CA1193803A - Meniscus prosthesis - Google Patents

Meniscus prosthesis

Info

Publication number
CA1193803A
CA1193803A CA000390306A CA390306A CA1193803A CA 1193803 A CA1193803 A CA 1193803A CA 000390306 A CA000390306 A CA 000390306A CA 390306 A CA390306 A CA 390306A CA 1193803 A CA1193803 A CA 1193803A
Authority
CA
Canada
Prior art keywords
knee
human
meniscus
prosthetic device
flexible structure
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000390306A
Other languages
French (fr)
Inventor
Charles H. Kenny
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Dow Silicones Corp
Original Assignee
Dow Corning Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dow Corning Corp filed Critical Dow Corning Corp
Application granted granted Critical
Publication of CA1193803A publication Critical patent/CA1193803A/en
Expired legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3872Meniscus for implantation between the natural bone surfaces
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/21Silicone

Abstract

MENISCUS PROSTHESIS

ABSTRACT

A meniscus prosthetic device for a human knee joint can be inserted into the knee joint so that the articulating cartilage in the knee totally remains intact. The prosthetic device translates between the articulating cartilage during normal knee movement. Insertion of the prosthetic device is accomplished by applying force on the ends of the device, thereby elastically spreading them, and placing the device between the tibial articulating cartilage and one of the femoral condyles. The forces thus applied can then be released causing the device to conform to its original C-shape. Prominences on the ends of the device may superiorly extend into the space defined by the femoral condyles, thereby securing the device in place.

Description

3~i~
J'.. _,. 9. ~;3 MENISCUS PR~~ X~

P~ACKGROUND ANl~ SUMMARY C)F THE INVE~TION

In recent years, medical science and biological engineers have been developing prosthetic devices to repl~ce natural components of the human body. The prosthetic devices have as their primary objective the replacement of natural bodily components which may have become diseased or damaged while at the same time preserving the natural bodily fun~tion associated with the replaced organ, limb or other body component. The prosthetic replacement of natural body components should not be confused, however, with the natural tr~n~l~ntation of a s~nilar living organ, lilrib or other body component. Prosthetic devices are totally man-made, being constructed primarily of synthetic materials while transplanta-tion is concerned with the replacement of a natural body organ or component received from a human donor.
The prosthetic devices constructed primarily from such synthetic materials must7 of course7 be compatible with living human tissue and, additionally, must be capable of per-forming the bodily function of the removed natural component.
A successful prosthetic device will last for an indefinite period of time without noticeable degeneration due to the inherent properties of the synthetic materials utilized. The present invention relates to a type of prosthetic device utili~ed in a human knee. The knee is a bicondylar joint formed by the articulation between the condyles of the femur and the articular cartilage of the tibia.
Typical conventional prosthetic devices for the knee are shown in U.~. Patents 3,924,277 (Freeman et al., issued December 9, 1975), 47081,866 (Upshaw et al., issued April 4, 1978)9 47207,627 (Cloutier, issued June 17, 198n), R~. 29,757 (Helfet7 reissued September 12, 1978), and 37869,731 (Waugh et , .~

3~3~3 al., issued March 11, 1975). The major problem associ-ated ~1ith the conventional knee joint prosthetic devices is the necessity of surgically removing or altering the articulating cartilage of both the femur and tibia. Additionally, many conventional prosthetic devices require that the device be fixedly secured to the femur and tibia by means of surgical cement or the like. The necessitv for removing or altering the femoral and tibial cartilage prior to the implantation of the conventional prosthetic devices increases the cost of surgical services associated with such implantation.
A.ccording to the present invention, however, a prosthetic device for a human knee is provided such that the articulating cartilage of the femur and tibia remains totally intact. ~dditionally, the prosthetic device according to the present invention is not intended to be surgically cemented in place. The device is designed to provide a natural substitute for damaged or diseased components in the knee joint area, such as, for example, arthritic conditions, damage due to automobile or athletic injuries, and the like. The device according to the present invention can be easilv manufactured, and more effi-ciently inserted into the human knee, so that manufacturing costs and the cost of surgical services are reduced compared to the conventional prosthetic devices.
The prosthetic device according to the present invention may be manufactured in varying sizes conforming to the varying sizes of the human body and, in addition, the inherent varying size of the inner and outer condyle of the femur.
According to a broad aspect, the invention relates to a meniscus prosthetic device to prevent and reverse degenerative changes in a human knee comprising a flexible structure for replacing natural components ~ $~$~
2(a) of a condylar joint in a human knee characterized in that the structure has a general C-shape which deflnes a generally interior circular space and is cons-tructed from an elastic, self-supporting material compatible with human tissue and capable of recovering from structural deformation.
Therefore, it js a primary object of the present invention to provide a prosthetic device which may be easily manufactured and quickly positioned by surgic~l methods, without requiring the surgical removal or alteration of the femur and tibial articulating surfaces. This and other objects of the invention will become clear from an inspection of the ~ ~ o~3~

detailed description of the invention, and from the appended clai ms.

F~RI~F DESCRIP'lllON O~ T~ DRAWINGS

FIGURE, 1 is a top view of a representative medial meniscus prosthetic device for a human right knee;
~ IGURF~ 2 is a lateral view of the device of FIGURE
l;
FIGURE 3 is a medial view of the device of FIGIJRE
l;
FIGURES 4 and 5 are cross-sectional views taken along lines 4-4 and 5-5, respectively7 of FIGUR~ l;
FIGURE 6 is a posterior view of a human right knee in extension showing the device of FIGUR~ 1 and a corres-ponding lateral device in position;
FIGURE 7 is a medial view of a human right knee in extension showing the representative medial device of FIGURE
1 in position; and FIGURE 8 is a medial view of a human right knee in flexion showing the translational movement of the repre-sentative medial device of FIGURF. 1.

DETAILED DESCRIPTION O~ THE INYENl~[ON

The representative embodiment of the present invention is illustrated generally in FIGURE 1 wherein the prosthetic device for a human knee is shown as a medial device for placement in a human right knee. It should be understood that the symmetry of the human body allows for the general representative device depicted in FIGURE 1 to be capable of performing its intended function in bo-th the medial and lateral positions of a human right knee, with the devices for the left Icnee being generally a mirror image of the right knee devices.
While the basic embodiment of the present invention remains ~.$~

unchanged, the varying sizes of the human knee coupled with the inherent varying size of the inner and outer condyles requires that these variables be taken into account when sizing a de~ice of the present invention for placeTnent in a human knee. There-fore, while only the medial meniscus prosthetic device for a human rigilt knee is depicted in the drawings, it should be understood that the lateral meniscus device for the human right knee is generally a mirror image thereof, while the medial and lateral meniscus devices for a human left knee are generally mirror images of the respective deviees for a human right knee.
Referring more specificaliy to FIGURE 1, it is seen that the representative medial meniscus prosthetic device 10 generally is a C-shaped structure having the terminal ends 11, 12 in close proximity to one another and defining a space 13 therebetween. The generally circular structure of the device additionally defines an inner space 14 with ~Thich a femoral condyle interacts. The device in its preferred embodiment has two raised prominences 15, 16 on each of the terminal ends of the prosthetic device. The prominences lS, 16 can be seen more clearly in FIGURF 2 viewin~, the meniscus prosthetic device 10 from the lateral side wherein the prominences 15, 16 are noticeably raised above the general surface of the device 10.
The prominences 15, 16, when properly placed in a human knee superiorly enter the space formed by the femoral condyles and thus secure the prosthetic device in position.
AdditionaLly, the prominences 15, 16 also encourage trans-lational movement of the device over the articulating surfaces when properly positioned in the knee. Sutures 17 can be seen in FIGURE 1 at the anterior~ posterior and medial positions of the prosthetic device 10. As stated above, the prominences 15, 16 can sufficiently hold the meniscus prosthetic device 10 in proper position. However, a physician in his judgment, may wish to utilize the optional sutures 17 to further secure the meniscus prosthetic device 10 to surrounding soft tissues in the knee area. Furthermore, it is presently conceived that a meniscus prosthetic device 10 cfln be constructed without prominences 15, 16, in which case either sutures 17, fibrous tissue ingrowth inlo a porous border, or a combination -thereof, would be utilized to securely position the device.
The cross-sectional area of the exterior portion 40 of the prosthetic device 10 when viewed in FIGURE d~, is greater than the cross-sectional area of the interior portion ~2. The change in cross-sectional area is gradual. In this manner, the femoral condyle can interact with and rest in the depressed portion formed by the change in cross-sectionsl area. ~IGURE 5 is a cross-section of the device showing prominence 16 and shows the increased cross-sectional area thereof relative to the cross-sectional area of FIGURE 4.
EIGURE 6 depicts the posterior view of a human right knee joint with the medial and lateral meniscus devices 10 and 60, respectively, in proper position~ As stated above3 for the right knee, the medial meniscus device 10 is generally that depicted by FIGURES 1-3, while the lateral meniscus prosthetic device 60 for the right knee is generally a mirror image thereof.
The right knee medial device 10 generally rests between the inner condyle 61 of the right femur bone 62 and the articular cartilage 63 of the tibia bone 64. ~imilarly, the right knee lateral meniscus prosthetic device 60 is positioned between the outer condyle 65 of the right femur bone 62 and the articular cartilage 63 of the tibia 64. The prominence 16 of the medial device device and the corresponding prominence 16~ of the lateral device can be seen in FIGURE 6 as superiorly extending into the space 66 defined by the inner and outer condyles 61 and 65, respectively, of the femur bone 62. Optionally, a suture, plurality of sutures, fibrous tissue ingrowth into a porous border, or a combination thereof, may be utilized to further secure the meniscus device to the surrounding soft tissue, such as, for example, the medial collateral ligament, the lateral collateral ligament, or the like.

~3 Referring now more specifically to FIGURE 7, wherein a medial view of a human right knee in extension showing the medial meniscus prosthetic device 10 in proper position, it can be seen that the prosthetic device 10 is positioned between the inner condyle 51 of the femur bone 62 and the articular cartilage 63 of the tibia 64. It should be particularly noted that the femoral condyle articular cartilage 70 and the tibial articular cartilage 63 are intact. An optional suture 17 can be seen in FIGURE 7 as being attached to the medial collateral ligament 72 for further securement of the medial meniscus prosthetic device 10 as desired by the attending physician.
Referring to FIGURE 8, wherein a medial view of a human right knee during flexion is depicted, it can be seen that the medial meniscus prosthetic device 10 is moved posteriorly from position A to position Fs with the correspondin~ flexion of the knee. Position A and position B ~epresent the ~~ m positional m~ovement during flexion. It should, therefore9 be understood that the prosthetic device can translate to ~ny position therebetween and, additionally, slightly rotate according to the natural movement of the knee.
The prosthetic device of the present invention may be constructed from an elastic, self-supporting material, such as, for example, silicone rubber. The prosthetic device 10 can7 thus, be elastically deformed, and recover from such structural deformation readily. Therefore, in a method of inserting a meniscus prosthetic device of the present invention, and again referring to the representative medial meniscus prosthetic device 10 of FIGURE 1, opposing forces may be applied to the terminal ends 11, 12 of the prosthetic device 10 enlarging the corresponding space 13 defined between the terminal ends 11, 12. With the force thus applied, the attending physician can then insert the meniscus device between the femoral condyle and the tibial articular cartilage. When the prosthetic device lû
is properly in place, the opposing forces previously applied can ~' be released causing the prominences 15, 16 to enter the space defined by the femoral condyles. The prominences 15, 16 secure the device while, simultaneously, encouraging anterior-posterior translation of the device during knee flexion. Once again, it should be understood that the method of inserting the medial meniscus device of the right knee discussed above is also repre-sen-tative of the lateral device of the right knee and, in addition, is representative of the method utilized for inserting the medial and lateral devices for the left knee.
Thus, it can be seen that accordin~ to the present invention a meniscus prosthetic device and method of inserting same has been provided that prevent and reverse degenerative changes in the knee joint. The meniscus prosthetic device of the present invention can be easily manufactured and inserted in a patient's knee without the necessity of removing or altering the femoral articular cartilage of the condyles or the tibial articular cartilage. Furthermore, the meniscus device of the present invention freely translates over the articulating surfaces of the tibia and does not have to firmly attach thereto.
While the invention has been herein shown and des-cribed in what is presently conceived to be the most practical and preferred embodiment thereof, it will be apparent to those of ordinary skill in the art that many modifications may be made thereof within the scope of the invention9 which scope is to be accorded the broadest interpretation of the appended claims so as to encompass all equivalent structures and methods.

Claims (6)

CLAIMS:
1. A meniscus prosthetic device to prevent and reverse degenerative changes in a human knee comprising:
a flexible structure for replacing natural components of a condylar joint in a human knee characterized in that the structure has a general C-shape which defines a generally interior circular space and is constructed from an elastic, self-supporting material compatible with human tissue and capable of recovering from structural deformation.
2. The device of claim 1 further characterized in that the flexible structure includes anterior and posterior prominences opposingly disposed at each of the terminal ends of said structure, said prominences being adapted to superior extension into the space defined by the femoral condyles of a human knee and having a greater cross-sectional area at the exterior portion of said flexible structure relative to the corresponding interior portion thereof.
3. The device of claims 1 or 2 wherein said elastic, self-supporting material is silicone rubber.
4. The device of claim 1 further characterized in having a means for securing the flexible structure to surrounding soft tissue.
5. The device of claim 4 wherein said means for securing said flexible structure is a suture or a porous border for tissue ingrowth.
6. The device of claim 2 wherein the transition in cross-section from said exterior portion to said interior portion is gradual.
CA000390306A 1980-11-28 1981-11-18 Meniscus prosthesis Expired CA1193803A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US06/211,292 US4344193A (en) 1980-11-28 1980-11-28 Meniscus prosthesis
US211,292 1980-11-28

Publications (1)

Publication Number Publication Date
CA1193803A true CA1193803A (en) 1985-09-24

Family

ID=22786302

Family Applications (1)

Application Number Title Priority Date Filing Date
CA000390306A Expired CA1193803A (en) 1980-11-28 1981-11-18 Meniscus prosthesis

Country Status (6)

Country Link
US (1) US4344193A (en)
EP (1) EP0053460A1 (en)
JP (1) JPS57501816A (en)
BR (1) BR8108895A (en)
CA (1) CA1193803A (en)
WO (1) WO1982001816A1 (en)

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