DE19529824A1 - Bi-condylar endoprosthesis for knee - Google Patents

Bi-condylar endoprosthesis for knee

Info

Publication number
DE19529824A1
DE19529824A1 DE1995129824 DE19529824A DE19529824A1 DE 19529824 A1 DE19529824 A1 DE 19529824A1 DE 1995129824 DE1995129824 DE 1995129824 DE 19529824 A DE19529824 A DE 19529824A DE 19529824 A1 DE19529824 A1 DE 19529824A1
Authority
DE
Germany
Prior art keywords
characterized
prosthesis according
tibia
section
radius
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.)
Withdrawn
Application number
DE1995129824
Other languages
German (de)
Inventor
Bodo Gnutzmann
May Ulrich Dr Schneider
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
GNUTZMANN BODO 28209 BREMEN DE
Original Assignee
GNUTZMANN BODO 28209 BREMEN DE
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by GNUTZMANN BODO 28209 BREMEN DE filed Critical GNUTZMANN BODO 28209 BREMEN DE
Priority to DE1995129824 priority Critical patent/DE19529824A1/en
Publication of DE19529824A1 publication Critical patent/DE19529824A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3868Joints for elbows or knees with sliding tibial bearing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION, OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02Inorganic materials
    • A61L27/04Metals or alloys
    • A61L27/045Cobalt or cobalt alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION, OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/28Materials for coating prostheses
    • A61L27/30Inorganic materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30112Rounded shapes, e.g. with rounded corners
    • A61F2002/30133Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/3011Cross-sections or two-dimensional shapes
    • A61F2002/30159Concave polygonal shapes
    • A61F2002/30179X-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878Special 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
    • A61F2002/30884Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0015Kidney-shaped, e.g. bean-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/0058X-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00011Metals or alloys
    • A61F2310/00029Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389The prosthesis being coated or covered with a particular material
    • A61F2310/00395Coating or prosthesis-covering structure made of metals or of alloys
    • A61F2310/00407Coating made of titanium or of Ti-based alloys
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION, OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS, OR SURGICAL ARTICLES
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/24Materials or treatment for tissue regeneration for joint reconstruction

Abstract

The bi-condylar knee endoprosthesis has a U-shaped femoral component (2) which attaches to the femur and a tibial component (4) which attaches to the tibia. The tibial component consists of a flat tibia tray (17) from which a pin (18) projects downwards into the tibia. Between the femoral component and the tibial component is a flat meniscus piece (3) which can move relative to the femoral and tibial components. The underside (15) of the meniscus piece slides on the upper side of the tibia tray whilst its upper side (12) has two separate bearing support sections (13,13') in which two condylar sections (7,7') of the femoral component can slide.

Description

The invention relates to a bicondylar knee endoprosthesis with one on the lower femoral head of a femur to be fastened, in a side view essentially U-shaped femoral component, one of which is a leg and bridge from two spaced apart, in the we substantial parallel condyle sections exist, the pass continuously into the outside of the other leg de, curved outsides form the femoral treads, and at least one from the inside in the area of the web Anchoring pin protrudes, and with one on the tibia plateau the tibia component to be attached, which consists of a plate-shaped tibial tray and one essentially Lichen Ti extending perpendicularly from its underside biastiel exists.  

Prostheses for a partial or complete er set of a knee joint are as sled or unikondy prostheses or as bicondylar endoprostheses in un Different design known, the selection of the prosthesis to be implanted by different Aspects is determined. So the choice depends on certain prosthesis u. a. for example depending on whether the Ligament of the knee joint to be treated damaged or is destroyed, as is the case after an accident or whether it is still intact, like this one in space common is the case when a natural knee joint due to excessive wear or severe deformation must be replaced by a total endoprosthesis.

Although it is of course desirable that a knee joint after implantation of a prosthetic knee, its natural che mobility is largely restored So far this has not been the case after the implantation of an endoprosthesis the case. This is due in particular to the fact that the Bewe in a natural knee joint due to a superimposed rolling and sliding movement when bending or Stretching a leg is relatively complicated, and that the natural conditions of the knee joint demge are difficult to imitate according to prosthetics. Acting a knee joint is primarily a hive kidney joint, which is fully tightened when stretched is allowed, but it allows by training as a dop pel joint in the bent position of the leg also a slight Rotational movement of the lower leg around its longitudinal axis. It is essentially formed by only two bones, näm Lich the two "articulated rollers" (condyles) and the plateau  well-formed articular surface of the tibia (tibia) while the fibula is not directly attached to the joint is involved and only serves as an approach for a sideband. To compensate for the differently shaped articular surfaces nen two crescent-shaped, wedge-shaped band sheaves ben (inner and outer meniscus), which not only in Ge cushioning, running and jumping to absorb shocks and pressure due to their relative mobility to the femur and Tibia also ensure that when bending the knee does not lead to positive constraints.

With previously known knee joint prostheses in question here standing genus is a substitute for the meniscus / menisci not part. Although generic Known prostheses, in which at the top of the Ti biatrays a plastic disc is arranged which one could possibly be viewed as a certain meniscus replacement, but is this plastic disc firmly (generally positive sig) on or in the metal tibia component held and therefore forms part of a function this prosthetic component.

Quite apart from the fact that with such a Pro thesis over time, especially with stronger loading load results in a relatively high abrasion, also leaves the mobility still leaves something to be desired and it can too Constraints come within the prosthesis that affect the Bone tissue is transferred and becomes one over time such damage to the tissue that the The prosthesis loosens and a reoperation is exchanged a correspondingly larger prosthesis is required.  

Since the contact surface of the femoral condyles when angled Knee is much smaller than when the knee is straight, the tibial tray is loaded relatively strongly asymmetrically, because a relative movement between that tight in the bone the tibia tray or the one that is firmly attached to it Native plastic disc and the femoral component not possible is.

The present invention is based on the object a knee endoprosthesis of the type described above to create whose mobility is that of an intact corresponds essentially to the natural knee joint, whereby that arise with comparable known prostheses Constraints that arise in the meniscus area in particular build harmful compressive forces, which can not only the prosthesis itself, but also the affected knot heavily stress, should be prevented, and at the same time opportunities for low abrasion combined good running properties with a long service life to be shown.

According to the invention, this object is achieved by that between the femoral component and the tibial component a movable relative to these two prosthetic components ches, essentially plate-shaped meniscus part is arranged, the bottom of which is slidable on the top of the tibial tray, and two with mutually spaced bearing cups formed are, in each of which a condyle section of the femoral com component is slidably supported or stored. The same constant relative mobility of all three components  excellently simulates that of a natural Chen healthy knee existing conditions and enables its movements without it harmful pressure or tensile forces in the joint and the here comes with associated effects on bone tissue.

The La. Formed on the top of the meniscus part shells to support the condyle sections are be preferably formed as concave recesses, with little at least one (first) bearing shell as a section of a ball surface is formed, the radius of which is equal to the curvature radius of the assigned, double-curved (first) Section of the condyle.

It has been shown that excellent results can be achieved if the other (second) bearing shell (with a corresponding double curvature of the assigned th second condyle section) in the same way is formed, but on the other hand it has been shown that a Manufacture of the meniscus part with two such spherite zen as well as the production of the assigned femoral component such that their condyle sections in each flexion or Stretched position of the knee joint exactly centered in their bearing shell due to the inevitable Manufacturing tolerances is extremely difficult. Under avoid However, this problem was solved found essentially the same good results nits leads. This is that the second camp shell of the meniscus part as a section of a cylindrical surface che is formed, the radius of which is equal to the curvature dius of the associated, simply curved second con  dylusabschnittes, with such training the length of the second bearing shell is expediently greater than the width of the second condyle associated with it cut can be performed, and still the second bearing shell is arranged so that it is on both sides protrudes over the second condyle section if he most condyle section centrally in the first bearing shell is arranged.

Furthermore, it has proven to be extremely useful if the medial bearing shell of the meniscus part as a second layer shell is formed, i.e. the medial condyle bearing as a roller bearing and the lateral condyle bearing in the manner of a ball bearing, with all the aforementioned Refinements of the (single or double) curvature dius of the condyle sections and thus also the lagerscha len is preferably about 25 mm, but for larger or smaller prostheses, of course, also larger or can be smaller.

Furthermore, it has proven to be extremely useful if the mutually facing and interacting sliding surfaces the meniscus part and tibia tray are not planar are formed, but when the top of the tibia trays and the underside of the meniscus part each as Section of a spherical surface with the same radius is formed are det, and preferably such that the top of the Tibial arrays convex and therefore the underside of the meninges kiss part is concave. One has mean prosthesis size a radius of the spherical surfaces of about 130 mm proved to be particularly useful, although the  water especially for larger or smaller prostheses can of course also be larger or smaller.

In such a configuration, the longitudinal axis runs of the tibia stem preferably through the center of curvature of the two spherical surfaces of the tibial tray or the meniscus partly, although it turned out to be useful if the tibial stem is at the center of the tibial tray is offset to the front, so that to the rear guarantee the cruciate ligaments a sloping spherical sliding surface is accomplished. This offset is generally about 10 mm.

All components of the prosthesis according to the invention, that is Femoral component, the meniscal component and the tibia component, consist preferably of a high-strength metal or Metal alloy, most preferably from a CrCo Mo alloy, expediently at least the barrel surfaces with titanium or a titanium alloy such as titanium Ni rop coated and the treads polished in any case are, with extremely good sliding properties an au Extremely little wear and tear and the prosthesis can be implanted without cement.

Further preferred refinements of the present invention tion are described in the subclaims.

The invention is based on an embodiment with reference to a somewhat simplified or schematic tized drawing further explained. It shows:  

Figure 1 is a side plan view of an inventive knee total endoprosthesis in an exploded view.

Fig. 2 seen the representation of Figure 2 in a rear view of the arrow II in Fig. 2. and

Fig. 3 seen a partial top view of the Explosionsdar position shown in FIG. 2 in the direction of section line III-III.

The drawing shows a somewhat schematic / simplified representation of a bi-condylar knee endoprosthesis, generally designated 1 , for better clarity in an exploded view, while its three components, which will be described in detail below, in the implanted state actually lie together.

The prosthesis 1 has a femur component, generally designated 2 , a meniscus partially designated 3 , and a tibia component, generally designated 4 , each consisting of a CrCoMo alloy and coated with titanium nirop. This ensures maximum stability and, due to the combination of metal and metal, extremely low wear and excellent sliding properties are achieved, especially since the sliding surfaces are polished.

The (after appropriate preparation of the bone tissue) to be attached to the lower femoral head femoral component 2 is in a side view substantially U-shaped, as can be seen from Fig. 1, the two legs 5 and 5 '(of which the front leg 5 can be seen longer is) and the web 6 from two mutually spaced a arranged parallel condyle sections 7 and 7 'best hen, which replace the natural condyles. From the inside of the web 6 of the U-shaped femoral component 2 - in each case in the region of a condyle section 7 or 7 '- two anchoring pins 8 project vertically. The outer sides of the femoral tread Kondylusab sections 7 , 7 'go from one leg 5 ' over the web 6 continuously into the other leg 5 and are circularly curved about an axis 9 with a radius r of 25 mm. The lateral condyle section 7 is also about a perpendicular to the axis 9 horizontal axis 9 'also curved with the radius r, so that the tread 10 of the condyle section 7 thus has the shape of the section of a spherical surface with the radius r. In contrast, the tread 11 of the condyle section 7 'with the radius r is only curved about the axis 9 and forms a section of a cylindrical surface.

The meniscus part 3 is essentially plate-shaped and is in the implanted state, on the one hand in contact with the femoral component 2 and on the other hand on the tibia component 4 . As can be seen from FIGS. 2 and 3 bar, on its upper side 12 two bearing shells 13 and 13 'are arranged at a mutual distance, in each of which a condyle section 7 or 7 ' is slidably supported or supported. The bearing shells 13 , 13 'are formed as concave recesses, the one (first) bearing shell being designed in accordance with the running surface 10 of the condyle section 7 as a portion of a spherical surface with the radius r, while the other (second) bearing shell 13 ' of Meniscus part 3 in accordance with the tread 11 of the Kondylusab section 7 'is ausgebil det as a portion of a cylindrical surface whose radius r is equal to the radius of curvature r of the assigned, simply curved second Kondylusab section 7 ' around the axis 9 . The length 1 of the second bearing shell 13 'is greater than the width b of the second condyle section 7 ' assigned to it, the arrangement being such that the second bearing shell 13 'protrudes on both sides in the implanted state over the second con dylus section 7 ' when the first Kondylusab section 7 is arranged centrally in the spherical first Lagerscha le 13 , so that the second Kondylusabschnitt 7 'has play on both sides and can move freely in the direction of the double arrow 14 from its central position to one side or the other. This ensures that the first condyle section 7 is always centered with its ku gel-shaped tread 10 in the bearing shell 13 of the meniscus part 3 assigned to it.

The underside 15 of the meniscus part 3 is formed as a concave portion of a spherical surface with the radius R, which is 128 mm in the illustrated embodiment. In the same way, the top 16 of the tibia component 4 is curved and represents a convex portion of a spherical surface with the radius R, so that the two sliding surfaces 15 of the meniscus part 3 and 16 of the Tibiakom component 4 can freely slide one another in the implanted state.

The tibia component 4 consists of a tibia tray 17 and a tibia stem 18 extending substantially perpendicularly from the underside thereof, the longitudinal axis 19 of the tibia stem passing through the center of curvature of the two Ku gel surfaces 15 , 16 and preferably from the center of the tibia tray 17 by about 10 mm is offset to the front, so that a sloping course of the spherical surfaces 15 , 16 to the back to the cruciate ligaments is ensured. The tibial stem 18 is provided with ribs 20 which start at a distance from the free end of the tibial stem 18 and extend to the underside of the tibial tray 17 , their length, measured at a right angle to the longitudinal axis 19 , decreasing towards the free end of the tibial stem 18 .

The tibia tray 17 and the meniscus part 3 are essentially kidney-shaped in the plan view, as can be seen from FIG. 3. They each have a continuous recess or indentation 21 for the strips running there on their back.

The bicondylar knee endoprosthesis according to the invention, in which for the first time the meniscus is movable on the Ti biatray and all three components consist of CRCOMO coated with titanium nirop, is relatively easy to implant without cement. It has due to the preferred design of the tibia component 4 with essentially X-shaped ribs 20 after implantation in all directions good primary stability and not only with low wear ge excellent sliding or running properties, but avoids due to the freely movable, le diglich of the ligament-controlled meniscus part 3 and its interaction with the tibial component 4 and the femoral component 2 any constraints within the joint and thus corresponding complaints or damage, even if the patient concerned has so-called X or O-legs. This is the case with a considerably larger number of people than is especially allowed by them. However, the ligaments adjust themselves in the course of this leg shape and the associated gait, so that it can be difficult after an implantation if - as is usually the case - the prosthesis is implanted according to a straight leg. This is harmless in the knee prosthesis according to the invention, since the joint can be adjusted visibly without constraint in accordance with the existing ligament apparatus and then its good properties can unfold without being affected.

Reference list

1 knee endoprosthesis
2 femoral component
3 meniscus part
4 tibia component
5 , 5 ′ leg (of 2 )
6 bridge (of 2 )
7 , 7 ′ condyle sections
8 anchoring pins
9 , 9 ' axis
10 treads (of 7 )
11 tread (from 7 ′)
12 top (of 3 )
13 , 13 ′ bearing cups (from 3 )
14 arrow
15 bottom (of 3 )
16 top (of 4 )
17 Tibial tray
18 Tibial stem
19 longitudinal axis (of 18 )
20 ribs
21 recess

Claims (23)

1.Bicondylar knee endoprosthesis to be attached to the lower femoral head, in a lateral view in the union union U-shaped femoral component, one leg and web of two mutually spaced, substantially parallel condyle sections, the steady in the outside of the other leg over going, curved outer sides of the femur treads bil, and from the inside in the area of the web at least an anchoring pin protrudes, and with a tibial component to be attached to the tibial plateau, which consists of a plate-shaped tibial tray and essentially perpendicular from its underside Extending Ti biastiel, characterized in that between the femoral component ( 2 ) and the tibia component ( 4 ) is arranged a relatively movable, essentially plate-shaped meniscus part ( 3 ) whose underside ( 15 ) slidably on the top ( 16 ) of the tibia tray ( 4 ), and on the upper side ( 12 ) two bearing shells ( 13 , 13 ') arranged at a mutual distance, in each of which a condyle section ( 7 or 7 ') of the femoral component ( 2 ) is slidably supported.
2. Prosthesis according to claim 1, characterized in that the on the top ( 12 ) of the meniscus part ( 3 ) ausgebil Deten bearing shells ( 13 , 13 ') are formed as concave recesses, with at least one (first) bearing shell ( 13 ) as Section of a spherical surface is formed, the radius (r) of which is equal to the radius of curvature (r) of the double-curved (first) condyle section ( 7 ) assigned to it.
3. Prosthesis according to claim 2, characterized in that the other (second) bearing shell ( 13 ') of the meniscus part ( 3 ) is designed as a section of a cylindrical surface whose radius (r) is equal to the radius of curvature (r) of the associated single curved ( 2 ) (second) section of the condyle ( 7 ').
4. A prosthesis according to claim 3, characterized in that the length ( 1 ) of the second bearing shell ( 13 ') is greater than the width (b) of the second condyle section associated with it ( 7 ').
5. Prosthesis according to claim 4, characterized in that the second bearing shell ( 13 ') protrudes on both sides over the second condyle section ( 7 ') when the first condyle section ( 7 ) is arranged centrally in the first bearing shell ( 13 ).
6. Prosthesis according to one or more of claims 3 to 5, characterized in that the second bearing shell ( 13 ') is the medial bearing shell of the meniscus part ( 3 ).
7. Prosthesis according to one or more of claims 2 to 6, characterized in that the radius of curvature (r) is about 25 mm.
8. Prosthesis according to one or more of the preceding claims, characterized in that the top ( 16 ) of the tibial tray ( 4 ) and the bottom ( 15 ) of the meniscus part ( 3 ) each formed as a portion of a spherical surface with the same radius (R) are.
9. A prosthesis according to claim 8, characterized in that the top ( 16 ) of the tibia tray ( 4 ) is convex and the underside ( 15 ) of the meniscus part ( 3 ) is concave.
10. A prosthesis according to claim 8 or 9, characterized in that the radius (R) of the spherical surfaces ( 15 , 16 ) is approximately 130 mm.
11. A prosthesis according to one or more of claims 8 to 10, characterized in that the longitudinal axis ( 19 ) of the tibial stem ( 18 ) extends substantially through the center of curvature about the two spherical surfaces ( 15, 16 ).
12. Prosthesis according to one or more of claims 8 to 11, characterized in that the tibia stem ( 18 ) from the center of the tibial tray ( 17 ) is arranged offset to the front.
13. A prosthesis according to claim 12, characterized in that the offset is approx. 10 mm.
14. Prosthesis according to one or more of the preceding claims, characterized in that the tibial tray ( 17 ) and the meniscus part ( 3 ) are kidney-shaped in a plan view in wesentli Chen.
15. A prosthesis according to one or more of the preceding claims, characterized in that a continuous recess ( 21 ) is provided on the back of the tibia tray ( 17 ) and the meniscus part ( 3 ).
16. Prosthesis according to one or more of the preceding claims, characterized in that the tibia stem ( 18 ) is provided with ribs ( 20 ).
17. A prosthesis according to claim 16, characterized in that the ribs ( 20 ) start at a distance from the free end of the tibia stem ( 18 ) and extend to the underside of the tibia tray ( 27 ).
18. A prosthesis according to claim 16 or 17, characterized in that the length of the ribs ( 20 ) decreases towards the free end of the tibia stem ( 18 ).
19. Prosthesis according to one or more of claims 16 to 18, characterized in that the tibia stem ( 18 ) has a + -shaped cross section at its ribbed section.
20. Prosthesis according to one or more of the preceding claims, characterized in that all components ( 2 to 4 ) consist of a high-strength metal.
21. A prosthesis according to claim 20, characterized by a Formation from a CrCoMo alloy.
22. Prosthesis according to one or more of the preceding claims, characterized in that at least the running surfaces ( 10 , 11 , 13 , 13 ', 15 , 16 ) are coated with titanium or a titanium alloy.
23. Prosthesis according to one or more of the preceding claims, characterized in that the running surfaces ( 10 , 11 , 13 , 13 ', 15 , 16 ) are polished.
DE1995129824 1995-08-14 1995-08-14 Bi-condylar endoprosthesis for knee Withdrawn DE19529824A1 (en)

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