US20120035736A1 - Tibial component - Google Patents

Tibial component Download PDF

Info

Publication number
US20120035736A1
US20120035736A1 US13067143 US201113067143A US2012035736A1 US 20120035736 A1 US20120035736 A1 US 20120035736A1 US 13067143 US13067143 US 13067143 US 201113067143 A US201113067143 A US 201113067143A US 2012035736 A1 US2012035736 A1 US 2012035736A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
lateral
medial
bearing
bearing region
surface
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.)
Abandoned
Application number
US13067143
Inventor
John J. O'Connor
John W. Goodfellow
David Murray
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
BTG International Ltd
Original Assignee
BTG International Ltd
Priority date (The priority date 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 date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3868Joints for elbows or knees with sliding tibial bearing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30324The prosthesis having different structural features at different locations within the same prosthesis differing in thickness
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The 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
    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30326The prosthesis having different structural features at different locations within the same prosthesis differing in height or in length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621Features concering the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30624Hinged joint, e.g. with transverse axle restricting the movement
    • A61F2002/30629Hinged joint, e.g. with transverse axle restricting the movement of the pin-guiding groove linkage type
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30767Special external and/or bone-contacting surfaces, e.g. coating for improving bone ingrowth
    • A61F2002/30934Special articulating surfaces
    • A61F2002/30935Concave articulating surface composed of a central conforming area surrounded by a peripheral annular non-conforming area

Abstract

A tibial knee joint prosthesis for attachment to a suitably prepared tibial bone, providing bearing portions in the lateral and medial compartments. The lateral and medial bearing surfaces of the component are inclined at different angles in the anterior to posterior direction of the knee, so that when mounted to the tibia, the lateral bearing surface of the prosthesis is higher than the medial bearing surface to the posterior side of the knee. In this way the lateral ligament is tightened progressively more than the medial ligament as the knee moves from extension to flexion, resulting in increased stability in the lateral compartment.

Description

  • The invention relates in general to prosthetic knee joint devices, and in particular to bi-compartmental devices for use in the lateral and medial compartments of the tibia.
  • Considerable development has taken place in recent decades with regard to knee joint replacement. However, continuous review of clinical experience with unicompartmental meniscal knee implants has shown that problems can occur, particularly in the case of replacement of the lateral compartment. Whilst great success has been achieved with medial compartmental replacement, dislocation of the meniscal bearing in the lateral compartment remains a problem. The success rate of such replacements has been limited, due to the fact that the lateral soft tissues (principally the lateral collateral ligament and the ilio-tibial band) offer less certain resistance to distraction of the joint. There is also evidence to suggest that the lateral compartment may lift off under certain circumstances, such as during single leg stance, resulting in unequal loading of the joint. The lateral collateral ligament is a much slimmer structure than the medial collateral ligament and there is evidence to suggest that it is slack in the unloaded joint, except at extension. It therefore offers much less resistance to bearing dislocation or lift-off than do the more inextensible medial structures. On the lateral side, the tendon of the popliteus muscle passes across the postero-lateral corner of the joint. When the joint is replaced, the tendon can act to propel the meniscal bearing towards the intercondylar region where dislocation can occur.
  • The early total condylar prostheses designed in the 1970's sacrificed both cruciate ligaments as does their successor, the Insall-Burstein posterior stabilised prosthesis. Many of the prostheses designed in the 1980's sacrificed the anterior cruciate ligament (ACL) but allowed retention of the posterior cruciate ligament. Attempts to develop total joint prostheses where the ACL is also retained have generally been unsuccessful. The prosthetic components were either designed to constrain antero-posterior translational movements and inadequate steps were taken to prevent loosening, or the components were unconstrained relative to anterior/posterior translation and many wore out.
  • It has been observed that during flexion and extension of the knee joint, the contact points between the femoral and tibial condyles move in an antero-posterior direction. The femoral component moves on the tibial plateau in a posterior direction during flexion and in an anterior direction during extension. One of the problems caused by absence of the ACL is increased antero-posterior movement of the femoral condyle relative to the tibial condyle, which is responsible for further loosening of the tibial component and often leads to dislocation. A conventional tibial component will generally have a large central pin for location in the prepared end of the tibia. The ACL may be present in a diseased knee but is usually removed to improve access to the joint area during surgery, which is necessary to provide sufficient clearance to insert the tibial component and provide a site for the central pin.
  • Examination of records of the state of the ligaments at the time of knee-replacement surgery shows that in more than 50% of cases, both in osteoarthritis or in rheumatoid arthritis, all the ligaments, including the ACL, were found to be intact. Where present, these ligaments are generally sacrificed in the above surgical techniques. Although tibial components having a central cut-out slot of the type illustrated in FIG. 1, which can be inserted with the ACL in place, have been employed, there will still be a tendency for dislocation or lift-off in the lateral compartment.
  • In those cases where the ligaments are already absent, they may be reconstructed. Since the attempts of the 1960's, the practice of ACL reconstruction in young athletes, using muscle tendons as grafts, has become widespread and there is a large body of surgeons for whom this operation forms a substantial part of their practice. Although such routine reconstructions have usually only been performed in young persons, following injury involving ligament damage, there is considerable scope for reconstruction in the elderly patients who are the usual candidates for knee replacement, in cases where the ACL is absent.
  • From the foregoing it is apparent that a need exists for knee replacement prostheses which provide sufficient stability in the lateral compartment and which are suitable for joints with intact cruciate ligaments.
  • The aim of the invention is to provide a tibial component that will cause the lateral ligament to be tightened relatively more than the medial. It is intended that such a component be suitable in surgical situations where the anterior cruciate ligament is retained, replaced or reconstructed.
  • In accordance with the present invention, there is provided a prosthesis for implantation in the knee joint, said prosthesis comprising: a tibial component having a first, upper surface and a second, lower surface opposite said first surface for attachment to the tibia, said first surface including a lateral bearing region and a medial bearing region, wherein the respective angles of inclination of said lateral and said medial bearing regions of said first surface, with respect to said second surface, are dissimilar.
  • Advantageously, the direction of inclination is between the anterior side and the posterior side, and the angle of inclination of the lateral bearing region is more positive than the angle of inclination of the medial bearing region. Preferably, the difference in angle of inclination is approximately 2 to 4 degrees. The angle of the lateral bearing region may be inclined positively to the second surface and the medial bearing region substantially parallel to the second surface. Alternatively, with appropriate changes made to the angles of saw cut in the tibia, the lateral bearing region may be substantially parallel to the second surface, and the medial bearing region inclined at a negative angle to said second surface, or the lateral bearing region can be inclined at a greater positive angle to the second surface, and the medial bearing region inclined at a lesser positive angle to said second surface. The bearing regions may be formed as flat plane plateaux. For added stability, the bearing regions may be given a convex, part-spherical or part cylindrical form. They can also be formed with a convex lateral bearing region and a concave medial bearing region, similar to the physiological knee, or alternatively with either the lateral region convex and the medial region flat, or the lateral region flat and the medial region concave. In practical terms, the angles of inclination of said lateral and said medial bearing regions may be chosen such that, when attached to the tibia, the lateral bearing region is inclined downwards at a lesser angle to the horizontal than the medial bearing region, in an anterior to posterior direction.
  • There is further provided a method of implanting a prosthesis comprising sawing the medial and lateral compartments of the tibial bone condyles and attaching the prosthesis to the prepared surface of the tibial bone, wherein the angle of the saw cut is chosen such that the posterior side of the lateral bearing region sits higher on the tibia than the posterior side of the medial bearing region.
  • In an alternative aspect of the invention there is provided a prosthesis for implantation in the knee, said prosthesis comprising: a tibial component for attachment to the tibia, having a first, upper surface and a second, lower surface opposite said first surface for attachment to the tibia, said first surface including a lateral bearing region and a medial bearing region, arranged such that the respective angles of inclination in sagittal planes of said lateral and said medial bearing regions of the component in situ are different.
  • Preferably the lateral and medial bearing regions are inclined downward, the angle of downward inclination of said lateral bearing region to the horizontal being less than the angle of inclination of said medial bearing region, such that the posterior of the lateral bearing region is higher than the posterior of the medial bearing region.
  • In a further aspect, the invention provides a prosthesis comprising a tibial component having lateral and medial portions of differing height, wherein the difference in height of the lateral and medial portions increases posteriorly, such as to progressively tighten the lateral ligament more than the medial ligament as the joint moves from extension to flexion.
  • The complete prosthesis may further comprise intermediate meniscal bearing components and a femoral component for attachment to the femur.
  • According to another aspect of the invention, there is provided a tibial component having lateral and medial bearing portions and dimensioned such that a difference in the respective thicknesses of the lateral bearing portion and the medial bearing portion increases in an anterior to posterior direction.
  • A further aspect of the invention provides a tibial component having lateral and medial bearing portions, wherein the thickness of at least one bearing portion changes progressively from the anterior side to the posterior side.
  • Preferably the cross-sectional area of the lateral bearing portion in a sagittal plane that bisects the lateral bearing portion is greater than the cross-sectional area of the medial bearing portion in a corresponding sagittal plane. The change in thickness of the lateral and medial bearing portions in the anterior to posterior direction is advantageously described by the following expression:

  • t lat(p) −t lat(a) >t med(p) −t med(a)
  • Where tlat(p) is the thickness of the lateral bearing portion to the posterior side, tlat(a) is the thickness of the lateral bearing portion to the anterior side, tmed(p) is the thickness of the medial bearing portion to the posterior side and tmed(a) is the thickness of the medial bearing portion to the anterior side. A further aspect of the invention provides a tibial component having a lateral and a medial bearing portion comprising means for tensioning the lateral ligaments progressively more than the medial ligament.
  • To better illustrate the invention, it will now be described, by way of example, with reference to the accompanying drawings.
  • FIG. 1 illustrates a prior art tibial tray component in plan (1 a), side (1 b) and posterior (1 c) views.
  • FIG. 2 depicts plan, side and posterior views of a tibial component according to a first embodiment of the invention, for incorporation in a right-hand joint.
  • FIG. 3 depicts plan, side and posterior views of a tibial component according to a first embodiment of the invention, for incorporation in a left-hand joint.
  • FIG. 4 depicts plan, side and posterior views of a tibial component according to a second embodiment of the invention, for incorporation in a right-hand joint.
  • FIG. 5 shows a side view of a tibial component according to a variant of the second embodiment, for incorporation in a right-hand joint.
  • FIG. 6 shows a side view of a tibial component according to an alternative variant of the second embodiment, for incorporation in a right-hand joint.
  • FIG. 7 shows a perspective view of a left-hand total knee prosthesis, incorporating a tibial component according to the second embodiment of the invention
  • The invention will be described in terms conventionally used to describe the geometry of the knee. The knee has an anterior side (A) and posterior side (P), and is divided laterally along sagittal planes (S) extending between the anterior and posterior sides. A central sagittal plane divides the knee into medial and lateral compartments. The tibia has a vertical, major axis TM along its length, and a horizontal plane TN defined normal to its major axis. In the figures, (A) denotes the anterior side of the tibial component, (P) denotes the posterior side, (M) denotes the medial side, (L) denotes the lateral side, (S) denotes a sagittal plane, TM denotes the vertical axis of the tibia, and TN the horizontal plane of the tibia.
  • Referring to FIG. 1, the prior art tibial component 10 comprises a generally flat tray, shaped to correspond to the cross-sectional shape of the top of a typically prepared tibial bone, having an anterior side (A), a posterior side (P), and medial and lateral sides (M) and (L). SL and SM designate typical sagittal planes, in this case bisecting the lateral and medial bearing portions. The component has a first, upper, major surface 11, which acts as a bearing articulation surface, and a second, lower, major surface 12, opposite the first surface, for attachment to the tibia. A central cutout 13, open at the posterior side (P) of the component, is provided to allow the tray to be slid into position onto a suitably prepared tibia, without being hindered by the presence of the cruciate ligaments. To either side of the central cutout are defined lateral and medial bearing portions having flat meniscal bearing regions 14, 15 parallel to the lower surface 12. The thickness of the component (height of upper surface relative to lower surface) is constant across both bearing regions.
  • The tibia is typically prepared by sawing the top of the tibia in each compartment at an angle of 7.5° sloping downwards from the horizontal, relative to the front of the tibia. A saw guide is pinned to the exposed bone of the proximal tibia and rests on a shoe around the ankle at the distal end. The slope of the guiding surface is set at an angle of 7.5° to this guide. This guide is used to remove a sliver of bone from the top of the tibia. The tibial component is then attached to the prepared end of the tibia oriented with its cutout facing posteriorly.
  • With this arrangement, since the surfaces of the lateral and medial bearing regions are parallel to one another, the lateral collateral ligament is insufficiently constrained. A prosthesis with this arrangement will have a tendency to dislocate or lift off.
  • The inventors have established by 3d digitisation and modelling of the healthy knee joint that the articulating surfaces of the medial and lateral condyles of the tibia are not parallel. The medial tibial condyle of the healthy knee joint is slightly concave while the lateral condyle is slightly convex. Study of the digitised shapes of cadaver specimens has enabled the positions of planar surfaces which best fit the two condyles to be determined. A representative analysis of knee joints shows that on average, in the sagittal plane, the angle of posterior inclination (i.e. in an anterior to posterior direction) of the best-fit plane to the medial tibial condyle relative to the normal axis of the tibia is around 2 degrees greater than the angle of posterior inclination for the lateral tibial condyle, in other words, the upper surface of the medial condyle of the tibia slopes downward from front to back at an angle on average 2 degrees greater than the upper surface of the lateral condyle.
  • Basing their ideas on this realisation, the inventors have developed an improved prosthetic component, which takes into account the difference in posterior inclination between the lateral and medial condyles.
  • FIGS. 2 and 3 illustrate right and left versions of a bicompartmental tibial tray component 20 in accordance with a first embodiment of the invention, similar to the conventional tibial tray component illustrated in FIG. 1. The component also has a first, upper, major surface 21, which acts as a bearing articulation surface, and a second, lower, major surface 22, opposite the first surface, for attachment to the tibia (not shown). By adjusting the angle of inclination in the sagittal plane of the lateral and medial bearing regions (24,25) to be different, the behaviour of the prosthetic knee joint can be arranged to reduce the likelihood of dislocation in the lateral compartment.
  • FIGS. 2 and 3 show the plateaux (24, 25) as flat surfaces inclined to each other. In surgery, a single saw guide is used to saw the surfaces of the lateral and medial compartments of the tibia parallel to each other, preferably at an angle of approximately 7.5° to the horizontal plane, normal to the major axis of the tibia. The articulating bearing surface of the component in the medial compartment is inclined at an angle β=0 i.e. is parallel to its under surface, so will also be inclined at an angle of 7.5°, when mounted to the prepared tibia. The articulating bearing surface in the lateral compartment of the component is inclined at an angle α, in the region of 3.5° to its lower surface, the component increasing in thickness in the antero-posterior direction. Thus when the component is mounted to the prepared tibia sawn at 7.5° to the horizontal it will provide a lateral bearing surface inclined at the lesser angle of 4° to the horizontal piane, and consequently the height difference between the medial and lateral bearing surfaces increases posteriorly. This will tend to keep the fibres of the lateral collateral ligament tighter than physiological as the joint flexes and the femoral condyles move backwards, increasing the contribution of the LCL to resisting bearing dislocation or lateral lift-off.
  • Although the relative inclination in the sagittal plane of the two bearing surfaces with the component in situ will most probably be in the region of 2 to 4 degrees, the essential element is an appropriate difference in slope between the bearing surfaces of the two compartments when the component is in situ, such that the height of the bearing surface on the lateral side reduces progressively at a lesser rate in the posterior direction than the height reduces on the medial side.
  • In FIGS. 2 and 3, the two plateaux are shown at the same level anteriorly and therefore at different levels posteriorly. The invention encompasses designs in which the lateral and medial bearing surfaces are at different levels both anteriorly and posteriorly; it may be appropriate to arrange the component such that both lateral and medial bearing regions are inclined relative to the lower surface of the component, but at different angles, as will be discussed later in this specification.
  • It may be appropriate to provide the tibial component with a raised side wall or flange at one side of the intercondylar cutout, as indicated at 26 in FIG. 2, in order to limit the extent of relative lateral/medial movement of the joint and to prevent contact between the meniscal bearings or femoral condyles and the exposed cut tibial bone.
  • FIG. 4 (a) to (c) shows a second embodiment of the invention incorporating a component (20) for a profiled meniscal bearing to provide added stability. In this embodiment, by making the bearing surfaces of convex, curved form, the resistance to dislocation can be further enhanced. The tibial plateaux are inclined to each other in the sagittal plane as in FIG. 2, such that, in situ, a plane fitted to the surface of the bearing region in the lateral compartment (24) will be inclined at a lesser angle to the horizontal than in the medial compartment (25). The curved bearing regions (24, 25) shown are defined by convex surfaces of part-cylindrical shape. The surfaces can also be defined by convex surfaces of part-spherical shape. As shown in FIG. 4 (d), if only one compartment is provided with a curved surface, advantageously, less bone removal may be required. The medial bearing region can be flat, with the lateral bearing region convex as shown in FIG. 4 (d), or alternatively, the lateral bearing region can be flat and the medial bearing region concave. It is also envisaged that bearing surfaces could be formed to more closely approximate the physiological tibial condyles, with the lateral bearing region having a convex form, and the medial bearing region having a concave form. Further improvements to stability may be provided by differentially inclining the surfaces in the frontal plane, such that each bearing region slopes downwards from the centre of the knee towards the exterior of the knee.
  • The radius of curvature of the cylindrical bearing surface is a function of the size of the prosthesis, and will increase for components destined for a larger knee. However, it is important that the radius be kept within limits, to keep the overall thickness of the tibial component as thin as possible, thus minimising the amount of tibial bone that has to be removed to accommodate the component.
  • It is to be appreciated that the actual angles of the articulating bearing surfaces of the tibial component are dependent on the angle of the saw cut in the tibia. A cut angle of 7.5° posterior tilt has been found to be ideal, especially where the femoral component is formed with spherical condyles, allowing the creation of equal flexion and extension gaps. However, the tibial bone could be sawn at other angles, provided that the relative change in thickness of the component in the posterior direction was greater in the lateral compartment than in the medial compartment, with the angles of inclination of the upper surfaces of the component correspondingly selected to achieve the desired differential inclination, when the component is in situ on the tibia. FIG. 5 illustrates a possible variant to the first embodiment. The bearing regions have different slopes but are inclined in the same direction, with the lateral bearing region inclined at 5½° to the lower surface and the medial bearing region inclined at a lesser angle of 2°. Provided the tibial saw cut is made at an increased angle of 9½° the resulting position of the lateral and medial bearing regions in situ on the tibia will be the same as for the first embodiment. It is to be appreciated that with a reduced angle of cut, in order to produce the necessary differential inclination, the component could even have a lateral bearing portion where the upper and lower surfaces were parallel, and a medial bearing portion where the upper surface was inclined in an anterior direction, as illustrated in FIG. 6, where lateral and medial bearing regions have angles of inclination α, β of 0° and −3½° (a negative angle indicating that the bearing region slopes toward the lower surface from the anterior side to the posterior side—as opposed to a positive angle where the bearing region slopes away from the lower surface from the anterior to the posterior side). In this case, a reduced angle of cut of 4° would be necessary to achieve the same overall differential inclination as in the first embodiment. It would also be possible to saw the tibial condyles at different angles, with the lateral compartment inclined at a lesser angle than the medial one, although this would necessitate a more complicated sawing arrangement. In this case a component with parallel medial and lateral plateaux could be employed, having a deformable central section, such that the lower surface of the component could conform to the differentially inclined tibial compartments, once affixed to the tibia. Where appropriate, separate lateral and medial bearing components could be employed.
  • FIG. 7 shows a complete left-hand 4-part knee prosthesis incorporating the tibial component of the second embodiment. The lateral (24) and medial (25) bearing regions of the tibial component are intended to co-operate in use with the lower bearing surfaces of the intermediate meniscal bearings (30,31). The upper bearing surfaces of the meniscal bearings cooperate in use with the bearing surfaces of a corresponding femoral component (40). As the joint moves from extension to flexion, the femoral component and meniscal bearings will move backwards on the bearing surfaces of the tibial component. Due to the differential inclination of the lateral and medial bearing surfaces, the lateral ligament will be progressively tightened, providing increasing resistance to dislocation as the knee is flexed.
  • Whilst FIGS. 1 to 6 do not show the means for fixing the tibial component to the bone, it is to be appreciated that this could be achieved in a number of ways. For example, a pin or pins could be applied centrally at the anterior side of the prosthesis, sloping downwards and backwards into the bone. Alternatively, pins or spikes could be applied laterally, as shown at (50) in FIG. 7. Such pins could either be formed as an integral part of the prosthesis, or as separate elements. Slots may be prepared in the tibia to accept the fixing means.
  • The component may be formed of any suitable surgically acceptable material, such as cobalt chrome vanadium, alumina or zirconia ceramic, or plastic, such as ultra-high molecular weight polyethylene (UHMWPE). Whilst the component described in the above embodiments is of unitary construction it is to be appreciated that it could also be constructed with separate lateral and medial bearing portions secured to one side of a tray element, with the other side of the tray element for attachment to the end of the tibia. Although the above embodiments have generally been described in the context of 3 component total knee prostheses, it is to be appreciated that the invention may also be applied with two component arrangements, where the femoral and tibial components bear directly against one another. In such arrangements, having a lateral tibial plateau which is higher posteriorly could prove particularly useful in reducing any problems of lift-off in extension of the joint. The tibial component in such arrangements may be formed from separate elements, as mentioned above, with bearing portions of a suitable material (e.g. UHMWPE) attached to a metal tray element. The differential inclination may be provided by adapting the tray or the individual bearing portions.

Claims (24)

  1. 1. A prosthesis for implantation in the knee joint, said prosthesis comprising: a tibial component having a first, upper surface and a second, lower surface opposite said first surface for attachment to the tibia, said first surface including a lateral bearing region and a medial bearing region, wherein the respective angles of inclination of said lateral and said medial bearing regions of said first surface, with respect to said second surface, are dissimilar.
  2. 2. A prosthesis according to claim 1 wherein the direction of inclination is between said anterior side and said posterior side.
  3. 3. A prosthesis according to claim 1 wherein the angle of inclination of the lateral bearing region is more positive than the angle of inclination of the medial bearing region.
  4. 4. A prosthesis according to claim 1 wherein the difference in angle of inclination between the lateral and medial bearing regions is within a range of approximately 2 to 4 degrees.
  5. 5. A prosthesis according to claim 1 wherein the height of the lateral bearing region increases from said anterior side to said posterior side.
  6. 6. A prosthesis according to claim 1 wherein the lateral bearing region is inclined at a positive angle to the second surface, and said medial bearing region is substantially parallel to said second surface.
  7. 7. A prosthesis according to claim 1 wherein the lateral bearing region is substantially parallel to the second surface, and said medial bearing region is inclined at a negative angle to said second surface.
  8. 8. A prosthesis according to claim 1 wherein the lateral bearing region is inclined at a positive angle to the second surface, and said medial bearing region is inclined at a lesser positive angle to said second surface.
  9. 9. A prosthesis according to claim 1, wherein the lateral and medial bearing regions are formed as flat plane plateaux.
  10. 10. A prosthesis according to claim 1, wherein the lateral and medial bearing regions have a convex, part-cylindrical form.
  11. 11. A prosthesis according to claim 1, wherein the lateral bearing region has a convex form and the medial bearing region has a flat form.
  12. 12. A prosthesis according to claim 1, wherein the lateral bearing region has a flat form and the medial bearing region has a concave form.
  13. 13. A prosthesis according to claim 1, wherein the lateral bearing region has a convex form and the medial bearing region has a concave form.
  14. 14. A prosthesis according to claim 1 wherein the angles of inclination of said lateral and said medial bearing regions are chosen such that, when attached to the tibia, the lateral bearing region is inclined downwards to the horizontal at a lesser angle than the medial bearing region, in an antero-posterior direction.
  15. 15. A method of implanting a tibial prosthesis comprising sawing the medial and lateral compartments of the tibial bone condyles and attaching the prosthesis to the prepared surface of the tibial bone, wherein the angle of the saw cut is chosen such that the posterior side of the lateral bearing region sits higher on the tibia than the posterior side of the medial bearing region.
  16. 16. A prosthesis for implantation in the knee, said prosthesis comprising: a tibial component for attachment to the tibia, having a first, upper surface and a second, lower surface opposite said first surface for attachment to the tibia, said first surface including a lateral bearing region and a medial bearing region, arranged such that the respective angles of inclination in sagittal planes of said lateral and said medial bearing regions of the component in situ when fitted to the tibia are different.
  17. 17. A prosthesis according to claim 16, wherein the lateral and medial bearing regions in situ are inclined downward to the horizontal from the anterior to the posterior side, the angle of downward inclination of said lateral bearing region to the horizontal being less than the angle of downward inclination of said medial bearing region, such that the posterior of the lateral bearing region is higher than the posterior of the medial bearing region.
  18. 18. A prosthesis comprising a tibial component having lateral and medial portions of differing height, wherein the difference in height of the lateral and medial portions increases posteriorly, such as to progressively tighten the lateral ligament more than the medial ligament as the joint moves from extension to flexion.
  19. 19. A prosthesis according to claim 16 further comprising an intermediate meniscal bearing component and a femoral component for attachment to the femur.
  20. 20. A tibial component having lateral and medial bearing portions and dimensioned such that a difference in the respective thicknesses of the lateral bearing portion and the medial bearing portion increases in an anterior to posterior direction.
  21. 21. A tibial component having lateral and medial bearing portions, wherein the thickness of at least one bearing portion changes progressively from the anterior side to the posterior side.
  22. 22. A tibial component according to claim 21, wherein the cross-sectional area of the lateral bearing portion in a sagittal plane that bisects the lateral bearing portion is greater than the cross-sectional area of the medial bearing portion in a corresponding sagittal plane.
  23. 23. A tibial component according to claim 21, wherein the change in thickness of the lateral and medial bearing portions in the anterior to posterior direction is described by the following expression:

    t lat(p) −t lat(a) >t med(p) −t med(a)
    Where tlat(p) is the thickness of the lateral bearing portion to the posterior side, tlat(a) is the thickness of the lateral bearing portion to the anterior side, tmed(p) is the thickness of the medial bearing portion to the posterior side and t(med(a) is the thickness of the medial bearing portion to the anterior side.
  24. 24. A tibial component having a lateral and a medial bearing portion comprising means for tensioning the lateral ligaments progressively more than the medial ligament.
US13067143 1999-06-16 2011-05-11 Tibial component Abandoned US20120035736A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
US10014920 US20020058997A1 (en) 1999-06-16 2001-12-14 Tibial component
US10692016 US7060101B2 (en) 1999-06-16 2003-10-24 Tibial component
US11407129 US20060190087A1 (en) 1999-06-16 2006-04-20 Tibial component
US12461435 US8066776B2 (en) 2001-12-14 2009-08-11 Tibial component
US13067143 US20120035736A1 (en) 2001-12-14 2011-05-11 Tibial component

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US13067143 US20120035736A1 (en) 2001-12-14 2011-05-11 Tibial component
US14597885 US20150209149A1 (en) 1999-06-16 2015-01-15 Tibial component
US15259283 US20170119534A1 (en) 1999-06-16 2016-09-08 Tibial component

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US12461435 Continuation US8066776B2 (en) 1999-06-16 2009-08-11 Tibial component

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US14597885 Continuation US20150209149A1 (en) 1999-06-16 2015-01-15 Tibial component

Publications (1)

Publication Number Publication Date
US20120035736A1 true true US20120035736A1 (en) 2012-02-09

Family

ID=42197019

Family Applications (4)

Application Number Title Priority Date Filing Date
US12461435 Active US8066776B2 (en) 1999-06-16 2009-08-11 Tibial component
US13067143 Abandoned US20120035736A1 (en) 1999-06-16 2011-05-11 Tibial component
US14597885 Abandoned US20150209149A1 (en) 1999-06-16 2015-01-15 Tibial component
US15259283 Pending US20170119534A1 (en) 1999-06-16 2016-09-08 Tibial component

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US12461435 Active US8066776B2 (en) 1999-06-16 2009-08-11 Tibial component

Family Applications After (2)

Application Number Title Priority Date Filing Date
US14597885 Abandoned US20150209149A1 (en) 1999-06-16 2015-01-15 Tibial component
US15259283 Pending US20170119534A1 (en) 1999-06-16 2016-09-08 Tibial component

Country Status (1)

Country Link
US (4) US8066776B2 (en)

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100331848A1 (en) * 2009-05-29 2010-12-30 Richard Michael Smith Methods and Apparatus for Performing Knee Arthroplasty
US20130018477A1 (en) * 2011-07-13 2013-01-17 The General Hospital Corporation D/B/A Massachusetts General Hospital Methods and Devices for Knee Joint Replacement with Anterior Cruciate Ligament Substitution
US8864836B2 (en) 2008-06-27 2014-10-21 Zimmer, Inc. ACL accommodating tibial design
US8911501B2 (en) 2011-12-29 2014-12-16 Mako Surgical Corp. Cruciate-retaining tibial prosthesis
US20150209149A1 (en) * 1999-06-16 2015-07-30 Btg International Limited Tibial component
US9198762B2 (en) 2011-01-10 2015-12-01 Howmedica Osteonics Corp. Bicruciate retaining tibial baseplate
US9345578B2 (en) 2013-02-22 2016-05-24 Stryker Corporation Bicruciate retaining tibial implant system
US9730712B2 (en) 2012-10-18 2017-08-15 Smith & Nephew, Inc. Alignment devices and methods
US9757243B2 (en) 2014-07-08 2017-09-12 Zimmer, Inc. Intercondylar component and fin attachment features for use in knee arthroplasty
US9999511B2 (en) 2011-01-27 2018-06-19 Smith & Nephew, Inc. Knee prosthesis

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2511216C (en) 2002-12-20 2011-02-01 Smith & Nephew, Inc. High performance knee prostheses
US10092288B2 (en) 2006-02-03 2018-10-09 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
US8088130B2 (en) 2006-02-03 2012-01-03 Biomet Sports Medicine, Llc Method and apparatus for coupling soft tissue to a bone
EP2255755B1 (en) 2007-11-02 2013-03-27 Biomet UK Limited Prosthesis for simulating natural kinematics
US8894715B2 (en) 2009-05-28 2014-11-25 Biomet Manufacturing, Llc Knee prosthesis
US20100305710A1 (en) * 2009-05-28 2010-12-02 Biomet Manufacturing Corp. Knee Prosthesis
USD744104S1 (en) 2011-12-29 2015-11-24 Mako Surgical Corp. Femoral implant component
USD744103S1 (en) 2011-12-29 2015-11-24 Mako Surgical Corp. Tibial baseplate
US9649195B2 (en) 2011-12-29 2017-05-16 Mako Surgical Corp. Femoral implant for preserving cruciate ligaments
USD745158S1 (en) 2011-12-29 2015-12-08 Mako Surgical Corp. Tibial implant components
US9668871B2 (en) * 2011-12-29 2017-06-06 Mako Surgical Corp. Cruciate-retaining tibial prosthesis

Citations (56)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4034418A (en) * 1975-05-26 1977-07-12 The Governing Council Of The University Of Toronto Artificial knee joint
US4224696A (en) * 1978-09-08 1980-09-30 Hexcel Corporation Prosthetic knee
US4728332A (en) * 1984-11-28 1988-03-01 Albrektsson Bjoern Artificial menisco-tibial joint
US4911721A (en) * 1984-11-28 1990-03-27 Aendergaten 3 Joint prosthesis
US4936853A (en) * 1989-01-11 1990-06-26 Kirschner Medical Corporation Modular knee prosthesis
US5047057A (en) * 1988-07-27 1991-09-10 Peter Lawes Tibial component for a replacement knee prosthesis
US5192328A (en) * 1989-09-29 1993-03-09 Winters Thomas F Knee joint replacement apparatus
US5203807A (en) * 1991-07-10 1993-04-20 Smith & Nephew Richards Inc. Knee joint prosthesis articular surface
US5219362A (en) * 1991-02-07 1993-06-15 Finsbury (Instruments) Limited Knee prosthesis
US5282870A (en) * 1992-01-14 1994-02-01 Sulzer Medizinaltechnik Ag Artificial knee joint
US6139581A (en) * 1997-06-06 2000-10-31 Depuy Orthopaedics, Inc. Posterior compensation tibial tray
US6190415B1 (en) * 1997-04-04 2001-02-20 T. Derek V. Cooke Deep flexion knee prosthesis
US6235060B1 (en) * 1996-11-13 2001-05-22 Hjs Gelenk System Gmbh Artificial joint, in particular endoprosthesis for replacing natural joints
US6406497B2 (en) * 2000-07-19 2002-06-18 Tsunenori Takei Artificial knee joint
US6503280B2 (en) * 2000-12-26 2003-01-07 John A. Repicci Prosthetic knee and method of inserting
US6510334B1 (en) * 2000-11-14 2003-01-21 Luis Schuster Method of producing an endoprosthesis as a joint substitute for a knee joint
US20040006394A1 (en) * 2002-05-08 2004-01-08 Lipman Joseph D. Self-aligning knee prosthesis
US20040083005A1 (en) * 1998-12-22 2004-04-29 Magnus Jacobsson Method of anchoring a prosthesis structure
US20040138755A1 (en) * 1999-06-16 2004-07-15 Btg International Limited Tibial component
US20050197710A1 (en) * 2004-02-26 2005-09-08 Hjs Gelenk System Gmbh Tibia plateau for a replacement joint
US20050209703A1 (en) * 1999-04-02 2005-09-22 Fell Barry M Surgically implantable prosthetic system
US20060100714A1 (en) * 2003-04-02 2006-05-11 Ortho Development Corporation Tibial augment connector
US20060195195A1 (en) * 2003-07-17 2006-08-31 Albert Burstein Mobile bearing knee prosthesis
US20060212124A1 (en) * 2003-05-02 2006-09-21 Thomas Siebel Knee joint prosthesis
US20070083266A1 (en) * 2001-05-25 2007-04-12 Vertegen, Inc. Devices and methods for treating facet joints, uncovertebral joints, costovertebral joints and other joints
US20070135926A1 (en) * 2005-12-14 2007-06-14 Peter Walker Surface guided knee replacement
US20070299532A1 (en) * 2006-06-22 2007-12-27 Depuy Products, Inc. Tibial insert having a keel including a bore formed therein
US20070299531A1 (en) * 2006-06-22 2007-12-27 Depuy Products, Inc. Tibial insert and method for implanting the same
US7320709B2 (en) * 2000-08-28 2008-01-22 Advanced Bio Surfaces, Inc. Method and system for mammalian joint resurfacing
US7341602B2 (en) * 1999-05-10 2008-03-11 Fell Barry M Proportioned surgically implantable knee prosthesis
US20080243259A1 (en) * 2007-03-30 2008-10-02 Lee Jordan S Mobile bearing insert having offset dwell point
US20090043396A1 (en) * 2006-03-21 2009-02-12 Komistek Richard D Moment induced total arthroplasty prosthetic
US20090226068A1 (en) * 2008-03-05 2009-09-10 Conformis, Inc. Implants for Altering Wear Patterns of Articular Surfaces
US20100131071A1 (en) * 2001-12-14 2010-05-27 Btg International Limited Tibial component
US20100191341A1 (en) * 2009-01-28 2010-07-29 Zimmer, Inc. Lateral condyle posterior inflection for total knee implant
US20100280624A1 (en) * 2001-06-14 2010-11-04 Alexandria Research Technologies, Llc Modular apparatus and method for sculpting the surface of a joint
US20100331848A1 (en) * 2009-05-29 2010-12-30 Richard Michael Smith Methods and Apparatus for Performing Knee Arthroplasty
US20110015750A1 (en) * 2007-05-16 2011-01-20 Zimmer, Inc. knee system and method of making same
US20110029091A1 (en) * 2009-02-25 2011-02-03 Conformis, Inc. Patient-Adapted and Improved Orthopedic Implants, Designs, and Related Tools
US8006839B2 (en) * 2008-12-09 2011-08-30 Zimmer, Inc. Method and apparatus for packaging medical devices
US20120022658A1 (en) * 2010-07-24 2012-01-26 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US20120109324A1 (en) * 2010-03-10 2012-05-03 John Keggi Low stress all poly tibial component
US20120197409A1 (en) * 2011-01-27 2012-08-02 Smith & Nephew, Inc. Constrained knee prosthesis
US8292965B2 (en) * 2008-02-11 2012-10-23 New York University Knee joint with a ramp
US8298288B2 (en) * 2008-06-24 2012-10-30 New York University Recess-ramp knee joint prosthesis
US8317870B2 (en) * 2010-09-30 2012-11-27 Depuy Products, Inc. Tibial component of a knee prosthesis having an angled cement pocket
US8496704B2 (en) * 2010-04-13 2013-07-30 Smith & Nephew, Inc. Systems and methods for tensioning ligaments and other soft tissues
US20130204383A1 (en) * 2012-02-06 2013-08-08 Zimmer, Inc. Tibial baseplates for special patient populations
US20130218283A1 (en) * 2007-08-27 2013-08-22 Kent M. Samuelson Systems and methods for providing an asymmetrical tibial component
US8535383B2 (en) * 2004-01-12 2013-09-17 DePuy Synthes Products, LLC Systems and methods for compartmental replacement in a knee
US20130317619A1 (en) * 2010-09-10 2013-11-28 Chris Alexander Dodd Femoral extension prosthetic component and tibial shelf prosthetic component for unicondylar meniscal bearing knee prosthesis and prosthesis including such a component
US20130317621A1 (en) * 2006-09-29 2013-11-28 Biomet Manufacturing, Llc Knee Prosthesis Assembly With Ligament Link
US20140052268A1 (en) * 2010-07-24 2014-02-20 Zimmer, Inc. Tibial prosthesis
US8721731B2 (en) * 2007-08-27 2014-05-13 Kent M. Samuelson Systems and methods for providing a tibial articulation feature
US20140156015A1 (en) * 2010-09-10 2014-06-05 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US20140163687A1 (en) * 2011-11-18 2014-06-12 Zimmer, Inc. Tibial bearing component for a knee prosthesis with improved articular characteristics

Family Cites Families (38)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1514468A (en) * 1974-07-03 1978-06-14 Nat Res Dev Endoprosthetic elbow joint devices
GB1601576A (en) * 1977-06-01 1981-10-28 Howmedica Elbow prosthesis
US4298992A (en) * 1980-01-21 1981-11-10 New York Society For The Relief Of The Ruptured And Crippled Posteriorly stabilized total knee joint prosthesis
FR2508793B1 (en) 1981-07-06 1983-10-28 Rambert Andre
GB2138296B (en) 1983-04-21 1987-03-18 Oec Europ Ltd Knee prosthesis
JPS6077752A (en) * 1983-09-30 1985-05-02 Hiroshi Shiyouji Meniscal artificial knee joint
US4808185A (en) * 1986-02-07 1989-02-28 Penenberg Brad L Tibial prosthesis, template and reamer
US5234433A (en) * 1989-09-26 1993-08-10 Kirschner Medical Corporation Method and instrumentation for unicompartmental total knee arthroplasty
US5059216A (en) * 1989-09-29 1991-10-22 Winters Thomas F Knee joint replacement apparatus
DE4009360C2 (en) * 1990-02-16 1993-08-05 Friedrichsfeld Ag Keramik- Und Kunststoffwerke, 6800 Mannheim, De
DE4006402A1 (en) 1990-03-01 1991-09-05 Wolff Walsrode Ag High-slip, drawn polypropylene film, for transparent packaging - contains mixts. of poly-iso-butyl-methacrylate! and poly-methyl-methacrylate as antiblocking agent, with antistatics and lubricants
FR2676916B1 (en) 1991-05-30 1997-03-28 Jbs Sa Tricompartmental knee prosthesis has menisci floating.
DE4202717C1 (en) * 1991-12-11 1993-06-17 Dietmar Prof. Dr. 3350 Kreiensen De Kubein-Meesenburg
US5275603A (en) * 1992-02-20 1994-01-04 Wright Medical Technology, Inc. Rotationally and angularly adjustable tibial cutting guide and method of use
US5358530A (en) * 1993-03-29 1994-10-25 Zimmer, Inc. Mobile bearing knee
US5871541A (en) * 1993-11-23 1999-02-16 Plus Endoprothetik, Ag System for producing a knee-joint endoprosthesis
EP0689406A1 (en) * 1993-12-30 1996-01-03 Bruno E. Dr. Gerber Knee endoprosthesis
EP0672397B1 (en) 1994-03-15 2000-06-07 Sulzer Orthopädie AG Tibial plate for an artificial knee joint
GB9413607D0 (en) * 1994-07-06 1994-08-24 Goodfellow John W Endoprosthetic knee joint device
US5549688A (en) * 1994-08-04 1996-08-27 Smith & Nephew Richards Inc. Asymmetric femoral prosthesis
GB2312168B (en) * 1996-04-17 1999-11-03 Finsbury Meniscal knee prosthesis
GB9611060D0 (en) 1996-05-28 1996-07-31 Howmedica Tibial element for a replacment knee prosthesis
US5964808A (en) * 1996-07-11 1999-10-12 Wright Medical Technology, Inc. Knee prosthesis
DE69725291D1 (en) 1997-07-10 2003-11-06 Ortho Id Lyon Soc knee prosthesis
FR2777452B1 (en) * 1998-04-15 2000-12-15 Aesculap Sa Knee Prosthesis
US6443991B1 (en) * 1998-09-21 2002-09-03 Depuy Orthopaedics, Inc. Posterior stabilized mobile bearing knee
JP4409784B2 (en) * 2000-05-29 2010-02-03 ツィマー ゲーエムベーハー Artificial knee joint
US8480754B2 (en) * 2001-05-25 2013-07-09 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US7364590B2 (en) * 2003-04-08 2008-04-29 Thomas Siebel Anatomical knee prosthesis
FR2855397B1 (en) * 2003-05-28 2005-07-15 Tornier Sa Elbow Prosthesis
WO2005072657A1 (en) * 2004-01-23 2005-08-11 Massachusetts General Hospital Anterior cruciate ligament substituting knee replacement prosthesis
US8328874B2 (en) * 2007-03-30 2012-12-11 Depuy Products, Inc. Mobile bearing assembly
US9173743B2 (en) * 2009-07-01 2015-11-03 Biomet Uk Limited Method of implanting a unicondylar knee prosthesis
CN102596108B (en) * 2009-08-10 2014-10-01 厄斯·威斯 Knee prosthesis
DE102009029360A1 (en) * 2009-09-10 2011-03-24 Aesculap Ag Knee endoprosthesis
US8257444B2 (en) * 2009-09-21 2012-09-04 Linares Medical Devices, Llc End surface mounted plugs incorporated into an artificial joint and including cushioned soft plastic between outer hardened plastic layers
US8647388B2 (en) * 2010-08-27 2014-02-11 Bluefish Orthopedics, Llc Elbow prosthesis and method for use
GB2507640B (en) * 2012-09-10 2015-08-26 Acumed Llc Radial head prosthesis with floating articular member

Patent Citations (69)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4034418A (en) * 1975-05-26 1977-07-12 The Governing Council Of The University Of Toronto Artificial knee joint
US4224696A (en) * 1978-09-08 1980-09-30 Hexcel Corporation Prosthetic knee
US4728332A (en) * 1984-11-28 1988-03-01 Albrektsson Bjoern Artificial menisco-tibial joint
US4911721A (en) * 1984-11-28 1990-03-27 Aendergaten 3 Joint prosthesis
US5047057A (en) * 1988-07-27 1991-09-10 Peter Lawes Tibial component for a replacement knee prosthesis
US4936853A (en) * 1989-01-11 1990-06-26 Kirschner Medical Corporation Modular knee prosthesis
US5192328A (en) * 1989-09-29 1993-03-09 Winters Thomas F Knee joint replacement apparatus
US5219362A (en) * 1991-02-07 1993-06-15 Finsbury (Instruments) Limited Knee prosthesis
US5203807A (en) * 1991-07-10 1993-04-20 Smith & Nephew Richards Inc. Knee joint prosthesis articular surface
US5282870A (en) * 1992-01-14 1994-02-01 Sulzer Medizinaltechnik Ag Artificial knee joint
US6235060B1 (en) * 1996-11-13 2001-05-22 Hjs Gelenk System Gmbh Artificial joint, in particular endoprosthesis for replacing natural joints
US6190415B1 (en) * 1997-04-04 2001-02-20 T. Derek V. Cooke Deep flexion knee prosthesis
US6139581A (en) * 1997-06-06 2000-10-31 Depuy Orthopaedics, Inc. Posterior compensation tibial tray
US20040083005A1 (en) * 1998-12-22 2004-04-29 Magnus Jacobsson Method of anchoring a prosthesis structure
US20100076562A1 (en) * 1999-04-02 2010-03-25 Fell Barry M Proportioned Surgically Implantable Knee Prosthesis
US20050209703A1 (en) * 1999-04-02 2005-09-22 Fell Barry M Surgically implantable prosthetic system
US7341602B2 (en) * 1999-05-10 2008-03-11 Fell Barry M Proportioned surgically implantable knee prosthesis
US20040138755A1 (en) * 1999-06-16 2004-07-15 Btg International Limited Tibial component
US20060190087A1 (en) * 1999-06-16 2006-08-24 Btg International Limited Tibial component
US7060101B2 (en) * 1999-06-16 2006-06-13 Btg International Limited Tibial component
US6406497B2 (en) * 2000-07-19 2002-06-18 Tsunenori Takei Artificial knee joint
US7320709B2 (en) * 2000-08-28 2008-01-22 Advanced Bio Surfaces, Inc. Method and system for mammalian joint resurfacing
US6510334B1 (en) * 2000-11-14 2003-01-21 Luis Schuster Method of producing an endoprosthesis as a joint substitute for a knee joint
US6503280B2 (en) * 2000-12-26 2003-01-07 John A. Repicci Prosthetic knee and method of inserting
US20070083266A1 (en) * 2001-05-25 2007-04-12 Vertegen, Inc. Devices and methods for treating facet joints, uncovertebral joints, costovertebral joints and other joints
US20100280624A1 (en) * 2001-06-14 2010-11-04 Alexandria Research Technologies, Llc Modular apparatus and method for sculpting the surface of a joint
US20100131071A1 (en) * 2001-12-14 2010-05-27 Btg International Limited Tibial component
US8066776B2 (en) * 2001-12-14 2011-11-29 Btg International Limited Tibial component
US20040006394A1 (en) * 2002-05-08 2004-01-08 Lipman Joseph D. Self-aligning knee prosthesis
US20060100714A1 (en) * 2003-04-02 2006-05-11 Ortho Development Corporation Tibial augment connector
US20060212124A1 (en) * 2003-05-02 2006-09-21 Thomas Siebel Knee joint prosthesis
US20060195195A1 (en) * 2003-07-17 2006-08-31 Albert Burstein Mobile bearing knee prosthesis
US7708782B2 (en) * 2003-07-17 2010-05-04 Exactech, Inc. Mobile bearing knee prosthesis
US8535383B2 (en) * 2004-01-12 2013-09-17 DePuy Synthes Products, LLC Systems and methods for compartmental replacement in a knee
US20050197710A1 (en) * 2004-02-26 2005-09-08 Hjs Gelenk System Gmbh Tibia plateau for a replacement joint
US20070135926A1 (en) * 2005-12-14 2007-06-14 Peter Walker Surface guided knee replacement
US20140107793A1 (en) * 2006-03-21 2014-04-17 Richard D. Komistek Moment induced total arthroplasty prosthetic
US20090043396A1 (en) * 2006-03-21 2009-02-12 Komistek Richard D Moment induced total arthroplasty prosthetic
US8636807B2 (en) * 2006-03-21 2014-01-28 Depuy (Ireland) Moment induced total arthroplasty prosthetic
US20070299531A1 (en) * 2006-06-22 2007-12-27 Depuy Products, Inc. Tibial insert and method for implanting the same
US20070299532A1 (en) * 2006-06-22 2007-12-27 Depuy Products, Inc. Tibial insert having a keel including a bore formed therein
US20130317621A1 (en) * 2006-09-29 2013-11-28 Biomet Manufacturing, Llc Knee Prosthesis Assembly With Ligament Link
US20080243259A1 (en) * 2007-03-30 2008-10-02 Lee Jordan S Mobile bearing insert having offset dwell point
US20110015750A1 (en) * 2007-05-16 2011-01-20 Zimmer, Inc. knee system and method of making same
US8715360B2 (en) * 2007-08-27 2014-05-06 Kent M. Samuelson Systems and methods for providing an asymmetrical tibial component
US8721731B2 (en) * 2007-08-27 2014-05-13 Kent M. Samuelson Systems and methods for providing a tibial articulation feature
US20130218283A1 (en) * 2007-08-27 2013-08-22 Kent M. Samuelson Systems and methods for providing an asymmetrical tibial component
US8292965B2 (en) * 2008-02-11 2012-10-23 New York University Knee joint with a ramp
US20090226068A1 (en) * 2008-03-05 2009-09-10 Conformis, Inc. Implants for Altering Wear Patterns of Articular Surfaces
US8298288B2 (en) * 2008-06-24 2012-10-30 New York University Recess-ramp knee joint prosthesis
US8006839B2 (en) * 2008-12-09 2011-08-30 Zimmer, Inc. Method and apparatus for packaging medical devices
US20100191341A1 (en) * 2009-01-28 2010-07-29 Zimmer, Inc. Lateral condyle posterior inflection for total knee implant
US20110029091A1 (en) * 2009-02-25 2011-02-03 Conformis, Inc. Patient-Adapted and Improved Orthopedic Implants, Designs, and Related Tools
US20100331848A1 (en) * 2009-05-29 2010-12-30 Richard Michael Smith Methods and Apparatus for Performing Knee Arthroplasty
US20120109324A1 (en) * 2010-03-10 2012-05-03 John Keggi Low stress all poly tibial component
US8496704B2 (en) * 2010-04-13 2013-07-30 Smith & Nephew, Inc. Systems and methods for tensioning ligaments and other soft tissues
US20130317620A1 (en) * 2010-04-13 2013-11-28 Smith & Nephew, Inc. Systems and methods for tensioning ligaments and other soft tissues
US20140052268A1 (en) * 2010-07-24 2014-02-20 Zimmer, Inc. Tibial prosthesis
US20120022658A1 (en) * 2010-07-24 2012-01-26 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US8574304B2 (en) * 2010-07-24 2013-11-05 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US8613775B2 (en) * 2010-07-24 2013-12-24 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US20140025177A1 (en) * 2010-07-24 2014-01-23 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US8568486B2 (en) * 2010-07-24 2013-10-29 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US20130317619A1 (en) * 2010-09-10 2013-11-28 Chris Alexander Dodd Femoral extension prosthetic component and tibial shelf prosthetic component for unicondylar meniscal bearing knee prosthesis and prosthesis including such a component
US20140156015A1 (en) * 2010-09-10 2014-06-05 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US8317870B2 (en) * 2010-09-30 2012-11-27 Depuy Products, Inc. Tibial component of a knee prosthesis having an angled cement pocket
US20120197409A1 (en) * 2011-01-27 2012-08-02 Smith & Nephew, Inc. Constrained knee prosthesis
US20140163687A1 (en) * 2011-11-18 2014-06-12 Zimmer, Inc. Tibial bearing component for a knee prosthesis with improved articular characteristics
US20130204383A1 (en) * 2012-02-06 2013-08-08 Zimmer, Inc. Tibial baseplates for special patient populations

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150209149A1 (en) * 1999-06-16 2015-07-30 Btg International Limited Tibial component
US8864836B2 (en) 2008-06-27 2014-10-21 Zimmer, Inc. ACL accommodating tibial design
US9943317B2 (en) 2009-05-29 2018-04-17 Smith & Nephew, Inc. Methods and apparatus for performing knee arthroplasty
US8728086B2 (en) * 2009-05-29 2014-05-20 Smith & Nephew, Inc. Methods and apparatus for performing knee arthroplasty
US9848888B2 (en) 2009-05-29 2017-12-26 Smith & Nephew, Inc. Methods and apparatus for performing knee arthroplasty
US20100331848A1 (en) * 2009-05-29 2010-12-30 Richard Michael Smith Methods and Apparatus for Performing Knee Arthroplasty
US9198762B2 (en) 2011-01-10 2015-12-01 Howmedica Osteonics Corp. Bicruciate retaining tibial baseplate
US9999511B2 (en) 2011-01-27 2018-06-19 Smith & Nephew, Inc. Knee prosthesis
US9005299B2 (en) * 2011-07-13 2015-04-14 The General Hospital Corporation Methods and devices for knee joint replacement with anterior cruciate ligament substitution
US9707085B2 (en) 2011-07-13 2017-07-18 The General Hospital Corporation Methods and devices for knee joint replacement with anterior cruciate ligament substitution
US20130018477A1 (en) * 2011-07-13 2013-01-17 The General Hospital Corporation D/B/A Massachusetts General Hospital Methods and Devices for Knee Joint Replacement with Anterior Cruciate Ligament Substitution
US8911501B2 (en) 2011-12-29 2014-12-16 Mako Surgical Corp. Cruciate-retaining tibial prosthesis
US9730712B2 (en) 2012-10-18 2017-08-15 Smith & Nephew, Inc. Alignment devices and methods
US9345578B2 (en) 2013-02-22 2016-05-24 Stryker Corporation Bicruciate retaining tibial implant system
US9757243B2 (en) 2014-07-08 2017-09-12 Zimmer, Inc. Intercondylar component and fin attachment features for use in knee arthroplasty

Also Published As

Publication number Publication date Type
US20170119534A1 (en) 2017-05-04 application
US20150209149A1 (en) 2015-07-30 application
US20100131071A1 (en) 2010-05-27 application
US8066776B2 (en) 2011-11-29 grant

Similar Documents

Publication Publication Date Title
US6660039B1 (en) Mobile bearing knee prosthesis
US5011496A (en) Prosthetic joint
US7413577B1 (en) Total stabilized knee prosthesis with constraint
US7264635B2 (en) Artificial knee joint
US5035700A (en) Prosthetic knee joint with improved patellar component tracking
US5116375A (en) Knee prosthesis
US6926739B1 (en) Prosthesis device for human articulations, in particular for the ankle articulation
EP0546726B1 (en) Prosthetic knee joint
US8236061B2 (en) Orthopaedic knee prosthesis having controlled condylar curvature
US4944756A (en) Prosthetic knee joint with improved patellar component tracking
US6730128B2 (en) Prosthetic knee joint
US7678152B2 (en) Artificial knee joint
US6946001B2 (en) Mobile bearing unicompartmental knee
US5683468A (en) Mobile bearing total joint replacement
US5071438A (en) Tibial prothesis with pivoting articulating surface
US3964106A (en) Three-part total knee prosthesis
US6056779A (en) Prosthesis for the knee articulation
US6090144A (en) Synthetic knee system
US4298992A (en) Posteriorly stabilized total knee joint prosthesis
US5358530A (en) Mobile bearing knee
US5549686A (en) Knee prosthesis having a tapered cam
US5219362A (en) Knee prosthesis
US5824104A (en) Meniscal knee prosthesis having bollard and mooring attachment means
US7875081B2 (en) Posterior stabilized knee prosthesis
US7338524B2 (en) Surgically implantable knee prosthesis

Legal Events

Date Code Title Description
AS Assignment

Owner name: BTG INTERNATIONAL LIMITED, UNITED KINGDOM

Free format text: CHANGE OF ADDRESS CERTIFICATE;ASSIGNOR:BTG INTERNATIONAL LIMITED;REEL/FRAME:033035/0812

Effective date: 20110628