CN1652734A

CN1652734A - Femoral components for knee arthroplasty

Info

Publication number: CN1652734A
Application number: CNA038108690A
Authority: CN
Inventors: 丹尼尔·F·贾斯廷; E·马洛·戈布尔
Original assignee: MedicineLodge Inc
Current assignee: MedicineLodge Inc
Priority date: 2002-05-24
Filing date: 2003-05-23
Publication date: 2005-08-10
Also published as: JP2005527294A; AU2003239872B2; GB0425295D0; CA2484522A1; ES2315044A1; GB2405347A; ES2315044B1; AU2003239872A1; EP1507495A4; CA2484522C; AU2003233691A1; CN1655739A; WO2003099106A2; JP4431491B2; JP2005527288A; JP4364792B2; CA2486552C; EP1509174A4; WO2003099159A2; EP1509174A2

Abstract

The invention relates to a thighbone knee prosthetic system repairing the machined surface of the joint at the end terminal of the thighbone, comprising a thighbone part matching with the machined joint surface and a plurality of connectors; wherein, the internal surface of the thighbone part is connected with the first connector after the thighbone part is combined with the machined joint surface and the first connector traverses through the middle lateral face or the lateral face of the machined joint surface; the thighbone part can be a one-block style system or a two-block style system. The invention also discloses how to match the thighbone components (namely, interlocking the groove with a taper or a flange part).

Description

The femoral component that is used for knee arthroplasty

Technical field

The present invention relates to a kind of femoral component that is used for complete knee joint appearance.

Background technology

In typical knee arthroplasty procedure, use surgical instruments cutting femur in order to form femoral component (being also referred to as) through the cutting femur through cutting.Femoral component typically is the form of metal cap, is installed in subsequently on the femur of cutting.This femoral component typically is designed to engage with the tibial component that is installed on the tibia of cutting.

In arthroplasty procedure, femoral component is inserted on the femur of cutting by otch.Femoral component is big more, and then needed otch is big more, has increased patient's rehabilitation duration thus, has also increased the misery relevant with operation and rehabilitation duration.

Shown in attached Fig. 1 and 2 is an embodiment who repairs with femoral component 10, and this femoral component has inner surface 12 and outer surface 14.Inner surface 12 is by the surface composition of a plurality of crossing substantially flats, and these surfaces are corresponding with the discontinuous cutting surface of femur.Inner surface 12 projections of stanchion 16a-b from engaging with the bone thigh.Stanchion 16a-b is designed to implant in the femur of cutting, thus femoral component is fixed on the femur.Outer surface 14 is connected with its joint by tibial component.

But, because stanchion is also press-fited in the femur that is fitted on through cutting from the inner surface of femoral component is protruding, increased the volume and the size of femoral component thus, thereby need when operation, offer big otch.

Therefore, need a kind of femoral component that is used for knee arthroplasty procedure, this femoral component volume not quite and not need be offered big otch when surgical operation.In addition, also need on a kind of femur that can be fixed firmly to and femoral component easy for installation through cutting.

Description of drawings

Below in conjunction with description of drawings each embodiment of the present invention.Should be realized that these accompanying drawings have only been described exemplary embodiments of the present invention, therefore can not regard as is limiting the scope of the invention.

Accompanying drawing 1 is the front perspective view of existing femoral component;

Accompanying drawing 2 is rear views of the existing femoral component shown in the accompanying drawing 1;

Accompanying drawing 3 is rear views of femoral component of the present invention, is characterised in that, the surface go up to form at least one screwed hole within it, is used to accept the connector that extends by the femur through cutting; Form with imaginary line illustrates optional second screwed hole and second connector; This connector can extend through middle part and/or sidepiece;

Accompanying drawing 4 is rear views of another femoral component of the present invention, be characterised in that, the surface is gone up and is formed at least one joint, accepts pit within it, and this pit is filled with acceptance, grafting material, is used to accept and engage the connector that at least one extends through the femur through cutting; Form with imaginary line shows optionally additional accept surface and connector;

Accompanying drawing 5 is the perspective views after the femoral component shown in the accompanying drawing 3 is installed on the femur of cutting; Be shown in phantom line optional dull and stereotyped 29 acceptance surface 66 corresponding to femoral component;

Accompanying drawing 6 is that the femoral component in accompanying drawing 3 and 5 is installed to the perspective view on the femur of cutting in the accompanying drawing 5, and connector (mainly being shown in phantom line) extends through through the femur of cutting and goes forward side by side into femoral component, thus femoral component is fixed on the femur;

Accompanying drawing 7 is side sectional views of another embodiment of femoral component, and this femoral component has inwardly outstanding flange, and as shown in the figure, this flange is installed on the femur of cutting and cuts in the respective slot of establishing, and thus this femoral component is fixed on the femur of cutting;

Accompanying drawing 8 is perspective views of femoral component, and this femoral component has the inner surface of taper, this inner surface be installed to have complementary tapered mating surface with it on the cutting femur, thus this femoral component is fixed on the femur of cutting;

Accompanying drawing 8a is the cutaway view of optional femoral component, and this femoral component has non-curved surface of cutting sth. askew, and is installed in as shown in the figure on the femur of cutting, shows that thus the femoral component with inwardly outstanding flange can have various inner surface;

Accompanying drawing 9 is perspective views of optional embodiment, and in this embodiment, femoral component is divided into two by sidepiece to the middle part;

Accompanying drawing 10 is the perspective views when femoral component is in assembled state shown in the accompanying drawing 9;

Accompanying drawing 11 is perspective views of two formula femoral components, and this femoral component has engaging tooth and is divided into two from sidepiece to the middle part;

Accompanying drawing 12 is perspective views of two formula femoral components, and this femoral component is divided into two in the past backward;

Accompanying drawing 13 is the perspective views when femoral component is in assembled state shown in the accompanying drawing 12;

Accompanying drawing 14 is the perspective views that have engaging tooth and be divided into two femoral component from front to back;

Accompanying drawing 15A-16B shows the assembling and the decomposition view of the two-piece type femoral component that the present invention is other.

The specific embodiment

Accompanying drawing 3-6 has described to use the femoral knee prosthesis system example of knee arthroplasty, and wherein femoral component slips into and arrive femoral cut place 60 (accompanying drawing 5) at an easy rate by middle part or sidepiece by otch.Subsequently, connector (for example bolt or screw) can insert by femur, up to the contact femoral component.This process has minimum invasive, and does not need and the same big otch of the parts with stanchion 16a-b shown in attached Fig. 1 and 2.Bolt, screw or other connectors are fixed firmly to femoral component on the femur of cutting, rather than only rely on compression fit.Fig. 7-8A has described to be used for the example of the

femoral component

70,80 of knee arthroplasty, matching relationship wherein, and for example mating flanges 78a-b is with groove 79a-b (accompanying drawing 7) or cooperate conical surface (accompanying drawing 8) that femoral component is remained on the femur of cutting.

Accompanying drawing 9-14 has described to be used for attachable two femoral components 102,131,161 and 191 of knee arthroplasty, and these two parts can be slipped into by otch by middle part or sidepiece easily and independently, and connects subsequently and be installed on the femoral cut part.Alternatively, wherein a part of can being connected at another part is installed to after the femur of cutting on the femoral cut part again; Two parts can install earlier, couple together subsequently again.Then, connector, for example bolt or screw can insert by femur, until the contact femoral component.Alternatively, can use bone femoral component to be joined on the femur of cutting with cement.

Connector, i.e. bolt or screw are connected to the part of femoral component on another part.This process has minimum infringement, and does not need the otch onesize with the monoblock femoral component, because a part of femoral component can be put into by otch after another part femoral component.Can use does not have independently one or more femoral component of corresponding matching with it yet, when for example only needing the part (for example tibia part) of parts in special process.

Accompanying drawing 15A-16B has described to be used for attachable two femoral components 210 of knee arthroplasty, and these two parts can be slipped into by otch by middle part or sidepiece easily and independently, connect subsequently and be installed to femoral cut partly to locate.Alternatively, wherein a part can be installed on the femoral cut part after another part is connected to the femoral cut part again.The one projection of extending from a femoral component part is connected to this part on another part.This process has minimum infringement, and does not need the otch onesize with the monoblock femoral component, because a part of femoral component can be put into by otch after another part femoral component.Use stanchion that femoral component is fixed on the femoral cut part.

Begin each femoral component is carried out detailed discussion from accompanying drawing 3,5 and 6 below.Accompanying drawing 3 is rear views of femoral knee prosthesis system 20, and this artificial limb system is used to rebuild the articular surface 64 (accompanying drawing 5) through cutting that is positioned at femur 60 terminal 62 places.As shown in Figure 5, femur 60 terminal 62 places have middle part 61 and relative sidepiece 63 through the articular surface 64 of cutting.

Artificial limb system 20 shown in the accompanying drawing 3 comprises: (i) femoral component 22 of U-shaped have (i) be suitable for through the inner surface 26 that matches of articular surface 64 of cutting and (ii) relative articular surface 24; (ii) first connector for example has the slender bolt 36 of the end of thread; And the screwed hole 32 that (iii) is formed at femoral component 22 inner surfacies 26.

Screwed hole 32 is formed in an example of the device on the inner surface 26 of femoral component 22, be used for matching with the articular surface 64 through cutting of femur 60 when femoral component 22, and when first connector 36 by through the middle part of the articular surface 64 of cutting or during sidepiece, first connector 36 is connected on the femoral component 22.

The certain angle of screwed hole 32 inclinations, this makes when femoral component 22 matches with the articular surface through cutting of femur 60, bolt 36 can be by the middle part 61 or the sidepiece 63 of articular surface 64 through cutting, so with screwed hole 32 screw-threaded engagement (referring to accompanying drawing 5-6).

Femoral component 22 comprises the medial condyle that takes the shape of the letter U substantially 28 of the lateral condyle 30 that connection takes the shape of the letter U substantially.Femoral component has leading section 35 and rearward end 37.Medial condyle 28 is connected with lateral condyle 30, has formed long and narrow seam 39 thus between medial condyle and lateral condyle.But in a further embodiment, femoral component of the present invention can only comprise lateral condyle that takes the shape of the letter U substantially or the medial condyle that takes the shape of the letter U substantially, and this depends on needed program.

Can use the optional dull and stereotyped 29 of bone thigh parts 22, think with artificial limb on the joint of complementary surface different surface areas is provided.

Accompanying drawing 3 shows that further system 20 comprises (i) optional second connector 38; And (ii) be formed on device (i.e. second screwed hole 34) on femoral component 22 inner surfacies 26, be used for matching with the articular surface 64 through cutting of femur 60 when femoral component 22, and second connector 38 passes through when the middle part of the articular surface 64 of cutting or sidepiece second connector 38 to be connected on the femoral component 22.

Alternatively, under the situation of needs, other connector can extend into forward surface, middle part and with enter another screwed hole adjacent with screwed hole 32.

Screw, bolt, pin or other securing members all are examples of connector among the present invention, can both be driven to pass femur 60 and then engage with the inner surface 26 of femoral component 22.One or more connectors 36,38 can be connected respectively to one or more holes 32,34.In one embodiment, connector is positioned on the opposite side of femoral component, as shown in Figure 3 each other.As indicated above, in a further embodiment, connector is installed to the same side (referring to accompanying drawing 4) of femoral component.Above-mentioned connector can hole (Fig. 3) maybe will be accepted by being threaded, grafting material is positioned on the inner surface 42 and engage with inner surface 26, and wherein securing member can penetrate inner surface 42 and engage, as shown in Figure 4.

Fig. 4 is the rear view of another femoral knee prosthesis system 40, comprising: (i) femoral component 41, and it has and is fit to the inner surface 42 that matches with articular surface 64 through cutting and relative articular surface 43; (ii) first connector for example has the elongated screw 52 of the end of thread; And (iii) be formed on pit 48 on femoral component 41 inner surfacies 42.

Femoral component 41 has at least one pit 48 (being engaged, accepting material 49 fills), and this pit is accepted at least one connector 52 that extends by the femur 60 through cutting; Optionally auxiliary pit 50 and corresponding connection assist 54 are shown in imaginary line.The

pit

48,50 that is filled with this kind material is formed in the another one example of the device on the inner surface 42 of femoral component 41, is used for connector is connected to femoral component.

Pit

48,50 is formed on the inner surface 26 of femoral component 22, and is filled with joint, accepts material, and for example binding agent (for example polymethyl methacrylate) or other are enough soft to accept connector but connector can be retained in wherein material.This type of is accepted, other example of grafting material comprises the flexible polymer that can accept first connector and make its distortion, for example acetal resin or polyether-ether-ketone.

In one embodiment, except use bolt or screw connect femoral component to the artificial limb, also can use bone further to strengthen bonding between femoral component and the femur through cutting with cement.Bone can and/or use in the installation process before femoral component is installed with cement.For example, after the femoral component part is connected by part, use syringe or other forms of distributing pipe between femoral component and femur, to inject the bone cement.In addition, porous or fibrous material (for example metal gauze) can inner surface 26 attached to femoral component 22 on, promote femoral component 22 and the bone growth between the femur 60 of cutting with this, and increase the bone contact surface area of cement between femoral component and femur through cutting.

Accompanying drawing 5 is that the femoral component 22 in the accompanying drawing 3 has been installed to the perspective view on the femur 60 of cutting.Be shown in phantom line optional dull and stereotyped 29 the complementation that is used to accept bone thigh parts and accept surface 66.

Accompanying drawing 6 is that the femoral component 22 in accompanying drawing 3 and 5 has been installed to the perspective view on the femur 60 of cutting in the accompanying drawing 5, and have connector 36 (representing) and extend in the femoral component 22 of going forward side by side, thus femoral component 22 is fixed on the femur 60 by femur 60 through cutting with imaginary line.This connected mode pulls to femoral component 22 tightly and is fixed on the femur 60.

Accompanying drawing 5 and 6 also shows a kind of method of rebuilding femoral surface, part as surgical procedures, comprise: (i) articular surface 64 at end 62 places of cutting femur 60 is formed on the articular surface 64 through cutting that extends between middle part 61 and the sidepiece 63 thus; The femoral component 22 that (ii) will have inner surface 26 is installed at least a portion of the articular surface 64 through cutting; (iii) make first connector 36 pass the sidepiece or the middle part of articular surface 64 through cutting; And (iv) connect first connector 36 to femoral component 22, thus first connector 36 with femoral component 22 be fastened to through the cutting articular surface 64.

In one embodiment, the operation of cutting articular surface comprises the medial condyle and the lateral condyle of cutting femur end.In accompanying drawing 5, the middle part and the lateral condyle of femur 60 are cut.As indicated above, femoral component 22 comprises the lateral condyle that takes the shape of the letter U substantially, and it is connected to the medial condyle that takes the shape of the letter U substantially.

In another embodiment, the operation of cutting articular surface 64 only comprises the medial condyle or the lateral condyle of cutting femur 60 ends 62, the medial condyle or the lateral condyle of not excising other.In this optional embodiment, femoral component is installed is comprised to the operation at least a portion of the articular surface 64 through cutting, make femoral component be configured as unicondular lateral condyle or medial condyle.

In one embodiment, sidepiece or the middle part that makes first connector 36 pass the articular surface 64 through cutting comprises: (i) hole by femur; And (ii) make first connector 36 pass this hole.Femur can be passed through and drilled getting with certain tilt angle alpha in this hole, shown in accompanying drawing 3 and 6.This hole can be by opening otch, suitably locating, use then drill bit to pass through this alignment guide spare boring, drilled therefrom getting to tubulose alignment guide spare near the skin the femur.Yet alternatively, first connector passes femur (for example, pass be used for the localized tubulose of first connector alignment guide spare) with inclination alpha and does not need to hole on femur in advance.In one embodiment, angle [alpha] is spent between the scope of about 45 degree about 15, for example about 30 degree, but can be any various angle that femoral component can be fixed on the femur.

The method of cutting femur may further include (i) makes second connector 38 (accompanying drawing 3) pass the sidepiece or the middle part of the articular surface through cutting; And (ii) connect second connector 38 to femoral component 22, thus second connector 38 with femoral component 22 be fastened to through the cutting articular surface.

As indicated above, accompanying drawing 7-8A has described the example of

femoral component

70,80, and wherein the matching relationship between femoral component and the femur through cutting remains on femoral component on the femur of cutting.The artificial limb femoral component can be other various selectable structures.

Accompanying drawing 7 is side sectional views of femoral component 70, comprises the main body 71 of U-shaped, and this main body has inner surface 73, outer surface 75, front end 77a and rear end 77b, and front-end and back-end are to the flange 78a of inner process, and 78b extends from the inner surface 73 of main body 71 respectively.As described in Figure, flange 78a-b is installed in the groove 79a in the corresponding incision femur 74, in the 79b, thus femoral component 70 is fixed on the part 72 through cutting of femur 74.In one embodiment, main body 71 has and the femoral component 22 identical or essentially identical structures shown in accompanying drawing 3,5 and 6, but has the flange 78a-b that the inner surface 73 by femoral component front and back end 77a-b inwardly stretches out.Groove 79a is formed on the anterior face 72a of femur, and groove 79b is formed on the posterior face 72b of femur.

Flange 78a-b can be by one or more joints to inner process.For example, rear flange 78b can be by the medial condyle projection, and another rear flange 78b extends from lateral condyle.Selectively, rear flange 78b can be from the middle part and lateral condyle extend.Accompanying drawing 7 is the exemplary from the rear flange 78b of the inner surface extension of lateral condyle and/or medial condyle.

Similarly, anterior lip 78a can extend from the inner surface 73 of the front end 77a of sidepiece or medial condyle, perhaps can be used as a flange from the front end of medial condyle and the front end inner surface projection of lateral condyle.

Thus, in one embodiment, femoral component 70 comprises (i) lateral condyle (being similar to the joint 30 in the accompanying drawing 3), and it has the structure that takes the shape of the letter U substantially and has inner surface 76 and opposed outer surface 77, and all extend between front end 73 and relative rear end 75 on each surface; And (ii) medial condyle (being similar to the joint 28 in the accompanying drawing 3), it has the structure that takes the shape of the letter U substantially and has inner surface 76 and opposed outer surface 77, all extend between front end 73 and relative rear end 75 on each surface, medial condyle is connected with lateral condyle, has formed long and narrow seam thus between medial condyle and lateral condyle.

The first joint flange 78a from lateral condyle or medial condyle one of at least inner surface 71 and in front end 77a projection; And second joint flange 78b by lateral condyle or medial condyle one of at least inner surface and in rear end 77b place projection.

The cooperation of flange 78a-b and groove is an example of matching relationship between femoral component 70 and the femur 74 through cutting, and this cooperation remains on femoral component 70 on the femur 74 of cutting.Other examples of this type of matching relationship comprise that independent flange is from the Subject Extension of U-shaped and enter through the single groove of cutting femur.

Like this, femoral component 70 comprises main body 71, and this main body has inner surface 73 and relative articular surface 75, and all extend between middle part and sidepiece on each surface, and inner surface 73 has the cross section that takes the shape of the letter U substantially; And have one at least, to preferably have first and second flange 78a-b outstanding to inside from the front end of main body 76 inner surfacies 73 or rear end.

Through the cutting femoral component 72 on be formed with tangent plane, its with inner surface 71 complementations, the while each complementary fit 79a-b be formed to accept each flange 78a-b.In this structure, femoral component 76 can slide on the femur 74 from sidepiece, and then flange 78a-b held by corresponding groove 79a-b on the femur 74, thus femoral component 76 is fixed on the femur 74.

The another one method that is used to rebuild femoral surface comprises: (i) articular surface of cutting femur 74 ends, form articular surface 72 thus through cutting, articular surface has front surface and rear surface, and extend between sidepiece and middle part on each surface and one of front surface and rear surface have groove 79a-b at least; And femoral component 70 is slided on the articular surface 72 of cutting, and the flange 78a-b of femoral component 70 matches with groove 79a-b, and femoral component 70 can slide into sidepiece from the middle part, also can slide into the middle part from sidepiece.

As shown in Figure 7, the step of cutting articular surface is preferably included in and forms the first and second relative groove 79a-b on the articular surface 72 of cutting, and wherein the first and second flange 78a-b of femoral component 70 are slidably mounted in the corresponding groove 78a-b, and the first and second flange 78a-b can slide into sidepiece from the middle part or slide into the middle part from sidepiece.

Accompanying drawing 8 expression femoral components 80 and the relation of the taper fit between the femur 90 of cutting, should middle matching relationship be the example of another matching relationship between femoral component 80 and the femur 90 through cutting, this cooperation remains on femoral component 80 on the taper cutting surface 88 of the femur 90 through cutting.

Accompanying drawing 8 is perspective views of femoral component 80, this femoral component has outer surface 82 and cone-shaped inner surface 84, this inner surface is installed on the femur 90 through cutting with complementary taper fit cutting surface 88 by the direction along arrow 89, thus femoral component 80 is fixed on the femur 90 of cutting.

More clearly, parts 80 comprise main body 82, and this main body 82 has inner surface 84 and relative articular surface 82, and extend between sidepiece 81 and middle part 83 on each surface.Inner surface 84 has the cross section that takes the shape of the letter U substantially and inwardly is tapered.The formation of this taper can be from the middle part to the sidepiece or from the sidepiece to the middle part.

In the embodiment shown in Figure 8, the femoral component 80 of U-shaped is formed, and wherein the U-shaped cavity that is limited by femoral component is dwindled to sidepiece by the middle part, and promptly size reduces.(in a further embodiment, the size of femoral component is reduced to the middle part by sidepiece, and inner surface 84 is shaped by matching surface).Femur 90 is cut the shape that becomes to match, and this makes that femoral component 80 is wedged on the femur 90, thereby femoral component is remained on the femur 90 when femoral component 80 slides on the bone thigh 90 along the direction of arrow 89 from sidepiece to middle part.

Such as accompanying drawing 8 reflection, the method that is used to rebuild femur 90 surfaces comprises: (i) articular surface of cutting femur 90 ends, form articular surface 88 thus through cutting, this articular surface has front surface 92 and rear surface 94, extend between sidepiece 96 and middle part 98 on each surface and one of front surface 92 and rear surface 94 are with respect to the inclination on other surface at least, and this makes front surface 92 and rear surface 94 assemble towards

sidepiece

96 and 98 places, middle part; And femoral component 80 is slided on the articular surface 88 of cutting, femoral component 80 can slide to sidepiece from the middle part, also can slide to the middle part from sidepiece.

Accompanying drawing 8a is the cutaway view of the another kind change embodiment of femoral component 80a, and it has articular surface 82a and is installed in the non-curved interior surface 84a that cuts sth. askew on the femur 86a of cutting as shown in the figure.Forward and backward flange 88a-b goes up corresponding groove 89a-b with femur 86a and matches.The femoral component with inwardly outstanding flange 88a-b shown in accompanying drawing 7 and the 8A can have various inner surface.The inner surface 84a of the femoral component shown in the accompanying drawing 8A can also be formed taper with accompanying drawing 7 similarly, and matches with the femur that is cut of complementary taper thus, as mentioned to the explanation of accompanying drawing 7.

As another feature of the present invention, accompanying drawing 9-14 has described to be used for combinative two formula femoral components 102 of knee arthroplasty, 131,161 and 191, wherein these two parts can be slipped into by otch by middle part or sidepiece easily and independently of one another, connect subsequently and be installed in femur through the cutting portion office.Alternatively, a part can be connected to after the femur of cutting at another part and be installed on the femur.Connector, for example bolt or screw can be inserted through the bone thigh, up to contacting with bone thigh parts.Fastener, for example bolt or screw partly are connected the part of femoral component with another.This process has minimum infringement, and does not need the otch onesize with the monoblock femoral component, because a part of femoral component can be put into by otch after another part femoral component.

Accompanying drawing 9 is perspective views of separated two formula femoral components 102 from the sidepiece to the middle part, and accompanying drawing 10 is for being in the perspective view of the femoral component 102 of assembled state.Femoral component 102 is designed to " final use (end use) ", be used for for good and all being installed in articular surface through cutting in the process of resurfacing, thereby be connected with the tibial component joint of tibia and/or artificial limb, this femoral component is designed to through operation and the usefulness of at least a portion of knee is replaced patient every day.

Accompanying drawing 9 has described to be used to rebuild the femoral knee prosthesis system 100 of femur end through the articular surface of cutting, and it comprises final use femoral component 102, and this femoral component has (A) inner surface 105, and this inner surface is suitable for matching with articular surface through cutting; And (B) relative articular surface 107.

The final use femoral component further comprises: (i) first promptly comprises the knee joint 103 of articular surface first area; (ii) second portion promptly comprises the tibia joint 104 of articular surface second area, and this second portion 104 can match with first 103 selectively; (iii) bolt 106,108, and it is designed to connect selectively first 103 and second portion 105.Bolt 106 and 108 is the examples that are used for being connected selectively the connecting device of first and second portion.Bolt 124 is fixed to femoral component 103 on the femur.But, also can use various additive methods that femoral component is fixed on the femur such as using bone with cement or be pressed into the stanchion that is cut in the bone thigh.In one embodiment, at least a portion knee joint 103 is corresponding to the front portion of the femur through cutting, and at least a portion tibia joint 104 is corresponding to the rear portion of the femur through cutting.

As shown in the figure, bolt 106,108 extends through each hole 110a-b, 112a-b, 114a-b, 116a-b along line of direction 118a-b, be used to connect two parts 103 and 105, thus shown in Figure 10 in conjunction with after condyle portions 103 and 105 jointly form femoral component 102.

The femoral component 102 of U-shaped separates along seam 109, and this makes femoral component 102 comprise front portion 103 and rear portion 105.At least one and preferably have first and second passage horizontal expansions that limit by hole 110a-b, 112a-b, 114a-b and 116a-b and connect anterior 103 and rear portions 105, make marquis when front portion 103 and rear portion 105 are aligned, bolt 106 and 108 can horizontal thread screws in this passage and mating part is secured together.

In the operation process of resurfacing, first and second parts 103,105 can be slipped into by otch by middle part or sidepiece easily and independently, connect subsequently and be installed in femur through the cutting portion office.Alternatively, wherein a part 103 or 105 can mating part connect and be installed to after the femur of cutting, be installed to again femoral cut partly on.

Thus, a kind of method of femoral component 102 rebuilding femoral surface of using comprises: (i) articular surface of cutting femur end forms the articular surface through cutting thus; (ii) the first 103 of final use femoral component is positioned at through on the articular surface of cutting or near, this first 103 comprises the first area of the articular surface of final use femoral component 102; (iii) the second portion 104 of final use femoral component 102 is positioned at through on the articular surface of cutting or near, this second portion 104 comprises the second area of the articular surface of final use femoral component 102; (iv) the first 103 with final use femoral component 102 is fixed on its second portion; And (v) final use femoral component 102 is connected and be fixed on the articular surface of cutting, for example by using bolt 124, screw, pin or other connecting devices.

Accompanying drawing 11 is perspective views of system 130, and this system comprises basic similarly femoral component 131, and this femoral component has engaging tooth 136,138 and separated to the middle part by sidepiece.Parts 131 comprise (i) first, promptly comprise the knee joint 132 of the first area of articular surface; (ii) second portion promptly comprises the tibia joint 134 of the second area of articular surface, and this second portion 134 is used for matching with first 132 selectively; And (iii) bolt 142,144 is designed to selectively first 132 is connected on the second portion 134 by each hole 146,148 of extend past, and other hole is not shown herein.Bolt the 142, the 144th is used for selectively first being connected to the example of the connecting device on the second portion.The example of the device that bolt 150 is resected femur parts 103 to the femur.

Opposite with the smooth joint 119 shown in the accompanying drawing 8, femoral component 131 can be formed with the seam 140 that has complementary fit tooth 136,138.In a further embodiment, for example shown in the accompanying drawing 12 and 13, first comprises the medial condyle 162 that takes the shape of the letter U substantially, and second portion comprises the lateral condyle 164 that takes the shape of the letter U substantially.

Accompanying drawing 12 is the perspective views that are divided into the femoral component 161 of two-part system 160 from front to back; Accompanying drawing 13 is perspective views that the femoral component 161 shown in the accompanying drawing 12 is in assembled state.

Femoral component 161 comprises: (i) lateral condyle 162, and it has and takes the shape of the letter U shape substantially and have side 163 and relative medial side face 166, and all extend between front end 165 and relative rear end 167 each side; (ii) medial condyle 164, and it has and takes the shape of the letter U shape substantially and have side surface 168 and relative medial side face 169, and all extend between front end 171 and relative rear end 173 each side.The side surface 168 of this medial condyle 164 is designed to match with the medial side face 166 of lateral condyle 162, makes thus to form slit 179 between the rear end of medial condyle and lateral condyle.

Bolt the 170, the 172nd when middle part joint and lateral condyle match, connects the example of medial condyle to the device of lateral condyle.Bolt 178 is fixed to femoral component 161 on the femur.But, also can use various other methods that femoral component is fixed on the femur, for example use bone with cement or be pressed into the stanchion that is cut in the femur.

Femoral component 161 is divided into two parts in centre from front to back along linear joint 180, makes femoral component 161 comprise mid portion and sidepiece part thus.Has one and preferably have first and second passage horizontal expansions that limit by hole 174a-b and 176a-b and run through middle part part and sidepiece part at least, this makes after two parts are aimed at, bolt 170,172 can be along laterally being threaded in each passage, and then two parts are secured together.

Accompanying drawing 14 is separated and is had the perspective view of the femoral component of engaging tooth from front to back.The system 190 of accompanying drawing 14 expressions comprises basic similarly femoral component 191, and this femoral component has engaging tooth 202,204, and is separated from front to back.Parts 191 comprise: (i) first promptly comprises the lateral condyle 192 of articular surface first area; (ii) second portion promptly comprises the medial condyle 194 of articular surface second area, and this second portion can match with first selectively; And (iii) bolt 196,198, it is designed to selectively first is connected on the

second portion.Bolt

196 and 198 is the examples that are used for being connected selectively the device of first and second portion.Can use bolt 206 or other methods of attachment that femoral component 191 is fixed on the femur.

As described in accompanying drawing 14, with to have linear joint opposite, femoral component 191 can be formed with the seam with the complementary engaging tooth that forms on each part.

Accompanying drawing 15A-D has shown the present invention assembly drawing and the exploded view of one or two formula femoral component in addition, and this strand thigh parts use the each several part of projection with link.These two parts can be slipped into by otch by middle part or sidepiece easily and independently, connect subsequently and be installed in femur through the cutting portion office.Alternatively, wherein a part can be connected to through the femur of cutting and after being installed on the femur, what be installed in femur again is cut the part place at another part.

Accompanying drawing 15 has been described a kind of femoral knee prosthesis system 210, be used to rebuild the articular surface that is positioned at the femur end through cutting, this system comprises: (i) the final use femoral component 211, it has (i) inner surface 215, be used for matching and (ii) relative articular surface 217 with articular surface through cutting.

Final use femoral component 211 comprises: (i) first promptly comprises the knee joint 214 of articular surface first area; And (ii) second portion, promptly comprising the tibia joint 212 of articular surface second area, this second portion 212 can match with first 214 selectively.Projection 224-230 extends from tibia joint 212, and is designed to be admitted by first 214, and first and second parts are matched.The other example of the device that stanchion 220-222 is resected femur parts 103 to the femur.

Femoral knee prosthesis system 210 further comprises

bolt

240, and 240a or screw are used for just first 214 being connected on the second portion 212 after in a single day projection 224-230 is installed to first.In one embodiment, only offer otch in knee one side.Therefore, only use one of

bolt

240 or 240a that first 214 is connected to second portion 212.

As shown in the figure, projection 224-230 extends by each hole 232,238,240 (the 4th hole is not shown), bolt 240 extends into by hole 242 and holes 244, makes bonded condyle portions 214,212 jointly form femoral component 210 thus, shown in Figure 15 B and 16B.Use projection 224-230 and at least one bolt 240 can between first 212 and second portion 214, form very strong connection.Bolt 240a extends through hole 242a and enters in the boring on the second portion 214.

As indicated above, femoral component of the present invention is slipped into by otch by sidepiece or middle part easily.In addition, femoral component of the present invention can also be easily (no matter as monoblock or two) is slipped into by the otch between sidepiece and the middle part.This femoral component is designed to be connected with tibia and/or artificial limb tibial component associated section.

It will also be appreciated that different shape mentioned above, structure and method can be mixed use and coupling forms other unique shapes, structure and method.

The disclosure of other of relevant apparatus and method of the present invention can obtain from following application: promptly, the applying date of applying for simultaneously with the present invention is on 05 23rd, 2003, the title U.S. Patent application for " ModularFemoral Components for Knee Arthroplasty (the module femoral component that is used for knee arthroplasty) ", the invention people of this application is Daniel F.Justin and E.MarloweGoble, the agency accepts numbering 13447.22.1, express delivery mailing label numbering EV203 529 702 US.The full text of this application all can be bonded to herein by reference.

The present invention can be presented as other particular forms under the situation that does not break away from its spirit or basic feature.The above embodiments should be considered to a kind of overall explanation and be not limited thereto.Protection scope of the present invention by additional claim rather than above explanation specified.All all are being comprised in the protection domain of the present invention with connotation and the change in the scope that claim of the present invention is equal to mutually.

Claims

1. one kind is used to rebuild the femoral knee prosthesis system that is positioned at the articular surface of femur end through cutting, and this artificial limb system comprises:

Femoral component, it has (i) and is suitable for the inner surface that matches of articular surface through cutting with femur; And (ii) relative articular surface;

First connector; And

The device that forms on the inner surface of femoral component is used for being coupled to femur on the articular surface of cutting and after first connector passes femur at femoral component, and first connector is connected on the femoral component.

2. femoral knee prosthesis system as claimed in claim 1, wherein, described connector is passed medial side face or the side of femur through the articular surface of cutting selectively.

3. femoral knee prosthesis system as claimed in claim 1, wherein, described first connector comprises the elongated bolt with thread head.

4. femoral knee prosthesis system as claimed in claim 1, wherein, the device that is used to connect is included in the screwed hole that forms on the femoral component inner surface, this screwed hole inclination certain angle, make after femoral component is coupled on the articular surface of femur through cutting, thereby bolt can pass medial side face or side and screwed hole screw-threaded engagement through the articular surface of cutting.

5. femoral knee prosthesis system as claimed in claim 1, wherein, the device that is used to connect is included in the pit that forms on the femoral component inner surface.

6. femoral knee prosthesis system as claimed in claim 5, wherein, the grafting material that described pit can be engaged with first connector is filled.

7. femoral knee prosthesis system as claimed in claim 6, wherein, described grafting material comprises binding agent.

8. femoral knee prosthesis system as claimed in claim 1, wherein, described femoral component comprises the lateral condyle that takes the shape of the letter U substantially that is connected with the medial condyle that takes the shape of the letter U substantially.

9. femoral knee prosthesis system as claimed in claim 1, wherein, described femoral component comprises lateral condyle that takes the shape of the letter U substantially or the medial condyle that takes the shape of the letter U substantially.

10. femoral knee prosthesis system as claimed in claim 1, wherein, described femoral component comprises:

First, this first comprises the first area of articular surface; And

Second portion, this second portion comprises the second area of articular surface, described second portion can match with first selectively;

Be used for selectively first being connected to the device of second portion.

11. femoral knee prosthesis system as claimed in claim 10, wherein, described first comprises lateral condyle, and described second portion comprises medial condyle.

12. femoral knee prosthesis system as claimed in claim 10, wherein, described first comprises anterior joint, and described second portion comprises the tibia joint.

13. femoral knee prosthesis system as claimed in claim 1 further comprises:

Second connector; And

The device that on the femoral component inner surface, forms, be used for femoral component be coupled to femur through on the articular surface of cutting and second connector pass after the medial side face or side of articular surface of cutting, second connector is connected on the femoral component.

14. one kind is used to rebuild and is positioned at the femoral knee prosthesis system of femur end through the articular surface of cutting, this articular surface through cutting has medial side face and relative side, and described artificial limb system comprises:

Femoral component, it has (i) and is suitable for the inner surface that matches of articular surface through cutting with femur; And (ii) relative articular surface; And

First connector, wherein the inner surface of femoral component is designed to, and when femoral component is coupled to femur on the articular surface of cutting and after first connector passes femur, is connected with first connector.

15. bone thigh knee prosthesis system as claimed in claim 14, wherein, described connector passes middle part or the sidepiece of femur through the articular surface of cutting selectively.

16. bone thigh knee prosthesis system as claimed in claim 14, wherein, described first connector comprises the elongated bolt with thread head.

17. bone thigh knee prosthesis system as claimed in claim 14 wherein, is formed with screwed hole on the inner surface of femoral component.

18. bone thigh knee prosthesis system as claimed in claim 14 wherein, is formed with pit on the inner surface of femoral component.

19. a method comprises:

The articular surface of cutting femur end is formed on the articular surface through cutting that extends between side and the medial side face thus;

The femoral component that will have inner surface is installed at least a portion of the articular surface through cutting;

Make first connector pass femur; And

First connector is connected on the femoral component, thus first connector with femoral component be fixed to through the cutting articular surface.

20. method as claimed in claim 19 wherein, makes connector pass femur and comprises side or the medial side face that makes first connector pass the articular surface through cutting.

21. method as claimed in claim 19, wherein, the cutting articular surface comprises the medial condyle or the lateral condyle of cutting femur end, and does not excise in addition other lateral condyle or medial condyle.

22. method as claimed in claim 19 wherein, is installed femoral component and is comprised that femoral component is unicondular lateral condyle or medial condyle.

23. method as claimed in claim 19, wherein, the cutting articular surface comprises the medial condyle and the lateral condyle of cutting femur end.

24. method as claimed in claim 19, wherein, described femoral component comprises the lateral condyle that takes the shape of the letter U substantially that is connected with the medial condyle that takes the shape of the letter U substantially.

25. method as claimed in claim 19 wherein, is passed through the side of articular surface of cutting or the step of medial side face first connector and is comprised:

On the skin of proximal femur end, offer otch; And make first connector pass femur.

26. method as claimed in claim 19 further comprises:

Make second connector pass the side or the medial side face of articular surface through cutting; And

Second connector is connected on the femoral component, thus second connector with femoral component be fixed to through the cutting articular surface.

27. a femoral component that is used to rebuild the knee prosthesis of the articular surface through cutting that is positioned at the femur end, this femoral component comprises:

Have the main body of inner surface and relative articular surface, all extend between side and medial side face on each surface, and this inner surface has the cross section that takes the shape of the letter U substantially; And

At least one is by the inwardly outstanding flange in the end of the inner surface of main body.

28. femoral component as claimed in claim 24, wherein, femoral component comprises by inwardly outstanding first flange of the leading section of the inner surface of main body with by the second inwardly outstanding flange of rearward end of the inner surface of main body.

29. a method comprises:

The articular surface of cutting femur end forms the articular surface through cutting with anterior face and posterior face thus, and all extend between side and medial side face on described surface, and at least one of anterior face and posterior face has groove; And

Femoral component is slided sliding on the articular surface of cutting, the flange of femoral component matches with above-mentioned groove, and femoral component is slided or slided to the middle part by sidepiece to sidepiece by the middle part.

30. method as claimed in claim 29, the step of wherein cutting articular surface is included in and forms the first and second relative grooves on the articular surface of cutting, and wherein first and second flanges of femoral component are slipped in the corresponding groove, and this first and second flange is slided to the middle part to sidepiece or by sidepiece by the middle part.

31. a femoral component that is used to rebuild the knee prosthesis of the articular surface through cutting that is positioned at the femur end, this femoral component comprises:

Have the lateral condyle of the structure that takes the shape of the letter U substantially, this lateral condyle has inner surface and outer surface on the other side, and all extend between leading section and relative rearward end on each surface;

Have the medial condyle of the structure that takes the shape of the letter U substantially, this medial condyle has inner surface and outer surface on the other side, and all extend between leading section and relative rearward end on each surface, and this medial condyle is connected with above-mentioned lateral condyle;

From the first outstanding joint flange of the inner surface of the leading section of lateral condyle or medial condyle at least;

And from the second outstanding joint flange of the inner surface of the rearward end of lateral condyle or medial condyle at least.

32. femoral component as claimed in claim 31 wherein forms elongated bolt between lateral condyle and medial condyle.

33. a method comprises:

The articular surface of cutting femur end forms the articular surface through cutting with anterior face and posterior face thus, and all extend between side and medial side face on each surface, forms first groove along anterior face, forms second groove along posterior face; And

Femoral component is slided to slide on the articular surface of cutting, this femoral component has inner surface and relative articular surface, femoral component is slided to the middle part from the middle part to sidepiece or from sidepiece, make thus from the first outstanding flange of the inner surface of femoral component to be accommodated in first groove, and be accommodated in second groove from the second outstanding flange of the inner surface of femoral component.

34. femoral component that is used to rebuild the knee prosthesis of the articular surface that is positioned at the femur end through cutting, this femoral component comprises the main body with inner surface and relative articular surface, all extend between side and medial side face on each surface, this inner surface has the cross section that takes the shape of the letter U substantially, and this cross section is by medial side aspect-oriented or inwardly tapered to medial side face ground by the side.

35. femoral component as claimed in claim 34, wherein, tapered inner surface is along outwards tapered to the direction at middle part by sidepiece.

36. femoral component as claimed in claim 34, wherein, tapered inner surface is along outwards tapered to the direction of sidepiece by the middle part.

37. femoral component as claimed in claim 34, wherein, the conical surface of main body is shaped as with the conical outer surface of femur through cutting and matches.

38. a method comprises:

The articular surface of cutting femur end, form taper articular surface thus through cutting with anterior face and posterior face, all extend between side and medial side face on each surface, anterior face and posterior face one of at least with respect to another surface tilt, anterior face and posterior face are assembled towards side and medial side face; And femoral component is being slided on the articular surface of cutting, this femoral component is slided to ground, middle part to sidepiece or by sidepiece by the middle part.

39. femoral component as claimed in claim 35, wherein, cone-shaped inner surface is along outwards tapered to the direction at middle part by sidepiece.

40. femoral component as claimed in claim 35, wherein, cone-shaped inner surface is along outwards tapered to the direction of sidepiece by the middle part.

41. femoral component as claimed in claim 35, wherein, the conical surface of main body is shaped as with the conical outer surface of femoral shaft and matches.