JP2014508554A - 仮脛骨プロテーゼ装置 - Google Patents
仮脛骨プロテーゼ装置 Download PDFInfo
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- 210000003127 knee Anatomy 0.000 claims abstract description 38
- 210000000629 knee joint Anatomy 0.000 claims abstract description 27
- 238000002513 implantation Methods 0.000 claims abstract description 13
- 210000002303 tibia Anatomy 0.000 claims description 27
- 238000000034 method Methods 0.000 claims description 16
- 210000000988 bone and bone Anatomy 0.000 claims description 14
- 210000000689 upper leg Anatomy 0.000 claims description 13
- 238000002271 resection Methods 0.000 claims description 7
- 238000001356 surgical procedure Methods 0.000 abstract description 10
- 230000002093 peripheral effect Effects 0.000 description 18
- 238000004513 sizing Methods 0.000 description 13
- 238000003780 insertion Methods 0.000 description 8
- 230000037431 insertion Effects 0.000 description 8
- 210000003041 ligament Anatomy 0.000 description 8
- 230000004888 barrier function Effects 0.000 description 7
- 230000000399 orthopedic effect Effects 0.000 description 4
- 210000002967 posterior cruciate ligament Anatomy 0.000 description 4
- 230000006641 stabilisation Effects 0.000 description 4
- 238000011105 stabilization Methods 0.000 description 4
- 230000007423 decrease Effects 0.000 description 3
- 230000014759 maintenance of location Effects 0.000 description 3
- 230000003278 mimic effect Effects 0.000 description 3
- 238000013150 knee replacement Methods 0.000 description 2
- 230000013011 mating Effects 0.000 description 2
- 125000006850 spacer group Chemical group 0.000 description 2
- 206010020649 Hyperkeratosis Diseases 0.000 description 1
- 239000004698 Polyethylene Substances 0.000 description 1
- 229920000491 Polyphenylsulfone Polymers 0.000 description 1
- 229910052581 Si3N4 Inorganic materials 0.000 description 1
- WAIPAZQMEIHHTJ-UHFFFAOYSA-N [Cr].[Co] Chemical class [Cr].[Co] WAIPAZQMEIHHTJ-UHFFFAOYSA-N 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 239000000919 ceramic Substances 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- -1 polyethylene Polymers 0.000 description 1
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- 210000004872 soft tissue Anatomy 0.000 description 1
- 230000000087 stabilizing effect Effects 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
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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
- A61F2/02—Prostheses implantable into 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
- A61F2/02—Prostheses implantable into the body
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- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/461—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of knees
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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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- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
- A61F2002/3042—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves with a pin cooperating with a helical groove
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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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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
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- 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
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- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30599—Special structural features of bone or joint prostheses not otherwise provided for stackable
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Abstract
【選択図】図1
Description
Claims (17)
- 生来の膝の中に埋植するための人工膝関節用の仮脛骨プロテーゼ装置であって、該仮脛骨プロテーゼ装置が、第1最終脛骨プロテーゼと第2最終脛骨プロテーゼの形状を択一的に模倣でき、前記生来の膝が近位脛骨と遠位大腿骨とを備え、かつ内外軸と前後軸と近遠軸とを有し、前記内外軸が内外方向に一致し、前記前後軸が前後方向に一致し、前記近遠軸が近遠方向に一致し、前記仮脛骨プロテーゼ装置が、
骨接触面とその反対側の台板上面とを有する脛骨台板と、
脛骨ベアリング部品高さを有する脛骨ベアリング部品であって、該脛骨ベアリング部品が、前記脛骨台板に取付け可能であり、前記脛骨ベアリング部品高さが前記第1最終脛骨プロテーゼを表現する、脛骨ベアリング部品と、
シム高さを有するシムであって、該シムが、前記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記シム高さに等しい距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライド可能に受け入れられ、前記シム高さが前記脛骨ベアリング部品高さと一緒に、前記第2最終脛骨プロテーゼを表現する、シムと、
を備える、仮脛骨プロテーゼ装置。 - さらに、
前記脛骨ベアリング部品に取付け可能なベース部品であって、該ベース部品が前記脛骨ベアリング部品と前記脛骨台板との間に配置可能である、ベース部品、
を含み、
前記シムが、前記ベース部品と前記脛骨ベアリング部品が前記近遠軸に沿って前記シム高さに等しい距離だけ分離されたとき前記脛骨ベアリング部品と前記ベース部品との間に前記前後方向へスライド可能に受け入れられる、
請求項1に記載の仮脛骨プロテーゼ装置。 - さらに、第1ロックを備え、前記シムが前記ベース部品と前記脛骨ベアリング部品との間に受け入れられたとき、前記第1ロックが前記近遠方向において前記脛骨ベアリング部品を前記ベース部品にロックし、それによって、前記脛骨ベアリング部品と前記ベース部品との間の前記近遠方向の有意の相対的移動が防止されることを特徴とする、請求項2に記載の仮脛骨プロテーゼ装置。
- さらに、第2ロックを備え、前記脛骨ベアリング部品が前記ベース部品に取り付けられたとき、前記第2ロックが、前記内外方向及び前記前後方向において前記脛骨ベアリング部品を前記ベース部品にロックし、それによって、前記脛骨ベアリング部品と前記ベース部品との間の前記内外方向及び前記前後方向の有意の相対的移動が防止されることを特徴とする、請求項3に記載の仮脛骨プロテーゼ装置。
- 前記ベース部品が、ベース部品下面と、その反対側のベース部品上面と、前記ベース部品上面から延びる突起部とを含み、前記ベース部品下面が前記脛骨台板上面に配置可能であり、かつ
前記脛骨ベアリング部品が、脛骨ベアリング部品下面と、その反対側の脛骨ベアリング部品上面とを含み、前記脛骨ベアリング部品下面が空洞部を形成する壁を有し、前記空洞部が前記ベース部品の前記突起部をその中に受け入れるサイズを持ち、前記空洞部が、前記壁が前記突起部と協働して前記脛骨ベアリング部品と前記ベース部品との間の前記内外方向及び前記前後方向の有意の相対的移動を防止するような前記突起部に対するサイズを持つ、
ことを特徴とする、請求項2に記載の仮脛骨プロテーゼ装置。 - 前記脛骨ベアリング部品が脛骨ベアリング部品下面と、その反対側の脛骨ベアリング部品上面とを含み、前記脛骨ベアリング部品下面がスロットを形成し、かつ
前記シムが、シム上面と、その反対側のシム下面と、前記シム上面から延びるレールとを含み、前記シムが、前記シムの前記レールを前記脛骨ベアリング部品の前記スロットの中で前記前後方向へスライドさせることによって前記脛骨ベアリング部品に取外し可能に取り付けできる、
ことを特徴とする、請求項2に記載の仮脛骨プロテーゼ装置。 - さらに、ロックを備え、前記脛骨ベアリング部品が前記脛骨台板に取り付けられたとき、前記ロックが前記内外方向及び前記前後方向において前記脛骨ベアリング部品を前記脛骨台板にロックし、それによって、前記脛骨ベアリング部品と前記脛骨台板との間の前記内外方向及び前記前後方向の有意の相対的移動が防止されることを特徴とする、請求項1に記載の仮脛骨プロテーゼ装置。
- 前記脛骨ベアリング部品の前記スロット及び前記シムの前記レールが、各々鳩尾形断面を有することを特徴とする、請求項7に記載の仮脛骨プロテーゼ装置。
- 前記脛骨ベアリング部品の前記スロット及び前記シムの前記レールが、各々T字形断面を有することを特徴とする、請求項7に記載の仮脛骨プロテーゼ装置。
- 前記ベース部品が、ベース部品下面と、その反対側のベース部品上面と、前記ベース部品上面から延びる突起部とを含み、前記突起部が前記突起部と前記ベース部品上面との間に窪み部を形成し、前記ベース部品下面が前記脛骨台板上面の上に設置可能であり、かつ
前記シムが、シム上面と、その反対側のシム下面と、シム前側面と、シム後側面とを含み、前記シムが、前記シム後側面に形成されたノッチを形成し、前記ノッチが前記シム上面と前記シム下面に及び、前記シムが、前記ベース部品の前記窪み部を前記シムの前記ノッチの中で前記前後方向へスライドさせることによって、前記ベース部品に取外し可能に取り付けできる、
ことを特徴とする、請求項1に記載の仮脛骨プロテーゼ装置。 - 生来の膝の中に埋植するための人工膝関節用の仮脛骨プロテーゼ装置であって、該仮脛骨プロテーゼ装置が、第1最終脛骨プロテーゼ、第2最終脛骨プロテーゼ及び第3最終脛骨プロテーゼの形状を択一的に模倣でき、前記生来の膝が近位脛骨と遠位大腿骨とを備え、かつ内外軸と前後軸と近遠軸とを有し、前記内外軸が内外方向に一致し、前記前後軸が前後方向に一致し、前記近遠軸が近遠方向に一致し、前記仮脛骨プロテーゼ装置が、
骨接触面とその反対側の台板上面とを有する脛骨台板と、
脛骨ベアリング部品高さを有する脛骨ベアリング部品であって、該脛骨ベアリング部品が前記脛骨台板に取付け可能であり、前記脛骨ベアリング部品高さが前記第1最終脛骨プロテーゼを表現する、脛骨ベアリング部品と、
第1シム高さを有する第1シムであって、該第1シムが、前記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さに等しい第1距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライド可能に受け入れられ、前記第1シム高さが前記脛骨ベアリング部品高さと一緒に、前記第2最終脛骨プロテーゼを表現する、第1シムと、
第2シム高さを有する第2シムであって、該シムが、前記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さと第2シム高さに等しい第2距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライド可能に受け入れられ、前記第1シム高さと前記第2シム高さが、前記脛骨ベアリング部品高さと一緒に、前記第3最終脛骨プロテーゼを表現する、第2シムと、
を備える、仮脛骨プロテーゼ装置。 - さらに、
前記脛骨ベアリング部品に取付け可能なベース部品であって、該ベース部品が前記脛骨ベアリング部品と前記脛骨台板との間に配置可能である、ベース部品、
を含み、
前記第1シムが、前記ベース部品と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さに等しい前記第1距離だけ分離されたとき前記脛骨ベアリング部品と前記ベース部品との間に前記前後方向へスライド可能に受け入れられ、かつ
前記第2シムが、前記ベース部品と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さと前記第2シム高さに等しい前記第2距離だけ分離されたとき前記脛骨ベアリング部品と前記ベース部品との間に前記前後方向へスライド可能に受け入れられる、
請求項11に記載の仮脛骨プロテーゼ装置。 - さらに、ロックを備え、前記脛骨ベアリング部品が前記ベース部品に取り付けられたとき、前記ロックが、前記内外方向及び前記前後方向において前記脛骨ベアリング部品を前記ベース部品にロックし、それによって、前記脛骨ベアリング部品と前記ベース部品との間の前記内外方向及び前記前後方向の有意の相対的移動が防止されることを特徴とする、請求項12に記載の仮脛骨プロテーゼ装置。
- さらに、ロックを備え、前記脛骨ベアリング部品が前記脛骨台板に取り付けられたとき、前記ロックが、前記内外方向及び前記前後方向において前記脛骨ベアリング部品を前記脛骨台板にロックし、それによって、前記脛骨ベアリング部品と前記脛骨台板との間の前記内外方向及び前記前後方向の有意の相対的移動が防止されることを特徴とする、請求項11に記載の仮脛骨プロテーゼ装置。
- 生来の膝の中に埋植するための人工膝関節用の最終脛骨プロテーゼのサイズを測定する方法であって、前記生来の膝が近位脛骨と遠位大腿骨とを備え、かつ内外軸と前後軸と近遠軸とを有し、前記内外軸が内外方向に一致し、前記前後軸が前後方向に一致し、前記近遠軸が近遠方向に一致し、前記方法が、
仮脛骨プロテーゼ装置を選択するステップであって、前記仮脛骨プロテーゼ装置が、
骨接触面とその反対側の台板上面とを有する脛骨台板と、
脛骨ベアリング部品高さを有する脛骨ベアリング部品であって、該脛骨ベアリング部品が、前記脛骨台板に取付け可能である、脛骨ベアリング部品と、
第1シム高さを有する第1シムであって、該第1シムが、前記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さに等しい第1距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライド可能に受け入れられる、第1シムと、
を備える、ステップと、
前記近位脛骨を切除して近位脛骨切除面を形成するステップと、
前記近位脛骨切除面の上に前記脛骨台板の前記骨接触面を配置するステップと、
前記脛骨台板の上に前記脛骨ベアリング部品を配置するステップと、
前記第1シムを前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライドさせることによって、前記大腿骨を前記第1シム高さより大きい距離を前記脛骨から引き離すことなく、前記脛骨ベアリング部品を前記脛骨台板から離間するステップと、
を含む、方法。 - さらに、
前記第1シムを前記脛骨台板と前記脛骨ベアリング部品との間から前記前後方向へ取り外すステップ、を含み、
前記仮脛骨プロテーゼ装置を選択する前記ステップが、さらに、
第2シム高さを有する第2シムを選択するステップであって、前記第2シムが、前 記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨 台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記第2シム高さに等しい第2 距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部品との間に前記前後 方向へスライド可能に受け入れられ、前記第2シム高さが前記第1シム高さと異なる、
ステップ、を含み、
かつ
前記第2シムを前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライドさせることによって、前記大腿骨を前記第2シム高さより大きい距離を前記脛骨から引き離すことなく、前記脛骨ベアリング部品を前記脛骨台板から離間するステップ、
を含む、請求項15に記載の方法。 - さらに、
前記仮脛骨プロテーゼ装置を選択する前記ステップが、さらに、
第2シム高さを有する第2シムを選択するステップであって、前記第2シムが、前 記脛骨台板と前記脛骨ベアリング部品の両方に対してスライド可能であり、前記脛骨 台板と前記脛骨ベアリング部品が前記近遠軸に沿って前記第1シム高さと前記第2シ ム高さに等しい第2距離だけ分離されたとき、前記脛骨台板と前記脛骨ベアリング部 品との間に前記前後方向へスライド可能に受け入れられる、ステップ、を含み、
かつ
前記第2シムを前記脛骨台板と前記脛骨ベアリング部品との間に前記前後方向へスライドさせることによって、前記大腿骨を前記第1シム高さと前記第2シム高さより大きい距離を前記脛骨から引き離すことなく、前記脛骨ベアリング部品を前記脛骨台板から離間するステップ、を含む、請求項15に記載の方法。
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