WO2010096960A1

WO2010096960A1 - Artificial knee replacement prostheses with anterior cruciate ligament reserved or reconstructed

Info

Publication number: WO2010096960A1
Application number: PCT/CN2009/070529
Authority: WO
Inventors: 王岩; 郑诚功
Original assignee: 北京纳通投资有限公司
Priority date: 2009-02-25
Filing date: 2009-02-25
Publication date: 2010-09-02

Abstract

An artificial knee replacement prostheses with an anterior cruciate ligament reserved or reconstructed, have a tibia table holder and a pad (20). The tibia table holder includes a table (30) and a fixedly attaching construction which fixedly attaches the table (30) and the tibia. The pad (20) has a passage for the anterior cruciate ligament (25) to pass through. A bore (31) running through the up and the below surfaces of the table (30) of the tibia table holder, and an anti-secede structure preventing the implanted bone blocks from secession, are provided on the tibia table holder. The size of the bore (31) is suitable for the anterior cruciate ligament (25) to be implanted and the bone attached thereto to pass through.

Description

Artificial knee replacement prosthesis that can preserve or reconstruct anterior cruciate ligament

Technical field

The invention belongs to artificial joint prosthesis technology, in particular to a new artificial knee joint prosthesis technology. Background technique

Artificial joints are one of the most important advances in the field of orthopedics in the twentieth century. They enable patients who used to rely on crutches to walk, even those who can only amputate, to walk like normal people, greatly improving the quality of life. As a mature treatment method, it has been widely used at home and abroad. At present, artificial joint replacement has become the ultimate treatment for the treatment of severe bone and joint diseases, and is known as an important milestone in the history of orthopedics development in the 20th century.

The development of total knee arthroplasty (TKR) surgery has also been a great success. However, all current knee prosthesis designs do not achieve the same function as normal knee joints, and are different from normal knee joints in terms of knee joint physiology and biomechanics. Moreover, in the long-term follow-up study, the complications of total knee arthroplasty are becoming more and more obvious, especially the stability of artificial joints during exercise is not ideal. The reason is that the current multi-generation artificial total knee replacement prosthesis design requires intraoperative removal of the anterior cruciate ligament (ACL), but it has not been preserved or reconstructed. The artificial total knee arthroplasty under the guidance of this design concept faces three problems, one is the instability of the knee joint after surgery; the other is to solve the knee joint instability defect after surgery, in the artificial total knee replacement prosthesis The design is designed to take remedial measures, such as the use of guide plates or joysticks; third, the removal of the anterior cruciate ligament with important functions results in a knee joint that is physiologically, biomechanically, and kinematically different from the normal knee joint. At present, almost all knee prosthesis designs sacrifice the anterior cruciate ligament except for the single prosthesis. The accuracy of artificial total knee replacement prosthesis surgery is very high. The design and manufacture of the prosthesis and the accuracy of the prosthesis installation are very important factors influencing the outcome of joint replacement surgery. As a result, overly complex designs clearly result in surgical failures in design, manufacturing, and prosthetic installation.

The ligament structure of the knee joint plays an important role in maintaining the sliding and rolling of the knee joint flexion and extension. The medial and lateral collateral ligaments and the anterior and posterior cruciate ligaments participate in this function. The importance of the anterior cruciate ligament has recently attracted the attention of clinicians. In order to preserve the anterior cruciate ligament, some explorations have been made, such as the simultaneous replacement of two prostheses (the femoral condyle and the external malleolus). , but the operation is very difficult. There is another one Although the horseshoe-shaped prosthesis can retain the anterior cruciate ligament, it is designed to preserve the cruciate ligament so that the anchoring area of the tibial plate support at the humerus is reduced, which may lead to early loosening and sinking of the prosthesis; In the operation, the ligament is always attached to the bone, which makes the surgery difficult to expose, and it is easy to cause errors such as rotation of the prosthesis and poor alignment. There are also designs that can only reconstruct the anterior cruciate ligament, the ligament is replaced with biomaterials, and the patient's own ligaments cannot be preserved, which also causes unnecessary waste and reduced application range, and the reconstruction of the ligament cannot be associated with the human ligament. In comparison, for example, the application number is

The Chinese invention patent application of 200510011371.0 is such a technology. Summary of the invention

In order to solve the problem that the existing artificial knee prosthesis technique cannot retain the patient's healthy anterior cruciate ligament or the anchoring area of the prosthesis and the tibia is reduced and the surgical operation is difficult even if the anterior cruciate ligament is retained, the present invention provides a method for retaining Or artificial anterior cruciate ligament can retain a large anchoring area, and the artificial knee joint replacement prosthesis and artificial knee joint prosthesis replacement method are convenient for operation.

The technical solution of the present invention is as follows:

An artificial knee replacement prosthesis that retains or reconstructs the anterior cruciate ligament, including a tibial plate holder and a pad, the tibial plate holder includes a water platform and a fixed connection structure for fixedly connecting the water platform to the tibia, the pad having a lower surface that mates with an upper surface of the tibial platform carrier water platform and is disposed on the water platform, the pad upper surface having a pair of laterally spaced apart spherical concavities to receive a femoral component condyle portion, respectively The pad further has a passage through which the anterior cruciate ligament passes, and the tibial plate holder is provided with a hole penetrating through the upper and lower surfaces of the tibial platform support water platform, the hole being sized to fit the anterior cruciate ligament to be placed and The attached bone piece passes through, and the position of the hole on the tibial platform support water platform is suitable for the tibial plate support to be fixed to the tibia, and the anterior cruciate ligament and its attached bone block can pass through the hole and enter the tibia and The anterior cruciate ligament is located at the normal physiological attachment site of the tibia; it also includes a detachment prevention structure for preventing the inserted bone mass from coming out.

The detachment prevention structure is a buckled detachment prevention structure provided on the cushion or a snap-proof detachment structure provided on the tibia platform support member or a fixed structure of the bone block and the tibia.

The tunnel is a tunnel having a rectangular or circular or triangular cross section.

The tunnel is located at a position in front of the middle of the tibial platform support water platform, that is, in a central portion of the coronal plane, and is located in the 1/3 of the anterior cruciate ligament at the anterior cruciate ligament. . The rectangular channel has a lateral diameter of 14 mm to 16 mm and a anteroposterior diameter of 17 mm to 19 mm. The buckled retaining structure provided on the pad is such that the lower surface of the pad can press a specific portion of the inserted bone block.

The channel on the pad through which the anterior cruciate ligament passes is a gap in the posterior portion of the pad.

The upper surface of the water platform and the lower surface of the gasket are provided with a fitting structure to fix the gasket on the water platform. The fitting structure is a protruding portion provided inside and outside the lower surface of the gasket and a concave portion provided on the upper surface of the corresponding water platform.

The notch is a U-shaped notch, and the front edge of the U-shaped opening corresponds to the position of the leading edge of the rectangular channel of the tibial platform support water platform, and the left and right transverse diameters are the same as the rectangular holes of the corresponding tibial plate support.

14mm~16mm, the U-shaped rim of the gasket is provided with a horizontal protruding edge which is stepped with the lower surface of the gasket.

The horizontal raised edge is disposed at a front portion of the U-shaped opening of the pad and a portion of the inner and outer sides connected to the front portion.

The fixed connection structure is a screw hole penetrating through the upper surface and the lower surface of the tibial plate holder or a connecting post disposed on the lower surface of the tibial plate holder and perpendicular to the lower surface of the tibial plate holder; the number of the fixed connection structures is at least 2 .

The surface of the connecting post is provided with a reinforcing rib that is connected to the lower surface of the tibial plate holder.

The edge of the tibial platform support water platform is provided with a reserved position of the posterior cruciate ligament that is recessed toward the center.

The prosthesis of the present invention also includes a femoral prosthesis disposed correspondingly over the pad.

The artificial knee prosthesis replacement method comprises the following steps: 1) drilling a bone pit at a portion of the anterior cruciate ligament to which the tibia is attached, the size of the bone pit being adapted to the anterior cruciate ligament bone to be placed; A tibial platform support having a water platform is fixedly coupled to the end surface of the tibia of the excavated bone pit, and the water platform is pre-opened with a hole penetrating the upper and lower surfaces, the size of the hole being suitable for the front cross to be placed The ligament and its attached bone block pass through, and the anterior cruciate ligament on the humerus after the bone block enters the tibia is located at the normal physiological attachment site of the tibia; 3) the bone block with the anterior cruciate ligament is passed through The hole is placed in the bone pit; 4), a pad is installed on the upper part of the water platform, and the femoral condyle is aligned with the pad to complete the prosthesis replacement.

The anterior cruciate ligament bone block in the above step 1) is a patient's own anterior cruciate ligament or an allogeneic anterior cruciate ligament. In the above step 2), there are still steps Γ: removing part of the bone from the end surface of the humerus of the bone block, so that the end surface of the tibia is planar. Technical effects of the present invention: The artificial knee replacement prosthesis of the present invention comprises a specific channel on the water platform of the tibial plate support, which is not the hole normally only for the anterior cruciate ligament, but the anterior cruciate ligament and its attached bone. a channel through which the block can pass, and the position of the hole enables the bone to pass through into a specific part of the tibia - 'so that the anterior cruciate ligament on the normal physiological attachment site is included, and a The prosthesis preventing the prolapse of the bone mass, the prosthesis thus structured can perform the prosthetic replacement operation for retaining the healthy anterior cruciate ligament, because a part of the bone piece integrated with the intact anterior cruciate ligament can be firstly cut out, After the water platform of the tibial plate support is fixed on the tibia, the anterior cruciate ligament and its attached bone block are placed through the hole into the corresponding position of the tibia, and at the same time, due to the anti-detachment structure, the inserted bone block can Fixed. If it is the patient's own complete anterior cruciate ligament, the bone can be cut back to the tibia. If it is allogeneic bone and attached anterior cruciate ligament, firstly on the humerus after measuring the size of the bone. Cut out the pit of the corresponding size and perform the above steps. The complete anterior cruciate ligament can be preserved by simply removing one of the channels due to the water platform of the tibial plate holder. Therefore, the anchoring area of the tibia and the tibia is still large, and the early loosening and sinking of the prosthesis is not caused. The replanted bone mass can be densely combined with the tibia after a period of growth, so that the function of the anterior cruciate ligament can be restored to the original function, and the sequelae such as joint dislocation which is prone to occur in the prior art are avoided. The installation of the tibial plate support on the tibia is a surgical operation under the condition that the anterior cruciate ligament is removed. Therefore, there is no obstruction of the anterior cruciate ligament, and the surgical site is exposed to a large extent, which is very convenient for surgical operation, that is, the tibial plate is conveniently completed. The mounting of the holder then inserts the bone piece to which the anterior cruciate ligament is attached through the channel into the tibia and completes the installation of other partial prosthetic components such as pads.

The U-shaped opening corresponding to the hole is arranged on the pad, and the pad can be conveniently placed on the water platform after the anterior cruciate ligament is installed, and the horizontal protruding edge of the u-shaped edge can just press the water platform The top of the bone is slightly protruding (because the top of the humerus is first flattened when it is placed back, the height of the returned bone is higher than the height of the hole in the tibia and can protrude from the upper surface of the water platform).

The tibial plate support and the tibial fixed connection structure adopt a plurality of fixed connection structures distributed on the lower surface of the tibial plate support, so that the connection between the tibial plate support and the tibia can be more stable. At the same time, due to the use of a plurality of fixed connection structures, the length of the screw or the connecting post can be made shorter than the length of the single connecting post, avoiding the pain caused by the deep hole in the tibia and reducing the damage to the bone. Conducive to the fixation of the prosthesis.

The surface of the connecting post is provided with reinforcing ribs connected to the lower surface of the tibial platform support to increase the strength of the connecting post.

The sacral pedicle and the anterior cruciate ligament are accommodated on the tibial plate support. The shape of the attached bone is adapted, and the rectangular bone piece is easier to realize in actual operation, and the removed bone piece has higher precision. DRAWINGS

Figure 1 is a schematic view showing the structure of a femoral prosthesis disposed on a femur;

Figure 2 is a structural view of the gasket;

Figure 3 is a bottom view of Figure 2;

Figure 4 is a diagram showing the relationship between the anterior cruciate ligament and its attached bone block after replacement;

Figure 5 is a structural diagram of the tibial platform support;

Figure 6 is a plan view of Figure 5.

The markers in the figure are listed below:

1, femoral prosthesis; 20, pad; 21, spherical concave; 22, U-shaped pad notch; 23, horizontal protrusion; 24, fastening boss; 25, anterior cruciate ligament; 26, bone block; , the water platform of the tibial platform support; 31, the tunnel; 32, the fastening recess; 33, the connecting column; 34, the position of the posterior cruciate ligament. detailed description

The technical solution of the present invention will be described in detail below with reference to the accompanying drawings.

2 and FIG. 3 are a preferred embodiment of a cushion 20 for a component of an artificial knee joint replacement prosthesis according to the present invention. Here, the passage through which the anterior cruciate ligament passes is a notch. In the middle rear portion of the gasket 20, the notch is U-shaped, that is, the horseshoe shape, and the two extended portions of the U-shaped structure are working bodies. The upper surface of each working body is provided with a spherical concave surface 21 for accommodating the femoral condyle, and the lower surface of the working body is provided with a fastening boss 24, and the fastening boss 24 functions as the water platform 30 of the underlying tibial platform carrier. Fit to form a fixed connection. The edge of the U-shaped gasket notch portion 22 of the gasket 20 is provided with a horizontal projection edge 23, preferably disposed along the periphery of the U-shaped notch as a U-shaped edge. The horizontal projection edge 23 has a step with the lower surface of the gasket 20, i.e., the lower surface of the horizontal projection edge 23 is spaced from the lower surface of the gasket 20. Preferably, the thickness of the horizontal raised edges 23 remains uniform throughout. The horizontal projecting edge 23 is a retaining structure provided in the notched portion 22 of the U-shaped gasket, and is a crimping and retaining structure. Of course, the detachment prevention structure may also be a snap-on detachment structure provided on the tibial plate support or a fixed structure of the bone block and the tibia, such as a screw-shaped fixing structure formed by both the bone block and the tibia to prevent the cross before attachment. The detachment of the bones of the ligaments.

As shown in FIG. 5 and FIG. 6, the other component of the artificial knee joint replacement prosthesis of the present invention is a tibial platform support member, The utility model comprises a water platform 30 and a connecting post 33 disposed on the lower surface of the water platform. The upper surface of the water platform 30 is provided with two fastening recesses 32. The fastening recesses 32 are arranged corresponding to the fastening bosses 24, and the two are matched to make the gasket 20 It can be snapped onto the water platform 30 of the platform carrier and secure the pad 20. A rectangular hole 31 is disposed between the two fastening recesses 32 of the water platform 30 of the tibial platform support, and the position is specifically located at a central position in a coronal plane, and is located at a frontal position in a sagittal plane. 3, in line with the anterior cruciate ligament at the attachment site of the tibia. The tunnel 31 can also be of other shapes. The function of the tunnel 31 is to pass the anterior cruciate ligament and the attached bone block. The shape of the tunnel 31 should be substantially the same as the shape of the tunnel 31 after the bone graft is replanted and the size is slightly larger than the size of the bone block. The rectangular channel has a lateral diameter of 14 mm to 16 mm and a anteroposterior diameter of 17 mm to 19 mm. The U-shaped opening of the pad 20 should correspond to the channel 31 to receive the anterior cruciate ligament and can be pressed against the displaced bone block by the horizontal raised edge 23. Of course, the pad 20 can also be other non-U-shaped port structures, such as a structure in which a through hole is provided for the anterior cruciate ligament to pass through. In this case, the through hole can be designed to be slightly offset from the hole 31 to be able to catch the returned bone. Block, in this case, the crimping and retaining structure is the portion of the lower surface of the liner 20 that can catch the bone block. Of course, the surgically placed bone block should protrude beyond the humerus and just coincide with the water platform of the tibial plate support. The upper surfaces of 30 are on the same plane.

The lower surface of the water platform 30 of the tibial platform support is provided with a plurality of fixed connection structures, and the number of the fixed connection structures is at least two. The fixed attachment structure can be a plurality of screw holes through the water platform 30 of the tibial plate holder, the screws passing through the screw holes to secure the water platform 30 of the tibial plate holder to the tibia. The fixed connection structure may also be a connecting post 33 disposed on the lower surface of the water platform 30 of the tibial plate holder as shown in Fig. 5, and the connecting post 33 may be integral with the water platform 30 of the tibial plate holder. The outer surface of the connecting post 33 may also be provided with reinforcing ribs which are also connected to the lower surface of the water platform 30 of the tibial platform support. The ribs can further enhance the strength of the connecting post. The edge of the water platform 30 corresponding to the position of the posterior cruciate ligament of the prosthesis is provided with a posterior cruciate ligament reserved position 34 to the central recess, and the posterior cruciate ligament reserved position 34 reserves space for the posterior cruciate ligament. Retain the posterior cruciate ligament.

The artificial knee replacement prosthesis of the present invention that retains or reconstructs the anterior cruciate ligament includes a tibial plate holder and a pad 20, and preferably includes a femoral prosthesis 1 as shown in FIG.

The structural function of the preferred embodiment of the present invention will now be further described in conjunction with the placement of the artificial knee replacement prosthesis of the present invention. The procedure for placement of an artificial knee replacement prosthesis that preserves or reconstructs the anterior cruciate ligament is as follows:

First, along the anterior cruciate ligament of the patient, the outer edge of the attachment site of the tibia is cut into the tibia and the bone block 26 on the tibia connected to the anterior cruciate ligament is removed. The anterior cruciate ligament, together with the attached bone mass 26, is removed. The shape of the bone block 26 can be a variety of shapes depending on the actual situation, preferably a cube-shaped bone block 26 that facilitates removal and subsequent replantation of the bone block 26. At present, some procedures for retaining the anterior cruciate ligament do not remove the anterior cruciate ligament, and the U-shaped tibial plate holder is used to fix the humerus. In this respect, it is extremely difficult to expose the anterior cruciate ligament to the humerus at the time of surgery, which is very difficult to cause the rotation and misalignment of the knee prosthesis. On the other hand, the water platform of the U-shaped tibial plate holder has a small anchoring surface on the tibia, which can easily lead to early loosening and sinking of the prosthesis. After the bone block 26 is removed by the method, the anchoring area of the water platform of the U-shaped tibial plate support at the end of the tibia is sufficiently large to avoid the above problems.

Next, part of the bone is removed by removing the end surface of the humerus of the bone block 26, and the end surface of the tibia is planar after the bone is removed. The effect of this step is that the planar humeral end face facilitates the placement of the tibial platform support water platform 30, while the space created by the elimination of part of the bone is reserved for the knee replacement prosthesis, so that the length of the leg of the patient remains unchanged after surgery. change.

Thirdly, the lower surface of the water platform 30 of the tibial plate support is fixed toward the end surface of the tibia, and is fixed by a fixed connection structure on the tibial platform support. The posterior cruciate ligament is placed in the posterior cruciate ligament reserve 34.

Fourthly, the bone block 26 is inserted into the bone hole of the tibia through the hole 31 through which the anterior cruciate ligament passes through the water platform 30 of the tibial platform support. The shape and diameter of the hole 31 should be on the bone block 26. The outer edge of the anterior cruciate ligament attachment site is equivalent. Since the bone of the end surface of the tibia has been removed, the height of the returned bone piece 26 is higher than that of the end surface of the tibia and protrudes above the upper surface of the water platform 30.

Fifth, the notched portion (ie, the notch) of the U-shaped pad 20 is pushed into the anterior cruciate ligament 25, so that the anterior cruciate ligament is placed in the hollow portion of the U-shaped pad 20 (see FIG. 4), and the pad is now placed. The lower surface of the 20 is engaged with the upper surface of the water platform 30 of the tibial platform support. At this time, the U-shaped horizontal protruding edge 23 is placed above the tunnel 31 to buckle the bone block 26 to fix the bone block 26, and no additional fixing operation is required for the bone block, which reduces the complexity of the operation and the complexity of the knee joint prosthesis. Degree, simple knee prosthesis structure is more conducive to improve the life of the prosthesis.

Of course, the thickness of part of the bone removed by the end face of the tibia can be controlled so that the back bone 26 is just flush with the upper surface of the water platform 30 of the tibial plate support, so that the pad 20 needs to be designed to be larger than the hole 31. The narrow structure allows the lower surface of the pad 20 to be pressed against the back bone block 26. For this situation and the top of the back bone block is located in the water platform 30 of the tibial plate support, it is also possible to provide a snap-proof structure on the water platform 30 of the tibial platform support, and the pad 20 is not Need to set the horizontal protrusion edge 23, The mating of the pad 20 and the water platform 30 can take a non-fixed connection. The snap-in anti-separation structure can be a movable card provided on the tunnel 31 of the water platform 30 of the tibial platform support, when the bone block 26 is placed. Open the activity card, put it in and pop it up to fix the bone.

The fixed structure of the bone block 26 and the tibia refers to directly screwing the screw into the bone block 26 and into the tibia to fix the two together.

Sixth, the femoral condyle is aligned with the spherical concave surface on the upper surface of the pad 20 and the replacement prosthesis process is terminated. Prior to operation of the procedure, the femoral prosthesis 1 (see Figure 1) can be placed on the femur by machining a number of planes on the femoral condyle to accommodate the femoral prosthesis surface and placing the femoral prosthesis on the femoral condyle. The combination of the above-described planes with the femoral prosthesis surface avoids the sliding of the femoral condyle relative to the femoral prosthesis and the resulting friction. The installation of the femoral prosthesis prevents the patient's femur from rubbing directly against the pad 20, causing damage to the femur.

Thus far, the purpose of the present invention for retaining the anterior cruciate ligament is achieved, and the pain caused by reconstructing the anterior cruciate ligament is reduced. After a period of growth, the replanted bone mass can be densely combined with the tibia, so that the function of the anterior cruciate ligament can be restored to the original function, and the sequelae such as joint dislocation which is prone to occur in the prior art can be avoided.

Thus, the artificial knee replacement prosthesis of the present invention accomplishes the purpose of reconstructing the anterior cruciate ligament.

In the present embodiment, the material of the femoral component 1 is a titanium alloy, a cobalt-based alloy such as a Ti-6A1_4V alloy, a Ti-6Al-7Nb alloy or the like, which may also be other various materials well known to those skilled in the art. The material of the liner 2 of the artificial knee replacement prosthesis may be an ultrahigh molecular polyethylene porous material, which may also be other various materials well known to those skilled in the art. The material of the tibial plate holder 3 is a titanium alloy, a cobalt-based alloy such as a Ti-6A1_4V alloy, a Ti-6Al_7Nb alloy, etc., and the material may also be other various materials well known to those skilled in the art.

The anterior cruciate ligament used for reconstruction includes various methods of synthetic anterior cruciate ligament and allogeneic anterior cruciate ligament as well as Achilles tendon and/or autologous quadriceps tendon, tendon, and the like. For the allogeneic anterior ligament, one end (fixed to the tibia) can be used with bone for easy fixation.

The allogeneic anterior cruciate ligament comes from the body. The advantage of using allografts is obvious, the patient's own healthy tissue will not be destroyed, so the extracted area will not be diseased. Obviously, this short surgery time reduces the patient's pain indirectly. Allogeneic corpses or wounds and other amputation procedures can ensure that the anterior cruciate ligament without infectious disease is collected and resterilized in a sterile state. The above disinfection method refers to direct disinfection with ethylene oxide, or vacuum packaging and disinfection with cobalt 60.

The advantage of using artificial ligaments instead of transplants is to avoid the pain of collecting tissue areas, and also The lack of donors for allograft replacements is avoided and there is no disease transmission.

The artificial knee joint replacement prosthesis capable of retaining or reconstructing the anterior cruciate ligament can be widely applied to various artificial knee joint replacements, such as: artificial surface total knee joint of fixed platform, artificial surface total knee joint of rotating platform, retention or The entire knee joint, hinge knee joint, etc. of the posterior cruciate ligament are not retained.

It should be noted that the above-described embodiments may be more fully understood by those skilled in the art, but are not intended to limit the invention in any way. Therefore, the present invention has been described in detail with reference to the embodiments of the present invention, but those skilled in the art will understand that the invention may be modified or equivalently substituted without departing from the spirit and scope of the invention. And its improvements, which should be covered by the scope of protection of the present invention.

Claims

Rights request

1. An artificial knee replacement prosthesis capable of retaining or reconstructing an anterior cruciate ligament, comprising a tibial plate support, the tibial plate support comprising a water platform and a fixed connection structure for fixedly connecting the water platform to the tibia, characterized in that the tibia The platform holder is provided with a passage through the upper and lower surfaces of the tibial platform support water platform for accommodating the anterior cruciate ligament, the passage being sized to fit the anterior cruciate ligament and the attached bone block to be inserted, and The position of the tunnel on the tibial platform support water platform is suitable for the tibial plate support to be fixed to the humerus, the anterior cruciate ligament and the attached bone block can pass through the tunnel to enter the tibia and the anterior cruciate ligament is located in the normal physiology of the tibia. An attachment site; further comprising an anti-off structure for preventing the anterior cruciate ligament from adhering to the bone.

2. An artificial knee replacement prosthesis capable of retaining or reconstructing an anterior cruciate ligament according to claim 1, further comprising a pad disposed between the femoral and tibial plateau support, the pad having an anterior cruciate ligament a passage through which the retaining structure is a buckled retaining structure provided on the liner or a snap-on retaining structure provided on the tibial platform support or a fixed structure of the bone and the tibia.

3. An artificial knee joint replacement prosthesis according to claim 1 or 2, wherein the tunnel is a rectangular cross section.

4. An artificial knee replacement prosthesis capable of retaining or reconstructing an anterior cruciate ligament according to claim 3, wherein said orifice is located at a position forward of a central portion of the tibial platform support water platform, and is located in a coronal plane. The central position is located in the anterior 1/3 of the sagittal plane to conform to the anterior cruciate ligament at the tibia attachment site. The lateral diameter of the rectangular channel is 14 mm to 16 mm, and the anterior and posterior sagittal diameter is 17 mm to 19 Mm.

The artificial knee joint replacement prosthesis capable of retaining or reconstructing the anterior cruciate ligament according to claim 2, wherein the pressing and retaining structure provided on the pad is such that the lower surface of the pad can press the insertion a specific part of the bone.

6. An artificial knee replacement prosthesis for retaining or reconstructing an anterior cruciate ligament according to claim 2, wherein the passage through the pad for the anterior cruciate ligament is a gap in the posterior portion of the pad. .

The artificial knee joint replacement prosthesis capable of retaining or reconstructing the anterior cruciate ligament according to claim 6, wherein the upper surface of the water platform and the lower surface of the pad are provided with a fitting structure to enable The liner is attached to the water platform. The fitting structure is a protruding portion provided inside and outside the lower surface of the gasket and a concave portion provided on the upper surface of the corresponding water platform.

The artificial knee joint replacement prosthesis capable of retaining or reconstructing the anterior cruciate ligament according to claim 7, wherein the notch is a U-shaped notch, and the leading edge of the U-shaped opening is the same as the tibial platform supporting water platform. of The position of the leading edge of the rectangular channel corresponds to the same as the rectangular hole of the corresponding tibial plate holder, which is 14 mm to 16 mm, and the U-shaped edge of the pad is provided with a step opposite to the lower surface of the pad. The horizontal raised edge of the structure.

9. The artificial knee replacement prosthesis capable of retaining or reconstructing an anterior cruciate ligament according to claim 1, wherein the fixed connection structure is a screw hole penetrating through the upper surface and the lower surface of the tibial plate holder or disposed on the tibia a connecting post on the lower surface of the platform support and perpendicular to the lower surface of the tibial platform support; the number of the fixed connection structures is at least 2.

10. The artificial knee joint replacement prosthesis according to claim 1, wherein the surface of the connecting post is provided with a reinforcing rib connected to the lower surface of the tibial plate holder.

11. An artificial knee replacement prosthesis for retaining or reconstructing an anterior cruciate ligament according to claim 1, wherein the edge of the tibial platform support water platform is provided with a reserved position for the posterior cruciate ligament that is recessed toward the center.

12. An artificial knee replacement prosthesis that retains or reconstructs an anterior cruciate ligament according to claim 1, further comprising a femoral prosthesis disposed correspondingly over the pad.

13. The artificial knee prosthesis replacement method comprises the following steps: 1) drilling a bone pit at a portion of the anterior cruciate ligament to which the tibia is attached, the size of the bone pit being adapted to the anterior cruciate ligament bone to be placed. 2) a tibial platform support having a water platform is fixedly connected to the end surface of the tibia of the excavated bone pit, and the water platform is pre-opened with a hole penetrating the upper and lower surfaces, and the size of the hole is suitable for being inserted. The anterior cruciate ligament and its attached bone block pass through, and the anterior cruciate ligament on the humerus after the bone block enters the tibia is located at the normal physiological attachment site of the tibia; 3) the bone with the anterior cruciate ligament is worn The hole is placed in the bone pit; 4), a pad is installed on the upper part of the water platform, and the femoral condyle is aligned with the pad to complete the prosthesis replacement.

14. The artificial knee joint prosthesis replacement method according to claim 13, wherein the anterior cruciate ligament bone block in step 1) is a patient's own anterior cruciate ligament bone mass or allogeneic pre-crossing. Ligament bones.

15. The artificial knee prosthesis replacement method according to claim 13, wherein the step (2) is performed as follows: Γ): removing the bone surface of the bone block to remove part of the bone, so that The end face of the humerus is flat.