US20020120340A1 - Knee joint prosthesis - Google Patents
Knee joint prosthesis Download PDFInfo
- Publication number
- US20020120340A1 US20020120340A1 US09/792,172 US79217201A US2002120340A1 US 20020120340 A1 US20020120340 A1 US 20020120340A1 US 79217201 A US79217201 A US 79217201A US 2002120340 A1 US2002120340 A1 US 2002120340A1
- Authority
- US
- United States
- Prior art keywords
- stem
- tray
- adapter assembly
- extending extension
- generally cylindrical
- 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.)
- Abandoned
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Images
Classifications
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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
- A61F2/30721—Accessories
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- 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
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- 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
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- A61F2002/30112—Rounded shapes, e.g. with rounded corners
- A61F2002/30133—Rounded shapes, e.g. with rounded corners kidney-shaped or bean-shaped
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- 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
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- 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
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- 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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
- A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
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- A61F2/30—Joints
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- 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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- 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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- 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
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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- 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
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30795—Blind bores, e.g. of circular cross-section
- A61F2002/30797—Blind bores, e.g. of circular cross-section internally-threaded
-
- 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
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30878—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
-
- 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
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
- A61F2002/4638—Tools for performing screwing, e.g. nut or screwdrivers, or particular adaptations therefor
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0015—Kidney-shaped, e.g. bean-shaped
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0017—Angular shapes
- A61F2230/0021—Angular shapes square
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/0006—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting angular orientation
Definitions
- the present invention relates generally to a joint prosthesis and more particularly to a knee joint prosthesis having a modular tibial component with an offset tibial stem.
- a knee joint prosthesis typically comprises a femoral component and a tibial component.
- the femoral component and tibial component are designed to be surgically attached to the distal end of the femur and the proximal end of the tibia respectively.
- the femoral component is further designed to cooperate with the tibial component in simulating the articulating motion of an anatomical knee joint.
- Knee joint prostheses in combination with ligaments and muscles, attempt to duplicate natural knee motion as well as absorb and control forces generated during the range of flexion.
- knee joint prostheses have proven to be effective in replacing the anatomical knee joint, they nevertheless have several disadvantages.
- knee joint prostheses sometimes lack interchangeability between a femoral component designed specifically for a right knee or a left knee and a particular component.
- the central canal is typically offset from the center of the tibial articulating surfaces or the center of the tibial plateau.
- the stems of most prior tibial implants have been positioned centrally to the implant base or tibial tray.
- a central location of the stem allows for particular implant to be used for either the right or left knee, such a stem position is associated with drawbacks.
- the primary drawback is that the centrally located stem was substantially offset from the center of the tibial canal itself when the base of the implant was aligned with the resected tibial surface.
- knee joint prosthesis with an offset tibia stem it is also known to provide a knee joint prosthesis with an offset tibia stem. While knee joint prosthesis with offset tibial stems provide certain identified advantages, they nevertheless can be the subject of certain improvement.
- the invention relates to a tibial component for a knee joint prosthesis having an offset stem.
- One particular advantage of the present invention is to provide a tibial component of a knee joint prosthesis having a common tibial tray and a plurality of tibial stems with various offsets for selectively engaging the tibial tray.
- Another advantage of the present invention is to provide a tibial component of a knee joint prosthesis having a offset modular stem that securely engages a tibial tray.
- Another advantage of the present invention is to provide a modular component of a knee joint prosthesis that permits different degrees of stem offset with minimal inventory.
- Another advantage of the present invention is the provision of a tibial component of a knee joint prosthesis having a stem which is offset immediately below a tibial tray.
- Another advantage of the present invention is the provision of a modular tibial component of a knee joint prosthesis having a stem that easily and securely engages a tray.
- Another advantage of the present invention is the provision of a modular tibial component of a knee joint prosthesis which provides an offset in any direction within the transverse plane.
- the present invention provides a modular tibial component for a knee joint prosthesis.
- the modular tibial component includes a tray, a stem and an adapter assembly.
- the tray includes a support surface and downwardly extending extension having a generally circular shape.
- the stem includes a main body portion and an upwardly extending extension.
- the adapter assembly connects the tray and the stem.
- the adapter assembly includes a first generally cylindrical cavity receiving the downwardly extending extension of the tray and a second generally cylindrical cavity receiving the upwardly extending extension of the stem.
- FIG. 1 is a front view illustration of a knee joint prosthesis, the knee joint prosthesis illustrated to include a first adapter assembly for providing a first predetermined offset according to the teachings of a preferred embodiment of the present invention.
- FIG. 2 is front view of a modular tibial component for a knee joint prosthesis including a second adapter assembly according to the teachings of the present invention for providing a second predetermined offset.
- FIG. 3 is front view of a modular tibial component for a knee joint prosthesis including a third adapter assembly according to the teachings of the present invention which does not include an offset.
- FIG. 4 is a bottom view of the tibial tray of the knee joint prosthesis of FIG. 1.
- FIG. 5 is a cross-sectional view taken along the line 5 - 5 of FIG. 4.
- FIG. 6 is an exploded view of a portion of the modular tibial component of FIG. 1.
- FIG. 7 is a cross-sectional view taken along the line 7 - 7 of FIG. 6.
- FIG. 8 is a cross-sectional view taken along the line 8 - 8 of FIG. 6.
- FIG. 9 is a cross-sectional view taken along the line 9 - 9 of FIG. 6.
- FIG. 10 is an enlarged view of the stem insert according to the present invention and shown in FIG. 6.
- FIG. 11 is an exploded view similar to FIG. 6, illustrating a portion of the modular tibial component of FIG. 2.
- FIG. 12 is a cross-sectional view taken along the line 12 - 12 of FIG. 11.
- FIG. 13 is a cross-sectional view taken along the line 13 - 13 of FIG. 11.
- FIG. 14 is a cross-sectional view taken along the line 14 - 14 of FIG. 11.
- FIG. 15 is another exploded view similar to FIG. 6, illustrating a portion of the modular tibial component of FIG. 3.
- FIG. 16 is a cross-sectional view taken along the line 16 - 16 of FIG. 15.
- FIG. 17 is an enlarged view of the locking insert of FIG. 15.
- FIG. 18 is an illustration of a modular femoral component for a knee joint prosthesis according to the teachings of the present invention.
- a knee joint prosthesis constructed in accordance with the teachings of a preferred embodiment of the present invention is illustrated and generally identified at reference number 10 .
- the knee joint prosthesis 10 is generally shown to include a tibial component 12 and a femoral component 14 .
- the tibial component 12 supports a bearing 16 which engages an articulation surface 18 of the femoral component 14 .
- the femoral component 14 and the bearing 16 shown in FIG. 1 are conventional in construction.
- the tibial component 12 illustrated in FIG. 1 will be understood to be modular in construction and generally include a stem 20 , a tray 22 , and a first adapter assembly 24 .
- the adapter assembly 24 connects the tray 22 and the stem 20 so as to provide an offset to the stem 20 in the transverse plane.
- a central axis of the stem 20 is offset from a central axis 27 of a downwardly extending extension 30 of the tray 22 .
- the first adapter assembly 24 provides a first offset of approximately 5 mm. It will become apparent below that the offset can be in any direction in the transverse plane.
- second and third adapter assemblies 28 and 30 according to the teachings of the preferred embodiment of the present invention are illustrated, respectively.
- the second and third adapter assemblies 28 and 30 are shown connecting the tray 22 and stem 20 of FIG. 1.
- the second adapter assembly 28 provides a second offset which in the embodiment illustrated is approximately 2.5 mm.
- the third adapter assembly is a neutral adapter assembly 30 and does not provide any offset.
- the central axis 26 of the stem 20 is aligned with the central axis 27 of the downwardly extending extension 29 of the tray 22 .
- the particular degrees of offset provided by the various adapter assemblies 24 , 28 , and 30 of the present invention are strictly a matter of design choice. Alternate offsets will be understood to fall within the scope of the present invention.
- the first adapter assembly 24 is illustrated to generally include an adapter body 32 , a locking insert member 34 and a stem insert member 36 .
- the adapter body 32 of the first adapter assembly 24 is shown to include a first generally cylindrical cavity 38 for receiving the downwardly extending extension 29 of the tray 22 and a second generally cylindrical cavity 40 for receiving and upwardly extending extension 42 of the stem 20 .
- the first generally cylindrical cavity 38 includes a first central axis 42 and the second generally cylindrical cavity 40 includes a second generally cylindrical axis 44 .
- the first central axis 42 and the second central axis 44 are parallel to one another and spaced apart. Insofar as the first adapter assembly 24 provides a 5 mm offset, the first and second central axes 42 and 44 are spaced apart 5 mm.
- the first generally cylindrical cavity 38 includes a first portion 46 for directly receiving the downwardly extending extension 29 of the tray 22 and a second reduced diameter portion 48 which receives the locking insert 34 .
- the first portion 46 preferably tapers slightly as it extends into the adapter body 32 from a top end of the adapter body 32 .
- the second generally cylindrical cavity 40 similarly includes a first portion 50 and a second portion 52 of reduced diameter.
- the first portion 50 preferably tapers slightly as it extends into the adapter body 32 from a lower end 54 of the adapter body 32 .
- the second portion 52 of the second generally cylindrical cavity 40 is shown to intersect the second portion 48 of the first generally cylindrical cavity 38 .
- the stem insert 36 is partially disposed within the first portion 50 and extends into the second portion 52 where it engages the locking insert member 34 .
- the stem insert member 36 is illustrated to include a lower portion 60 which is externally threaded for engaging an internally threaded aperture of the upwardly extending extension 42 of the stem 20 .
- the stem insert member 36 further includes a central portion 62 having a hexagonal or other suitable cross-section which can be engaged by a tool (not shown) for rotating the stem insert member 36 into the stem 20 .
- the stem insert member 36 includes an upper end 64 including an enlarged diameter head 66 which extends into the second portion 52 of the second generally cylindrical cavity 40 .
- the locking insert member 34 includes an upper portion having an internally threaded aperture 68 and having a square, hexagonal or other suitable cross section that can be engaged by a tool (not shown).
- the internally threaded aperture 68 threadably receives a fastener 70 which extends through a central aperture 72 provided in the tray 22 .
- the locking insert member 34 additionally includes a radially extending segment 74 for engaging the head 66 of the stem insert member 36 .
- the stem insert member 36 is screwed into the stem 20 .
- the adapter body 32 is placed over the upwardly extending extension 42 of the stem 20 such that the upwardly extending portion 42 is received in a press fit within the first portion 50 of the first generally cylindrical aperture 40 and the upper end 64 of the stem insert member 36 extends into the reduced diameter second portion 52 of the second generally cylindrical cavity 40 .
- the locking insert member 34 is inserted into the first generally cylindrical cavity 38 with the radially extending segment 74 opposite the side of the reduced diameter portion 48 which intersects the reduced diameter portion 52 .
- the locking insert member 34 is rotated approximately between 180° and 270° such that the radially extending portion 74 engages the enlarged head 66 of the stem insert member 36 .
- the adapter body 32 is rotated about the axis 27 to provide the offset in the desired direction.
- the first portion 46 of the first generally cylindrical cavity 38 is now press fit onto the downwardly extending extension 29 of the tray 22 .
- the stem 20 is secured to the tray 22 by the threaded fastener 70 which extends through the aperture 72 and threadably engages the internally threaded aperture 68 of the locking insert member 34 .
- Rotation of the threaded fastener 70 in a clockwise direction causes the locking insert member 34 to be drawn towards the tray 22 and a secure connection to be established between the tray 22 and the stem 20 .
- the second adapter assembly 28 is illustrated to generally include an adapter body 80 , a locking insert member 82 and a stem insert member 84 .
- the stem insert member 84 is identical to stem insert member 36 described above.
- the adapter body 80 of the second adapter assembly 28 is shown to include a first generally cylindrical cavity 86 for receiving the downwardly extending extension 29 of the tray 22 and a second generally cylindrical cavity 88 for receiving the upwardly extending extension 42 of the stem 20 .
- the first generally cylindrical cavity 86 includes a first central axis 90 and the second generally cylindrical cavity 88 includes a second generally cylindrical axis 92 .
- the first central axis 90 and the second central axis 92 are parallel to one another and spaced apart.
- the second adapter assembly 80 provides a 2.5 mm offset
- the first and second central axes 90 and 92 are spaced apart 2.5 mm.
- the first generally cylindrical cavity 86 includes a first portion 94 for directly receiving the downwardly extending extension 29 of the tray 22 and a second reduced diameter portion 96 which receives the locking insert 82 .
- the first portion 94 preferably tapers slightly as it extends into the adapter body 80 from a top end.
- the second generally cylindrical cavity 88 similarly includes a first portion 98 and a second portion 100 of reduced diameter.
- the first portion 98 preferably tapers slightly as it extends into the adapter body 80 from a lower end 102 of the adapter body 80 .
- the second portion 100 of the second generally cylindrical cavity 88 is shown to intersect the second portion 96 of the first generally cylindrical cavity 86 .
- the locking insert member 82 includes an upper portion having an internally threaded aperture 104 and having a square, hexagonal or other suitable cross section that can be engaged by a tool.
- the internally threaded aperture 104 threadably receives the fastener 70 which extends through the central aperture 72 in the tray 22 .
- the locking insert member 82 additionally includes a radially extending segment 106 defining a cavity 108 for engaging the head 66 of the stem insert member 36 .
- the aperture 108 includes a non-cylindrical opening for receiving the head 66 of the stem insert member 36 and retaining the head 66 upon rotation in the manner discussed above with respect to the first adapter assembly 24 .
- the third adapter assembly 30 is illustrated to generally include an adapter body 110 and a locking insert member 112 .
- the adapter body 110 of the third adapter assembly 30 is shown to include a first generally cylindrical cavity 114 for receiving the downwardly extending extension 29 of the tray 22 an a second generally cylindrical cavity 116 for receiving the upwardly extending extension 42 of the stem 20 .
- the first generally cylindrical cavity includes a first central axis 118 and the second generally cylindrical cavity includes a second generally cylindrical axis 120 .
- the first central axis 118 and the second central axis 120 are coincident as the third adapter assembly 30 does not provide any offset.
- the first generally cylindrical cavity 114 includes a first portion 122 for directly receiving the downwardly extending extension 29 of the tray 22 and a second reduced diameter portion 124 which receives the locking insert 112 .
- the first portion 122 preferably tapers slightly as it extends into the adapter body 110 from an upper end.
- the second generally cylindrical cavity 116 similarly includes a first portion 126 and a second portion 128 of reduced diameter.
- the first portion 126 preferably tapers slightly as it extends into the adapter body 110 from a lower end 130 of the adapter body 110 .
- the second portion 128 of the second generally cylindrical cavity 126 is shown to communicate with the second portion 124 of the first generally cylindrical cavity 114 .
- the locking insert member 112 is illustrated to include a lower portion 132 which is externally threaded for engaging the internally threaded aperture of the upwardly extending extension 42 of the stem 20 .
- the locking insert member 112 further includes a central portion 134 and an upper portion 136 .
- the upper portion has a square, hexagonal or other suitable cross section which can be engaged by a tool (not shown) for rotating the locking insert member 112 into the stem 20 .
- the internally threaded aperture 138 threadably receives the fastener 70 which extends through the central aperture 72 provided in the tray 22 .
- FIG. 18 a modular femoral component for a knee joint prosthesis of the present invention is generally identified at reference 200 .
- the embodiment of FIG. 18 illustrates application of the teachings of the present invention adapted to a modular femoral component 200 .
- the modular femoral component 200 includes an articulating member 202 , a stem 204 and an adapter assembly 206 . While not shown in great detail, it will be understood by those skilled in the art that the adapter assembly 206 is substantially identical to the first adapter assembly 24 described above.
- the adapter assembly 206 connects the articulating member 202 and the stem 204 and provides an offset between an upwardly extending extension 208 of the articulating member and a downwardly extension 210 of the stem 204 .
- the adapter assembly 206 will be understood to include an adapter body, locking insert member and stem insert member substantially identical to that described above with respect to the first adapter assembly 24 .
- the adapter assembly of the modular femoral component 200 may be similar to either of the second and third adapter assemblies 28 and 30 .
Abstract
Description
- The present invention relates generally to a joint prosthesis and more particularly to a knee joint prosthesis having a modular tibial component with an offset tibial stem.
- A knee joint prosthesis typically comprises a femoral component and a tibial component. The femoral component and tibial component are designed to be surgically attached to the distal end of the femur and the proximal end of the tibia respectively. The femoral component is further designed to cooperate with the tibial component in simulating the articulating motion of an anatomical knee joint. Knee joint prostheses, in combination with ligaments and muscles, attempt to duplicate natural knee motion as well as absorb and control forces generated during the range of flexion.
- While known knee joint prostheses have proven to be effective in replacing the anatomical knee joint, they nevertheless have several disadvantages. For example, knee joint prostheses sometimes lack interchangeability between a femoral component designed specifically for a right knee or a left knee and a particular component. In this regard, in a normally shaped tibia, the central canal is typically offset from the center of the tibial articulating surfaces or the center of the tibial plateau. The stems of most prior tibial implants have been positioned centrally to the implant base or tibial tray. Although a central location of the stem allows for particular implant to be used for either the right or left knee, such a stem position is associated with drawbacks. The primary drawback is that the centrally located stem was substantially offset from the center of the tibial canal itself when the base of the implant was aligned with the resected tibial surface.
- To a more limited extent, it is also known to provide a knee joint prosthesis with an offset tibia stem. While knee joint prosthesis with offset tibial stems provide certain identified advantages, they nevertheless can be the subject of certain improvement.
- According to one aspect of the present invention, the invention relates to a tibial component for a knee joint prosthesis having an offset stem.
- One particular advantage of the present invention is to provide a tibial component of a knee joint prosthesis having a common tibial tray and a plurality of tibial stems with various offsets for selectively engaging the tibial tray.
- Another advantage of the present invention is to provide a tibial component of a knee joint prosthesis having a offset modular stem that securely engages a tibial tray.
- Another advantage of the present invention is to provide a modular component of a knee joint prosthesis that permits different degrees of stem offset with minimal inventory.
- Another advantage of the present invention is the provision of a tibial component of a knee joint prosthesis having a stem which is offset immediately below a tibial tray.
- Another advantage of the present invention is the provision of a modular tibial component of a knee joint prosthesis having a stem that easily and securely engages a tray.
- Another advantage of the present invention is the provision of a modular tibial component of a knee joint prosthesis which provides an offset in any direction within the transverse plane.
- In one form, the present invention provides a modular tibial component for a knee joint prosthesis. The modular tibial component includes a tray, a stem and an adapter assembly. The tray includes a support surface and downwardly extending extension having a generally circular shape. The stem includes a main body portion and an upwardly extending extension. The adapter assembly connects the tray and the stem. The adapter assembly includes a first generally cylindrical cavity receiving the downwardly extending extension of the tray and a second generally cylindrical cavity receiving the upwardly extending extension of the stem.
- Additional advantages and features of the present invention will become apparent from the following description and appended claims, taken in conjunction with the accompanying drawings.
- The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein:
- FIG. 1 is a front view illustration of a knee joint prosthesis, the knee joint prosthesis illustrated to include a first adapter assembly for providing a first predetermined offset according to the teachings of a preferred embodiment of the present invention.
- FIG. 2 is front view of a modular tibial component for a knee joint prosthesis including a second adapter assembly according to the teachings of the present invention for providing a second predetermined offset.
- FIG. 3 is front view of a modular tibial component for a knee joint prosthesis including a third adapter assembly according to the teachings of the present invention which does not include an offset.
- FIG. 4 is a bottom view of the tibial tray of the knee joint prosthesis of FIG. 1.
- FIG. 5 is a cross-sectional view taken along the line5-5 of FIG. 4.
- FIG. 6 is an exploded view of a portion of the modular tibial component of FIG. 1.
- FIG. 7 is a cross-sectional view taken along the line7-7 of FIG. 6.
- FIG. 8 is a cross-sectional view taken along the line8-8 of FIG. 6.
- FIG. 9 is a cross-sectional view taken along the line9-9 of FIG. 6.
- FIG. 10 is an enlarged view of the stem insert according to the present invention and shown in FIG. 6.
- FIG. 11 is an exploded view similar to FIG. 6, illustrating a portion of the modular tibial component of FIG. 2.
- FIG. 12 is a cross-sectional view taken along the line12-12 of FIG. 11.
- FIG. 13 is a cross-sectional view taken along the line13-13 of FIG. 11.
- FIG. 14 is a cross-sectional view taken along the line14-14 of FIG. 11.
- FIG. 15 is another exploded view similar to FIG. 6, illustrating a portion of the modular tibial component of FIG. 3.
- FIG. 16 is a cross-sectional view taken along the line16-16 of FIG. 15.
- FIG. 17 is an enlarged view of the locking insert of FIG. 15.
- FIG. 18 is an illustration of a modular femoral component for a knee joint prosthesis according to the teachings of the present invention.
- With initial reference to FIG. 1, a knee joint prosthesis constructed in accordance with the teachings of a preferred embodiment of the present invention is illustrated and generally identified at
reference number 10. Theknee joint prosthesis 10 is generally shown to include atibial component 12 and afemoral component 14. Thetibial component 12 supports abearing 16 which engages anarticulation surface 18 of thefemoral component 14. Insofar as the present invention is concerned, it will be understood that thefemoral component 14 and thebearing 16 shown in FIG. 1 are conventional in construction. - The
tibial component 12 illustrated in FIG. 1 will be understood to be modular in construction and generally include astem 20, atray 22, and afirst adapter assembly 24. In a manner which will be discussed more fully below, theadapter assembly 24 connects thetray 22 and thestem 20 so as to provide an offset to thestem 20 in the transverse plane. Explaining further, when thestem 20 is attached to thetray 22 through thefirst adapter assembly 24, a central axis of thestem 20 is offset from acentral axis 27 of a downwardly extendingextension 30 of thetray 22. In the embodiment illustrated, thefirst adapter assembly 24 provides a first offset of approximately 5 mm. It will become apparent below that the offset can be in any direction in the transverse plane. - With brief reference to FIGS. 2 and 3, second and
third adapter assemblies tray 22 and stem 20 of FIG. 1. As will be discussed more fully below, thesecond adapter assembly 28 provides a second offset which in the embodiment illustrated is approximately 2.5 mm. The third adapter assembly is aneutral adapter assembly 30 and does not provide any offset. Explaining further, thecentral axis 26 of thestem 20 is aligned with thecentral axis 27 of the downwardly extendingextension 29 of thetray 22. It will be appreciated by those skilled in the art that the particular degrees of offset provided by thevarious adapter assemblies - With continued reference to FIG. 1 and additional reference to FIGS. 4 through 10, the
first adapter assembly 24 will be further described. Thefirst adapter assembly 24 is illustrated to generally include anadapter body 32, a lockinginsert member 34 and astem insert member 36. Theadapter body 32 of thefirst adapter assembly 24 is shown to include a first generallycylindrical cavity 38 for receiving the downwardly extendingextension 29 of thetray 22 and a second generallycylindrical cavity 40 for receiving and upwardly extendingextension 42 of thestem 20. The first generallycylindrical cavity 38 includes a firstcentral axis 42 and the second generallycylindrical cavity 40 includes a second generallycylindrical axis 44. In the embodiment illustrated, the firstcentral axis 42 and the secondcentral axis 44 are parallel to one another and spaced apart. Insofar as thefirst adapter assembly 24 provides a 5 mm offset, the first and secondcentral axes - The first generally
cylindrical cavity 38 includes afirst portion 46 for directly receiving the downwardly extendingextension 29 of thetray 22 and a second reduceddiameter portion 48 which receives the lockinginsert 34. Thefirst portion 46 preferably tapers slightly as it extends into theadapter body 32 from a top end of theadapter body 32. The second generallycylindrical cavity 40 similarly includes afirst portion 50 and asecond portion 52 of reduced diameter. Thefirst portion 50 preferably tapers slightly as it extends into theadapter body 32 from alower end 54 of theadapter body 32. Thesecond portion 52 of the second generallycylindrical cavity 40 is shown to intersect thesecond portion 48 of the first generallycylindrical cavity 38. In a manner to be described further below, thestem insert 36 is partially disposed within thefirst portion 50 and extends into thesecond portion 52 where it engages the lockinginsert member 34. - With particular reference to FIG. 10, the
stem insert member 36 is illustrated to include alower portion 60 which is externally threaded for engaging an internally threaded aperture of the upwardly extendingextension 42 of thestem 20. Thestem insert member 36 further includes acentral portion 62 having a hexagonal or other suitable cross-section which can be engaged by a tool (not shown) for rotating thestem insert member 36 into thestem 20. Further, thestem insert member 36 includes anupper end 64 including anenlarged diameter head 66 which extends into thesecond portion 52 of the second generallycylindrical cavity 40. - With particular reference to the cross-sectional views of FIGS. 8 and 9, the locking
insert member 34 will be further described. The lockinginsert member 34 includes an upper portion having an internally threadedaperture 68 and having a square, hexagonal or other suitable cross section that can be engaged by a tool (not shown). The internally threadedaperture 68 threadably receives afastener 70 which extends through acentral aperture 72 provided in thetray 22. The lockinginsert member 34 additionally includes aradially extending segment 74 for engaging thehead 66 of thestem insert member 36. - Upon selection by the surgeon of the
first adapter assembly 24, thestem insert member 36 is screwed into thestem 20. Next, theadapter body 32 is placed over the upwardly extendingextension 42 of thestem 20 such that the upwardly extendingportion 42 is received in a press fit within thefirst portion 50 of the first generallycylindrical aperture 40 and theupper end 64 of thestem insert member 36 extends into the reduced diametersecond portion 52 of the second generallycylindrical cavity 40. At this point, the lockinginsert member 34 is inserted into the first generallycylindrical cavity 38 with theradially extending segment 74 opposite the side of the reduceddiameter portion 48 which intersects the reduceddiameter portion 52. Upon complete insertion, the lockinginsert member 34 is rotated approximately between 180° and 270° such that theradially extending portion 74 engages theenlarged head 66 of thestem insert member 36. - The
adapter body 32 is rotated about theaxis 27 to provide the offset in the desired direction. Thefirst portion 46 of the first generallycylindrical cavity 38 is now press fit onto the downwardly extendingextension 29 of thetray 22. Thestem 20 is secured to thetray 22 by the threadedfastener 70 which extends through theaperture 72 and threadably engages the internally threadedaperture 68 of the lockinginsert member 34. Rotation of the threadedfastener 70 in a clockwise direction causes the lockinginsert member 34 to be drawn towards thetray 22 and a secure connection to be established between thetray 22 and thestem 20. - With reference now to FIGS. 2 and 11 through14, the
second adapter assembly 28 of the present invention will now be described. Thesecond adapter assembly 28 is illustrated to generally include anadapter body 80, a lockinginsert member 82 and astem insert member 84. Thestem insert member 84 is identical to steminsert member 36 described above. - The
adapter body 80 of thesecond adapter assembly 28 is shown to include a first generallycylindrical cavity 86 for receiving the downwardly extendingextension 29 of thetray 22 and a second generallycylindrical cavity 88 for receiving the upwardly extendingextension 42 of thestem 20. The first generallycylindrical cavity 86 includes a firstcentral axis 90 and the second generallycylindrical cavity 88 includes a second generallycylindrical axis 92. In the embodiment illustrated, the firstcentral axis 90 and the secondcentral axis 92 are parallel to one another and spaced apart. Insofar as thesecond adapter assembly 80 provides a 2.5 mm offset, the first and secondcentral axes - The first generally
cylindrical cavity 86 includes afirst portion 94 for directly receiving the downwardly extendingextension 29 of thetray 22 and a second reduceddiameter portion 96 which receives the lockinginsert 82. As with thefirst adapter assembly 24, thefirst portion 94 preferably tapers slightly as it extends into theadapter body 80 from a top end. The second generallycylindrical cavity 88 similarly includes afirst portion 98 and asecond portion 100 of reduced diameter. Thefirst portion 98 preferably tapers slightly as it extends into theadapter body 80 from alower end 102 of theadapter body 80. Thesecond portion 100 of the second generallycylindrical cavity 88 is shown to intersect thesecond portion 96 of the first generallycylindrical cavity 86. - With particular reference to the cross-sectional views of FIGS. 13 and 14, the locking
insert member 82 will be further described. The lockinginsert member 82 includes an upper portion having an internally threadedaperture 104 and having a square, hexagonal or other suitable cross section that can be engaged by a tool. The internally threadedaperture 104 threadably receives thefastener 70 which extends through thecentral aperture 72 in thetray 22. The lockinginsert member 82 additionally includes aradially extending segment 106 defining acavity 108 for engaging thehead 66 of thestem insert member 36. Theaperture 108 includes a non-cylindrical opening for receiving thehead 66 of thestem insert member 36 and retaining thehead 66 upon rotation in the manner discussed above with respect to thefirst adapter assembly 24. - With reference now to FIGS. 3 and 15 through17, the
third adapter assembly 30 of the present invention will now be described. Thethird adapter assembly 30 is illustrated to generally include anadapter body 110 and alocking insert member 112. Theadapter body 110 of thethird adapter assembly 30 is shown to include a first generallycylindrical cavity 114 for receiving the downwardly extendingextension 29 of thetray 22 an a second generallycylindrical cavity 116 for receiving the upwardly extendingextension 42 of thestem 20. The first generally cylindrical cavity includes a firstcentral axis 118 and the second generally cylindrical cavity includes a second generallycylindrical axis 120. In the embodiment illustrated, the firstcentral axis 118 and the secondcentral axis 120 are coincident as thethird adapter assembly 30 does not provide any offset. - The first generally
cylindrical cavity 114 includes afirst portion 122 for directly receiving the downwardly extendingextension 29 of thetray 22 and a second reduceddiameter portion 124 which receives thelocking insert 112. Thefirst portion 122 preferably tapers slightly as it extends into theadapter body 110 from an upper end. The second generallycylindrical cavity 116 similarly includes afirst portion 126 and a second portion 128 of reduced diameter. Thefirst portion 126 preferably tapers slightly as it extends into theadapter body 110 from alower end 130 of theadapter body 110. The second portion 128 of the second generallycylindrical cavity 126 is shown to communicate with thesecond portion 124 of the first generallycylindrical cavity 114. - With particular reference to FIG. 17, the locking
insert member 112 is illustrated to include alower portion 132 which is externally threaded for engaging the internally threaded aperture of the upwardly extendingextension 42 of thestem 20. The lockinginsert member 112 further includes acentral portion 134 and anupper portion 136. The upper portion has a square, hexagonal or other suitable cross section which can be engaged by a tool (not shown) for rotating the lockinginsert member 112 into thestem 20. The internally threadedaperture 138 threadably receives thefastener 70 which extends through thecentral aperture 72 provided in thetray 22. - Turning finally to FIG. 18, a modular femoral component for a knee joint prosthesis of the present invention is generally identified at
reference 200. The embodiment of FIG. 18 illustrates application of the teachings of the present invention adapted to a modularfemoral component 200. The modularfemoral component 200 includes an articulatingmember 202, astem 204 and anadapter assembly 206. While not shown in great detail, it will be understood by those skilled in the art that theadapter assembly 206 is substantially identical to thefirst adapter assembly 24 described above. In this regard, theadapter assembly 206 connects the articulatingmember 202 and thestem 204 and provides an offset between an upwardly extending extension 208 of the articulating member and adownwardly extension 210 of thestem 204. Theadapter assembly 206 will be understood to include an adapter body, locking insert member and stem insert member substantially identical to that described above with respect to thefirst adapter assembly 24. Alternatively, it will be understood that the adapter assembly of the modularfemoral component 200 may be similar to either of the second andthird adapter assemblies - While the invention has been described in the specification and illustrated in the drawings with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted for elements thereof without departing from the scope of the invention as defined in the claims. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, it is intended that the invention not be limited to the particular embodiment illustrated by the drawings and described in the specification as the best mode presently contemplated for carrying out this invention, but that the invention will include any embodiments falling within the description of the appended claims.
Claims (3)
Priority Applications (6)
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US09/792,172 US20020120340A1 (en) | 2001-02-23 | 2001-02-23 | Knee joint prosthesis |
AT02251274T ATE552804T1 (en) | 2001-02-23 | 2002-02-25 | KNEE JOINT PROSTHESIS |
EP02251274A EP1234557B1 (en) | 2001-02-23 | 2002-02-25 | Knee joint prosthesis |
US10/289,585 US7025788B2 (en) | 2001-02-23 | 2002-11-07 | Knee joint prosthesis |
US10/934,282 US7497874B1 (en) | 2001-02-23 | 2004-09-03 | Knee joint prosthesis |
US11/358,926 US7445639B2 (en) | 2001-02-23 | 2006-02-21 | Knee joint prosthesis |
Applications Claiming Priority (1)
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US09/792,172 US20020120340A1 (en) | 2001-02-23 | 2001-02-23 | Knee joint prosthesis |
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US10/289,585 Continuation-In-Part US7025788B2 (en) | 2001-02-23 | 2002-11-07 | Knee joint prosthesis |
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US10/289,585 Expired - Lifetime US7025788B2 (en) | 2001-02-23 | 2002-11-07 | Knee joint prosthesis |
US11/358,926 Expired - Lifetime US7445639B2 (en) | 2001-02-23 | 2006-02-21 | Knee joint prosthesis |
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US11/358,926 Expired - Lifetime US7445639B2 (en) | 2001-02-23 | 2006-02-21 | Knee joint prosthesis |
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Also Published As
Publication number | Publication date |
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ATE552804T1 (en) | 2012-04-15 |
US20030055508A1 (en) | 2003-03-20 |
US7025788B2 (en) | 2006-04-11 |
EP1234557B1 (en) | 2012-04-11 |
EP1234557A3 (en) | 2003-11-05 |
US7445639B2 (en) | 2008-11-04 |
US20060142867A1 (en) | 2006-06-29 |
EP1234557A2 (en) | 2002-08-28 |
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