JP3419931B2 - Artificial knee joint - Google Patents
Artificial knee jointInfo
- Publication number
- JP3419931B2 JP3419931B2 JP32320394A JP32320394A JP3419931B2 JP 3419931 B2 JP3419931 B2 JP 3419931B2 JP 32320394 A JP32320394 A JP 32320394A JP 32320394 A JP32320394 A JP 32320394A JP 3419931 B2 JP3419931 B2 JP 3419931B2
- Authority
- JP
- Japan
- Prior art keywords
- sliding surface
- knee joint
- femoral component
- shape
- component
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Landscapes
- Prostheses (AREA)
Description
【発明の詳細な説明】
【０００１】
【産業上の利用分野】本発明は、慢性リウマチ、変形性
膝関節症、偽痛風、突発性骨壊死など高度に変形した膝
関節の関節を正常な機能に回復させるために用いる人工
膝関節に関するものである。
【０００２】
【従来の技術】従来の人工膝関節として、置換後の安定
性と可動性を確保するため例えば特開平３ー１５４６０
号公報に記載される技術の如く、脛骨コンポーネントの
摺動面中央に突起が形成され、他方大腿骨コンポーネン
トの脚部間に該突起を受容すべく凹部が形成され、これ
ら突起と凹部の協働させる方法が採用されていた。
【０００３】また、同様の目的のため特開平４ー１５８
８６０号公報の発明の如く、脛骨コンポーネントの摺動
面の中央後部に凹状摺動面が形成され、他方大腿骨コン
ポーネントには屈曲を担うべく対応嵌合する凸状摺動面
が形成され、これら摺動面を協働させる方法をとるもの
もあった。
【０００４】
【発明が解決しようとする課題】しかしながら、上記前
者の従来技術は、大腿骨コンポーネントの脚部間を大き
な凹部とするため、大腿骨関節面を多量に骨切りし且つ
後十字靱帯も切除しなければならず、さらに正常な膝関
節の生理的な動きを再現することが難しいという不具合
があった。
【０００５】また後者の従来技術では、上記生理的な動
きには近づき、可動域も広いという優れた効果を奏する
ものであったが、骨切量も少なくなく、後十字靱帯の切
除という問題を回避することができないという不具合が
あった。
【０００６】
【課題を解決するための手段】上記課題を解決するた
め、本発明の人工膝関節は、大腿骨コンポーネントと脛
骨の近位部に固定される脛骨コンポーネントから構成さ
れる人工膝関節において、上記大腿骨コンポーネント
は、一対の後壁が後側に開く概ねハ字状に配置されると
ともに、屈曲摺動面が横幅方向に連続する曲面で構成さ
れ、上記脛骨コンポーネントは、荷重を受ける摺動面の
後部外縁側に外側に向かって漸次下る縁下り曲斜面を形
成したことを特徴とする。
【０００７】
【作用】本発明の人工膝関節は大腿骨コンポーネントに
おいて一対の後壁が後側に開く概ねハ字状に配置されて
いることにより、十字靱帯を収容するスペースが与えら
れ、もって骨切り量が少量であることに加えて十字靱帯
を切除する必要もなくなった。
【０００８】また、大腿骨コンポーネントの一対の後壁
が上記ハ字状に配置されるとともに、他方の脛骨コンポ
ーネントの摺動面の後部外縁側に外側に向かって漸次下
る縁下り曲斜面を形成したことによって、屈曲運動中に
両コンポーネントの摺動面が協働して大腿骨コンポーネ
ントの相対的前移動および横移動を防止して運動の安定
性を確保しつつ、屈曲の回転中心を少しづつ後方に移動
せしめ、もって正常な膝関節の生理的運動を忠実に再現
する。
【０００９】
【実施例】以下、本発明の実施例を図面に基づいて具体
的に説明する。図１は、本実施例の人工膝関節Ｋを示
し、この人工膝関節Ｋは大腿骨の遠位部に固定される大
腿骨コンポーネントＦと脛骨の近位部に固定される脛骨
コンポーネントＴから構成されている。
【００１０】このうち大腿骨コンポーネントＦは、図２
および図３に示すように前壁１を架橋部２を介して一対
の後壁３，３と一体結合した構造であって、摺動側の表
面は前側がパテラ摺動面４ａ、中央部が伸展位摺動面４
ｂ、後側が屈曲摺動面４ｃ、他方の骨固定側が骨接触面
６となっている。また、図４に示すように上記後壁３の
間は大きめの切り欠き、すなわちＰＣＬ溝５となってお
り、ここに十字靱帯（ＰＣＬ）を収容することができ
る。
【００１１】図５は、上記屈曲摺動面４ｃの形状を示す
横断面図であり、同図に示すように屈曲摺動面４ｃは横
幅方向に連続する曲面で構成された形状となっている。
【００１２】次に、他方の脛骨コンポーネントＴの構造
を説明する。図６に示すように脛骨コンポーネントＴ
は、トレー７の上側に摺動特性に優れるプラスチック製
のプレート８が固定され、図７に示すようにプレート８
の後側中央が前記大腿骨コンポーネントＦのＰＣＬ溝５
に対応するＰＣＬ溝１０となっている。また、プレート
８の上面の中央は中央隆起部９ａ、その左右に位置する
摺動面のうち、前側が伸展位摺動面９ｂ、後側外縁部が
屈曲摺動面９ｃとなっていて、このうち屈曲摺動面９ｃ
は図６に示すように外側に向かって漸次下る形状の縁下
り曲斜面９ｄが形成されている。
【００１３】さて、このような特徴を有する人工膝関節
Ｋは、以下に説明する方法によって摺動面の形状が求め
られたものであり、その方法を詳述する。本発明の大腿
骨コンポーネントＦの形状に対して「作用」の項で述べ
た”運動の安定性を確保しつつ屈曲の回転中心を少しづ
つ後方に移動せしめもって正常な膝関節の生理的運動を
忠実に再現する”理想的な脛骨コンポーネントＴの形状
は脛骨コンポーネントＴを固定しその上で健常な大腿骨
の運動を再現して得られた包絡面である。実用上でこの
形状を求める方法は、大腿骨の脛骨に対する運動を求め
るべく正常の膝関節の側面動態撮影を行い、正常のロー
ルバックモーション（即ち膝屈曲に伴い脛骨の最下点の
脛骨前縁よりの距離を暫定的に次式にて近値した。（本
式はより多くの正常ロールバックモーションのデータを
収集して修正することにより、より良い人工膝関節の設
計が可能である。）
ｄ＝2.05×101 ＋2.00×10-2x ＋3.89×10-4x ＋9.23×
10-6x
だたしｄ：大腿骨の最下点の脛骨前縁よりの距離
ｘ：膝の屈曲角度
この位置を中心として生理的許容範囲として、最大伸展
位では回旋・前後方向・横方向ともに０とし、膝屈曲角
度に応じて漸増し、最大屈曲位において最高回旋で１６
度・前後横方向では２ｍｍまでの緩みを許すこととし
た。ただし、各屈曲角における緩みの３つの要素の最高
値において２ｍｍだけ大腿骨コンポーネントＦの位置が
高くなるように２次曲線（放物線）的に変化させること
により緩みの変位が大きくなるほどより大きな復元力
（理論的な位置に戻そうとる力）が働くようにした。
【００１４】この条件を満たすように大腿骨コンポーネ
ントＦをコンピュータ内で運動させ、得られた包絡面の
形状を脛骨コンポーネントＴのベースの輪郭に合わせて
トリムして第１回目の形状とする。
【００１５】続いて、出来上がった大腿骨コンポーネン
トＦと脛骨コンポーネントＴの各屈曲角において、新た
に開発したポテンシアル法（即ち２つの形状の接触のす
べての仕方において各々のコンポーネントの重心の位置
の落差を求めてその落差が最低になる位置を求め、生体
内における接触位置を予測し、その近傍に於ける落差の
変化率を安定性の指標とする方法）を用いて人工膝関節
の運動の安定性とロールバックモーションを評価し、接
触位置と接触面積を算定した後、接触面積の小さ過ぎる
大腿骨コンポーネントＦの部位の曲率を減じるように形
状変更を行い、安定性を高めたい屈曲角における最高緩
みを減じ、安定性を減じたい屈曲角の最高緩みを増して
再度、包絡面を求める。この過程を、要求を満たす運動
の安定性とロールバックモーションが得られるまで繰り
返し人工膝関節の形状を決定する。数回の繰り返しで実
用的な範囲内の形状は得られるが、試行と評価を繰り返
せばより性能の高い形状を見出すことができる。
【００１６】そして、このような作業の結果、前述のよ
うに大腿骨コンポーネントＦにおいて一対の後壁３，３
が後側に開く概ねハ字状に配置されるとともに、屈曲摺
動面４ｃが横幅方向に連続する曲面で構成され、かつ他
方の脛骨コンポーネントＴにおいて荷重を受ける摺動面
９ｃの後部外縁側に外側に向かって漸次下る縁下り曲斜
面を形成した人工膝関節Ｋが求められた。
【００１７】
【発明の効果】叙上のように、本発明の人工膝関節は大
腿骨コンポーネントにおいて一対の後壁が後側に開く概
ねハ字状に配置されていることにより、十字靱帯を収容
するスペースが与えられ、もって骨切り量が少量である
ことに加えて十字靱帯を切除する必要もなくなった。し
たがって、膝の関節付近の筋力を健全かつ正常なものに
維持することができる。
【００１８】さらに、大腿骨コンポーネントの一対の後
壁が上記ハ字状に配置されるとともに、他方の脛骨コン
ポーネントの摺動面の後部外縁側が外側に向かって漸次
下る縁下り曲斜面となっているので、屈曲運動中に両コ
ンポーネントの摺動面が協働して大腿骨コンポーネント
の相対的前移動および横移動を防止して運動の安定性を
確保しつつ、屈曲の回転中心を少しづつ後方に移動せし
め、もって正常な膝関節の生理的運動を忠実に再現す
る。
【００１９】以上のような、格別に優れた効果を奏する
ものである。Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to the normal functioning of a highly deformed knee joint such as chronic rheumatism, osteoarthritis of the knee, pseudogout, or sudden osteonecrosis. The present invention relates to an artificial knee joint used for restoring the subject. 2. Description of the Related Art As a conventional artificial knee joint, for example, Japanese Unexamined Patent Publication (Kokai) No. 3-15460 has been proposed in order to ensure stability and mobility after replacement.
As in the technique described in the publication, a projection is formed in the center of the sliding surface of the tibial component, while a recess is formed between the legs of the femoral component to receive the projection, and the cooperation of the projection and the recess is performed. A method to make it happen was adopted. For the same purpose, Japanese Patent Application Laid-Open No. 4-158
As in the invention of the '860 patent, a concave sliding surface is formed at the center rear of the sliding surface of the tibial component, while a convex sliding surface is formed on the femoral component that mates with the corresponding sliding surface to perform bending. Some have adopted a method in which the sliding surfaces cooperate. [0004] However, in the former prior art, in order to form a large recess between the legs of the femoral component, a large amount of osteotomy of the articular surface of the femur is performed, and the posterior cruciate ligament is also formed. It has to be resected, and it is difficult to reproduce the normal physiological movement of the knee joint. [0005] In the latter prior art, the physiological movement is approached and the excellent effect of widening the range of motion is achieved. However, the amount of osteotomy is not small, and the problem of resection of the posterior cruciate ligament is not solved. There was a problem that it could not be avoided. [0006] In order to solve the above-mentioned problems, a knee prosthesis of the present invention comprises a femoral component and a tibial component fixed to a proximal portion of a tibia. The femoral component is arranged in a generally C-shape with a pair of posterior walls open rearward, and the curved sliding surface is formed of a curved surface that is continuous in the lateral width direction. It is characterized in that a curving slope is formed on the rear outer edge side of the moving surface so as to gradually descend outward. The knee joint prosthesis of the present invention is provided with a space for accommodating the cruciate ligament by providing the femoral component with a pair of posterior walls arranged in a generally C-shape that opens rearward. In addition to the small cutting amount, there is no need to remove the cruciate ligament. [0008] A pair of posterior walls of the femoral component are arranged in the above-mentioned C-shape, and a curved edge is formed on the rear outer edge of the sliding surface of the other tibial component. This allows the sliding surfaces of both components to cooperate during the flexion motion to prevent relative forward and lateral movement of the femoral component and to ensure motion stability while gradually moving the center of rotation of the flexion backward. To accurately reproduce the normal physiological movements of the knee joint. Embodiments of the present invention will be specifically described below with reference to the drawings. FIG. 1 shows a knee prosthesis K of the present embodiment, which comprises a femoral component F fixed to a distal part of a femur and a tibial component T fixed to a proximal part of a tibia. Have been. The femoral component F is shown in FIG.
As shown in FIG. 3, the front wall 1 is integrally connected to a pair of rear walls 3 and 3 via a bridge portion 2. Extension sliding surface 4
b, the bending sliding surface 4c on the rear side and the bone contacting surface 6 on the other bone fixing side. In addition, as shown in FIG. 4, a large notch, that is, a PCL groove 5 is formed between the rear walls 3, and a cruciate ligament (PCL) can be accommodated therein. FIG. 5 is a cross-sectional view showing the shape of the bent sliding surface 4c. As shown in FIG. 5, the bent sliding surface 4c is formed of a curved surface that is continuous in the width direction. . Next, the structure of the other tibial component T will be described. As shown in FIG. 6, the tibial component T
A plastic plate 8 having excellent sliding characteristics is fixed on the upper side of the tray 7, and as shown in FIG.
The rear center of the PCL groove 5 of the femoral component F
Is formed in the PCL groove 10. Further, the center of the upper surface of the plate 8 is a central raised portion 9a, of the sliding surfaces located on the left and right thereof, the front side is an extended sliding surface 9b, and the rear outer edge is a bent sliding surface 9c. Of which the bending sliding surface 9c
As shown in FIG. 6, a downwardly curved curved surface 9d having a shape gradually falling outward is formed. The artificial knee joint K having such characteristics is obtained by determining the shape of the sliding surface by the method described below, and the method will be described in detail. With respect to the shape of the femoral component F of the present invention, the physiological movement of the normal knee joint can be reduced by gradually moving the center of rotation of the flexion backward while ensuring the stability of the movement described in the section of "action". The ideal shape of the tibial component T to be faithfully reproduced is an envelope obtained by fixing the tibial component T and then reproducing the motion of a healthy femur. In practice, this shape is determined by taking a lateral dynamic image of a normal knee joint in order to determine the motion of the femur with respect to the tibia, and performing a normal rollback motion (ie, the tibial anterior edge at the lowest point of the tibia with knee flexion). The provisional distance was tentatively approximated by the following formula (this formula allows better knee prosthesis design by collecting and correcting more normal rollback motion data): d = 2.05 x 10 1 +2.00 x 10 -2 x + 3.89 x 10 -4 x + 9.23 x
10 -6 x Saddle d: Distance from the lowermost point of the femur to the tibial anterior edge x: Bend angle of the knee As a physiologically acceptable range around this position, in the maximum extension position, rotation, anteroposterior direction, and lateral direction Both are set to 0 and gradually increase according to the knee flexion angle.
The degree of looseness up to 2 mm in the horizontal direction is allowed. However, by changing the position of the femoral component F in a quadratic curve (parabolic) so as to increase the position of the femoral component F by 2 mm at the maximum value of the three elements of the slack at each bending angle, a larger restoring force increases as the slack displacement increases. (The power to return to the theoretical position). The femoral component F is moved in the computer so as to satisfy this condition, and the shape of the obtained envelope is trimmed according to the contour of the base of the tibial component T to obtain a first shape. Subsequently, at each bending angle of the completed femoral component F and tibial component T, the newly developed potentiometric method (that is, the drop of the position of the center of gravity of each component in all the ways of contacting the two shapes) The position where the head is minimized is determined, the contact position in the living body is predicted, and the rate of change of the head in the vicinity is used as an index of stability.) After evaluating the contact position and the contact area, the shape is changed so as to reduce the curvature of the portion of the femoral component F whose contact area is too small, and the maximum slackness at the bending angle at which the stability is desired to be enhanced is increased. To reduce the stability and increase the maximum slack of the bending angle for which the stability is to be reduced, find the envelope surface again. This process is repeated until the stability of the motion and the rollback motion satisfying the requirements are obtained, and the shape of the artificial knee joint is determined. A shape within a practical range can be obtained by repeating several times, but a shape with higher performance can be found by repeating trial and evaluation. As a result of such an operation, as described above, the pair of rear walls 3 and 3
Are arranged in a substantially C-shape that opens rearward, and the bending sliding surface 4c is formed of a curved surface that is continuous in the lateral width direction, and is located on the rear outer edge side of the sliding surface 9c that receives a load in the other tibial component T. An artificial knee joint K having a gradually lowering sloping slope toward the outside was obtained. As described above, the knee prosthesis of the present invention accommodates the cruciate ligament because the pair of posterior walls of the femoral component are arranged in a substantially C-shape that opens rearward. This gives the patient less space and eliminates the need for resection of the cruciate ligament in addition to the small amount of osteotomy. Therefore, healthy and normal muscular strength near the knee joint can be maintained. Further, the pair of posterior walls of the femoral component are arranged in the above-mentioned C-shape, and the rear outer edge side of the sliding surface of the other tibial component is formed as a downward-sloping curved slope that gradually descends outward. During the flexion movement, the sliding surfaces of both components cooperate to prevent relative forward movement and lateral movement of the femoral component and to ensure the stability of the movement, while gradually moving the center of rotation of the flexion backward. To accurately reproduce the normal physiological movements of the knee joint. As described above, the present invention provides a particularly excellent effect.
【図面の簡単な説明】
【図１】本発明実施例の人工膝関節の斜視図である。
【図２】図１の人工膝関節を構成する大腿骨コンポーネ
ントの前面図である。
【図３】図２の大腿骨コンポーネントの側面図である。
【図４】図２の大腿骨コンポーネントの上面図である。
【図５】図４のＸーＸ線図である。
【図６】図１の人工膝関節を構成する脛骨コンポーネン
トの前面図である。
【図７】図６の脛骨コンポーネントの上面図である。
【符号の説明】
Ｋ 人工膝関節
Ｆ 大腿骨コンポーネント
Ｔ 脛骨コンポーネント
１ 前壁
２ 架橋部
３ 後壁
４ａ パテラ摺動面
４ｂ、９ｂ 伸展位摺動面
４ｃ、９ｃ 屈曲摺動面
５、１０ ＰＣＬ溝
６ 骨接触面
７ トレー
８ プレート
９ａ 中央隆起部
９ｄ 縁下り曲斜面BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of an artificial knee joint according to an embodiment of the present invention. 2 is a front view of a femoral component constituting the knee prosthesis of FIG. 1; FIG. 3 is a side view of the femoral component of FIG. 2; FIG. 4 is a top view of the femoral component of FIG. 2; FIG. 5 is an XX diagram of FIG. 4; FIG. 6 is a front view of a tibial component constituting the knee prosthesis of FIG. 1; FIG. 7 is a top view of the tibial component of FIG. 6; [Description of Signs] K Artificial knee joint F Femoral component T Tibial component 1 Front wall 2 Bridge portion 3 Rear wall 4a Patella sliding surface 4b, 9b Extension sliding surface 4c, 9c Flexing sliding surface 5, 10 PCL groove 6 Bone contact surface 7 Tray 8 Plate 9a Central ridge 9d Curved slope down edge
───────────────────────────────────────────────────── フロントページの続き (72)発明者 井口 普敬 愛知県知多郡美浜町大字河和字岡ノ脇 131番地の２ (56)参考文献 特開 平３−267055（ＪＰ，Ａ) 特開 昭55−133247（ＪＰ，Ａ) (58)調査した分野(Int.Cl.7，ＤＢ名) A61F 2/38 ＷＰＩ（ＤＩＡＬＯＧ)────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Hirotaka Iguchi 131--2, Okanowaki, Kawawa, Mihama-cho, Chita-gun, Aichi Prefecture (56) References JP-A-3-267055 (JP, A) JP-A-55 -133247 (JP, A) (58) Fields investigated (Int. Cl. 7 , DB name) A61F 2/38 WPI (DIALOG)
Claims (1)
ーネントと脛骨の近位部に固定される脛骨コンポーネン
トから構成される人工膝関節において、上記大腿骨コン
ポーネントは、一対の後壁が後側に開く概ねハ字状に配
置されるとともに、屈曲摺動面が横幅方向に連続する曲
面で構成され、上記脛骨コンポーネントは、荷重を受け
る摺動面の後部外縁側に外側に向かって漸次下る縁下り
曲斜面を形成してなる人工膝関節。(57) An artificial knee joint comprising a femoral component fixed to a distal part of a femur and a tibial component fixed to a proximal part of a tibia, wherein the femur is The bone component has a pair of rear walls arranged in a generally C-shape that opens rearward, and the bending sliding surface is formed of a curved surface that is continuous in the width direction. The tibial component has a sliding surface that receives a load. A knee prosthesis with a curving slope that descends gradually toward the outside at the rear outer edge.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP32320394A JP3419931B2 (en) | 1994-12-26 | 1994-12-26 | Artificial knee joint |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP32320394A JP3419931B2 (en) | 1994-12-26 | 1994-12-26 | Artificial knee joint |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH08173465A JPH08173465A (en) | 1996-07-09 |
| JP3419931B2 true JP3419931B2 (en) | 2003-06-23 |
Family
ID=18152198
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP32320394A Expired - Lifetime JP3419931B2 (en) | 1994-12-26 | 1994-12-26 | Artificial knee joint |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3419931B2 (en) |
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-
1994
- 1994-12-26 JP JP32320394A patent/JP3419931B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| JPH08173465A (en) | 1996-07-09 |
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