JP2005527288A - Modular femoral element for knee arthroplasty - Google Patents

Abstract

An artificial knee joint system for forming a new surface on a joint surface resected at the tip of the femur includes a thigh element configured to engage with the resected joint surface, and a mounting member. The inner surface of the femoral element is engaged with the removed articular surface of the femur so that when the first mounting member passes the inner or outer surface of the excised joint surface, the inner surface of the femoral element is coupled to the first mounting member. Configured. The femoral element can be used in monolithic and separate systems. Also disclosed are methods of engaging the thigh components (e.g., including a lip that is tapered or connected by a groove).

Description

  The present invention relates to a femoral element for use in total knee arthroplasty.

  In normal knee arthroplasty treatment, the femur is resected using surgical instruments to form a resected portion of the thigh, the so-called resected femur. Usually, a metal cap-like femoral element is attached to the resected femur. The femoral element is usually designed to articulate with a tibial element attached to the resected tibia.

  In arthroplasty treatment, the femoral element reaches the resected femur inserted through the incision. If the femoral element is large and bulky, a large incision is required, so that the period required for recovery becomes longer, and the patient suffers from the surgery and recovery period.

  Illustrated in FIGS. 1 and 2 is one embodiment of an artificial femoral element 10 having an inner surface 12 and an outer surface 14. The inner surface 12 is composed of a plurality of intersecting substantially flat surfaces corresponding to the cut surfaces of the femur. The pegs 16a, 16b protrude from the inner surface 12 to engage the femur. The pegs 16a, 16b are implanted in the resected femur to secure the femoral element to the femur. The outer surface 14 articulates with the tibial element.

Since the peg is fixed to the excised femur by crimping and protrudes from the inner surface, the femoral element also has a large bulky dimension, and it is necessary to enlarge the incision during surgery.
Therefore, the femoral element used for knee arthroplasty is not bulky and does not require a large incision during the operation. There is also a need for a femoral element that is securely fixed to a resected femur and is easy to attach.

  An object of the present invention is to provide a compact femoral element that can be attached minimally invasively without requiring a large incision in knee arthroplasty. It is a further object of the present invention to provide a separate femoral element that is secured to a resected femur and is easy to attach.

  In order to achieve the above object, an artificial knee joint system of the present invention is an artificial knee joint system for forming a new surface on a joint surface excised at the distal end of a femur, and (i) A thigh element having an inner surface configured to engage the articulating surface and (ii) an opposing articulating surface, the element further comprising a first portion comprising a first section of the articulating surface; A second portion comprising a second section of the surface, the second portion being selectively engageable with the first portion, and means for selectively coupling the first portion to the second portion .

  According to another aspect of the present invention, an artificial knee joint system for forming a new surface on a joint surface resected at the distal end of the femur is configured to (i) engage with the resected joint surface. A thigh element having a configured inner surface and (ii) an opposing connecting surface, the element further comprising a first portion comprising a first section of the connecting surface and a second section comprising a second section of the connecting surface. The portion and the first portion are selectively connected to the second portion.

  According to a further aspect of the present invention, the femoral element of the knee prosthesis for forming a new surface on the articulated surface resected at the distal end of the femur has a substantially U-shaped shape and is posterior to the front end. An outer condyle having an outer surface and an inner surface facing each other extending between the ends, and an inner surface facing the outer surface having a substantially U-shape and extending between each of the front and rear ends. And the medial condyle is configured to engage the anterior surface of the lateral condyle and the medial condyle is selective to the lateral condyle to form a slot between the medial condyle and the lateral condyle To be connected to.

  According to still another aspect of the present invention, the femoral element of the artificial knee joint for forming a new surface on the joint surface resected at the tip of the femur includes a patella condyle and a femur from which at least a part thereof has been resected. A tibial condyle configured to correspond to the anterior portion of the bone and selectively coupled to the patella condyle, and (i) the articular surface from which the patella condyle and the tibial condyle have been resected And (ii) collectively forming thigh elements having an inner surface configured to engage with and (ii) opposing articulating surfaces.

  3-6 illustrate an example of a knee prosthesis system used in knee arthroplasty, wherein the femoral element is slid through the incision to the medial or lateral surface to provide a femoral resection. 60 (see FIG. 5). Mounting members such as bolts and screws are inserted from the femur and reach the femoral element. The treatment is minimally invasive and does not require large incisions like the elements with pegs 16a, 16b shown in FIGS. Bolts, screws and other mounting members securely fix the femoral element to the resected femur without relying solely on crimping. 7 to 8A show examples of artificial knee joint systems 70 and 80 used for knee arthroplasty, and include engaging lips 78a and 78b and grooves 79a and 79b (see FIG. 7), or engaging tapered surfaces. (See FIG. 8) and the like to hold the femoral element to the resected femur.

  FIGS. 9-14 show separable separable femoral elements 102, 131, 161 and 191 used in knee arthroplasty, the two separated parts separately passing through the incision and the medial surface Alternatively, after being slid to the outer surface, it is connected and attached to the femoral resection. Optionally, one part may be attached to the femoral resection and the other connected to the femoral resection. Both parts may be attached first and then connected. Mounting members such as bolts and screws are inserted from the femur to reach the femoral element. Optionally, bone cement may be used to secure the femoral element to the resected femur.

  Connecting members such as bolts and screws attach one of the thigh elements to the other. The treatment is minimally invasive and does not require a large incision as an integral component because one of the femoral elements is placed through the incision and the other is placed. If only a portion of the femoral element (eg, the tibia) is required for a particular treatment, the individual portion of the femoral element may be used without its corresponding engaging element.

  FIGS. 15A-16B show a separable separable femoral element 210 used in knee arthroplasty, with the two separate parts sliding separately through the incision to the medial or lateral surface And then attached to the femoral resection. Optionally, one part may be attached to the femoral resection and the other connected to the femoral resection. An integrated ridge extending from a part of the thigh element attaches the same part to the other. The treatment is minimally invasive and does not require a large incision as an integral component because one of the femoral elements is placed through the incision and then the other. The peg is used to secure the femoral element to the femoral resection.

  Each of these thigh elements will first be described in detail with respect to FIGS. FIG. 3 is a rear perspective view of the knee prosthesis system 20 for forming a new surface on the resected joint surface 64 (see FIG. 5). As shown in FIG. 5, the articulated surface 64 of the distal end portion 62 of the femur 60 has an inner surface 61 and an outer surface 63 that faces the inner surface 61.

  The artificial knee joint system 20 of FIG. 3 includes: (i) a U-shaped femoral element 22 having an inner surface 26 configured to engage a resected articulating surface 64 and an opposing articulating surface 24; (ii) A first mounting member such as a long bolt 36 having a threaded end; and (iii) a screw hole 32 formed in the inner surface 26 of the thigh element 22.

  When the thigh element 22 is engaged with the cut joint surface 64 of the femur 60 and the first mounting member 36 passes through the inner surface or the outer surface of the cut joint surface 64, the screw hole 32 passes through the first mounting member. 2 is an example of means formed on the inner surface 26 of the thigh element 22 to connect 36 to the thigh element 22; When the femoral element 22 is engaged with the cut joint surface 64 of the femur 60, the bolt 36 passes through the inner surface 61 or the outer surface 63 of the cut joint surface 64 and is screwed into the screw hole 32. As shown, the screw hole 32 forms an angle.

  The femoral element 22 has a generally U-shaped medial condyle 28 connected to a generally U-shaped lateral condyle 30. The thigh element has a front end 35 and a rear end 37. The medial condyle 28 is connected to the lateral condyle 30 and an elongated slot 39 is formed between the lateral condyle 30 and the medial condyle 28. In other embodiments, the femoral element of the present invention may comprise a generally U-shaped lateral condyle, or only a generally U-shaped medial condyle, depending on the desired procedure.

Any plate 29 of the femoral element 22 may be used to construct different surfaces that engage the complementary surfaces of the prosthesis.
In FIG. 3, the knee prosthesis system 20 includes (i) an optional second mounting member 38, and (ii) the femoral element 22 engaged with the articulated surface 64 of the femur 60, and the second mounting member 38. Means through the inner surface 26 of the thigh element 22 (eg, second screw holes) to connect the second mounting member 38 to the thigh element 22 as it passes through the inner or outer surface of the cut articulating surface 64. 34).

Optionally, other mounting members may extend from the front side of the inner surface to other screw holes proximate to the screw holes 32 as needed.
Examples of mounting members of the present invention include screws, bolts, pins and other fasteners that are moved through the femur 60 to engage the inner surface 26 of the femoral element 22. One or more mounting members 36, 38 may be mounted in one or more screw holes 32, 34, respectively. In one embodiment, the mounting members are each on opposite sides of the thigh element, as shown in FIG. As described above, in other embodiments, the mounting member may be attached to the same surface of the thigh element (see FIG. 4). These mounting members place and contain material on the inner surface 42 by having screw holes (see FIG. 3) or so that the fasteners penetrate or engage as described below with respect to FIG. By engaging, the inner surface 26 may be engaged.

  FIG. 4 is a rear perspective view of another knee prosthesis system that includes (i) an inner surface 42 configured to engage a resected joint surface 64 and an opposing connecting surface 43. And (ii) a first mounting member such as a long screw 52 having a threaded end, and (iii) a pocket 48 formed on the inner surface 42 of the thigh element 41.

  The femoral element 41 has at least one pocket 48 (filled with engagement and containment material 49) that houses at least one mounting member 52 that extends through the resected femur 60, and any additional pockets. 50 and the corresponding mounting member 54 are indicated by dashed lines. The pockets 48, 50 filled with the engagement / accommodating material are another example of means formed on the inner surface 42 of the thigh element 41 for connecting the mounting member to the thigh element.

  The pockets 48 and 50 are formed on the inner surface 26 of the thigh element 22 and engage / accommodate an adhesive (for example, polymethylmethacrylate) or other materials that can accommodate and hold the mounting member with sufficient flexibility. Filled with material. Other examples of the engagement / accommodating material include a bendable polymer such as Delrin (registered trademark Delrin) or polyetheretherketone that can accommodate the first mounting member and deform its shape.

  In one embodiment, in addition to using bolts or screws to attach the femoral element to the prosthesis, bone cement is used to further reinforce the adhesion of the femoral element to the resected femur. Also good. Bone cement may be applied before or during attachment of the femoral element. For example, the femoral element may be partially installed and then bone cement may be injected between the femoral element and the femur using a syringe or other delivery tube. In addition, a porous or fibrous material, such as a wire mesh, is attached to the inner surface 26 of the femoral element 22 to promote bone growth between the femoral element 22 and the resected femur 60, You may comprise the surface for mounting | wearing a bone cement between made femur.

FIG. 5 shows a perspective view of the femoral element of FIG. 3 attached to the resected femur 60. A surface 66 that complementarily accommodates any plate 29 of the femoral element is shown in broken lines.
FIG. 6 shows a perspective view of the femoral element 22 of FIGS. 3 and 5, which is attached to the resected femur 60 of FIG. 5 and penetrates the femur 60 into the femoral element 22. It has a mounting member 36 that extends (mainly indicated by a dashed line) to secure the femoral element 22 to the femur 60. This mounting member pulls the femoral element 22 firmly toward the femur 60 and fixes it.

  FIGS. 5 and 6 also illustrate a method for forming a new surface on the femur as part of a surgical procedure, which includes (i) ablating the articulating surface 64 at the distal end 62 of the femur 60. Forming a resected joint surface 64 extending between the inner surface 61 and the outer surface 63; and (ii) attaching the femoral element 22 having the inner surface 26 to at least a portion of the resected joint surface 64. And (iii) passing the first mounting member 36 through the outer surface or the inner surface of the cut joint surface 64; and (iv) connecting the first mounting member 36 to the thigh element 22, 36 includes a step of fixing the thigh element 22 to the cut joint surface 64.

  In one embodiment, resecting the articulating surface comprises resecting the medial and lateral condyles at the tip of the femur. In FIG. 5, the medial and lateral condyles of the femur 60 are excised. As described above, the femoral element 22 has a generally U-shaped lateral condyle connected to a generally U-shaped medial condyle.

  In another embodiment, the step of resecting the articulating surface 64 comprises the step of resecting only one of the medial or lateral condyles at the distal end 62 of the femur 60 and the other side condyle is not resected. In this embodiment, the step of attaching the femoral element to at least a portion of the resected articular surface 64 comprises a single condylar femoral element with only one of the lateral or medial condyles.

  In one embodiment, the step of penetrating the outer surface or the inner surface of the joint surface 64 from which the first mounting member 36 has been removed includes (i) forming a hole in the femur, and (ii) first from the hole. And a step of advancing the mounting member 36. The hole may be formed in the femur with an inclination angle α as shown in FIGS. 3 and 6. The hole may be formed by incising the skin proximate to the femur, and may be formed using a drill through the guide with the tube-shaped positioning guide properly oriented. Optionally, the first mounting member does not form a hole from the outset and is inclined at an inclination angle α (eg, by advancing through a tubular positioning guide used to orient the first mounting member). And may be advanced through the femur. In one example, the angle α is in the range of about 15 degrees to about 45 degrees, for example about 30 degrees, but may be other different angles that allow the femoral element to be attached to the femur. .

  A method for forming a new surface in the femur includes (i) a step of penetrating the second mounting member 38 (see FIG. 3) through the outer surface or the inner surface of the cut joint surface, and (ii) the second mounting member 38. To the thigh element 22 and the mounting member 38 further fixes the thigh element 22 to the cut joint surface.

  As described above, FIGS. 7 to 8A show an example of the femoral elements 70 and 80. When the femoral element is engaged with the resected femur, the femoral element is removed from the femur. Retained. The artificial femoral element may have other different shapes.

  FIG. 7 is a side cross-sectional view of the thigh element 70, which projects inwardly from a U-shaped body 71 having an inner surface 73, an outer surface 75, a front end 77a and a rear end 77b and extending from the inner surface 73 of the body. It has a front lip 78a and a rear lip 78b. As shown, the anterior lip 78a and the posterior lip 78b are respectively attached to corresponding grooves 79a, 79b provided on the resected femur 74 to attach the femoral element 70 to the resected portion 72 of the femur 74. Secure to. In one embodiment, the body 71 has the same or substantially the same shape as the thigh element 22 shown in FIGS. 3, 5 and 6, but from the inner surface 73 of its front end 77a and rear end 77b. It has a front lip 78a and a rear lip 78b protruding in the direction. The groove 79a is formed on the front surface 72a of the femur, and the groove 79b is formed on the rear surface 72b of the femur.

  The anterior lip 78a and the posterior lip 78b may protrude inwardly from one or more lateral condyles. For example, one posterior lip 78b may extend from the medial condyle and another posterior lip 78b may extend from the posterior condyle. If desired, the posterior lip 78b may extend from the posterior and medial condyles. FIG. 7 shows a posterior lip 78b extending from the inner surface of the posterior and / or medial condyle.

  Similarly, the anterior lip 78a may extend from the inner surface 73 of the anterior end 77a of the lateral or medial condyle, or it may be a single lip that extends from the inner surfaces of both the medial and lateral condyles.

  Thus, in one embodiment, the femoral element 70 is (i) a lateral condyle (e.g., having an inner surface 73 and an opposing outer surface 75, each extending between an anterior end 77a and an opposing rear end 77b, e.g. 3) and (ii) a medial condyle having an inner surface 73 and an outer surface 75 facing each other between a front end 77a and a rear end 77b facing each other (ii). For example, the medial condyle is connected to the lateral condyle and an elongate slot is formed between the bilateral condyles.

  The first engagement lip 78a projects at least from the inner surface 71 of the lateral condyle or medial condyle at the front end 77a, and the second engagement lip 78b projects at least from the inner surface of the lateral condyle or medial condyle at the rear end 77b.

  The engaging lips 78a and 78b and the groove are held by the femur 74 from which the femoral element 70 is removed by the engagement between the femoral element 70 and the excised femur 74. In other embodiments, a single engaging lip extends from the U-shaped body to a single groove in the femur that is excised to create such an engagement.

  Accordingly, the thigh element 70 has a body 71 having an articulating surface 75 extending between the outer surface and the inner surface and facing the inner surface 73, and an inner surface 73 having a substantially U-shaped cross section, and at least One, preferably first and second lips 78a, 78b project inwardly from the front or rear end of the inner surface 73 of the body 71.

  The cutting portion is formed on the femoral surface 72 cut so as to complement the inner surface 71 with respect to the engaging grooves 79a and 79b formed so as to accommodate the lips 78a and 78b, respectively. In this configuration, the femoral element 76 is slid along the side to the femur 74, and the lips 78 a, 78 b are housed in the corresponding grooves 79 a, 79 b of the femur and secure the femoral element 70 to the femur 74. To do.

  Other methods for forming a new surface on the femur include: (i) resecting the articulating surface at the distal end of the femur 74, each having a front surface and a rear surface extending between the outer surface and the inner surface. Forming the joint surface 72, at least one of the front surface and the rear surface has grooves 79a and 79b, and (ii) sliding the femoral element 70 to the cut joint surface 72; The lips 78a, 78b of the element 70 engage with the grooves 79a, 79b, and the thigh element 70 consists of sliding from the inner surface to the outer surface or from the outer surface to the inner surface.

  As shown in FIG. 7, the step of cutting the articulating surface preferably includes forming opposing first and second grooves 79 a, 79 b of the cut joint surface 72. The second lips 78a and 78b are slid to reach the first and second grooves 79a and 79b, and the first and second lips 78a and 78b are moved from the inner surface to the outer surface or from the outer surface to the inner surface. To be slid.

  FIG. 8 shows a taper state between the femoral element 80 and the resected femur 90, and the femur from which the femoral element 80 has been resected by the engagement of the femoral element 80 and the resected femur 90. Ninety tapered cut surfaces 88 are retained.

  FIG. 8 is a perspective view of a femoral element 80 having an outer surface 82 and a tapered inner surface 84, wherein the inner surface 84 has a resected femur having a tapered resection surface 88 in the direction of arrow 89. Attach to 90 to secure the femoral element 80 to the resected femur 90.

  More specifically, the thigh element 80 has a body with an inner surface 84 and an articulating surface 82 facing each other and extending between the outer surface 81 and the inner surface 83. Inner surface 84 has a generally U-shaped cross section that tapers inwardly. The thigh element 80 is tapered from the inner surface to the outer surface or from the outer surface to the inner surface.

  In the embodiment of FIG. 8, the U-shaped femoral element 80 is formed such that its U-shaped cavity decreases in size from the inside to the outside. (In other embodiments, the femoral element is reduced in size from the outside to the inside and the inner surface 84 is formed to have an engagement surface.) The femur 90 is excised to have an engagement surface and an arrow When the femoral element 80 is slid in the direction 89 from the outside toward the inside and reaches the femur 90, the femoral element 80 sandwiches the femur 90, and the element 80 holds the femur 90.

  As shown in FIG. 8, the method for forming a new surface on the femur 90 includes: (i) excising the articulating surface at the distal end of the femur 90 so that it is between the outer surface 96 and the inner surface 98, respectively. Forming a resected articulating surface 88 having a front surface 92 and a rear surface 94 extending at a distance, and at least one of the front surface 92 and the rear surface 94 is inclined with respect to the other, the front surface 92 and the rear surface 94 being the outer surface 96. Or (ii) sliding the femoral element 80 to the resected articulating surface 88, and the femoral element 80 is from the inner surface to the outer surface or from the outer surface to the inner surface. And sliding.

  FIG. 8A shows a cross-sectional view of another femoral element 80a, which has an articulating surface 82a and a non-chamfered curved inner surface 84a that is attached to a resected femur 86a. The front lip 88a and the rear lip 88b engage with the corresponding grooves 89a and 89b. FIGS. 7 and 8A show that the thigh elements having inwardly projecting lips 88a, 88b have different inner surfaces. The inner surface 84a of the femoral element of FIG. 8A may be tapered as in FIG. 7 and engages a complementary tapered and resected femur as previously described.

  As another feature of the present invention, FIGS. 9-14 show separable separable femoral elements 102, 131, 161 and 191 used in knee arthroplasty, with the two separate parts separately. After sliding through the incision to the medial or lateral surface, it is connected and attached to the femoral resection. Optionally, one part may be attached to the femoral resection and the other connected thereto. Mounting members such as bolts and screws are inserted from the femur to reach the femoral element. Connecting members such as bolts and screws attach a part of the thigh element to the other part. The treatment is minimally invasive and does not require a large incision as an integral element because one of the femoral elements is placed through the incision and then the other.

  FIG. 9 is a perspective view of the separable thigh element 102 divided from the outside to the inside. FIG. 10 is a perspective view of the thigh element 102 showing the assembled state. The femoral element 102 is configured for “end use” and is permanently attached to the resected articular surface to articulate the tibia and / or artificial tibial element while forming a new surface; Designed so that patients who have undergone treatment to replace at least part of their knee can actually be used on a daily basis.

  FIG. 9 shows a knee prosthesis system 100 for forming a new surface on the articulated surface resected at the tip of the femur, which system is configured to engage (A) the resected articular surface. A thigh element 102 having a formed inner surface 105 and (B) an opposing connecting surface 107.

  The femoral elements are (i) a patella condyle 103 comprising a first part, i.e. a first section of the articulating surface, and (ii) a tibial condyle 104 comprising a second part, i.e. a second part of the articulating surface, The second portion 104 is selectively engageable with the first portion 103; and (iii) bolts 106, 108 configured to selectively couple the first portion 103 to the second portion 104; Have. Bolts 106 and 108 are an example of means for selectively connecting the first part to the second part. Bolts 124 secure the femoral element 103 to the femur. Other different methods may be used to secure the femoral element 103 to the femur, such as bone cement or a peg crimped to the resected femur. In one example, at least a portion of the patella condyle 103 corresponds to the anterior portion of the resected femur and at least a portion of the tibial condyle 104 corresponds to the posterior portion of the resected femur.

  As shown in FIG. 10, the bolts 106 and 108 are connected to the openings 110a, 110b, 112a, 112b, 114a, 114b, 116a, 116b along the orientation lines 118a, 118b to connect the portions 103, 105. The patella condyle 103 and the tibial condyle 104, each extending through and connected to each other, form a femoral element 102 as a whole.

  U-shaped femoral element 102 is divided along joint 119 and has a front portion 103 and a rear portion 105. First and second passages constituted by at least one, preferably openings 110a, 110b, 112a, 112b, 114a, 114b, 116a, 116b, extend from the front portion 103 and the rear portion 105 along the sides. When these portions 103 and 105 are arranged, the bolts 106 and 108 formed with threads are screwed into the passage from the side to fix the engaging portions.

  In the procedure of forming a new surface, the first and second portions 103, 105 are separately slid through the incision and slid to the inner or outer surface before being connected and attached to the femoral resection surface. Optionally, the portion 103 or 105 may be attached to the thigh resection surface before the engagement portion is connected and attached to the thigh resection surface.

  A method of forming a new surface on the femur using the femoral element 102 includes the steps of (i) resecting the articulating surface at the distal end of the femur to form a resected articular surface; Disposing the first portion 103 on or near the resected joint surface, the first portion 103 having a first section of the articulating surface of the femoral element, and (iii) the femoral element Placing the second portion 104 on or near the resected articular surface, the second portion 104 having a second section of the articulating surface of the femoral element; Securing the first portion 103 to the second portion 104; and (v) attaching the thigh element 102 to the excised joint surface using, for example, bolts 124, screws, pins or other attachment means. Consists of.

  FIG. 11 shows a perspective view of a system 130 consisting of generally similar femoral elements 131 with engaging teeth 136, 138 and divided from the outside to the inside. The femoral element 131 includes (i) a first portion, ie, a patella condyle 132 comprising a first section of the articulating surface, and (ii) a second portion, ie, a tibial condyle 134 comprising a second section of the articulating surface, The second portion 134 is selectively engageable with the first portion 132, and (iii) passes through the openings 146, 148 and other unillustrated openings, respectively, thereby making the first portion 132 the second portion. And bolts 142 and 144 configured to selectively connect to 134. Bolts 142 and 144 are an example of means for selectively connecting the first part to the second part. The bolt 150 is an example of a means for fixing the femoral element 103 to the femur.

Instead of the smooth joint 119 of FIG. 8, the thigh element 131 may comprise a joint 140 having complementary engaging teeth 136, 138.
In other embodiments, as described with respect to FIGS. 12 and 13, the first portion has a generally U-shaped medial condyle 162 and the second portion has a generally U-shaped posterior condyle 164.

FIG. 12 shows a perspective view of the femoral element 161 of the system 160 divided from front to rear, and FIG. 13 shows a perspective view of the femoral element 161 of FIG. 12 in an assembled state.
The femoral element 161 includes: (i) a lateral condyle 162 that is generally U-shaped and has an outer surface 163 and an inner surface 166 facing each other that extend between an anterior end 165 and an opposing rear end 167; A medial condyle 164 that is U-shaped and has an outer surface 168 and an inner surface 169 facing each other and extending between an anterior end 171 and an opposing rear end 173. The lateral surface 168 of the medial condyle 164 is configured to engage the medial surface 166 of the lateral condyle 162 and a slot 179 is formed between the medial and lateral condyles at the posterior end.

  Bolts 170 and 172 are an example of means for connecting the medial condyle to the lateral condyle when the medial and lateral condyles are engaged. Bolts 178 secure the femoral element 161 to the femur. Other different methods may be used to secure the femoral element to the femur, such as bone cement or a peg crimped into the resected femur.

  The thigh element 161 is divided from the front to the rear along the linear joint 180 at the center, and the element includes a front part and a rear part. At least one and preferably first and second passages constituted by openings 174a, 174b, 176a, 176b extend laterally through the front and rear, and these front and rear are aligned. Then, the bolts 170 and 172 are screwed into the respective passages from the side to fix both the front part and the rear part.

  FIG. 14 is a perspective view showing a thigh element divided from the front to the rear and having engagement teeth. FIG. 14 shows a system 190 consisting of similar femoral elements 191 with engaging teeth 202, 204 and divided from front to back. The femoral element 191 includes (i) a first portion, ie, a patella condyle 192 comprising a first section of the articulating surface, and (ii) a second portion, ie, a tibial condyle 194 comprising a second section of the articulating surface, The two portions 134 are selectively engagable with the first portion 132 and (iii) have bolts 196, 198 configured to selectively connect the first portion to the second portion. Bolts 196, 198 are an example of means for selectively connecting the first part to the second part. Bolt 206 or other attachment methods may be used to secure femoral element 191 to the femur.

As shown in FIG. 14, unlike a linear joint, the femoral element 191 may have a joint with engagement teeth formed in each part.
FIGS. 15A-15D show exploded and assembled views of another separated thigh element of the present invention, which connect the parts using ridges. The two parts are separately slid through the incision to the medial or lateral surface before being joined and attached to the femoral resection. Optionally, one may be attached to the cut surface of the thigh and then the other may be connected thereto and attached to the cut surface of the thigh.

  15A and 15B show a knee prosthesis system 210 for forming a new surface on the articulated surface resected at the tip of the femur, which (i) engages the resected articular surface. The thigh element 211 has an inner surface 215 configured as described above and (ii) an opposing connecting surface 217.

  The femoral element 211 includes (i) a patella condyle 214 comprising a first section, ie, a first section of the articulating surface, and (ii) a tibial condyle 212 comprising a second section, ie, the second section of the articulating surface, The two portions 212 consist of being selectively engageable with the first portion 214. The ridges 224, 226, 228, 230 extending from the tibial condyle 212 are configured to be received in the first portion 214 and engage the first portion and the second portion. The pegs 220 and 222 are another example of means for fixing the femoral element 103 to the femur.

  The knee prosthesis system 210 includes bolts 240, 240 a configured to connect the first portion 214 to the second portion 212 when the ridges 224, 226, 228, 230 are attached to the first portion 214. It further has a screw. In one embodiment, the incision is made only on one side of the knee. Accordingly, only one of the bolts 240, 240 a is used to connect the first portion 214 to the second portion 212.

  The protrusions 224, 226, 228, 230 extend through the openings 232, 238, 240 (the fourth opening is not shown), respectively, and the bolt 240 is perforated through the opening 242. Reaching portion 244, the combined condyles 214, 212 form the femoral element 210 shown in FIGS. 15A and 16A. By using the protrusions 224, 226, 228, 230 and at least one bolt 240, the first portion 212 and the second portion 214 are firmly connected. The bolt 240a passes through the opening 242a and reaches the perforated opening of the second portion 214.

  As described above, the femoral element of the present invention is slid to the inner or outer surface through the incision. In addition, the femoral element of the present invention (whether integral or separate) may be slid through the incision between the inner and outer surfaces. These femoral elements may be designed to connect the shin and / or prosthetic shin elements.

It will be appreciated that various forms, configurations and methods as described above may be combined to form other different forms, configurations and methods.
Regarding the apparatus and method of the present invention, a US application filed on the same date as the filing date of the present application (inventor: Daniel F. Justin and E. Marlowe Goble), title of invention: “knee” And "Femoral Components for Knee Arthroplasty"), the disclosure of which is also disclosed herein.

  The present invention may be implemented in other specific forms without departing from the content or essential characteristics thereof. The described embodiments are illustrative and not limiting and should be considered in all respects. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes that come within the meaning and range of equivalency of the claims are to be embraced within their scope.

The front perspective view which shows the conventional thigh element. FIG. 2 is a rear perspective view showing the conventional thigh element of FIG. 1. FIG. 6 is a rear perspective view of the thigh element of the present invention, wherein at least one screw hole formed in the inner surface is configured to receive a mounting member extending through the resected femur, Two threaded holes and a mounting member are shown in broken lines, the mounting member extending through the inner surface and / or the outer surface. FIG. 6 is a rear perspective view of another femoral element of the present invention, at least one engagement filled with a receiving and engaging material that receives and engages at least one mounting member extending through the resected femur; A mating / accommodating pocket is provided, and an optional accommodating surface and mounting member are indicated by broken lines. FIG. 4 is a perspective view of the femoral element of FIG. 3 attached to a resected femur, with the receiving surface 66 of any plate 29 of the femoral element shown in broken lines. FIG. 6 is a perspective view of the femoral element of FIGS. 3 and 5 having a mounting member attached to the resected femur of FIG. 5 and extending through the resected femur to the femoral element. Fixed to the femur. FIG. 6 is a side cross-sectional view of another femoral element, with an inwardly projecting lip mounted in a corresponding groove formed in the resected femur to secure the femoral element to the resected femur. FIG. 6 is a perspective view of a femoral element having a tapered inner surface attached to a resected femur and having a tapered engagement surface and secured to the resected femur. FIG. 6 is a cross-sectional view of another femoral element having a curved surface that is not chamfered, showing the state of being attached to a resected femur and the femoral element having an inwardly projecting lip having a different inner surface Indicates that it may be. The perspective view which shows the Example from which the separation type femoral element divided | segmented into the inner side from the outer side differs. FIG. 10 is a perspective view showing the thigh element of FIG. 9 in an assembled state. The perspective view which shows the separation-type femoral element which has an engagement tooth and was divided | segmented into the inside from the outer side. The perspective view which shows the separation-type femoral element divided | segmented from the front to back. FIG. 13 is a perspective view showing the thigh element of FIG. 12 in an assembled state. The perspective view which shows the thigh element which has an engagement tooth and was divided | segmented back from the front. The rear exploded view which shows the other separated type thigh element of this invention. FIG. 15B is a rear perspective view showing the thigh element of FIG. 15A in an assembled state. The front exploded view which shows the thigh element of FIG. 15A. The front perspective view which shows the thigh element of FIG. 15A of the assembled state.

Claims (20)

An artificial knee joint system for forming a new surface on the joint surface resected at the tip of the femur,
A femoral element having (i) an inner surface configured to engage the resected articular surface; and (ii) an opposing articulating surface, the element further comprising:
A first portion comprising a first section of an articulating surface;
A second portion comprising a second section of the articulating surface, the second portion being selectively engageable with the first portion;
Means for selectively coupling the first part to the second part. The knee prosthesis system of claim 1, wherein the first portion has a patella condyle and the second portion has a tibial condyle. The knee prosthesis system of claim 1, wherein the first portion has a generally U-shaped medial condyle and the second portion has a generally U-shaped lateral condyle. The knee prosthesis system of claim 1, wherein the means for selectively coupling the first part to the second part comprises a bolt extending between the first part and the second part. The knee prosthesis system of claim 1, further comprising means for securing the femoral element to the articular surface resected at the tip of the femur. The artificial knee joint system according to claim 5, wherein the means for fixing the femoral element to the joint surface excised at the distal end of the femur includes a bolt. The artificial knee joint system according to claim 5, wherein the first portion is located on a side surface of the second portion. The artificial knee joint system according to claim 5, wherein the first part is attached above the second part. The artificial knee joint system according to claim 5, wherein the first portion has a raised portion and a groove corresponding to the raised portion and the groove for connecting the second portion. 6. The knee prosthesis system of claim 5, wherein the second portion of the femoral element has a protrusion configured to selectively engage the first portion. 11. The knee prosthesis system of claim 10, wherein the means for selectively connecting the first part to the second part comprises a bolt. The prosthetic knee joint system according to claim 1, wherein the plurality of protrusions extend from the second portion and selectively engage with the plurality of openings of the first portion, respectively. An artificial knee joint system for forming a new surface on the joint surface resected at the tip of the femur,
A femoral element having (i) an inner surface configured to engage the resected articular surface; and (ii) an opposing articulating surface, the element further comprising:
A first portion comprising a first section of an articulating surface;
A knee prosthesis system comprising a second portion comprising a second section of articulating surfaces and a first portion selectively coupled to the second portion. 14. The knee prosthesis system of claim 13, wherein the first portion has a patella condyle and the second portion has a tibial condyle. 14. The knee prosthesis system of claim 13, wherein the first portion has a generally U-shaped medial condyle and the second portion has a generally U-shaped lateral condyle. 14. The knee prosthesis system of claim 13, wherein the means for selectively coupling the first part to the second part comprises a bolt extending between the first part and the second part. A femoral element of an artificial knee joint for forming a new surface on the joint surface resected at the tip of the femur;
A lateral condyle having a generally U-shaped shape, each having an outer surface and an opposing inner surface extending between an anterior end and an opposing posterior end;
A medial condyle having a generally U-shaped shape, each having an outer surface and an opposite inner surface extending between an anterior end and an opposite posterior end, and a slot formed between the medial and lateral condyles A femoral element comprising: the lateral surface of the medial condyle is configured to engage the medial surface of the lateral condyle, and the medial condyle is selectively coupled to the lateral condyle. A femoral element of an artificial knee joint for forming a new surface on the joint surface resected at the tip of the femur;
Configured to correspond to the patella condyle and the anterior portion of the femur, at least a portion of which has been resected;
A tibial condyle configured to be selectively coupled to the patella condyle, and thereby the patella condyle and the tibial condyle (i) an inner surface configured to engage the resected joint surface; (ii) ) A thigh element comprising collectively forming thigh elements having opposing articulating surfaces; 19. The femoral element according to claim 18, wherein the tibial condyle has at least one protrusion extending therefrom. 19. A femoral element according to claim 18, wherein the patella condyle has at least one opening for receiving the protrusion.

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