FR2760352A1 - Total knee joint prosthesis - Google Patents

Total knee joint prosthesis Download PDF

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Publication number
FR2760352A1
FR2760352A1 FR9702969A FR9702969A FR2760352A1 FR 2760352 A1 FR2760352 A1 FR 2760352A1 FR 9702969 A FR9702969 A FR 9702969A FR 9702969 A FR9702969 A FR 9702969A FR 2760352 A1 FR2760352 A1 FR 2760352A1
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FR
France
Prior art keywords
implant
shaft
prosthesis
tibial implant
finger
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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.)
Granted
Application number
FR9702969A
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French (fr)
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FR2760352B3 (en
Inventor
Philippe Berret
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Individual
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Individual
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Priority to FR9702969A priority Critical patent/FR2760352B3/en
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Publication of FR2760352B3 publication Critical patent/FR2760352B3/en
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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
    • A61F2/3836—Special connection between upper and lower leg, e.g. constrained
    • A61F2/384—Special connection between upper and lower leg, e.g. constrained hinged, i.e. with transverse axle restricting the movement
    • A61F2/385—Special connection between upper and lower leg, e.g. constrained hinged, i.e. with transverse axle restricting the movement also provided with condylar bearing surfaces
    • 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
    • A61F2/3886—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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30354—Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30362—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit with possibility of relative movement between the protrusion and the recess
    • A61F2002/30364—Rotation about the common longitudinal axis
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
    • A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30772—Apertures or holes, e.g. of circular cross section
    • A61F2002/30774—Apertures or holes, e.g. of circular cross section internally-threaded
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special 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
    • A61F2002/30884—Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special 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
    • A61F2002/30886—Special 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 externally-threaded
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
    • 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
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The prosthesis consists of femoral and tibial implants which are able to perform a flexion-extension angular movement relative to one another in the saggital plane and pivot in the frontal plane. The femoral implant is able to turn about one end (21) of a one-piece angled peg (20), while the tibial implant is able to pivot about the other end of the same peg. The upper end of the peg is able to rotate and move freely in bearings (8) in ovoid cavities in the side walls of the inter-cotyloidal box of the femoral implant, while the lower shank of the peg is able to rotate and move freely in a socket in a plate (23) connected to the tibial implant.

Description

La présente invention concerne le domaine de la prothèse articulaire du corps humain et plus particulièrement celui de la prothèse totale du genou. The present invention relates to the field of joint prosthesis of the human body and more particularly that of the total knee prosthesis.

Différents types de prothèses destinées à remplacer totalement l'articulation du genou ont déjà été proposées. Different types of prostheses intended to completely replace the knee joint have already been proposed.

De telles prothèses sont généralement concues de manière à permettre à un implant tibial d'effectuer par rapport à un implant fémoral une rotation suivant un axe horizontal, recréant le mouvement de la flexion-extension, et une rotation suivant un axe vertical, recréant le mouvement pivotant du tibia. Such prostheses are generally designed so as to allow a tibial implant to perform relative to a femoral implant a rotation along a horizontal axis, recreating the movement of the flexion-extension, and a rotation along a vertical axis, recreating the movement pivot of the tibia.

Le mouvement de flexion-extention est généré par l'assemblage de pièces formant un mécanisme logé dans un boitier entre les condyles fémoraux prothétiques et mis en rotation sur des rondelles plastiques insérées dans les parois latérales dudit boitier. The flexion-extension movement is generated by the assembly of parts forming a mechanism housed in a housing between the prosthetic femoral condyles and rotated on plastic washers inserted in the side walls of said housing.

Selon les prothèses du type ci-dessus le mouvement pivotant du tibia s'effectue par l'intermédiaire d'un axe monté sur l'implant tibial ou rattaché au mécanisme mobile de l'implant fémoral et pouvant tourner à l'intérieur d'un fourreau plastique noyé dans une douille métallique solidaire de l'implant tibial ou du mécanisme mobile de l'implant fémoral. According to the prostheses of the above type, the pivoting movement of the tibia is effected by means of an axis mounted on the tibial implant or attached to the mobile mechanism of the femoral implant and capable of turning inside a plastic sheath embedded in a metal socket secured to the tibial implant or the mobile mechanism of the femoral implant.

De telles prothèses ne donnent pas entière satisfation, car les mécanismes induisants les mouvements de flexion extention et de rotation des implants fémoraux et tibiaux font intervenir un nombre important de pièces, variant de sept à dix pour la plupart. Such prostheses are not entirely satisfactory, since the mechanisms inducing the flexion, extension and rotation movements of the femoral and tibial implants involve a large number of parts, varying from seven to ten for the most part.

Le nombre élevé de ces pièces plastiques et métalliques impose une limitation des sections et des épaisseurs de matière de certaines d'entre elles pouvant provoquer une usure prématurée et une rupture. The high number of these plastic and metallic parts imposes a limitation of the sections and the thicknesses of material of some of them which can cause premature wear and rupture.

Un élément important soumis aux frottements, tel que le fourreau, est indémontable et sa détérioration entraîne l'extraction de la prothèse.  An important element subjected to friction, such as the sheath, cannot be dismantled and its deterioration leads to the extraction of the prosthesis.

Le nombre élevé de ces pièces entraine également des résections osseuses du boitier intercondylien d'en moyenne 40 à 45 cm3. The high number of these parts also leads to bone resections of the intercondylar case of an average of 40 to 45 cm3.

L'implantation de certains types de ces prothèses demande des résections supplémentaires à la découpe habituellement opérée pour positionner l'implant tibial. The implantation of certain types of these prostheses requires additional resections to the cutting usually performed to position the tibial implant.

Ces résections affaiblissent le capital osseux nécessaire à la bonne tenue et au fonctionnement durable d'une prothèse totale du genou soumise à de fortes contraintes mécaniques. These resections weaken the bone capital necessary for the good performance and lasting functioning of a total knee prosthesis subjected to strong mechanical stresses.

La prothèse selon l'invention se propose de remédier à ces inconvénients et d'apporter de nouveaux avantages techniques, en ce sens que le mécanisme responsable de la flexion extension et de la rotation de l'implant tibial ne comporte que quatre pièces, chacune d'entre elles bénéficiant d'épaisseurs de matière optimale leur conférant une durabilité accrue. The prosthesis according to the invention proposes to remedy these drawbacks and to bring new technical advantages, in the sense that the mechanism responsible for the flexion extension and the rotation of the tibial implant comprises only four parts, each of '' benefit from optimum material thicknesses giving them increased durability.

La résection du boitier intercondylien avoisine 22 cm3. The resection of the intercondylar box is around 22 cm3.

Ce volume réduit augmente la surface et la résistance des condyles fémoraux et améliore la stabilité de la prothèse. This reduced volume increases the surface area and the resistance of the femoral condyles and improves the stability of the prosthesis.

Les principales pièces soumises aux contraintes de compression et de frottement, telles que le plateau sur lequel frottent les condyles fémoraux et la fourrure renfermant le doigt angulaire autour duquel l'implant tibial pivote sont une même pièce massive logée dans la semelle et la queue de l'implant tibial
La conception de la prothèse rend le plateau démontable et permet aisément son remplacement.The main parts subject to compression and friction stresses, such as the plate on which the femoral condyles rub and the fur enclosing the angular finger around which the tibial implant pivots are the same massive part housed in the sole and tail of the tibial implant
The design of the prosthesis makes the tray removable and allows easy replacement.

Pour cela et selon une première caractéristique, une extrémité d'un doigt monobloc angulaire est montée sur deux paliers rainurés circulairement, insérés dans deux cavités ovoïdes du boitier intercondylien de l'implant fémoral, alors que l'autre extrémité du doigt tourne en appui dans un fourreau du plateau positionné à l'intérieur de l'embase et de la queue de l'implant tibial. For this and according to a first characteristic, one end of an angular monobloc finger is mounted on two circularly grooved bearings, inserted in two ovoid cavities of the intercondylar case of the femoral implant, while the other end of the finger rotates in a sheath of the plate positioned inside the base and the tail of the tibial implant.

Le bloc intercondylien, mortaisé suivant son axe médian et sur une plage angulaire définie, permet le déplacement du doigt induisant la flexion-extention et la rotation des implants fémoraux et tibiaux entre eux. The intercondylar block, slotted along its median axis and over a defined angular range, allows the displacement of the finger inducing flexion-extension and rotation of the femoral and tibial implants between them.

Diverses autres caractéristiques ressortent de la description faite ci-dessous en référence aux dessins annexés qui montrent à titre d'exemple non limitatif une forme de réalisation de l'objet de l'invention. Various other characteristics will emerge from the description given below with reference to the accompanying drawings which show by way of nonlimiting example an embodiment of the subject of the invention.

- La figure 1 est une vue dorsale d'une prothèse conforme à l'invention. - Figure 1 is a back view of a prosthesis according to the invention.

- La figure 2 est une vue en coupe dans le plan
sagittal, prise selon la ligne 2-2 de la Fig 1.- Figure 2 is a sectional view in the plane
sagittal, taken along line 2-2 of Fig 1.

- La figure 3 est une vue dans le plan sagittal du plateau et de l'implant tibial conforme à l'invention. - Figure 3 is a view in the sagittal plane of the tray and the tibial implant according to the invention.

- La figure 4 est une vue dans le plan sagittal d'un palier et du doigt angulaire de la prothèse conforme à l'invention. - Figure 4 is a view in the sagittal plane of a bearing and the angular finger of the prosthesis according to the invention.

Selon les figures 1 et 2, la prothèse totale du genou conforme à l'invention comprend un implant fémoral 1 et un implant tibial 2 pouvant effectuer l'un par rapport à l'autre un mouvement angulaire de flexion extension dans le plan sagittal et un pivotement dans le plan frontal. According to FIGS. 1 and 2, the total knee prosthesis according to the invention comprises a femoral implant 1 and a tibial implant 2 which can perform, relative to each other, an angular movement of flexion extension in the sagittal plane and a pivoting in the frontal plane.

Pour cela, la pièce fémorale 1 pouvant être en un matériau métallique approprié pour l'utilisation médicale est représentée en partie avant par la trochlée 3 et en partie arrière par les condyles 4 réunis par le boitier intercondylien 5 délimité latéralement par les parois 6 percées de deux cavités ovoïdes 7 recevant des paliers 8 munis d'évidements circulaires 9. For this, the femoral part 1 which can be made of a metallic material suitable for medical use is represented in the front part by the trochlea 3 and in the rear part by the condyles 4 joined by the intercondylar case 5 delimited laterally by the walls 6 pierced with two ovoid cavities 7 receiving bearings 8 provided with circular recesses 9.

Le boitier intercondylien 5 possède, solidarisé à sa face supérieure 10, une queue 11 dont les axes médians, dans le plan dorsal et le plan saggital, forment avec la face 10 deux angles de 850, la queue 11 se terminant par un congé 12 et un axe fileté 13 sur lesquels peuvent venir se visser un bouchon ou une extention de queue. The intercondylar box 5 has, secured to its upper face 10, a tail 11 whose median axes, in the dorsal plane and the saggital plane, form with the face 10 two angles of 850, the tail 11 ending in a leave 12 and a threaded pin 13 on which can be screwed a plug or a tail extension.

Les faces latérales 6, 10 et 14 du boitier 5, la paroi périphérique 15 de la queue 11 et la face interne 16 de la trochlée 3, destinées à venir au contact des faces de résection du fémur et de son canal médullaire peuvent être munies de dispositifs, réalisés mécaniquement et par projection, améliorant l'ancrage dans l'os. The lateral faces 6, 10 and 14 of the case 5, the peripheral wall 15 of the tail 11 and the internal face 16 of the trochlea 3, intended to come into contact with the resection faces of the femur and its medullary canal can be provided with devices, made mechanically and by projection, improving anchoring in the bone.

La partie inférieure du boitier 5 possède un évidement 17 limité par les faces 18 et 19 qui tiennent le rôle de butée au mouvemement d'un doigt angulaire monobloc 20 dont le tenon 21 est libre en rotation et déplacement dans les évidements circulaires 9 des deux paliers identiques 8 logés dans les cavités ovoïdes 7 des parois latérales 6 du boitier intercondylien 5 de l'implant fémoral 1. The lower part of the housing 5 has a recess 17 limited by the faces 18 and 19 which act as an abutment for the movement of a one-piece angular finger 20 whose tenon 21 is free to rotate and move in the circular recesses 9 of the two bearings identical 8 housed in the ovoid cavities 7 of the side walls 6 of the intercondylar box 5 of the femoral implant 1.

Les butées 18 et 19 autorisent un débattement angulaire de flexion-extention proche de 1200. The stops 18 and 19 allow an angular deflection-extension close to 1200.

L'implant tibial 2 pouvant être en un matériau métallique approprié pour l'utilisation médicale, est muni d'une embase 22 destinée à recevoir le plateau 23 et d'une queue 24 se terminant par le congé 12 et l'axe fileté 13 sur lesquels peuvent venir se visser un bouchon ou une extention de queue. The tibial implant 2, which may be of a metallic material suitable for medical use, is provided with a base 22 intended to receive the plate 23 and with a tail 24 ending in the leave 12 and the threaded axis 13 on which can be screwed a plug or a tail extension.

La rigidité de la liaison entre l'embase 22 et la queue 24 est assurée par trois nervures 25 servant également d'aillettes anti-rotation de l'implant tibial 2 dans le canal médullaire du tibia où il est implanté. The rigidity of the connection between the base 22 and the tail 24 is provided by three ribs 25 also serving as anti-rotation fins of the tibial implant 2 in the medullary canal of the tibia where it is implanted.

La face inférieure 26 de l'embase 22, la paroi périphérique 27 de la queue 24 et les nervures 25 peuvent être munies de dispositifs, réalisés mécaniquement et par projection, améliorant l'ancrage dans l'os. The underside 26 of the base 22, the peripheral wall 27 of the tail 24 and the ribs 25 may be provided with devices, produced mechanically and by projection, improving anchoring in the bone.

Selon la figure 3, la prothèse totale du genou conforme à l'invention comprend un plateau 23, pouvant être en un matériau favorisant le glissement tel que le polyéthylène haute densité, entaillé d'un épaulement 28, d'un trou lamé 29 et d'un fourreau 30 destiné à contenir la rotation et le déplacement du doigt 20. According to Figure 3, the total knee prosthesis according to the invention comprises a plate 23, which may be made of a material promoting sliding such as high density polyethylene, notched with a shoulder 28, with a blade hole 29 and d 'a sheath 30 intended to contain the rotation and displacement of the finger 20.

Le fourreau 30 et le plateau 23 ne forment qu'une seule et même pièce. The sheath 30 and the plate 23 form a single piece.

L'embase 22 de l'implant tibial 2 est muni d'un évidement 31 et d'un trou taraudé 32, tandis que la queue 24 est percée d'une cavité 33. The base 22 of the tibial implant 2 is provided with a recess 31 and a tapped hole 32, while the tail 24 is pierced with a cavity 33.

L'assemblage du plateau 23 et de l'implant tibial 2 est obtenu par emboitement sans jeu de l'épaulement 28 dans l'évidement 31 tandis que le fourreau 30 se loge dans la cavité 33 de la queue 24 de l'implant tibial 2. The assembly of the plate 23 and the tibial implant 2 is obtained by interlocking without play of the shoulder 28 in the recess 31 while the sheath 30 is housed in the cavity 33 of the tail 24 of the tibial implant 2 .

Le maintien en position des pièces 23 et 2 est obtenu par le montage de la vis 34 à travers le trou lamé 29 et blocage dans le trou taraudé 32. The holding in position of the parts 23 and 2 is obtained by mounting the screw 34 through the blade hole 29 and blocking in the tapped hole 32.

Selon la figure 4, la prothèse totale du genou conforme à l'invention comprend un doigt angulaire monobloc 20 formé de l'arbre 35 surmonté perpendiculairement et en tout point symétrique par le tenon 21, de l'arbre 36 et en sa partie centrale du collet 37 pourvu d'un congé de renfort 38 et d'un congé d'appui 39. According to FIG. 4, the total knee prosthesis according to the invention comprises a one-piece angular finger 20 formed from the shaft 35 surmounted perpendicularly and at all symmetrical points by the pin 21, from the shaft 36 and in its central part of the collar 37 provided with reinforcement leave 38 and support leave 39.

L'axe median AA' de l'arbre 35 du doigt angulaire monobloc 20 forme avec l'axe médian BB' de l'arbre 36 un anqle C. The median axis AA 'of the shaft 35 of the one-piece angular finger 20 forms with the median axis BB' of the shaft 36 an anqle C.

Les deux paliers 8, identiques de part leur forme, sont munis d'évidements circulaires 8 non débouchants destinés à recevoir et à contenir avec un léger jeu la rotation et le déplacement du tenon 21. The two bearings 8, identical in terms of their shape, are provided with non-opening circular recesses 8 intended to receive and contain with a slight play the rotation and the displacement of the lug 21.

En position de fonctionnement de la prothèse conforme à l'invention, dans le plan frontal l'axe médian de l'arbre 36 du doigt angulaire monobloc 20 est confondu avec l'axe médian CC' de la prothèse totale. In the operating position of the prosthesis according to the invention, in the frontal plane the median axis of the shaft 36 of the one-piece angular finger 20 is coincident with the median axis CC 'of the total prosthesis.

Dans le plan saggital l'axe médian BB' de l'arbre 36 du doigt angulaire monobloc 20 est confondu avec l'axe DD' de la prothèse totale, tandis que la face 40 des condyles fémoraux 4 vient au contact de la face 41 du plateau 23, l'arbre 36 du doigt angulaire monobloc 20 est inséré, libre en rotation et déplacement dans le fourreau 30 du plateau 23 solidarisé mécaniquement à l'implant tibial 2, jusqu'au contact de la paroi 42 du collet 37 avec la face d'appui 43 du plateau 23. In the saggital plane the median axis BB 'of the shaft 36 of the one-piece angular finger 20 is coincident with the axis DD' of the total prosthesis, while the face 40 of the femoral condyles 4 comes into contact with the face 41 of the plate 23, the shaft 36 of the one-piece angular finger 20 is inserted, free to rotate and move in the sheath 30 of the plate 23 mechanically secured to the tibial implant 2, until contact with the wall 42 of the collar 37 with the face support 43 of the plate 23.

L'implant fémoral 1 tourne alors autour de l'extrémité 21 du doigt angulaire monobloc 20 et l'implant tibial 2 pivote autour de l'autre extrémité 36 du doigt angulaire monobloc 20. The femoral implant 1 then rotates around the end 21 of the one-piece angular finger 20 and the tibial implant 2 pivots around the other end 36 of the one-piece angular finger 20.

Les avantages de la présente invention ressortent bien à la description. The advantages of the present invention appear clearly from the description.

Sont à souligner:
- Une conception du mécanisme de la prothèse totale ne faisant intervenir que très peu de pièces, toutes massives, diminuent d'autant son coût de fabrication, et redonnant à l'articulation prothésée ses mouvements naturels.Please note:
- A design of the mechanism of the total prosthesis involving only very few parts, all massive, reduce its manufacturing cost correspondingly, and restoring the prosthetic joint its natural movements.

- Des résections fémorales et tibiales limitées du fait du volume réduit du boitier intercondylien et du positionnement du doigt servant de pivot dans la queue de l'implant tibial. - Limited femoral and tibial resections due to the reduced volume of the intercondylar box and the positioning of the finger serving as a pivot in the tail of the tibial implant.

- L'augmentation de la stabilité de la prothèse et une meilleure répartition des contraintes qu'elle subie, par l'élargissement des surfaces condyliennes et par l'alignement du pivot dans l'axe médian de la prothèse. - The increase in the stability of the prosthesis and a better distribution of the stresses which it undergoes, by the widening of the condylar surfaces and by the alignment of the pivot in the median axis of the prosthesis.

- La posibilité de changer simplement et rapidement le plateau et la fourrure du doigt, pièces principales de glissement, réalisées en une seule pièce. - The possibility of quickly and simply changing the plate and the fur of the finger, main sliding parts, made in one piece.

- Le choix donné aux praticiens de visser des extentions de queues sur l'implant fémoral et tibial.  - The choice given to practitioners to screw tail extensions on the femoral and tibial implant.

Claims (6)

REVENDICATIONS (36) du doigt angulaire monobloc (20).CLAIMS (36) of the monobloc angular finger (20). -1 Prothèse totale du genou, du type comprenant un implant fémoral et un implant tibial pouvant effectuer l'un par rapport à l'autre un mouvement angulaire de flexion-extension dans le plan sagittal et un pivotement dans le plan frontal caractérisée en ce que l'implant fémoral (1) tourne autour de l'extrémité (21) du doigt angulaire monobloc (20) et en ce que l'implant tibial (2) pivote autour de l'autre extrémité -1 Total knee prosthesis, of the type comprising a femoral implant and a tibial implant capable of carrying out an angular movement of flexion-extension in the sagittal plane and a pivoting in the frontal plane, characterized in that the femoral implant (1) rotates around the end (21) of the monobloc angular finger (20) and in that the tibial implant (2) pivots around the other end -2 Prothèse selon la revendication 1, caractérisée en ce que le tenon (21) du doigt angulaire monobloc (20) est libre en rotation et déplacement dans les évidements circulaires non débouchants (9) des deux paliers identiques (8) logés dans les cavités ovoïdes (7) des parois latérales (6) du boitier intercondylien (5) de l'implant fémoral (1) et en ce que l'arbre (36) du doigt angulaire monobloc (20) est libre en rotation et déplacement dans le fourreau (30) du plateau (23) solidarisé mécaniquement à l'implant tibial (2). -2 Prosthesis according to claim 1, characterized in that the pin (21) of the one-piece angular finger (20) is free to rotate and move in the circular non-opening recesses (9) of the two identical bearings (8) housed in the cavities ovoids (7) of the side walls (6) of the intercondylar casing (5) of the femoral implant (1) and in that the shaft (36) of the monobloc angular finger (20) is free to rotate and move in the sheath (30) of the plate (23) mechanically secured to the tibial implant (2). -3 Prothèse selon la revendication 2, caractérisée en ce que, en position de fonctionnement,dans le plan frontal l'axe médian de l'arbre (36) du doigt angulaire monobloc (20) est confondu avec l'axe médian CC' de la prothèse totale, et en ce que dans le plan saggital l'axe médian BB' de l'arbre (36) du doigt angulaire monobloc (20) est confondu avec l'axe DD' de la prothèse totale. -3 Prosthesis according to claim 2, characterized in that, in the operating position, in the frontal plane the median axis of the shaft (36) of the one-piece angular finger (20) coincides with the median axis CC 'of the total prosthesis, and in that in the saggital plane the median axis BB 'of the shaft (36) of the one-piece angular finger (20) coincides with the axis DD' of the total prosthesis. -4 Prothèse selon la revendication 2, caractérisée en ce que l'axe médian AA' de l'arbre (35) du doigt angulaire monobloc (20) forme avec l'axe médian BB' de l'arbre (36) un anqle S et en ce que l'arbre (35) est surmonté perpendiculairement et en tout point symétrique par le tenon (21). -4 Prosthesis according to claim 2, characterized in that the median axis AA 'of the shaft (35) of the one-piece angular finger (20) forms with the median axis BB' of the shaft (36) an anqle S and in that the shaft (35) is surmounted perpendicularly and at any symmetrical point by the tenon (21). -5 Prothèse selon la revendication 2, caractérisée en ce que le fourreau (30) et le plateau (23) ne forme qu'une seule et même pièce et en ce que le fourreau (30) se loge dans la cavité (33) de la queue (24) de l'implant tibial (2). -5 Prosthesis according to claim 2, characterized in that the sheath (30) and the plate (23) form only one and the same piece and in that the sheath (30) is housed in the cavity (33) of the tail (24) of the tibial implant (2). -6 Prothèse selon la revendication 1, caractérisée en ce implant fémoral (1) et l'implant tibial (2) sont munis de queues (11) et (24) se terminant par les congés (12) et les axes filetés (13) sur lesquels peuvent venir se visser un bouchon ou une extention de queue.  -6 Prosthesis according to claim 1, characterized in this femoral implant (1) and the tibial implant (2) are provided with tails (11) and (24) ending with the fillets (12) and the threaded axes (13) on which can come screw a plug or a tail extension.
FR9702969A 1997-03-10 1997-03-10 TOTAL KNEE PROSTHESIS Expired - Fee Related FR2760352B3 (en)

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