WO2000013616A1 - Modular knee implant system - Google Patents

Modular knee implant system Download PDF

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Publication number
WO2000013616A1
WO2000013616A1 PCT/US1999/019344 US9919344W WO0013616A1 WO 2000013616 A1 WO2000013616 A1 WO 2000013616A1 US 9919344 W US9919344 W US 9919344W WO 0013616 A1 WO0013616 A1 WO 0013616A1
Authority
WO
WIPO (PCT)
Prior art keywords
implant
trochlear
patellar
knee
femoral
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.)
Ceased
Application number
PCT/US1999/019344
Other languages
English (en)
French (fr)
Inventor
Alan C. Merchant
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.)
Individual
Original Assignee
Individual
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
Application filed by Individual filed Critical Individual
Priority to EP99943893A priority Critical patent/EP1109514B1/en
Priority to HK01108817.3A priority patent/HK1038493B/en
Priority to JP2000568427A priority patent/JP4118516B2/ja
Priority to DE69938050T priority patent/DE69938050T2/de
Priority to AU56899/99A priority patent/AU768133B2/en
Publication of WO2000013616A1 publication Critical patent/WO2000013616A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • 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
    • A61F2/3859—Femoral components
    • 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
    • A61F2/3877—Patellae or trochleae
    • 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
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2002/30316—The 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
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30667—Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30708—Means for distinguishing between left-sided and right-sided devices, Sets comprising both left-sided and right-sided prosthetic parts
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
    • A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
    • A61F2002/30891—Plurality of protrusions
    • A61F2002/30892—Plurality of protrusions parallel
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
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    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4631—Special tools for implanting artificial joints the prosthesis being specially adapted for being cemented
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0084—Means for distinguishing between left-sided and right-sided devices; Sets comprising both left-sided and right-sided prosthetic parts
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    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00017—Iron- or Fe-based alloys, e.g. stainless steel
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    • A61F2310/00005—The prosthesis being constructed from a particular material
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    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
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    • A61F2310/00179—Ceramics or ceramic-like structures

Definitions

  • the present invention relates in general to a modular knee implant system for a prosthetic joint, and more particularly to a system including a trochlear implant.
  • a knee joint connects three bones: the femur (thigh bone), the tibia (leg bone), and the patella (knee cap). Either through disease, injury, or pre-mature wear from mal-alignment, the knee joint can be damaged, and all or portions of the damaged joint surfaces may need to be replaced with a prosthetic implant.
  • the most common prosthetic knee implant is referred to as a "total knee replacement" system because all knee joint surfaces are replaced.
  • the total knee replacement system includes a patellar implant, a femoral implant and a tibial implant. Different portions of the knee are referred to as compartments. For example, each condyle (rounded end of the femur) is a separate compartment.
  • unicompartmental replacements can be used when only the medial (toward the body's midline) compartment or the lateral (away from the body's midline) compartment of the femoral-tibial surface needs to be replaced.
  • the unicompartmental replacement systems have femoral and tibial implants but do not include a patellar implant.
  • Currently available unicompartmental implant systems are designed to be modular and work with their total knee counterparts from the same manufacturer with respect to using the same instruments and same bone contour. When these unicompartmental implant systems need to be replaced with a total knee system, both the femoral and tibial implants must be removed.
  • the surface of the knee joint compartment between the patella and the groove on the front of the femur requires replacement.
  • Several prosthetic implants are available which replace this part of the knee joint and are called “total patello-femoral" prostheses or implants.
  • the total patello-femoral prostheses have a patellar implant that is installed on the patella and another implant which replaces at least a portion of the femur that contacts the patella.
  • a more general object of the present invention is to provide a trochlear implant for a prosthetic joint that reduces the amount of bone removed for the implant.
  • the present invention provides a prosthetic knee of the type which includes a femoral implant and a patellar implant.
  • the femoral implant and patellar implant have bearing surfaces that slidably engage the femoral implant with the patellar implant when the femoral implant and patellar implant move relatively
  • a trochlear implant has an articulation surface shaped to slidably receive a portion of the bearing surface of the patellar implant The articulation surface is substantially similar in shape to a portion of the bearing surface of the femoral implant such that the patellar implant is usable with the femoral implant and the trochlear implant
  • the present invention also provides a trochlear implant for use in a prosthetic knee
  • the trochlear implant mounts to the knee end of a femur and cooperates with a patellar implant mounted to the back side of a patella
  • the patellar implant is a component of a prosthesis system including a femoral implant for replacing the knee end of the femur
  • the trochlear implant has an articulation surface shaped to slidably receive a portion of the patellar implant
  • the articulation surface is substantially similar in shape to a portion of a surface of the femoral implant such that the patellar implant is capable of being used with the femoral implant and the trochlear implant
  • the present invention provides a method of knee replacement using a prosthetic knee system
  • a trochlear implant and a patellar implant are provided The patellar implant cooperates with the trochlear implant and a femoral implant
  • the trochlear implant
  • FIGURE 1 is a front view of an installed total knee prosthesis
  • FIGURE 2 is a side view of the installed total knee prosthesis of Figure 1
  • FIGURE 3 is an exploded front view of the components of the prosthetic knee implant system of the present invention
  • FIGURE 4 is a perspective view of one embodiment of the trochlear implant of Figure 3 installed in a human knee
  • FIGURE 5 is a perspective view of an embodiment of trochlear implant of the present invention suitable for installation in a left knee.
  • FIGURE 6 is a side view of the trochlear implant of Figure 5.
  • FIGURE 7 is a bottom view of the trochlear implant of Figure 5.
  • FIGURE 8 is a front view of the trochlear implant of Figure 5 installed in a human knee.
  • FIGURE 9 is a side view of the trochlear implant of Figure 5 installed in the human knee.
  • FIGURE 10 is a diagram of a common generation curve used in a preferred embodiment of the trochlear implant of Figure 3.
  • FIGURE 11 is a diagram showing the rotation of the common generation curve of Figure 10 to generate the segments of surfaces of revolution that define the shape of the articulation surface of the trochlear implant and that define the shape of the femoral load bearing surface of a femoral implant, and that also define the shape of a load bearing surface of the patellar implant.
  • FIGURE 12 is a bottom view of the trochlear implant of Figure 5 showing the angles used to taper the peripheral edges.
  • FIGURE 13 is an exploded view of a second prosthetic knee system using another embodiment of the trochlear implant of the present invention.
  • FIGURE 14 is an exploded view of a third prosthetic knee system using yet another embodiment of the trochlear implant of the present invention.
  • FIGURE 15 is an exploded view of a fourth prosthetic knee system using another alternative embodiment of the trochlear implant of the present invention.
  • FIGURE 16 is a flowchart of a method of knee replacement using the components of the prosthetic knee system of the present invention.
  • a prosthetic knee implant 100 suitable for use with the present invention is installed in a human knee 102.
  • the knee 102 has a femur 104, a patella 106 and a tibia 108.
  • the prosthetic knee 100 includes a femoral implant 110, a patellar implant 1 12 and an optional tibial implant 1 14.
  • the tibial implant 114 has a tibial platform component 1 16 and a tibial bearing component 1 18.
  • the patellar implant 112 is shaped to mate with the femoral implant 110.
  • the tibial implant 114, and in particular the tibial bearing component 118, is shaped to mate with the femoral implant 110.
  • the femoral implant 110 is shaped to slidably receive the patellar implant 112 and the tibial implant 114.
  • Figure 2 is a side view of the installed prosthetic knee of Figure 1 and also shows a tendon 120 that attaches the muscles to the patella 106.
  • the femoral implant 110 and the patellar implant 112 have bearing surfaces, 122 and 124, respectively. When the femoral implant and patella implant move relative to each other, the bearing surfaces 122 and 124 allow the femoral implant 110 and patella implant 112 to slidably engage.
  • the tibial implant 114 also has a bearing surface 126 that slidably engages another portion of the femoral bearing surface 122 when the femur 104 and tibia 108 move relative to each other.
  • the prosthetic knee system of the present invention includes a femoral implant 110, a patellar implant 112 and a trochlear implant 130.
  • the trochlear implant 130 has an articulation surface 132 shaped to slidably receive a portion of the bearing surface 124 of the patellar implant 112.
  • the patellar implant 112 has an apex 134 that aligns with a longitudinal axis 136 forming a trochlear groove in both the femoral implant 110 and the trochlear implant 130.
  • the articulation surface 132 of the trochlear implant 130 is substantially similar in shape to a portion of the femoral bearing surface 122 of the femoral implant 110. Therefore, the patellar implant 112 is usable with both the femoral implant 110 and the trochlear implant 130.
  • the patient's patella is not subjected to additional bone loss and trauma because the existing patellar implant 112 is usable with the new femoral implant 1 10.
  • the articulation surface 138 of the trochlear implant 130 has a shape that substantially congruently engages the patellar implant 112.
  • the articulation surface 132 of the trochlear implant 130 is shaped to provide substantially point contact with the patellar implant 112.
  • the articulation surface 132 of the trochlear implant 130 is shaped to provide substantially line contact with the patellar implant 112. In other embodiments, the articulation surface 132 of the trochlear implant 130 is shaped to provide a combination of congruent and line contact with the patellar implant 112.
  • the trochlear implant 130 is asymmetrical about the longitudinal axis 136 for installation in either a right knee or a left knee. In Figure 3, the trochlear implant 130 is for installation in a right knee. In an alternate embodiment, the trochlear implant 130 symmetrical about the longitudinal axis and can be installed in either the right knee or the left knee.
  • the bearing surface of the femoral implant 110, the bearing surface of the patellar implant 1 12 and the articulation surface of the trochlear implant 130 are aligned to and are generated by a common generation curve 138, Figure 3.
  • the articulation surface of the trochlear implant 130 is shaped to receive and engage a substantially spherical, dome-shaped patellar implant 130.
  • the trochlear implant 130 may be made of cast cobalt-chrome-molybdenum and the articulation surface 132 is polished. Alternately, the trochlear implant 130 is made of cobalt-chrome, stainless steel or other suitable metal alloy. In another alternative embodiment, the trochlear implant 130 is made of a ceramic. In yet another embodiment, the trochlear implant 130 is made of titanium. In another alternate embodiment, a surface treatment is applied to harden and/or smooth the articulation surface of the trochlear implant 130. In particular, a trochlear implant 130 made of titanium is treated to harden and smooth the articulation surface.
  • the trochlear implant 130 is installed in the trochlear groove between the condyles 142 of a knee-end of a femur 104 in a human knee 100, Figure 4. In this embodiment, the trochlear implant 130 does not contact the tibia 108 or a tibial implant. In an alternate embodiment, the trochlear implant 130 can contact the tibia 108 or the tibial implant.
  • a peripheral edge 152 defines and forms the articulation surface 132 and a back surface 154
  • the back surface 154 has a cement retaining rim 156 extending along a portion of the back surface 154 and portion of the peripheral edge 152
  • Three fixation pins 158 project from the back surface 154
  • the back surface 154 is textured
  • the back surface 154 has a porous coating
  • no cement retaining rim 156 is provided
  • no fixation pins are provided
  • any number, such as one, two, or more than three, fixation pins 158 project from the back surface 154
  • the trochlear implant 130 is fixed to the femur using screws
  • the trochlear implant 130 of the present invention is shown in a human knee with the patellar implant 112
  • the trochlear implant 130 contacts the patellar implant 112 for a range of knee motion
  • Primary and secondary load bearing regions, 162 and 164, respectively, on the patellar implant 112 engage primary and secondary load bearing regions, 166 and 168, respectively, of the articulation region 132 of the trochlear implant 130 to produce substantially anatomical patella-femoral articulation
  • the primary load bearing region 162 of the patellar implant 112 lifts off the primary load bearing region 166 of the trochlear implant 130
  • the secondary load bearing region 164 of the patellar implant 1 12 slidably engages the secondary load bearing region 168 of the trochlear implant 130
  • the primary load bearing region 162 of the patellar implant 1 12 slidably engages the primary load bearing region 166 of the
  • the patellar implant 112 does not contact the trochlear implant 130
  • the patellar implant 112 slidably engages the trochlear implant 130 from an angle of about 20° when the knee is almost straight to an angle of about 110° when the knee is bent
  • Figure 10 shows the common generation curve 138 that is used to generate the shapes of the articulation and load bearing surfaces of the trochlear implant, femoral implant, patellar implant and tibial implant in a preferred embodiment of the present invention
  • the formation of the load bearing surfaces of the femur, patellar and tibial implants is described in detail in U.S. Patent 4,470, 158 to Pappas et al. which is incorporated herein by reference.
  • the primary and secondary load bearing regions of the articulation and load bearing surfaces are formed as surfaces of revolution and their shape is defined or generated by the common generation curve F 138.
  • the shape of the load bearing or articulation surfaces is defined by rotating the common generation curve F 138 through a predetermined angle about the generating axis 172 at the same major generating radii Dl and D2 where Dl and D2 are equal to each other and also equal to a predefined radius.
  • the peak 174 of the common generation curve F 138 forms the apex 134 ( Figure 3) of the patellar implant and the longitudinal axis 136 ( Figure 3) of the femoral implant and the trochlear implant.
  • Figure 11 shows the segments S 1 and S2 of the load bearing regions of the load bearing surface and articulation surface of the femoral implant and trochlear implant of the present invention, respectively.
  • Segment S 1 forms the secondary load bearing region 164, 168 ( Figure 9).
  • Segment S2 forms the primary load bearing regions 162, 166 ( Figure 9) of the patellar implant and trochlear implant, respectively.
  • the common generating curve 138 is rotated at an angle of ⁇ l, equal to 0°, at a radial distance from generating axis Cl at ⁇ .
  • the common generating curve 138 is substantially parallel to the line LI for a distance of SI or .314 inches.
  • Tangent to line LI the common generating curve 138 is rotated about generating axis C2 for an angle of ⁇ 2 at a radial distance of R2.
  • ⁇ 2 and R2 equal about 90° and 1.388 inches, respectively.
  • the shape of the trochlear implant ends at line L2.
  • the load bearing regions of the patellar implant and femoral implant are generated in a similar manner.
  • segment S 1 is formed substantially parallel to the line LI for a distance of .612 inches
  • segment S2 is formed for an angle ⁇ 2 of 107. 75° with R2 equal to 1.388 inches. Therefore, the trochlear implant load bearing regions 148, 146 ( Figure 9) formed with segments SI and S2, respectively, substantially match the load bearing regions S I and S2 of the femoral implant.
  • the trochlear implant 130 is tapered. To taper the trochlear implant 130, a portion of the common generation curve 138 is used and peripheral side edges 176, 178 of the trochlear implant 130 are formed at predetermined angles ⁇ 3 and ⁇ 4 with respect to the longitudinal axis 136. In one embodiment, the predetermined angles ⁇ 3 and ⁇ 4 are substantially equal to about 20° and 30°, respectively. In an alternate embodiment, ⁇ 3 and ⁇ 4 are the same.
  • Figure 13 shows a second prosthetic knee system, such as the Johnson &
  • FIG. 14 shows a third prosthetic knee system, such as the Intermedics
  • a patellar implant 190 is usable with either a femoral implant 192 or the trochlear implant 188.
  • Figure 15 shows a fourth prosthetic knee system, such as the Zimmer "Insall/Burstein (I B) II" modular knee system, with a fourth embodiment of the trochlear implant 194 of the present invention.
  • a patellar implant 196 is usable with either a femoral implant 198 or the trochlear implant 194.
  • a flowchart of an embodiment of a method of knee replacement using the components of the prosthetic knee system is shown.
  • a trochlear implant of the present invention is provided, and in step 204, a patellar implant suitable for use with the present invention is also provided.
  • the patellar implant is installed in a patella in a knee.
  • the trochlear implant is installed in the trochlear groove in a knee-end of a femur bone.
  • a femoral implant suitable for use with the trochlear implant is provided.
  • the shape of the articulation surface of the trochlear implant and the shape of the load bearing surface of the femoral implant are substantially similar.
  • the trochlear implant is removed, and in step 214 the existing patellar implant is left in place in the patella.
  • the patellar implant has a detachable load bearing surface, however, even in such patellar implants, the portion of the patellar implant that is attached to the patella bone remains in place.
  • step 216 the surgeon installs the femoral implant n the knee-end of the femur bone. If the tibia portion of the knee also needs to be replaced, a tibial implant is also provided in step 218, and installed in step 220.

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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)
  • Orthopedics, Nursing, And Contraception (AREA)
PCT/US1999/019344 1998-09-04 1999-08-24 Modular knee implant system Ceased WO2000013616A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
EP99943893A EP1109514B1 (en) 1998-09-04 1999-08-24 Modular knee implant system
HK01108817.3A HK1038493B (en) 1998-09-04 1999-08-24 Modular knee implant system
JP2000568427A JP4118516B2 (ja) 1998-09-04 1999-08-24 モジュール式膝インプラントシステム
DE69938050T DE69938050T2 (de) 1998-09-04 1999-08-24 Modulares knieimplantatsystem
AU56899/99A AU768133B2 (en) 1998-09-04 1999-08-24 Modular knee implant system

Applications Claiming Priority (2)

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US09/148,110 1998-09-04
US09/148,110 US6616696B1 (en) 1998-09-04 1998-09-04 Modular knee replacement system

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US (1) US6616696B1 (enExample)
EP (1) EP1109514B1 (enExample)
JP (1) JP4118516B2 (enExample)
AT (1) ATE384495T1 (enExample)
AU (1) AU768133B2 (enExample)
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WO (1) WO2000013616A1 (enExample)

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JP4118516B2 (ja) 2008-07-16
US6616696B1 (en) 2003-09-09
AU768133B2 (en) 2003-12-04
EP1109514A1 (en) 2001-06-27
AU5689999A (en) 2000-03-27
DE69938050D1 (de) 2008-03-13
ATE384495T1 (de) 2008-02-15
HK1038493A1 (en) 2002-03-22
DE69938050T2 (de) 2009-01-08
JP2002524138A (ja) 2002-08-06
EP1109514A4 (en) 2006-11-08
EP1109514B1 (en) 2008-01-23

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