WO2013078994A1 - 一种膝关节假体 - Google Patents

一种膝关节假体 Download PDF

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Publication number
WO2013078994A1
WO2013078994A1 PCT/CN2012/085436 CN2012085436W WO2013078994A1 WO 2013078994 A1 WO2013078994 A1 WO 2013078994A1 CN 2012085436 W CN2012085436 W CN 2012085436W WO 2013078994 A1 WO2013078994 A1 WO 2013078994A1
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WO
WIPO (PCT)
Prior art keywords
curved surface
arc surface
knee joint
arc
column
Prior art date
Application number
PCT/CN2012/085436
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English (en)
French (fr)
Inventor
曲铁兵
郑诚功
宋大勇
侯丽丽
Original Assignee
北京纳通科技集团有限公司
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 北京纳通科技集团有限公司 filed Critical 北京纳通科技集团有限公司
Priority to EP12853451.8A priority Critical patent/EP2786727B1/en
Priority to US14/361,172 priority patent/US9554911B2/en
Publication of WO2013078994A1 publication Critical patent/WO2013078994A1/zh

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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
    • A61F2/3836—Special connection between upper and lower leg, e.g. constrained
    • 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
    • A61F2/3886—Joints for elbows or knees for stabilising knees against anterior or lateral dislocations

Definitions

  • the present invention relates to a prosthesis for use in a human body, particularly in connection with a prosthesis that replaces the structural function of the knee joint. Background technique
  • knee prostheses have been widely used, traditional knee prostheses are not detailed enough to mimic human movements, resulting in uncomfortable movements of the human body when using prostheses, and often cannot be made in place.
  • the traditional knee prosthesis only pays attention to the flexion movement between the femur and the tibia of the knee joint during the flexion, and ignores the external rotation of the femur relative to the tibia during the flexion.
  • a knee joint prosthesis comprising a companion movement and a femoral component and a tibial component respectively applied to the femur and the tibia, the femoral component including an intercondylar groove, the posterior intercondylar groove being provided with a cam, the tibial component
  • the upper side includes an inner side bearing surface and an outer side bearing surface, and a column is disposed between the inner side bearing surface and the outer side bearing surface, the column is matched with the inter-turn groove, and the rear part of the column is
  • the outer side of the surface includes a first curved surface, and the rear surface of the vertical pillar further includes a second curved surface on the inner side of the first curved surface; the cam is correspondingly disposed with the first curved surface and the second arc a third arc surface and a fourth arc surface that cooperate with each other; the first curved surface can cooperate with the third curved surface to guide the femur to externally rotate relative to the tibia, and the
  • the first curved surface has the same curvature as the third curved surface
  • the second curved surface has the same curvature as the fourth curved surface
  • the second curved surface and the fourth curved surface are the same
  • the curvature is smaller than the curvature of the first arc surface and the third arc surface.
  • first arc surface, the second arc surface, the third arc surface and the fourth arc surface are arc surfaces.
  • the radius of the first curved surface and the third curved surface is 3-10 mm, and the radius of the second curved surface and the fourth curved surface is 30-50 mm.
  • a line connecting a center of the first curved surface with the first and second curved surfaces and a straight line located in a front-rear direction of the tibia The angle is 5-20 degrees.
  • the column is asymmetrically disposed on the tibial component, and the post is located in a direction of the outer crotch support surface of the tibial component.
  • the column and the cam are both asymmetric structures.
  • the rear surface of the pillar gradually extends forward from the outside to the inside.
  • the front side of the column is designed with a circular arc shoulder
  • the front surface of the column is a circular arc surface
  • the vertical column is a thumb type with a curvature as a whole.
  • the first curved surface on the column of the present invention cooperates with the third curved surface on the cam to facilitate guiding the femur to smoothly rotate outward relative to the tibia, and the second curved surface on the vertical column and the second on the cam
  • the four arc surfaces cooperate to gradually limit the external rotation of the femur relative to the tibia, and when the second arc surface is completely in contact with the fourth arc surface, the external rotation of the femur relative to the tibia is completely prevented.
  • the present invention solves the accurate knee simulation by practical means.
  • the joint flexion and extension movement is safe and reliable, which can further improve the use level of the knee prosthesis, and meet the higher needs of patients, which makes the product more marketable.
  • FIG. 1 is a schematic view showing the structure of a femoral component in a knee joint prosthesis of the present invention
  • FIG. 2 is a schematic view showing the structure of a tibial component in a knee joint prosthesis of the present invention
  • FIG. 3 is a schematic structural view of a knee joint prosthesis in a state of use according to the present invention.
  • Figure 4 is a schematic view showing the structure of the knee joint prosthesis of the present invention.
  • Figure 5 is a schematic view showing the structure of the knee joint prosthesis of the present invention.
  • FIG. 6 is a side view showing the structure of a middle joint of a knee joint prosthesis according to the present invention.
  • FIG. 7 is a schematic view showing the three-dimensional structure of a middle joint of a knee joint prosthesis according to the present invention
  • Figure 8 is a schematic view showing the three-dimensional structure of a cam in a knee joint prosthesis according to the present invention
  • FIG. 9 is a schematic view showing the position of a boundary between a first arc surface and a second arc surface of a middle joint of a knee joint prosthesis according to the present invention.
  • the so-called “front” and “rear” directions are identical to the front and rear directions of the human body after the knee prosthesis is implanted into the human body, and the present invention is described by taking the left knee joint prosthesis as an example.
  • the present invention comprises a femoral component 1 for fixation to the distal end of the femur and a tibial component 2 for attachment to the proximal end of the humerus.
  • the femoral component 1 and the tibial component 2 cooperate such that the tibia can support the femur by the present invention.
  • the femoral component 1 and the tibial component 2 can also cooperate to mimic the flexion and extension of the human knee joint.
  • the fitting relationship between the femoral component 1 and the tibial component 2 is clearly shown, and the front half of the femoral component 1 is cut away.
  • the tibial component 2 includes an inner ankle support surface 21 and an outer lateral support surface 22 disposed to the left and right.
  • a column 23 is disposed between the medial condyle bearing surface 21 of the tibial component 2 and the lateral condyle bearing surface 22, and the femoral component 1 includes an intercondylar groove 11, and the post 23 can be received in the intercondylar groove 11.
  • the column 23 is generally a curved thumb type 233 as seen from the side, and the curved thumb type 233 can ensure that the cam 12 does not undergo deep flexion using the knee prosthesis of the present invention.
  • the column 23 is removed (i.e., dislocation occurs) to ensure safe use of the present invention.
  • the front and rear portions of the column 23 are curved, and the sides are smoothly transitioned, and the front portion of the column 23 has a width smaller than the width of the rear portion.
  • the front side of the column 23 is designed with a circular shoulder to ensure that the upper end of the front portion of the column 23 does not collide with the tibia when the knee prosthesis of the present invention is deeply flexed or the lower tibia is used to better protect the tibia.
  • the front surface of the column 23 is a circular arc surface, which can ensure contact with the front side arc surface of the femoral box at the groove 11 of the femoral component, thereby increasing the contact area and reducing the stress.
  • a cam 12 is disposed at the rear of the inter-turn groove 11. As shown in FIG. 8, the cam 12 has a structure with a large intermediate portion at both ends, and the outer edges of the two ends of the cam 12 are preferably equal in diameter, but may not be equal, and do not affect the present. Implementation of the inventive solution.
  • the outer surface of the rear surface of the pillar 23 is a first curved surface 231 as viewed in a cross section, and correspondingly, the outer surface of the front surface of the cam 12 is a third surface matched with the first curved surface 231.
  • the curved surface 121, the first curved surface 231 and the third curved surface 121 may be an elliptical curved surface or a circular arc surface.
  • the curvature of the first curved surface 231 and the third curved surface 121 should be close, and Best equal.
  • the first curved surface 231 and the third curved surface 121 are both circular arc surfaces, and the same radius of curvature is 3-10 mm, and the optimum value is 5 mm.
  • the surface of the rear surface of the pillar 23 on the inner side of the first curved surface 231 is a second curved surface 232, correspondingly, the inner side of the front surface of the cam 12 is the second and the second surface.
  • the arcuate surface 232 and the fourth arcuate surface 122 may be an elliptical arc surface or a circular arc surface.
  • the curvature of the second arcuate surface 232 and the fourth arcuate surface 122 should be close, and preferably equal.
  • the second curved surface 232 and the fourth curved surface 122 are both circular arc surfaces, and the radius of curvature is the same, both 30-50 mm, and the optimum value is 40 mm.
  • the curvature of the second curved surface 232 and the fourth curved surface 122 is preferably smaller than the curvature of the first curved surface 231 and the third curved surface 121, that is, the second curved surface 232 and the fourth curved surface 122. It is flatter than the first curved surface 231 and the third curved surface 121, which can better achieve the effect of limiting the femoral external rotation of the tibia.
  • the cooperative movement process between the femoral component 1 and the tibial component 2 is as follows:
  • the inner side is the center of rotation and the outer side is the rotational track.
  • the column 23 on the patella component 2 moves within the intercondylar groove 11 on the femoral component 1, and when the knee flexes to a certain angle, the post 23 on the patella component 2 and the cam on the femoral component 1 12 phases of contact.
  • the first curved surface 231 of the column 23 is in contact with the third curved surface 121 of the cam 12, and the two curved surfaces cooperate to guide the femur to externally rotate relative to the tibia to mimic the human body.
  • the knee joint continues to bend, the second curved surface 232 of the column 23 is gradually in contact with the fourth curved surface 122 of the cam 12, and the two curved surfaces 232, 122 cooperate to gradually restrict the external rotation of the femur relative to the tibia, and when the two When the curved surfaces are completely in contact, the external rotation of the femur relative to the tibia is completely prevented.
  • the column 23 is on the tibia member 2, and the boundary between the first curved surface 231 and the second curved surface 232 on the rear surface of the column 23 is preferably located on the left rear side of the column 23, and is preferably the following position.
  • the line connecting the center of the first curved surface 231 to the boundary between the first and second curved surfaces 231, 232 and the straight line in the front-rear direction of the tibia is 5- 20 degrees, the best value is 10-15 degrees. It can be seen from the cooperative movement process between the femoral component 1 and the tibial component 2 that the angle is the angle at which the femur can be externally rotated relative to the tibia.
  • the column 23 is asymmetrically disposed on the tibial component 2, and the column 23 is located in the medial posterior aspect of the tibial component 2 (the cross line in the figure shows the center position of the column 23 and the femoral component 2 ), that is, the direction in which the outer crucible supports the surface 22.
  • the eccentricity of the post 23 relative to the tibial component 2 is preferably 0.5-5 mm backward and 0.5-5 mm outward, and the eccentricity data can be determined according to different human conditions.
  • This asymmetrical position of the post 23 relative to the tibial component 2 The setting is closer to the normal anatomy of the human body, and it can be more advantageous for the present invention to guide and limit the external rotation of the femur relative to the tibia.
  • the column 23 and the cam 12 can be arranged in a shape-size symmetrical structure according to actual needs, but it is preferably arranged in an asymmetrical structure, and the asymmetric structure can more easily satisfy the above functional requirements.
  • the rear surface of the post 23 may be asymmetrical, preferably the rear surface of the post 23 extends progressively forward from the outside to the inside.
  • the front surface of the column 23 can also be asymmetrical.
  • the pillars 23 as a whole have an asymmetrical structure.
  • the cam 12 may be asymmetric only with respect to the front surface, but it is preferable that the cam 12 as a whole has an asymmetrical structure.
  • the beneficial effects of the present invention are that, compared with the prior art, the first curved surface 231 on the column 23 of the present invention and the third curved surface 121 on the cam 12 cooperate with each other to facilitate guiding the femur to smoothly rotate outward relative to the tibia.
  • the second curved surface 232 on the 23 cooperates with the fourth curved surface 122 on the cam 12 to gradually restrict the external rotation of the femur relative to the tibia, and completely blocks when the second curved surface 232 is in full contact with the fourth curved surface 122.
  • the external rotation of the femur relative to the tibia The invention solves the accurate simulation of the knee joint flexion and extension action by practical means, and is safe and reliable, can further improve the use level of the knee joint prosthesis, and meets the higher demand of the patient, and makes the product more market value.

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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)

Abstract

一种膝关节假体，包括股骨部件（1）与胫骨部件（2），股骨部件（1）上包括有髁间槽（11），髁间槽（11）后部设置有凸轮（12），胫骨部件（2）上包括左右设置的内髁支承表面（21）和外髁支承表面（22），内髁支承表面（21）和外髁支承表面（22）之间设置有立柱（23），立柱（23）与髁间槽（11）相适配，立柱（23）后部表面外侧包括有第一弧面（231），立柱（23）后部表面位于第一弧面（231）的内侧还包括有第二弧面（232）；凸轮（12）上相应设置有与第一弧面（231）和第二弧面（232）相配合的第三弧面（121）和第四弧面（122）；第一弧面（231）能够与第三弧面（121）相配合以引导股骨相对胫骨进行外旋，第二弧面（232）能够与第四弧面（122）相配合以限制股骨相对胫骨进行外旋。所述膝关节能准确模拟膝关节屈伸动作，而且安全可靠。

Description

一种膝关节假体 技术领域
本发明涉及一种应用于人体的假体， 尤其与替代膝关节结构功能的假体有关。 背景技术
目前， 许多病人的膝关节因为肌肉及软骨组织损伤导致无法正常行走和屈伸， 需要植 入假体替代膝关节发挥作用， 帮助病人重新正常站立、 行走和屈伸。 虽然， 膝关节假体已 经广泛应用， 但是传统的膝关节假体在模仿人体动作时还不够细致， 导致人体使用假体时 动作不舒畅， 经常无法做出到位动作。 尤其是模仿膝关节进行屈腿时， 传统的膝关节假体 只注重实现屈腿过程中膝关节的股骨与胫骨之间的屈曲运动，而忽略了屈腿过程中股骨相 对胫骨的外旋动作， 这就导致屈腿动作很难到位， 甚至在屈腿过程中会由于该动作不符合 人体生理特点， 导致损害假体， 甚至损害患者的股骨与胫骨， 加重病情。
但是， 由于人体在屈腿过程中的外旋动作既要求流畅又要求动作幅度不能过大， 否则 会对患者构成伤害。 目前， 虽然该领域技术人员已关注到该问题， 但无法提出解决这个问 题的实际手段。 模仿股骨相对胫骨进行外旋的动作， 需要动作流畅， 并适时阻止外旋动作 的继续， 如果不能适时阻止外旋动作， 很可能引起脱臼， 甚至影响人身安全。 所以， 至今 在无法提供有效手段时， 假体设计者为免除责任对此望而生畏。 发明内容
针对现有技术中存在的问题， 本发明的目的为提供一种结构简单、 膝关节屈伸时不但 可实现屈曲运动且可使股骨可靠地相对胫骨进行外旋的膝关节假体。
为实现上述目的， 本发明的技术方案如下：
一种膝关节假体， 包括配合运动且分别应用于股骨与胫骨的股骨部件与胫骨部件， 所 述股骨部件上包括有髁间槽， 所述髁间槽后部设置有凸轮， 所述胫骨部件上包括左右设置 的内髁支承表面和外髁支承表面， 所述内髁支承表面和外髁支承表面之间设置有立柱， 所 述立柱与所述髁间槽相适配， 所述立柱后部表面外侧包括有第一弧面， 所述立柱后部表面 位于所述第一弧面的内侧还包括有第二弧面；所述凸轮上相应设置有与所述第一弧面和第 二弧面相配合的第三弧面和第四弧面；所述第一弧面能够与所述第三弧面相配合以引导所 述股骨相对所述胫骨进行外旋，所述第二弧面能够与所述第四弧面相配合以限制所述股骨 相对所述胫骨进行外旋。
进一步， 从横断面上看， 所述第一弧面与第三弧面的曲率相同， 所述第二弧面与第四 弧面的曲率相同， 且所述第二弧面与第四弧面的曲率小于所述第一弧面与第三弧面的曲 率。
进一步， 所述第一弧面、 第二弧面、 第三弧面与第四弧面均为圆弧面。
进一步， 所述第一弧面与第三弧面的半径为 3-10毫米， 所述第二弧面与第四弧面的 半径为 30-50毫米。
进一步， 在所述胫骨部件的横断面上， 连接所述第一弧面的圆心与所述第一、 第二弧 面交界处的直线， 与位于所述胫骨的前后方向的直线之间的夹角为 5-20度。
进一步， 所述立柱非对称地设置在所述胫骨部件上， 所述立柱位于所述胫骨部件的中 后部偏所述外髁支承表面方向。
进一步， 所述立柱和凸轮均为非对称结构。
进一步， 所述立柱后部表面由外向内逐渐向前延伸。
进一步， 所述凸轮两端外缘的直径相等。
进一步， 所述立柱前侧采用圆弧削肩设计， 所述立柱前部表面为圆弧面， 并且所述立 柱从侧面看整体为带弧度的拇指型。
与现有技术相比， 本发明中立柱上的第一弧面与凸轮上的第三弧面相互配合， 方便引 导股骨相对胫骨流畅地外旋， 立柱上的第二弧面与凸轮上的第四弧面相配合， 逐渐限制股 骨相对胫骨的外旋动作， 并且当第二弧面与第四弧面完全接触时， 完全阻止股骨相对胫骨 的外旋动作， 本发明采用实际手段解决了准确模拟膝关节屈伸动作， 而且安全可靠， 可进 一步提高膝关节假体的使用水平， 满足患者更高需求的同时使得产品更加具有市场价值。 附图说明
图 1为本发明 种膝关节假体中股骨部件结构示意图
图 2为本发明 种膝关节假体中胫骨部件结构示意图
图 3为本发明 种膝关节假体使用状态一结构示意图
图 4为本发明 种膝关节假体使用状态二结构示意图
图 5为本发明 种膝关节假体使用状态三结构示意图
图 6为本发明 种膝关节假体中立柱侧视结构示意图
图 7为本发明 种膝关节假体中立柱立体结构示意图 图 8为本发明一种膝关节假体中凸轮立体结构示意图；
图 9为本发明一种膝关节假体中立柱第一弧面与第二弧面交界处位置示意图。 具体实施方式
体现本发明特征与优点的典型实施例将在以下的说明中详细叙述。应理解的是本发明 能够在不同的实施例上具有各种的变化， 其皆不脱离本发明的范围， 且其中的说明及附图 在本质上是当作说明之用， 而非用以限制本发明。
本发明中， 所称的 "前"、 "后"方向与所述膝关节假体植入人体以后人体的前后方 向相一致， 并且本发明以左膝关节假体为例进行描述。
如图 1与图 2所示， 本发明包括股骨部件 1与胫骨部件 2， 股骨部件 1用于固定在股 骨远端， 胫骨部件 2用于固定在胫骨近端。 股骨部件 1与胫骨部件 2相互配合， 使得胫骨 可通过本发明支撑股骨。股骨部件 1与胫骨部件 2之间还能够配合运动， 以模仿人体膝关 节的屈伸动作。
图 3-图 5中为清楚表示出股骨部件 1与胫骨部件 2之间的配合关系，切去了股骨部件 1的前半部分。如图 2与图 3所示，胫骨部件 2上包括左右设置的内髁支承表面 21和外髁 支承表面 22。 胫骨部件 2的内髁支承表面 21和外髁支承表面 22之间设置有立柱 23， 股 骨部件 1上包括有髁间槽 11， 立柱 23可容置在髁间槽 11内。
如图 4与图 6、 图 7所示， 立柱 23从侧面看整体为带弧度的拇指型 233， 该带弧度的 拇指型 233可以保证使用本发明膝关节假体进行深度屈曲时凸轮 12不会脱出立柱 23 (即 发生脱臼） ， 保证本发明的使用安全。
立柱 23前部与后部均为弧面，且各面之间圆滑过渡，立柱 23前部宽度小于后部宽度。 立柱 23前侧采用圆弧削肩设计， 从而可以保证使用本发明膝关节假体深度屈曲时或低位 髌骨时立柱 23前部上端不会与髌骨相撞，以更好地保护髌骨。立柱 23前部表面为圆弧面， 可以保证与股骨部件 1髁间槽 11处股骨盒的前侧圆弧面接触时， 增大接触面积， 降低应 力。
髁间槽 11后部设置有凸轮 12， 如图 8所示， 凸轮 12为两端大中间小的结构， 凸轮 12两端外缘的直径优选为相等， 但也可以不相等， 均不影响本发明技术方案的实现。
如图 3-图 8所示， 从横断面上看， 立柱 23后部表面外侧为第一弧面 231， 相对应地， 凸轮 12前部表面外侧为与第一弧面 231相配合的第三弧面 121，第一弧面 231与第三弧面 121可以是椭圆弧面， 也可以是圆弧面。 第一弧面 231与第三弧面 121的曲率应接近， 且 最好相等。 在本实施例中， 第一弧面 231与第三弧面 121均为圆弧面， 且曲率半径相同， 均为 3-10毫米， 最佳值为 5毫米。
如图 3-图 8所示， 从横断面上看， 立柱 23后部表面位于第一弧面 231内侧的表面为 第二弧面 232，相对应地，凸轮 12前部表面内侧为与第二弧面 232相配合的第四弧面 122， 第二弧面 232与第四弧面 122可以是椭圆弧面， 也可以是圆弧面。第二弧面 232与第四弧 面 122的曲率应接近， 且最好相等。 在本实施例中， 第二弧面 232与第四弧面 122均为圆 弧面， 且曲率半径相同， 均为 30-50毫米， 最佳值为 40毫米。
本发明中， 从横断面上看第二弧面 232和第四弧面 122的曲率优选小于第一弧面 231 和第三弧面 121的曲率， 即第二弧面 232和第四弧面 122比第一弧面 231和第三弧面 121 更加平坦， 这样能够更佳地实现限制股骨相对胫骨外旋的效果。
本发明的膝关节假体应用于人体时，股骨部件 1与胫骨部件 2之间的配合运动过程如 下：
膝关节在屈伸过程中， 以内侧为旋转中心， 外侧为旋转轨迹。 膝关节屈伸时， 胫骨部 件 2上的立柱 23在股骨部件 1上的髁间槽 11内移动， 当膝关节屈曲到一定角度后， 胫骨 部件 2上的立柱 23才会与股骨部件 1上的凸轮 12相接触。
当立柱 23与凸轮 12相接触时，首先是立柱 23的第一弧面 231与凸轮 12的第三弧面 121相接触， 该两个弧面相配合， 引导股骨相对胫骨进行外旋， 以模仿人体真实的膝关节 屈伸时股骨相对胫骨的外旋动作。
膝关节继续弯曲， 立柱 23的第二弧面 232与凸轮 12的第四弧面 122逐渐接触， 该两 个弧面 232、 122相配合， 逐渐限制股骨相对胫骨的外旋动作， 并且当该两个弧面完全接 触时， 就会完全阻止股骨相对胫骨的外旋动作。
如图 9所示， 立柱 23在胫骨部件 2上， 立柱 23后部表面上的第一弧面 231与第二弧 面 232之间的交界处优选位于立柱 23左后侧， 并优选下述位置： 在胫骨部件 2的横断面 上， 连接第一弧面 231的圆心与第一、 第二弧面 231、 232交界处的直线， 与位于胫骨的 前后方向的直线之间的夹角为 5-20度，最佳值为 10-15度。 由上述股骨部件 1与胫骨部件 2之间的配合运动过程可知， 该角度即为股骨能够相对胫骨外旋的角度。
如图 2所示， 立柱 23非对称地设置在胫骨部件 2上， 立柱 23位于胫骨部件 2的中后 部偏外髁方向 （图中十字交叉线示出了立柱 23和股骨部件 2的中心位置） ， 也即偏外髁 支承表面 22的方向。 立柱 23相对胫骨部件 2的偏心优选为向后 0.5-5毫米， 向外 0.5-5 毫米， 该偏心数据可根据不同人体情况来确定。 立柱 23相对胫骨部件 2的这种非对称位 置的设置方式， 更接近人体的正常解剖， 并且能够更加有利于本发明引导和限制股骨相对 胫骨的外旋运动。
另外， 立柱 23与凸轮 12可根据实际需要设置成形状尺寸对称结构， 然而优选设置成 非对称结构， 非对称结构能够更容易满足上述功能要求。 立柱 23 的后部表面可以是非对 称的， 优选为立柱 23后部表面由外向内逐渐向前延伸。 同时， 立柱 23的前部表面也可以 是非对称的。 本发明中， 优选立柱 23整体均为非对称结构。 相应地， 凸轮 12可以仅前部 表面为非对称的， 然而优选凸轮 12整体均为非对称结构。
本发明的有益效果在于， 与现有技术相比， 本发明中立柱 23上的第一弧面 231与凸 轮 12上的第三弧面 121相互配合， 方便引导股骨相对胫骨流畅地外旋， 立柱 23上的第二 弧面 232与凸轮 12上的第四弧面 122相配合， 逐渐限制股骨相对胫骨的外旋动作， 并且 当第二弧面 232与第四弧面 122完全接触时， 完全阻止股骨相对胫骨的外旋动作。本发明 采用实际手段解决了准确模拟膝关节屈伸动作， 而且安全可靠， 可进一步提高膝关节假体 的使用水平， 满足患者更高需求的同时使得产品更加具有市场价值。
本发明的技术方案已由优选实施例揭示如上。本领域技术人员应当意识到在不脱离本 发明所附的权利要求所揭示的本发明的范围和精神的情况下所作的更动与润饰，均属本发 明的权利要求的保护范围之内。

Claims

权利要求
1.一种膝关节假体， 包括配合运动且分别应用于股骨与胫骨的股骨部件与胫骨部件， 所述股骨部件上包括有髁间槽，所述髁间槽后部设置有凸轮，所述胫骨部件上包括左右设 置的内髁支承表面和外髁支承表面， 所述内髁支承表面和外髁支承表面之间设置有立柱， 所述立柱与所述髁间槽相适配， 其特征在于， 所述立柱后部表面外侧包括有第一弧面， 所 述立柱后部表面位于所述第一弧面的内侧还包括有第二弧面;所述凸轮上相应设置有与所 述第一弧面和第二弧面相配合的第三弧面和第四弧面;所述第一弧面能够与所述第三弧面 相配合以引导所述股骨相对所述胫骨进行外旋，所述第二弧面能够与所述第四弧面相配合 以限制所述股骨相对所述胫骨进行外旋。
2.如权利要求 1所述的膝关节假体， 其特征在于， 从横断面上看， 所述第一弧面与第 三弧面的曲率相同，所述第二弧面与第四弧面的曲率相同，且所述第二弧面与第四弧面的 曲率小于所述第一弧面与第三弧面的曲率。
3.如权利要求 2所述的膝关节假体， 其特征在于， 所述第一弧面、 第二弧面、 第三弧 面与第四弧面均为圆弧面。
4.如权利要求 3所述的膝关节假体， 其特征在于， 所述第一弧面与第三弧面的半径为
3-10毫米， 所述第二弧面与第四弧面的半径为 30-50毫米。
5.如权利要求 3所述的膝关节假体， 其特征在于， 在所述胫骨部件的横断面上， 连接 所述第一弧面的圆心与所述第一、第二弧面交界处的直线，与位于所述胫骨的前后方向的 直线之间的夹角为 5-20度。
6.如权利要求 1所述的膝关节假体， 其特征在于， 所述立柱非对称地设置在所述胫骨 部件上， 所述立柱位于所述胫骨部件的中后部偏所述外髁支承表面方向。
7.如权利要求 1所述的膝关节假体， 其特征在于， 所述立柱和凸轮均为非对称结构。
8.如权利要求 7所述的膝关节假体， 其特征在于， 所述立柱后部表面由外向内逐渐向 前延伸。
9.如权利要求 7所述的膝关节假体， 其特征在于， 所述凸轮两端外缘的直径相等。
10.如权利要求 1所述的膝关节假体， 其特征在于， 所述立柱前侧采用圆弧削肩设计， 所述立柱前部表面为圆弧面， 并且所述立柱从侧面看整体为带弧度的拇指型。
PCT/CN2012/085436 2011-11-28 2012-11-28 一种膝关节假体 WO2013078994A1 (zh)

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US9554911B2 (en) 2017-01-31

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