US3774244A - Knee-joint prosthesis - Google Patents

Knee-joint prosthesis Download PDF

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Publication number
US3774244A
US3774244A US00224479A US3774244DA US3774244A US 3774244 A US3774244 A US 3774244A US 00224479 A US00224479 A US 00224479A US 3774244D A US3774244D A US 3774244DA US 3774244 A US3774244 A US 3774244A
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United States
Prior art keywords
femoral
component
tibial
condyle
knee
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Expired - Lifetime
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US00224479A
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English (en)
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P Walker
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RELIEF RUPTURED AND CRIPPLED S
SOC RELIEF RUPTURED AND CRIPPLED US
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RELIEF RUPTURED AND CRIPPLED S
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    • A—HUMAN NECESSITIES
    • 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
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • 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
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2002/3895—Joints for elbows or knees unicompartimental

Definitions

  • a knee-joint prosthesis comprises a femoral condyle component and a tibial condyle component secured, respectively, to the femoral and tibial condyles by a cement in resected areas of the bones.
  • the femoral component is an elongated, doubly-curved member that extends from the anterior to the posterior of the femoral condyle and has an external surface shaped to match closely the anatomical shape of the femoral condyle.
  • the tibial component is an elongated member extending from adjacent the anterior extremity to adjacent the posterior extremity of the tibial condylar plateau and positioned for engagement by and support of the fmoral component.
  • the external surface of the tibial component closely matches in transverse crosssections along its length the transverse shape of the external surface of the femoral component and is generated by a generally straight, anterior-posterior line moved along said transverse curvature.
  • the prosthesis may be duo-condylar, or it may be made uni-condylar by provision of the components on only one pair of condyles.
  • This invention relates to a knee-joint prosthesis and, in particular, to a prosthesis that provides for replacement of the inter-engaging surfaces of the femoral and tibial condyles by which the weight of the body above the knee is transmitted from the femur to the tibia.
  • the knee joint is the largest joint of the body and is also subject to the greatest stresses of any joint in the body. It supports the entire weightof the body above the knee and does so in various relative angular positions of the femur (thighbone) and the tibia (legbone) upon articulation of the joint. In addition to sustaining high stresses, the knee joint must also provide freedom of articular movement. Injury or disease of the knee joint can, of course, be extremely painful and prevent functioning of the joint.
  • the otherrtype of knee-joint prosthesis consists of femoral and tibial components in the form of metal and plastic bands received on the femoral and tibial condyles.
  • the components are arcuate in. both the length- 2 tibial condyle in a position for engagement by and sup port of the femoral component of the prosthesis.
  • the supporting or external surface of the tibial component is shaped closely to match, in transverse cross-sections along its length, the transverse shape of the external surface of the femoral component and is a surface genwise and transverse directions.
  • Substantial bone resection is required for placement of both components, and the matching curvatures in both the anterior'posterior and lateral directions significantly restrict flexiblity of joint movement and only partially duplicate natural articular function.
  • a knee-joint prosthesis that provides partial or total replacement of the engaging surfaces of the femoral and tibial condyles, afi'ords relief from pain and restores function and load-bearing capability-to the knee-joint.
  • the knee-joint prosthesis of the invention rep resents an appropriate appliance for correction of various injuries and diseases of the knee joint, its use is particularly advantageous in cases of arthritis.
  • the prosthesis comprises a femoral condyle component and a tibial condyle component mounted, respectively, on the femoral and tibial condyles in positions so that the two components match and provide load transfer and motion capability.
  • the femoral component includes an elongated, doubly curved member that is secured to one of the femoral condyles and extends from the anterior to the posterior of the femoral condyle.
  • the tibial component is an elongated member that extends from adjacent the anterior extremity to adjacent the posterior extremity of the tibial plateau and is secured to the erated by a generally straight, anterior-posterior line moved along a line matching the external transverse shape of the femoral component.
  • the femoral component has a multiplicity of projections extending from its internal surface to enhance the anchoring of the component in place on the femoral condyle.
  • projections may take various ties disposed in generally transverse zones to provide a mechanical locking between the post and a layer or zone of cement between the post and the resected bone.
  • the knee prosthesis of the invention may be placed in either one or both femoral-tibial condyle pairs, as may be required for a given patient.
  • a duo-condylar prosthesis which will usually be preferred, it'is desirable that the two femoral condyle components be interconnected by a crossbar extending between them and curved in the transverse direction to match the anatom ical shape of the anterior intercondylar notch, the crossbar holding the spacing and a parallel relationship between the two femoral members.
  • 'I'I'he femoralcomponent of a duo-condyler prosthesis is preferably of one-piece construction and symmetrical so that it can be installed in either the right or left knee joint.
  • the tibial component for both the internal and external condyles of both left and right joints may be identical; in other words, only one'form of tibialcomponent need be provided, and two identical pieces used in a duo-condylar prosthesis.
  • the preferred materials are Type 3l6-L Stainless Steel or surgical cobalt-chrome alloy for the femoral component and a high-molecular weight polyethylene or other appropriate high-molecular weight plastic for the tibial component.
  • the femoral component should have a highly-polished surface to reduce friction to a minimum and provide minimum wear and thus long useful life.
  • FIG. 5 is a pictorial view of the tibial component, viewed from above, in front of, and laterally inwardly of a component placed at the internal condyle of a right knee joint;
  • the reference numerals 10 and 12 designate generally the femur (thighbone) and the tibia (legbone) of a human leg. Only the lower end of the femur and the upper end of the tibia are shown in the figures. Although the drawings illustrate the general outline of the portions of the femur and the tibia at the knee joint, the details of the bone shapes are not illustrated. Reference may be made to various appropriate standard references for descriptions and illustrations of the anatomy of a knee joint.
  • reference numerals l4 and 16 designate, respectively, the external condyle and internal condyle of the right femur
  • reference numerals l5 and 17 designate, respectively, the exterior and interior tibial condyles
  • reference numeral 20 is applied to the lateral ligaments
  • reference numeral 22 is applied to the cruciate ligaments.
  • FIG. 2 of the drawings the anterior of the joint is to the right and the posterior is to the left.
  • the crosspiece 36 is curved to present outwardly concave and inwardly convex surfaces, the curvature generally matching the intercondylar notch between the femoral condyles so that the crosspiece 36 is recessed into the intercondylar notch, such that it does not materially afiect the action of the patella when the joint is in a flexed position.
  • Each of the condyle ccomponents 32 and 34 of the femoral piece 30 has a relatively massive, elongated post or pin 40 projecting from its internal surface and positioned and oriented so that its longitudinal axis is formed with several shallow concavities 42 located in zones oriented transversely of the longitudinal axis of the post.
  • a number of small pins 43 say l/l6 inch-in diameter and 1/16 inch high, project from the internal surfaces of the components 32 and 34 at appropriate spacing.
  • the femoral piece is placed in the joint by resecting small amounts of bone in the regions that will underlie the condyle components 32 and 34 so that the external surfaces of the components 32 and 34 will be generally contiguous to the anatomical surfaces of the femoral condyles.
  • a hole 44 is formed to receive the post 40, and holes 46 and 48 are also formed near the posterior and anterior extremities of the components 32 and 34 and extending generally perpendicular to the surface of the condyles at these points (see FIG. 2).
  • the component is secured to the bone by an appropriate cement, such as polymethyl methacrylate.
  • a layer of cement is applied at the interface between the internal surfaces of the components 32 and 34, and bodies of cement are packed in the holes 46 and 48 at the extremities of the components as well as in the hole 44 that receives the post 40.
  • the cement in the holes 46 and 48 and around the post locks the femoral piece securely in place on the femur.
  • a duo-condylar prosthesis has two identical tibial condyle components 50, one for each tibial condyle, mounted in reverse orientation, laterally, on the respective medial and lateral tibial condyles.
  • Each tibial component is generally rectangular in plan, although (as shown) it has rounded corners 51 that are located near the respective lateral extremities of the tibial plateau, when thecomponent is in place.
  • Each tibial component is mounted with its longer axis oriented in the anterior-posterior direction in the joint.
  • the bottom surface 52 and the interiorly located side surface 54 of each component are generally flat.
  • the flatness of the tibial components in the anterior-posterior direction allows relatively free sliding and rolling of the femoral component on the tibial component in a manner resembling the function of the anatomical joint.
  • the transverse curvatures of the respective tibial components and the matching of the cross-sectional shapes of the tibial and femoral components in the areas in engagement limits rotation and lateral laxity in the joint.
  • the tibial components provided relatively large surface areas for seating on the tibial plateau to ensure strength and durability in the joint and to provide a substantial load-bearing area, but these features are achieved without any undesirable restriction in the freedom of articulation.
  • a knee-joint prosthesis comprising a femoral condyle component adapted to be secured mom of the femoral condyles, and a tibial condyle component adapted to be secured to thetibial condyle corresponding to said femoral condyle, the femoral condyle component being an elongated, doubly curved member shaped and dimensioned to extend from the anterior to the posterior of the femoral condyle and having a varying curvature in the anterior-posterior direction closely matching the anatomical shape of the femoral condyle and having in transverse cross-sections along its length a laterally outwardly located essentially flat zone and a laterally inwardly located curved zone that is externally convex, the tibial condyle component being an elongated member shaped and dimensioned to extend from adjacent the anterior extremity to adjacent the posterior extremity of the femoral-engaging surface of the tibial

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
US00224479A 1972-02-08 1972-02-08 Knee-joint prosthesis Expired - Lifetime US3774244A (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US22447972A 1972-02-08 1972-02-08

Publications (1)

Publication Number Publication Date
US3774244A true US3774244A (en) 1973-11-27

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US00224479A Expired - Lifetime US3774244A (en) 1972-02-08 1972-02-08 Knee-joint prosthesis

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US (1) US3774244A (enrdf_load_stackoverflow)
AU (1) AU472408B2 (enrdf_load_stackoverflow)
CA (1) CA991803A (enrdf_load_stackoverflow)
DE (1) DE2304988A1 (enrdf_load_stackoverflow)
FR (1) FR2171321B1 (enrdf_load_stackoverflow)
GB (1) GB1383474A (enrdf_load_stackoverflow)

Cited By (154)

* Cited by examiner, † Cited by third party
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US3878566A (en) * 1974-05-08 1975-04-22 Richards Mfg Co Patello-femoral prosthesis
US3886599A (en) * 1974-07-25 1975-06-03 Schlein Louis Charles Surgically implantable total ankle prosthesis
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AU472408B2 (en) 1976-05-27
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DE2304988A1 (de) 1973-08-16
CA991803A (en) 1976-06-29

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