WO2015076326A1 - Élément pour un remplacement d'articulation de genou artificielle, et dispositif d'articulation de genou - Google Patents

Élément pour un remplacement d'articulation de genou artificielle, et dispositif d'articulation de genou Download PDF

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Publication number
WO2015076326A1
WO2015076326A1 PCT/JP2014/080733 JP2014080733W WO2015076326A1 WO 2015076326 A1 WO2015076326 A1 WO 2015076326A1 JP 2014080733 W JP2014080733 W JP 2014080733W WO 2015076326 A1 WO2015076326 A1 WO 2015076326A1
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Prior art keywords
condyle
posterior condyle
posterior
femoral
component
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PCT/JP2014/080733
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English (en)
Japanese (ja)
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経憲 武井
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経憲 武井
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Publication of WO2015076326A1 publication Critical patent/WO2015076326A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30252—Three-dimensional shapes quadric-shaped
    • A61F2002/30253—Three-dimensional shapes quadric-shaped ellipsoidal or ovoid
    • 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
    • A61F2002/30934—Special articulating surfaces

Definitions

  • the present invention relates to an artificial knee joint replacement component and a knee joint device.
  • Patent Document 1 Conventionally, many proposals have been made to provide an artificial knee joint that moves closer to a human knee joint (for example, Patent Document 1).
  • the artificial knee joint of Patent Document 1 includes a femoral component attached to the femur and a tibial component attached to the tibia, and the thickness of the medial condyle (intrafemoral condyle) of the femoral component is determined as the lateral condyle.
  • the thickness of the inner articular surface of the tibial component that supports the medial condyle is made thinner than the lateral articular surface that supports the lateral condyle,
  • a line (joint line) connecting the lowest point of the contact surface between the medial condyle and the lateral condyle and the medial joint surface and the lateral joint surface in the vertical cross section is inclined inward at substantially equal angles over the entire range of bending and stretching angles.
  • the human knee joint has been regarded as a hinge joint that only performs bending and stretching movements, but with the bending and stretching movements, a rotational movement of about 30 ° occurs in the knee joints.
  • the outer rotation (2 °) of the lower leg called the terminal rotation, is seen at the final stage. In this sense, the knee joint is not a purely hinged joint.
  • FIG. 1A is a schematic diagram (schematic diagram) of a contact portion between the femur Fem of the left leg and the tibia Tib as seen from the back side of the human body.
  • FIG. 1B is a plan view showing an end (proximal end) of the tibia Tib in FIG. 1A in contact with the femur Fem. 1A and 1B, the left side is the outside of the left knee joint, and the right side is the inside of the left knee joint.
  • the protruding distal end of the femur Fem consists of femoral condyles located on the medial and lateral sides.
  • the convex portion projecting to the outer (left) lower end is the femoral outer condyle LC of the femur Fem
  • the convex portion projecting to the inner (right) lower end is the femoral intracondylar MC of the femur Fem.
  • a substantially elliptical portion located on the left side of the upper end of the tibia Tib is a portion that flexes and extends the knee, and sometimes rotates or rotates on the femoral condyle LC of the femur Fem.
  • the posterior condyle abutment surface TLG of the outer condyle of the tibial condyle, and the substantially elliptical portion located on the upper right side of the tibia Tib is in contact with the intrafemoral condyle MC of the femur Fem during flexion and extension of the knee.
  • the horizontal line Z represents the surface of the femoral endocondyle MC of the femur Fem that contacts the posterior condyle contact surface TMG when the knee joint is extended (flexion angle 0 °).
  • the femur Fem and the tibia Tib are in contact with each other so that they can bend and stretch and rotate.
  • the tibia is rotated approximately 30 ° in the direction of the arrow Y in accordance with the knee flexion movement (operation of twisting the ankle from the knee inward from the outside).
  • the tibia Tib can be rotated by about 2 ° (referred to as “end rotation: Screw home”).
  • the human knee joint is not only a simple flexion and extension movement as seen in the hinge joint, but also a rotational movement in which the tibia is internally rotated with the flexion and the tibia is externally rotated during the extension. It has a structure with.
  • the rotational movement accompanying the bending and stretching of the knee joint is indispensable for bending the knee of the knee joint by 90 ° or more above the bending angle and further enabling deep bending like a normal seat.
  • the bending angle is an angle formed by the longitudinal axis of the femur and the longitudinal axis of the tibia. As shown in FIG.
  • the joint surface of the knee joint is varus with respect to the lower limb functional axis (Mechanical Axis or Functional Axis). If the joint surface is in a state perpendicular to the functional axis, the thigh and the lower leg are in contact with each other at the same vertical plane at the time of bending, and thus the bending is limited. A shift occurs between the lower leg and the axis of the thigh with articulation, and the deep flexion becomes possible. Further, since the tibia is internally rotated with the bending, the foot part is internally rotated from the lower leg. In the standing position, the foot part facing forward is folded under the trunk by the internal rotation of the lower leg together with the lower leg, so that the sitting position is possible. If the coordination of flexion, rotation, and valgus movement at the knee joint is broken, the range of motion of the knee joint is significantly limited. The human knee joint is an elaborate and mysterious organ with such extremely complex movements.
  • the present invention has been made in view of the above circumstances, and is capable of simultaneously inducing a flexion-extension motion and a rotational motion, and is an artificial knee joint component and knee closer to the human knee joint.
  • An object is to provide a joint device.
  • a femoral condyle with a generally semi-elliptical posterior condylar condyle that abuts against the tibial component during flexion and extension, and a posterior condyle that abuts the tibial component during flexion and extension A femoral component having a posterior condyle of a substantially semi-elliptical sphere having a posterior condyle, A tibial component having at least an inner condyle contact surface that contacts the posterior condyle portion of the endocondyle and an outer condyle contact surface that contacts at least the posterior condyle portion of the outer condyle, In the posterior condyle portion of the internal condyle, the true surface when the spherical surface of the portion where the posterior condyle portion of the internal condyle and the contact surface of the internal condyle abut at a bending angle of 0
  • the sphere's sphere is the posterior condyle sphere.
  • the posterior condyle of the external condyle when the spherical surface of the portion where the posterior condyle condyle and the contact surface of the external condyle abut at a flexion angle of 0 ° to 90 ° is assumed to be a part of a true sphere,
  • the sphere's center is the posterior condyle center.
  • the posterior condyle of the internal condyle is increased from a certain bending angle, the posterior condyle of the femoral component from the posterior condyle of the femoral component and the posterior condyle contact surface of the internal condyle It has a contour shape that shortens the diameter to the lowest point where it abuts, Every time the posterior condyle of the external condyle increases from a certain bending angle, the posterior condyle of the femoral component comes into contact with the external condyle contact surface
  • an artificial joint component and a knee joint device that are capable of simultaneously inducing a flexion and extension movement and a rotational movement and that are closer to the human knee joint.
  • FIG. 1A is a schematic diagram (schematic diagram) of a contact portion between the femur and tibia of the left leg as viewed from the back side of the human body.
  • FIG. 1B is a plan view showing an end (proximal end) of the tibia in FIG. 1A in contact with the femur.
  • FIG. 1C is a schematic view of the end of the femur in FIG. 1A that contacts the tibia as seen from the back side of the human body.
  • FIG. 2 is a left side view (viewed from the outside of the left leg) showing the femoral condyles of the femur of the knee joint of the left leg.
  • FIG. 1A is a schematic diagram (schematic diagram) of a contact portion between the femur and tibia of the left leg as viewed from the back side of the human body.
  • FIG. 1B is a plan view showing an end (proximal end) of the tibia in FIG. 1A
  • FIG. 3 is a right side view (view from the inside of the left leg) showing the femoral endocondyle of the femur of the knee joint of the left leg.
  • FIG. 4 is a side view of the basic conceptual configuration of the femoral condyle of the femoral component having the same shape as the shape approximated in the portion of the femur that contacts the tibia of the femoral condyle shown in FIG. It is explanatory drawing which shows a figure.
  • FIG. 5 is a side view of the basic conceptual configuration of the femoral endocondyle of the femoral component having the same shape as the shape approximated to the portion of the femoral endocondyle that contacts the tibia shown in FIG.
  • FIG. 6 shows the posterior condyle part of the external condyle of the femoral condyle and the posterior condyle part of the femoral internal condyle approximated to an ellipse when the bending angle is 0 °. It is the figure seen from the external condyle posterior condyle side.
  • FIG. 7A shows a substantially circular shape of the posterior condyles in the femoral condyle and the external femoral condyle of the femoral component when the femoral component of the left leg is viewed from the back side of the human body when the bending angle is 0 °.
  • FIG. 7B is a schematic view of the respective posterior condyles in the femoral condyle and the femoral condyle approximated to be substantially circular in FIG. 7A as viewed from the side where the femoral component is attached to the femur.
  • FIG. 8A is an explanatory view of the positional relationship between the femoral internal condyle and the external femoral condyle in the femoral component as viewed from the side where the femoral component is attached to the femur.
  • FIG. 8B is an explanatory diagram of the positional relationship between the femoral condyle and the femoral condyle in the femoral component as viewed from the femoral condyle side.
  • FIG. 9 is an explanatory diagram showing a side structure of the actual femoral component derived from the conceptual structure shown in FIGS. 4 to 8 as viewed from the external femoral condyle side.
  • FIG. 10 is an explanatory diagram showing a configuration derived from the conceptual configuration shown in FIGS. 4 to 8 and viewed from the side where an actual femoral component is attached to the femur.
  • FIG. 11 is an explanatory diagram showing a configuration in which the frontal plane of the actual femoral component when the bending angle is 0 ° is viewed from the posterior condyle side.
  • FIG. 12 is a trihedral view showing the positional relationship between FIGS. 9 to 11.
  • FIG. 10 is an explanatory diagram showing a configuration derived from the conceptual configuration shown in FIGS. 4 to 8 and viewed from the side where an actual femoral component is attached to the femur.
  • FIG. 11 is an explanatory diagram showing a configuration in which the frontal plane of
  • FIG. 13A is a diagram illustrating the movement of the posterior condyle of the posterior condyle of the femoral endocondyle of the femoral component in the knee flexion and extension movement with respect to the tibial component when viewed from the opposite side to FIG. 9.
  • 10 is an explanatory diagram showing movement when viewed from the right side.
  • FIG. 13B is an explanatory diagram illustrating movement of the posterior condyle of the condyle when FIG. 13A is viewed from the side where the femoral component is attached to the femur.
  • FIG. 13B is an explanatory diagram illustrating movement of the posterior condyle of the condyle when FIG. 13A is viewed from the side where the femoral component is attached to the femur.
  • FIG. 14A is an explanatory diagram of the movement relationship of the posterior condyle of the posterior condyle on the femoral component side in the knee flexion and extension movement with respect to the tibial component when viewed from the same side as FIG. 9.
  • FIG. 14B is an explanatory diagram showing a movement state of each of the ball centers in the posterior condyle of the femoral component and the posterior condyle of the external condyle as viewed from the side where the femoral component is attached to the femur.
  • FIG. 15 is an explanatory diagram showing the state of the ground contact surface where the posterior condyle part contacts the tibial component in the trajectory of the posterior condyle part in FIG. 14B.
  • FIG. 16 is an explanatory diagram showing the relationship between the bending angle of the femoral endocondyle and the tibial arthroplasty surface.
  • FIG. 17A is a diagram showing a joint surface shape in a tibial component.
  • FIG. 17B is a cross-sectional view taken along line A-A ′ shown in FIG. 17A.
  • FIG. 17C is a cross-sectional view taken along line B-B ′ shown in FIG. 17A.
  • FIG. 17D is a cross-sectional view taken along the line C-C ′ shown in FIG. 17A.
  • FIG. 17E is a cross-sectional view taken along the line D-D ′ shown in FIG. 17A.
  • FIG. 17A is a diagram showing a joint surface shape in a tibial component.
  • FIG. 17B is a cross-sectional view taken along line A-A ′ shown in FIG. 17A.
  • FIG. 17C is a cross-sectional view taken along
  • FIG. 18 shows the contact of the posterior condyle of the inner condyle formed by the contour line of the posterior condyle of the inner condyle in the state when the bending angle is 0 ° and the posterior condyle of the inner condyle when the bending angle is 0 °.
  • Explanatory drawing which looked at the state which the tibial component which has a surface, and the posterior condyle of the state in the state when the said bending angle exceeds 90 degrees contact
  • FIG. 19 is an explanatory diagram illustrating the relationship between the center line of the inner and outer condyles connecting the knee flexion / extension movement and the posterior condyle sphere center and the posterior condyle sphere center of the condyle on the frontal plane.
  • FIG. 20 is an explanatory diagram showing the relationship between the knee flexion / extension motion and the knee flexion / extension axis in the frontal plane.
  • FIG. 21 is an explanatory diagram showing the position of the patella component connected to the femoral component.
  • FIG. 22 is an explanatory diagram showing an example in which the contour line of the femoral endocondyle of the femoral component is approximated on the XY coordinates with the lowest point of the medial posterior condyle fitting circle when the bending angle is 0 ° as the origin. is there.
  • FIG. 23 shows an example in which the outline of the femoral condyle of the femoral component is approximated on the XY coordinates with the lowest point of the posterior condylar sphere PC when the bending angle is 0 ° as coordinates (2, 3). It is explanatory drawing shown.
  • FIG. 24A is an explanatory diagram showing the functional axes of the femur and tibia when the degree of flexion is 0 °.
  • FIG. 24B is an explanatory diagram showing the functional axes of the femur and tibia in the deep bent state.
  • the artificial knee joint replacement component of the present invention includes a femoral endocondyle having a substantially hemispherical posterior condyle that contacts the tibial component during flexion and extension, and the tibial component and the tibial component during flexion and extension.
  • the frontal plane, horizontal plane, and sagittal plane used in the present embodiment indicate the respective planes assuming that the artificial joint replacement component is mounted on a human knee joint.
  • FIG. 2 is a left side view (viewed from the outside of the left leg) showing the femoral condyle LC of the femur Fem of the knee joint of the left leg.
  • FIG. 3 is a right side view (viewed from the inside of the left leg) showing the femoral endocondyle MC of the femur Fem of the knee joint of the left leg.
  • the femoral outer condyle LC and the femoral condyle MC of the femur Fem are viewed from the outside in FIG. 2 and from the inside in FIG.
  • the posterior condyle MPC of the femoral condyle MC and the posterior condyle LPC of the femoral condyle LC, which are also shown in FIG. 1, are the knee joint, the lateral side in FIG. 2 and the medial side in FIG.
  • the portion that abuts on the tibia Tib can be approximated to a substantially circular semicircle, and precisely, the lower half is a part of a perfect hemisphere and the upper half is a part of an elliptical hemisphere. Can be thought of as an approximately elliptical hemisphere.
  • FIG. 4 shows the basic conceptual configuration of the femoral condyle LC of the femoral component FCN having the same shape as the shape approximated at the portion of the femoral fem condyle LC shown in FIG. It is explanatory drawing which shows the figure which looked at from the side.
  • the posterior condyle LPC located on the right side of FIG. 4 and the anterior condyle LAC located on the left side of FIG. 4 are integrally formed.
  • the posterior condyle LPC portion of the external condyle can be approximated to a shape made up of a part of a perfect semicircle and a part of an ellipse, and more specifically, the lower half is a perfect hemisphere.
  • the shape is a part, and the upper half is a part of an elliptical hemisphere.
  • the part of the anterior condyle condyle LAC is formed by inclining an ellipsoid having the same short diameter as that of the posterior condyle LPC of the external condyle by approximately 8 ° posteriorly. It is the shape connected with.
  • the spherical surface of the part where the posterior condyle LPC at the bend angle 0 ° to the bend angle 90 ° and the posterior condyle contact surface TLG of the tibial component TCN abuts The spherical center of the true sphere when assumed to be a part of the outer condyle is the posterior condyle sphere center DO1, and the posterior condyle sphere center DO1 of the posterior condyle LPC and the ellipse of the anterior condyle LAC
  • a line connecting the apex in the long axis direction of the body is defined as an external condylar longitudinal axis AX1.
  • the anterior condyle condyle portion short axis AX3 of the anterior condyle condyle LAC is located forward of the posterior condylar axis AX4 (of the human body).
  • the anterior condyle condyle short axis AX3 is inclined backward by approximately 8 ° with respect to the posterior condylar axis AX4.
  • the case of 8 ° is shown, but the external condylar longitudinal axis AX1 is inclined backward with respect to the horizontal plane in the state of the bending angle of 0 °, and the angle is generally in the range of 6 ° to 11 °. It is.
  • FIG. 5 is a side view of the basic conceptual configuration of the femoral endocondyle MC of the femoral component FCN having the same shape as the shape approximated in the portion in contact with the tibia Tib of the femoral endocondyle MC shown in FIG. It is explanatory drawing which shows a figure. As shown in FIG. 5, when the angle is set clockwise from the bending angle of 0 °, the point indicated by each angle is the lowest point when the knee bends at that angle.
  • the joint surface shape of the anterior condyle MAC located on the right side of FIG. 5 can be approximated as a part of an approximately ellipsoid.
  • the posterior condyle MPC located on the left side of FIG. 5 can be approximated to a semicircular semicircular shape like the posterior condyle LPC of the external condyle LC of the femur.
  • the shape is a part of a perfect hemisphere, and the upper half is a part of an elliptical hemisphere.
  • the diameter of the sphere of the posterior condyle MPC located on the left side in FIG. 5 is constant and hardly changes when the bending angle is 0 ° to 90 °, but the bending angle is larger than 90 °. Then, the shape is gradually shortened.
  • the surface of the tibial component TCN comes into contact with the surface of the upper half of the elliptical hemisphere of the posterior condyle MPC of the femoral endocondyle MC due to the change in the bending angle.
  • the position of the heart moves (eccentric).
  • the spherical surface of the portion where the posterior condyle MPC of the internal condyle and the posterior condyle contact surface TMG of the tibial component TCN contact at the bending angle of 0 ° to 90 ° is a true sphere.
  • the spherical center of the true sphere when assumed to be a part of the inner condyle is the posterior condyle sphere center DO2, and the posterior condyle centroid DO2 when the bending angle is 0 ° and the femoral condyle MC.
  • a line connecting the leading edge of the anterior condyle portion MAC is defined as an anteroposterior axis AX2.
  • the short axis passing through the lowest point of the anterior condyle MAC of the femoral condyle MC is on the same line as the posterior condylar axis AX5 passing through the lowest point when the bending angle is 0 °.
  • FIG. 6 shows the posterior condyle LPC of the femoral condyle LC and the posterior condyle MPC of the femoral endocondyle MC approximated to a substantially elliptical shape when the bending angle is 0 °. It is the figure seen from the posterior condyle part LPC side of the femoral condyle LC.
  • 7A and 7B are views showing the positional relationship between the posterior condyle MPC of the femoral endocondyle MC and the posterior condyle LPC of the femoral condyle LC in FIG.
  • FIG. 7A shows a substantially circular shape of the posterior condyles in the femoral condyle and the external femoral condyle of the femoral component when the femoral component of the left leg is viewed from the back side of the human body when the bending angle is 0 °.
  • FIG. The circle located on the left side of FIG. 7A is the posterior condyle LPC of the femoral condyle LC, and the circle located on the right side is the posterior condyle MPC of the femoral intracondyle MC.
  • FIG. 7B is a schematic view of the posterior condyles in the femoral condyle and the femoral condyle approximated to be substantially circular in FIG.
  • the component for total knee arthroplasty according to the present invention is such that each time the posterior condyle MPC of the endocondyle increases from a certain flexion angle, the posterior condyle in the femoral component FCN from the posterior condyle sphere center DO2 of the femoral component.
  • the part MPC has a contour shape in which the diameter to the lowest point at which it comes into contact with the posterior condyle contact surface TMG is shortened.
  • the posterior condyle LPC in the femoral component FCN abuts on the posterior condyle of the external condyle from the posterior condyle ball center DO1. It has a contour shape in which the diameter to the lowest point in contact with the surface TLG is shortened.
  • the shape of the frontal face when the bending angle is 0 ° is a perfect circle in which the portion corresponding to the distal portion (lower half) is a half of a true sphere.
  • the portion corresponding to the proximal portion (upper half) can be approximated to an ellipsoidal hemisphere (hemisphere) in which the ellipsoidal sphere (long sphere) is halved. It can be approximated to an approximately elliptical sphere with the same major axis of the elliptical hemisphere.
  • the shape seen from the proximal end side of the posterior condyle MPC of the internal condyle of the femoral condyle MC and the posterior condyle LPC of the external femoral condyle LC when the bending angle is 0 °. Can approximate a true sphere. That is, the rotational ball center in the posterior condyle MPC of the femoral endocondyle MC is not decentered from the bending angle of 0 ° to 90 ° when it is bent in contact with the tibia, but the bending angle If it exceeds 90 °, it will be eccentric. This is the first finding of the inventor.
  • the shape of the posterior condyle MPC of the femoral endocondyle MC in the portion that contacts the tibial component TCN is such that the lower half is the perfect hemisphere, the upper half is the elliptical hemisphere, and the bending angle From 0 ° to 90 °, the surface of the perfect hemisphere is in contact with the surface of the tibial component TCN, and from 90 ° to 180 °, the flat surface of the elliptical hemisphere whose diameter continuously decreases Abuts the surface of the tibial component TCN.
  • the posterior condyle LPC of the outer condyle LC of the substantially elliptical sphere is shown, but it may be approximated to a substantially true sphere.
  • the basic shapes of the posterior condyle MPC and the posterior condyle LPC can be shown as spheres, but they are not true spheres.
  • the outline of the distal part is a perfect circle, but in the proximal part, the minor axis is an ellipse shorter than the radius of the circle.
  • the length of the minor axis of this ellipse is the same as the diameter of the circle, so that its center coincides with the center of the perfect circle. In other words, it is as follows.
  • the posterior condyle centroid DO2 of the posterior condyle MPC of the endocondyle MC of the femoral condyle MC and the posterior condyle sphere of the posterior condyle LPC of the external condyle LC of the femoral condyle LC are shown.
  • the posterior condyle condyle ball center DO1 in the posterior condyle LPC of the femoral condyle LC when the bending angle is 0 ° is It is located behind the inner condyle posterior condyle ball center DO2 in the posterior condyle MPC of the intraosseous condyle MC (back side of the knee joint). Further, when viewed from the end surface on the femoral condyle LC side, the posterior condyle LPC of the femoral condyle LC is located in a state that does not protrude from the outline of the posterior condyle MPC of the femoral condyle MC.
  • two spheres (the external condyle posterior condyle LPC and the internal condyle posterior condyle) from any one of the bend angles between the bend angles 135 ° to 150 ° and the bend angle exceeding 150 °.
  • the contour of the surface of the part MPC is substantially the same.
  • a shape is shown in which the contours of the surfaces of the two spheres are substantially the same over the bending angle of 135 ° to 150 °.
  • the length of the center line AX6 between the inner and outer condylar spheres connecting the posterior condyle sphere center DO1 of the posterior condyle LPC and the posterior condyle center DO2 of the posterior condyle MPC of the inner condyle is as follows. Is always constant.
  • the posterior condyle MPC and the posterior condyle LPC shown in FIG. 7A are not strictly true spheres, but are located at the distal half (lower half) of the round hemisphere and proximal to the sphere. It approximates to a shape combining the elliptical hemisphere of the part (upper half).
  • the diameter of the perfect hemisphere (lower half) in the distal part and the major axis of the elliptical hemisphere (upper half) in the proximal part are the same, but the minor diameter of the elliptical hemisphere (upper half) Is shorter than the diameter of the perfect hemisphere (lower half).
  • the broken lines shown in the upper part of the posterior condyle part MPC and the posterior condyle part LPC shown in FIG. 7A are obtained by inverting and transferring the respective perfect hemispheres to the upper part. As shown in FIG.
  • a virtual sphere obtained by moving the posterior condyle portion MPC of the internal condyle to the outside along the horizontal plane by the distance of the center line AX6 between the internal and external condyles is a virtual internal condyle VMC
  • the outline of the virtual internal condyle VMC is a dotted line It shows with.
  • the virtual inner condyle VMC ball center is assumed to be the virtual inner condyle ball center DO3, the virtual inner condyle ball center DO3 of the virtual inner condyle VMC, and the outer condyle of the outer condyle posterior condyle LPC.
  • a line FPL connecting the end point of the posterior condyle MPC and the virtual condyle VMC is parallel to the frontal plane line or the horizontal bottom line.
  • the joint surfaces of the perfect hemisphere and the elliptical hemisphere of the posterior condyle LPC and the virtual condyle VMC are the same plane. Therefore, the posterior condyle sphere center DO1 and the virtual inner condyle sphere center DO3 are on the same plane.
  • the virtual endocondylar sphere DO3 is located on the axis viewed from the external condyle posterior condyle sphere DO1 perpendicular to the frontal plane, in FIG.
  • the heart DO3 can be seen as the same point.
  • the center-to-center line AX6 of the inner and outer condyles is connected to the inner condylar posterior condyle sphere DO2 of the posterior condyle MPC and the virtual inner condylar sphere DO3 of the virtual inner condyle VMC.
  • the knee flexion and extension axis AX66 can be indicated by the same line.
  • the inner diameter of the posterior condyle LPC of the external condyle is shorter than the internal diameter of the posterior condyle MPC of the internal condyle, and the center line AX6 between the internal and external condylar spheres when the bending angle is 0 ° is the horizontal line HL. Since it is parallel, if the line connecting the most distal points (the lowest point of the lower hemisphere) between the posterior condyle part MPC and the posterior condyle part LPC is the distal condyle line DCL, the distal condyle line DCL is in a state of being inclined (varus) against the posterior condyle LPC side with respect to the horizontal line HL. As shown in FIG.
  • the posterior condyle line PCL is the femoral endocondyle.
  • the last point of the MC and the external femoral condyle LC abuts, which means that the femoral endocondyle MC and the femoral external condyle LC of the femoral component FCN at the upper end of the tibial component TCN when the bending angle is 0 °
  • the plane on which the abuts are also inversion, but the degree is smaller than the degree of the distal condyle line DCL and the horizontal line HL.
  • the center-to-center line AX6 between the inner and outer condyles and the surgical epicondylar line SEL maintain a parallel relationship with each other.
  • the surgical epicondylar line SEL will be described.
  • the points protruding in the lateral direction of the femoral inner condyle and the outer femoral condyle are respectively mp (inner Condyle protrusion) and lp (external condyle protrusion).
  • the femoral origin of the lateral collateral ligament which is the outside of the knee joint, is a convex portion lp that protrudes only at one location.
  • the origin of the collateral ligament which is the inside of the knee joint, has a horseshoe shape so as to surround the edge of the internal condylar groove ms.
  • the straight line connecting the lp and the mp is referred to as a clinical epicondylar line (CEA), and the straight line connecting the lp and the ms is referred to as a surgical epicondylar line (SEL).
  • CEA clinical epicondylar line
  • SEL surgical epicondylar line
  • the posterior condyle MPC and the posterior condyle LPC of the external condyle can be approximated to a substantially spherical shape. Since the posterior condyle MPC and the virtual condyle VMC move on the same plane, the knee flexion / extension axis AX66 is parallel to the frontal plane line CL (FPL) in FIG. 7B, and in FIG. Parallel to HL. At this time, the posterior condyle sphere center DO1 is located behind the virtual condyle sphere center DO3. For this reason, the center-to-center line AX6 between the inner and outer condyles is distorted. Note that FIG. 7B can also be regarded as a frontal face when the bending angle is 90 °, and in this case, the frontal face line FPL can be replaced with a horizontal line HL.
  • FIG. 8A is an explanatory view of the positional relationship between the femoral condyle MC and the femoral condyle LC in the femoral component FCN as viewed from the side where the femoral component FCN is attached to the femur Fem.
  • FIG. 8B is an explanatory view of the positional relationship between the femoral condyle MC and the femoral condyle LC in the femoral component FCN as viewed from the femoral condyle LC side.
  • the external condylar longitudinal axis AX1 of the femoral condyle LC is parallel to the sagittal direction line, while the internal condylar longitudinal axis AX2 of the femoral internal condyle MC is the sagittal plane (external condylar longitudinal axis AX1). )
  • the center line AX6 between the inner and outer condylar spheres connecting the posterior condyle sphere center DO1 of the posterior condyle LPC and the posterior condyle center DO2 of the posterior condyle MPC of the inner condyle. Is parallel to the surgical supracondylar line SEL.
  • the external condyle longitudinal axis AX1 of the femoral condyle LC tilts backward with respect to the internal condylar longitudinal axis AX2 of the femoral endocondyle MC.
  • the external condyle longitudinal axis AX1 is tilted by 8 ° with respect to the internal condylar longitudinal axis AX2, but as described above, the external condylar longitudinal axis AX1 is generally Since the tilt is 6 ° to 11 ° backward, the tilt of the external condylar longitudinal axis AX1 can be set as appropriate.
  • FIG. 9 is an explanatory diagram showing a side structure of the actual femoral component FCN as seen from the external femoral condyle LC side, derived from the conceptual structure shown in FIGS.
  • the range of range of motion that can be guided by replacement with an artificial knee joint is set to the flexion angle of 0 ° (extension state) to 135 °, but the joint surface smoothly moves to the proximal posterior condyle joint surface. In fact, it is assumed that 150 ° bending is possible.
  • FIG. 10 is an explanatory diagram showing a configuration derived from the conceptual configuration shown in FIGS. 4 to 8 and viewed from the side where the actual femoral component FCN is attached to the femur.
  • the external condylar longitudinal axis AX1 of the femoral condyle LC when the bending angle is 0 ° is parallel to the femoral sagittal line SL
  • the internal condylar longitudinal axis AX2 of the femoral internal condyle MC is Converge 20 ° forward with respect to the femoral sagittal line SL.
  • the femoral sagittal line SL refers to a horizontal line on the femoral sagittal plane that is parallel to the median sagittal plane and equally divides the femoral component FCN left and right.
  • the center line AX6 between the inner and outer condylar spheres connecting the posterior condyle sphere center DO1 of the posterior condyle LPC and the posterior condyle center DO2 of the posterior condyle MPC of the endocondyle is as described above.
  • FIG. 11 is an explanatory diagram showing a configuration in which the frontal plane of the actual femoral component FCN is viewed from the posterior condyle side when the bending angle is 0 °.
  • the femoral component FCN according to the present embodiment has a range of motion of the knee joint when the artificial knee joint of the present invention is mounted, and the flexion angle is 0 ° to 150 °.
  • the replacement coating with the artificial material has the bending angle of 0 ° to 135 °.
  • FIG. 12 is a trihedral view showing the positional relationship between FIGS. 9 to 11.
  • the femoral sagittal line SL and the perpendicular VL are shown as lines on the femoral sagittal plane.
  • FIG. 13A shows the movement of the posterior condyle condyle ball center DO2 of the posterior condyle MPC of the femoral endocondyle MC of the femoral component FCN from the opposite side to FIG.
  • FIG. 10 is an explanatory view showing movement when viewed from the right side.
  • FIG. 13B is an explanatory diagram showing movement of the posterior condyle sphere center DO2 when FIG. 13A is viewed from the side where the femoral component FCN is attached to the femur.
  • the surface of the tibial component TCN is between the bending angle 0 ° and the bending angle 90 °.
  • the portion that abuts is the surface portion of the perfect hemisphere, and the posterior condyle sphere center DO2 maintains the same position as the bending angle of 0 °.
  • the portion that contacts the surface of the tibial component TCN becomes the surface portion of the elliptical hemisphere. Move down. However, the position of the lowest point P of the femoral condyle MC is the same at all the bending angles.
  • the movement of the posterior condyle sphere center DO2 does not affect the position of the lowest point P at all.
  • the diameter of the sphere of the posterior condylar MPC increases as the bending angle increases. The tendency to shorten gradually becomes remarkable.
  • the posterior condylar sphere center DO2 of the endocondyle is the highest point on the anteroposterior axis AX2 in the horizontal state when the bending angle is 0 °.
  • FIG. 14A is a diagram illustrating the movement relationship of the posterior condyle condyle LDO of the posterior condyle LPC on the femoral component FCN side in the knee flexion and extension movement with respect to the tibial component TCN when viewed from the same side as FIG.
  • FIG. 14B is a diagram illustrating movement states of the respective ball centers in the posterior condyle MPC and the posterior condyle LPC of the femoral component FCN as viewed from the side where the femoral component FCN is attached to the femur.
  • FIG. 15 is an explanatory diagram showing a state of the ground contact surface where the posterior condyle LPC contacts the tibial component TCN in the locus of the posterior condyle LPC in FIG. 14B.
  • the contour lines of the posterior condyle MPC and the posterior condyle LPC are strictly elliptical from the state of a perfect circle when the bending angle exceeds 90 °. Although it becomes a shape, in FIG. 14B and FIG. 15, it demonstrates by a perfect circle shape. As described in detail with reference to FIG. 6, as shown in FIG.
  • the posterior condyle condyle ball center DO1 of the posterior condyle LPC at the bend angle 0 ° has the bend angle 0 °.
  • the posterior condyle posterior condyle MP2 is located on the same horizontal plane as the posterior condyle sphere center DO2 of the endocondyle, and therefore, the posterior condyle sphere center DO1 and the posterior condyle centroid DO2 are connected to each other.
  • the sphere center line AX6 is a horizontal line.
  • the posterior condyle sphere center DO1 of the posterior condyle LPC of the external condyle is positioned posterior to the posterior condyle center DO2 of the posterior condyle MPC of the internal condyle.
  • the femoral condyle LC moves in the distal direction as it bends. For this reason, the posterior condyle sphere center DO1 of the femoral condyle LC must move in the posterior distal direction with bending.
  • the most distal point of the femoral condyle MC maintains the lowest point P regardless of the bending angle, and the posterior condyle of the external condyle Since the LPC moves as shown in FIG. 14A, the heights of the most distal point of the posterior condyle LPC and the most distal point of the femoral condyle MC finally become the bending angles of 135 ° to 150 °. Will be the same from anywhere in between.
  • the sphere of the posterior condyle MPC shown on the right side of FIG. 14B has a diameter at a portion of the frontal plane that abuts against the tibial surface.
  • the diameter gradually decreases to 150 °.
  • the femoral component FCN is viewed from the side on which the femoral component is mounted, it is always the same. Since the surface is seen, keep the maximum diameter.
  • the height of the lowest point of the condylar posterior condyle MPC remains constant and remains the same, while the condylar posterior condyle ball center DO2 moves in the posterior distal direction.
  • the center line AX6 between the inner and outer condylar spheres which is the distance between the posterior condyle sphere center DO2 of the posterior condyle MPC and the posterior condyle sphere center DO1 of the posterior condyle LPC, is constant.
  • the posterior condyle centroid DO1 of the posterior condyle LPC is distanced from the posterior condyle centroid DO2 of the posterior condyle MPC of the posterior condyle MPC as the knee is bent. Moves rearwardly and distally along an arc that hardly changes. Due to the movement of the femoral external condyle LC including the posterior condyle LPC associated with the flexion of the knee, the internal rotation of the femur, and the tibial external rotation when viewed from the tibia, are generated.
  • FIG. 16 is an explanatory view showing the relationship between the bending angle of the femoral endocondyle MC and the tibial joint formation surface. From 0 ° to 90 °, the lowest point of the posterior condyle MPC is the fixed point. However, as the bend angle becomes larger than 90 ° with bending, The diameter of the condyle MPC is shortened. When the depth of intrusion of the femoral fem of the femur Fem with respect to the tibial surface of the femoral condyle MC at the bending angle of 0 ° is 5 mm, the influence of the difference in diameter on the contact surface hardly occurs up to the bending angle of 90 °. However, when the bending angle is 90 ° or more, the diameter of the posterior condyle MPC is shortened, so that the posterior condyle sphere center DO2 is decentered and the posterior movement of the posterior condyle center DO2 occurs.
  • FIG. 17A is a diagram showing a joint surface shape in the tibial component TCN.
  • FIG. 17B is a cross-sectional view taken along line A-A ′ shown in FIG. 17A.
  • FIG. 17C is a cross-sectional view taken along line B-B ′ shown in FIG. 17A.
  • FIG. 17D is a cross-sectional view taken along the line C-C ′ shown in FIG. 17A.
  • FIG. 17E is a cross-sectional view taken along the line D-D ′ shown in FIG. 17A.
  • the posterior condyle sphere center DO1 of the posterior condyle LPC of the external condyle is posterior to the posterior condyle center DO2 of the posterior condyle MPC of the posterior condyle MPC.
  • the influence of the positional shift in the front-rear direction between the posterior condyle sphere center DO1 and the posterior condyle sphere center DO2 continues to the bending angle of 90 °.
  • the bending angle is 90 ° or more
  • the diameter of the femoral internal condyle MC of the femoral component FCN at the contact surface with the tibial component TCN is shortened, and the femoral component FCN is further out of the femoral component FCN.
  • the fall occurs with bending.
  • the shape of the surface of the tibial component TCN with which the femoral component FCN abuts needs to be a shape that allows the femoral component FCN to bend and extend.
  • the femoral component condyle MC of the femoral component FCN is in contact with the posterior condyle contact surface TMG, which is a portion that contacts the tibial component TCN.
  • the opening shape of the inner condyle posterior condyle contact surface TMG is substantially elliptical.
  • the external condyle condyle contact surface TLG that is the portion where the femoral condyle LC of the femoral component FCN contacts the tibial component TCN.
  • the opening shape of the posterior condyle contact surface TLG is centered on the femoral intracondyle MC of the femoral component FCN, which is the trajectory of the femoral condyle LC. It is a substantially oval shape curved in a substantially arc shape.
  • the posterior condyle contact surface TLG of the external condyle is a substantially elliptical arc-shaped opening centered on the contact point that contacts the lowest point of the posterior condyle MPC on the posterior condyle contact surface TMG. .
  • the depth of the external condyle posterior condyle contact surface TLG becomes deeper toward the rear. This is because the femoral condyle LC of the femoral component FCN shown in FIG. 14A rotates while tilting backward during the flexion and extension movement.
  • the depth of the posterior condyle contact surface TMG of the internal condyle is deepest at the position where the lowest point P of the posterior condyle MPC of the internal condyle of the femoral condyle MC is located.
  • the depth shape of the posterior condyle abutment surface TLG of the tibial component TCN is described in Kapandji (Reference: The Physiology of the Joint Vo1.2 Second Edition p.87 Fig.44, 45 1979). And approximate.
  • FIG. 17B shows the posterior condyle MPC formed by the contour line of the posterior condyle MPC in the state when the bending angle is 0 ° and the posterior condyle MPC in the state when the bending angle is 0 °.
  • a state in which the tibial component TCN having the abutment surface TMG and the posterior condyle MPC in the state when the bending angle exceeds 90 ° is in contact with the tibial component TCN passes through the posterior condyle sphere center DO2. It is explanatory drawing seen from the front face. As shown in FIG.
  • the posterior condyle MPC shown in FIG. 18 has a lower half of a true sphere and an upper half of an elliptic sphere when the bending angle is 0 °.
  • the contour of the lower half of the posterior condyle MPC is applied as it is as the surface of the tibial component TCN.
  • the posterior condyle MPC of the endocondyle exceeds the bending angle of 90 °, the diameters of the lower half and the upper half of the posterior condyle MPC differ from each other. Therefore, as shown by a broken line in FIG.
  • the surface of the upper half of the inner condyle posterior condyle MPC comes into contact with the edge of the contact surface TMG, and is lifted from the lowest point P by the height d. Therefore, the shape of the posterior condyle contact surface TMG of the tibial component TCN is desirably formed based on the upper half contour of the femoral component FCN. Although not shown in FIGS. 17A to 17E, a raised portion for guiding the femoral component FCN is formed between the posterior condyle contact surface TMG and the posterior condyle contact surface TLG of the condyle. May be.
  • FIG. 19 is an explanatory diagram showing the relationship between the center-to-center line AX6 of the inner and outer condyles connecting the knee flexion / rotation movement on the frontal plane and the posterior condyle sphere center DO1 and the posterior condyle sphere center DO2.
  • the posterior condyle centroid DO2 of the posterior condyle MPC of the endocondyle with bending is not changed from 0 ° to 90 °, and when the bend angle exceeds 90 °, Move back and down.
  • the center line AX6 between the inner and outer condyles is horizontal when the bend is 0 °, but always skews outward when the bend is larger than 0 °.
  • the posterior condyle sphere center DO1 of one posterior condyle LPC moves inward and downward with bending. Since the length of the center line AX6 between the inner and outer condyles is always constant, the outer femoral condyle LC rolls and rotates as the femoral inner condyle MC rolls.
  • FIG. 20 is an explanatory diagram showing the relationship between the knee flexion / extension movement and the knee flexion / extension axis AX66 in the frontal plane.
  • the knee flexion-extension axis AX66 is a line segment that connects the posterior condyle concentric sphere center DO2 of the posterior condyle MPC and the virtual endocondylar sphere center DO3 of the virtual endocondyle VMC. It becomes the knee flexion and extension axis when the bone component abuts on the tibial component and performs the flexion and extension movement. That is, the horizontal state is maintained when the bending angle is 0 ° to 90 °.
  • the knee flexion / extension axis AX66 connecting the condyle ball center DO2 and the virtual inner condyle ball center DO3 is kept horizontal. That is, the knee flexion / extension axis AX66 functions as an axis that always maintains a horizontal state, unlike the center-to-center line AX6.
  • FIG. 21 is an explanatory diagram showing the position of the patella component PT connected to the femoral component FCN.
  • 21 is an explanatory diagram showing the position of the patella component PT in the femoral component FCN shown in FIG.
  • the upper right of FIG. 21 is an explanatory view showing the positions of the femoral component FCN and the patella component on the frontal plane of the femoral component FCN shown in FIG.
  • the lower left of FIG. 21 is an explanatory view showing the position in the side view of the patella component PT when the femoral component FCN shown in FIG. 9 is at the bending angle of 90 °.
  • FIG. 21 is an explanatory view showing the position of the patella component in the frontal plane view when the femoral component FCN shown in FIG. 10 is at the bending angle of 90 °.
  • the rotation of the femoral component FCN accompanying the flexion may cause the patella component PT to be subjected to lateral stress from the inside to the outside.
  • the inner condylar longitudinal axis AX2 converges forward by 20 °. Therefore, the side stress is minimized.
  • the forward protrusion of the femoral condyle LC is less than the forward protrusion of the femoral condyle MC, the lateral stress is not applied to the patella component PT.
  • the final point of the patella component PT is the midpoint of the center line AX6 between the inner and outer condylar spheres connecting the posterior condyle sphere center DO1 and the posterior condyle center centroid DO2. It passes on a line perpendicular to the center line AX6 between the inner and outer condylar spheres.
  • the patella component PT keeps a position between the joint surfaces of the femoral condyle MC and the femoral condyle LC.
  • the femoral endocondyle MC moves forward relative to the femoral condyle LC until the flexion angle is 90 °, so that the patella component PT due to the femoral external rotation.
  • the inward movement of the motor is controlled.
  • the bending angle exceeds 90 °, the diameter of the femoral endocondyle MC is shortened. Since the femoral endocondyle MC is converged at the front and expanded at the rear, the patella component PT is not subjected to excessive lateral stress due to knee rotation. Therefore, almost no change occurs in the position of the patella component PT in the inner and outer directions (lateral direction) in the knee joint. Therefore, the last point of the patella component PT is located on the vertical line VL or the femoral sagittal line SL.
  • FIG. 22 shows an example in which the contour line of the femoral internal condyle MC of the femoral component FCN is approximated on the XY coordinates with the lowest point of the medial posterior condyle fitting circle when the bending angle is 0 ° as the origin.
  • FIG. 23 approximates the contour line of the femoral condyle LC of the femoral component FCN on the XY coordinates with the lowest point of the posterior condylar sphere PC when the bending angle is 0 ° as coordinates (2, 3).
  • a state where it is tilted by 8 ° is shown.
  • contour of the proximal portion on the posterior condyle side where the X coordinate value is positive can be expressed by the following equation (5).
  • (X-2) 2 /17.5 2 + (y-20.5) 2 /17.5 2 1 2 (5)
  • the outline of the distal part on the posterior condyle side can be expressed by the following formula (6).
  • (X-2) 2 + (y-23.5) 2 17.5 2 (6)
  • the shapes of the femoral condyle LC and the femoral condyle MC of the femoral component FCN can all be indicated by circles and ellipses. Therefore, the actual design and manufacture of each component is extremely easy.
  • FIG. 24A is an explanatory diagram showing the functional axes MA of the femur Fem and the tibia Tib when the degree of flexion is 0 °.
  • FIG. 24B is an explanatory diagram showing the functional axes MA of the femur Fem and the tibia Tib in the deep bent state. Changes in the knee flexion movement of the center line AX6 between the inner and outer condylar spheres and the knee flexion and extension axis AX66 affect the function of the lower limbs. As shown in FIG. 24A, when the bending angle is 0 °, the functional axes MA (0 °) of the femur and the lower leg are on the same line.
  • the knee flexion / extension axis AX66 is always parallel to the horizontal plane as described above, but the diameter of the posterior condyle of the femoral condyle is larger than the diameter of the posterior condyle of the external femoral condyle.
  • the distal condyle line of the femur Fem is always inclined outward and upward with respect to the femoral functional axis.
  • the tibial joint surface in contact with the femur Fem is inclined inward and downward with respect to the lower leg functional axis. For this reason, the joint surface of the knee joint is skewed from the outer upper side to the inner lower side with respect to the lower limb function axis.
  • the relationship between the contact surfaces of the femoral component and the tibial component and the lower limb function axis maintains the state. For this reason, although the thigh function axis and the crus function axis form the same straight line at the bend angle of 0 °, the thigh function axis and the crus function axis are inversion with bending. Due to the deviation between the femoral functional axis and the crus functional axis that occurs with bending, it is possible to avoid overlapping each other during deep bending. Since the relationship between the joint surfaces of the femoral component and the tibial component of the knee prosthesis also forms the above-mentioned form, the knee can be deeply bent even after the knee prosthesis is formed.
  • the lowermost point of the femoral outer condyle side of the femur descends with bending as described above.
  • the articular surface on the tibia side with respect to the femoral condyle gradually becomes a deep concave surface with bending. Therefore, the contact area on the joint surface between the femur and the tibia with respect to the femoral condyle increases with bending.
  • the external condyle side joint surface of the tibial component TCN has a negative depth corresponding to the descending amount of the posterior condylar condyle ball center DO2 due to the bending of the femoral internal condyle MC of the femoral component FCN.
  • An internal and external line that is formed as a model and that connects the posterior condyle centroid DO2 of the femoral endocondyle MC of the femoral component FCN and the posterior condyle centroid DO1 of the external femoral condyle LC.
  • the center line AX6 of the condylar sphere is parallel to the surgical epicondylar line SEL, the center line AX6 of the inner and outer condylar spheres is displaced outwardly and downward along with bending, but the knee flexion and extension axis AX66 is constantly in the horizontal position. Can maintain the lateral stability of the knees.
  • the shortening of the diameter (proximal half) of the proximal part (upper half) of the posterior condyle MPC of the femoral endocondyle MC of the femoral component FCN is achieved by maintaining the isometric length of the medial collateral ligament and the bending angle being 130 ° or more.
  • This structure is indispensable for the formation of the same contour of the femoral internal and external condyles.
  • this invention demonstrated the case where this invention was applied to the component for artificial knee joint replacement which replaces a human knee joint by surgery, this invention is not limited to this,
  • two legs The present invention can be similarly applied to a knee joint device such as a walking robot.
  • the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the invention in the implementation stage. Further, the functions executed in the above-described embodiments may be combined as appropriate as possible.
  • the above-described embodiment includes various stages, and various inventions can be extracted by an appropriate combination of a plurality of disclosed constituent elements. For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, if the effect is obtained, a configuration from which the constituent requirements are deleted can be extracted as an invention.
  • a femoral endocondyle having a substantially semi-elliptical spherical inner condyle posterior condyle that contacts the tibial component during flexion and extension, and a substantially semi-elliptical ectocondylar posterior condyle that contacts the tibial component during flexion and extension.
  • the posterior condyle of the internal condyle when the spherical surface of the part where the posterior condyle of the internal condyle and the posterior condyle of the internal condyle abut at a flexion angle of 0 ° to 90 ° is assumed to be a part of a true sphere.
  • the sphere of the sphere is the posterior condyle centroid
  • the spherical surface of the posterior condyle of the external condyle where the posterior condyle of the posterior condyle and the abutment surface of the posterior condyle contact at a flexion angle of 0 ° to 90 ° is assumed to be a part of a true sphere.
  • the posterior condyle of the femoral component When the sphere of the true sphere is a posterior condyle centroid, Each time the posterior condyle of the internal condyle is increased from a certain bending angle, the posterior condyle of the femoral component from the posterior condyle of the femoral component and the posterior condyle contact surface of the internal condyle It has a contour shape that shortens the diameter to the lowest point where it abuts, Each time the posterior condyle of the external condyle increases from a certain bending angle, the posterior condyle of the external condyle in the femoral component is brought into contact with the posterior condyle contact surface of the external condyle.
  • An artificial knee joint replacement component having a contour shape in which a diameter to a lowest point of contact is shortened.
  • ⁇ 3> A substantially elliptical arc-shaped opening centered on a contact point where the posterior condyle contact surface of the external condyle contacts the lowest point of the posterior condyle portion of the posterior condyle of the internal condyle posterior condyle.
  • the component for artificial knee joint replacement according to any one of ⁇ 1> to ⁇ 2>, wherein the component has a lowest point near one end of both ends in the length direction.
  • ⁇ 4> A line connecting the posterior condyle sphere of the posterior condyle of the femoral component and the posterior condyle of the posterior condyle of the femoral component of the femoral component.
  • the posterior condyle part of the inner and outer condyles is defined as a virtual inner condyle
  • the posterior condyle of the inner and outer condyles is defined as a virtual sphere that has moved the distance between the center lines of the inner and outer condyles.
  • the knee flexion-extension axis connecting the posterior condyle centroid and the virtual endocondyle centroid is When it is always parallel to the horizon, Assuming that the femoral component and the tibial component are mounted, in an extended state with a flexion angle of 0 °, The posterior condyle portion of the tibial component is defined with the edge of a part of a true sphere on the opposite side of the diameter-decreasing side of the contour shape of the posterior condyle portion of the endocondyle as the lowest point.
  • the posterior condyle portion of the external condyle is defined by taking the edge of a part of a true sphere opposite to the side of the reduced diameter of the contour shape of the posterior condyle portion as the lowest point, and Abut on the posterior condyle abutment surface,
  • the posterior condyle portion of the femoral component and the posterior condyle portion of the external condyle are respectively in the contour shape of the posterior condyle portion of the internal condyle and the contour shape of the posterior condyle portion of the external condyle.
  • the component for artificial knee joint replacement according to any one of ⁇ 1> to ⁇ 3>, wherein the component is rolled toward the side where the diameter is shortened and continuously contacts the tibial component.
  • the artificial body according to any one of ⁇ 1> to ⁇ 4>, wherein a line connecting the posterior condyle sphere center of the inner condyle and the posterior condyle sphere center of the outer condyle is parallel to a surgical condylar line.
  • Component for knee replacement ⁇ 6>
  • a knee joint device comprising the artificial knee joint replacement component according to any one of ⁇ 1> to ⁇ 5>.
  • femoral condyle having a posterior condyle side sphere (inner posterior condyle centroid) whose diameter to the joint lowest point is shortened as the angle increases from a certain bending angle; and A femoral component forming an external condyle (femoral condyle) having a posterior condyle side sphere (flexion posterior condyle sphere) whose diameter to the joint lowest point by bending is constant; Internal condyle side joint surface with the lowest position of the posterior condyle side (posterior condyle of the femoral condyle) associated with knee flexion (the femoral condyle) And a tibial component formed as a negative model of the femoral condyles of the above-mentioned condyle side joint surface (the condyle posterior condyle contact surface) that moves with rotation in
  • the position of the posterior condyle side centroid descends along the perpendicular passing through the posterior condyle side centroid (the endocondyle posterior condyle sphere)
  • the joint surface of the tibial component on the outer condyle side is the posterior condyle side ball center (the posterior condyle on the inner condyle) associated with the bending of the inner condyle (the femoral condyle)
  • ⁇ 3> The posterior condyle side centroid of the femoral component (intrafemoral condyle) and the posterior condyle side centroid of the external condyle (external condyle)
  • the component for artificial knee joint replacement according to the above ⁇ 1> wherein a line connecting the external bone condyle is parallel to the surgical condylar line.
  • the internal condyle of the femoral component (the femoral internal condyle) has a posterior condyle side centroid (an posterior condylar sphere that decreases in diameter to the joint lowest point every time the angle increases from 90 ° of bending).
  • Endocondylar part having a posterior condyle side sphere (inner condyle posterior condyle sphere) whose diameter to the joint lowest point is shortened every time the angle is increased from a certain bending angle, and the joint lowest point by bending

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  • Prostheses (AREA)

Abstract

　L'invention concerne un élément pour un remplacement d'articulation de genou artificielle, comprenant : un élément fémoral ayant un condyle médial fémoral, qui a une partie de condyle postérieure médiale semi-ellipsoïde qui vient en contact avec un élément tibial pendant un mouvement de courbure et d'étirement, et un condyle latéral fémoral, qui a une partie de condyle postérieure latérale semi-ellipsoïde qui vient en contact avec l'élément tibial pendant un mouvement de courbure et d'étirement ; et l'élément tibial ayant une surface de contact de partie de condyle postérieure médiale qui vient en contact avec au moins la partie de condyle postérieure médiale, et une surface de contact de partie de condyle postérieure latérale qui vient en contact avec au moins la partie de condyle postérieure latérale. Lorsqu'en prenant la surface sphérique de la portion de la partie de condyle postérieure médiale, sur laquelle la partie de condyle postérieure médiale et la surface de contact de partie de condyle postérieure médiale sont en contact l'une avec l'autre à un angle de courbure de 0° à 90°, comme faisant partie d'une vraie sphère, le centre sphérique de la vraie sphère est déterminé comme étant un centre sphérique de partie de condyle postérieure médiale, et, lorsqu'en prenant la surface sphérique de la portion de la partie de condyle postérieure latérale, sur laquelle la partie de condyle postérieure latérale et la surface de contact de partie de condyle postérieure latérale sont en contact l'une avec l'autre à un angle de courbure de 0° à 90°, comme faisant partie d'une vraie sphère, le centre sphérique de la vraie sphère est déterminé comme étant un centre sphérique de partie de condyle postérieure latérale, la partie de condyle postérieure médiale a un contour façonné de telle sorte que le diamètre s'étendant du centre sphérique de partie de condyle postérieure médiale au point le plus bas de l'élément fémoral, sur lequel la partie de condyle postérieure médiale est en contact avec la surface de contact de partie de condyle postérieure médiale, diminue à chaque fois que l'angle de courbure augmente à partir d'un angle donné, et la partie de condyle postérieure latérale a un contour façonné de telle sorte que le diamètre s'étendant du centre sphérique de partie de condyle postérieure latérale au point le plus bas de l'élément fémoral, sur lequel la partie de condyle postérieure latérale est en contact avec la surface de contact de partie de condyle postérieure latérale, diminue à chaque fois que l'angle de courbure augmente à partir d'un angle donné.
PCT/JP2014/080733 2013-11-21 2014-11-20 Élément pour un remplacement d'articulation de genou artificielle, et dispositif d'articulation de genou WO2015076326A1 (fr)

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JP2013-241019 2013-11-21
JP2013241019A JP2017018150A (ja) 2013-11-21 2013-11-21 人工膝関節置換術用コンポーネント及び人工膝関節構造

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CN107280818A (zh) * 2016-03-31 2017-10-24 杨晨 人工膝关节置换用股骨侧假体和胫骨侧假体
CN107280817A (zh) * 2016-03-31 2017-10-24 温晓玉 股骨侧内侧、外侧单髁假体和股骨滑车假体

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WO2017167172A1 (fr) * 2016-03-31 2017-10-05 杨晨 Prothèses pour le remplacement de genou artificiel
CN107280818A (zh) * 2016-03-31 2017-10-24 杨晨 人工膝关节置换用股骨侧假体和胫骨侧假体
CN107280817A (zh) * 2016-03-31 2017-10-24 温晓玉 股骨侧内侧、外侧单髁假体和股骨滑车假体
JP2019510605A (ja) * 2016-03-31 2019-04-18 晨 楊 人工膝関節置換用プロテーゼ
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CN107280818B (zh) * 2016-03-31 2024-02-27 杨晨 人工膝关节置换用股骨侧假体和胫骨侧假体

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