JP2005517470A - 膝蓋大腿関節の置換方法とその器具類 - Google Patents
膝蓋大腿関節の置換方法とその器具類 Download PDFInfo
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- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
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- 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
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- 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
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- 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
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Abstract
Description
Claims (24)
- 膝蓋大腿関節置換を必要とする患者への埋め込み用の膝蓋大腿関節置換部材であって、
前記部材が、大腿骨インプラント構成部材と膝蓋インプラント構成部材から成り、
前記大腿骨インプラント構成部材は、骨に対向する面と上面とを具備し、前記上面は、その長手軸に沿って配置された連節溝を画定し、前記連節溝は、上方へ角度付けされた上向き部を有するように構成された遠位終点を有しており、
前記膝蓋インプラント構成部材は、前記大腿骨インプラントの前記連節溝と摺動可能に連節される連節面と、その反対側に配置された固定面とを具備しており、
前記部材が、膝蓋大腿関節の完全な可動域を持つことを特徴とする膝蓋大腿関節置換部材。 - 前記大腿骨インプラントの連節溝が、前記連節溝に沿って長手方向に配向された略凹形状をしており、前記膝蓋インプラントの連節面が、前記連節溝に対して概して相補的な略凸形状をしていることを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 前記骨に対向する面が、前記大腿骨インプラントの最外縁の少なくとも一部に沿って周縁に配置されたアンダーカット・エッジを有することを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 前記骨に対向する面が、接着材の一部を受け入れるように大きさと形状が決められた少なくとも1つの陥凹ポケットを有し、前記陥凹ポケットは、前記部材が骨の表面に埋め込まれる際の表面積を増加させ、かつ接着の向上をもたらすことを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 前記大腿骨インプラントの骨に対向する面が、粗面を具備することを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 前記粗面が、少なくとも1つのスパイクまたはペグを具備することを特徴とする請求項5記載の膝蓋大腿関節置換部材。
- 前記粗面が、多孔質皮膜を具備することを特徴とする請求項5記載の膝蓋大腿関節置換部材。
- 前記膝蓋インプラントの前記固定面が、骨内へ挿入されるように大きさと形状が決められた少なくとも1つの骨固定部材を具備することを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 前記骨固定部材が、前記骨固定部材に沿って周縁に配置された環状の保持溝を具備することを特徴とする請求項8記載の膝蓋大腿関節置換部材。
- 前記膝蓋固定面が、前記骨固定部材に加えて、さらに少なくとも1つのペグを具備することを特徴とする請求項8記載の膝蓋大腿関節置換部材。
- 前記大腿骨インプラントの骨に対向する面が、さらに髄内ステムを具備し、前記髄内ステムが、患者の大腿骨管内へ挿入されるように大きさと形状が決められていることを特徴とする請求項1記載の膝蓋大腿関節置換部材。
- 膝蓋大腿関節置換部材と、患者の大腿骨の前面の切開用骨鋸の使用を精確にガイドする切開用ガイドと、患者の大腿骨への骨ドリル・ビットの挿入を精確にガイドするドリル・ガイドと、から成る膝蓋大腿関節置換システム。
- ユーザが骨鋸を用いて骨を切開する前に前記骨鋸を精確に配置するための前記切開用ガイドの配置が容易になされるように大きさと形状が決められた隙間ゲージを、さらに具備することを特徴とする請求項12記載の膝蓋大腿関節置換システム。
- 膝蓋大腿関節置換を受ける患者の手術による切開部へ挿入されるように大きさと形状が決められており、前記膝蓋大腿関節置換部材を受け入れるように骨を処理するための研磨表面を備えるように少なくとも部分的に表面加工された骨やすりを、さらに具備することを特徴とする請求項12記載の膝蓋大腿関節置換システム。
- 前記ドリル・ガイドは、穿孔する骨に面して配置するドリル・ガイド・ブロックを具備し、前記ドリル・ガイド・ブロックは、ドリル・ビットが前記ドリル・ガイド・ブロックの片側の入口からその反対側へ摺動可能に通ることをガイドするように大きさと形状が決められたドリル・ガイド通路を画定し、さらに前記ドリル・ガイド・ブロックは、髄内管の穿孔を容易にする安定したガイドをもたらすことを特徴とする請求項12記載の膝蓋大腿関節置換システム。
- 前記ドリル・ガイド・ブロックには、ユーザが手術中に前記ドリル・ガイド・ブロックを適当な位置に置けるように構成されたハンドルが設けられていることを特徴とする請求項15記載膝蓋大腿関節置換システム。
- 前記ドリル・ガイド・ブロックには、ドリル・ガイド・スタイラスが設けられており、前記ドリル・ガイド・スタイラスは、患者の大腿骨の前面と前記ドリル・ガイド・スタイラスの近位端に位置するドリル・ガイド・スタイラス/大腿骨接点との間を結ぶように大きさと形状が決められており、さらに前記ドリル・ガイド・スタイラスは、前記ドリル・ガイドの動作中、前記ドリル・ガイド・ブロックを安定させることを特徴とする請求項15記載の膝蓋大腿関節置換システム。
- 前記ドリル・ガイド・ブロックには、手術中に骨に面して置かれる前記ドリル・ガイド・ブロックの表面から突き出た少なくとも1つのドリル・ガイド配置用先端部が設けられており、前記配置用先端部は、前記ドリル・ガイドの追加的な補強手段となることを特徴とする請求項17記載の膝蓋大腿関節置換システム。
- 前記切開用ガイドが、髄内ロッドと、切開用ガイド部材と、スタイラス・アームと、から成り、
前記髄内ロッドは、患者の大腿骨内に設定される髄内管に挿入できるように大きさと形状が決められ、さらにその表面には、前記髄内ロッドの長手方向軸に沿って配向される少なくとも1つの溝が設けられており、
前記切開ガイド部材は、前記髄内ロッドの近位端に接続され、さらに前記切開用ガイドの動作中に骨鋸を摺動可能にガイドできるように大きさと形状が決められた切開用ガイド・スロットを画定するため、前記切開用ガイド部材の長手方向軸に沿って二分されており、
前記スタイラス・アームは、前記切開用ガイドの近位端に可動可能に接続され、さらに前記スタイラス・アームのスタイラス/大腿骨接点と患者の大腿骨前面との間を安定させるように大きさと形状が決められていることを特徴とする請求項12記載の膝蓋大腿関節置換システム。 - 前記切開用ガイドが、個々のアンカー・ガイド入口を画定する少なくとも1つのアンカー・ガイドを具備し、前記少なくとも1つのアンカー・ガイドは、固定点を提供できるように前記鋸ガイド部材上に配置されており、外科医は前記固定点を介して患者の骨に固定用の穴を穿孔し、また手術中の安定のためアンカーを前記アンカー・ガイド入口に通して患者の骨に固定させることができ、前記スタイラス・アームと前記アンカー・ガイドによって、前記切開用ガイドを安定させる複数の安定点が提供されることを特徴とする請求項19記載の膝蓋大腿関節置換システム。
- 患者への膝蓋大腿関節置換部材の埋込みに使用する器具一式であって、前記器具一式が、
膝蓋大腿関節置換部材と、
患者の大腿骨に髄内管を穿孔する作業においてドリル・ビットを安定、配置させるためのドリル・ガイドと、
患者の大腿骨の前面を切開する作業において骨鋸刃を安定、配置させるための切開用ガイドと、から成ることを特徴とする器具一式。 - 前記膝蓋大腿関節置換部材を受け入れる患者の大腿骨表面を処理するための骨やすりをさらに具備することを特徴とする請求項21記載の器具一式。
- 患者の処理済みの前記大腿骨表面に、前記ドリル・ガイド、前記切開用器具及び前記膝蓋大腿関節置換部材の構成部材を強制的に挿入するための衝撃部材をさらに具備することを特徴とする請求項22記載の器具一式。
- 膝蓋大腿関節置換を必要とする患者に膝蓋大腿関節置換部材を埋め込む方法であって、前記方法が、
ドリル・ガイドと、髄内ロッド構成部材を有する切開用ガイドと、大腿骨インプラント構成部材と膝蓋インプラント構成部材を有する膝蓋大腿関節置換部材と、を供給すること、
前記患者の膝蓋大腿関節を外科的に露出させ、前記ドリル・ガイドを患者の大腿骨の遠位端へ固定し、前記ドリル・ガイドを使用してドリル・ビットを前記大腿骨に対して精確に配置させること、
前記ドリル・ビットを使用して前記大腿骨内に髄内管を準備すること、
前記ドリル・ビットとドリル・ガイドを取り外すこと、
切開用骨切開器具を精確にガイドできるように前記大腿骨の前記髄内管に前記髄内ロッドを挿入することにより、前記切開用ガイドを前記大腿骨に固定すること、
前記大腿骨の前面を実質上平らになるように処理するため前記大腿骨の前面を切開し、前記患者から前記切開用ガイドを取り外すこと、
前記大腿骨インプラント構成部材を前記大腿骨の処理済みの前面に埋め込むこと、
前記大腿骨インプラント構成部材と前記膝蓋インプラント構成部材が摺動可能に連接する関節を成すように前記膝蓋インプラント構成部材を前記患者に埋込むこと、から成る方法。
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US5683398A (en) * | 1996-02-20 | 1997-11-04 | Smith & Nephew Inc. | Distal femoral cutting block assembly |
US6702821B2 (en) * | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
JP4319337B2 (ja) * | 2000-07-27 | 2009-08-26 | 泉工医科工業株式会社 | 人工膝関節の大腿骨コンポーネント |
US6514259B2 (en) * | 2001-02-02 | 2003-02-04 | Carnegie Mellon University | Probe and associated system and method for facilitating planar osteotomy during arthoplasty |
AU2003219773B2 (en) * | 2002-02-14 | 2007-02-01 | Biomet Spain Orthopaedics S.L. | Method and instrumentation for patello-femoral joint replacement |
-
2003
- 2003-02-14 AU AU2003219773A patent/AU2003219773B2/en not_active Ceased
- 2003-02-14 DK DK03716047.0T patent/DK1480582T3/da active
- 2003-02-14 JP JP2003567307A patent/JP4761240B2/ja not_active Expired - Fee Related
- 2003-02-14 PT PT03716047T patent/PT1480582E/pt unknown
- 2003-02-14 WO PCT/US2003/004621 patent/WO2003068119A2/en active Application Filing
- 2003-02-14 EP EP03716047A patent/EP1480582B1/en not_active Expired - Lifetime
- 2003-02-14 ES ES03716047T patent/ES2391148T3/es not_active Expired - Lifetime
- 2003-02-14 US US10/366,415 patent/US20030181984A1/en not_active Abandoned
- 2003-02-14 CN CN038040182A patent/CN1633265B/zh not_active Expired - Fee Related
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2009
- 2009-01-14 JP JP2009005913A patent/JP2009131638A/ja active Pending
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8801715B2 (en) | 2007-09-28 | 2014-08-12 | Lexi Corporation, Ltd. | Apparatus for preoperative planning of artificial knee joint replacement operation and jig for supporting operation |
JP2012531265A (ja) * | 2009-06-24 | 2012-12-10 | コンフォーミス・インコーポレイテッド | 患者適合型の改良された整形外科用インプラント、設計および関連ツール |
JP2011078529A (ja) * | 2009-10-06 | 2011-04-21 | Biomet Japan Inc | 人工膝関節設置用ジグ |
JP2012045417A (ja) * | 2011-10-31 | 2012-03-08 | Lexi:Kk | 人工膝関節置換手術用治具 |
JP2014111117A (ja) * | 2013-11-20 | 2014-06-19 | Lexi:Kk | 人工膝関節置換手術用治具 |
JP2016043114A (ja) * | 2014-08-25 | 2016-04-04 | 京セラメディカル株式会社 | 人工膝関節置換術用手術器具 |
Also Published As
Publication number | Publication date |
---|---|
AU2003219773A1 (en) | 2003-09-04 |
PT1480582E (pt) | 2012-10-02 |
EP1480582A2 (en) | 2004-12-01 |
ES2391148T3 (es) | 2012-11-22 |
DK1480582T3 (da) | 2012-10-22 |
WO2003068119A2 (en) | 2003-08-21 |
US20090326660A1 (en) | 2009-12-31 |
JP4761240B2 (ja) | 2011-08-31 |
CN1633265A (zh) | 2005-06-29 |
JP2009131638A (ja) | 2009-06-18 |
AU2003219773B2 (en) | 2007-02-01 |
CN1633265B (zh) | 2010-12-08 |
US20030181984A1 (en) | 2003-09-25 |
EP1480582A4 (en) | 2008-12-03 |
EP1480582B1 (en) | 2012-07-18 |
WO2003068119A3 (en) | 2003-12-04 |
US8226726B2 (en) | 2012-07-24 |
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