面,第二部分选择性地与第一部分配合;和
用于选择性地连接第一部分和第二部分的装置。
2、如权利要求1所述的股骨膝关节假肢系统,其特征在于:第一部分包括髌骨,第二部分包括胫骨。
3、如权利要求1所述的股骨膝关节假肢系统,其特征在于:第一部分包括基本上U形的内髁,第二部分包括基本上U形的外髁。
4、如权利要求1所述的股骨膝关节假肢系统,其特征在于:用于选择性地连接第一部分和第二部分的装置包括在第一部分和第二部分之间延伸的螺钉。
5、如权利要求1所述的股骨膝关节假肢系统,其进一步包括用于将股骨部件固定到股骨末端经切削的关节表面的装置。
6、如权利要求5所述的系统,其特征在于:用于将股骨部件固定到股骨末端经切削的关节表面的装置包括螺钉。
7、如权利要求5所述的系统,其特征在于:第一部分位于第二部分的侧部上。
8、如权利要求5所述的系统,其特征在于:第一部分安装在第二部分的上方。
9、如权利要求5所述的系统,其特征在于:第一部分具有隆起和凹槽,它们对应于第二部分中的锁定隆起和凹槽。
10、如权利要求5所述的系统,其特征在于:股骨部件的第二部分包括突起,其构造成选择性地配合第一部分。
11、如权利要求10所述的系统,其特征在于:用于选择性地连接第一部分和第二部分的装置包括螺钉。
12、如权利要求1所述的系统,其特征在于:多个突起从第二部分延伸并选择性地配合在第一部分中的多个孔各个孔中。
13、一种用于重修股骨末端经切削的关节表面的股骨膝关节假肢系统,该假肢系统包括:
最终用途的股骨部件,其具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面,该最终用途的股骨部件进一步包括:
第一部分,其包括关节接合表面的第一断面;
第二部分,其包括关节接合表面的第二断面,第一部分选择性地连接第二部分。
14、如权利要求13所述的股骨膝关节假肢系统,其特征在于:第一部分包括髌骨,第二部分包括胫骨。
15、如权利要求13所述的股骨膝关节假肢系统,其特征在于:第一部分包括基本上U形的内髁,第二部分包括基本上U形的外髁。
16、如权利要求13所述的股骨膝关节假肢系统,其特征在于:用于选择性地连接第一部分和第二部分的装置包括在第一部分和第二部分之间延伸的螺钉。
17.一种方法包括:
切除股骨末端接合表面,从而形成切除的关节表面;
将最终用途股骨部件的第一部分定位到切除的关节表面上或与之靠近,其中第一部分包括最终用途股骨部件的接合表面的第一断面;
将最终用途股骨部件的第二部分定位到切除的关节表面上或与之靠近,其中第二部分包括最终用途股骨部件的接合表面的第二断面;
将最终用途股骨部件的第一部分固定到最终用途股骨部件的第二部分;和
将最终用途股骨部件连接到切除的关节表面。
18、一种用于重修股骨末端经切削的关节表面的膝关节假肢的股骨部件,该股骨部件包括:
外髁,其具有基本上U形的构造,并具有侧部侧和相对的中部侧,每侧都在前端和相对的后端之间延伸;和
内髁,其具有基本上U形的构造,并具有侧部侧和相对的中部侧,每侧都在前端和相对的后端之间延伸,内髁的侧部侧构造成配合外髁的中部侧,从而在内髁和外髁之间形成槽,其中内髁选择性地连接到外髁。
19、一种用于重修股骨末端经切削的关节表面的膝关节假肢的最终用途股骨部件,该股骨部件包括:
髌骨,其构造成髌骨的至少一部分对应于经切削的关节表面的前部;和
胫骨,其构造成选择性地连接髌骨,从而组合的髌骨和胫骨共同形成最终用途股骨部件,该股骨部件具有:(i)适于配合经切削的关节表面的内表面;和(ii)相对的关节接合表面。
20、如权利要求19所述的股骨部件,其特征在于:胫骨具有至少一个从那里伸出的突起。
21、如权利要求19所述的股骨部件,其特征在于:髌骨具有至少一个用于容纳突起的孔。
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CA2233265C (en) * | 1997-04-04 | 2004-09-14 | Bryan Cornwall | KNEE PROSTHESIS FOR DEEP BENDING |
DE19716879C2 (de) * | 1997-04-22 | 1999-07-15 | Plus Endoprothetik Ag | Femurschlitten |
EP0928172B1 (de) * | 1997-07-04 | 2001-06-06 | ESKA Implants GmbH & Co. | Stiellose kniegelenkendoprothese |
FR2768329B1 (fr) * | 1997-09-15 | 1999-12-10 | Richard Minfelde | Piece femorale de prothese tricompartimentale du genou a encombrement antero-posterieur variable |
FR2769494B1 (fr) * | 1997-10-14 | 1999-12-31 | Michel Timoteo | Piece femorale pour prothese de genou |
US6171340B1 (en) * | 1998-02-27 | 2001-01-09 | Mcdowell Charles L. | Method and device for regenerating cartilage in articulating joints |
EP2314257B9 (en) * | 2000-05-01 | 2013-02-27 | ArthroSurface, Inc. | System for joint resurface repair |
ES2278716T3 (es) * | 2001-03-26 | 2007-08-16 | Zimmer Gmbh | Protesis de rodilla. |
-
2003
- 2003-05-23 CN CNA038119102A patent/CN1655739A/zh active Pending
- 2003-05-23 CA CA2486552A patent/CA2486552C/en not_active Expired - Fee Related
- 2003-05-23 EP EP03734180A patent/EP1509174A4/en not_active Withdrawn
- 2003-05-23 JP JP2004506635A patent/JP4364792B2/ja not_active Expired - Fee Related
- 2003-05-23 GB GB0425295A patent/GB2405347B/en not_active Expired - Fee Related
- 2003-05-23 ES ES200450072A patent/ES2315044B1/es not_active Expired - Lifetime
- 2003-05-23 DE DE10392660T patent/DE10392660T5/de not_active Withdrawn
- 2003-05-23 AU AU2003239872A patent/AU2003239872B2/en not_active Ceased
- 2003-05-23 CN CNA038108690A patent/CN1652734A/zh active Pending
- 2003-05-23 JP JP2004506687A patent/JP4431491B2/ja not_active Expired - Fee Related
- 2003-05-23 EP EP03729131A patent/EP1507495A4/en not_active Withdrawn
- 2003-05-23 CA CA2484522A patent/CA2484522C/en not_active Expired - Fee Related
- 2003-05-23 AU AU2003233691A patent/AU2003233691B2/en not_active Ceased
- 2003-05-23 WO PCT/US2003/016503 patent/WO2003099159A2/en not_active Application Discontinuation
- 2003-05-23 WO PCT/US2003/016517 patent/WO2003099106A2/en active Application Filing
Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7641662B2 (en) | 2005-10-20 | 2010-01-05 | Beijing Implant Science And Technology Develop Co., Ltd. | Femoral condyle cutting and shaping center |
CN102695477A (zh) * | 2009-05-29 | 2012-09-26 | 史密夫和内修有限公司 | 用于执行膝关节成形术的方法和器械 |
CN102695477B (zh) * | 2009-05-29 | 2015-09-23 | 史密夫和内修有限公司 | 用于执行膝关节成形术的方法和器械 |
US9730705B2 (en) | 2009-05-29 | 2017-08-15 | Smith & Nephew, Inc. | Methods and apparatus for performing knee arthroplasty |
US9848888B2 (en) | 2009-05-29 | 2017-12-26 | Smith & Nephew, Inc. | Methods and apparatus for performing knee arthroplasty |
US9943317B2 (en) | 2009-05-29 | 2018-04-17 | Smith & Nephew, Inc. | Methods and apparatus for performing knee arthroplasty |
US10743889B2 (en) | 2009-05-29 | 2020-08-18 | Smith & Nephew, Inc. | Methods and apparatus for performing knee arthroplasty |
CN102846414A (zh) * | 2011-06-30 | 2013-01-02 | 德普伊产品公司 | 聚合物股骨试件部件 |
CN103027767A (zh) * | 2011-09-30 | 2013-04-10 | 德普伊产品公司 | 具有成角度的骨水泥腔的膝关节假体的胫骨组件 |
CN103027767B (zh) * | 2011-09-30 | 2016-08-17 | 德普伊产品公司 | 具有成角度的骨水泥腔的膝关节假体的胫骨组件 |
US9186162B2 (en) | 2011-10-27 | 2015-11-17 | Smith & Nephew, Inc. | Devices and methods for performing knee arthroplasty |
Also Published As
Publication number | Publication date |
---|---|
JP2005527288A (ja) | 2005-09-15 |
CN1652734A (zh) | 2005-08-10 |
WO2003099106A2 (en) | 2003-12-04 |
CA2486552C (en) | 2011-01-11 |
AU2003233691A1 (en) | 2003-12-12 |
EP1507495A2 (en) | 2005-02-23 |
WO2003099159A3 (en) | 2004-08-19 |
JP4364792B2 (ja) | 2009-11-18 |
DE10392660T5 (de) | 2005-09-01 |
EP1509174A4 (en) | 2011-04-27 |
ES2315044A1 (es) | 2009-03-16 |
AU2003239872A1 (en) | 2003-12-12 |
GB2405347A (en) | 2005-03-02 |
CA2484522A1 (en) | 2003-12-04 |
GB2405347B (en) | 2006-08-23 |
WO2003099159A2 (en) | 2003-12-04 |
WO2003099106A3 (en) | 2004-03-18 |
EP1507495A4 (en) | 2011-02-02 |
ES2315044B1 (es) | 2009-12-30 |
AU2003233691B2 (en) | 2008-03-06 |
AU2003239872B2 (en) | 2008-05-22 |
CA2484522C (en) | 2011-08-02 |
JP2005527294A (ja) | 2005-09-15 |
EP1509174A2 (en) | 2005-03-02 |
GB0425295D0 (en) | 2004-12-15 |
JP4431491B2 (ja) | 2010-03-17 |
CA2486552A1 (en) | 2003-12-04 |
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