EP0744931A1 - Prothese de genou articulee - Google Patents

Prothese de genou articulee

Info

Publication number
EP0744931A1
EP0744931A1 EP95908319A EP95908319A EP0744931A1 EP 0744931 A1 EP0744931 A1 EP 0744931A1 EP 95908319 A EP95908319 A EP 95908319A EP 95908319 A EP95908319 A EP 95908319A EP 0744931 A1 EP0744931 A1 EP 0744931A1
Authority
EP
European Patent Office
Prior art keywords
component
bearing surface
groove
femoral
knee joint
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.)
Ceased
Application number
EP95908319A
Other languages
German (de)
English (en)
Inventor
Robert Johnson
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.)
JOHNSON, ROBERT
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP0744931A1 publication Critical patent/EP0744931A1/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3886—Joints for elbows or knees for stabilising knees against anterior or lateral dislocations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3868—Joints for elbows or knees with sliding tibial bearing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3877—Patellae or trochleae

Definitions

  • This invention relates to knee joint prostheses and to components of such prostheses.
  • GB-A-2120943 discloses a knee joint prosthesis of the non- constrained type, in which relative movement of femoral and tibial components is controlled by soft tissue.
  • the prosthesis comprises a tibial component for attachment to the tibia of a patient, a femoral component for attachment to the femur, and a meniscal component which is located in use between the tibial and femoral components.
  • the bearing surface of the femoral component is curved, being generated by revolving a revolving a straight line about one or more axes which are parallel to the medial-lateral axis of the knee.
  • the corresponding bearing surface of the meniscal component is generated similarly by revolving a straight line.
  • the bearing surface of the tibial component defines a conical recess, and the corresponding bearing surface of the meniscal component is similarly conical.
  • a patella when present, slides over the bearing surface of the femoral component.
  • the knee prosthesis disclosed in GB-A-2120943 allows flexing movement between the femur and tibia by virtue of relative movement between the femoral and meniscal components.
  • the prosthesis allows twisting movement between the femur and tibia by virtue of relative rotational movement between the tibial and meniscal components.
  • the present invention provides a knee joint prosthessiiss wwhhiicchh ccoo ⁇ mmprriisseess ::
  • a tibial component having a bearing surface which defines a recess which is tapered inwardly towards its base when viewed in cross-section
  • a meniscal component having (i) a tibial bearing surface that is appropriately conical to engage the tibial component bearing surface, and (ii) a femoral bearing surface for engaging a femoral component, which defines a recess which is tapered inwardly towards its base when viewed along the anterior-posterior axis, at least towards its medial and lateral extremities;
  • the conical shape of the recess in the tibial component as disclosed in GB-A-2120943 allows rotational movement between the tibia and femur, while providing a stable configuration for the tibial and meniscal components.
  • a femoral bearing surface on the meniscal component which defines a recess which is tapered inwardly towards its base when viewed along the anterior-posterior axis, at least towards the medial and lateral extremities of the recess, and by providing the femoral component with a bearing surface that is correspondingly tapered so that, when viewed along the anterior-posterior axis, the bearing surface appears to be cut away, at least towards the medial and lateral extremities of the component.
  • the femoral component can engage the meniscal component more securely in this way.
  • the tapered configuration of the femoral component bearing surface allows the component to be formed with a deep groove between its condylar portions without having to remove a large quantity of bone. This can facilitate secure engagement between the femoral component and a peg provided on the femoral bearing surface of the meniscal component.
  • the portions of the femoral bearing surface of the meniscal component which define the tapered portion of the recess can be substantially straight when viewed in cross-section.
  • the portions of the femoral bearing surface of the meniscal component which define the tapered portion of the recess are generally rounded in a concave sense.
  • the femoral bearing surface might have a parabolic portion or a spherical portion.
  • the recess will generally rounded when viewed in cross-section along both the medial/lateral and anterior/ posterior axes. However, the configurations of the rounded surfaces when viewed along these axes will generally be different from one another.
  • the bearing surface of the femoral component is defined as a surface of revolution, defined about an axis parallel to the medial/lateral axis.
  • This has the significant advantage of facilitating manufacture to produce a bearing surface which has an acceptable finish, for example to be manufactured with a geometrical accuracy of not more than about ⁇ 5 ⁇ m and a surface roughness of not more than about 0.05 ⁇ m R a (centre line average) .
  • the surface is defined by revolving a line about one or more axes. The shape of the line, the number and locations of the axes and the radius of the revolution are selected according to the configuration of the bearing surface.
  • the line might be straight or curved, or have portions which are straight and portions which are curved.
  • curved line (or portion of a line) might be a portion of a circle, an ellipse, or a parabola.
  • the recess in the femoral bearing surface of the meniscal component is defined by revolution of a line, especially a line that is the same over at least part of its length as that which is revolved to generate the femoral component bearing surface.
  • a line especially a line that is the same over at least part of its length as that which is revolved to generate the femoral component bearing surface.
  • the radius about which the line is revolved can vary along the bearing surface. For example a relatively small radius can be appropriate at the posterior end of the bearing surface, and a relatively large radius at the anterosuperior end of the bearing surface.
  • the recess within the femoral bearing surface of the meniscal component can be continuously concave across the entire surface. It can be convex over a portion only of its surface, for example because of a peg which extends from the surface to engage a groove in the bearing surface of the femoral component.
  • the femoral component has a groove in its bearing surface and the meniscal component has a peg protruding from its femoral bearing surface which can be received in the groove in the femoral component bearing surface, to move relative to the femoral component bearing surface as the knee is flexed, within the groove.
  • the thickness of the meniscal component is substantially constant at least over a portion of the component, especially over portions towards the medial and lateral extremities of the component, away from any peg that is provided to protrude into a groove in the femoral component.
  • the recess in the tibial component and the corresponding tibial bearing surface of the meniscal component are preferably conical in the sense that they are generated over at least a substantial portion of their respective areas by revolution of a line about the longitudinal axis of the tibia, thus facilitating rotational freedom of movement of the meniscal component (and the femoral component in contact with it) relative to the tibial component around that axis.
  • the line may but need not necessarily be straight
  • the invention provides a knee joint prosthesis which comprises:
  • a femoral component having a bearing surface through which loads are transferred, directly or indirectly, to a tibial component, the femoral component bearing surface having a groove formed in it extending generally in the anterior-posterior plane towards the upper anterior edge of the component;
  • a patellar component having a bearing surface for engaging the bearing surface of the femoral component, the patellar component bearing surface having a peg extending from it which can be received in the groove in the femoral component bearing surface;
  • the groove in the femoral component bearing surface being wider at its upper end than towards the other end of the groove.
  • the patella moves upwardly over the femoral bearing surface, away from the interface with the tibia. As it approaches the upper reaches of the femoral bearing surface, it is caused by soft tissue which is connected to it to deviate laterally from the axis of the femur.
  • This can be accommodated in a knee joint prosthesis by providing a curved groove for the patella to move in.
  • a disadvantage of this arrangement is that increased inventory is required to accommodate left and right knees.
  • the patella can be damaged if it becomes disengaged from the groove because of the damaging profile of the surface that it then contacts.
  • the prosthesis of this aspect of the invention has the advantage that it can accommodate the tendency of a patella to deviate laterally when the knee is straightened. This is achieved by providing a wide groove across which the patella can move when towards the top of the groove.
  • the groove in the femoral bearing surface can be flared laterally or, more preferably, both laterally and medially. Flaring the groove in both senses has the advantage that a single component can be used for both left and right knees.
  • the femoral component is tapered on its bearing surface, at least towards its medial and lateral extremities, to engage a load bearing surface which defines a recess which is tapered inwardly towards its base when viewed in cross- section along the anterior-posterior axis.
  • the bearing surface of the femoral component can be substantially straight, or generally rounded in a convex sense, at least at its medial and lateral extremities.
  • the bearing surface of the femoral component is defined as a surface of revolution, especially by revolving a line about one or more axes. As discussed above in greater detail, the shape of the line, the number and locations of the axes and the radius of the revolution are selected according to the configuration of the bearing surface.
  • the bearing surface of the patellar component which engages the femoral component bearing surface is defined too as a surface of revolution, especially by revolution of a line. It is preferred that the line that is revolved is the same, at least over part of its length, as the line which is revolved to generate at least the upper part of the femoral component bearing surface. This has the advantage of providing line contact between the bearing surfaces of the femoral and patellar components.
  • the edges of the groove, where the groove meets the bearing surface of the femoral component can be rounded.
  • the corners at the root of the peg can be rounded when the component is viewed along the groove in the femoral component, preferably to match the rounded edge of the groove.
  • the depth of the groove in the femoral component is greater than the depth of the peg on the patellar component, at least towards the lower end of the groove.
  • the depth of the groove in the femoral component at the upper end of the groove is approximately equal to the depth of the peg on the patellar component.
  • This has the advantage that loads transmitted between the patellar and femoral components are transmitted through the peg and the base of the groove, in addition to transmission between the bearing surfaces outside the groove and peg regions. This can enable the patellar component to withstand high loads applied to it from above even when it is not fully supported by contact with the femoral component bearing surface because of widening of the groove in that surface.
  • the width of the groove in the femoral component at the upper end of the groove can be greater than the width of the peg on the patellar component, measured from one side of the peg to the opposite edge of the patellar component.
  • the invention provides a femoral component of a knee joint prosthesis which has a bearing surface through which loads are transferred, directly or indirectly, to a tibial component, the femoral component bearing surface having a groove formed in it extending generally in the anterior- posterior plane towards the upper anterior edge of the component to define two condylar portions and a space between them, the groove being defined medially and laterally by walls which extend into the space between the condylar portions, to an extent that is greater than the thickness of the condylar portions adjacent to the groove.
  • Knee joint prostheses frequently include a peg which protrudes into a groove in the femoral component between two condylar portions, for example provided on the tibial component or, more commonly, on a meniscal component or a patellar component.
  • the peg serves to control the relative movement of the femoral component and the tibial, meniscal or patellar component as the case may be. It can also minimise the instance of the femoral and tibial, meniscal or patellar components becoming separated.
  • the peg protrude into the groove in the femoral component as deep as possible to optimise the features mentioned above.
  • the component of this aspect of the invention enables a deep groove to be provided for a peg to protrude into, while maintaining the degree of resection to a minimum.
  • This is achieved by having the groove defined medially and laterally by walls which extend into the space between the condylar portions to an extent that is greater than the thickness of the condylar portions adjacent to the groove.
  • the walls can be provided by an insert that is provided in the groove or more preferably by working, especially machining, the material of the femoral component.
  • a further advantage of providing deep walls to define a groove in a femoral component is that they can control flow of cement used in the attachment of a component to a resected femur, to reduce flow of cement (a) from the region between the resected end of the femur and the component, and (b) into the groove where it might interfere with the peg protruding into the groove.
  • the depth of the walls which define the groove is greater than the thickness of the condylar portions adjacent to the groove, at least in the posterior portion of the component through which load is transmitted to a tibial component when the knee joint is flexed.
  • the bearing surface of the femoral component in which the groove is formed can have any of a number of configurations. For example, it might be generally planar when viewed along the anterior-posterior axis, for example as would be generated by revolution of a straight line. Alternatively, it might be generally rounded, as discussed above.
  • the groove in the femoral component bearing surface is wider at its upper end than towards the other end of the groove.
  • the edges of the groove are rounded where the groove meets the bearing surface of the femoral component.
  • the invention also provides individual components of the knee joint prostheses of the invention.
  • Figure 1 is an exploded isometric view of a knee prostheses
  • Figure 2 is an isometric view of a femoral component which can be used in the prostheses shown in Figure 1;
  • Figure 3 is an isometric view of another femoral component which can be used in the prostheses shown in Figure 1;
  • Figure 4 is another view of the femoral component shown in Figure 3;
  • Figure 5 is a sectional elevation of a knee joint prosthesis which includes femoral and patellar components
  • Figures 6a and 6b are sectional elevations through a femoral component at different points along the groove between its condylar portions to show the variation in width of the groove;
  • Figures 7a and 7b are elevational views through another femoral component at different points along the groove between its condylar portions to show the variation in width of the groove;
  • Figures 8a and 8b are sectional elevations through the components shown in Figures 7a and 7b.
  • Figure 1 shows a knee joint prostheses which includes a metal femoral component 1 having two condylar portions 3.
  • the femoral component has a bearing surface 5 on the outside of the condylar portions, and extending generally in the anterior-posterior plane towards the above anterior edge.
  • a metal tibial component 11 has a recess 13 formed in its upper surface.
  • the recess is tapered inwardly towards its base.
  • the taper can extend to the base of the recess. However, the taper could extend only part way towards the base, so that the recess is frusto-conical when viewed in cross-section.
  • the recess is defined by the bearing surface 14 of the tibial component.
  • a stem extends downwardly from the apex of the recess, to be received in the cavity along the axis of the resected tibia.
  • a meniscal component 17 has a tibial bearing surface 19 that is appropriately tapered to engage the bearing surface of the tibial component within the recess.
  • the meniscal component has a bearing surface 21 which defines a recess which is tapered inwardly towards its base when viewed along the anterior- posterior axis, at least towards its medial and lateral extremities.
  • the shape of the recess corresponds to that of the bearing surface 5 of the femoral component which it engages when the prostheses has been implanted.
  • Figure 2 shows the end of a femoral component which can be used in a knee joint prostheses of the type shown in Figure 1.
  • Figure 2 shows in more detail the dome-shape which is imparted to the bearing surface 5 of the component .
  • the bearing surface can be seen to be tapered. It is defined by substantially straight lines when the component is viewed along the anterior- posterior axis.
  • a component with this configuration can be generated by revolving such a straight line around an axis substantially parallel to the medial-lateral axis of the knee. More than one such axis may be used to generate respective portions of the component. Different radii can be used to generate different portions of the bearing surface.
  • Figures 3 and 4 are viewed of another femoral component which is tapered on its the bearing surface.
  • the bearing surface is generally rounded in a convex sense at its medial and lateral extremities, the groove 9 being provided in the region between these extremities.
  • the configuration of the component shown in Figures 3 and 4 is generated by revolving a curved line, especially an arc of a circle.
  • Figure 5 shows the femoral component 1 of a knee joint prostheses engaging a patellar component 41.
  • the femoral component engages the bearing surface 43 of the patellar component, in contact with the bearing surface 5 of the femoral component.
  • a peg 43 on the patellar component is received in the groove 9 in the femoral component.
  • Figures 6a and 6b are sections through a femoral component at two locations along the groove 9.
  • Figure 6a is a sectional elevation taken at the lower end of the groove, in a location occupied by patella 41 when the knee joint is flexed.
  • Figure 6b is a sectional elevation through the component at a location towards the upper end of the groove, which the patella occupies when the knee joint is straightened.
  • the width of the groove 9 in the femoral component 1 is approximately equal to the width of the peg 45 on the patella 41.
  • the depth of the groove 9 is greater than that of the peg 45.
  • the width of the groove 9 is greater than that of the peg 45 on the patella 41. Indeed, the width is greater than the width of the patella, measured from one side of the peg to the opposite edge of the patella. Consequently, when the knee joint is straightened and the patella is pulled laterally, the patella moves to one side of the groove. As the knee joint is subsequently flexed, the patella moves along the groove towards the narrowed portion thereof, so that the patella comes into engagement with the other edge of the groove, towards the orientation shown in Figure 6a.
  • Figures 7a and 7b are elevational views of a femoral component 1 in which a groove 9 formed in the bearing surface 5 is defined medially and laterally by awls 51,53 which extend into the space between the condylar portions 55,57 on each side of the groove to an extent that is greater than the thickness of the condylar portions adjacent to the groove.
  • Figures 8a and 8b are sections through the component shown in Figure 7a and 7b, on the lines I-I and II-II in Figure 7b.
  • a patella component 59 is shown.
  • the groove 9 in the femoral component shown in Figures 7 and 8 is wider at its upper end towards the upper anterior edge of the component than towards its other end.

Abstract

Cette prothèse de genou articulée comprend un élément tibial (11) présentant une surface portante délimitant un évidement (13) effilé vers l'intérieur en direction de sa base, vu en section, un élément ménisque (17) présentant (i) une surface portante (19) destinée à l'élément tibial, conçue de façon conique afin de venir en contact avec la surface portante de l'élément tibial, et (ii) une surface portante (21) conçue pour recevoir un élément fémoral, et ledit élément fémoral (1), effilé de façon appropriée au niveau de sa surface portante (5) afin de venir en contact avec la surface portante correspondante de l'élément ménisque. On peut loger dans une gorge (9) formée dans la surface portante de l'élément fémoral, une cheville (45) située sur un élément rotule. La gorge peut être plus large à son extrémité supérieure qu'à son autre extrémité. Cette gorge, ménagée dans la surface portante de l'élément fémoral, est délimitée par des parois qui s'étendent à l'intérieur de celle-ci sur une distance supérieure à l'épaisseur de l'élément adjacent.
EP95908319A 1994-02-18 1995-02-14 Prothese de genou articulee Ceased EP0744931A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GB9403165A GB9403165D0 (en) 1994-02-18 1994-02-18 Knee joint prostheses
GB9403165 1994-02-18
PCT/GB1995/000307 WO1995022303A2 (fr) 1994-02-18 1995-02-14 Prothese de genou articulee

Publications (1)

Publication Number Publication Date
EP0744931A1 true EP0744931A1 (fr) 1996-12-04

Family

ID=10750584

Family Applications (1)

Application Number Title Priority Date Filing Date
EP95908319A Ceased EP0744931A1 (fr) 1994-02-18 1995-02-14 Prothese de genou articulee

Country Status (4)

Country Link
EP (1) EP0744931A1 (fr)
AU (1) AU1668295A (fr)
GB (1) GB9403165D0 (fr)
WO (1) WO1995022303A2 (fr)

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6319283B1 (en) 1999-07-02 2001-11-20 Bristol-Myers Squibb Company Tibial knee component with a mobile bearing
US6210445B1 (en) 1999-10-26 2001-04-03 Bristol-Myers Squibb Company Tibial knee component with a mobile bearing
US6210444B1 (en) 1999-10-26 2001-04-03 Bristol-Myers Squibb Company Tibial knee component with a mobile bearing
US6217618B1 (en) 1999-10-26 2001-04-17 Bristol-Myers Squibb Company Tibial knee component with a mobile bearing
FR2901996B1 (fr) * 2006-06-12 2008-08-22 Jean Francois Biegun Composant femoral pour genou droit ou gauche
EP3471646B1 (fr) 2016-06-17 2023-07-05 Zimmer, Inc. Système de planification chirurgicale peropératoire
US10893948B2 (en) 2017-11-02 2021-01-19 Howmedica Osteonics Corp. Rotary arc patella articulating geometry

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3924277A (en) * 1971-05-04 1975-12-09 Nat Res Dev Knee joint prosthesis
US4224696A (en) * 1978-09-08 1980-09-30 Hexcel Corporation Prosthetic knee
GB2120943B (en) * 1982-03-13 1985-04-11 Thackray C F Ltd Knee prosthesis
EP0135319A3 (fr) * 1983-08-24 1985-07-24 ARTHROPLASTY RESEARCH & DEVELOPMENT (PTY) LTD. Prothèse d'articulation du genou
US4714472A (en) * 1987-01-20 1987-12-22 Osteonics Corp. Knee prosthesis with accommodation for angular misalignment
FR2698265B1 (fr) * 1992-11-24 1995-02-10 Corum Ste Civile Endo-prothèse totale de genou et éléments d'essai pour la pose de cette dernière.

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9522303A3 *

Also Published As

Publication number Publication date
WO1995022303A3 (fr) 1995-10-12
GB9403165D0 (en) 1994-04-06
AU1668295A (en) 1995-09-04
WO1995022303A2 (fr) 1995-08-24

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